Pediatric Training Research Articles

Adolescent-Reported Changes in Provider Behavior Following Pediatrician Training in Stimulant Diversion Prevention: Results From a Cluster Randomized Controlled Trial.

To test whether pediatrician training leads to provider utilization of stimulant diversion prevention strategies as reported by adolescent patients with ADHD. Pediatric practices received a stimulant diversion prevention workshop (SDP) or continued treatment-as-usual (TAU) in a cluster-randomized controlled trial. Surveys were completed by 341 stimulant-treated patients at baseline and three follow-up assessments. In intent-to-treat analyses of patient reports, SDP adolescents reported more provider use of diversion prevention strategies compared to TAU. They also reported more parent-patient communication about diversion. Provider satisfaction with the training was strong. Pediatricians can make use of clinical practice strategies for the prevention of stimulant diversion following a 1-hr training; findings are novel given their reliance on confidential patient report of provider behavior and increase confidence in the results. Coupled with the positive provider satisfaction ratings, results suggest that this brief workshop may be an option for concerned providers that also has the effect of increasing discussion at home about safe use of stimulants.

Teaching pediatric cardiology fellows to communicate serious news: a pilot study

BackgroundPediatric cardiology fellows often deliver serious news to families. Effective clinician-patient communication is the basis of strong therapeutic relationships and improves health outcomes, increases patient adherence, and enhances patient satisfaction. Communication training improves physicians’ communication skills, ability to deliver serious news, and meet the informational and emotional needs of patients and family members. However, there is little data surrounding pediatric cardiology fellows competencies or training in communication skills.MethodsPediatric cardiology fellows participated in a 3-hour communication training session. The session used VitalTalk methodology and was facilitated by two VitalTalk facilitators. Fellows spent 1 h learning the skills of delivering serious news and responding to emotion and 2 h in role play with standardized actors followed by a brief group wrap-up activity. Participants took an anonymous, electronic pre- and post-survey and an 8-month follow-up survey via REDCap. Participants were asked about their preparedness and comfort performing certain communication skills and leading challenging conversations specific to pediatric cardiology. Response options used a combination of 0 (low comfort/preparedness) to 100 (high comfort/preparedness) point scales and multiple choice.Results9 fellows participated in the training and 100% completed all three surveys. Eight were first-year fellows and 1 was a third-year fellow. Finding the right words, balancing honesty with hope, and clinical and prognostic uncertainty were the top three factors that contributed to making conversations difficult. Following the course, there was a significant increase in fellow preparedness to communicate a new diagnosis of congenital heart disease, discuss poor prognoses, check understanding, and respond to emotion and an increase in fellow comfort responding to emotions. Four fellows reported using the skills from this training course in various clinical settings at 8-month follow up.ConclusionsCommunicating serious news effectively is a skill that can be learned in a sustainable way and is essential in the field of pediatric cardiology. Our study demonstrates that an interactive, VitalTalk course can improve preparedness and comfort to deliver serious news in a cohort of pediatric cardiology trainees. Future studies are needed to evaluate translation of skills to clinical practice and durability of these skills in larger cohorts.

Children's Heartbeat: A Web-Based Program to Spread Knowledge on Arrhythmias in Children.

Expertise in pediatric arrhythmia management is lacking in most low- and middle- income countries (LMIC). Strategies to disseminate education in pediatric electrophysiology are essential to meet this need. Children's Heartbeat was created to meet the growing demand for pediatric electrophysiologic consultation in LMIC. Children's Heartbeat is a virtual video-conferencing program that uses the Extension for Community Healthcare Outcomes model to disseminate knowledge about pediatric arrhythmia management from pediatric electrophysiologists to clinicians in medically under-resourced regions worldwide. Monthly virtual case-based sessions are held with pediatric electrophysiologists and clinicians in medically under-resourced settings to discuss pediatric electrophysiology management. Since its inception, Children's Heartbeat viewership has grown exponentially to include 181 total registrants, 64 average monthly participants, and an additional 121 average viewers of recorded sessions. Attendees have expressed increased confidence in pediatric arrhythmia management. Children's Heartbeat has successfully provided pediatric electrophysiology consultation to medically under-resourced regions globally and have increased clinicians' confidence in caring for children with arrhythmias. Future directions include spreading the program to general pediatric and pediatric cardiology trainees and practicing pediatricians in rural parts of high-income countries and evaluating the direct impact of Children's Heartbeat on the management of arrhythmias in pediatric patients in LMIC.

Paediatric rheumatology in Nigeria: history, challenges and the future.

Pediatric rheumatology is a relatively new subspecialty in Nigeria. For many years, rheumatic disease had not been well-recognized or studied in Nigeria, so there has been a low suspicion index. The clinical presentation of most pediatric rheumatic diseases (PRDs) mimics non-rheumatic diseases making it a diagnostic challenge most of the time. The story has changed in Lagos since the creation of a pediatric rheumatology unit at the Lagos State University Teaching Hospital. There is now a high index of suspicion for these diseases in the hospital but no one knows about what is happening in the other 35 states of the country who do not have a pediatric rheumatologist. Major challenges being faced presently are poor awareness among healthcare workers and the community, high cost of investigations and medications, lack of pediatric rheumatologists in most hospitals in the country, lack of pediatric rheumatology training centers for both undergraduate and postgraduate training, and lack of research data. The healthcare community in Nigeria is looking forward to a future where pediatric rheumatology will be highly recognized and established.

Asian representation in the United States (US) oncology workforce.

152 Background: The American Society of Clinical Oncology (ASCO) started the Diversity in Oncology initiative in 2017. Minority representation in the US oncology physician workforce was the subject of a recent series of ASCO State of the Oncology Workforce in America snapshots (1). However, Asian minority representation was not mentioned in any of these reports. Our objective was to determine the proportion of Asian workforce in various oncology specialties inclusive of physician and non-physician practitioners as well as physician trainees. Methods: We searched the web for publicly available data on Asian representation among US oncology adult (A) and pediatric (P) practitioners and trainees. Major data sources included the 2020 US Census, Association of American Medical Colleges, Accreditation Council for Graduate Medical Education, and professional societies. Practitioners included hematologists/oncologists (H/O), gynecologic oncologists (GYNO), radiation oncologists (RADO), surgical oncologists (SURGO), hematopathologists (HP), oncology nurse practitioners (ONP), oncology physician assistants (OPA), and oncology nurses (ON). Trainees included fellows (F) and residents (R). For reference, we obtained similar data on US population, medical students (MS), adult internal medicine residents (AIMR), gynecology residents (GYNR), pediatric residents (PR), pathology residents (PATHR), surgery residents (SURGR), nurses (RN), nurse practitioners (NP), and physician assistants (PA). For a snapshot of the oncology workforce, data from 2020-2022 were used. Whenever available, we obtained serial data for trainees over the years. Results: A snapshot of the proportions of Asians based on their professions is shown (Table). While Asians comprise only 6.2% of the US population, between 14.7% to 32.1% of physician practitioners in various oncology subspecialties are Asian. Moreover, between 17.9% to 35.3% of oncology physician trainees and 26.7% of medical students are Asian and these proportions have remained stable from 2005 to 2022. Data are unavailable for HP, SURGO, and non-physician practitioners except for OPA (7.0%) and RN (7.2%). Conclusions: Asians comprise a large segment of the US oncology workforce. While only 1 in 20 people in the US are Asians, between 1 in 3 and 1 in 5 oncology physician practitioners and trainees are Asians. Data are limited for non-physician practitioners. Asian minority representation should be highlighted and considered as an example of success in diversity. 1. JCO Oncol Pract 2020-2022. Snapshot of Asian representation among oncology trainees and practitioners in the US. Trainees 2022 A-H/O-F 35.3% AIMR 35.9% 2022 P-H/O-F 20.0% PR 22.0% 2022 RADO-R 26.4% MS 26.7% 2022 GYNO-F 17.9% GYNR 14.9% 2022 HP-F 20.0% PATHR 26.6% 2022 SURGO-F 21.2% SURGR 19.2% Practitioners 2021 A-H/O 32.1% OPA 7.0% 2021 P-H/O 20.4% RN 7.2% 2021 RADO 25.9% HP/SURGO/ONP/ON NA 2020 GYNO 14.7% US Census 6.2%

36 Pediatric Code Cart Training: Can Augmented Reality Improve Pediatric Readiness for Emergency Medicine Residents

36 Pediatric Code Cart Training: Can Augmented Reality Improve Pediatric Readiness for Emergency Medicine Residents

Mapping out Remediation: An Actionable Roadmap to Support Trainees Through Remediation

What’s NewThis qualitative analysis offers an actionable, stepwise approach to remediation. IntroductionThe goal of graduate medical education is for trainees to develop the competence needed to practice independently; however, some residents struggle to achieve competency and require remediation. Evidence around how to best facilitate remediation is lacking. The objective of this study was to understand best practices for remediation in pediatrics. MethodA national web-based survey of pediatric residency program directors (PDs) on remediation practices was performed. The survey included 3 open-ended questions about PDs’ experiences with remediation. Self-reported barriers to and strategies for remediation were systematically analyzed using inductive thematic analysis to develop a theory of effective remediation in pediatric residency training. ResultsA total of 99 out of 195 (50.8%) program directors responded. Two main themes emerged: developing a personalized plan that ensures competency attainment and fostering psychological safety. Twelve categories outline actionable steps that PDs can take to make the remediation process successful. DiscussionBuilt from insight from pediatric PDs, we propose a conceptual model for effective remediation that accounts for competency attainment while safeguarding the emotional health of the resident. The conceptual model breaks the remediation process down into four phases: identification of the learner who struggles, planning the remediation process, implementation of the plan, and assessing the outcome of the process.

The integral co-management role of the medical pediatric urologist: Improving the care of children with urological conditions

The complexities of modern medicine prompt a re-evaluation of traditional patient care models to enhance safety and quality. We implemented a one-year pilot Medical Pediatric Urology fellowship, jointly developed by Urology and Pediatric Hospital Medicine, where a pediatrician received postgraduate training in both specialties. This innovative program aimed to augment knowledge and expertise in non-surgical aspects of pediatric urology. Upon completion of the fellowship, the trained pediatrician assumed the role of medical pediatric urologist (MPU), integrating into both Pediatrics and Urology faculties. Unlike the traditional specialist consultation model, the MPU became integral member of the Urology Division, working full-time and sharing responsibilities for both inpatient and outpatient pediatric urology care at a tertiary pediatric hospital in Canada. This study aims to delineate the training curriculum, role, clinical outcomes, and educational impact of the MPU over eight years. We retrospectively analyzed clinical outcomes, including patient volumes seen annually by MPU, urologists, and nurse practitioners from 2021 to 2023. Clinic wait times and patient satisfaction were compared between MPU's community and tertiary hospital pediatric urology clinics. Educational impact was assessed through pediatric residents' ratings for the MPU as a clinical teacher during urology rotations using a Likert scale. Integration of MPU led to the establishment of specialized clinics, including those for neurogenic bladder and posterior urethral valves. MPU accounted for approximately 34.7% of all outpatient clinic visits. Subjective feedback highlighted enhanced quality of care with MPU co-management in the inpatient setting. Additionally, in a community-based medical urology clinic (CUC) staffed by the MPU and a pediatric urology nurse practitioner, patients experienced shorter wait times and higher satisfaction (53±36 days and 194±108 days) (p<0.01), with 97% vs. 91% of families reported feeling highly satisfied with care (p<0.01) compared with hospital clinics, respectively. The MPU received ratings of 4/5 or 5/5 as a clinical teacher from 81.82% of pediatric residents. Our novel co-management approach in pediatric urology integrates medical and surgical expertise. However, limitations include the retrospective design and single-center setting. Nonetheless, this framework presents a potential model for other surgical specialties, offering a unique practice niche for trainees interested in the medical management of surgical conditions. The medical pediatric urologist plays a pivotal role as an educator, hospitalist, and director of the outpatient clinic, effectively integrating medical and surgical expertise. The MPU model is promising for optimizing safety and quality of care in pediatric urology.

Effects of Postpartum Web-Based Breastmilk and Breastfeeding Education: A Quasi-Experimental Study

Objective: The aim of the study was to examine the effect of web-based breastfeeding education applied to postpartum primiparous women on breastmilk, breastfeeding knowledge and self-efficacy. Methods: This quasi-experimental study was conducted with 73 participants (experimental group=37; control group=36) at the Zeynep Kamil Gynecology and Pediatrics Training and Research Hospital in Istanbul, Türkiye. The study was at postpartum services between June 2018 and October 2019. The participants in the experimental group attended the internet-based breastmilk and breastfeeding education program; where as those in the control group received routine care. Data were collected pre and post training using the demographic information form, Breastmilk and Breastfeeding Knowledge Test and Breastfeeding Self-Efficacy Scale. Results: Our result showed that there was no significant difference found between the experimental and control groups on post-training on Breastmilk and Breastfeeding Knowledge Test (p&gt;.05). On the other hand, there was significant difference between the experimental and control groups on post-training on Breastfeeding Self-Efficacy Scale (p

Diagnosis of suspected pediatric distal forearm fractures with point-of-care-ultrasound (POCUS) by pediatric orthopedic surgeons after minimal training

BackgroundSeveral studies have advocated the use of ultrasound to diagnose distal forearm fractures in children. However, there is limited data on the diagnostic accuracy of ultrasound for distal forearm fractures when conducted by pediatric surgeons or trainees who manage orthopedic injuries in children. The objective of this study was to determine the diagnostic accuracy of point-of-care ultrasound (POCUS) for pediatric distal forearm fractures when conducted by pediatric surgeons and trainees after minimal training.MethodsThis diagnostic study was conducted in a tertiary hospital emergency department in Germany. Participants were children and adolescents under 15 years of age who presented to the emergency department with an acute, suspected, isolated distal forearm fracture requiring imaging. Pediatric surgeons and trainees, after minimal training for sonographic fracture diagnosis, performed 6-view distal forearm POCUS on each participant prior to X-ray imaging. All data was retrospectively collected from the hospital’s routine digital patient files. The primary outcome was the diagnostic accuracy of POCUS compared to X-ray as the reference standard.ResultsFrom February to June 2021, 146 children under 15 met all inclusion and exclusion criteria, and 106 data sets were available for analysis. Regarding the presence of a fracture, X-ray and Wrist-POCUS showed the same result in 99.1%, with 83/106 (78.3%) fractures detected in both modalities and one suspected buckle fracture on POCUS not confirmed in the radiographs. Wrist-POCUS had a sensitivity of 100% (95% CI [0.956, 1]) and a specificity of 95.8% (95% CI [0.789, 0.999]) compared to radiographs. In 6 cases, there were minor differences regarding a concomitant ulnar buckle. The amount of prior ultrasound training had no influence on the accuracy of Wrist-POCUS for diagnosing distal forearm fractures. All fractures were reliably diagnosed even when captured POCUS images did not meet all quality criteria.ConclusionPediatric surgeons and trainees, after minimal training in POCUS, had excellent diagnostic accuracy for distal forearm fractures in children and adolescents using POCUS compared to X-ray.

Clinician Willingness to Prescribe Medications for Opioid Use Disorder to Adolescents in Indiana.

Prescribing medications for opioid use disorders (MOUD), including buprenorphine, naltrexone, and methadone, to adolescents remains an underused evidence-based strategy for reducing harms associated with opioid use. To identify potential associations between clinician- and community-level characteristics regarding clinicians' self-reported willingness to prescribe MOUD to adolescents. This cross-sectional study included a phone survey of Indiana clinicians and spatial analysis of community-level characteristics. Clinicians were eligible for inclusion in analyses if actively providing health care and listed on the Buprenorphine Practitioner Locator website, a publicly available national registry of clinicians possessing a waiver to legally prescribe buprenorphine (ie, waivered clinicians). Community-level characteristics, including total population, rurality or urbanicity, percentage with incomes below the federal poverty line, and racial or ethnic makeup. Clinicians were asked about their willingness to prescribe MOUD to adolescents younger than 18 years if clinically indicated. Responses were recorded as no, yes, or yes with conditions. Among the 871 clinicians listed on the website as of July 2022, 832 were eligible for inclusion and contacted by phone. Among waivered clinicians, 759 (91.2%) reported being unwilling to prescribe MOUD to adolescents, 73 clinicians (8.8%) reported willingness to prescribe MOUD to adolescents, and only 24 (2.9%) would do so without conditions. A multivariable logistic regression model including spatially lagged community-level variables showed that, among areas with waivered clinicians, clinicians practicing in more populated areas were significantly less likely to prescribe to adolescents (β = 0.65; 95% CI, 0.49-0.87; P = .003). Similarly, those in more rural areas were significantly more likely to prescribe to adolescents (β = 1.27; 95% CI, 1.02-1.58; P = .03). Variation in clinician willingness to prescribe was not explained by other community-level characteristics. Among all waivered clinicians, advanced practice clinicians were less likely than physicians to report willingness to prescribe (β = 0.58; 95% CI, 0.35-0.97; P = .04), as were physicians without any specialty training relevant to MOUD prescribing when compared with family medicine clinicians (β = 0.40; 95% CI, 0.18-0.89; P = .03). A small subgroup of waivered clinicians had training in pediatrics (13 clinicians [1.6%]), and none were willing to prescribe MOUD to adolescents. From this cross-sectional study, it appears that Indiana adolescents continued to face gaps in access to MOUD treatment, despite its well-established efficacy. Programs that support primary care practitioners, including family medicine clinicians and pediatricians, in safe and appropriate use of MOUD in adolescents may bridge these gaps.

Paediatric medical imaging in Ireland- challenges, training, and the use of distraction techniques

The National Model of Care for Paediatric Healthcare Services, published in 2016, aims to ensure high-quality care for children across Ireland. However, with few exceptions, radiology departments in general hospitals “lack the necessary physical infrastructure, facilities, and staff training required for paediatrics.” These deficiencies can adversely affect a patient's behaviour and emotions, exacerbating fear of the healthcare system. This study sought to identify the challenges faced by radiographers in Ireland during paediatric imaging, with a focus on post-qualification training and the use of distraction techniques. A cross-sectional, qualitative online survey was conducted via Microsoft Forms, comprising 37 close-ended and eight open-ended questions on paediatric training, challenges, and distraction use. Ninety-six participants were recruited through snowball sampling from 26 hospitals and private clinics across Ireland. Only a small proportion of radiographers (n = 25, 26%) undertook post-qualification training in paediatric imaging, and many reported inadequate educational opportunities (n = 52, 60%). Patient cooperation (n = 45, 52%) and toddlers (n = 75, 90%) were identified as the most challenging aspect and age group, respectively. While distraction is commonly employed (n = 79, 91%), radiology departments often provide insufficient equipment (n = 65, 76%). The lack of equipment and training highlights the need for improvement in paediatric medical imaging services. The development of new training courses and distraction tools may enhance practice, ensuring the provision of high-quality paediatric care. Expanding radiographer training and implementing distraction tools may help paediatric patients better cope with the anxiety and stress associated with healthcare settings.

Skills on wheels: caregiver perspectives on the design and long-term impact of a pediatric wheelchair Skills training program.

Manual wheelchair skills training programs are novel developments, particularly in the United States. As perceived by the caregivers of participants, this study aimed to examine the long-term impact of the Skills on Wheels program on participants' occupational engagement and quality of life at home, at school, and in the community. Secondly, this study investigated the caregivers' perspectives of the program design of Skills on Wheels. This was a qualitative inquiry based upon thematic analyses of semi-structured interviews after participation in a pediatric wheelchair skills training program. The study participants were 9 caregivers whose children participated in this program over the 2021 and 2022 implementation years. Caregivers were given a 10-question semi-structured interview. The five overarching topics included program impact: (i) occupational engagement, (ii) program impact: quality of life factors, (iii) program resources/design, (iv) novelty/importance of program/wheelchair skills training, and (v) desired continued wheelchair skills practice in the future. Results provided tangible feedback to integrate into program design and supported the Skills on Wheels program's positive value as it relates to impact on quality of life and occupational engagement for participants.

Integrating novel interventional techniques into pediatric pulmonology training.

To review the evolution of pediatric pulmonology interventions and propose strategies for advancing training in the field. I examined the historical development of pediatric pulmonology interventions and current training practices, including hands-on courses and fellowship programs. I reviewed a survey of US pediatric pulmonology centers to assess variability in procedural expertise. Historically, foreign body removal dominated pediatric pulmonology interventions. Advancements in technology have expanded the field to include techniques such as endobronchial and transbronchial biopsies, airway lumen restoration, and cryotherapy, enabling more accurate tissue sampling with larger specimens while maintaining safety. Hands-on courses, offered globally and at major conferences, provide opportunities for skill development, self-assessment, and networking. However, limited availability leads to high demand and long waiting lists. A survey of US pediatric pulmonology centers revealed significant variability in procedural expertise, highlighting the need for uniform training across institutions. To better integrate interventional techniques, I propose that pediatric pulmonology training could benefit from a structured, tiered approach: (1) expanding hands-on workshops and incorporating them into fellowship programs, (2) facilitating collaborations between centers of excellence to allow trainees to rotate through institutions with advanced expertise, and (3) developing an additional year of training for an "Advanced Pediatric Pulmonologist" certification. This approach aims to ensure proficiency in the latest interventional techniques, standardize care, and foster advancements across the field.

Bridging oral health and nutrition: Assessing produce prescription programs in pediatric dental clinics serving low-income communities.

This study assesses the needs and feasibility of conducting a produce prescription (produce Rx) program in a pediatric dental clinic setting serving low-income patients. We conducted a cross-sectional quantitative survey examining several household characteristics including demographics, benefits received, fruit and vegetable intake patterns, food security, feasibility of a produce Rx program, and respondents' answers to questions based on social cognitive theory constructs. The survey was administered at the University of Nebraska Medical Center (UNMC) pediatric dental clinic, a pediatric dental residency clinical training site. One hundred adult respondents with low income completed a 36-item questionnaire during their child's dental appointment. Almost half of respondents reported experiencing food insecurity (45%). Respondents who were food insecure experienced higher levels of nutrition insecurity (p = 0.012), less confidence in choosing fruits and vegetables (FVs) (p = 0.026), difficulty in purchasing FVs in their neighborhood (p = 0.012), and more concern that FVs cost too much (p < 0.001) when compared to respondents who were food secure. Notwithstanding the barriers they face, almost all respondents reported that they eat FVs because of health benefits (95%) and to set a good example for their family (91%). Additionally, most respondents expressed an interest in produce Rx programs (80%) and nutrition education activities (81%). This study demonstrated the potential for produce Rx program uptake in a pediatric dental clinic setting through positive caregiver-reported need and interest. Future studies should explore how produce Rx programs can be adapted most effectively in this novel setting.

POCUS for pediatric appendicitis in the pediatric emergency department: An 8-year retrospective review.

In many centers, pediatric radiology-performed ultrasound and/or POCUS fellowship training are not readily available. To present our experience using point of care ultrasound (POCUS) in a pediatric emergency medicine training program without POCUS fellowship-trained staff, and to demonstrate that POCUS of the appendix is feasible outside the context for POCUS fellowship training. We identified children diagnosed with appendicitis or periappendiceal abscess from June 2016 to June 2024. Variables reviewed include details of PED visit such as presenting symptoms, laboratory and imaging results, and PED treatment, as well as surgical report and pathology result. We evaluated the frequency and performance characteristics of POCUS over the study period. 999 children were diagnosed with appendicitis. POCUS was performed in 360 of 845 cases (43%) of histology-confirmed appendicitis and in 19 of 69 cases (28%) in which histology was negative for appendicitis. Both the number of POCUS examinations for appendicitis and the percentage of examinations correctly identifying appendicitis steadily increased over the study period. Accuracy was highest in the 5-10-year age range and lowest for females from 10 to 15 years. In 96% of cases with a pathology result of appendicitis and a positive POCUS examination, POCUS correctly identified appendicitis. However, only 6 of 19 POCUS examinations in children without appendicitis on histology found no appendicitis. Performance of POCUS for appendicitis was significantly associated with increased opioid administration and a 20-min mean decrease in length of pediatric emergency department stay. POCUS for appendicitis within the context of PEM fellowship training is feasible and associated with decreased length of stay.

Gender Distribution in Paediatric Cardiology Training Programs in Canada

BackgroundDespite female medical students being the majority, there are certain medical specialities that continue to have a prevalence of male trainees, such as adult cardiology. The purpose of this study is to examine gender distribution within Canadian paediatric cardiology training programs. MethodsBoth application and successful matches to core paediatric residency programs and paediatric cardiology programs were obtained through the Canadian Resident Matching Service. Analysis was performed to determine if the association between gender of paediatric residents and paediatric cardiology applicants/fellows was significant. ResultsBetween 2016 and 2024, 12% (n = 3/26) of individuals who successfully matched into a Canadian paediatric cardiology training program identified as female and 88% (n = 23/26) identified as male. Between 2013 and 2023, 78% (n = 947/1220) of individuals who successfully matched into a Canadian paediatrics residency identified as female and 22% (n = 273/1220) identified as male. There was a statistically significant difference between the gender of paediatric residents and the gender of paediatric cardiology residents (P < 0.0001). There was no significant association between applicant gender and match outcome within paediatric cardiology training programs (P < 0.23). ConclusionsThere is a gender discrepancy within Canadian paediatric cardiology training programs with a predominance of male trainees in the recent era. It appears that female under-representation in the field is due to the low number of female applicants. Although limited by sample size, there was no clear association between applicant gender and success of admission to a paediatric cardiology training program.

The Relationship between Pediatric Medical Training and Neonatal Care in the Delivery Room and Beyond.

The modern neonate differs greatly from newborns cared for a half-century ago, when the neonatal-perinatal medicine certification examination was first offered by the American Board of Pediatrics. Delivery room resuscitation and neonatal care are constantly evolving, as is the neonatal workforce. Similarly, the Accreditation Council for Graduate Medical Education review committees revise the requirements for graduate medical education programs every 10 years, and the modern pediatric medical trainee is also constantly evolving. Delivery room resuscitation, neonatal care, and pediatric residency training are codependent; changes in one affect the other and subsequently influence neonatal outcomes. In this educational perspective, we explore this relationship and outline strategies to mitigate the impact of decreased residency training in neonatal-perinatal medicine.

Anti-Asian American, Native Hawaiian, and Pacific Islander Racism in Academic Pediatrics: Recommendations for Training, Research, and Clinical Practice

This paper discusses how anti-Asian American, Native Hawaiian, and Pacific Islander (AANHPI) racism affects pediatric training, research, and clinical practice. Extant research shows that racism and discrimination are social determinants of health that impact AANHPI populations, including youth. AANHPI youth face significant health disparities and a wide range of barriers to health care access. However, AANHPIs tend to be seen by clinicians and depicted in training as monolithic, high achieving, and a relatively low priority in terms of pediatric workforce recruitment and training and pediatric research. After a brief discussion of US policies that have explicitly aimed to exclude, punish, or imprison AANHPIs, the paper explains AANHPI racism and its consequences. The paper then describes evidence of anti-AANHPI racism in pediatrics and offers recommendations for training, research, and clinical practice.

Proposed changes to pediatric radiology training and certification: report of the alternate training working group.

Proposed changes to pediatric radiology training and certification: report of the alternate training working group.