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PEM Pandemic Pivot: A Hybrid Approach to Pediatric Emergency Medicine Training in Thailand Allows for COVID-era Flexibility.

Published online by Cambridge University Press:  13 July 2023

Jessica Bailey
Affiliation:
Oregon Health & Science University, Portland, USA
Beech Burns
Affiliation:
Oregon Health & Science University, Portland, USA
Danielle Sullivan
Affiliation:
Oregon Health & Science University, Portland, USA
Melinda Hartenstein
Affiliation:
Oregon Health & Science University, Portland, USA
Pakorn Husen
Affiliation:
BDMS Samitivej Children's Hospital, Bangkok, Thailand
Hathaitip Chaiprapa
Affiliation:
BDMS Samitivej Children's Hospital, Bangkok, Thailand
Uthen Pandee
Affiliation:
BDMS Samitivej Children's Hospital, Bangkok, Thailand
Parit Plainkum
Affiliation:
BDMS Samitivej Children's Hospital, Bangkok, Thailand
Erin Burns
Affiliation:
Oregon Health & Science University, Portland, USA
Surangkana Techapaitoon
Affiliation:
BDMS Samitivej Children's Hospital, Bangkok, Thailand
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Abstract

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Introduction:

The COVID-19 pandemic poses challenges in maintaining global medical education partnerships, with travel restrictions and infection control concerns forcing program adaptation. The Pediatric Emergency Medicine Specialty Training and Accelerated Review (PEM-STAR) program is one such international collaboration which addresses education and training gaps in emergency care for children within Thailand. As an assessment of PEM-STAR’s ability to deliver consistent outcomes despite COVID-19 constraints, we compared program results for Cohort #1 (2018-2019, pre-pandemic) and Cohort #2 (2019-2021, spanning pandemic).

Method:

Oregon Health & Science University and Bangkok Dusit Medical Services implemented the PEM-STAR tandem physician-nurse curriculum in 2018. The cornerstone of the year-long course is a set of 22 PEM-specific topic modules, incorporating remote-accessible voiceover slide lectures, quizzes, and scholarly references to teach pediatric emergency medicine essentials. Content is reviewed via monthly teleconferences. Baseline and final assessments include written knowledge tests and high-fidelity simulation cases led by physician-nurse teams. Cohort #1 simulations were performed with evaluators in-situ using critical action checklists and validated teamwork assessment tools. Due to COVID-19 restrictions, Cohort #2 final assessments were hybrid; students completed Thailand-based simulations while Oregon leaders assessed and debriefed teams via videoconference.

Results:

Written exam scores for pre-pandemic Cohort#1 improved from 48.6% (95%CI 40.30-56.9) to 92.0% (95%CI 88.1-95.9) (p< 0.001). Cohort #2, during the pandemic, had scores improve similarly from 48.5% (95%CI 40.1-56.9) to 96.4% (95%CI 94.8-98.0) (p< 0.001). One-hundred percent of physician-nurse teams from both Cohort #1 and Cohort #2 achieved the program’s established passing score on final simulation testing: performing >85% of critical action items and scoring > 85% on the teamwork tool.

Conclusion:

The PEM-STAR design, with its emphasis on videoconferencing, web-based content, and asynchronous learning, required minimal modifications to maintain satisfactory knowledge and skill acquisition during the pandemic. Educational partnerships emphasizing these features have distinct sustainability advantages in times of global disorder.

Type
Lightning and Oral Presentations
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of World Association for Disaster and Emergency Medicine