An Innovative Pilot Curriculum Training Pediatric Residents in Referral and Communication Skills on a Cardiology Rotation

Harahsheh, Ashraf S.; Ottolini, Mary; Lewis, Kathleen; Blatt, Benjamin; Mitchell, Stephanie; Greenberg, Larrie

doi:10.1016/j.acap.2016.05.146

Cited by 19 publications

(26 citation statements)

References 10 publications

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“…This is a global issue and has recently been recognized by the American Board of Pediatrics as an essential “entrustable professional activity”, one in which residents must demonstrate proficiency by the end of their training 5,12 . Thus, new residency curriculum and continuing medical education activities should focus on empowering primary care pediatricians to recognize red-flags for referrals as well as effectively communicate and negotiate with families surrounding emotionally laden complaints and requests for subspecialty referral 5,13 . The authors of this paper support the development and implementation of quality improvement initiatives at the primary care level.…”

Section: Discussionmentioning

confidence: 99%

Pediatric Chest Pain—Low-Probability Referral: A Multi-Institutional Analysis From Standardized Clinical Assessment and Management Plans (SCAMPs®), the Pediatric Health Information Systems Database, and the National Ambulatory Medical Care Survey

Harahsheh

O’Byrne

Pastor

et al. 2017

Clin Pediatr (Phila)

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We conducted a study to assess test characteristics of red-flag criteria for identifying cardiac disease causing chest pain and technical charges of low-probability referrals. Accuracy of red-flag criteria was ascertained through study of chest pain Standardized Clinical Assessment and Management Plans (SCAMPs®) data. Patients were divided into 2 groups: Group1 (concerning clinical elements) and Group2 (without). We compared incidence of cardiac disease causing chest pain between these 2 groups. Technical charges of Group 2 were analyzed using the Pediatric Health Information System database. Potential savings for the US population was estimated using National Ambulatory Medical Care Survey data. Fifty-two percent of subjects formed Group 1. Cardiac disease causing chest pain was identified in 8/1656 (0.48%). No heart disease was identified in patients in Group 2 ( P = .03). Applying red-flags in determining need for referral identified patients with cardiac disease causing chest pain with 100% sensitivity. Median technical charges for Group 2, over a 4-year period, were US2014$775 559. Eliminating cardiac testing of low-probability referrals would save US2014$3 775 182 in technical charges annually. Red-flag criteria were an effective screen for children with chest pain. Eliminating cardiac testing in children without red-flags for referral has significant technical charge savings.

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Section: Discussionmentioning

confidence: 99%

Pediatric Chest Pain—Low-Probability Referral: A Multi-Institutional Analysis From Standardized Clinical Assessment and Management Plans (SCAMPs®), the Pediatric Health Information Systems Database, and the National Ambulatory Medical Care Survey

Harahsheh

O’Byrne

Pastor

et al. 2017

Clin Pediatr (Phila)

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“…It included practicing a case requiring subspecialty referral [16]. The workshop ended with evaluation and feedback sessions and found an improvement in trainees' confidence and communication skills in simulation [16]. In our experience, we found the reflective exercises to be particularly valuable.…”

Section: Develop a Multifaceted Curriculum To Engage Trainees At All mentioning

confidence: 83%

“…The multimodal teaching techniques were incorporated to engage trainees who respond best to various teaching styles. Similarly, a pilot training program in a pediatric GME program successfully conducted workshops on referral and communication skills [16]. It included practicing a case requiring subspecialty referral [16].…”

Section: Develop a Multifaceted Curriculum To Engage Trainees At All mentioning

confidence: 99%

“…Similarly, a pilot training program in a pediatric GME program successfully conducted workshops on referral and communication skills [16]. It included practicing a case requiring subspecialty referral [16]. The workshop ended with evaluation and feedback sessions and found an improvement in trainees' confidence and communication skills in simulation [16].…”

Section: Develop a Multifaceted Curriculum To Engage Trainees At All mentioning

confidence: 99%

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Developing a communication curriculum for primary and consulting services

Lopez

Campbell

2020

Medical Education Online

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Communication skills are fundamental to effective patient care, and inter-subspecialty communication is frequently identified as a key component of medical education curriculums globally. The team primarily responsible for a patient, the 'primary service', may often request a consult from a specialist, the 'consulting service', for questions of diagnosis, management, or assistance in arranging or performing a procedure or test. Few resources exist to support the development and growth of communication curriculums across primary and consulting services. We provide tips to improve communication across services in patient care and enhance learning for multiple levels of providers. This article provides a guide for the planning and implementation of a communication curriculum and highlights key components for success, based on our experience as teaching faculty on primary and consulting services, at a large academic institution. With the proper collaborations, teaching touch points, specialist consult communication tool, peer coaches, and timely feedback, this course can meet numerous educational and institutional priorities.

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“…1 While the reason for ordering an echocardiogram when it had an R indication could not be elicited by the current chart review, evidence supports parent anxiety and parent demand as one of the drivers for low-probability testing and unnecessary referrals. 7,8 Future training curriculums 9 and quality improvement initiatives 10 emphasizing appropriate communication skills to reduce unnecessary testing need to be developed in the context of heart murmur evaluation.…”

Section: Discussionmentioning

confidence: 99%

Recurrent Cardiology Evaluation for Innocent Heart Murmur: Echocardiogram Utilization

Dalal

Dzelebdzic

Frank

et al. 2018

Clin Pediatr (Phila)

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We conducted a retrospective study to identify electrocardiogram (ECG) and echocardiogram utilization among patients presenting for a follow-up cardiology evaluation with innocent heart murmur between 2012 and 2014. The 2014 echocardiogram Appropriate Use Criteria was applied. We observed high rates of ordering ECGs and echocardiograms on follow-up visits (79% and 36%); only 1 patient had an appropriate indication for echocardiogram while the rest had rarely appropriate indication. Having had an ECG done did not affect echocardiogram ordering behavior. Older patient age was the only factor associated with a higher likelihood for ordering echocardiograms on follow-up visit (odds ratio = 1.016, P = .021). In this small sample study, we noticed high rates of test utilization and low-probability utilization of echocardiogram in the recurrent evaluation of children with innocent heart murmur. A larger, multicenter prospective study to investigate patterns and drivers of test utilization in children with innocent heart murmur presenting for a follow-up cardiology visit is needed.

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An Innovative Pilot Curriculum Training Pediatric Residents in Referral and Communication Skills on a Cardiology Rotation

Cited by 19 publications

References 10 publications

Pediatric Chest Pain—Low-Probability Referral: A Multi-Institutional Analysis From Standardized Clinical Assessment and Management Plans (SCAMPs®), the Pediatric Health Information Systems Database, and the National Ambulatory Medical Care Survey

Pediatric Chest Pain—Low-Probability Referral: A Multi-Institutional Analysis From Standardized Clinical Assessment and Management Plans (SCAMPs®), the Pediatric Health Information Systems Database, and the National Ambulatory Medical Care Survey

Developing a communication curriculum for primary and consulting services

Recurrent Cardiology Evaluation for Innocent Heart Murmur: Echocardiogram Utilization

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