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Published on: January 15, 2017
General emergency physician perceptions of caring for children: A qualitative interview study
Regina L Toto1, Eva M Delgado1, Tara Ketterer1
1Children's Hospital of Philadelphia Philadelphia Pennsylvania USA.
Insights
Emergency physicians often feel unprepared to care for children, especially infants. Increased experience, simulation, and specific rotations can improve pediatric emergency medicine training and physician confidence.
Area of Science:
- Pediatric Emergency Medicine
- Medical Education Research
- Qualitative Health Research
Background:
- Emergency physicians manage most pediatric cases in U.S. emergency departments (EDs).
- Pediatric exposure during emergency medicine (EM) residency is variable, with limited encounters of critically ill children.
- Physicians report feeling less prepared for pediatric conditions, with infants posing unique challenges.
Purpose of the Study:
- To qualitatively explore emergency physician perspectives on caring for pediatric patients.
- To understand the perceived challenges and educational needs of recent EM graduates regarding pediatric care.
Main Methods:
- An interview-based qualitative study design was employed.
- In-depth virtual interviews were conducted with 12 emergency physicians who graduated residency between 2015-2019.
- Conventional content analysis was used to identify themes from transcribed interviews.
Main Results:
- Three major themes emerged: (1) experience and exposure are crucial for comfort, (2) simulation and specific rotations (e.g., pediatric anesthesia) are beneficial, and (3) unique emotional challenges exist in pediatric care.
- Participants recommended increased autonomy, neonate exposure, and consideration of community setting differences in EM pediatric education.
- Physicians highlighted the need for enhanced preparedness in managing diverse pediatric conditions.
Conclusions:
- This study provides insight into the perceived experiences of recent emergency physicians caring for children.
- Findings underscore the importance of targeted educational strategies to improve pediatric emergency medicine training.
- Recommendations focus on enhancing physician confidence and competence in managing pediatric emergencies.
Background:
Emergency physicians care for most children presenting to U.S. emergency departments (EDs). Pediatric exposure during emergency medicine (EM) residency can be variable and critically ill children are rarely encountered. A recent needs assessment revealed that emergency physicians feel less prepared to manage various conditions in children and that infants, regardless of presenting complaint, pose particular challenges. Emergency physician perceptions of the experience of caring for pediatric patients have not been widely examined through a qualitative lens.
Methods:
We designed an interview-based qualitative study to explore emergency physician perspectives on pediatric patient care. We recruited emergency physicians who graduated from residency in 2015-2019 and all rotated through the same large tertiary children's hospital. Four trained interviewers conducted in-depth, one-on-one virtual interviews. An interdisciplinary team transcribed and then coded the interviews. The team performed a conventional content analysis for themes. Recruitment continued until thematic saturation was achieved.
Results:
Twelve participants completed interviews. These participants trained in five diverse residency programs. Likewise, the participants now practice in a variety of settings. Three major themes emerged from the data: (1) experience and exposure are key to establishing comfort caring for children; (2) simulation, pathways, and the pediatric anesthesia rotation are educationally useful; and (3) caring for children poses unique emotional challenges. Participants shared many recommendations for future pediatric education for EM trainees, including increasing autonomy and exposure to neonates and considering how care might differ in a community setting.
Conclusions:
This interview-based qualitative study elucidates key themes in recently graduated emergency physicians' perceived experience of caring for children. Our findings have important educational implications for this group of emergency physicians and those who share similar experiences in training and practice.
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