Transition to Pediatric Practice: A Residency Elective Experience to Prepare Senior Pediatric Residents for General Pediatric Primary Care

Pediatric Resident Education in Pulmonary (PREP): A Subspecialty Preparatory Boot Camp Curriculum for Pediatric Residents

INTRODUCTION

Medical errors can occur any time resident physicians transition between rotations, especially to unfamiliar areas such as subspecialty pediatrics. To combat this, we created and implemented the pediatric resident education in pulmonary (PREP) boot camp using Kern's six-step approach to curriculum development.

METHODS

PREP was a 5-hour session with multiple high-yield components held on the first day of each new rotation, aimed to prepare residents to care for complex pulmonary inpatients, including those with tracheostomy and ventilator dependence, asthma, and cystic fibrosis. The curriculum was evaluated at multiple time points through surveys of residents and faculty and two formal resident focus group sessions.

RESULTS

PREP was successfully implemented in July 2018 with continued monthly sessions held. Thirty-five residents participated in the first year. Resident perceived preparedness and confidence in taking call duties increased significantly following PREP. All residents rated PREP as extremely helpful or very helpful, the highest ratings possible. Overall, residents preferred active learning strategies. All qualitative data revealed positive effects of PREP. Clinical faculty in the pulmonology division found PREP similarly helpful and felt that PREP better prepared residents to provide care to pulmonary inpatients than our previous model.

DISCUSSION

Our monthly preparatory boot camp on the first day of residents' inpatient pulmonary rotation has improved resident experience, preparedness, and ability to care for complex pulmonary patients. The curriculum was adjusted in response to feedback to increase hands-on time and interactive sessions. Protected time for residents and active learning strategies were key to success of PREP.

How to Find an Academic Position After Residency: Who, What, When, Where, Why, and How

Introduction

Transitioning from trainee to practicing physician is a process that is not frequently discussed during postgraduate training, but such a discussion is necessary if the number of academic physicians is to increase and physicians from underrepresented communities are to gain insight about the varied opportunities to join academe. This workshop combines a case-based format in its didactic portion with a step-by-step guide and time line to introduce the process for securing an academic position postresidency.

Methods

Kern's six-step model was used as the framework for the workshop's design, delivery, and assessment. The workshop was presented to medical students and residents at a series of programs fostering the development of the next generation of academic physicians that were offered at host medical schools across the US between July 2016 and May 2017.

Results

Evaluation data were collected from 64 participants from nine academic medicine conferences across the nation. In comparing pre- and postworkshop responses, there was a statistically significant increase in confidence to find an academic position after residency (1.95 vs. 3.18, paired-sample t test, p < .001). More than 90% of respondents agreed or strongly agreed that the workshop's three objectives were met. Participants commented that they appreciated discussions on contracts and the steps they should take following residency in order to successfully obtain an academic position.

Discussion

This workshop may assist trainees in making better-informed decisions about considerations that are important for finding and retaining an academic position long-term.

Neonatal Intensive Care Unit Boot Camp: A Preparatory Curriculum for Pediatric Residents

Introduction

Resident training has changed significantly in recent years, resulting in reduced experiences and practice. Because pediatric residents have fewer required intensive care unit (ICU) rotations, we introduced a neonatal ICU (NICU) boot camp (2014-2015) that continues today to prepare residents immediately prior to beginning an NICU rotation.

Methods

The NICU boot camp consists of three 1-hour sessions: two interactive lectures with case-based application and one hands-on, integrative learning using simulation. The sessions are designed to cover basic information to assist in daily rounding and decision making while in the NICU. After their NICU rotation, residents complete a 12-item questionnaire. Program evaluation includes direct observation during sessions, faculty debriefing, and a postprogram resident survey.

Results

Fifty-seven residents participated; questionnaire responses were available from 46 (80.70%). Combined percentages of very useful and extremely useful responses for the three sessions were 82.61%, 78.26%, and 82.60%, with 86.95% for the overall program; 80.40% agreed that repeating boot camp prior to each NICU rotation would be useful. Analysis of narrative responses revealed that participation in boot camp enhanced residents' readiness and confidence for patient care in the NICU and as stated for each educational objective.

Discussion

Program evaluation results support highly effective and sustainable implementation and achievement of educational objectives. Minor refinements continue for enhancing active learning and content materials and for increasing rigor of program evaluation. Results also suggest that our boot camp may benefit other pediatric programs and serve as a model for use in other resident specialty programs.