486 - National Landscape of Neonatal-Perinatal Medicine Fellowship Advanced Airway Curricula and Assessment Techniques

Poster Number: 486
Publication Number: 486.124

Mark R. Castera, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; Brielle Formanowski, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; Heather French, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States

Background: Tracheal intubation (TI) is an ACGME-required skill for Neonatal-Perinatal Medicine (NPM) fellows to develop; yet there is no standard for TI training in NPM fellowship programs. Individual NPM fellows attain TI competency at variable times during fellowship. The best training structure to support TI competency development is unknown.

Objective: 1. Characterize US NPM fellowship TI education & assessment practices.
2. Explore how NPM fellowship size & educational resource availability impact TI education.

Design/Methods: We conducted a cross-sectional study of NPM fellowship leaders in Sept 2022. A 32-item survey was created using iterative review by 6 NPM education experts. Survey questions to understand TI education practices, barriers, assessment practices, and perceived effectiveness used Likert scale ratings, multiple-choice, & free-text responses. The survey was sent electronically to all US NPM fellowship leaders. Data was collected by REDCap.

Results: 89% (98/110) of fellowship programs responded to the survey, and program demographics are reported in Table 1. Large programs report higher airway curriculum satisfaction (p=0.009) and more hands-on TI training during clinical orientation (p=0.012) than small and medium programs. Differences between programs that report higher versus lower satisfaction are shown in Table 2. Programs with highest curriculum satisfaction report fewer time-constraints (p=0.012) and fewer equipment shortages (p=0.036).  There is wide variability in preferred definitions for TI competency among all programs, regardless of size (Figure 1). TI competency is typically reviewed every 6 months. The number of TI attempts by graduation (median=50, IQR 36.25 to 63.75) and expected success rate (median=80, IQR 75 to 85) for graduating fellows were variable.

Conclusion(s):

Significant variability exists in educational curricula and resources for TI training in NPM programs. Compared to small and medium programs, large programs report greater curricular satisfaction. Various curriculum components affect educator satisfaction.  Trainee TI competency is poorly defined & reviewed infrequently by many NPM programs. Programs report variable numbers of TI completion by graduation. Next steps are interviews with NPM program leaders to explore TI competency definitions & optimal training approaches. Future investigation is needed to determine which TI educational & assessment practices correlate with improved clinical performance.