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Background: Poorly managed pediatric pain has negative long-term outcomes, including needle phobia, increased pain and anxiety with subsequent procedures, and healthcare avoidance in adulthood. Evidence-based interventions to reduce procedural pain and anxiety are vastly underutilized, and a literature search revealed no specific curriculum to teach residents optimal skills for pain and anxiety management in minor procedures (e.g. venipuncture, laceration repair). Thus, we developed a multimedia-based lecture with PowerPoint, utilizing results from a focus group interview (conducted with 7 pediatric residents, to determine educational content and identify residents’ needs and learning preferences).

Objective: To measure residents’ learning outcomes (knowledge, attitudes, perceived competence, and practice change) and satisfaction with a newly developed procedural pain and anxiety curriculum.

Design/Methods: Pediatric and combined internal medicine/pediatric residents were invited to complete the curriculum online through the in-house learning management system (Cornerstone) during their emergency medicine rotation. Data were collected between July 2019 and June 2020 (pre- and post-tests, as well as a follow-up survey 3-12 months later). McNemar’s test was used to measure pre- and post-test knowledge gains while Wilcoxon signed-rank test was used to compare changes in attitudes, perceived competence, and reported changes in procedural management.

Results: Seventy-two residents were invited to participate, with 28 completing the intervention with pre- and post-tests (39% completion rate) and 12 of those residents completing the follow-up survey. Residents increased their knowledge by 24.3% (p<0.0001) (Figure 1). There was no significant change in attitudes towards pain and anxiety management. Positive improvements, although non-significant, were seen in perceived competence and reported change in medical practice (Figures 2 and 3). Course evaluation data found that 75% of residents planned to utilize knowledge from the course in the next few weeks (Table). The majority of residents who completed the follow-up survey reported that knowledge learned in the course improved their practice and/or led to changes in their practice.

Conclusion(s): Early outcomes of the curriculum revealed significant knowledge increase. Additionally, these results provide a foundation for evaluation of an online game-based version of the curriculum, which we plan to make available to learners beyond our home institution.

Presented at the 2021 PAS Virtual Conference


Emergency Medicine | Medical Education | Neurology | Pediatrics

Teaching Pediatric Procedural Pain and Anxiety Management to Residents: Early Outcomes of a Newly Developed Curriculum