Technical skills experiences in pediatric emergency medicine fellowship programs

Guidelines for Pediatric Emergency Medicine (PEM) fellowship programs were published by the Curriculum Subcommittee, Section of Emergency Medicine, American Academy of Pediatrics in February 1993. The guideline listed 120 technical skills that the subcommittee felt all fellows should be able to perform at the completion of their training. The purpose of this study was to measure the experience of PEM fellows in performing skills recommended by the subcommittee and to determine if documentation lists were being maintained. A written survey was mailed to 63 graduating fellows in May 1993, requesting information on the number of times procedure skills were performed. Limited experience was defined as having performed a procedure five or less times. Thirty-two surveys (51%) were returned. Eleven fellows (34%) stated they maintained a procedure documentation list. Of 117 skills analyzed, the majority of fellows had limited experience in 49 procedures and zero experience in 22 procedures. The majority of fellows had limited experience in 12 of 20 life- or limb-saving procedures and zero experience in five. Large emergency department volumes did not influence number of procedure completions. Our data indicate that graduating PEM fellows have limited experience in performing many common as well as several life- and limb-saving skills. Documentation lists of technical skills are not being maintained by most fellows.