The development of a national pediatric trauma curriculum

Figures & data

Table

Practice points

Current programs do not offer enough material related to pediatric trauma. Modified Delphi techniques can provide an excellent means of obtaining consensus on curriculum content. Future direction would include validating the results using a ranking system.

Figure 1. Development of level 1 draft.

Figure 2. Schematic representation for the development of the level 2 draft.

Table 1.  Domains for the pediatric trauma curriculum

Domains selected by initial four expert panels
Introduction to pediatric trauma, epidemiology, burden of illness, and trauma prevention
Assessment and initial management of pediatric trauma patient
Assessment and management of pediatric airway
Assessment and management of shock
Assessment and management of thoracic injuries
Assessment and management of abdominal and pelvic injuries
Assessment and management of spinal and neurological injuries
Assessment and management of pediatric head injuries
Assessment and management of pediatric burns and electrical injuries
Assessment and management of pediatric orthopedic injuries

Table 2.  Summary of feedback from the site coordinators

Overall

• It was valuable to include general trauma objectives.

• Consider further objectives in the future – eye trauma, facial trauma, and penetrating neck trauma.

• When developing a course based on this, consider having different ages (neonates, preschoolers, school-aged children, and adolescents) as part of the cases to show the age-related differences.

• Consider changing the format to CanMEDS.

• Consider having ATLS as a prerequisite if developed into a course.

Objective specific

• Challenge the role of the diagnostic peritoneal lavage.

• Know the indications for the use of contrast when using CT scanning to help identify potential intra-abdominal/pelvic injuries.

• Knowledge of a general joint exam would be a better objective, with emphasis on a few special tests for the knee and shoulder examination.

• Is it important to distinguish the difference between spinal and neurogenic shock?

• Is there a need to differentiate the need for cuffed and uncuffed endotracheal tubes for airway management?

• Unsure of the detail needed for pediatric orthopedics and the dislocation reductions.

• The change in scoring system—in Quebec, minor head injury is 13–15.

• There is a lack of evidence for the second impact syndrome.

• Important to be aware of published guidelines for severe head injury, but recognize that they are guidelines.

• Appreciate that spinal cord injury without radiological abnormality (SCIWORA) may be delayed.

• Unsure of the detail required for all the fracture types.