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Using an Innovative Model to Improve Performance of the Infant Hip Examination.

Neha S Joshi¹, Sidney Zven^2,3, Brian Graziose^2,3

¹Department of Pediatrics, Stanford University, Palo Alto, California.

Hospital Pediatrics

|July 17, 2024

Summary

This summary is machine-generated.

A new teaching bundle significantly improved pediatric interns' ability to screen for developmental dysplasia of the hip. This intervention enhanced infant hip examination skills and abnormality detection across multiple residency programs.

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Area of Science:

Pediatric Medicine
Medical Education
Orthopedic Screening

Background:

Developmental dysplasia of the hip (DDH) requires early detection through physical examination.
Pediatric interns often lack sufficient experience in performing infant hip examinations upon entering residency.
Standardized training is crucial for improving diagnostic skills in pediatric residents.

Purpose of the Study:

To evaluate the effectiveness of a novel teaching bundle in enhancing pediatric interns' developmental dysplasia of the hip screening skills.
To assess improvements in the identification of key hip examination maneuvers (Galeazzi, Ortolani, Barlow) after the intervention.

Main Methods:

A multicenter prospective cohort study involving 117 pediatric interns across 6 residency sites.
Baseline hip examination skills were assessed using a checklist before and after participants received a standardized teaching bundle.
Data analysis included t-tests and chi-squared tests, supplemented by qualitative feedback from focus groups.

Main Results:

Significant improvements were observed in the detection rates for all tested maneuvers: Galeazzi sign (2% to 88%), Barlow sign (27% to 69%), and Ortolani sign (22% to 92%).
Post-instructional assessment showed a marked increase in interns' ability to correctly identify hip abnormalities.
Qualitative feedback highlighted the limited prior experience and the positive impact of the teaching bundle.

Conclusions:

Pediatric residents commonly enter training programs with deficits in infant hip examination proficiency.
The implemented standardized teaching bundle effectively improved interns' skills in performing the infant hip examination and identifying DDH abnormalities.
This intervention demonstrates a successful strategy for enhancing essential pediatric diagnostic skills.