159 Procedural Skills Needs for Canadian Paediatricians: A National Snapshot
Bibliographic record
Abstract
Procedural practice by paediatricians in Canada is likely evolving. The availability of non- or minimally invasive technologies, practice type, geographical variation, and the expanding scope of multiprofessional providers are examples of factors that may contribute to such changes. There is, however, limited knowledge of the procedural competencies required of general paediatricians today. An accurate understanding of the skills required is vital for planning, preparing, and allocating limited educational resources both for current and future paediatricians. The primary objective of the study was to conduct a comprehensive analysis of the procedural practice of Canadian paediatricians, with the aim of building a needs assessment for independent general paediatric practice. A one-time survey was sent to paediatricians through the Canadian Paediatric Surveillance Program (CPSP) (www.cpsp.cps.ca/surveillance). In addition to demographic information about practice type and location, participants were asked to indicate the frequency with which they performed each of 32 pre-selected procedures. The procedure list was developed in consultation with CPSP members and a variety of paediatricians. Data was combined and summarized descriptively, with valid percentages calculated where appropriate. The survey response rate was 33% (938/2,822). Of the respondents, 589 (63%) participated either partly or entirely in general paediatrics practice, and 245 (42%) had practiced for > 20 years. All provinces were represented, and practice styles ranged from urban tertiary care to remote/rural. Of the respondents who practice general paediatrics, 71% reported performing procedures. Regularly performed procedures (at least monthly) included bag-mask ventilation for infants, lumbar puncture, ear curettage, peripheral intravenous line insertion and immunization (indicated by 54%, 48%, 39%, 27%, 25% of respondents, respectively). Rarely performed procedures (yearly or less) included chest compressions, intraosseous insertion, intubation, chest tube insertion and defibrillation (80%, 65%, 57%, 53%, 52%, respectively). Procedures reported as never performed included peripheral intravenous central catheter (PICC) line insertion, central venous line (CVL) insertion, arterial line insertion, tracheostomy tube change and thoracentesis (90%, 89%, 82%, 76%, 73%, respectively). This report of real-world experiences from Canadian general paediatricians suggests a wide variability in the frequency of procedural performance. It helps to establish priorities for continuing professional educational activities and postgraduate medical education curricula in the era of competency-based medical education. Additional investigation on importance and maintenance of proficiency of these procedures would be of added value to this needs assessment, and has been undertaken by the research group.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.005 | 0.011 |
| Science and technology studies | 0.005 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".