Residents on the transport team. Balancing service and education
D. R. Durbin, A. P. Giardino and A. T. Costarino
Department of Pediatrics, Children's Hospital of Philadelphia (Pa), USA.
OBJECTIVES: To describe an educational program for pediatric house staff
who participate in interhospital transport and to present an evaluation of
the educational program. DESIGN: Educational program evaluation that used
multiple confidential surveys of participating pediatric house staff.
SETTING: The interhospital transport team of a large, urban pediatric
hospital. PARTICIPANTS: Twenty-six pediatric second-year residents who
participated in required rotations with the transport service.
INTERVENTION: The institution of an educational program designed
specifically for the clinical transport rotation. RESULTS: Before their
service with the transport team, residents have doubts about their clinical
skills, fund of knowledge, and ability to practice independently in a
mobile environment. These doubts decrease as the residents participate in
the educational program during their transport clinical service. All
residents perceive service on the transport rotation to be of educational
benefit with regard to communications or cognitive skills. Alternatively,
transport service provides little opportunity for residents to improve
technical skills. Among the various skills that residents could obtain
during transport service, improvement in clinical judgement was most
commonly cited by residents who performed more than 10 transports. Among
the specific curricular components in the educational program, interactive
teaching methods were judged to be more valuable than written materials.
CONCLUSIONS: Serving as a physician on interhospital transports can be an
important educational opportunity for pediatric house staff when that
experience is concentrated in a designated rotation and combined with a
focused educational program. Contrary to expectations, there was little
opportunity for residents to develop technical skills on transport.
Therefore, educators should focus on the development of communications and
cognitive skills. Interhospital transport programs that debate the use of
residents as members of the service should consider the potential
educational benefit of the clinical service to house staff.
