Are Graduating Pediatric Residents Prepared to Perform Infant Lumbar Punctures?

Marc A. Auerbach, Marjorie Lee White, Sweta Bhargava, Pavan Zaveri, Elizabeth B. Seelbach, Rebekah A. Burns, Renuka Mehta, Brett McAninch, Daniel Fein, Todd P. Chang, David O. Kessler

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objectives Few published studies describe graduating pediatric residents' procedural skills or success rates. This information would help guide supervisors' decisions about graduating residents' preparedness, training, and supervision needs. This study aimed to measure success rates for graduating pediatric residents performing infant lumbar puncture (LP) during the final months of their training and to describe their experiences performing and supervising infant LPs during the course of their training. Methods This survey-based study was conducted at 10 academic medical institutions in 2013. The survey consisted of 4 domains: (1) demographics, (2) exposure to infant LP training as an intern, (3) number of LPs performed and supervised during residency, and (4) specific information on the most recent clinical infant LP. Results One hundred ninety-eight (82%) of 242 eligible graduating residents responded to the survey. A 54% success rate was noted for graduating residents when they were the first provider performing the infant LPs. Success rates were 24% if they were not the first provider to attempt the LP. Overall, graduating residents were supervised on 29% of their LPs, used anesthesia for 29%, and used the early stylet removal technique for 63%. The graduating residents performed a median of 12 infant LPs and supervised others on a median of 5 infant LPs throughout their residency. The vast majority reported feeling confident and prepared to perform this procedure. Conclusions At the end of residency, graduating pediatric residents were rarely supervised and had low infant LP success rates despite confidence in their skills. However, graduating residents frequently supervised others performing this procedure.

Original languageEnglish (US)
Pages (from-to)116-120
Number of pages5
JournalPediatric Emergency Care
Volume34
Issue number2
DOIs
StatePublished - Feb 1 2018

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Spinal Puncture
Pediatrics
Internship and Residency
Emotions
Anesthesia
Demography

Keywords

  • clinical competence
  • graduate medical education
  • infant
  • lumbar puncture
  • residency

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Emergency Medicine

Cite this

Auerbach, M. A., White, M. L., Bhargava, S., Zaveri, P., Seelbach, E. B., Burns, R. A., ... Kessler, D. O. (2018). Are Graduating Pediatric Residents Prepared to Perform Infant Lumbar Punctures? Pediatric Emergency Care, 34(2), 116-120. https://doi.org/10.1097/PEC.0000000000000914

Are Graduating Pediatric Residents Prepared to Perform Infant Lumbar Punctures? / Auerbach, Marc A.; White, Marjorie Lee; Bhargava, Sweta; Zaveri, Pavan; Seelbach, Elizabeth B.; Burns, Rebekah A.; Mehta, Renuka; McAninch, Brett; Fein, Daniel; Chang, Todd P.; Kessler, David O.

In: Pediatric Emergency Care, Vol. 34, No. 2, 01.02.2018, p. 116-120.

Research output: Contribution to journalArticle

Auerbach, MA, White, ML, Bhargava, S, Zaveri, P, Seelbach, EB, Burns, RA, Mehta, R, McAninch, B, Fein, D, Chang, TP & Kessler, DO 2018, 'Are Graduating Pediatric Residents Prepared to Perform Infant Lumbar Punctures?', Pediatric Emergency Care, vol. 34, no. 2, pp. 116-120. https://doi.org/10.1097/PEC.0000000000000914
Auerbach MA, White ML, Bhargava S, Zaveri P, Seelbach EB, Burns RA et al. Are Graduating Pediatric Residents Prepared to Perform Infant Lumbar Punctures? Pediatric Emergency Care. 2018 Feb 1;34(2):116-120. https://doi.org/10.1097/PEC.0000000000000914
Auerbach, Marc A. ; White, Marjorie Lee ; Bhargava, Sweta ; Zaveri, Pavan ; Seelbach, Elizabeth B. ; Burns, Rebekah A. ; Mehta, Renuka ; McAninch, Brett ; Fein, Daniel ; Chang, Todd P. ; Kessler, David O. / Are Graduating Pediatric Residents Prepared to Perform Infant Lumbar Punctures?. In: Pediatric Emergency Care. 2018 ; Vol. 34, No. 2. pp. 116-120.
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abstract = "Objectives Few published studies describe graduating pediatric residents' procedural skills or success rates. This information would help guide supervisors' decisions about graduating residents' preparedness, training, and supervision needs. This study aimed to measure success rates for graduating pediatric residents performing infant lumbar puncture (LP) during the final months of their training and to describe their experiences performing and supervising infant LPs during the course of their training. Methods This survey-based study was conducted at 10 academic medical institutions in 2013. The survey consisted of 4 domains: (1) demographics, (2) exposure to infant LP training as an intern, (3) number of LPs performed and supervised during residency, and (4) specific information on the most recent clinical infant LP. Results One hundred ninety-eight (82{\%}) of 242 eligible graduating residents responded to the survey. A 54{\%} success rate was noted for graduating residents when they were the first provider performing the infant LPs. Success rates were 24{\%} if they were not the first provider to attempt the LP. Overall, graduating residents were supervised on 29{\%} of their LPs, used anesthesia for 29{\%}, and used the early stylet removal technique for 63{\%}. The graduating residents performed a median of 12 infant LPs and supervised others on a median of 5 infant LPs throughout their residency. The vast majority reported feeling confident and prepared to perform this procedure. Conclusions At the end of residency, graduating pediatric residents were rarely supervised and had low infant LP success rates despite confidence in their skills. However, graduating residents frequently supervised others performing this procedure.",
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