Failure of Israeli pediatric residency curricula to cover child development and special education issues: results of a national survey on levels of knowledge

Abstract

Background There is an increasing prevalence of developmental difficulties among Israeli children. We aimed to assess whether pediatricians are equipped to diagnose and manage them. Methods We assessed the knowledge of basic child development issues and availability of services and content of special education systems among a randomly selected national sample of residents and senior Israeli pediatricians. This was done via an 70-itemed survey developed especially for this study which consisted of seven main subjects: developmental milestones, global developmental delay, autism spectrum disorder, attention deficit hyperactivity disorder, protocol for referring to a child development institute, availability and facilities of special education systems, and medical conditions associated with developmental delay. Results A total of 310 pediatricians (an 86 % usable response rate) participated. The total median knowledge score was 32.1 % (IQR 17.8–53.5 %). Knowledge was significantly better among senior pediatricians (p < .001), those working in an office-based setting (p < .001), and those who were parents (p < .001) or had a family history of a developmental condition (p = .003). Most responders (94 %) felt that their resident training in child development was inadequate, and that they do not have sufficient access to resources and guidelines about child development and special education systems (80 %). Conclusions The gap in knowledge on topics of child development and special education systems among Israeli pediatricians stems from inadequacies in the current curricula of pediatric residencies. The alarmingly low scores of our survey on these issues call for prompt revamping of the syllabus to include them.

“I’m 'just' a community pediatrician” views and challenges of pediatricians working in the community in Israel

“…However, while financial incentives have a short-term positive effect on recruiting physicians for less prestigious professions and working in the community, they do not have a long-term effect on keeping doctors in the community or on changing the profession’s reputation [ 2 ]. While improving pediatric education and continuing education is necessary to fill in the gaps documented for community pediatricians [ 7 ], this study suggests that reducing the feeling of professional isolation is critical to creating an environment conducive to continuing professional development for community pediatricians. Building platforms for routine professional meetings, peer learning and consultation could reduce the feeling of professional isolation and strengthen the competence and autonomy necessary to effect a change in the prestige of the profession (both internally and externally perceived).…”

“…Our research findings, despite the scale of the study, reinforce the need for policy change in the field of community pediatrics. As earlier work by Latzer et al [ 7 ] highlighted, developing and applying a community residency that includes the “new morbidities” and relevant skills for working with parents, as well as professional community mentorship, is crucial [ 7 , 8 , 27 , 28 ]. However, as highlighted in the current study, transformation is also required within community services.…”

“…These morbidities may be considered low in severity, but are very prevalent and can impact significantly upon overall developmental outcomes and health later in life. In Israel, as in many other countries, the nature of pediatric training is still predominantly based in hospital, with a focus on physical illness [ 7 ]. The appropriate tools, skills and exposure required for community pediatric work [ 5 , 8 ] are inadequately provided.…”