Pediatric injury prevention. Preparing residents for patient counseling

M. S. Wright
Division of Pediatric Emergency Medicine, Case Western Reserve University School of Medicine, Rainbow Babies and Childrens Hospital, Cleveland, Ohio, USA. msw5@po.cwru.edu

OBJECTIVES: To describe counseling practices on injury prevention and barriers to patient counseling by pediatric residents and determine whether education about injury prevention or use of educational aids promotes this activity in resident ambulatory practices. DESIGN: Cross-sectional mail survey. SETTING: Accredited US pediatric residency programs. PARTICIPANTS: Pediatric chief residents. MAIN OUTCOME MEASURE: Reported frequencies of patient counseling performed on various injury prevention topics. RESULTS: All residents reported that they were expected to educate patients and families about injury prevention in the continuity clinic setting. Almost all residents (98.5%) reported that they counseled on at least 1 injury prevention topic. On all topics except for poisoning prevention, residents were most likely to counsel patients and families on those topics about which they had received education. Additionally, those residents familiar with the American Academy of Pediatrics The Injury Prevention Program included more injury prevention topics in their counseling repertoire (P = .01). The most frequently identified barriers to counseling included lack of information about the topic and lack of time in the visit. CONCLUSIONS: Most pediatric residents counsel their patients and families on a variety of injury prevention topics. This activity is promoted by the education offered during residency training. Focused efforts should be made to educate residents about those injury topics not being taught and to address counseling barriers with educational interventions that promote prevention counseling during patient visits.

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