Pediatrics Research Today is a free monthly online journal that collates and summarizes the latest research about Pediatrics, including details on child development, perinatal medicine, child health care.

Pediatricians' reports of their education in ethics.

Kesselheim JC, Johnson J, Joffe S

Department of Pediatric Oncology, Dana-Farber Cancer Institute, 44 Binney St, Boston, MA 02115, USA. steven_joffe@dfci.harvard.edu

OBJECTIVE: To study pediatricians' assessments of the quality of their ethics education, the impact of various learning methods, and their confidence in confronting ethical dilemmas arising in pediatric practice. DESIGN: Cross-sectional survey. PARTICIPANTS: Two hundred fifty physicians who completed pediatric or medicine/pediatric residency programs in 2004 were randomly selected from the American Medical Association Physician Masterfile. Evaluable responses were received from 150 of 215 eligible pediatricians (70%). RESULTS: Of 150 respondents, 44.7% rated their ethics education during residency as fair or poor. More than 80% reported that informal discussions with fellow residents and attending physicians had a moderate or major effect on their ethics education, whereas 53.3% reported that formal teaching conferences had a moderate or major impact. Most respondents (>60%) reported confidence in addressing 4 of 23 ethical challenges, a moderate proportion (40%-60%) reported confidence in addressing 8 of 23 ethical challenges, and fewer (<40%) reported confidence in addressing 11 of the ethical challenges. Areas associated with low confidence included ethics in end-of-life care and research ethics. CONCLUSIONS: Efforts are needed to augment formal and informal ethics teaching during residency. Additional studies at both the individual physician and residency program levels are needed to improve the ethics education that pediatricians-in-training receive.

Published 8 April 2008 in Arch Pediatr Adolesc Med, 162(4): 368-73.
Full-text of this article is available online (may require subscription).

Articles on Pediatrics published 21 March 2008:

Educational interventions to reduce prescribing errors.   Arch Dis Child, 93(4): 313-5.

OBJECTIVE: Little is known about teaching paediatricians to prescribe or about assessing their competency. This study aimed to identify educational interventions to reduce dose calculation errors. DESIGN: Literature review, a questionnaire survey of paediatric healthcare professionals, observation and interviews were performed. RESULTS: Literature review identified one paper describing an in-service test for medical trainees. 319/559 questionnaires were returned (57%). 34 mentioned educational ... [Abstract] [Full-text]

Articles on Pediatrics published 11 March 2008:

Pediatric trauma rehabilitation: a value-added safety net.   J Trauma, 64(3): 819-23.

This article reviews the literature on the effectiveness of rehabilitation after pediatric trauma. The characteristics of comprehensive pediatric trauma rehabilitation services during the initial acute care hospitalization, as well as subsequent inpatient and outpatient care during the first 12 months after injury are discussed. Important research questions and the challenges associated with conducting such research are identified. For many children, rehabilitation is the final common pathway ... [Abstract] [Full-text]

Evaluation of a multidisciplinary pediatric mock trauma code educational initiative: a pilot study.   J Trauma, 64(3): 761-7.

BACKGROUND: Our aim was to develop and evaluate a multidisciplinary pediatric mock trauma code orientation program for residents on their pediatric hospital rotation. METHODS: A before and after evaluation of trauma team residents from various programs was conducted. The 1-hour educational session consisted of a 15-minute mock trauma code, a debriefing and teaching intervention, and then a new, postintervention mock trauma code. Before and after each session, residents completed a ... [Abstract] [Full-text]

Articles on Pediatrics published 10 March 2008:

Paediatric palliative care: challenges and emerging ideas.   Lancet, 371(9615): 852-64.

Paediatric palliative care is an emerging subspecialty that focuses on achieving the best possible quality of life for children with life-threatening conditions and their families. To achieve this goal, the individuals working in this field need to: clearly define the population served; better understand the needs of children with life-threatening conditions and their families; develop an approach that will be appropriate across different communities; provide care that responds adequately to ... [Abstract] [Full-text]

Articles on Pediatrics published 7 March 2008:

The effect of lack of insurance, poverty and paediatrician supply on immunization rates among children 19-35 months of age in the United States.   J Eval Clin Pract, 14(2): 248-53.

RATIONAL, AIMS AND OBJECTIVES: Previous studies found that the increasing number of paediatricians in the United States was associated with improved childhood immunization coverage, while the increasing poverty level and the lack of health insurance reduced access to health care. We evaluated whether changes in the number of paediatricians, poverty level and health insurance affected national childhood immunization coverage in the state levels of the United States. METHODS: Data were collected ... [Abstract] [Full-text]

Articles on Pediatrics published 5 March 2008:

Ambiguous abbreviations: an audit of abbreviations in paediatric note keeping.   Arch Dis Child, 93(3): 204-6.

OBJECTIVE: To assess the frequency, nature and understanding of abbreviations in medical records. DESIGN: Audit of abbreviation use and meaning in paediatric handover sheets and medical notes compared to two standards, the Trust Intranet Medical Dictionary (TID) and Mosby's Medical Dictionary (MMD). A selection of abbreviations was shown to healthcare professionals to examine interpretation of abbreviations. SETTING: Large inner-city district general hospital, Birmingham, UK. MAIN OUTCOME ... [Abstract] [Full-text]

Articles on Pediatrics published 4 March 2008:

Assessment of parental understanding by pediatric residents during counseling after newborn genetic screening.   Arch Pediatr Adolesc Med, 162(3): 199-204.

OBJECTIVE: To investigate pediatric residents' efforts to assess understanding in discussions about positive newborn screening test results. Newborn screening saves lives, but confusion about false-positive and carrier results often leads to psychosocial problems. DESIGN: Explicit-criteria abstraction of transcripts of encounters with standardized parents of a fictitious infant found to carry cystic fibrosis or sickle cell hemoglobinopathy. SETTING: Simulated doctor-patient encounter. ... [Abstract] [Full-text]

Articles on Pediatrics published 3 March 2008:

Improving pediatric dosing through pediatric initiatives: what we have learned.   Pediatrics, 121(3): 530-9.

OBJECTIVE: The goal was to review the impact of pediatric drug studies, as measured by the improvement in pediatric dosing and other pertinent information captured in the drug labeling. METHODS: We reviewed the pediatric studies for 108 products submitted (July 1998 through October 2005) in response to a Food and Drug Administration written request for pediatric studies, and the subsequent labeling changes. We analyzed the dosing modifications and focused on drug clearance as an important ... [Abstract] [Full-text]

© 2005-2008 Pediatrics Research Today. All Rights Reserved.