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Background: Neuropsychological assessments are used in hospitals to examine brain-behaviour relationships, and are an integral part of care for medically complex patients. Unfortunately, waitlists can be lengthy. We gathered information regarding best-practice guidelines and physician referral patterns in an effort to better manage the neuropsychology waitlist at a pediatric hospital. Methods: We conducted: 1) A semi-structured telephone survey with 4 Canadian, pediatric, hospital-based neuropsychology services; 2) An electronic survey distributed to referring physicians at CHEO; 3) A focus group for CHEO neurologists and neurosurgeons. Results: The telephone survey indicated that there are no clear, best-practice guidelines for pediatric neuropsychologists working in a tertiary, pediatric hospital. The electronic survey revealed some confusion about neuropsychology services and indicated the need for better communication between neuropsychology and referral sources. The focus group revealed that demand for neuropsychology services far outstrips supply and confirmed the need for better communication. Conclusions: The results confirmed the need for best-practice guidelines to be developed around delivering neuropsychology services within a pediatric tertiary care setting, as well as continuing to work closely with neurology and neurosurgery to ensure that the neuropsychological needs of their patients are met.

Purpose Childhood experiences affect health across the lifespan. Evidence-based prevention and treatment strategies targeting early-life stress are emerging. Nevertheless, faculty physicians' preparation to incorporate this science into practice has not been well studied. The purpose of this study was to explore medical faculty knowledge and beliefs, timing and route of knowledge acquisition, perceived relevance and application of topics, and any associated faculty characteristics. Method The research team developed and administered a 39-question survey to faculty from six departments at the University of Illinois College of Medicine and Rush Medical College in Chicago. The team employed quantitative and qualitative methods to analyze responses. Results Eighty-one (8.8%) eligible faculty completed the survey. Of respondents, 53 (65.4%) achieved a high score on knowledge questions, 34 (42.0%) on beliefs questions, and 42 (59.1%) described high concept exposure, but only six (7.4%) through a formal route. Although 78 (96.8%) respondents indicated that survey concepts are relevant, only 18 (22.2%) reported fully incorporating them in their work. Respondents reporting full incorporation of concepts were significantly more likely to attain high concept exposure scores than those not fully incorporating concepts (17 respondents, 94.4%, vs. 25 respondents, 39.7 %, P < .001), whether reporting formal or informal exposure. Both quantitative and qualitative analysis highlighted limited awareness among respondents of trauma prevalence among healthcare workers, lack of familiarity with interventions, and challenges in addressing childhood experiences given time and resource constraints. Conclusions Most respondents had some familiarity with the impact of childhood experiences on health and perceived the relevance of this science. Nonetheless, many identified the need for additional coaching. Because results suggest that exposure supports full application of concepts, intentional faculty development and establishment of medical education competencies is pivotal to prepare faculty to include these crucial topics in patient care and teaching.