Pediatr Emerg Care. 2020 Feb;36(2):e66-e71. doi: 10.1097/PEC.0000000000001139.
Parents' Perspective on Trainees Performing Invasive Procedures: A Qualitative Evaluation.
Pediatric emergency care
Madeline L McCarthy, Lindsey T Chaudoin, Mark R Mercurio, Elizabeth G J O'Brien, Sweta Bhargava, Sarah Y Cohen, Marc Auerbach, Gunjan Tiyyagura
- From the Department of Pediatrics, Yale-New Haven Hospital, New Haven, CT.
- Department of Pediatric Emergency Medicine, Columbia University College of Physicians and Surgeons, New York, NY.
- Yale School of Medicine.
- Timothy Dwight College, Yale University, New Haven, CT.
OBJECTIVES: When obtaining informed permission from parents for invasive procedures, trainees and supervisors often do not disclose information about the trainee's level of experience. The objectives of this study were 3-fold: (1) to assess parents' understanding of both academic medical training and the role of the trainee and the supervisor, (2) to explore parents' preferences about transparency related to a trainee's experience, and (3) to examine parents' willingness to allow trainees to perform invasive procedures.
METHODS: This qualitative study involved 23 one-on-one interviews with parents of infants younger than 30 days who had undergone a lumbar puncture. In line with grounded theory, researchers independently coded transcripts and then collectively refined codes and created themes. Data collection and analysis continued until thematic saturation was achieved. In addition, to triangulate the findings, a focus group was conducted with Yale School of Medicine's Community Bioethics Forum.
RESULTS: Our analysis revealed 4 primary themes: (1) the invasive nature of a lumbar puncture and the vulnerability of the newborn creates fear in parents, which may be mitigated by improved communication; (2) parents have varying degrees of awareness of the medical training system; (3) most parents expect transparency about provider experience level and trust that a qualified provider will be performing the procedure; and (4) parents prefer an experienced provider to perform a procedure, but supervisor presence may be a qualifying factor for inexperienced providers.
CONCLUSIONS: Physicians must find a way to improve transparency when caring for pediatric patients while still developing critical procedural skills.