Children's Safety Initiative: A National Assessment of Pediatric Educational Needs among Emergency Medical Services Providers

Abstract

Objective Emergency Medical Services (EMS) providers may have critical knowledge gaps in pediatric care due to lack of exposure and training. There is currently little evidence to guide educators to the knowledge gaps most likely to improve patient safety. The objective of this study was to identify educational needs of EMS providers related to pediatric care in various domains in order to inform development of curricula. Methods The Children’s Safety Initiative-EMS performed a three-phase Delphi survey on patient safety in pediatric emergencies among providers and content experts in pediatric emergency care including physicians, nurses and pre-hospital providers of all levels. Each round included questions related to educational needs of providers or the effect of training on patient safety events. We identified knowledge gaps in the following domains: case exposure, competency and knowledge, assessment and decision making, and critical thinking and proficiency. Individual knowledge gaps were ranked by portion of respondents who ranked them “highly likely” (likert-type score 7–10 out of 10) to contribute to safety events. Results There were 737 respondents who were included in analysis of the first phase of the survey. Paramedics were 50.8% of respondents; EMT-Basics/first responders were 22% and physicians 11.4%. The top educational priorities identified in the final round of the survey include: pediatric airway management, responder anxiety when working with children, and general pediatric skills among providers. The top three needs in decision-making include knowing when to alter plans mid-course, knowing when to perform and advanced airway, and assessing pain in children. The top 3 technical or procedural skills needs were pediatric advanced airway, neonatal resuscitation, and intravenous/intraosseos access. For neonates, specific educational needs identified included knowing appropriate vital signs and preventing hypothermia. Conclusions This is the first large-scale Delphi survey related to pediatric pre-hospital education. Our results provide foundational information related to the educational needs of pre-hospital providers. Medical directors and educators can use the results to shape future curricular development.

Understanding the value of mixed methods research: the Children's Safety Initiative-Emergency Medical Services

“…In CSI-EMS, we sought to find consensus among experienced EMS professionals regarding the most likely contributors to patient safety events in the out-of-hospital care of children 18. The Delphi method in this case followed the focus groups in a qual→QUAN mixed methods format.…”

Family Centered Practice During Pediatric Death in an Out of Hospital Setting

“…23 This topic is unfortunately overlooked when highlighting inadequacies in pediatric prehospital education. 24 It is our hope that the insights gleaned from this study will be integrated into educational and training programs aimed at EMS providers and other health professionals who are likely to encounter the death of a child during their careers so that all families are consistently treated with dignity and respect during one of the worst days of their lives.…”

Reliability and Usability of a 7-Minute Chart Review Tool to Identify Pediatric Prehospital Adverse Safety Events

“…The Children' s Safety Initiative-Emergency is a large multiphase study funded by the National Institutes of Health to characterize the epidemiology of patient safety events in the prehospital emergency care of children. 4,[17][18][19][20] We developed the pediatric prehospital safety event detection system (PEDS) chart review tool on the basis of hospital chart review tools. 10,21,22 Building on our previously reported findings of focus groups of EMS providers 18 and a national Delphi survey of prehospital care experts, 17 which was used to identify and categorize factors contributing to safety events, we developed and refined tool content and established content validity.…”