Table 3.
Number (N) and percentage (%) of GPeds with little to no experience performing the procedure during residency training along with representative quotes that provide explanation for their lack of experience
| Procedure | Number N () Participants Commenting Little to No Experience | Representative Quote |
|---|---|---|
| Bag Mask Ventilation | 7 (13.7) |
‘Bag valve mask ventilation was mostly through simulation … the only time that I was exposed to doing bag valve mask ventilation was in the NICU during resuscitation and not super frequently.’ ‘I can’t say that I remember a time when I actually bagged a[n] older kid.’ |
| Neonatal Endotracheal Intubation | 5 (9.8) |
‘I can’t say that I’ve ever successfully done this on a real person. I put like a couple LMAs, but I never actually intubated a live person.’ ‘I did intubate some babies in the NICU [but] I never had more than one attempt.’ |
| Umbilical Catheter Placement | 3 (5.9) |
‘I was kind of a witness to one. I don’t think overall this is something that we do repeatedly.’ ‘I learned this as well in a skill lab during my residency training and probably had like three attempts throughout my residency career to do the umbilical catheter placement.’ |
| Lumbar Puncture | 3 (5.9) |
‘I don’t know that I have a lot of vivid memories of [learning] these.’ ‘I probably did only two lumbar punctures.’ |
| Simple Laceration Repair | 12 (23.5) |
“I honestly don’t feel like I ever really learned that, which I should have but I really never did … ‘In residency, the only time we got to do that was in the emergency room and even then, we didn’t get to do it very often because they had so many suture techs working.’ |
| I & D of abscess | 10 (19.6) |
‘Honestly, I don’t think I ever did that because the suture techs always did that.’ ‘Not a lot, not as many as I wanted to just because it’s always like hit or miss with your emergency department shifts, but I felt like that’s something I could do in my office. But I don’t really feel comfortable with it.’ |
| Reduction of a Simple Dislocation | 51 (100) |
‘Reduction … that is probably the one I’m least comfortable with because I really didn’t do a ton of that at all. I’ve never even done a nursemaid’s yet.’ ‘I did like two or three nursemaid’s. I never fixed a dislocated joint or anything like that. I definitely wasn’t trained on any of that.’ |
| Temporary Splinting of a Fracture | 18 (35.3) |
‘I can tell you I never actually did a temporary splint of a fracture.’ ‘I think I was supposed to learn this in the ED, but don’t think I did, and I have no idea how to do it. I didn’t learn anything or definitely did not get enough formal practice.’ |
| Giving Immunizations | 24 (47.1) |
‘I don’t think I was ever trained on giving immunizations. I mean no one said “Here’s the thing. Go ahead and give it.” I mean I knew what to do, but I don’t think I was every trained.’ ‘I never gave a shot as a resident, never.’ |
| Bladder Catheterization | 12 (23.5) |
‘I did not and still do not have a lot of experience cathing [sp].’ ‘I would assess the need and order it, but I never placed a bladder catheterization.’ |
| Peripheral Intravenous Catheter Placement | 23 (45.1) |
‘I remember attempting some IVs as a resident. I don’t recall if I was ever successful at doing one.’ ‘IV placements? I wish we would have gotten more of because we didn’t get a whole lot of practice with that.’ |
| Venipuncture | 17 (33.3) |
‘I actually probably did more of those as a med student rather than a resident. As a resident, we really didn’t do venipunctures.’ ‘I did arterial punctures. This is just venipuncture? I think I did maybe a couple.’ |
| Removal of a Foreign Body | 13 (25.5) |
“I don’t recall ever doing unless it was something like in the ear canal which I thought I could get it out by forceps or something like that. Nasal canal that I could get to. So, a couple times. And definitely not frequently. ‘Yeah. I honestly don’t remember ever having the opportunity to remove a foreign body from anything.’ |
Abbreviations: LMA = Laryngeal Mask Airways; NICU = Neonatal Intensive Care Unit; NRP = Neonatal Resuscitation Program; PALS = Pediatric Advanced Life Support; PICU = Pediatric Intensive Care.