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Dixon AC. Pediatric fractures - an educational needs assessment of Canadian pediatric emergency medicine residents. Open Access Emerg Med. 2015;7:25-9doi: 10.2147/OAEM.S82393.
Dixon, A. C. (2015). Pediatric fractures - an educational needs assessment of Canadian pediatric emergency medicine residents. Open access emergency medicine : OAEM, 725-9. https://doi.org/10.2147/OAEM.S82393
Dixon, Andrew C. "Pediatric fractures - an educational needs assessment of Canadian pediatric emergency medicine residents." Open access emergency medicine : OAEM vol. 7 (2015): 25-9. doi: https://doi.org/10.2147/OAEM.S82393
Dixon AC. Pediatric fractures - an educational needs assessment of Canadian pediatric emergency medicine residents. Open Access Emerg Med. 2015 Jun 08;7:25-9. doi: 10.2147/OAEM.S82393. eCollection 2015. PMID: 27147887; PMCID: PMC4806804.
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Open Access Emerg Med. 2015 Jun 08;7:25-9. doi: 10.2147/OAEM.S82393. eCollection 2015.

Pediatric fractures - an educational needs assessment of Canadian pediatric emergency medicine residents.

Open access emergency medicine : OAEM

Andrew C Dixon

Affiliations

  1. Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.

PMID: 27147887 PMCID: PMC4806804 DOI: 10.2147/OAEM.S82393

Abstract

OBJECTIVES: To determine the gaps in knowledge of Canadian pediatric emergency medicine residents with regards to acute fracture identification and management. Due to their predominantly medical prior training, fractures may be an area of weakness requiring a specific curriculum to meet their needs.

METHODS: A questionnaire was developed examining comfort level and performance on knowledge based questions of trainees in the following areas: interpreting musculoskeletal X-rays; independently managing pediatric fractures, physical examination techniques, applied knowledge of fracture management, and normal development of the bony anatomy. Using modified Dillman technique the instrument was distributed to pediatric emergency medicine residents at seven Canadian sites.

RESULTS: Out of 43 potential respondents, 22 (51%) responded. Of respondents, mean comfort with X-ray interpretation was 69 (62-76 95% confidence interval [CI]) while mean comfort with fracture management was only 53 (45-63 95% CI); mean comfort with physical exam of shoulder 60 (53-68 95% CI) and knee 69 (62-76 95% CI) was low. Less than half of respondents (47%; 95% CI 26%-69%) could accurately identify normal wrist development, correctly manage a supracondylar fracture (39%; 95% CI 20%-61%), or identify a medial epicondyle fracture (44%; 95% CI 24%-66%). Comfort with neurovascular status of the upper (mean 82; 95% CI 75-89) and lower limb (mean 81; 95% CI 74-87) was high.

INTERPRETATION: There are significant gaps in knowledge of physical exam techniques, fracture identification and management among pediatric emergency medicine trainees. A change in our current teaching methods is required to meet this need.

Keywords: education; fractures; pediatric; radiologic interpretation

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