Aim Trainees in paediatrics are required to become competent at a number of practical procedures but often express concern at lack of opportunities. We aimed to survey the number of practical procedures undertaken in 3 months, in two level 3 neonatal units in Scotland, and how these opportunities are distributed amongst trainees.
Method Opportunities occurring for 7 procedures were documented during a 3 month period in 2 separate units, an antenatal referral centre for cardiac and surgical anomalies and a large district general hospital. Procedures recorded were intubation, umbilical arterial and venous lines (UAC, UVC), peripheral arterial lines, long lines, chest drains and lumbar punctures. Data was collected on the number of opportunities, training status of practitioner and clinical characteristics of the baby.
Results During a 3 month period, intubation was the most common procedure performed in both units. Chest drains, peripheral arterial lines and long lines were less frequently performed. In the district general unit 45% of procedures were undertaken by nurse practitioners with 48% procedures performed by trainees. In the referral unit, which had junior trainees (year 1 and 2 of specialist training), only 16% of procedures were attempted by these doctors.
Conclusion This study provides quantitative information on training opportunities for paediatric trainees in level 3 units. We suggest that there are ample training opportunities for intubations occurring in both units. However, only a small percentage were performed by junior trainees. Further training opportunities may be required for junior trainees to gain competency. Long line and peripheral arterial line insertions took place frequently only in the cardiac and surgical referral unit.
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