Pediatric Trauma Education in the United States: A Nationwide Clinician Needs Assessment

Standardized training and education are priorities for improving system-level quality and outcomes for pediatric trauma patients. The objective of this study is to identify common educational needs of pediatric trauma clinicians in the United States and the gaps in currently available education courses, to inform future curriculum development.

An anonymous, IRB-approved, 30-item cross-sectional survey was developed and distributed to pediatric trauma clinicians via e-mail. Demographic and quantitative data were analyzed with descriptive statistics. Open-ended responses were analyzed using reflexive thematic analysis.

Two hundred four surveys were analyzed. Respondents were faculty physicians (40.7%), nurses (23.5%), trauma program managers (18.6%), advanced practice providers (11.3%), EMS (4.4%), and trainee physicians (1.5%) representing thirty-seven states. 70% worked at a pediatric trauma center. 65% had taken the ATLS course, but only 50% felt that the course prepared them to care for pediatric trauma patients. 97% had taken PALS, but only 45% felt the course prepared them for pediatric trauma care. Respondents ranked comfort with specific pediatric trauma skills. Confidence was lowest for chest tube placement (mean=5.7/10) and dosing intubation medications (6.1/10). Confidence was highest for tourniquet placement (8.2/10) and assigning a GCS to a school-aged child or teen (8.1/10). Qualitative themes included: (1) Neither ATLS nor PALS provide comprehensive pediatric trauma education; (2) Comfort with pediatric trauma comes from experience rather than course completion; (3) There is a desire for additional pediatric-specific education, and (4) Multiple specific topics were identified as educational needs.

ATLS and PALS alone do not meet the need for comprehensive pediatric trauma education in the United States. Experience is most helpful for proficiency, putting low-volume centers at a disadvantage. Pediatric-specific trauma education is desired, including simulation-based courses and app-based reference materials. Pediatric procedural skills, age-specific assessment and physiology, and evidence-based best practices should be targeted.