33. BARRIERS AND FACILITATORS TO PEDIATRIC RESIDENT EDUCATION IN THE EMERGENCY DEPARTMENT: A QUALITATIVE STUDY UTILIZING FOCUS GROUPS

Abstract

Background The Accreditation Council for Graduate Medical Education mandates pediatric residency programs provide educational experiences. Local resident evaluations of the Pediatric Emergency Department (ED) declined over the last 5 years. This prompted a literature review showing that resident perspectives on educational experiences are sparse. This study discovers the barriers and facilitators to resident education in the Pediatric ED. Methods This qualitative study utilizing focus groups was completed at a large Pediatric training hospital. Trained facilitators performed semi-structured interviews prompting discussion of resident experiences in the Pediatric ED. One pilot and 6 focus groups (32 pediatric residents) achieved data saturation. Sessions were audio recorded, de-identified and then transcribed by a professional service. Three authors (CJ, JM, SS) analyzed the transcripts independently using line-by-line coding. Following code agreement, authors identified central categories and themes drawing on grounded theory. Results 6 categories emerged: (1) ED environment (2) Consistent goals, expectations, and resources (3) ED workflow (4) Preceptor Accessibility (5) Resident Growth and Development (6) Preconceived Notions of the ED. Residents value a respectful work environment despite the chaotic nature of the ED. They need clear rotation goals and expectations with a strong orientation. Autonomy with open communication and shared decision-making allows residents to feel like members of the team. Residents gravitate toward welcoming, available preceptors who love to teach. More ED environment exposure increases comfort and efficiency and helps develop medical decision-making skills. Lastly, residents admit preconceptions about the ED and personality traits affect performance. Conclusion Residents identified barriers and facilitators to ED education. Educators must provide a safe and open learning environment, clear rotation expectations and goals, consistent attitudes with a teamwork mentality, and allow autonomy to build residents practice styles.