Purpose Biological and chemical terrorism is a legitimate threat to children in the United States, and it is incumbent upon both pediatricians and emergency medicine physicians to be knowledgeable in this area. The AAP has recently recommended the integration of biological and chemical terrorism education into residency curricula. Currently, the extent of such education in emergency medicine and pediatric residencies is program dependent. The objectives of this study include developing a tool for assessing residents' knowledge on essential aspects of evaluating and treating pediatric victims of biological and chemical terrorism, comparing the baseline fund of knowledge of pediatric and emergency medicine residents at a single institution, and assessing the effect of an educational intervention.
Methods Using information from the Centers for Disease Control (CDC) and Department of Defense (DOD), a written, validated, multiple-choice test was created to evaluate knowledge of identification, isolation, and treatment of pediatric victims of biological and chemical terrorism. The examination covered all agents on the CDC “A” list of bioterror agents, as well as chemical agents highlighted by the DOD. The test was then administered to pediatric and emergency medicine residents prior to any formal educational on terrorism in either residency's curriculum (“pretest”). A 1-hour lecture covering all essential material was delivered to all available residents. The identical written test was administered 5 months after the lectures (“post-test”) to all available residents, including those who had been unavailable for the lecture.
Results Thirty-four pediatric and 16 emergency medicine residents took the pretest. Pediatric residents scored a median of 65% correct and emergency medicine residents scored a median of 70% correct (p = .03). Twenty-five pediatric and 10 emergency medicine residents took the post-test. Residents who took both tests and attended the lecture improved from a pretest median score of 66% correct to a post-test median score of 70% (p = .11).
Conclusions This pilot study suggests that emergency medicine residents may demonstrate a higher baseline fund of knowledge as to the identification, treatment, and isolation requirements of pediatric biological and chemical terrorism patients than do pediatric residents. Pediatric residents may be in particular need of education on these topics. It is unclear whether traditional lecture-based education will be effective in producing lasting gains in knowledge or if more rigorous educational interventions are required.
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