Education of pediatric subspecialty fellows in transport medicine: a national survey

Mickells, Geoffrey E.; Goodman, Denise M.; Rozenfeld, Ranna A.

doi:10.1186/s12887-017-0780-5

Cited by 10 publications

(10 citation statements)

References 11 publications

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“…The result of this review reveals that the release of intrauterine meconium increases the likelihood of birth asphyxia. This finding is again supported by studies conducted in in Pakistan [ 56 , 62 ], Indonesia [ 72 ] and India [ 78 , 79 ]. A possible reason for this finding is that the presence of meconium in amniotic fluid enhances the chance of meconium aspiration occurring during intrauterine gasping or during the initial breaths taken after birth, which may cause acute airway obstruction, surfactant dysfunction or inactivation [ 80 ].…”

Section: Discussionsupporting

confidence: 76%

Prevalence and risk factors associated with birth asphyxia among neonates delivered in Ethiopia: A systematic review and meta-analysis

Ahmed¹,

Mosa²,

Sultan³

et al. 2021

PLoS ONE

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Background A number of primary studies in Ethiopia address the prevalence of birth asphyxia and the factors associated with it. However, variations were seen among those studies. The main aim of this systematic review and meta-analysis was carried out to estimate the pooled prevalence and explore the factors that contribute to birth asphyxia in Ethiopia. Methods Different search engines were used to search online databases. The databases include PubMed, HINARI, Cochrane Library and Google Scholar. Relevant grey literature was obtained through online searches. The funnel plot and Egger’s regression test were used to see publication bias, and the I-squared was applied to check the heterogeneity of the studies. Cross-sectional, case-control and cohort studies that were conducted in Ethiopia were also be included. The Joanna Briggs Institute checklist was used to assess the quality of the studies and was included in this systematic review. Data entry and statistical analysis were carried out using RevMan 5.4 software and Stata 14. Result After reviewing 1,125 studies, 26 studies fulfilling the inclusion criteria were included in the meta-analysis. The pooled prevalence of birth asphyxia in Ethiopia was 19.3%. In the Ethiopian context, the following risk factors were identified: Antepartum hemorrhage(OR: 4.7; 95% CI: 3.5, 6.1), premature rupture of membrane(OR: 4.0; 95% CI: 12.4, 6.6), primiparas(OR: 2.8; 95% CI: 1.9, 4.1), prolonged labor(OR: 4.2; 95% CI: 2.8, 6.6), maternal anaemia(OR: 5.1; 95% CI: 2.59, 9.94), low birth weight(OR = 5.6; 95%CI: 4.7,6.7), meconium stained amniotic fluid(OR: 5.6; 95% CI: 4.1, 7.5), abnormal presentation(OR = 5.7; 95% CI: 3.8, 8.3), preterm birth(OR = 4.1; 95% CI: 2.9, 5.8), residing in a rural area (OR: 2.7; 95% CI: 2.0, 3.5), caesarean delivery(OR = 4.4; 95% CI:3.1, 6.2), operative vaginal delivery(OR: 4.9; 95% CI: 3.5, 6.7), preeclampsia(OR = 3.9; 95% CI: 2.1, 7.4), tight nuchal cord OR: 3.43; 95% CI: 2.1, 5.6), chronic hypertension(OR = 2.5; 95% CI: 1.7, 3.8), and unable to write and read (OR = 4.2;95%CI: 1.7, 10.6). Conclusion According to the findings of this study, birth asphyxia is an unresolved public health problem in the Ethiopia. Therefore, the concerned body needs to pay attention to the above risk factors in order to decrease the country’s birth asphyxia. Review registration PROSPERO International prospective register of systematic reviews (CRD42020165283).

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Section: Discussionsupporting

confidence: 76%

Prevalence and risk factors associated with birth asphyxia among neonates delivered in Ethiopia: A systematic review and meta-analysis

Ahmed¹,

Mosa²,

Sultan³

et al. 2021

PLoS ONE

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“…Fellows and graduates may perceive inherent value in gaining particular knowledge and skills, such as greater understanding of the logistics and personnel involved in transferring patients and experience working with a healthcare team in a unique and dynamic setting. 3,10,14 Meanwhile, PDs may have had limited personal exposure to TM or may underestimate the limited exposure to TM for fellows while in residency. 3 PDs may not be aware of the extent of participation in elements of transport among graduates.…”

Section: Discussionmentioning

confidence: 99%

“…Survey respondents demonstrate variable levels of interest and engagement in TM training; in particular, fellows and graduates often reported greater interest and value in a TM rotation than PDs. Similar to fellows in related fields, 10 PHM fellows and graduates selected clinical topics as the most essential elements of TM training. In accordance with the literature, our findings suggest that direct patient care, one-on-one instruction, and simulation would be appropriate and popular methods for delivering this type of educational content.…”

Section: Discussionmentioning

confidence: 99%

“…In accordance with the literature, our findings suggest that direct patient care, one-on-one instruction, and simulation would be appropriate and popular methods for delivering this type of educational content. 10,11 Curriculum design for a TM rotation should reinforce clinical PHM competencies related to TM while focusing on topics that are specific to the transport environment, such as methods of interfacility transport, handoffs, transitions of care, and team leadership. 2,7,12 Trainee comfort level with different forms of transport (eg, fear of flying, motion sickness) and local and state policies regarding interfacility transfer should also be Fellows were asked to identify reservations (rather than barriers) to participating in a Transport Medicine rotation.…”

Section: Discussionmentioning

confidence: 99%

“…9 A recent study of pediatric emergency, critical care, and neonatal medicine fellowships revealed a paucity of formal or published TM curricula in these programs. 10 Furthermore, no standard or published TM curricula have been established for PHM fellowships. The primary objective of our study is to determine attitudes regarding TM training among PHM fellows, recent PHM fellowship graduates, and PHM fellowship program directors (PDs).…”

mentioning

confidence: 99%

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Current Perspectives on Transport Medicine in Pediatric Hospital Medicine Fellowships

Corden

Huynh

Mandal

et al. 2018

Journal of Hospital Medicine

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Transport medicine (TM) is a Pediatric Hospital Medicine (PHM) Core Competency and part of the proposed PHM fellowship curricular framework. No published TM curricula are available. This cross-sectional study was designed to determine attitudes toward TM training among PHM fellowship stakeholders and conduct a TM curriculum needs assessment. Unique, web-based, anonymous surveys for PHM fellows, graduates, and program directors (PDs) were administered, with response rates of 57%, 37%, and 44%, respectively. Fellows' interest in completing a TM rotation is greater than their perceived interest by PDs (P = .06). Graduates who completed a TM rotation were more likely to recommend a TM rotation than those who did not (P = .001). Perceived barriers included lack of a formal TM curriculum and time constraints. Stabilizing patients and triage of referrals were deemed important learning objectives, and active learning strategies were prioritized. Curriculum design should focus on topics specific to the transport process and environment.

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Team Models in Interfacility Transport-Building and Maintaining Competencies

Whyte

Narvey²

2017

Curr Treat Options Peds

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Interfacility transport I Transport teams I Mobile intensive care I Safety and system design Opinion statementPurpose of review Transport teams have evolved their capability to provide mobile intensive care units to optimize patient outcomes in most regionalized systems of health care. Our goal was to review the current literature to determine the best model of practice for interfacility transport and the specific training required to achieve and maintain competencies in transport medicine. Recent findings The literature remains largely consensus based and experiential, and there has been little development in the 'state of the art' over the past 5 years. Transport practitioners, regardless of their professional backgrounds, must acquire numerous skills to meet the needs of the patient, owing to the unique and dynamic nature of each transport. The broader their scope of practice, the larger the range of competencies they must acquire. A critical volume of patients is required to maintain standards and performance especially for technical skills. Thus, teams should be specialized in the care of specific patient populations, as well as the field of transport processes, safety, and system design. Summary For teams to be dedicated to the transport service, we often need to combine neonatal, (with or without high-risk mothers) with paediatric volumes, to ensure a critical mass of patients to build and maintain competencies. Ideally, a collaborative practice team model is created to facilitate this, with clinicians from different health care backgrounds and areas of practice. This permits the collective sum of its members' individual skills and abilities, facilitates cross training of all, and provides maximum flexibility for the team. Teams should be located at tertiary level hospitals for ready access to education and practical skills but should be centrally coordinated and dispatched for greatest efficiencies, and integration of air and land modalities. 'On-line' medical control provided by an experienced consultant and expert in transport medicine, together with transport policies and procedures, must be in place to guide performance and ensure optimal outcomes. Regular debriefing, extensive transport reviews, and a database help determine each individual's educational needs. Trends in key team performance indicators allow for benchmarking and help drive better performance.

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Education of pediatric subspecialty fellows in transport medicine: a national survey

Cited by 10 publications

References 11 publications

Prevalence and risk factors associated with birth asphyxia among neonates delivered in Ethiopia: A systematic review and meta-analysis

Prevalence and risk factors associated with birth asphyxia among neonates delivered in Ethiopia: A systematic review and meta-analysis

Current Perspectives on Transport Medicine in Pediatric Hospital Medicine Fellowships

Team Models in Interfacility Transport-Building and Maintaining Competencies

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