Section 1 – to be filled out by each individual
1. Please indicate the approximate percent (using numbers only) of your clinical practice that is in the specialties listed.
- Pediatric Diagnostic Radiology
- Pediatric Interventional Radiology
- Adult Interventional Radiology
- Adult Diagnostic Radiology
- Neuroradiology
- Surgery
- Cardiology
- Other
2. How many years of each type of residency and fellowship training below did you do (for all that apply, please specify the number of years of training)?
- Pediatric residency
- Radiology residency
- Surgery residency
- Interventional radiology fellowship
- Pediatric interventional radiology fellowship
- Pediatric radiology fellowship
- Pediatric neuroradiology fellowship
- Neuroradiology fellowship
- Body fellowship
- Other (please specify)
3. Do you have regular teaching obligations to medical students, residents, or fellows (please check all that apply)?
- No teaching obligations
- Medical students
- Residents
- Dedicated pediatric IR fellows
- Other fellows (pediatric radiology, general IR, etc.)
- Other (please specify)
4. In you training were you taught how to administer pediatric sedation?
- Yes
- No
5. Are you currently Pediatric Advanced Life Support (PALS) certified, or PALS equivalent?
- Yes
- No
6. Throughout your training and practice have you received any formal training in delivering bad new to parents and family?
- Yes
- No
7. Do you feel comfortable delivering bad news to parents and family members?
- Most of the time
- Sometimes
- Rarely or never
8. How many nights out of 365 each year are you on call for general IR, pediatric IR, or diagnostic radiology?
- Number of nights a year of general IR
- Number of nights a year of pediatric IR
- Number of nights a year of diagnostic pediatric radiology
- Number of nights a year of diagnostic adult radiology
9. Do you take pediatric and adult interventional call at the same time?
- Yes
- No
10. Do you take pediatric interventional and diagnostic call at the same time?
- Yes
- No
11. If you answered yes to either question 9 or 10 is there any additional compensation?
- No compensation
- Additional salary
- Schedule adjustments
- Other (please specify)
12. Do you perform or have enough access to specialized assistance/colleague consultation for complex body IR cases (pulmonary AVM, hepatic AVM, TIPS, etc.)?
- Yes
- No
13. Do you perform or have enough access to specialized assistance/colleague consultation for neuro IR cases (stroke lysis, cerebral AVM, etc.)?
- Yes
- No
14. If you practice in the USA, how do you think the implementation of the new IR/DR certificate will affect pediatric IR fellowships and the future of pediatric IR?
(The new IR/DR certificate was approved by the ABMS in September of 2012. IR is now a recognized primary specialty of medicine; recognition of subspecialties of IR is possible in the future. The proposed curriculum will include a clinical year followed by 3 years of diagnostic radiology training, and 2 years of IR training (must include an ICU rotation, outpatient IR clinical experience, and an IR admitting service). Graduates will have full DR and IR competency. The conversion of current VIR fellowships to residency training programs will be gradual, over 7 or more years.)
- No impact
- Good for pediatric IR
- Bad for pediatric IR
- Other (please specify)
15. Please explain your answer to question 14. Choose all that apply:
- Potentially decreased training opportunities
- Potentially increased training opportunities
- Increased awareness of PIR
- Decreased awareness of PIR
- Increased interest in training in PIR
- Decreased interest in training in PIR
- Other (please specify)
16. How satisfied are you regarding your current arrangement to provide quality Pediatric IR care?
- Very satisfied
- Somewhat satisfied
- Neutral
- Somewhat dissatisfied
- Very dissatisfied
- Other (please specify)
17. Are you the individual designated to answer additional practice questions on behalf of your group (or a solo practitioner)?
- Yes
- No
Section 2 – The follows questions refer to the entire practice.
18. What best describes your practice type?
- Free standing children’s hospital
- Children’s hospital within an adult hospital
- Primarily adult hospital with some pediatrics
- Outpatient clinic only
- Other (please specify)
19. Is your practice (select all that apply)?
- Academic
- Private practice
- Public or Government Institution
- Other (Please specify)
20. Which best describes your group practice?
- Pediatric radiology
- Interventional radiology
- General radiology
- Surgery
- Neuroradiology
- Cardiology
- Other (please specify)
21. In which country do you practice?
- USA
- Canada
- UK
- Australia
- Other (please specify)
22. If you practice in the US, in what state do you practice?
23. How many staff or attendings (not including trainees such as fellows or residents, or colleagues who occasionally provide specialized assistance or consultation such as neuroradiologists) perform PIR, including yourself?
24. Ideally, how many pediatric IR attending physicians do you need to fully cover your pediatric IR service including, call, rounding, and clinic?
25. When seeking new PIR faculty please rate the importance of the following types of subspecialty training:
Required / Preferred / No NeededPediatric Radiology
Pediatric interventional radiology
Adult interventional radiology
Neuroradiology
Other (please specify)
26. If you are currently recruiting or have recruited to a pediatric IR staff position in the last 2 years, for how long was the position vacant?
- < 6mths
- 6 mths – 1 year
- 1-2 years
- 2-5 years
- > 5 years
27. Does your group have help with attending IR coverage from an affiliated or outside group? If so by whom? Please choose all that apply:
- No additional help
- Adult interventionalists
- Pediatric radiologists
- Interventional neuroradiologists
- Surgery
- Other (please specify)
28. Is your practice affiliated with a fellowship program?
- No affiliated fellowship program
- Adult interventional radiology fellows rotate with your practice
- Affiliated with a pediatric interventional radiology fellowship program
- Affiliated with both pediatric and adult interventional radiology fellowships
29. Do you have dedicated pediatric IR assistance on a regular basis by midlevel providers, allied health professionals, residents, or fellows, and if so by whom (check all that apply)?
- No assistance
- Nurse practitioner
- Physician Assistant
- Radiographer or radiology assistant (RA)
- Resident
- Fellow
30. Ideally, how many ancillary staff such as PAs, NPs, RAs, and radiographers are needed to fully cover your pediatric IR service, including rounding, and clinic?
31. Do you have a dedicated IR clinic and if so, approximately how often is it held?
- No clinic
- Daily
- Weekly
- Monthly
- Other (please specify)
32. Does someone from your team perform daily rounds? If so, select all that apply:
- No
- Attending physician (Staff radiologist/Consultant)
- Nurse
- Mid-level provider (Allied health professional/non-medical practitioners)
- Trainee (resident, registrar, or fellow)
- Hospitalist
- Other (Please specify)
33. Do you have admitting privileges?
- Yes
- No
34. If you do not have admitting privileges or routinely admit your patients to another service, to what service do you most often admit your patients? (Select all that apply.)
- General pediatric service
- Pediatric surgery
- Pediatric ICU
- Adult medicine service
- Adult surgery service
- Other (please specify)
35. How many of each type of facilities below do you have?
- Fluoroscopy suite
- Dedicated IR suite
- Shared cardiac/IR suite
- Dedicated C-arm
- CT fluoroscopy
- Other, please specify
36. How many IR rooms per day does your service run?
37. How do you perform pediatric sedation? Please choose all that apply:
- Nurse with PIR supervision
- Anesthesia service
- Pediatric intensivist
- Sedation service with sedation provider
- We do not perform sedation
- Other (please specify)
38. If your pediatric IR sedation is provided by the anesthesia service, how many room-days of anesthetic coverage do you have per week?
- <1 room-day
- 1 room-day
- >1 but <5 room-days
- >5 room-days
39. IF in the US, does your practice require PALS certification to perform pediatric cases?
- Yes
- No
40. Are your Pediatric IR staff required to submit data from serious safety events into a hospital wide computer program?
- Yes
- No
41. How many patient episodes (individual visits to IR, not individual procedures), did your institution have in 2014 (calendar year or most recent complete academic year) for children aged 18 or less?
42. What are the approximate number of the following type of PIR cases your practice performs a year:
- Vascular access
- Biopsy/drainage
- Body angiography and interventions
- Neuro angiography and interventions
- Spine interventions
- Vascular anomalies
- Venous interventions
- Dialysis interventions
- Enteric access (gastric, gastrojejunostomy)
- Cecostomy
- Locoregional tumor therapy
- Musculoskeletal interventions
- Biliary interventions
- GU interventions
43. What is the biggest challenge to your PIR service at the moment? Please choose all that apply:
- No challenges
- Lack of appropriately trained PIRs
- Call/lifestyle burden
- Insufficient clinical infrastructure for operating (e.g. inadequate IR rooms or scheduled time in them)
- Insufficient clinical infrastructure for other work (e.g. clinical space, nursing staff to support clinic)
- Lack of support or time from department or administration
- Lack of sedation support
- Keeping up skills for difficult or infrequent procedures
- Turf/referral issues
- Asymmetric skill set within group, due to differences in training
- Burdensome regulatory or paperwork demands
- Other (please specify)