Firearm Curriculum for Pediatric Residents Improves Safe Storage Counseling

Objectives Firearms are the leading cause of death among children and adolescents. Despite evidence to support physician training in firearm safety counseling, formal curricula are limited in pediatric residency programs. We sought to develop and implement a resident-led, feasible, sustainable, and impactful firearm safety curriculum for pediatric residents. Methods A firearm safety curriculum was developed by pediatric residents using Kern’s curriculum development framework and delivered to their peers at a single academic center from 2019 - 2020. The three-part series included workshops on basic firearm safety counseling principles, case-based practice, and advocacy training and a gun lock program in collaboration with the local police department. Impact was measured by feasibility, sustainability, acquired knowledge, and provision of counseling to patients and families. Results A total of 31 residents participated in the three-hour lecture series. Sessions were integrated into the existing didactic curriculum, and no costs or faculty time were required for implementation. A total of 1,477 patient charts were reviewed from 2019 - 2021. Compared to a historical cohort, participants asked about presence of a firearm (27% to 69%, p \u3c .0001) and counseled on firearm safety more often (25% vs. 9%, p \u3c .0001). Conclusions A firearm safety curriculum designed specifically for pediatric residents was deemed feasible and resulted in a statistically significant improvement in inquiries about firearm ownership and safety counseling in an urban tertiary care continuity clinic. This study highlights the value in providing firearm safety education at the resident level to foster more discussions to keep children safe from firearm injuries

Book of Abstracts: 2019 Health Equity Summer Research Summit Organized by the Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, Houston, Texas 77030, USA on June 18th, 2019

Copyright © 2020 Harris. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

Osteoarthritis Classification Scales: Interobserver Reliability and Arthroscopic Correlation

The MARS Group* Background: Osteoarthritis of the knee is commonly diagnosed and monitored with radiography. However, the reliability of radiographic classification systems for osteoarthritis and the correlation of these classifications with the actual degree of confirmed degeneration of the articular cartilage of the tibiofemoral joint have not been adequately studied. Methods: As the Multicenter ACL (anterior cruciate ligament) Revision Study (MARS) Group, we conducted a multicenter, prospective longitudinal cohort study of patients undergoing revision surgery after anterior cruciate ligament reconstruction. We followed 632 patients who underwent radiographic evaluation of the knee (an anteroposterior weight-bearing radiograph, a posteroanterior weight-bearing radiograph made with the knee in 45°of flexion [Rosenberg radiograph], or both) and arthroscopic evaluation of the articular surfaces. Three blinded examiners independently graded radiographic findings according to six commonly used systems-the Kellgren-Lawrence, International Knee Documentation Committee, Fairbank, Brandt et al., Ahlbäck, and Jäger-Wirth classifications. Interobserver reliability was assessed with use of the intraclass correlation coefficient. The association between radiographic classification and arthroscopic findings of tibiofemoral chondral disease was assessed with use of the Spearman correlation coefficient. Results: Overall, 45°posteroanterior flexion weight-bearing radiographs had higher interobserver reliability (intraclass correlation coefficient = 0.63; 95% confidence interval, 0.61 to 0.65) compared with anteroposterior radiographs (intraclass continue