Pediatrics
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Multicenter Study
Impact of Just-in-Time and Just-in-Place Simulation on Intern Success With Infant Lumbar Puncture.
Simulation-based skill trainings are common; however, optimal instructional designs that improve outcomes are not well specified. We explored the impact of just-in-time and just-in-place training (JIPT) on interns' infant lumbar puncture (LP) success. ⋯ Across multiple institutions, intern success rates with infant LP are poor. Despite improving process measures, adding JIPT to training bundles did not improve success rate. More research is needed on optimal instructional design strategies for infant LP.
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Neurodevelopmental disability is the most common complication for survivors of surgery for congenital heart disease (CHD). ⋯ Early neurodevelopmental outcomes for survivors of cardiac surgery in infancy have improved modestly over time, but only after adjustment for innate patient risk factors. As more high-risk CHD infants undergo cardiac surgery and survive, a growing population will require significant societal resources.
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The risk for firearm violence among high-risk youth after treatment for an assault is unknown. ⋯ High-risk youth presenting to urban EDs for assault have elevated rates of subsequent firearm violence. Interventions at an index visit addressing substance use, mental health needs, retaliatory attitudes, and firearm possession may help decrease firearm violence among urban youth.