Medicine and Health Sciences Commons^™

The Covid Cohort: Pem Fellowship Training During A Pandemic, Thuy L. Ngo, Derya Caglar, Lisa Yanek, Michelle Eckerle, Jerri A. Rose, Mellisa M. Tavarez, Frances Turcotte Benedict, Melissa Langhan

Manuscripts, Articles, Book Chapters and Other Papers

Background: The COVID-19 pandemic led to training programs abruptly stopping in-person learning and redesigning curricula. Trainees had decreased patient contact. Trainee well-being became even more vital with social isolation and fears of infecting loved ones increased. Our study evaluated impacts of COVID-19 on Pediatric Emergency Medicine (PEM) fellowship programs, including effects on fellows’ clinical and didactic experiences, and effects on fellows’ well-being.

Methods: In this cross-sectional study, two surveys inquiring about the impact of COVID-19 on PEM fellowship training were developed using an iterative process: one for Program Directors (PDs) and one for fellows. Survey questions, which consisted of multiple …

Exploring Factors For Implementation Of Epas In Pediatric Subspecialty Fellowships: A Qualitative Study Of Program Directors., Angela S. Czaja, Richard B. Mink, Bruce E. Herman, Pnina Weiss, David A. Turner, Megan L. Curran, Diane E J Stafford, Angela Myers, Melissa L. Langhan

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: To understand fellowship program directors' (FPDs) perspectives on facilitators and barriers to using entrustable professional activities (EPAs) in pediatric subspecialty training.

METHODS: We performed a qualitative study of FPDs, balancing subspecialty, program size, geographic region and current uses of EPAs. A study coordinator conducted 1-on-1 interviews using a semistructured approach to explore EPA use or nonuse and factors supporting or preventing their use. Investigators independently coded transcribed interviews using an inductive approach and the constant comparative method. Group discussion informed code structure development and refinement. Iterative data collection and analysis continued until theoretical sufficiency was achieved, yielding a thematic …

Relationship Between Epa Level Of Supervision With Their Associated Subcompetency Milestone Levels In Pediatric Fellow Assessment., Richard B. Mink, Carol L. Carraccio, Bruce E. Herman, Pnina Weiss, David A. Turner, Diane E J Stafford, Kathleen A. Mcgann, Jennifer Kesselheim, Deborah C. Hsu, Pamela C. High, Jill J. Fussell, Megan L. Curran, Patricia R. Chess, Cary Sauer, Sarah Pitts, Angela Myers, John D. Mahan, Christiane E L Dammann, Tandy Aye, Alan Schwartz, Subspecialty Pediatrics Investigator Network

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Entrustable Professional Activities (EPA) and competencies represent components of a competency-based education framework. EPAs are assessed based on the level of supervision (LOS) necessary to perform the activity safely and effectively. The broad competencies, broken down into narrower subcompetencies, are assessed using milestones, observable behaviors of one's abilities along a developmental spectrum. Integration of the two methods, accomplished by mapping the most relevant subcompetencies to each EPA, may provide a cross check between the two forms of assessment and uncover those subcompetencies that have the greatest influence on the EPA assessment.

OBJECTIVES: We hypothesized that 1) there would be …

Is It Too Complex? A Survey Of Pediatric Residency Program's Educational Approach For The Care Of Children With Medical Complexity., Kira Sieplinga, Christopher Kruger, Emily J. Goodwin

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Although Entrustable Professional Activities (EPAs) regarding pediatric training in care for children with medical complexity (CMC) exist, it is unknown what US pediatric training programs provide for education related to care of CMC and whether educators perceive that pediatric residents are prepared to care for CMC upon graduation.

METHODS: From June, 2021 through March 2022, we surveyed US pediatric residency program delegates about practice settings, current educational offerings, perception of resident preparedness regarding care of CMC, and likelihood to implement CMC education in the future.

RESULTS: Response rate was 29% (56 /195). A third of responding programs (34%, n …

A Step-By-Step Guide For Mentors To Facilitate Team Building And Communication In Virtual Teams., Julia F. Aquino, Robert Riss, Sara M. Multerer, Leora N. Mogilner, Teri L. Turner

Manuscripts, Articles, Book Chapters and Other Papers

As collaborative work in medical education has increasingly moved online, team mentors have had to adapt their practices into the virtual environment. Fostering connection, communication and productivity on virtual teams requires specific skills and deliberate practice that differ from in-person teamwork. Drawing from best practices in business, education and medicine and also from our own experience as a virtual team, we present a guide for mentors to create and sustain successful virtual teams. Grounded in Tuckman's Five Stage Model of Team Development, we offer specific strategies for virtual team mentors to promote team cohesion, mitigate conflict, maintain productivity and leverage …

Global Health Electives In The Covid-19 Era: Resuming Travel And Strengthening Global Health Academic Partnerships., Heather Haq, Amos Msekandiana, Mogomotsi Matshaba, Linoeo Thahane, Jennifer Watts, Reena Tam, Nicole St Clair, Charles Schubert, Amy Rule, Pia Pannaraj, Michael Pitt, David Oleson, Brittany Murray, Lee Morris, Joanne Mendoza, Megan Mchenry, Elizabeth Keating, Kathy Ferrer, Heather Crouse, Tania Condurache, Maneesh Batra, Adelaide Barnes, James Conway

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Burnout In Pediatric Nephrology Fellows And Faculty: Lessons From The Sustainable Pediatric Nephrology Workforce Project (Superpower)., Susan M. Halbach, Kartik Pillutla, Patricia Seo-Mayer, Alan Schwartz, Darcy K. Weidemann, John D. Mahan

Manuscripts, Articles, Book Chapters and Other Papers

Physician well-being is an important contributor to both job satisfaction and patient outcomes. Rates of burnout among physicians vary by specialty, ranging from 35 to 70%. Among pediatric residents, longitudinal data demonstrates consistent rates of burnout around 50-60%, although little is known about burnout among pediatric subspecialty fellows. Specifically, the degree of burnout among pediatric nephrologists remains unknown, as does the impact faculty burnout may have on trainee burnout. We sought to evaluate prevalence and predictors of burnout among US pediatric nephrology fellows and faculty, and assess for interactions between groups. In this multi-center pilot survey of all United States …

Identifying The Content And Context Of Pain Within Paediatric Rheumatology Healthcare Professional Curricula In The Uk: A Summative Content Analysis., Rebecca Rachael Lee, Janet E. Mcdonagh, Mark Connelly, Sarah Peters, Lis Cordingley

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The curriculum for professionals working in paediatric rheumatology should include pain but it is unclear to what extent this currently occurs. The aim of this study was to identify pain-related curriculum content and the context in which pain is presented in educational and training documentation for healthcare professionals in this clinical speciality.

METHODS: Core curricula documents from UK based professional organisations were identified in partnership with healthcare professionals. Documents were analysed using a summative content analysis approach. Key pain terms were quantified and weighted frequencies were used to explore narrative pain themes. Latent content was interpreted qualitatively to explore …

Application Of The Multi-Facet Rasch Model To Evaluate The Chief Resident Selection Survey: A Two-Year Study., Kadriye O. Lewis, Haiqin Chen, Ross Newman

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Introduction The Chief Resident (CR) selection process is described by many residency programs as a collective effort from the residency program leadership, key faculty members, and resident peers. Unfortunately, the literature does not show any established guidelines, methods, or psychometric sound instruments to aid this process. The purpose of this study was to evaluate the properties of the newly developed CRs selection survey across two years using the Multi-Facet Rasch Model (MFRM). Methods This study used the MFRM to analyze two-year data from the newly developed CRs selection survey. After the first implementation of the tool in 2015, this instrument …

Current Milestones Assessment Practices, Needs, And Challenges Of Program Directors: A Collective Case Study In A Pediatric Hospital Setting., Kadriye O. Lewis, Susan B. Hathaway, Denise Bratcher, Douglas Blowey, Jane F. Knapp

Manuscripts, Articles, Book Chapters and Other Papers

Introduction Accreditation Council for Graduate Medical Education's (ACGME's) Milestones assessment requirement has placed new demands on Program Directors (PDs), especially those with limited knowledge of assessment and evaluation activities. There is a lack of clarity on how Program Director (PDs)/Associate PDs (APDs) are effectively implementing milestones assessment and evaluation practices in the Graduate Medical Education programs. The purpose of this study was to investigate current assessment practices, needs, and challenges of PDs in implementing milestones assessment within their residency and fellowship programs in a pediatric hospital setting. Methods This study used a collective case study approach to obtain information from …

Establishing A Multi-Institutional Quality And Patient Safety Consortium: Collaboration Across Affiliates In A Community-Based Medical School., Emily Hillman, Joann Paul, Maggie Neustadt, Mamta Reddy Md, David Wooldridge, Lawrence Dall, Betty Drees

Manuscripts, Articles, Book Chapters and Other Papers

The landscape of health care delivery and medical education is evolving. Institutions must continually reassess priorities, strategies, and partnerships to align the knowledge and skills of the health care workforce with the delivery of quality, socially accountable, collaborative health care that meets the needs of diverse populations in communities. This article describes the development, implementation, and early outcomes of the University of Missouri-Kansas City's (UMKC) Health Care Quality and Patient Safety Consortium. Inspired by an actual patient safety event, the consortium aimed to improve patient outcomes by establishing quality improvement and patient safety (QIPS) education and scholarship as foundational within …

A Randomized Controlled Trial Of An Online Immunization Curriculum., Barbara A. Pahud, S Elizabeth Williams, Brian R. Lee, Kadriye O. Lewis, Donald B. Middleton, Shannon Clark, Sharon Humiston

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Immunization education for physicians-in-training is crucial to address vaccine concerns in clinical practice. Vaccine education is not standardized across residency programs. The Collaboration for Vaccination Education and Research (CoVER) team developed an online curriculum for pediatric (Peds) and family medicine (FM) residents.

METHODS: A cluster randomized controlled trial (RCT) was performed during the 2017-2018 academic year to evaluate the CoVER curriculum. A convenience sample of residency institutions were randomly allocated to the intervention or control group, with stratification by residency type. The intervention, the CoVER curriculum, consisted of four online modules and an in-person training guide. Control sites continued …

Identifying Medical Residents’ Perceived Needs In Vaccine Education Though A Needs Assessment Survey, Sarah Williams, Shannon Clark, Sharon Humiston, Barbara Pahud, Donald Middleton, Kadriye O. Lewis

Manuscripts, Articles, Book Chapters and Other Papers

Background: Vaccine education during residency is not standardized. Little is known about resident perspectives on vaccines and ideal vaccine training.

Methods: A convenience sample of pediatric and family medicine (FM) residents were surveyed using a de novo 22 question survey to understand perspectives on vaccines and current and preferred vaccine education curriculum. Responses were analyzed categorically and compared by resident year using Fisher’s Exact test.

Results: In October 2016, 126 residents from 9 pediatric and FM programs completed the survey. Resident respondents’ training levels varied. Most were 25-29 years old and female. High familiarity with vaccines and agreeing to defer …

Agreement Of Program Directors With Clinical Competency Committees For Fellow Entrustment., Richard Mink, Bruce E. Herman, Carol Carraccio, Tandy Aye, Jeanne M. Baffa, Patricia R. Chess, Jill J. Fussell, Cary G. Sauer, Diane E J Stafford, Pnina Weiss, Megan L. Curran, Christiane E L Dammann, Pamela C. High, Deborah Hsu, Jennifer C. Kesselheim, John D. Mahan, Kathleen A. Mcgann, Angela Myers, Sarah Pitts, David A. Turner, Alan Schwartz

Manuscripts, Articles, Book Chapters and Other Papers

Objectives: Fellowship program directors (FPD) and Clinical Competency Committees (CCCs) both assess fellow performance. We examined the association of entrustment levels determined by the FPD with those of the CCC for 6 common pediatric subspecialty entrustable professional activities (EPAs), hypothesizing there would be strong correlation and minimal bias between these raters.

Methods: The FPDs and CCCs separately assigned a level of supervision to each of their fellows for 6 common pediatric subspecialty EPAs. For each EPA, we determined the correlation between FPD and CCC assessments and calculated bias as CCC minus FPD values for when the FPD was or was …

Bilingual And Bicultural Research Teams: Unpacking The Complexities., Maya I I. Ragavan, John Cowden

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Researchers often describe use of "bilingual/bicultural" research teams, especially for research being conducted with marginalized communities. In this perspectives article, we argue that while increasing the diversity of research teams is imperative, using the term "bilingual/bicultural" without further explanation is problematic. We first review the nuances of the terms bilingual and bicultural individually. Next, we describe how the terms bilingual and bicultural cannot be conflated. Finally, we provide recommendations for researchers, journals, and funding agencies.

Determining The Instructional Effectiveness Of Online Vaccine Education Modules: A Focus-Group Analysis, Sarah Williams, Shannon Clark, Sharon Humiston, Barbara Pahud, Donald Middleton, Kadriye O. Lewis

Manuscripts, Articles, Book Chapters and Other Papers

Vaccine education for pediatric and family medicine residents is inadequate. Implementation of evidence-based instructional design methods for medical education is understudied. We conducted four focus groups with residents who had completed a novel immunization curriculum to explore their satisfaction with design, content and impact on confidence. Data were analyzed using thematic content analysis. Overall satisfaction with the curriculum was high. Residents valued the interactive design and content, reported improvement in confidence in discussing vaccines with parents, and shared recommendations for future iterations of the modules. Technical challenges were reported with the learning management system. Medical education modules developed using best …

Curriculum For Neurogastroenterology And Motility Training: A Report From The Joint Anms-Esnm Task Force., C P Gyawali, E Savarino, A Lazarescu, S Bor, A Patel, R Dickman, A Pressman, A M Drewes, John Rosen, V Drug, M Saps, L Novais, M Vazquez-Roque, D Pohl, M A L Van Tilburg, A Smout, S Yoon, J Pandolfino, G Farrugia, G Barbara, S Roman

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Although neurogastroenterology and motility (NGM) disorders are some of the most frequent disorders encountered by practicing gastroenterologists, a structured competency-based training curriculum developed by NGM experts is lacking. The American Neurogastroenterology and Motility Society (ANMS) and the European Society of Neurogastroenterology and Motility (ESNM) jointly evaluated the components of NGM training in North America and Europe. Eleven training domains were identified within NGM, consisting of functional gastrointestinal disorders, visceral hypersensitivity and pain pathways, motor disorders within anatomic areas (esophagus, stomach, small bowel and colon, anorectum), mucosal disorders (gastro-esophageal reflux disease, other mucosal disorders), consequences of systemic disease, consequences of therapy …

Patient-Centred Attitudes Among Medical Students In Mali, West Africa: A Cross-Sectional Study., Emily A. Hurley, Seydou Doumbia, Caitlin E. Kennedy, Peter J. Winch, Debra L. Roter, Sarah M. Murray, Steven A. Harvey

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND/OBJECTIVE: Patient-centred attitudes have been shown to decline during medical training in high-income countries, yet little is known about attitudes among West African medical students. We sought to measure student attitudes towards patient-centredness and examine validity of the 18-item Patient-Practitioner Orientation Scale (PPOS) in this context.

PARTICIPANTS/SETTING: 430 medical students in years 1, 3, 5 and 6 of a 6-year medical training programme in Bamako, Mali.

DESIGN: We conducted a cross-sectional survey, compared the proportion of students who agreed with each PPOS item by gender and academic year, and calculated composite PPOS scores. To examine psychometrics of the PPOS and …

Driving Organizational Change From The Bedside: The Aacn Clinical Scene Investigator Academy., Susan R. Lacey, Caryl Goodyear-Bruch, Adrienne Olney, Dave Hanson, Marian S. Altman, Natasha S. Varn-Davis, Debbie Brinker, Ramón Lavandero, Karen S. Cox

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Staff nurses are pivotal in leading change related to quality improvement efforts, although many lack skills to steer change from the bedside. The American Association of Critical-Care Nurses (AACN) staff nurse leadership program, Clinical Scene Investigator (CSI) Academy, teaches and empowers staff nurses in leadership skills and change concepts to translate evidence into practice affecting patient outcomes.

OBJECTIVES: To describe the curriculum of the AACN CSI Academy that provides staff nurses with the leadership skills required to create unit-based change projects that positively impact patient/family outcomes.

METHODS: The curriculum of the Academy included leadership topics, communication, change concepts, quality …

Ethical Concerns When Minors Act As Standardized Patients., Erwin Jiayuan Khoo, Robert Schremmer, Douglas S. Diekema, John Lantos

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When minors are asked to assist medical educators by acting as standardized patients (SPs), there is a potential for the minors to be exploited. Minors deserve protection from exploitation. Such protection has been written into regulations governing medical research and into child labor laws. But there are no similar guidelines for minors' work in medical education. This article addresses the question of whether there should be rules. Should minors be required to give their informed consent or assent? Are there certain practices that could cause harm for the children who become SPs? We present a controversial case and ask a …

The Creation Of A Model Pediatric Ward For African American Children In 1920s Kansas City., Jane F. Knapp, Robert Schremmer

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Task Force 2: Pediatric Cardiology Fellowship Training In Noninvasive Cardiac Imaging. Spctpd/Acc/Aap/Aha., Shubhika Srivastava, Beth F Printz, Tal Geva, Girish S. Shirali, Paul M Weinberg, Pierre C Wong, Peter Lang, Society Of Pediatric Cardiology Training Program Directors, American College Of Cardiology, American Academy Of Pediatrics, American Heart Association

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Task Force 2: Pediatric Cardiology Fellowship Training In Noninvasive Cardiac Imaging., Shubhika Srivastava, Beth F. Printz, Tal Geva, Girish S. Shirali, Paul M. Weinberg, Pierre C. Wong, Peter Lang

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

2015 Spctpd/Acc/Aap/Aha Training Guidelines For Pediatric Cardiology Fellowship Programs (Revision Of The 2005 Training Guidelines For Pediatric Cardiology Fellowship Programs)., R D. Ross, M Brook, J A. Feinstein, P Koenig, P Lang, R Spicer, J A. Vincent, A B. Lewis, G R. Martin, P J. Bartz, P S. Fischbach, D R. Fulton, G P. Matherne, B Reinking, S Srivastava, B Printz, T Geva, Girish S. Shirali, P Weinberg, P C. Wong, L B. Armsby, R N. Vincent, S R. Foerster, R J. Holzer, J W. Moore, A C. Marshall, L Latson, A M. Dubin, E P. Walsh, W Franklin, R J. Kanter, J P. Saul, M J. Shah, G F. Van Hare, T F. Feltes, S J. Roth, M C. Almodovar, D B. Andropoulos, D J. Bohn, J M. Costello, R J. Gajarski, A R. Mott, K Stout, A M. Valente, S Cook, M Gurvitz, A Saidi, S A. Webber, D T. Hsu, D D. Ivy, T J. Kulik, E Pahl, D N. Rosenthal, R Morrow, W T. Mahle, A M. Murphy, J S. Li, Y M. Law, J W. Newburger, S R. Daniels, D Bernstein, B S. Marino

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Resident Efficiency In A Pediatric Emergency Department., M Denise Dowd, Celeste Tarantino, Theodore M. Barnett, Laura Fitzmaurice, Jane F. Knapp

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OBJECTIVES: To measure the hourly rate of patients evaluated and treated by resident physicians in an academic pediatric emergency department (PED) and examine differences in the rate by subspecialty and year of training.

METHODS: For all residents rotating in an academic, urban children's hospital PED, the rate of patients seen per hour over the course of their rotation was calculated using an electronic tracking system, EmSTAT, for calendar year 2000. Rates are reported as the mean number of patients seen per resident hour worked. Mean differences are reported for resident subspecialties (emergency medicine, pediatrics, and family practice) and postgraduate year …