Lessons learned and new strategies for success: Evaluating the Implementation of Competency-Based Medical Education in Queen's Pediatrics.

Objectives: In 2017, Queen's University launched Competency-Based Medical Education (CBME) across 29 programs simultaneously. Two years post-implementation, we asked key stakeholders (faculty, residents, and program leaders) within the Pediatrics program for their perspectives on and experiences with CBME so far.

Methods: Program leadership explicitly described the intended outcomes of implementing CBME.

Celiac Disease and Inflammatory Bowel Disease Are Associated With Increased Risk of Eating Disorders: An Ontario Health Administrative Database Study.

Introduction: Previous national registry studies have reported an increased risk of eating disorders in immune-mediated conditions (inflammatory bowel disease and celiac disease). Our objective was to examine the association between immune-mediated gastrointestinal (GI) diseases and incident eating disorders in Ontario.

Methods: This was a retrospective matched cohort study of individuals <50 years of age with a diagnosis of an immune-mediated GI disease between 2002 and 2020 ("cases").

Inflammatory Bowel Disease and Primary Sclerosing Cholangitis in a Pediatric Patient With Neurofibromatosis Type 1.

We describe a case of a 15-year-old adolescent boy with neurofibromatosis type 1 who presented with inflammatory bowel disease and primary sclerosing cholangitis. The literature available on the association of neurofibromatosis type 1 with inflammatory bowel disease is limited to 7 clinical case reports, and none had comorbid primary sclerosing cholangitis. We present a review of the published literature on this rare association and add the findings of our patient.

Dedicated Assessors: description of an innovative education intervention to facilitate direct observation in the clinical setting.

Background: The Department of Pediatrics at Queen's University undertook a pilot project in July 2017 to increase the frequency of direct observations (DO) its residents received without affecting the patient flow in a busy hospital-based pediatric ambulatory care clinic. Facilitating DO for authentic workplace-based assessments is essential for assessing resident's core competencies. The purpose of this study was to pilot an innovative education intervention to address the challenge of implementing DO in the clinical setting.

Chronic, Gross Hematuria Caused by Idiopathic Ureteric Stricture.

An otherwise healthy, 10-year-old boy presented with chronic, gross hematuria. This persisted daily for 5 years despite extensive multidisciplinary workup with renal biopsy and resulted in severe iron deficiency anemia. The extensive workup and requirement for routine follow-up, investigations, and procedures led to significant psychosocial distress for the patient.

Competence committee: How meeting frequency impacts committee function and learner-centered assessment.

The Department of Pediatrics at Queen's University wrestled with following the RCPSC guidelines with regards to Competence Committee (CC) meeting frequency, this article outlines adaptations we made to CC function and the rationale for our design decisions. After adopting a monthly meeting approach that focuses on formative assessment and greater resident feedback we have created an enhanced learner-centered assessment process that more fully empowers our residents with timely formative feedback to better support them in actively taking ownership of and responsibility for their learning.

Accuracy of parents and health care professionals at estimating infant emesis volume.

Objective: To quantify visual estimation inaccuracies of infant emesis by parents and caregivers (P/Cs) and health care professionals (HCPs).

Methods: A single-blinded survey was performed in which P/Cs and HCPs visually estimated predetermined volumes of simulated emesis spilled on receiving blankets or pyjamas.

Results: HCPs' estimations of volumes 1 and 3 were 150.

Use of intranasal midazolam for manual separation of labial adhesions in the office.

Use of orally administered flavored midazolam elixir in the office setting has been previously described as an alternative to general anesthetic for manual separation of severe or persistent labial adhesions. We share the technique of using atomized intranasal midazolam for sedation (and amnesia) that has quicker onset, shorter duration, and well described safety and patient tolerance. This technique eliminates the problems associated with a child who refuses to swallow the elixir.

Unnecessary irradiation to non-thoracic structures during pediatric chest radiography.

Background: Recent reports have indicated that infants and young children have a higher sensitivity than older children and adults to radiation exposure and the potential for harmful side effects.

Objective: To determine whether the present landmarks used in film positioning result in unnecessary radiation to non-thoracic structures on chest radiographs in the pediatric and neonatal population.

Materials And Methods: Chest radiographs of 195 pediatric patients and 149 neonates were analyzed for extent of radiation field to non-thoracic regions.

The Cockcroft-Gault formula should not be used in children.

Background: Although designed for adults, the Cockcroft-Gault formula was recently proposed for use in children > or =13 years of age.

Methods: We compared the feasibility of the Cockcroft-Gault formula against the standard pediatric Schwartz formula and a novel cystatin C-based formula. Our patient cohort included 262 children aged 1 to 18 years with various renal pathologies, who underwent a 99-technetium diethylenetriaminepentaacetate ((99)Tc DTPA) glomerular filtration rate (GFR) renal scan.