• Pediatric emergency care · Jan 2025

    Procedural Entrustment Alignment Between Pediatric Residents and Their Preceptors in the Pediatric Emergency Department.

    • Michael P Goldman, Martin D Slade, Katherine Gielissen, Alexander W Hirsch, Elizabeth A Prabhu, Dana W Dunne, and Marc A Auerbach.
    • Department of Internal Medicine, Section of General Medicine, Yale University School of Medicine.
    • Pediatr Emerg Care. 2025 Jan 22.

    ObjectiveEntrustment describes the balance of supervision and autonomy between resident and preceptor to complete doctoring tasks like procedures. Entrustment alignment between resident and preceptor facilitates safe, successful outcomes, and promotes learning. Study objectives describe procedural entrustment alignment between senior pediatric residents and their preceptors and report the impact of a simulation-based formative assessment (SFA) on entrustment alignment.MethodsThis prospective observational study enrolled a convenience sample of senior pediatric residents in 2023. The SFA was videoed, consisted of obtaining informed consent and performing simulated procedures (laceration [LAC] and lumbar puncture [LP]). Residents self-assessed their entrustability pre/post-SFA. A PEM preceptor panel individually rated videos of the residents. PEM panel's scores were compared to residents' scores on both an 8-point scale and the dichotomized variable of needing "in versus out" of the room entrustment.ResultsTwenty-four residents' SFAs were rated by 9 panelists. Before the SFA, entrustment alignments on the 8-point scale were as follows: resident LAC 4.08 vs PEM panel 4.97 (P < 0.001), and resident LP 4.75 vs PEM panel 5.31 (P = 0.15). After the SFA, entrustment alignments were as follows: resident LAC 5.21 vs PEM panel 4.97 (P = 0.32), and resident LP 5.54 vs PEM panel 5.31 (P = 0.52). The dichotomized analyses revealed improved alignment post-SFA: LAC-pre-kappa = 0.03 vs LAC-post 0.46, and LP-pre-kappa = (-0.03) vs LP-post = 0.24.ConclusionsOur findings indicate senior pediatric residents desire less entrustment (more supervision) for procedures but better align with preceptors after an SFA. This work offers insight into procedural entrustment decision making and the potential of SFA's to facilitate procedural learning.Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…