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Fulltext How can we improve code blue training for non-paediatricians: an experience from students-conducted assessment in national clinical skills conference

Khoo, Erwin Jiayuan, Kutzsche, Stefan

Malaysian Journal of Paediatrics and Child Health, 2018;24(1):27-42.

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Introduction: Training of all health personnel involved in paediatric care is a key determinant of successful outcome during paediatric emergencies. We aimed to identify the need for paediatric Mock Code Blue skills training among non-paediatricians in a pre-hospital setting through checklist assessment of their performance. Methods: A paediatric septic shock and cardiac arrest Mock Code Blue pre-hospital scenarios were presented for non-paediatricians during a National Clinical Skills Conference. Eight medical student assessors and four clinical facilitators were involved in this training. Participants were expected to be able to demonstrate the skills and teamwork necessary to managepaediatric emergencies according to the learning outcomes. Results: A total of 97 delegates participated in a facilitated paediatric Mock Code Blue for multidisciplinary groups of health personnel. Outcome measures showed a significant lack of communication and team work skills, and weakness in “closing the loop” as barriers to successful resuscitation. Conclusion: We recommend Mock Code Blue simulation training to be offered regularly to all groups of healthcare providers involved in paediatric and neonatal care while not overlooking the emphasis on non-technical skills.

John Langdon Down (1828-1896) - a pioneer in caring for mentally disabled patients

Kutzsche S

Acta Paediatr, 2018 11;107(11):1851-1854.

PMID: 30028542 DOI: 10.1111/apa.14505

How Cicely Williams (1893-1992) accelerated progress in maternal and child health during the 20th century

Khoo EJ, Kutzsche S

Acta Paediatr, 2024 Apr 21.

PMID: 38644646 DOI: 10.1111/apa.17251

Fulltext Applying educational theories into planning a psychomotor learning activity: an undergraduate neonatal resuscitation programme experience

Khoo EJ, Chua SH, Kutzsche S

Arch Argent Pediatr, 2019 04 01;117(2):e181-e187.

PMID: 30869503 DOI: 10.5546/aap.2019.eng.e181

The Neonatal Resuscitation Programme is a good example of an effective educational intervention that has improved perinatal mortality rates in many countries. This paper shares our experience of planning an undergraduate Neonatal Resuscitation Programme using basic principles of education theory of spiral curriculum, Bloom's taxonomy in planning learning outcomes, Kolb's learning model and Miller's model of clinical assessment. Engaging clinicians in pedagogical theories may not be well aligned with how clinicians traditionally thought they learnt best, yet it is key to improving learning concept and educational intervention outcomes in the healthcare professions. This article aims to illustrate the application of such educational theories into one example of practice. We structured this paper in the scope of content, delivery and assessment when planning a psychomotor learning activity.

Fulltext Neonatal alloimmune thrombocytopaenia associated with maternal HLA antibodies

Wendel K, Akkök ÇA, Kutzsche S

BMJ Case Rep, 2017 Jul 05;2017.

PMID: 28679510 DOI: 10.1136/bcr-2016-218269

Neonatal alloimmune thrombocytopaenia (NAIT) generally results from platelet opsonisation by maternal antibodies against fetal platelet antigens inherited from the infant's father. Newborn monochorionic twins presented with petechial haemorrhages at 10 hours of life, along with severe thrombocytopaenia. Despite the initial treatment with platelet transfusions and intravenous immunoglobulin, they both had persistent thrombocytopaenia during their first 45 days of life. Class I human leucocyte antigen (HLA) antibodies with broad specificity against several HLA-B antigens were detected in the maternal serum. Weak antibodies against HLA-B57 and HLA-B58 in sera from both twins supported NAIT as the most likely diagnosis. Platelet transfusion requirements of the twins lasted for 7 weeks. Transfusion of HLA-matched platelet concentrates was more efficacious to manage thrombocytopaenia compared with platelet concentrates from random donors. Platelet genotyping and determination of HLA antibody specificity are needed to select compatible platelet units to expedite safe recovery from thrombocytopaenia in NAIT.

Parents' perceptions of bedside teaching

Khoo EJ, Parameshwara N, Kutzsche S

Clin Teach, 2019 10;16(5):497-501.

PMID: 30421519 DOI: 10.1111/tct.12967

BACKGROUND: Bedside teaching (BST) in a hospital setting can play an important role during medical students' clinical placements in paediatrics. Parents often feel obliged to allow their child to participate, even if they are reluctant. The aim of this study was to examine the perceptions of parents who, with their children, were involved in medical students' BST.

METHODS: Consenting parents participated in a semi-structured interview assessing their experience of having their child involved in BST. The qualitative data were analysed using thematic analysis. Parents were assured that their children's treatment would not be negatively affected in the case of withdrawal from the study.

RESULTS: A total of 54 parents responded and discussed their experience of their children's participation in clinical teaching. The majority of parents were keen to support medical students' learning, and felt that they could develop better insight into their child's health in association with the teaching session. Some parents found the sessions tiring; their interest increased when they were more actively involved in planning the BST sessions.

DISCUSSION: This study emphasises children's and adolescents' autonomy as a main principle in making decisions about involving them in BST. Clinical teachers often face problems attempting to properly plan and conduct BST sessions. Parents appreciate having an active role in planning the sessions and are supportive of medical student education. Clinical teachers must ensure that they protect the best interests of paediatric patients and their parents. At the same time, they should advocate for the obvious benefits of BST.

Fulltext Stronger and More Vulnerable: A Balanced View of the Impacts of the NICU Experience on Parents

Janvier A, Lantos J, Aschner J, Barrington K, Batton B, Batton D, et al.

Pediatrics, 2016 09;138(3).

PMID: 27489297 DOI: 10.1542/peds.2016-0655

For parents, the experience of having an infant in the NICU is often psychologically traumatic. No parent can be fully prepared for the extreme stress and range of emotions of caring for a critically ill newborn. As health care providers familiar with the NICU, we thought that we understood the impact of the NICU on parents. But we were not prepared to see the children in our own families as NICU patients. Here are some of the lessons our NICU experience has taught us. We offer these lessons in the hope of helping health professionals consider a balanced view of the NICU's impact on families.

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