Browsing by Author "Wing, Robyn"

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    Does Length of Emergency Medicine Training Matter for Leadership Skills in Pediatric Resuscitation? A Pilot Study
    (2023-04-28) Schoppel, Kyle; Keilman, Ashley; Fayyaz, Jabeen; Padlipsky, Patricia; Diaz, Maria Carmen G.; Wing, Robyn; Hughes, Mary; Franco, Marleny; Swinger, Nathan; Whitfill, Travis; Walsh, Barbara
    Background The majority of pediatric patients in the United States (US) are evaluated and treated at general emergency departments (GEDs) that are often ill prepared for pediatric patients. Despite rotating at large pediatric hospitals, during training Emergency Medicine (EM) residents care perform few pediatric resuscitations. It is possible that discrepancies in length of EM residency training may allow for variable exposure to pediatric patients, critical resuscitations, and didactic events. The goal of this study was to compare leadership skills of EM residents graduating from 3 vs. 4-year programs during simulated pediatric resuscitations using a previously validated leadership assessment tool, the Concise Assessment of Leader Management (CALM). Methods This was a prospective, multicenter, simulation-based cohort pilot study that included graduating 3rd- and 4th-year EM resident physicians from 6 EM residency programs. We measured leadership performance across three simulated pediatric resuscitations using the CALM tool and compared leadership scores between the 3rd- vs. 4th-year resident cohorts. We also correlated leadership to self-efficacy scores. Results Forty-seven residents (24 3rd-year residents and 23 4th-year residents) participated. Out of a total possible CALM score of 66, residents from 3-year programs scored 45.2 [SD ± 5.2], 46.8 [SD ± 5.0], and 46.6 [SD ± 4.7], whereas residents from 4-year programs scored 45.5 [SD ± 5.2], 46.4 [SD ± 5.0], 48.2 [SD ± 4.3] during the sepsis, seizure and cardiac arrest cases respectively. The Total Leadership Score (TLS) for the 3-year cohort was 46.2 [SD ± 4.8] vs. 46.7 [ SD ± 4.5] (p = 0.715) for the 4-year cohort. Conclusions These data suggest there may be no difference in leadership skills between 3rd- vs 4th-year EM residents in our study cohort. This pilot study provides the basis of future work that will assess a larger multicenter cohort with the hope to obtain a more generalizable dataset.
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    Preparedness for Pediatric Office Emergencies: A Multicenter, Simulation-Based Study
    (AAP, 2021-09) Abulebda, Kamal; Yuknis, Matthew L.; Whitfill, Travis; Montgomery, Erin E.; Pearson, Kellie J.; Rousseau, Rosa; Diaz, Maria Carmen G.; Brown, Linda L.; Wing, Robyn; Tay, Khoon-Yen; Good, Grace L.; Malik, Rabia N.; Garrow, Amanda L.; Zaveri, Pavan P.; Thomas, Eileen; Makharashvili, Ana; Burns, Rebekah A.; Lavoie, Megan; Auerbach, Marc A.; Improving Pediatric Acute Care Through Simulation (ImPACTS); Pediatrics, School of Medicine
    OBJECTIVES Pediatric emergencies can occur in pediatric primary care offices. However, few studies have measured emergency preparedness, or the processes of emergency care, provided in the pediatric office setting. In this study, we aimed to measure emergency preparedness and care in a national cohort of pediatric offices. METHODS This was a multicenter study conducted over 15 months. Emergency preparedness scores were calculated as a percentage adherence to 2 checklists on the basis of the American Academy of Pediatrics guidelines (essential equipment and supplies and policies and protocols checklists). To measure the quality of emergency care, we recruited office teams for simulation sessions consisting of 2 patients: a child with respiratory distress and a child with a seizure. An unweighted percentage of adherence to checklists for each case was calculated. RESULTS Forty-eight teams from 42 offices across 9 states participated. The mean emergency preparedness score was 74.7% (SD: 12.9). The mean essential equipment and supplies subscore was 82.2% (SD: 15.1), and the mean policies and protocols subscore was 57.1% (SD: 25.6). Multivariable analyses revealed that independent practices and smaller total staff size were associated with lower preparedness. The median asthma case performance score was 63.6% (interquartile range: 43.2–81.2), whereas the median seizure case score was 69.2% (interquartile range: 46.2–80.8). Offices that had a standardized process of contacting emergency medical services (EMS) had a higher rate of activating EMS during the simulations. CONCLUSIONS Pediatric office preparedness remains suboptimal in a multicenter cohort, especially in smaller, independent practices. Academic and community partnerships using simulation can help address gaps and implement important processes like contacting EMS.