Sakina Sojar,1 Caitlin Li,2 and Lauren
Goverman3
1)
Pediatric Emergency Medicine Fellow, PGY4,
Hasbro Children’s Hospital, Brown University
2)
Pediatric Resident, PGY3, Massachusetts General
Hospital for Children
3)
Pediatric Resident, PGY2, Massachusetts General
Hospital for Children
See One, Do One, Teach One May Be Traditional, But There’s a Better Way!
Learning how to do procedures as a trainee can be
exhilarating but stressful. Not only do you have to remember all the steps of
the procedure, which supply closet has the extra LP needles, and what percent
lidocaine your attending prefers, it’s also essential to obtain high-quality
informed consent. For many skills that residents learn, there’s a standard
resource they can use to make sure they’re not letting anything slip—shouldn’t they
be equally supported in obtaining informed consent?
Lumbar punctures are one of the most common procedures
performed by pediatricians, and we noticed that every resident has their own
style for obtaining informed consent. Interns learn from their senior residents
and attendings, then adapt the consent process fit their own style. After a
literature review, we decided that the best strategy to address this variation
in consent quality would be to create an electronic tool that could guide the process
and ensure that every family had an equal opportunity to learn about the risks
and benefits prior to consenting to the procedure.
As a team, we designed a prototype model that could be displayed
on an iPad, then went through cycles of cognitive interviews with families who
were visiting the pediatric emergency department. Each cycle, we implemented
families’ suggested changes into the tool until we consistently received
feedback that they liked the design and felt that it helped them adequately
understand the procedure. Like any research project, we ran into delays ranging
from IRB submissions to lack of space in the busy emergency department, but in
the end we were pleased to have a tool that can improve the quality of care we
provide to our patients. We’re looking forward to integrating it into pediatric
residents’ clinical work flow!
For us, this project reinforced the importance of teamwork
and collaboration. By having multiple residents working together, we were able
to move forward even when some of us were on busy clinical rotations, and we
were able to see the project through to the end even when our fearless leader
moved to another institution to start her fellowship. We also realized what a
valuable resource the GME office is, and we’re so grateful to them for
supporting this project!
