151 - Bag Mask Ventilation: The Resident Perspective

Publication Number: 4148.151

Morgan E. Hill, Cincinnati Children's Hospital Medical Center, Loveland, OH, United States; Margaret L. Smith, University of Cincinnati CECH College/Cincinnati Children's Hospital, Thomson, GA, United States

Background: Competency in bag mask ventilation (BMV) is required for graduating pediatric residents as per the Accreditation Council for Graduate Medical Education. However, procedural volumes are decreasing, and opportunities vary by hospital type/location, program size, and presence of fellows. Pediatric program directors and residents perceive that residents achieve BMV competency, yet Neonatal Perinatal Medicine program directors feel that a majority of entering fellows are not competent in BMV. There is limited data incorporating the pediatric resident perspective on BMV.

Objective: To explore the perspectives of pediatric residents regarding BMV, including training opportunities, competency assessment, and general importance.

Design/Methods: This is a qualitative study of pediatric residents at a large academic children's hospital. Residents were invited to participate in a one-time focus group using a convenience approach. Qualitative data was obtained through a semi-structured focus group conducted by MH using an interview guide that was iteratively developed, revised, and validated by study investigators and consisted of open-ended questions to gather information about resident perceptions, feelings, and experiences with BMV. MH and LS analyzed the data using thematic analysis with an inductive approach. The interview transcript was used to create the code document. An iterative coding approach was performed. Major themes that emerged were extracted and summarized.

Results: Nine residents participated in the focus group (Table 1). All residents in the focus group believe BMV is a critical skill for general pediatricians but suspect they do not have sufficient opportunities for training and assessment. Resident-generated items about barriers and facilitators to BMV training were coded into four themes, highlighted by resident quotes (Table 2). Residents emphasized the importance of working as part of an interprofessional team in both simulated and clinical environments, affording the opportunity to collaborate with and receive feedback from experts. Four "Cs" essential for understanding BMV training in residency were identified (Figure 1).

Conclusion(s): BMV is perceived as a critical skill and increased training is desired. Program leadership should collaborate for residents to receive expert coaching and develop confidence in providing this critical skill, ultimately leading to a 5th C: BMV competency. Replicating this qualitative study with residents from diverse programs nationwide could enhance generalizability, foster collaboration among program directors, and inform programmatic change.

Table 1. Pediatric Resident Demographics


Table 2. Barriers and Facilitators to Bag Mask Ventilation Training


Figure 1. The Four Cs to Achieve Bag Mask Ventilation Success in Pediatric Residency
The Four Cs to Achieve Bag Mask Ventilation Success in Pediatric Residency: Bag mask ventilation is critical, requires collaboration, demands coaching, and can lead to confidence.