Assessment of the Training Needs of Paediatric Residents in Developing a Curriculum in Gastroenterology

Abstract

Abstract BACKGROUND: Well defined and focused objectives are essential for effective learning. Paediatric residents are expected to meet the educational objectives as set out by the Royal College of Physicians and Surgeons of Canada (RCPSC). For rotation in paediatric gastroenterology, it is unclear how the objectives and list of key clinical conditions was originally developed and which of them are most important for general practice. With increasing educational commitments, residents have limited time to acquire all the essential skills needed for clinical practice. OBJECTIVES: To identify topics in gastroenterology which are of most importance in general pediatric practice. This would enable development of a concise and focused curriculum for pediatric residents doing rotation in gastroenterology. DESIGN/METHODS: All paediatricians in the four Canadian Atlantic provinces were surveyed with a mailed questionnaire. The list consisted of 14 clinical conditions from the current RCPSC objectives with additional 6 generated after input from regional paediatric gastroenterologists. Information was collected on demographics including type and duration of pediatric practice. The participants ranked the conditions on a 4 point Likert scale (from Not Important to Very Important). RESULTS: Of the 234 subjects, 132 (56%) responded. Of these, 57.5% were female, 48.8% were academic and 48% were general pediatricians. The majority (73.2%) were in practice >10 years and 75.6% felt that a rotation in gastroenterology should be mandatory in pediatric residency training. Celiac disease, gastroesophageal reflux and obesity were identified as Very Important conditions by 94.4%, 96.1% and 96.0% of the participants respectively. These are currently not in RCPSC list of clinical problems. Clinical situations encountered in long-term follow-up of survivors of liver transplantation (RCPSC objective) and chronic pancreatitis were considered Not Important by 61.3% and 58.3% of respondents respectively. Academic pediatricians placed significantly more importance on abdominal pain than non-academic pediatricians (p=0.029). Pediatricians in practice for <10 years identified issues encountered in long-term follow-up of liver transplantation (p=0.039) and celiac disease (p=0.015) as significantly more important than those in practice longer. There were no significant differences between general paediatricians and specialists in cross analysis of all other variables studied. CONCLUSION: Needs assessment for paediatric residency curriculum development is important as it can identify gaps in RCPSC objectives. Input from general pediatricians should be sought systematically and on an ongoing basis in order to keep the curriculum current and focused.