General emergency physician perceptions of caring for children: A qualitative interview study

IF 1.7 Q2 EDUCATION, SCIENTIFIC DISCIPLINES
Regina L. Toto MD, MSEd, Eva M. Delgado MD, Tara Ketterer MPH, Emily Berner MD, Sarah I. Landau MD, Molly Crowe MD, Angeliz Caro Monroig MD, Gillian Sedigh Haghighat MD, MSEd, Cynthia J. Mollen MD, MSCE
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Abstract

Background

Emergency physicians care for most children presenting to U.S. emergency departments (EDs). Pediatric exposure during emergency medicine (EM) residency can be variable and critically ill children are rarely encountered. A recent needs assessment revealed that emergency physicians feel less prepared to manage various conditions in children and that infants, regardless of presenting complaint, pose particular challenges. Emergency physician perceptions of the experience of caring for pediatric patients have not been widely examined through a qualitative lens.

Methods

We designed an interview-based qualitative study to explore emergency physician perspectives on pediatric patient care. We recruited emergency physicians who graduated from residency in 2015–2019 and all rotated through the same large tertiary children's hospital. Four trained interviewers conducted in-depth, one-on-one virtual interviews. An interdisciplinary team transcribed and then coded the interviews. The team performed a conventional content analysis for themes. Recruitment continued until thematic saturation was achieved.

Results

Twelve participants completed interviews. These participants trained in five diverse residency programs. Likewise, the participants now practice in a variety of settings. Three major themes emerged from the data: (1) experience and exposure are key to establishing comfort caring for children; (2) simulation, pathways, and the pediatric anesthesia rotation are educationally useful; and (3) caring for children poses unique emotional challenges. Participants shared many recommendations for future pediatric education for EM trainees, including increasing autonomy and exposure to neonates and considering how care might differ in a community setting.

Conclusions

This interview-based qualitative study elucidates key themes in recently graduated emergency physicians’ perceived experience of caring for children. Our findings have important educational implications for this group of emergency physicians and those who share similar experiences in training and practice.

普通急诊医生对儿童护理的看法:定性访谈研究
背景 美国急诊科(ED)收治的大多数儿童都是由急诊科医生诊治的。在急诊医学(EM)住院医师培训期间,他们接触到的儿科病人并不固定,而且很少遇到重症患儿。最近的一项需求评估显示,急诊医生在处理儿童的各种病症时感到准备不足,而婴儿无论主诉如何,都会带来特殊的挑战。急诊医生对儿科患者护理经验的看法尚未通过定性视角进行广泛研究。 方法 我们设计了一项基于访谈的定性研究,以探讨急诊医生对儿科患者护理的看法。我们招募了 2015-2019 年毕业的急诊科医生,他们都在同一家大型三级儿童医院轮转。四名训练有素的访谈者进行了一对一的深度虚拟访谈。一个跨学科团队对访谈进行了转录和编码。团队对主题进行了常规内容分析。招募工作一直持续到主题饱和为止。 结果 12 名参与者完成了访谈。这些参与者曾在五个不同的住院医师培训项目中接受培训。同样,这些参与者现在也在不同的环境中执业。数据中出现了三大主题:(1) 经验和接触是建立舒适儿童护理的关键;(2) 模拟、路径和儿科麻醉轮转在教育上是有用的;(3) 儿童护理带来了独特的情感挑战。学员们就未来针对急诊科学员的儿科教育提出了许多建议,包括增加自主权和接触新生儿的机会,以及考虑在社区环境下护理工作可能会有哪些不同。 结论 这项以访谈为基础的定性研究阐明了新近毕业的急诊科医生所感知的儿童护理经验中的关键主题。我们的研究结果对这群急诊医生以及那些在培训和实践中有类似经历的医生具有重要的教育意义。
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来源期刊
AEM Education and Training
AEM Education and Training Nursing-Emergency Nursing
CiteScore
2.60
自引率
22.20%
发文量
89
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