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O'Hara K, Tseng A, Moss S, Herbst L, Marsicek S, Molas-Torreblanca K, Herbst B, Maniscalco J, Ziniel SI. Defining Supervision Preferences and Roles Within a New Subspecialty: Pediatric Hospital Medicine. Acad Pediatr 2022; 22:858-866. [PMID: 35318160 DOI: 10.1016/j.acap.2022.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/10/2022] [Accepted: 02/22/2022] [Indexed: 11/01/2022]
Abstract
OBJECTIVE To describe supervision preferences among pediatric hospitalists, Pediatric Hospital Medicine (PHM) fellows, and senior residents (SRs), and to better define the ideal role of a PHM fellow. METHODS We conducted a cross-sectional survey study at 6 institutions nationwide. We developed 3 complementary surveys, one for each population (hospitalists, fellows, SRs). We calculated univariate descriptive and bivariate statistics for categorical variables using Chi-square tests with the Rao-Scott correction to account for clustering by institution. RESULTS Survey respondents included 106 of 200 hospitalists (53%), all 20 fellows (100%), and 149 of 380 SRs (39%). Most hospitalists and all fellows preferred the supervising hospitalist to have 3+ years of experience or be fellowship-trained. Nearly all fellows preferred the attending round in-person providing progressive independence; while hospitalists and SRs desired greater attending presence on rounds. Hospitalists and fellows wanted more frequent communication when the attending does not round with the team, and more hospitalists desired at least 2 points of contact regardless of attending presence on rounds. Fifty-five percent of SRs reported experiencing much less/less autonomy when on with a fellow than when supervised by a hospitalist only. Regarding the fellow's role, most participants agreed SRs should lead rounds and contact the fellow first with questions. The majority agreed teaching should be a shared responsibility but lacked consensus about how to provide feedback. CONCLUSIONS Study results reveal preferences about supervising fellows in this new subspecialty. Hospitalists, fellows, and SRs may have differing opinions regarding workflow, communication, and teaching, impacting team leadership and autonomy.
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Affiliation(s)
- Kimberly O'Hara
- Department of Pediatrics (K O'Hara, SI Ziniel), University of Colorado School of Medicine, Aurora, Colo. kimberly.o'
| | - Ashlie Tseng
- Department of Pediatrics (A Tseng), Virginia Commonwealth University School of Medicine, Richmond, Va
| | - Stephanie Moss
- Department of Hospital Medicine (S Moss), Cleveland Clinic Community Care, Cleveland, Ohio; Department of Pediatric Hospital Medicine (S Moss), Pediatrics Institute, Cleveland Clinic, Cleveland, Ohio
| | - Lori Herbst
- Division of Hospital Medicine, Department of Pediatrics (L Herbst, B Herbst), Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio; Geriatrics & Palliative Care Division, Department of Family and Community Medicine (L Herbst), University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Sarah Marsicek
- Department of Pediatrics (S Marsicek), AdventHealth for Children, Orlando, Fla
| | - Kira Molas-Torreblanca
- Department of Pediatrics (K Molas-Torreblanca), Keck School of Medicine of USC, Los Angeles, Calif; Division of Hospital Medicine (K Molas-Torreblanca), Children's Hospital Los Angeles, Los Angeles, Calif
| | - Brian Herbst
- Division of Hospital Medicine, Department of Pediatrics (L Herbst, B Herbst), Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio; Department of Internal Medicine (B Herbst), University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Jennifer Maniscalco
- Department of Pediatrics (J Maniscalo), Johns Hopkins University, Johns Hopkins All Children's Hospital, Office of Medical Education, St. Petersburg, Fla
| | - Sonja I Ziniel
- Department of Pediatrics (K O'Hara, SI Ziniel), University of Colorado School of Medicine, Aurora, Colo
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Abstract
This article is the first in a 7-part series (Table 1) that aims to comprehensively describe the current state and future directions of pediatric emergency medicine fellowship training from the essential requirements to considerations for successfully administering and managing a program to the careers that may be anticipated on program completion. This overview article provides a framework for the series.
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