Is it too complex? A survey of pediatric residency program’s educational approach for the care of children with medical complexity

Abstract

Background Although Entrustable Professional Activities (EPAs) regarding pediatric training in care for children with medical complexity (CMC) exist, it is unknown what US pediatric training programs provide for education related to care of CMC and whether educators perceive that pediatric residents are prepared to care for CMC upon graduation. Methods From June, 2021 through March 2022, we surveyed US pediatric residency program delegates about practice settings, current educational offerings, perception of resident preparedness regarding care of CMC, and likelihood to implement CMC education in the future. Results Response rate was 29% (56 /195). A third of responding programs (34%, n = 19) provide a specific educational CMC offering including combinations of traditional didactics (84%, n = 16), asynchronous modules/reading (63%, n = 12), experiential learning (58%, n = 11), and simulation-based didactics (26%, n = 5). The majority (93%, n = 52) of respondents agreed residents should be competent in providing primary care for CMC upon graduation and CMC should receive primary care from a resident (84%, n = 47). A total of 49% (n = 27) of respondents reported their residents are very or extremely well prepared to care for CMC after graduation. A total of 33% (n = 18) of programs reported CMC receive primary care from residents. Respondent average perception of resident preparedness was significantly higher in programs with educational offerings in five of eleven EPAs (nutrition and weight, transitions, feeding tubes, advocacy, and care coordination). The majority (78%, n = 29) of programs without educational offerings are at least somewhat likely to implement CMC curricula in the next three years. Conclusion Pediatric residency programs report residents should be competent in care for CMC upon graduation. Pediatric residents are exposed to a wide variety of clinical care models for CMC. The minority of responding programs have intentional CMC educational offerings. Of those programs that provide CMC education, the offerings are variable and are associated with a perception of improved preparedness to care for CMC upon graduation.

Nurse‐led proactive mobile application in symptom management for children with medical complexity: Study protocol for a randomized controlled trial

“…Children with medical complexity (CMC) have become increasingly important in the past decade (Sieplinga et al, 2023). It has been estimated that the highest number of CMC in the United States is between 0.4% and 0.7% (Berry et al, 2014).…”

Adapting to Adversity: A Case Study of Asynchronous Learning Implementation in a Relocated University Amidst War

“…Asynchronous learning, a mode of education where teaching materials are prepared and delivered to learners to access at their convenience [19,20], has become an instrumental element of the "university without walls" concept. This non-traditional education system diverges from synchronous learning, where all participants must be present at the same time, either physically or virtually [21,22]. With frequent electricity blackouts and uncertain access to stable internet due to rocket attacks, asynchronous learning technologies have offered a semblance of normalcy and continuity to Ukrainian students.…”

The challenge and opportunity of pediatric hospital care in the era of medical complexity

“…A minority of pediatric residency programs provide intentional CMC educational programming, and most trainees report a lack of preparedness in caring for this population. 3 Pediatric trainees require deliberate educational experience to ensure they can meet the unique care needs of CMC. 3 Pediatric hospital medicine competencies and fellowship training programs have incorporated a specific focus on CMC.…”

“…3 Pediatric trainees require deliberate educational experience to ensure they can meet the unique care needs of CMC. 3 Pediatric hospital medicine competencies and fellowship training programs have incorporated a specific focus on CMC. 4 As healthcare systems, hospitals, and training programs evolve to meet the needs of CMC, partnership with children, youth, and caregivers is critical in this journey.…”