Fears and Stressors of Trainees Starting Fellowship in Pediatric Cardiology

Brown, David W.; Binney, Geoffrey; Gauthier, Zachary; Blume, Elizabeth D.

doi:10.1007/s00246-019-02276-z

Cited by 14 publications

(19 citation statements)

References 14 publications

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“…Such training can prove stressful for trainees even in well-structured programmes; hence, it is critically important that the training provided be of high-quality and relatively standardised across different borders. 19,22 Creative solutions in reducing stress may include novel instructional techniques (e.g. echocardiography bootcamp or simulation) which can be easily incorporated into training at an early stage to allay some of these pressures on trainees.…”

Section: Discussionmentioning

confidence: 99%

Paediatric and adult congenital cardiology education and training in Europe

et al. 2022

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Background: Limited data exist on training of European paediatric and adult congenital cardiologists. Methods: A structured and approved questionnaire was circulated to national delegates of Association for European Paediatric and Congenital Cardiology in 33 European countries. Results: Delegates from 30 countries (91%) responded. Paediatric cardiology was not recognised as a distinct speciality by the respective ministry of Health in seven countries (23%). Twenty countries (67%) have formally accredited paediatric cardiology training programmes, seven (23%) have substantial informal (not accredited or certified) training, and three (10%) have very limited or no programme. Twenty-two countries have a curriculum. Twelve countries have a national training director. There was one paediatric cardiology centre per 2.66 million population (range 0.87–9.64 million), one cardiac surgical centre per 4.73 million population (range 1.63–10.72 million), and one training centre per 4.29 million population (range 1.63–10.72 million population). The median number of paediatric cardiology fellows per training programme was 4 (range 1–17), and duration of training was 3 years (range 2–5 years). An exit examination in paediatric cardiology was conducted in 16 countries (53%) and certification provided by 20 countries (67%). Paediatric cardiologist number is affected by gross domestic product (R2 = 0.41). Conclusion: Training varies markedly across European countries. Although formal fellowship programmes exist in many countries, several countries have informal training or no training. Only a minority of countries provide both exit examination and certification. Harmonisation of training and standardisation of exit examination and certification could reduce variation in training thereby promoting high-quality care by European congenital cardiologists.

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Section: Discussionmentioning

confidence: 99%

Paediatric and adult congenital cardiology education and training in Europe

et al. 2022

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“…Stressors in pediatric subspecialty fellows have been identified in some individual subspecialties, but not broadly across all groups. At the start of their training, pediatric cardiology fellows at a single institution self-reported fears and stressors [ 22 ]. Pediatric emergency medicine and critical care fellows across the country self-reported stressors, and identified factors associated with burnout using Likert scales [ 5 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…No studies have identified self-reported stressors for pediatric residents; they have only been identified by program directors [ 19 ] or by collecting objective data such as work hours and demographics and comparing them to burnout data [ 4 , 20 , 21 ]. Only a few studies have queried pediatric subspecialty fellows about their stressors [ 5 , 22 , 23 ], but all of these studies focused on specific subspecialties rather than pediatric fellows more generally.…”

Section: Introductionmentioning

confidence: 99%

Thematic analysis comparing stressors for pediatric residents and subspecialty fellows at a large children’s hospital

Bajaj

Reed

2022

Annals of Medicine

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Introduction Pediatric residents and subspecialty fellows experience a significant number of stressors during training, but they have rarely been self-reported or compared between groups. This qualitative study aimed to identify and compare themes of stressors experienced by pediatric residents and subspecialty fellows at a single large children’s hospital. Materials and methods Using an open-ended survey at single time point for each group, we asked residents and fellows to list the stressors they face in training. The survey data was iteratively analyzed using thematic analysis then quantified by its frequency in each group and compared using a chi-square distribution or a Fisher’s exact test, as appropriate. Results Twenty-eight of 159 residents (18%) and 38 of 180 fellows (21%) answered the survey question, and an average of 2.8 stressors were identified by each resident and fellow. Two major themes and five major subthemes were shared between both groups. The theme Stressors at Home included the subthemes Difficulty Maintaining Overall Health and External Stressors . The theme Stressors at Work encompassed the subthemes Clinical Stressors Innate to Patient Care, Demanding Workload and Schedule, and Stressors Related to Culture of Work Environment . Within the subthemes, there were differences in categories of stressors between the groups. While there was no statistically significant difference in the distribution of themes, subthemes, or categories of stressors mentioned between groups, in general residents identified stressors associated with lack of autonomy and control whereas fellows focused on clinical uncertainty and complex situations. Conclusions While residents and fellows shared similar themes and subthemes for stressors, there was variability between individual categories. This study identified individual self-reported stressors that can be used by programs to design interventions to improve trainee well-being, but it also implies that programmatic support at different levels of training should be tailored to the target group. KEY MESSAGE At our hospital, we found that some self-reported stressors facing pediatric residents and fellows were common and some unique. Stressors included those that can be eliminated or diminished as well as those that cannot. With knowledge that these disparities exist, training programs should use unique strategies to provide support for the two groups and their stressors.

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“…Due to increasing sub-specialization and concerns for duty-hour violations, these measures were re-examined and are no longer a requirement. The pace of change in our field will inevitably leave trainees insufficiently prepared without constant evolution and re-evaluation of how we train them [ 26 ]. One way addressing this feeling of insufficiency has been to build the trainee’s confidence and competence through entrustment with various tasks [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

Entrustable Professional Activities and Their Relevance to Pediatric Cardiology Training

et al. 2022

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Entrustable professional activities (EPAs) have become a popular framework for medical trainee assessment and a supplemental component for milestone and competency assessment. EPAs were developed to facilitate assessment of competencies and furthermore to facilitate translation into clinical practice. In this review, we explore the rationale for the introduction of EPAs, examine whether they fulfill the promise expected of them, and contemplate further developments in their application with specific reference to training in pediatric cardiology.

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Fears and Stressors of Trainees Starting Fellowship in Pediatric Cardiology

Cited by 14 publications

References 14 publications

Paediatric and adult congenital cardiology education and training in Europe

Paediatric and adult congenital cardiology education and training in Europe

Thematic analysis comparing stressors for pediatric residents and subspecialty fellows at a large children’s hospital

Entrustable Professional Activities and Their Relevance to Pediatric Cardiology Training

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