CAP is one of the leading illnesses that cause both morbidity and mortality among children worldwide. Guidelines for the management of CAP in infants and children older than 3 months of age were published by PIDS and IDSA in 2011. We designed this study to identify knowledge gaps in the management of CAP among Pediatric residents and to improve the knowledge of residents regarding existing IDSA CAP guidelines for children.
A set of 10 case scenario based multiple choice questions (MCQ) regarding diagnosis and management of CAP were administered to pediatric residents. Each question was assigned 1 point, with 10 being the maximum score. The specific areas assessed were: Triaging patients with CAP to appropriate site of care, diagnostic evaluation, antimicrobial therapy, adjunctive surgical therapy, contingency planning for patients not responding to therapy, discharge criteria and prevention of CAP. The study group attended a presentation covering current IDSA management guidelines of CAP in children and the control group did not. Both groups received a copy of the IDSA CAP guidelines to review. Two weeks later a 10 MCQ post-test, assessing the above mentioned areas was administered to both the groups.
Pre-test questionnaires were administered to 52 residents, 22 (42%) of whom were 1st yr residents. The mean score was 5.3±1.5. Most correct responses (73.0%) were received for questions on selection of antimicrobial therapy. The question on adjunctive therapy was poorly scored with only 13.4% correct responses. There was significant difference between test scores of junior (1st yr) and senior residents (2nd & 3rd yr) (4.6 vs. 5.8, p=0.004).
36 post-tests were administered to 17 controls and 19 study participants. There was significant improvement in mean post-test scores (5.2 vs. 6.0, p=0.0047) among all participants. There was no significant difference in mean post-test scores between the control and study groups (6.1 vs. 5.9, p=0.67).
Conclusion: Our study shows that deficiencies exist in pediatric residents’ knowledge of CAP management based on existing IDSA guidelines. There was improvement in test scores after residents were provided with the IDSA CAP guidelines to review. Awareness and appropriate clinical application of the published guidelines to patient management of CAP is important to improve outcomes in children.
B. Asmar, None