Locked and (Un)-Loaded Discussions: A Pediatric Resident Safe Firearm Storage Counseling Curriculum.

Introduction: Firearm-related fatalities are a public health crisis. Despite recognizing the vital nature of counseling parents/caregivers regarding firearm safety, residents remain uncomfortable asking patients about the presence of firearms in homes and discussing American Academy of Pediatrics recommendations regarding safe firearm storage. Methods: We designed an interactive curriculum to improve pediatric resident knowledge, skills, attitudes, and behavior regarding counseling families about safe firearm storage. Components of the curriculum included a didactic session, a hands-on experience to better understand the parts of a firearm and its relevant storage/safety devices, and role-playing scenarios. Results: The curriculum was delivered to 53 pediatric residents in two different residency programs. A statistically significant improvement in knowledge and skills related to safe firearm storage counseling was demonstrated in both settings. Furthermore, a statistically significant change in counseling behavior was noted among one resident group. Curriculum evaluation revealed overwhelmingly positive learner responses. Discussion: An adaptable interactive safe firearm storage counseling curriculum was well received by pediatric residents and improved resident knowledge and skills, resulting in an increase in safe firearm storage counseling discussions with families.

Call Me Maybe A Simulation Based Curriculum for Telephone Triage Education in a Pediatric Residency.

Pediatrician communication with caregivers by phone has traditionally made a significant impact on patient care but remains a source of medical liability. Despite its importance, few publications exist regarding the education of pediatric residents on telephone triage. Our study involved the development of an educational curriculum aimed at expanding the pediatric resident skill set in telephone triage. Our method of curriculum development is based on Kolb's experiential learning theory. We utilized a combination of resource familiarization, didactic education, and simulation in the building of knowledge through reflection upon concrete experience, generalization of knowledge gained, and application of this new knowledge. We developed a 30-min PowerPoint presentation in which instructors reviewed the basic tenets of telephone triage. In the pilot study, residents were divided into two groups-a didactic-first group and a simulation-first group. Their performance was monitored during two scripted, symptom based "parent" phone call simulations. The didactic-first group received the PowerPoint didactic prior to the simulation, and the simulation-first group received the didactic after the simulation. A comparison of resident evaluations by faculty and self-documented confidence level revealed statistically significant higher evaluation scores in the didactic-first group, and an overall improvement in resident confidence with telephone triage. We conclude that this educational curriculum may improve pediatric resident performance in telephone triage.

Paediatric case of ductal origin of right pulmonary artery presenting with exertional dyspnoea and mimicking asthma and primary ciliary dyskinesia.

Ductal origin of pulmonary artery is a rare anomaly that is frequently misdiagnosed. Patients may present with exertional dyspnoea, recurrent respiratory infections and pulmonary hypertension. The presence of pulmonary hypertension can adversely affect clinical outcome in these patients; hence, early identification and intervention is the key to improve survival. A case of a 3-year-old child presenting with exertional dyspnoea is presented in this report. Chest radiograph revealed right-sided pulmonary hypoplasia and mediastinal shift to the right. Pulmonary artery agenesis was suspected when CT of the chest demonstrated right-sided pulmonary artery agenesis. Cardiac catheterisation revealed the correct diagnosis of ductal origin of right pulmonary artery. The most striking feature of this case is that the clinical presentation is mild compared with the findings on imaging.