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INTRODUCTION: While case-based learning is an effective method, teaching resources in pediatric infectious diseases are limited. Thus, we developed a case-based learning module for a common pediatric infectious diseases topic, osteomyelitis. METHODS: This module contains two resource files, both meant to be printed. The case file contains questions with blank spaces for the trainee (medical student, junior resident) to complete. The case answers file is used as a guide by the teacher (attending physician, fellow, senior resident) and/or the trainee after working through the case. This resource may be used in one-to-one sessions, in a small-group setting, or as self-directed learning. The session is estimated to take 60-90 minutes. A suggested reading list is included. RESULTS: This resource was used in a small-group format with the pediatric residents of the Hospital for Sick Children in Toronto for an academic half-day session in November 2015. Twenty-eight learner evaluations were received. The session was rated a 4.8 out of 5 (with 5 = outstanding) and ultimately voted by the residents to be the best academic half-day session of the year. Compared to delivering a didactic lecture on the same topic, the facilitators found preparation time was reduced and interactions with the trainees were more engaging. All were willing to facilitate a similar session again. DISCUSSION: This resource was effective and popular from the perspective of both learners and teachers. Additional modules are currently under preparation in order to create a case-based teaching resource for pediatric infectious diseases.
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OBJECTIVE: To describe the long-term outcomes of pediatric pleural empyema. DESIGN: Prospective observational study from October 2008 to October 2011. SETTING: Tertiary care children's hospital. PARTICIPANTS: Children with pleural empyema (loculations and/or septations identified on radiologic imaging or frank pus on thoracentesis). MAIN OUTCOME MEASURES: Children were seen 1, 6, and 12 months postdischarge. Outcome measures included symptoms and signs of respiratory disease, child and parental impact, radiographic resolution, spirometry, and health-related quality of life (Pediatric Quality of Life Inventory score). Analysis was based on the last observation carried forward for missing data. RESULTS: Eighty-two of 88 patients (93%) eligible were recruited. Fifty-four percent were male and mean (SD) age was 4.5 (3.4) years. Outcome data was obtained in 100% at 1 month, 90% at 6 months, and 72% at 1 year. Seventy-one percent had effusions occupying a quarter or more of the hemithorax and 62% of effusions were drained. Fever, cough, parental work loss, child school loss, radiographic abnormalities, and abnormal spirometry results were common in the first month and then declined. By the last observation, 2% of patients had abnormal radiographs (aside from pleural thickening), 6% had mild obstruction on spirometry, and Pediatric Quality of Life Inventory scores were better than for children with asthma (P < .001). Patients with abnormal outcomes in 1 measure had normal outcomes in all other clinical measures. CONCLUSIONS: Clinically important phenomena persist in the short-term, but virtually all children with pleural empyema have no long-term sequelae.
