Pediatric Resident Performance of the Rapid Cardiopulmonary Assessment
Status Manuscript Submitted
An analysis of pediatric resident performance of the rapid cardiopulmonary assessment (AKA the Primary Survey, the ABCs) in the resuscitation area of an urban Pediatric Emergency Department.
The Cumulative Pediatric Experiences of Emergency Medicine Residents
Status In Process
I am the primary mentor for one of our Pediatric Emergency Medicine fellow’s research project, which is an investigation of the cumulative clinical experiences of two classes of Emergency Medicine residents from the University of Cincinnati. We plan to utilize the electronic medical record to describe the breadth and depth of two since graduated classes of residents in both EDs at Cincinnati Children’s. We built a comprehensive data dictionary and plan to describe not only the diagnoses that residents evaluated, but also elect individual procedures and medical and trauma resuscitations. The scaffolding for our data dictionary was the American Board of Emergency Medicine content specifications. We hope to develop a process that other programs can utilize to assess their resident experience and improve their pediatric education and clinical experiences.
Pediatric Milestones in the Emergency Medicine Rotation
Status Data Analysis
We developed an online evaluation for the more than 250 trainees that rotate through the Emergency Department in order to capture shift based evaluations by their attendings and fellows. It features a customized customized Qualtrics survey optimized for mobile devices and after initial deployment in 2013 has been maintained with an eye towards ongoing improvement initiatives designed to increase and maintain faculty evaluation complete rates. The data we have amassed has helped us identify areas for improvement in dozens of residents in a manner that our previous processes couldn’t achieve.
Feedback Sticky Notes
Status In Process
Residents do many procedures in the ED. They rarely have the same preceptor more than once. In a decidedly low tech manner we have developed sticky notes that will allow residents to keep a record of procedure performance in the ED (LP, I&D) in their handbook that they will share with the next attending or fellow that precepts them.
Nurses Teaching Procedures to Pediatric Residents
Status Data Analysis
Residents need to know how to perform IVs and bladder catheterizations. Why shouldn’t the best teachers teach them. It just so happens that nurses are those teachers. We therefore developed a unique curriculum lead by nurses in order to train and precept residents in IVs and bladder caths. We also explored potential barriers to interdisciplinary education.
Residents selected for Rapid Sequence Intubation
Status In Process
Pediatric residents are not required to perform endotracheal intubation anymore. However, many will enter careers in which it is a key skill. Therefore we developed a new program in which select residents volunteered for advanced training not only in video laryngoscopy, but also in our detailed Rapid Sequence Intubation checklist.
The Residents As Teachers Curriculum
Status In Process
I helped develop a website to gather real-time feedback for pediatric residents precepting and teaching students. The study also involves reviewing video recorded interactions.
The Medical Resuscitation Committee
Status In Process
I am on a multidisciplinary committee of Emergency Medicine physicians, nurses and other health care professionals that focuses on the care of critically ill patients in the resuscitation area of the Emergency Department. We are collaborating to describe the development of our committee, including our in situ simulation, care algorithm and educational conferences which have lead to important interventions in the resuscitation area at Cincinnati Children’s. You can view our current care algorithms at mrc.pemcincinnati.com.
Patel A, Unaka N, Holland D, Schuler C, Mangeot C, Sucharew H, Younts A, Maag L, Treasure J, Sobolewski B, Statile A. A Quality Improvement Initiative to Increase Physical Exam Teaching on Family- Centered Rounds Utilizing a Web-based Tool. Pediatric Quality and Safety. In Press.
Patel A, Unaka N MD, Sobolewski B, Statile A. Five Steps for Success in Building Your Own Educational Website. Academic Pediatrics. Volume 17, Issue 4, May–June 2017, Pages 345–348. PMID: 28300656
I developed an educational website focused on the physical exam for residents rotating through the inpatient Hospital Medicine teams. We also gathered usage and experiential data and used our experience to offer advice on the design of educational websites. You can view the site at PhysicalExamToolkit.com.
Zackoff, M. W., DeBlasio, D., Sobolewski, B. and Klein, M. (2016), Implementation of point-of-care tools for assessment of teaching. Med Educ, 2016. 50: 1169. doi:10.1111/medu.13183. PMID: 27761997
Description of our efforts to use a customized website to evaluate resident teaching at the point-of-care. The site is live at RATC.pemcincinnati.com.
Sobolewski, B, Kerrey, BT, Geis, GL, Bria, CL, Mittiga, MR, Gonzalez del Rey, JG. The April Effect: A Novel Orientation Approach to Improve Rotation Transitions During Pediatric Residency. Academic Pediatrics, April 2016, Volume 16, Issue 3, Pages 220–223.
This study detailed our efforts to develop an online orientation for residents rotating through the Emergency Department at Cincinnati Children’s Hospital Medical Center. Following a targeted needs assessment we developed a multimedia orientation to address the challenges of orienting 30-40 residents from a multitude of training levels and programs to our ED. The current version is live at pemcincinnati.com/orientation. This study was also my Masters in Education thesis. I learned quite a bit about the full process of curriculum design.
Chang TP, Pham PK, Sobolewski B, Doughty CB, Jamal N, Kwan KY, Little K, Brenkert TE, Mathison DJ. Pediatric Emergency Medicine asynchronous e-learning: a multi-center randomized control Solomon-4-group study. Academic Emergency Medicine, 2014 Aug; 21(8):912-9.
A multi-site Solomon four group design whereby we randomized residents working in the ED to access to online educational modules. Module use improved post test scores in those randomized to the intervention, and ultimately we noted that web-based asynchronous e-learning potentially has the ability to standardize education among multiple institutions with common curricula, especially in the ED – a rotation that is far from standardized. Through participation in this study I was exposed to new methodology, and met new colleagues and friends that I continue to work with.
Sobolewski B, Richey L, Kowatch R, Grupp-Phelan J, Mental Health Follow-Up among Adolescents with Suicidal Behaviors after Emergency Department Discharge. Archives of Suicide Research, 2013;17(4):323-34.
My fellows research project. This was a prospective study of suicidal adolescents discharged from the ED. We noted that 1/5 returned to the ED within a very short time period for admission. I learned how to submit an IRB for the first time, as well as design a survey instrument and conduct statistical analysis (including everybody’s favorite – multivariable logistic regression).
Delgado A, Sobolewski B, Murtagh-Kurowski E. A tale of 2 torsions: Ovarian Torsion in Infants and Toddlers. Pediatric Emergency Care. 2013 Mar: 29(3):374-6.
A case report of two young children with ovarian torsion. The educational focus was on how abdominal pain can be difficult to assess in babies and toddlers.
Sobolewski BA, Mittiga MR, Reed JL. Atlantoaxial rotary subluxation following minor trauma. Pediatric Emergency Care. 2008 Dec;24(12):852-6.
A case report detailing a child with a seemingly minor injury that resulted in a rare diagnosis – one where the first and second cervical vertebrae are rotated and locked in place.
Sobolewski BA, Zgibor JC, Orchard TJ. ACE inhibitors and calcium channel blockers: patterns of use and associations with mortality in type I diabetes. Diabetes Research and Clinical Practice. 2004 Jul; 65(1):37-43.
I wrote this paper a long time ago during medical school, back when I was just getting my feet wet in academic medicine. I learned a lot about data abstraction and analysis and had the opportunity to present a poster at the American Diabetes Association’s Annual Meeting.
Books and Chapters
Sobolewski, B. Emergency Medicine Section: Med Study Pediatrics Core Curriculum, 8th Edition. The Med Study Corporation, 2015.
Sobolewski, B. Emergency Medicine Section: Med Study Pediatrics Core Curriculum, 7th Edition. The Med Study Corporation, 2015.
Sobolewski, B, Mittiga, M, Gonzalez del Rey, J. Chapter 14: Pediatrics. The Atlas of Emergency Medicine, 4th Edition. McGraw Hill, 2015.
Sobolewski, B, Grupp-Phelan, J, Marino, B. Chapter 20: The Critically Ill and Injured Child. Blueprints Pediatrics, 6th Edition. Lippincott Williams & Wilkins, 2013
Editor in Chief – The Pocket 2007-08 to 2016-17 editions
Pediatric Resident handbook at Cincinnati Children’s Hospital Medical Center
Editor – The Senior Pocket 3rd Edition, and 4th Edition – Intern handbook for new Residents at Cincinnati Children’s Hospital Medical Center
Career Development & Professional Activities
Emerging Leaders Program
Cincinnati Children’s Hospital Medical Center
Fellows Teaching Workshop
June 10, 2009
Cincinnati Children’s Hospital Medical Center – Cincinnati, OH
How to Teach Evidence-Based Clinical Practice
May 31 to June 5, 2009
McMaster University – Hamilton, Ontario, Canada
20th Annual Leadership Skills Training Program for the Pediatric Chief Resident
May 20- 24, 2007
Teaching and Leading EBM: A Workshop for Teachers and Champions of Evidence-Based Medicine
April 22 – 25, 2007
Duke University – Durham, NC