Do Pediatric Residents Learn Resuscitation from Pediatric Advanced Life Support (Pals) Training?
*Richard Mink Department Of Pediatrics, David Geffen School Of Medicine , Medical Center 1000 W. Carson St. Box 491, Torrance, Canada
*Corresponding Author: Richard Mink
Department Of Pediatrics, David Geffen School Of Medicine , Medical Center 1000 W. Carson St. Box 491, Torrance, Canada Email:email@example.com
Published on: 2017-10-12
Background: The Pediatric Advanced Life Support (PALS) course is designed to teach the pediatric provider initial stabilization of critically ill children and residency programs often employ it as the main method to achieve this. We hypothesized that although PALS may initially teach residents the knowledge and skills needed to resuscitate children, this information is not retained. Methods: Fourteen first and 14 third year pediatric residents were evaluated before PALS (PRE), within 1 month following the course (POST) and 6-8 months later (F/U). Evaluation included assessments of knowledge (multiple choice and casebased questions), skills (bag-mask ventilation, intubation, intraosseous catheter insertion and defibrillation using checklists) and a confidence questionnaire, although the participants did not complete all evaluations. Results: For first and third year residents, scores on multiple choice testing improved at POST, but in neither group was this information retained at F/U. Performance of bag-mask ventilation, defibrillation, and intubation did not significantly improve in either group at POST or F/U. However, intraosseous catheter insertion was better at POST and F/U in first years, but only at F/U in third years. Third year resident confidence was greater at both POST and F/U even though knowledge and skills were largely unchanged. Conclusions: Given the lack of retention of knowledge and minimal improvement in skill performance, residency programs should be cautious about basing resident resuscitation education on PALS. Other instructional techniques need to be utilized but learning should be formally assessed to ensure that residents are prepared for the emergencies that they may encounter in practice.
Because pediatric resuscitations are rare and residents are spending less time in intensive care units due to changes in requirements and work hour regulations, there is concern that graduates of pediatric residency programs are inadequately prepared to perform resuscitation. Studies have shown that trainees are receiving fewer opportunities to perform skills such as intubation  and are completing residency prior to achieving competency in basic resuscitation skills .