Resident Education Committee
Pediatric Section
Society of Critical Care Medicine
October 8, 1999
Members of the Resident Education Committee
I trust this finds you enjoying the fall weather and eagerly awaiting the onset of RSV season ! The Computers in Critical Care meeting (aka 12th PCCC) in Portland in late September was a peek into the future. Our Committee met on Saturday, September 25th and discussed various issues new and old. For those of you who were unable to attend, here is a brief summary of the proceedings at the meeting.
Cathleen Patterson-Dehn, MSN, RNCS is a Nurse Practitioner working toward her Ph.D. at the Beth Israel Medical Center in NYC. She has worked diligently over the past year with Ed Conway, statisticians and her Doctorate advisors to analyze the pre and post-test (Versions A & B) examinations. She presented the results of her analysis of these tests including validity testing, analysis of each question and overall reliability. The conclusions noted in the abstract (Clinical Intensive Care Vol 10, No. 4, p 145, 1999 [abstract]) are: "There is sufficient internal consistency to provide merit to the exams. Preliminary results support the construct validity of the test forms. To allow for a more standardized PCCM rotation a core curriculum should be devised and the exams adapted accordingly." Cathleen and her team have put in an extraordinary amount of work in evaluating the tests and I wish to thank them and congratulate them on a job well done. My brief summary does not do justice to the extensive analysis and if any of you want more information, please contact me and I will send it to you (I did not want to wantonly kill trees for this mailing). She has graciously agreed to continue to work with us on further analysis of the exam (Version C now) and this will help us greatly in determining which questions should be included in our final test pool.
The last sentence in Cathleen's conclusions set us off on a "lively discussion" of the age-old question that has plagued us for years, "What do we want to teach our Residents?" Obviously, each of us has an opinion on this matter and I believe our opinions have more in common than one suspects. There is bound to be institutional bias but certain basic principles will remain common to all. In order to lay this issue to rest (since it takes up 10-20 minutes at each committee meeting), it was felt that we should come up with a "Mission Statement" outlining a) the goals and objectives of the Committee and b) goals and objectives for the PICU rotation. I think this is a good starting point and want to move ahead with getting this written over the next few months with a first draft by the SCCM 2000. I would encourage those of you who have such a document already written to send it along to me by OCTOBER 29th together with your input. Also, any volunteers who would like to work on this document, please contact Margaret Winkler or myself.
Margaret Winkler from Lexington, KY (winkler@pop.uky.edu) has offered to serve as Co-Chair of the Committee. It takes two people to do what Ed did single-handedly! Actually, this arrangement will ensure that at least one of us will be at every Committee meeting (held in conjunction with SCCM and the Colloquium).
The Version C of the Test was sent out in July and hopefully you have all had the opportunity to review it. The feedback so far has been positive. Mary Lieh-Lai from Detroit has had some very constructive suggestions and once I get more input from others (hint), we will revise the test. For now please continue to administer the test solely as a POST-TEST (end of rotation). A reminder to send in your test scores and the answer sheets every quarter to me. The first lot will be due in here EARLY OCTOBER (now!). This is very important for us since Cathleen will continue to evaluate the test. I will plan on getting a Test D ready by March/April which will be a "best of" incorporating the most pertinent questions from Versions A, B and C (also looking at feedback generated by Cathleen).
We will continue to need questions. The reasons for this are two-fold. We would like to establish a "bank" of 200-300 questions and eventually move the test to the Web. Dr. Barry Markovitz has offered to help with this enterprise. Once we have the test on the Web with immediate feedback to the examinee (like the Pediatric Board Recertification Examination) we can also allow sites to tailor the content of the test based on their patient population and local curriculum. There was an impressive plenary session at the Colloquium on the use of multimedia for teaching. Dr. Dana Braner and the Media Lab at Doernbecher (Portland, OR) have done some very impressive work on collecting, cataloging and developing multimedia-based teaching tools. My ambition is to ultimately incorporate multimedia into the test making it a multi-dimensional tool. This will obviously take time, effort and resources (aka money) and would be an excellent long-term project for our committee.
Some centers have begun using the "Manual of Pediatric Critical Care" book by Dr. Narendra Singh with varying degrees of success. We all realize that there is no perfect textbook which will offer just the right fund of knowledge. I encourage you to evaluate this book for now for the needs of your program and we will discuss this further at the SCCM. Ed Conway is reviewing a book by Dr. Tobias and this might be a viable alternative for us.
The other projects ahead for us are related to how to give us a voice in decisions related to resident education in the PICU at the national level. This will mean initiatives at the level of the AAP, ABP and RRC. Many of the intensivists I have spoken to or heard from, lament the fact that there is such a bias away from the PICU (and sometimes towards the NICU) at their programs and that the Residents are getting short-changed. If any of you have used successful arguments to have program directors reverse this bias, I would encourage you to share them.
I am very enthusiastic about working with such a fantastic group of individuals who are committed to enhancing resident education. I know there are some great ideas out there and would love to hear from you. I have asked Carl Weigle to see if we can have an e-mail alias on his server which will form a distribution list of members of this committee and allow us to communicate more effectively (Oh No, more e-mail !). I will let you know what comes up. This letter is being sent out by e-mail (and by USPS to members whose e-mail addresses I do not have). Making sure that we have you current e-mail address will save some trees and postage. Please feel free to contact Margaret, Ed or me on any of the issues noted above.
In summary,
- Please send us goals/objectives that you currently use by END-October
- More questions are needed in all categories
- Please Fax/mail Post-test scores (& copies of tests) every quarter. They are due NOW !
- Those of you who have not sent this in, please send the Demographic Data Sheets ASAP.
- Keep the comments, suggestions and advice coming!
I will e-mail a survey toward the end of the month to see how many of you have Internet and CD-ROM access that housetaff can use at the hospital.
Thank you for your continued participation on this Committee. I enjoyed meeting with many members of the Committee two weeks ago and I look forward to meeting the rest in the not too distant future. Margaret and I will work hard toward fulfilling the primary goal of this committee - better patient care through better education.
Sincerely,
MohanMohan R. Mysore, M.D.
Pediatric Critical Care
Children's Hospital
8301 Dodge Street
Omaha NE 68114-4114
Tel: 402-354-7071
Fax: 402-354-7093
e-mail: mmysore@chsomaha.org
Addendum November 18, 1999:
Next meeting of this committee: Saturday February 12, 2000 from 1600 to 1730 hrs
in Room 225 of the Orange County Convention Center.