Rapid Response Review: A Fellow-Led Curriculum Enhancing Pediatric Resident Critical Care Education

Introduction: When pediatric patients decompensate on the floor, pediatric residents often collaborate with the rapid response team (RRT). Few studies evaluate the impact of rapid responses (RR) on resident education. Nationally, pediatric residents are experiencing decreased exposure to critical care. Thus, our institution's Pediatric Critical Care Medicine (PCCM) fellows implemented Rapid Response Review (RRR) as part of the residency program’s morning report curriculum. We aimed to assess the impact of these monthly sessions on resident critical care knowledge and resident comfort in caring for acute patient instability.


Methods: At RRR, PCCM fellows presented recent RR cases and challenged residents to discuss differential diagnoses, initial evaluations, and management. Fellows also reviewed relevant PCCM topics. RRR attendees from November 2023 to October 2024 completed voluntary, anonymous pre- and post-session surveys with multiple choice questions and free-text learning points. We analyzed 5-point Likert scale responses using unpaired t-tests and learning points using thematic framework analysis with descriptive statistics.


Results: Following 12 RRRs, 82 residents completed pre-surveys and 88 completed post-surveys. Resident comfort at RRs increased from 3.00 to 3.44 (5=extremely comfortable,1=not at all,p < 0.0028). Resident knowledge of when to call a RR increased from 4.05 to 4.52 (5=strongly agree,1=strongly disagree,p=0.0001). 69.3% strongly agreed that RRR improved their understanding of managing acute clinical deterioration. Thematic analysis found that 53.0% of participant-submitted learning points coded as Beginner and 47.0% as Advanced. PGY1s submitted the majority of the Advanced responses (58.1%). The most commonly coded topic was Resuscitation (42.4%). 16.7% of responses coded as Other, relating to hospital operations, and were mostly submitted by senior residents (72.7%).


Conclusions: As a result of attending RRR, residents at this institution feel more prepared to recognize acutely ill patients, intervene, and call a RR. Limitations include small sample size, varying participants between sessions and surveys, and potential acquiescence and non-response bias. This study demonstrates the efficacy of implementing PCCM education that is generalizable to other pediatric residency programs.