Primary and secondary surveys are frequently performed incompletely and inefficiently regardless of level of training or type of training program. There is no difference in measured performance among different types of residency programs. The impact of trauma resuscitation education on improved survey performance should be studied prospectively.

Introduction Leadership and teaching skills are essential, but not often emphasized, components of medical training. As emergency care develops as a specialty in Uganda, two cadres of providers are being trained: physicians and non-physician clinicians (NPCs). Building formal leadership and educator training into these curricula is essential. Methods A week long continuing education (CE) course on leadership and teaching is described and evaluated for effectiveness using Kirkpatrick’s framework for learner-centred outcomes. The emergency care trained NPCs participated in a week-long course consisting of lectures, role-playing, and small group discussions, as well as a personality self-assessment. The evaluation process consisted of: 1) an immediate post-course survey to measure learner satisfaction, 2) a retrospective, pre/post self-assessment with a Likert-type scoring tool to measure knowledge gains, and 3) a three-month follow up survey and structured interviews to measure knowledge retention and behaviour change in practice. Results All 15 NPCs participated in the evaluation process. Learner satisfaction was high with an average score of 9.3 (on a 1–10 scale) for course content, amount learned, and use of time. Participants reported gains in knowledge for each of the 24 competencies measured, with an average difference in pre- and post-course Likert scores of 1.11 (on a scale of 1–5). Lastly, all 15 participants shared detailed examples of using course content in practice three months after the course finished. The most frequently mentioned themes were “giving and receiving feedback,” “delegating and assigning tasks,” and “communication.” Conclusion This course was a successful CE intervention in this setting as measured by Kirkpatrick’s framework. The most frequently mentioned concepts used in practice point to the NPCs ability to take on leadership roles in this setting. Further research and evaluation methods should focus on the influence of culture and personalities on leadership education and translation into practice in an EM setting.

Background Although children with special health care needs (CSHCN) represent a minority of the population, they go through more hospitalizations, more admissions to the Emergency Department (ED), and receive a major number of medical prescriptions, in comparison to general pediatric population. Objectives of the study were to determine the reasons for admission to the ED in Italian CSHCN, and to describe the association between patient’s demographic data, clinical history, and health services requirements. Methods Ad hoc web site was created to collect retrospective data of 3479 visits of CSHCN to the ED in 58 Italian Hospitals. Results Seventy-two percent of patients admitted to ED were affected by a previously defined medical condition. Most of the ED admissions were children with syndromic conditions (54%). 44.2% of the ED admissions were registered during the night-time and/or at the weekends. The hospitalization rate was of 45.6% among patients admitted to the ED. The most common reason for admission to the ED was the presence of respiratory symptoms (26.6%), followed by gastrointestinal problems (21.3%) and neurological disorders (18.2%). 51.4% of the access were classified as ‘urgent’, with a red/yellow triage code. Considering the type of ED, 61.9% of the visits were conducted at the Pediatric EDs (PedEDs), 33.5% at the Functional EDs (FunEDs) and 4.6% at the Dedicated EDs (DedEDs). Patients with more complex clinical presentation were more likely to be evaluated at the PedEDs. CSHCN underwent to a higher number of medical procedures at the PedEDs, more in comparison to other EDs. Children with medical devices were directed to a PedED quite exclusively when in need for medical attention. Subjects under multiple anti-epileptic drug therapy attended to PedEDs or FunEDs generally. Patients affected by metabolic diseases were more likely to look for medical attention at FunEDs. Syndromic patients mostly required medical attention at the DedEDs. Conclusions Access of CSHCN to an ED is not infrequent. For this reason, it is fundamental for pediatricians working in any kind of ED to increase their general knowledge about CHSCN and to gain expertise in the management of such patients and their related medical complexity.