Welcome to the Choosing Wisely Campaign series! This is the fourth episode of a 5-part series exploring the ABIM Foundation’s Choosing Wisely Lists. This campaign aims to promote conversations between clinicians and patients to avoid unnecessary medical tests, treatments, and procedures.

Our third case-based episode presents a child with fever and cough. After a clear discussion of the case and thoughtful consideration of the etiology and treatment strategies, we use the AAP’s Choosing Wisely Hospital Medicine and Infectious Diseases lists to create a resource-conscious care plan that is safe and patient-centered.

In the coming episodes, we’ll explore the pediatric lists and apply our knowledge to cases of common presentations seen in primary and acute care pediatrics.

Series Learning Objectives:

1. Introduction to the Choosing Wisely Campaign: Understand the origins, historical precedent, and primary goals of the campaign.
2. Case-Based Applications: Explore five common presentations in primary and acute care pediatrics, applying concepts from various Choosing Wisely lists to guide management and resource stewardship.
3. Effective Communication: Learn strategies for engaging in tough conversations with parents and colleagues to create allies and ensure evidence-based practices are followed.

Modified rMETRIQ Score: 14/15

Competencies:

AACN Essentials:

• 1: 1.1 g; 1.2 f; 1.3 d, e
• 2: 2.1 d, e; 2.2 g; 2.4 f, g; 2.5 h, i, j, k
• 7: 7.2 g, h, k
• 9: 9.1i, j; 9.2 i, j; 9.3 i, k

NONPF NP Core Competencies:

• 1: NP 1.1h; NP 1.2 k, m; NP 1.3 f, j, h
• 2: NP 2.1 j, g; NP 2.2 k, n; NP 2.4 h, i; NP 2.5 k, l, m, n, o
• 7: NP 7.2 m
• 9: NP 9.1 m, n; NP 9.2 n; NP 9.3 p

References

ABIM Foundation. (2019). Communicating about overuse with vulnerable populations. Retrieved from https://www.choosingwisely.org/files/Communicating-About-Overuse-to-Vulnerable-Population_Final2.pdf

American Academy of Pediatrics [AAP] Committee on Infectious Diseases & Pediatric Infectious Diseases Society. (2018). Five things physicians and patients should question. Retrieved from https://downloads.aap.org/AAP/PDF/Choosing%20Wisely/CWInfectiousDisease.pdf

de Benedictis, F. M., Kerem, E., Chang, A. B., Colin, A. A., Zar, H. J., & Bush, A. (2020). Complicated pneumonia in children. Lancet (London, England), 396(10253), 786–798. https://doi.org/10.1016/S0140-6736(20)31550-6

Kato, H. (2024) Antibiotic therapy for bacterial pneumonia. J Pharm Health Care Sci 10, 45. https://doi.org/10.1186/s40780-024-00367-5

Schlapbach, L. J., Watson, R. S., Sorce, L. R., Argent, A. C., Menon, K., Hall, M. W., Akech, S., Albers, D. J., Alpern, E. R., Balamuth, F., Bembea, M., Biban, P., Carrol, E. D., Chiotos, K., Chisti, M. J., DeWitt, P. E., Evans, I., Flauzino de Oliveira, C., Horvat, C. M., Inwald, D., … Society of Critical Care Medicine Pediatric Sepsis Definition Task Force (2024). International Consensus Criteria for Pediatric Sepsis and Septic Shock. JAMA, 331(8), 665–674. https://doi.org/10.1001/jama.2024.0179

Smith, D. K., Kuckel, D. P., & Recidoro, A. M. (2021). Community-Acquired Pneumonia in Children: Rapid Evidence Review. American family physician, 104(6), 618–625.

Society of Hospital Medicine, AAP, & Academic Pediatric Association. (2021). Five things physicians and patients should question. Retrieved from https://downloads.aap.org/AAP/PDF/Choosing%20Wisely/CWHospitalmedicine.pdf

Yun K. W. (2024). Community-acquired pneumonia in children: updated perspectives on its etiology, diagnosis, and treatment. Clinical and experimental pediatrics, 67(2), 80–89. https://doi.org/10.3345/cep.2022.01452

Welcome to the Choosing Wisely Campaign series! This is the third episode of a 5-part series exploring the ABIM Foundation’s Choosing Wisely Lists. This campaign aims to promote conversations between clinicians and patients to avoid unnecessary medical tests, treatments, and procedures.

Our second case-based episode presents an infant with diarrhea and diaper dermatitis. After a clear discussion of the case and thoughtful consideration of the etiology and treatment strategies, we use the AAP’s Choosing Wisely dermatology and gastroenterology, hepatology, and nutrition lists to create a resource-conscious care plan that is safe and patient-centered.

In the coming episodes, we’ll explore the pediatric lists and apply our knowledge to cases of common presentations seen in primary and acute care pediatrics.

Series Learning Objectives:

1. Introduction to the Choosing Wisely Campaign: Understand the origins, historical precedent, and primary goals of the campaign.
2. Case-Based Applications: Explore five common presentations in primary and acute care pediatrics, applying concepts from various Choosing Wisely lists to guide management and resource stewardship.
3. Effective Communication: Learn strategies for engaging in tough conversations with parents and colleagues to create allies and ensure evidence-based practices are followed.

Modified rMETRIQ Score: 15/15

Competencies:

AACN Essentials:

• 1: 1.1 g, 1.2f, 1.3de
• 2: 2.1 de, 2.2g, 2.4fg, 2.5 hijk
• 7: 7.2 ghk
• 9: 9.1ij, 9.2ij, 9.3ik

NONPF NP Core Competencies:

• 1: NP1.1h, NP 1.2km, NP 1.3fjh
• 2: NP2.1jg, NP2.2kn, NP 2.4hi, NP2.5 klmno
• 7: NP7.2m
• 9: NP9.1mn, NP9.2n, NP9.3p

References

ABIM Foundation. (2019). Communicating about overuse with vulnerable populations. Retrieved from https://www.choosingwisely.org/files/Communicating-About-Overuse-to-Vulnerable-Population_Final2.pdf

AAP Section on Dermatology. (2021). Five things physicians and patients should question. https://downloads.aap.org/AAP/PDF/Choosing%20Wisely/CWDermatology.pdf

AAP Section on Gastroenterology, Hepatology, and Nutrition. (2023). Five things physicians and patients should question. https://downloads.aap.org/AAP/PDF/Choosing%20Wisely/CWGastroenterology.pdf

Harriet Lane Service (Johns Hopkins Hospital), Anderson, C. C., Kapoor, S., & Mark, T. E. (2024). The Harriet Lane handbook: a manual for pediatric house officers (23rd ed.). Elsevier.

Jauregui, J., Nelson, D., Choo, E., Stearns, B., Levine, A. C., Liebmann, O., & Shah, S. P. (2014). External validation and comparison of three pediatric clinical dehydration scales. PloS one, 9(5), e95739. https://doi.org/10.1371/journal.pone.0095739

Johnson, H., & Yu, J. (2022). Current and Emerging Therapies in Pediatric Atopic Dermatitis. Dermatology and therapy, 12(12), 2691–2703. https://doi.org/10.1007/s13555-022-00829-4

Semon, A. K., Keenan, O., & Zackular, J. P. (2021). Clostridioides difficile and the Microbiota Early in Life. Journal of the Pediatric Infectious Diseases Society, 10(Supplement_3), S3–S7. https://doi.org/10.1093/jpids/piab063

Welcome to the Choosing Wisely Campaign series! This is the second episode of a 5-part series exploring the ABIM Foundation’s Choosing Wisely Lists. This campaign aims to promote conversations between clinicians and patients to avoid unnecessary medical tests, treatments, and procedures.

The first of our case-based episodes presents a school age child with syncope. After a clear discussion of the case and thoughtful consideration of an acute care differential, we use the AAP’s Choosing Wisely cardiac list to create a resource-conscious care plan that is safe and patient-centered.

In the coming episodes, we’ll explore the pediatric lists and apply our knowledge to cases of common presentations seen in primary and acute care pediatrics.

Series Learning Objectives:

1. Introduction to the Choosing Wisely Campaign: Understand the origins, historical precedent, and primary goals of the campaign.
2. Case-Based Applications: Explore five common presentations in primary and acute care pediatrics, applying concepts from various Choosing Wisely lists to guide management and resource stewardship.
3. Effective Communication: Learn strategies for engaging in tough conversations with parents and colleagues to create allies and ensure evidence-based practices are followed.

Competencies:

AACN Essentials:

• 1: 1.1 g, 1.2f
• 2: 2.1 de, 2.2g, 2.5 ij
• 6: 6.1 i
• 7: 7.2 ghk
• 9: 9.1ij, 9.2ij, 9.3ik

NONPF NP Core Competencies:

• 1: NP1.1h, NP 1.2km
• 2: NP2.1jg, NP2.2kn, NP2.5 lo
• 6: NP6.1o
• 7: NP7.2m
• 9: NP9.1mn, NP9.2n, NP9.3p

References:

AAP Section on Cardiology and Cardiac Surgery. (2020). Five things physicians and patients should question. https://downloads.aap.org/AAP/PDF/Choosing%20Wisely/CWCardio.pdf

Gilpin, K., & Goode, Z. (2024). Syncope. Pediatrics in review, 45(10), 606–608. https://doi.org/10.1542/pir.2023-006053

Welcome to the Choosing Wisely Campaign series! This 5-part series will explore the ABIM Foundation’s Choosing Wisely Campaign, its historical precedent, and its goals. We will discuss how this initiative aims to promote conversations between clinicians and patients to avoid unnecessary medical tests, treatments, and procedures.

The introduction episode dives into the historic 2010 editorial in the New England Journal of Medicine that inspired over 80 professional societies to write their “Top 5 Lists” of tests and procedures that could be avoided in evidence-based care. To better understand the problem, we then pick apart the survey that provided insight into why we over order and the harm it causes to vulnerable populations.

In the coming episodes, we’ll explore the pediatric lists and apply our knowledge to cases of common presentations seen in primary and acute care pediatrics.

Author: Becky Carson, DNP, APRN, CPNP-PC/AC

www.thepedsnp.com

Instagram: @thepedsnppodcast

Series Learning Objectives:

1. Introduction to the Choosing Wisely Campaign: Understand the origins, historical precedent, and primary goals of the campaign.
2. Case-Based Applications: Explore five common presentations in primary and acute care pediatrics, applying concepts from various Choosing Wisely lists to guide management and resource stewardship.
3. Effective Communication: Learn strategies for engaging in tough conversations with parents and colleagues to create allies and ensure evidence-based practices are followed.

Competencies:

AACN Essentials:

• 1: 1.1 g, 1.2f
• 2: 2.1 de, 2.2g, 2.5 ij
• 6: 6.1 i
• 7: 7.2 ghk
• 9: 9.1ij, 9.2ij, 9.3ik

NONPF NP Core Competencies:

• 1: NP1.1h, NP 1.2km
• 2: NP2.1jg, NP2.2kn, NP2.5 lo
• 6: NP6.1o
• 7: NP7.2m
• 9: NP9.1mn, NP9.2n, NP9.3p

Modified rMETRIQ Score: 15/15

Learn more about our peer review process at www.thepedsnp.com/peerreview

References:

ABIM Foundation. (2019). Communicating about overuse with vulnerable populations. Retrieved from https://www.choosingwisely.org/files/Communicating-About-Overuse-to-Vulnerable-Population_Final2.pdf

Brody, H. (2010). Medicine's ethical responsibility for health care reform--the Top Five list. The New England journal of medicine, 362(4), 283–285. https://doi.org/10.1056/NEJMp0911423

Lipitz-Snyderman, A., & Bach, P. B. (2013). Overuse of health care services: when less is more … more or less. JAMA internal medicine, 173(14), 1277–1278. https://doi.org/10.1001/jamainternmed.2013.6181

PerryUndem Research/Communication. (2014). Unnecessary tests and procedures in the health care system. Retrieved from https://www.choosingwisely.org/files/Final-Choosing-Wisely-Survey-Report.pdf

Smith-Bindman, R., Chu, P. W., Azman Firdaus, H., Stewart, C., Malekhedayat, M., Alber, S., Bolch, W. E., Mahendra, M., Berrington de González, A., & Miglioretti, D. L. (2025). Projected Lifetime Cancer Risks From Current Computed Tomography Imaging. JAMA internal medicine, e250505. Advance online publication. https://doi.org/10.1001/jamainternmed.2025.0505

Wyman, O. (2019). Right Place, Right Time: Health Information & Vulnerable Populations. https://www.oliverwyman.com/RightPlaceRightTime.html

This is the final episode of The Peds NP Acute Care PNP Faculty series. The series was created and peer-reviewed by national leaders in acute care PNP education in collaboration to meet the needs of our current and future colleagues. In the push for competency-based education where faculty verify the skills of what a student can do, rather than their knowledge, our series focuses on the application of didactic content with a practical approach so that you can learn nuances of clinical skills before you reach the bedside.

As I come to an end of my time as a faculty member at the Catholic University of America and our Acute Care PNP Faculty series, I remember my graduation from Johns Hopkins. These terminal moments are likened to a graduation, and serve as a wonderful time for reflection. The episode recollects the student speaker commencement address given at my graduation, filled with vehicular metaphors and acknowledgements of failure. A common theme of “Onward” is woven throughout to remind listeners that, at whatever graduation you find yourself celebrating right now, be hopeful and excited at the good that is left to do in the world.

The Peds NP will return in 2025 from Duke University…

Author: Becky Carson, DNP, APRN, CPNP-PC/AC

Peer Review:

This episode was peer reviewed using a modified revised METRIQ (rMETRIQ) Score. Learn more about The Peds NP's formal peer review process at www.thepedsnp.com/peerreview

rMETRIQ Score: 12/15

What does this score mean? This episode underwent a formal quality assurance and peer review process. It received a lower score because of the editorial nature of the content that could not achieve the highest score for question 1 and 4 criteria. There is sufficient background to situate the listener, but there are no referrals to other valuable sites. References are sited, but they do not correspond to specific statements.

Financial disclosures/conflicts of interest: None

Connect with The Peds NP

email: thepedsnp@gmail.com

Instagram: @thepedsnppodcast

References:

Carson, R.A. (2024). Student speaker commencement address [Speech transcript]. Johns Hopkins School of Nursing Commencement. https://alumni.jhu.edu/commencement-2016(Original work published 2016).

Welcome to The Peds NP Acute Care Faculty series! This series was created and peer-reviewed by national leaders in acute care PNP education collaborating with one another to meet the needs of our current and future colleagues. In the push for competency-based education where faculty verify the skills of what a student can do, rather than their knowledge, our series focuses on the application of didactic content with a practical approach so that you can learn nuances of clinical skills before you reach the bedside.

This episode reviews the features of a patient presentation in the pediatric intensive care unit (PICU) and goes in depth on how learners can incorporate trends, new findings, and summaries into a succinct discussion in family-centered rounds. After an introduction with some general best practices, the guide begins with effective pre-rounding and progresses to the step-by-step components of a PICU patient presentation. The template describes each component’s contents in detail, followed immediately by an example to demonstrate the practical application of each concept… “It might sound something like this:”... This episode is a valuable tool for any pediatric provider seeking to increase their skills in succinct synthesis and patient presentations, regardless of clinical setting.

This episode was peer reviewed by The Peds NP faculty series peer review team. You can read about our novel and scholarly approach to peer review, review our faculty lineup, and learn more about the series, competency mapping, references, and show notes at www.thepedsnp.com. There was no financial support or conflicts of interest to report. Follow me on Instagram @thepedsnppodcast. Email me at thepedsnp@gmail.com. Remember that this isn’t just a podcast, you’re listening for the kids.

Authors (alphabetical): Jackie Calhoun, DNP, CRNP, CPNP-AC, CCRN, Becky Carson, DNP, APRN, CPNP-PC/AC, Lena Oliveros, MSN, CPNP-AC, Priscila Reid, DNP, APRN, FNP-C, CPNP-AC

Peer Review:

This episode was peer reviewed using a modified revised METRIQ (rMETRIQ) Score. Learn more about The Peds NP's formal peer review process at www.thepedsnp.com/peerreview

rMETRIQ Score: 15/15

What does this score mean? This episode underwent a quality assurance process using formal peer review and achieved the top scores based on established quality criteria for podcasts.

Financial disclosures/conflicts of interest: None

Connect with The Peds NP

email: thepedsnp@gmail.com

Instagram: @thepedsnppodcast

References:

Bolick, B.N., Reuter-Rice, K., Madden, M.A., Severin, P.N. (2020). Pediatric Acute Care: A guide for Interprofessional Practice (2nd ed.). Jones & Barlett Learning. Burlington, MA.

Oubre, R. (2024). Systems versus problem-based notes. Dr. Oubre’s Digest. https://droubredigest.beehiiv.com/p/systems-versus-problems-based-notes

Stanford Medicine. (nd). Coaching best practices– Presenting a patient. https://med.stanford.edu/content/dam/sm/peds/documents/Program%20Information/coaching/Coaching%20Feedback%20Summary_Presenting%20a%20Patient.pdf

UC San Diego School of Medicine. (2018). Overview and general information about oral presentation. Practical Guide to Clinical Medicine. https://meded.ucsd.edu/clinicalmed/oral.html