Determining the paediatric educational needs of prehospital providers: part 1

Abstract

Caring for paediatric patients presents unique challenges to prehospital personnel who may have limited training, experience and confidence caring for children. The State of Oregon recently increased its paediatric training requirements for prehospital providers; however, little is known about the specific educational needs, barriers, and preferences of providers in this largely rural state. Objectives: the purpose of this study was to characterize the paediatric educational needs, barriers, and preferences of prehospital providers in Oregon. Methods: this was a qualitative analysis of 9 focus group discussions with a total of 64 prehospital providers from the State of Oregon. An iterative process of theme identification was used to generate themes, and then inter-rater checking was applied to confirm themes and assure inter-rater reliability. Results: participants identified a need for more paediatric training. They described knowledge gaps in assessing medically ill children, working with children with long-term medical conditions, and dealing with issues related to communication and the emotional difficulty of caring for children. Distance and cost were identified as barriers to attaining paediatric education, especially for rural providers. Other barriers included finding time for training and courses that are not designed specifically for the prehospital provider. Providers recommended increasing time spent with children during training by involving local schools and paediatricians. They recommended expanding the courses to include the areas where they felt less comfortable and increasing hands-on training opportunities. Simulation and online training were suggested as effective modalities to augment their trainings. Conclusion: our findings support previous studies that show prehospital providers feel less comfortable providing care to children.The specific barriers that our respondents identified can be related to the demographics of Oregon.To address the needs of prehospital providers in caring for children, we recommend: 1) expanding the curriculum to involve more time with children and an increased emphasis on assessing medically complicated children; 2) take measures to assure that the training is affordable and accessible to providers in different practice settings, and does not require long distance travel to attend; and 3) use online training modules and simulation to bring flexible ‘hands-on’ training to providers.