O3207: PICU Passport: A Multicenter Study of a Handheld Resident Curriculum

Background: Pediatric resident learning primarily occurs through clinical experiences. However, there is variability between programs and even within them in the types of patients and pathologies that residents encounter. Similar discrepancies occur in the pediatric intensive care unit (PICU), where all pediatric residents rotate. In the PICU, residents are often exposed to various modes of education via lectures, reading assignments, or a resident PICU handbook. However, given the rigors of clinical care in the PICU, it is unclear if these teaching methods are routinely completed. We sought to streamline resident learning and evaluate the impact of a handheld checklist curriculum called the “PICU Passport” on residents rotating in the PICU at six different U.S. residency programs.

Methods: The topics and procedures of the PICU Passport were selected based on national requirements for pediatric residents. Passports were given to residents at six different institutions at the beginning of their PICU rotations. Residents were surveyed before and after their rotations about their educational experiences and self-reported comfort caring for critically ill children. Residents who completed a prior PICU rotation and filled out the pre-rotation survey were included in the initial data analysis.

Results: 476 total residents that had previously rotated through the PICU responded to the pre-Passport survey and 192 residents responded to the post-survey. Among pre-Passport survey respondents, 65% felt that teaching was targeted, 78% thought faculty were engaged in teaching, and 92% thought they acquired skills and knowledge important to their pediatrics residency. In contrast, among those that responded to the post-Passport survey questions, 80% felt that teaching was targeted, 81% thought faculty were engaged in teaching, and 95% thought they acquired important skills and knowledge. 78 residents who had previously rotated through the PICU responded to both pre- and post- Passport surveys. These residents felt more prepared to plan the initial management of a critically ill child (67% vs. 92%; P < 0.001) and comfortable caring for a critically ill child while determining disposition for a higher level of care (39% vs. 74%; P < 0.001) after an additional month in the PICU with the Passport. 24 residents responded both pre and post-Passport to the education-focused questions which showed no significant difference in satisfaction with their educational experiences, reception of targeted teaching from faculty, or empowerment to ask faculty for targeted teaching. Of 186 resident respondents, 48% felt the Passport helped identify gaps in knowledge and skills and 59% felt the tool was easy to use.

Conclusion: The PICU Passport potentially enhances resident learning in the PICU, leading them to feel more prepared and comfortable in the management of a critically ill child. Many residents found the passport easy to use and helpful in identifying knowledge gaps.