Microaggressions in health care occur frequently and negatively impact the well-being of trainees. High-realism simulation can effectively train health care providers to communicate in emotionally difficult situations. In 2023, we developed and piloted 4 simulation scenarios for pediatric residents centered on addressing microaggressions in the clinical environment that built on an existing didactic curriculum.
View Article and Find Full Text PDFBackground And Objective: Pediatric interfacility transport teams facilitate access to subspecialty care, and physicians often guide management remotely as transport medical control (TMC). Pediatric subspecialty fellows frequently perform TMC duties, but tools assessing competency are lacking. Our objective was to develop content validity for the items required to assess pediatric subspecialty fellows' TMC skills.
View Article and Find Full Text PDFAlthough rare in pediatrics, ischemic priapism carries significant risk of erectile dysfunction if not treated promptly. We report a case of idiopathic ischemic priapism in a male aged 14 years, refractory to traditional therapies, including aspiration/irrigation, phenylephrine injection, and distal shunt. However, the priapism resolved after intracavernosal injections of tissue plasminogen activator (tPA) with preservation of normal erectile function.
View Article and Find Full Text PDFIntroduction Effective debriefing during simulation-based training (SBT) is critical to promote learning outcomes. Despite debriefing's central role in learning and various published debriefing methods and techniques, little is known about faculty development structure for debriefing training among novice facilitators. Continuing medical education courses often use simulation-based methods but provide minimal training in debriefing techniques to novice facilitators.
View Article and Find Full Text PDFBackground: Workplace-based assessment (WBA) is critical to graduating competent physicians. Developing assessment tools that combine the needs of faculty, trainees, and governing bodies is challenging but imperative. Entrustable professional activities (EPAs) are emerging as a clinically oriented framework for trainee assessment.
View Article and Find Full Text PDFObjectives: To explore the thesis experience of recent Master of Health Professions Education (MHPE) graduates in the University of Illinois at Chicago (UIC) program.
Methods: This is a qualitative case study exploring the experience of MHPE graduates between 2014 and 2016 (n=31). Using convenience sampling, all graduates with an email address (n=30) were invited to participate in an online survey and semi-structured interviews.
Because of its multi-organ involvement, the syndrome of sepsis provides clinical challenges to a wide variety of health care providers. While multi-organ dysfunction triggered by sepsis requires general supportive critical care provided by intensivists, the impact of sepsis on renal function and the ability of renal replacement therapies to modulate its biologic consequences provide a significant opportunity for pediatric nephrologists and related care providers to impact outcomes. In this review, we aim to highlight newer areas of understanding of the pathobiology of sepsis with special emphasis on those aspects of particular interest to pediatric nephrology.
View Article and Find Full Text PDFSymptomatic cerebral edema from diabetic ketoacidosis occurs infrequently but carries a high rate of mortality and morbidity owing to complications from intracranial hypertension. Treatment options are limited but include hyperosmolar therapy with mannitol or hypertonic saline, tracheal intubation for airway protection, and hyperventilation via mechanical ventilation. We describe here the successful use of an intracranial pressure/cerebral perfusion pressure-targeted management strategy through ventriculostomy catheter placement with intracranial pressure monitoring and cerebrospinal fluid drainage, hyperosmolar therapy with hypertonic saline, and controlled hyperventilation to treat life-threatening complications of cerebral edema in a pediatric patient with severe diabetic ketoacidosis.
View Article and Find Full Text PDFPyogenic sacroiliitis accounts for 1-2% of all cases of septic arthritis with less than 200 cases reported in the English literature since the beginning of the twentieth century. Cultures of joint fluid usually grow Staphylococcus aureus. Prognosis is excellent; however, diagnosis may be difficult due to rarity of disease and non-specific signs, symptoms, and physical findings.
View Article and Find Full Text PDFObjective: Bedside ultrasound, as performed by the intensivist, is gaining in popularity and has become a powerful tool to understand the physiological state of the critically ill patient and to decrease procedural risks. This review assesses clinical applications of bedside ultrasound in the pediatric intensive care unit.
Design: A literature review was conducted to identify English language studies in Pubmed as of June, 2010, using combinations of the following search terms: 'pediatric,' 'ultrasound,' 'critical care,' and 'intensive care.