Creating the Subspecialty Pediatrics Investigator Network

High, Pamela; McGann, Kathleen A.; Pitts, Sarah; Baffa, Gina; Turner, David A.; Fussell, Jill J.; High, Pam; Hsu, Deborah; Stafford, Diane; Aye, Tandy; Sauer, Cary G.; Kesselheim, Jennifer C.; Myers, Angie; McGann, K P; Dammann, Christiane E.L.; Chess, Patricia R.; Mahan, John D.; Weiss, Pnina; Curran, Megan L.; Schwartz, Alan; Carraccio, Carol; Herman, Bruce; Mink, Richard; Havalad, Vinod; Pinheiro, Joaquim; Alderman, Elizabeth M.; Fuloria, Mamta; McCabe, Megan; Mehta, Jay; Rivas, Yolanda; Rosenberg, Maris; Doughty, Cara; Hergenroeder, Albert C.; Kale, Arundhati S.; Lee-Kim, YoungNa; Rama, Jennifer A.; Steuber, Phil; Voigt, Bob; Hardy, Karen; Johnston, Samantha; Boyer, Debra; Mauras, Carrie; Schonwald, Alison; Sharma, Tanvi; Barron, Christine; Dennehy, Penny; Jacobs, Elizabeth; Welch, Jennifer; Kumar, Deepak; Mason, Katherine; Roizen, Nancy; Rose, Jerri A.; Bokor, Brooke; Chapman, Jennifer; Frank, Lowell; Sami, Iman; Schuette, Jennifer; Lutes, R. Esther; Savelli, Stephanie; Amirnovin, Rambod; Harb, Rula; Kato, Roberta M.; Marzan, Karen; Monzavi, Roshanak; Vanderbilt, Doug; Doughty, Lesley; McAneney, Constance; Rice, Ward R.; Widdice, Lea E.; Erenberg, Fran; Gonzalez, Blanca E.; Adkins, Deanna; Green, Deanna; Narayan, Aditee P.; Rehder, Kyle J; Clingenpeel, Joel; Starling, Suzanne P.; Karpen, Heidi; Rouster‐Stevens, Kelly; Bhatia, Jatinder; Fuqua, John S.; Anders, Jennifer; Trent, Maria; Ramanathan, Rangasamy; Nicolau, Yona; Dozor, Allen J.; Kinane, T. Bernard; Stanley, Takara L.; Rao, Amulya Nageswara; Bone, Meredith; Camarda, Lauren; Heffner, Viday; Kim, Olivia; Nocton, James J.; Rabbitt, Angela L.; Tower, Richard L.; Amaya, Michelle; Jaroscak, Jennifer Joi; Kiger, James; Macias, Michelle M.; Titus, Olivia; Awonuga, Modupe; Vogt, Karen; Warwick, Anne B.; Coury, Dan; Hall, Mark A.; Letson, Megan M.; Rose, Melissa J.; Glickstein, Julie S.; Lusman, Sarah Shrager; Roskind, Cindy G.; Soren, Karen; Katz, J; Siqueira, Lorena M.; Atlas, Mark; Blaufox, Andrew D.; Gottleib, Beth; Meryash, David L.; Vuguin, Patricia; Weinstein, Toba; Armsby, Laurie B.; Madison, Lisa; Scottoline, Brian; Shereck, Evan; Henry, M.; Teaford, Patricia A.; Long, Sarah S; Varlotta, Laurie; Zubrow, Alan B.; Barlow, Courtenay B.; Feldman, Heidi M.; Ganz, Hayley; Grimm, Paul; Lee, Tzielan; Weiner, Leonard B.; Molle-Rios, Zarela; Slamon, Nicholas; Guillén, Úrsula; Miller, Karen; Federman, Myke; Cron, Randy Q; Hoover, W.; Simpson, Tina; Winkler, Margaret; Harik, Nada; Ross, Ashley; Alibrahim, Omar; Carnevale, Frank; Waz, Wayne R.; Bany-Mohammed, Fayez; Kim, Jaehwan; Printz, Beth F.; Brook, Mike; Hermiston, Michelle L.; Lawson, Erica; Schaik, Sandrijn van; McQueen, Alisa; Booth, Karin Vander Ploeg; Tesher, Melissa; Barker, J. C.; Friedman, Sandra; Mohon, Ricky; Sirotnak, Andrew; Brancato, John C.; Sayej, Wael N.; Maraqa, Nizar; Haller, Michael J.; Stryjewski, Brenda; Brophy, Pat D.; Rahhal, Riad; Reinking, Ben; Volk, Paige; Bryant, Kristina; Currie, Melissa; Potter, Katherine E.; Falck, Alison; Weiner, Joel; Carney, Michele; Felt, Barbara T.; Barnes, Andy; Bendel, Catherine M.; Binstadt, Bryce A.; Carlson, Karina M.; Garrison, Carol B.; Moffatt, Mary; Rosen, John M.; Sharma, Jotishna; Tieves, Kelly S.; Hsu, Hao-Jen; Kugler, John D.; Simonsen, Kari; Fastle, Rebecca K.; Dannaway, Doug; Krishnan, Sowmya; McGuinn, Laura; Lowe, Mark E.; Witchel, Selma F.; Matheo, Loreta; Abell, Rebecca; Caserta, Mary T.; Nazarian, Emily; Yussman, Susan M.; Diaz-Thomas, Alicia; Hains, David S.; Talati, Ajay J.; Adderson, Elisabeth E.; Kellogg, N; Vásquez, Margarita; Allen, Coburn H.; Brion, Luc P.; Green, Michael; Journeycake, Janna M.; Yen, Kenneth; Quigley,, Ray; Blaschke, Anne J.; Bratton, Susan L.; Yost, Christian C.; Etheridge, Susan P.; Laskey, Toni; Pohl, John F.; Soprano, Joyce V.; Fairchild, Karen D.; Norwood, Vicky; Johnston, Troy A.; Klein, Eileen J.; Kronman, Matthew P.; Nanda, Kabita; Smith, Lincoln; Allen, David E.; Frohna, John G.; Patel, Neha; Estrada, Cristina; Fleming, Geoffrey M.; Gillam-Krakauer, Maria; Moore, Paul; Khoury, Joseph; Helderman, Jennifer; Barretto, Greg; Levasseur, Kelly; Johnston, Lindsay

doi:10.1016/j.jpeds.2017.09.079

Cited by 19 publications

(4 citation statements)

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“…The study team included 8 members of the Association of Pediatric Program Directors (APPD) Subspecialty Pediatrics Investigator Network (SPIN), representing 7 different subspecialties, and a dedicated study coordinator who conducted the interviews. 29 The APPD SPIN team members all had significant knowledge and experience with training pediatric subspecialty fellows and GME but variable personal experience with EPA implementation. One member (MLL) with expertise in qualitative research led the team and provided training to both the study coordinator and other research team members.…”

Section: Methodsmentioning

confidence: 99%

Exploring Factors for Implementation of EPAs in Pediatric Subspecialty Fellowships: A Qualitative Study of Program Directors

Czaja,

Mink,

Herman

et al. 2024

Journal of Medical Education and Curricular Development

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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 analysis. RESULTS Twenty-eight FPDs representing 11 pediatric subspecialties were interviewed, of whom 16 (57%) reported current EPA use. Five major themes emerged: (1) facilitators including the intuitive nature and simple wording of EPAs; (2) barriers such as workload burden and lack of a regulatory requirement; (2) variable knowledge and training surrounding EPAs, leading to differing levels of understanding; (3) limited current use of EPAs, even among self-reported users; and (4) complementary nature of EPAs and milestones. FPDs acknowledged the differing strengths of both EPAs and milestones but sought additional knowledge about the value added by EPAs for assessing trainees, including the impact on outcomes. CONCLUSIONS Identified themes can inform effective and meaningful EPA implementation strategies: Supporting and educating FPDs, ongoing assessment of the value of EPAs in training, and practical integration with current workflow. Generating additional data and engaging stakeholders is critical for successful implementation for the pediatric subspecialties.

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Section: Methodsmentioning

confidence: 99%

Exploring Factors for Implementation of EPAs in Pediatric Subspecialty Fellowships: A Qualitative Study of Program Directors

Czaja,

Mink,

Herman

et al. 2024

Journal of Medical Education and Curricular Development

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“…Using a modified Delphi approach, the steering committee of the Subspecialty Pediatrics Investigator Network (SPIN) ( 11 ), an educational research network, adapted the supervision scales to the pediatric pulmonology EPAs with input from members of the Pediatric Pulmonary Training Directors Association in 2017 ( Table 1 ). The SPIN steering committee is composed of up to two representatives from each of the 14 pediatric subspecialties approved by the Accreditation Council for Graduate Medical Education (ACGME) and for which the ABP offers certification, as well as representatives from the Council of Pediatric Subspecialties, ABP, and Association of Pediatric Program Directors Fellowship Executive Committee and Longitudinal Educational Assessment Research Network.…”

Section: Methodsmentioning

confidence: 99%

Minimum Supervision Levels Required by Program Directors for Pediatric Pulmonary Fellow Graduation

et al. 2021

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Background: Entrustable professional activities (EPAs) define the essential tasks expected of subspecialists in unsupervised practice. Although EPAs have been piloted in some programs, their use for summative assessment of pediatric pulmonology fellows for graduation has not been studied. Objective: To determine the minimum level of supervision that pediatric pulmonary program directors (PDs) require of their fellows for graduation and compare it with the minimum level of supervision they expect for a practicing subspecialist for the five pediatric pulmonology EPAs. Methods: Using a modified Delphi approach, we developed supervision scales for the five pediatric pulmonology EPAs and conducted a national survey of pediatric pulmonary PDs in the United States through the Subspecialty Pediatric Investigators Network between April 2017 and August 2017. Results: Forty-six pediatric pulmonary PDs completed the survey, representing a response rate of 85%. The majority did not require fellows to be trusted to practice without supervision for graduation for any of the five EPAs (level 5); the median minimum level of supervision they required was 4, equating to indirect supervision for complex cases. The minimum level for graduation , defined by consensus as the level of supervision for which no more than 20% of PDs would want the level to be lower to allow a fellow to graduate, was 3, which corresponded to requiring supervision for both simple and complex cases. There was a statistically significant difference between the minimum level of supervision deemed necessary by PDs for graduation and for practice as a subspecialist for each of the EPAs. Conclusion: Most pediatric pulmonary PDs reported that they would graduate fellows who may still require indirect supervision for the five pediatric pulmonology EPAs. The findings suggest a need for stakeholders to reevaluate the structure and outcomes of training programs and ensure support for pediatric pulmonologists in their early practice period.

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“…The study was conducted by the Subspecialty Pediatrics Investigator Network (SPIN), a medical education research network. 15 Briefly, SPIN is a collaboration between the Council of Pediatric Subspecialties, the American Board of Pediatrics (ABP), the Association of Pediatric Program Directors Fellowship Executive Committee, and the Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network (APPD LEARN). 16 It also includes up to 2 representatives from each of the 14 pediatric subspecialties that have ABP certification.…”

Section: Methodsmentioning

confidence: 99%

Agreement of Program Directors With Clinical Competency Committees for Fellow Entrustment

Mink

Herman

Carraccio

et al. 2020

Journal of Medical Education and Curricular Development

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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 not a member of the CCC. In addition, we examined the effect of program size, FPD understanding of EPAs, and subspecialty on the correlations. Data were obtained in fall 2014 and spring 2015. Results: A total of 1040 fellows were assessed in the fall and 1048 in the spring. In both periods and for each EPA, there was a strong correlation between FPD and CCC supervision levels ( P < .001). The correlation was somewhat lower when the FPD was not a CCC member ( P < .001). Overall bias in both periods was small. Conclusions: The correlation between FPD and CCC assignment of EPA supervision levels is strong. Although slightly weaker when the FPD is not a CCC member, bias is small, so this is likely unimportant in determining fellow entrustment level. The similar performance ratings of FPDs and CCCs support the validity argument for EPAs as competency-based assessment tools.

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Creating the Subspecialty Pediatrics Investigator Network

Cited by 19 publications

References 1 publication

Exploring Factors for Implementation of EPAs in Pediatric Subspecialty Fellowships: A Qualitative Study of Program Directors

Exploring Factors for Implementation of EPAs in Pediatric Subspecialty Fellowships: A Qualitative Study of Program Directors

Minimum Supervision Levels Required by Program Directors for Pediatric Pulmonary Fellow Graduation

Agreement of Program Directors With Clinical Competency Committees for Fellow Entrustment

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