Resident Education Committee
Pediatric Section
Society of Critical Care Medicine

Communication to Committee Members

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December 7, 2000

To members of the resident education committee:

I apologize for this long delay in communicating with you - my last note was the minutes of the SCCM meeting in Orlando. Since then I have been caught up with our transitioning into a new facility and living out of boxes at work. Hopefully, now that we are settled in, I will be able to devote more of my time and energies to the committee.

I would like to draw your attention to our new contact information since both Margaret and I have moved recently. She has moved to Birmingham, AL as division chief and I have just moved across the street into a new hospital. Our new contact information is at the end of this letter.

Some of you have contacted me with questions about when we will have more results of the tests available. The doctoral candidate from NYU who was analyzing the test scores as part of her dissertation, is no longer able to provide us with the analysis and any more number crunching is going to cost us the services of a statistician (she had given us a figure of $5000). Since we have no funds to speak of for running this committee, in October, I applied for a grant from a Foundation based here to see if I can get funds to pay for a statistician etc. I am sorry to report to you that the grant did not get funded and even though I will try again for the next cycle (April 1), I think it would be wise to explore other avenues and funding sources. If any of you have local funds that we can tap into, please let either Margaret or me know and we can apply for a grant with you as the "PI". Also, if any of you have a PNP or research assistant who would like to take this up as a "project", please let me know. Either Margaret or I will try and set up a program to analyze the tests so please send me your test scores at the earliest. Also, it would be helpful for us to know what data you would like reported back to you. This would help us in providing the necessary information and avoid some of the excrutiatingly detailed analysis that was done in the past.

I realize it is frustrating not to be able to use the data you are collecting especially if your department Chairperson is breathing down your neck to show some results or if you want to use the results to pressure the local RRC to consider increasing the PICU time spent by housestaff. We are looking for other sources for funding and I have contacted Rich Brilli to see if the SCCM will provide us with support.

I would also like to draw your attention to the recent "Review Article" on Pediatric Residency Education by Mulvey et al (FOPE II project) in the August issue of Pediatrics. I look forward to your comments since I believe that it continues to sell the PICU experience short and that it once again appears to favor the NICU rotations/experience. Maybe we can discuss this when we meet at the SCCM.

There has been a fair amount of movement this summer of faculty and Margaret has assumed the role of Division Director in Birmingham, Alabama. She remains very involved in our committee's operation and I look forward to continuing to work with her on our projects. However, I would encourage more of you to write in with thoughts, ideas and advice to keep us going and giving us the feedback (positive or negative) which is so very important to keep us striving for more. It is hard to work in a vacuum. Dr. Pettignano has also moved - to Orlando and the transition has probably not given him the time to work on the curriculum. I have taken the liberty of listing topics that I believe are critical to our curriculum and look forward to your input.

1. Intubation
2. Mechanical Ventilation
3. Shock
4. Withdrawal of support, brain death and organ donation (ethics as they relate to our patient population)
5. ARDS
6. Management of intracranial hypertension
7. Sedation, analgesia and NMB
8. Vasoactive drugs and (hemodynamic monitoring)
9. Pharmacokinetics and pharmacodynamics
10. Enteral and parenteral nutrition
11. Renal replacement therapy and renal failure
12. Management of common PICU emergencies (hyperkalemia, DKA, status asthmaticus tumor lysis syndrome and status epilepticus)

I realize that most, if not all of us are already teaching/reviewing these topics at a minimum, however, I thought it important for us to define these topics and then move on to "assigning" or "volunteering" individuals to write/edit presentations (power point preferably) and handouts. What do you think ? I envision eventually having this teaching material (and the test) web-based.

Please stay in touch and, if you want your test scores analyzed, please have them sent to me by mid-December and we will attempt to get them analyzed before we meet at the SCCM. Please send the scores by mail or fax to me. The committee will meet either on Saturday February 10 from 3:30 to 4:30 pm or on Sunday February 11, 2001 from 5:15 to 6:15 pm. We look forward to seeing you there - I realize that the Fellowship Director's meeting is also at the same time on Sunday, hence our attempts to move the meeting to Saturday right after the Critical Care Course. I will send out another mailing as soon as the timing and location are finalized. If you are unable to attend our meeting and have an issue you want discussed, please let us know.

I am using the mailing list set up at the University of Minnesota mail server by Ken Tegtmeyer. I hope it still works since he has moved to Portland, OR. Finally, a reminder to keep sending new questions so we can build a question bank and also let us know what you think of questions on the current test (Version C) - specifics would be helpful, so we can drop the "clunkers".

Best Wishes to you, your families and colleagues for a joyful Holiday Season and a great New Year !

Mohan R. Mysore
PICU, Children's Hospital
8200 Dodge Street
Omaha NE 68114-4114
Tel: 402-955-4226
Pager: 402-977-7987
Fax: 402-955-3262
E-mail: mmysore@chsomaha.org

Margaret K. Winkler, M.D.
Associate Professor of Pediatrics
Pediatric Critical Care
The Children's Hospital of Alabama
1600 7th Ave. South, ACC#504
Birmingham AL 35233
Tel: 205-939-9387
Fax: 205-975-6505
E-mail: MWinkler@peds.uab.edu

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