Implementing and evaluating an injury prevention curriculum within a pediatric residency program.
ABSTRACT Many pediatric residency programs struggle to incorporate injury prevention training into their curricula.
To analyze whether a 2-week injury prevention course helps pediatric residents to learn and retain more information than their peers who receive the standard education on injury prevention topics.
A mandatory 2-week injury prevention course is provided for all interns at Cincinnati Children's Hospital Medical Center (CCHMC). Residents at CCHMC, completed a 50-question test on basic injury prevention topics at intern orientation and at the end of their first and third years of training. A control group of two intern classes from comparable children's hospitals who did not receive the injury prevention course were given the identical test at similar time periods. Data were analyzed using SPSS, and t tests were used to calculate and compare the mean percent change in test scores.
Seventy-six pediatric interns were enrolled (33 intervention and 43 controls). After internship, posttests were obtained on 29 (88%) intervention residents and 38 (88%) controls. On completing residency, posttests were received from 16 (48%) CCHMC residents and 22 (51%) controls. There was no difference in demographics or prior injury prevention training between the groups at study enrollment. A total of 63.6% of controls reported receiving injury prevention training by the end of their residency. There was a significant difference in the improvement of mean test scores between the intervention and control groups after internship (14.1% vs. 3.2%; p < 0.001) and again after the third year (11.9% vs. 5.5%; p = 0.02).
An injury prevention curriculum for pediatric residents can significantly increase and sustain their fund of knowledge on these important topics.
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ABSTRACT: To ascertain and compare beliefs, attitudes, and counseling practices of primary care physicians of children and adolescents regarding firearm injury prevention counseling. Cross-sectional survey. State of Washington. All active members of the state chapters of the American Academy of Pediatrics and American Academy of Family Physicians. A total of 979 pediatricians and family physicians (53%) responded to the survey after two mailings. Attitudes, beliefs, and current practices with regard to firearm safety counseling among families of child and adolescent patients. Only 25% of pediatricians and 12% of family physicians currently counsel more than 5% of their patients. Pediatricians were more likely than family physicians (70% vs 46%, P < .001, chi 2 test) to believe that physicians have a responsibility to counsel families about firearm safety. Pediatricians recommended removing guns from the home more frequently than family physicians (32% vs 19%, P < .001, chi 2 test), but most physicians of both specialties perceived that parents are rarely receptive to this advice. However, 97% of physicians from both specialties agreed that firearms should be stored locked separately from ammunition, and a substantial majority believed that parents would be receptive to this advice. Compared with physicians who owned guns (32%), non-owners were 15 times more likely (odds ratio, 15; 95% confidence interval, 10 to 23) to agree that families with children should not keep firearms in the home. Few primary care physicians who see children and adolescents currently counsel families about firearm safety, although many agree that they have such a responsibility. At least half of these physicians would potentially benefit from an intervention to improve their knowledge of and counseling skills on this topic.Archives of Pediatrics and Adolescent Medicine 10/1995; 149(9):973-7. · 4.25 Impact Factor
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ABSTRACT: The American Academy of Pediatrics believes that health education, through office-based counseling, can contribute to childhood injury prevention. This report extends previously published work on the effectiveness of primary care-based counseling and compares the costs and estimated monetary value of the benefits of safety counseling targeting children ages 0 to 4 years. We estimate the savings achievable with comprehensive childhood injury prevention counseling organized around the three Framingham Safety Surveys used in The Injury Prevention Program (TIPP) developed by the American Academy of Pediatrics. We verify the estimated savings by comparing them with the effects of pediatrician counseling from separate analyses of the most fully evaluated interventions--in child motor vehicle occupant injuries, burns, and falls. TIPP pediatrician injury counseling sessions between the ages of 0 and 4 years can achieve estimated savings of $880 per child or $80 per visit. If all 19.2 million children ages 0 to 4 years completed TIPP, we estimate that $230 million would be saved annually in medical spending, and injury costs would decline $3.4 billion. each dollar spent on TIPP childhood injury prevention targeting children ages 0 to 4 years returns nearly $13. TIPP pediatrician injury counseling is a cost-effective method of preventing childhood injuries and should be more widely adopted.Pediatrics 08/1995; 96(1 Pt 1):1-4. · 5.30 Impact Factor
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ABSTRACT: The American Academy of Pediatrics (AAP) believes that health education, through office-based counseling, can contribute to childhood injury prevention. This report presents the results of a critical review of the scientific literature on the effectiveness of primary care-based counseling to prevent childhood unintentional injury. A panel selected from the AAP Committee and the AAP Section on Injury and Poison Prevention searched the English-language scientific literature for all articles about childhood unintentional injury prevention counseling. A standardized format was developed to record data on each study. Two members of the panel independently reviewed each article. Articles that were original reports and in which unintentional injury prevention counseling took place in a primary care setting were included. Articles were encoded and analyzed by computer and then grouped by quality of evidence using the US Preventive Services Task Force (USPSTF) method of categorizing results of medical care evaluation. Articles were rated by strength of study design in order to compare studies within each USPSTF group. Twenty articles met the criteria for inclusion. Of these, 18 showed positive effects of injury prevention counseling including five randomized/controlled, 10 non-randomized/controlled, two multiple time series, and one descriptive study. In 15 of the positive studies, physicians performed the counseling. Positive outcomes as measured by increased knowledge, improved behavior, or decreased injury occurrence were reported for both motor vehicle and non-motor vehicle injuries. The literature review supports the recommendation of the AAP to include injury prevention counseling as part of routine health supervision. This recommendation has implications for health care reimbursement and care content.Pediatrics 11/1993; 92(4):544-50. · 5.30 Impact Factor