Medical Control Curriculum for Trainees

Interfacility transport of children has grown significantly over the last few decades of care. Patients are commonly cared for at smaller, regional medical centers and then require transport to tertiary medical centers for further care. The need for interfacility transport is ever prevalent in the pediatric population where tertiary care centers have become more centralized. The act of interfacility transportation is fraught with risk for the patient and such risk has been mitigated with the use of specialized pediatric transport teams. Recent data shows that the use of a physician as a standard member on an interfacility transport team is not common, rather the physician serves as the transport medical control (TMC) to direct patient management “sight unseen.” At the Medical College of Wisconsin, , the TMC is a critical care provider and/or trainee who relies on the outside medical team as well as the transport team to provide patient information to guide medical care.
Historically, “on-the-job” training has been utilized as the means to teach trainees how to act as the TMC. A graduated autonomy would be provided as skills were obtained. Initially, attending physicians would lead the calls from the outside providers and fellows would listen to the conversation and ask questions where indicated. As the fellow advances in their training, they would take over as the lead provider on the call, obtaining all pertinent information and providing recommendations for patient management. Finally, fellows would advance to complete management of the interfacility transport with patient care, transport team configuration, and transport modality decisions made by the fellow with attending oversight.
The Medical College of Wisconsin team sought to standardize the TMC education process for the PCCM fellows and saw an opportunity to construct a curriculum that met varying adult learner styles, while addressing what we felt were the highest yield topics surrounding pediatric interfacility transport.