BMV and Tracheostomy Education: A Needs Assessment of Pediatric Residents and Program Directors

Introduction: Bag-mask ventilation (BMV) is a required and lifesaving competency for general pediatrics residents. It is unknown how or whether residents learn this skill. Similarly, despite an increasing population of tracheostomy (trach)-dependent children, trach management is not a core skill and residents’ trach education are unknown. BMV and trach care is encountered more often in the pediatric intensive care unit (PICU) than general wards, making the PICU a high yield learning environment for these skills.


Methods: Surveys were created to assess pediatric residents’ and residency program directors’ (PDs) perspectives on resident clinical exposure, education, and confidence regarding BMV and trach management. Surveys were emailed to United States PDs; if PDs approved their programs’ residents’ involvement, a link was provided for distribution to residents. Survey data was gathered using REDCap.


Results: 23 PDs completed the PD survey; representing 16 university-based programs and 7 community-based programs. 10 PDs felt their residents were “very prepared” to perform BMV at the completion of their training. No PDs felt their residents were “very prepared” in trach management by the end of training. Most PDs (81%) believe that general pediatricians should know how to suction and change a tracheostomy tube.
89 residents completed the survey. 43% of residents reported only performing BMV on manikins, yet 63% of residents reported confidence with BMV on actual pediatric patients. 79% expressed interest in more BMV education. Of the residents who had performed BMV on patients, 80% reported having these experiences in ICUs. For trach care, most residents felt general pediatricians should know how to suction (89%) and change (75%) a trach tube. Only 22% of residents reported confidence in trach management and 87% reported wanting more trach education.


Conclusions: Most PDs and residents express confidence with BMV despite almost half of residents never having performed BMV on an actual patient. Very few residents and no PDs express confidence with trach management. Especially as resident rotation requirements change, there is a need to develop standardized and generalizable methods of teaching and assessing these important skills.