Targeted organized teaching scripts (TOTS) in the pediatric emergency department

Abstract

Efficient learning in the pediatric emergency department (PED) has traditionally focused on precepting 1 and self-directed learning. [2][3][4] However, common challenges to education in the PED remain, specifically inconsistent resident exposure to key pathologies, 5 faculty with limited educational resources and training, 1,6 and increasing time constraints. 1,7 Teaching scripts are an alternative tool which create brief and focused teaching moments between educators and learners outside of precepting. 1,8 Utilizing theories of microlearning and just-in-time training, 9-12 the development of teaching scripts focuses on planning, organizing, and prioritizing information for educators to share knowledge at a moment's notice. 8,13 We examined the effect of premade, readily available teaching scripts on satisfaction with resident education in a busy PED. E XPL ANATIONTargeted organized teaching scripts (TOTS) were developed for 10 topics designated as core content for both pediatric and emergency medicine board exams 14,15 and identified by division leadership as knowledge gaps among residents (Figures S1-S10). Scripts contain bulleted outlines emphasizing high-yield information for ED management and can be presented by faculty in 3-5 min. Faculty were introduced to TOTS and the use of teaching scripts during a regularly scheduled faculty meeting.The scripts were printed on large laminated cards and kept in boxes at attending workstations (Figure 1). Each card included a tracking QR code for residents to scan. All residents rotating through the PED during the 3 months before (n = 49) and after (n = 53) implementation of the TOTS program were surveyed to assess their level of satisfaction with teaching received in the PED and the topics they were taught during their rotation (preintervention survey n = 19, postintervention survey n = 28). DE SCRIP TIONTOTS were utilized by two-thirds (22/34) of attendings and fellows with "acetaminophen toxicity" and "intussusception" most frequently reviewed. Thirty-four residents (64%) received teaching on at least one topic by faculty using TOTS. Despite variable use, TOTS were well received by residents and faculty with 79% and 78%,