Integrating Community Based Injury Prevention for Pediatric Residents

Injury is the leading cause of mortality among children. Others have demonstrated pediatric residents are not prepared to provide recommended injury prevention counseling.

An injury component (one half day per week) was initiated for third year pediatric residents during a required four-week rotation. Sessions included physician-led didactics, injury manual review, role-playing and interaction with caregivers at a mobile child safety center. Surveys were administered prior to initiating the rotation and again shortly after course completion.

Twelve pre and post surveys were completed. More residents reported feeling “very comfortable” doing safety counseling with parents after the experience. (75% vs 8%). Mean summary scores of knowledge significantly increased from baseline of 9/18 to 12/18 (p < .01).

At baseline, 11/12 residents correctly identified proper bike helmet fit and choking hazards. However, only one resident correctly reported smoke detector maintenance guidelines. None correctly answered the recommended height for booster seat graduation.

At follow up, all residents but one increased their scores. As a group, residents increased knowledge of prevention in all areas except gun storage (10/12 answered correctly on both surveys). Though improved, areas of weakness remained in areas such as epidemiology, booster seat graduation and counseling on swimming lessons.

This study demonstrated that senior pediatric residents had insufficient information regarding basic injury prevention. A brief exposure increased specific knowledge of recommended messages and self-described comfort with injury prevention counseling. Yet, there remain critical areas where knowledge is lacking. Dedicated time to injury prevention should be included in all years of residency training.