Teaching resuscitation to pediatric residents - The effects of an intervention

Objective: To evaluate the effectiveness of an educational intervention on pediatric residents' resuscitation fund of knowledge, technical skills, con fidence, and overall performance. Design: Prospective, nonconcurrent, controlled interventional trial. Setting: Urban pediatric tertiary care hospital. Participants: An intervention group (IG) of 28 pediatric residents graduati ng in 1997, and a control group (CG) of 30 pediatric residents graduating i n 1996. Interventions: Resuscitation course with didactic lectures and skills pract ice stations, as well as a minimum of 3 practice mock resuscitations with i mmediate feedback throughout postgraduate year 3. Main Outcome Measures: Fu nd of knowledge, using the Pediatric Advanced Life Support test and short a nswer test; technical skills, using the Airway and Vascular Access Skills A ssessment; experience and confidence, using an anonymous survey; and overal l performance, evaluated using a videotaped mock resuscitation test. Results: The IG scored better on the short answer test (P<.001). A larger n umber of IG residents were successful in the completion of ancillary airway maneuvers and femoral vascular access (P=.02), as well as endotracheal int ubation (P=.004) and intraosseous access (P=.002). The IG was more confiden t in their leadership role (P=.0001) and technical skills (P=.05). Trends t oward improved overall performance were noted for the IG mock resuscitation s. Residents in the IG were more likely to assess the airway in fewer than 2 minutes (P=.02), recognize the threat to life in fewer than 5 minutes (P= .02), and complete the primary survey in a timely fashion (P=.05). They req uired fewer prompts (P=.04) and made fewer mistakes (P=.07). Conclusions: A structured, formal curriculum can improve the necessary fund of knowledge, skills, confidence, and leadership required for resuscitatio n.