Procedural skill needs for Canadian paediatricians: A national profile

Background and Objectives: Procedural practice by paediatricians in Canada is evolving. Little empirical information is available on the procedural competencies required of general paediatricians. Accordingly, the aim of this study was to conduct a needs assessment of Canadian general paediatricians to identify procedural skills required for practice, with the goal of informing post-graduate and continuing medical education. Methods: A survey was sent to paediatricians through the Canadian Paediatric Surveillance Program (CPSP) (www.cpsp.cps.ca/surveillance). In addition to demographic information about practice type and location, participants were asked to indicate the frequency with which they performed each of 32 pre-selected procedures and whether each procedure was considered essential to their practice. Results: The survey response rate was 33.2% (938/2,822). Data from participants who primarily practice general paediatrics were analyzed (n=481). Of these, 71.0% reported performing procedures. The most frequently performed procedures were: bag-valve-mask ventilation of an infant, lumbar puncture, and ear curettage, being performed monthly by 40.8%, 34.1%, and 27.7% of paediatricians, respectively. The procedures performed by most paediatricians were also those found most essential to practice, with a few exceptions. Respondents performed infant airway procedures with greater frequency and rated them more essential when compared to the same skill performed on children. We found a negative correlation between procedures being performed and difficulty maintaining proficiency in a skill. Conclusions: This report of experiences from Canadian general paediatricians suggests a wide variability in the frequency of procedural performance. It helps establish priorities for post-graduate and continuing professional medical education curricula in the era of competency-based medical education.