257 - Neonatal Abdominal Exam Video Effective in Teaching Physical Exam Skills

Poster Number: 257
Publication Number: 257.330

John G. Barber, Stanford University School of Medicine, San Jose, CA, United States; John G. Barber, Stanford University School of Medicine, San Jose, CA, United States; Rebecca Blankenburg, Stanford University School of Medicine, Palo Alto, CA, United States; Di Lu, Stanford University School of Medicine, Palo Alto, CA, United States; Janelle Aby, Stanford University School of Medicine, Palo Alto, CA, United States

Background: Nationally, pediatric residents need to further develop their physical exam abilities (Chiang, PAS 2018). This educational deficit has been compounded by COVID learning restrictions, and it has become difficult to achieve clinical competence in the pediatric physical exam through patient exposure alone. Adjunct educational modalities must be explored to make up this knowledge gap.

Objective: To determine the impact of a neonatal abdominal exam video on residents’ physical exam skills and self-efficacy.

Design/Methods: This was an IRB-approved, pre-/post-intervention study. A faculty expert recorded a 4.25 min demonstration of the neonatal abdominal exam. Based on expert consensus and the content of the video recording, a 6-item neonatal abdominal exam scoring rubric was created and used to assess residents’ abdominal exam abilities. Pre- and post-intervention abdominal exams were assessed by blinded faculty using the rubric. Residents also completed immediate post-rotation and 6-month follow up surveys to assess the subjective impact of the educational video. Paired and unpaired t-tests were used to assess the improvement in skills.
 

Results: 44 residents were observed performing a neonatal abdominal exam, with a total of 82 scores submitted by the end of the study (38 pre- and 44 post-intervention). Residents scored a mean of 2.11 (out of 6 total possible points) pre-intervention and improved to 4.59 post-intervention (p < 0.05). For the 18 residents who had both pre- and post-intervention scores recorded, scores improved from a mean of 1.78 to 4.78 (p < 0.05). On immediate post-rotation surveys, respondents (n = 20) identified that they had most improved in their knowledge of what might be felt with palpation, location of where palpation should begin, and the ideal depth of palpation. On 6-month follow up surveys (n = 8), 87.5% of respondents reported that the video intervention improved their ability to detect hepatosplenomegaly on patients all ages. 100% of these respondents said the video intervention improved their ability to detect any abdominal abnormality by physical exam in patients of all ages. Conclusion(s): A video demonstration is a simple and effective tool in teaching pediatric residents the neonatal abdominal exam and can improve their physical exam skills and self-efficacy.