Pediatric Resident Education Research Articles

Literacy Promotion: An Essential Component of Primary Care Pediatric Practice: Policy Statement.

Reading together often with infants and young children strengthens their relationships with parents/caregivers at a critical time in child development, stimulating brain circuitry and early attachment. A positive parenting practice, shared reading helps build the foundation for healthy social-emotional, cognitive, language, and literacy development, setting the stage for school readiness and providing enduring benefits across the life course. Pediatric physicians and advanced care providers have a unique opportunity to encourage parents/caregivers to establish routines and enjoy conversations around books and stories with their children beginning in infancy. Research has demonstrated that parents read and children learn when pediatricians offer literacy promotion as a practical and evidence-based primary prevention strategy in primary care practice to support early brain and child development. This supports families with a strengths-based approach, shaping a child's life trajectory and helping mitigate stress and adverse experiences. The American Academy of Pediatrics (AAP) recommends that pediatricians encourage shared reading beginning at birth and continuing at least through kindergarten as a strategy for supporting parents/caregivers, enhancing foundational relationships, promoting positive language-rich interactions, and helping families create a nurturing and stimulating home environment. The integration of literacy promotion into pediatric resident education is crucial to achieve that goal and thus is also essential. The AAP supports advocacy toward establishing public and private funding for diverse high-quality, developmentally appropriate children's books in the languages preferred by the family to be provided at pediatric health supervision visits to all children, but especially to children living in underresourced communities. This statement is supported by multiple AAP policies and implementation resources, including the accompanying "Literacy Promotion: An Essential Component of Primary Care Pediatric Practice: Technical Report."

Prioritizing Health Literacy Educational Objectives for Pediatric Residents – A Delphi Study

ObjectiveChildren of caregivers with limited health literacy are at risk of poorer health outcomes. Thus, health literacy-informed communication tools are critical to achieving a more equitable health system. However, there is no agreement on the health literacy skills pediatric residents should attain. We used Delphi methodology to establish consensus on health literacy objectives to inform development of a pediatric resident curriculum. MethodsOur Delphi panel participated in three rounds of anonymous surveys to rank the importance of health literacy objectives in pediatric resident education. Consensus was defined as ≥70% of panelists identifying an objective as essential or 100% agreeing an objective was recommended or essential. ResultsThirteen pediatric health literacy experts comprised a racially, geographically, and professionally-diverse panel. After three survey rounds, 27 of the initial 65 objectives met consensus. All final objectives aligned with Accreditation Council for Graduate Medical Education (ACGME) core competencies. ConclusionsA panel of pediatric health literacy experts established consensus on health literacy objectives specific to pediatric resident training. These prioritized objectives align with ACGME core competencies, as well as evidence-based strategies like teach-back, and newer considerations like addressing organizational health literacy. They should inform future health literacy curricula and assessment within pediatric residency programs.

Improved tracheostomy-dependent patient outcomes after implementation of the Pediatric Resident Education in Pulmonary (PREP) Boot Camp.

Children with tracheostomies are high risk for morbidity and mortality. Pediatric resident physicians are not routinely taught skills to care for this vulnerable patient population. Few reports link educational interventions to improved patient outcomes. This study evaluates the impact of an intensive educational training program on pediatric residents' observed skills and tracheostomy-dependent patient outcomes. Pediatric post-graduate year 2 (PGY2) resident physicians rotating through the inpatient pediatric pulmonology month at Children's Hospital Colorado July 2018-2019 participated in the Pediatric Resident Education in Pulmonary (PREP) Boot Camp, an intensive educational program with an interactive lecture and simulation experience on patients with tracheostomy-dependence. PGY2s who partook in PREP and PGY3s who rotated before PREP initiation were invited to be studied. Primary outcomes included: (1) resident skills assessed by direct observation during simulation encounters and (2) rates of intensive care unit (ICU) transfers in tracheostomy-dependent patients following acute events before and after introduction of PREP. We hypothesized that increased education would enhance resident skills and improve patient outcomes by decreasing the rate of ICU transfers. PGY2 residents retained skills learned during PREP up to 11 months following initial participation, and significantly outperformed their PGY3 counterparts. There was a significant decrease in ICU transfer rate in patients with tracheostomies admitted to the pulmonary team during the 19 months following initiation of PREP. Enhanced early education may improve resident physicians' ability to care for complex patients with tracheostomies and could improve outcomes in this high-risk population.

The Value of the Pediatric Urgent Care in Pediatric Resident Education.

Pediatric urgent care (UC) is a growing field and may provide unique learning opportunities for pediatric residents. We aimed to assess whether a UC rotation could be feasible and meaningful and help fill educational gaps. Within our current X+Y rotational model, we used Kern's 6-step approach for curriculum development to create a longitudinal UC educational experience for postgraduate year 2 (PGY2) pediatric residents. We assessed progress towardachieving our aim by using a mixed-methods approach matched to Kirkpatrick's levels of learning, including program annual evaluations, self-assessed UC competencies, and 360 milestone evaluations. A total of 14 PGY2s participated in our yearlong longitudinal rotation without duty hour violations or deviations from well childcare. Thematic analysis revealed concepts of autonomy, procedural access, and intentionality of education. Residents showed statistical improvement in 4/10 milestones and 26/27 self-assessed performance items. Of 14 residents, 6 scored ≥4 on all milestones by the end of the year. Our curriculum demonstrates a valuable role for the pediatric UC in the procedural and clinical education of pediatric residents. Practical implications and assessment tools of such a curriculum may be valuable for others interested in integrating this learning experience into their current educational model.

Evaluating a Pediatric Palliative Care Elective Rotation Through Prompted Reflective Writing and Aligning With Competencies.

Background: Hospice and palliative medicine is important in the education of pediatric residents. Little is known about if and how residents' learnings during a pediatric palliative care elective fulfill core competencies and Pediatrics subcompetencies as set forth by the Accreditation Council for Graduate Medical Education (ACGME) and published subspecialty competencies for residents in pediatric hospice and palliative medicine (pHPM). Objectives: To evaluate what residents are learning on a four-week pediatric palliative care elective rotation at a single institution and how these learnings fulfill ACGME and pHPM competencies. Setting/Subjects: Prompted, written reflections were collected from residents completing a pediatric palliative care rotation at a large, urban academic center in the United States between academic years 2016-2017 and 2020-2021. Measurements: A qualitative, inductive reasoning approach was used to analyze reflections for emergent themes and codes. A deductive approach was used to map resulting codes to ACGME core competencies, Pediatric subcompetencies, and pHPM competencies. Results: Twenty-five resident reflections were collected. Inductive analysis revealed three primary themes and 102 codes. These codes were mapped to all six ACGME core competencies and mapped to most Pediatric subcompetencies with the exception of performing a physical examination, organizing and prioritizing patients, diagnostic evaluation, and community and population health. Codes mapped to most pHPM competencies with the exception of two symptom-based competencies, malignant bowel obstruction and severe fatigue. Conclusions: Residents' written reflections following a pediatric palliative care elective rotation demonstrated robust learnings that fulfill many core, specialty, and subspecialty competencies, particularly those that relate to patient- and family-centered care, communication, professionalism, and systems-based practice.

Pediatric Residents' Perceptions of a Point-of-Care Ultrasound Collaboration With Emergency Medicine.

Background Pediatric residencies expanding their point-of-care ultrasound (POCUS) education face barriers, including a lack of established curriculum and qualified educators. Prior studies report partnerships between pediatrics and pediatric emergency medicine (PEM); however, many non-PEM emergency medicine (EM) physicians with POCUS fellowship training also have experience with pediatric POCUS and represent an alternate educational partner. Objectives To improve pediatric residents' POCUS skills through collaborative education with EM and evaluate perceptions of the teaching format and instructors. Methods First through third-year pediatric residents attended a half-day didactic and hands-on session about renal, lung, and musculoskeletal (MSK) POCUS. These educational sessions were led by EM faculty with POCUS fellowship training and assisted by EM residents. Post-session surveys were administered to pediatric residents to assess prior POCUS experience, changes in confidence in acquiring and interpreting renal, lung, and MSK POCUS images, and opinions about the educational format. Statistical analyses of the post-session survey data were performed using SPSS. Results Thirty-nine pediatric residents attended the session and completed the survey of 45 total residents in the program (86.7%), with 89.7% completing 10 or fewer POCUS studies. Residents' comfort level with performing lung POCUS increased from 5.1% to 82.1% (p< .001), renal POCUS from 10.3% to 76.9% (p< .001), and MSK POCUS from 7.7% to 84.6% (p< .001). 87.2% rated the educational format as effective, and 94.9% (37/39) rated emergency medicine faculty as 'very effective' in providing ultrasound education relevant to the practice of pediatrics. Conclusion Pediatric resident POCUS education taught by EM faculty with POCUS fellowship training was well-received by pediatric residents and significantly improved confidence in acquiring and interpreting POCUS.

The Early Effects of the Coronavirus Disease-19 Pandemic on Pediatric Resident Education: A National Assessment.

Residency programs must ensure resident competence for independent practice. The coronavirus disease-19 (COVID-19) pandemic disrupted health care delivery, impacting pediatric residencies. This study examines the impact on pediatric resident education. The authors conducted a mixed methods national survey of pediatric residency program directors (PDs) from May 2020 to July 2020. Data analysis included descriptive statistics, chi-square, and Wilcoxon rank sum tests. Multivariable modeling identified factors associated with resident preparation for more senior roles. Thematic analysis was performed on open-ended questions about PD COVID-19 pandemic recommendations to peers, Accreditation Council for Graduate Medical Education and American Board of Pediatrics. Response rate was 55% (110/199). PDs reported the COVID-19 pandemic negatively affected inpatient (n=86, 78.2%), and outpatient education (n=104, 94.5%), procedural competence (n=64; 58.2%), and resident preparation for more senior roles (n=50, 45.5%). In bivariate analyses, increasingly negative impacts on inpatient and outpatient education were associated with an increasingly negative impact on resident preparation for more senior roles (P=.03, P=.008), these relationships held true in multivariable analysis. Qualitative analysis identified 4 themes from PD recommendations: 1) Clear communication from governing bodies and other leaders; 2) Flexibility within programs and from governing bodies; 3) Clinical exposure is key for competency development; 4) Online platforms are important for education, communication, and support. The COVID-19 pandemic negatively impacted inpatient and outpatient education. When these were more negatively impacted, resident preparation for more senior roles was worse, highlighting the importance of competency based medical education to tailor experiences ensuring each resident is competent for independent practice.

Changing Degrees: Incorporating the Impacts of Climate Change on Health into Pediatric Residency Education and Practice.

The American Academy of Pediatrics (AAP) was the first major medical society to release a policy statement on the impacts of climate change on pediatric health. It is estimated that globally, children bear the burden of climate-induced disease. However, many undergraduate and graduate medical curricula do not cover this topic. This article builds on previous literature to propose a framework for such a curriculum as well as justify its relevance in light of current accreditation requirements. Some curricular topics include extreme heat and heat-related injury, degradations in air quality and pediatric respiratory disease, spread of vector-borne and diarrheal illness, and mental health effects. Lastly, it addresses clinical applications for this knowledge, including screening vulnerable patients, offering anticipatory guidance, and advocating for the medical benefits of planetary health.

Barriers and Facilitators to Pediatric Resident Education in the Emergency Department: A Qualitative Study.

Objective Local resident evaluations of the pediatric emergency department (ED) declined over the last five years. Sparse literature exists on resident perspectives of educational experiences. This study explored the barriers and facilitators to resident education in the Pediatric ED. Methods This qualitative study utilized focus groups at a large pediatric training hospital. Trained facilitators performed semi-structured interviews prompting discussion of resident experiences in the pediatric ED. One pilot and six focus groups (38 pediatric residents) achieved data saturation. Sessions were audio recorded, de-identified and 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 themes drawing on grounded theory. Results Six categories emerged: (1) ED environment, (2) consistent goals, expectations, and resources, (3) ED workflow, (4) preceptor accessibility, (5) resident growth and development, (6) ED preconceived notions. Residents value a respectful work environment despite the chaotic nature of the ED. They need clear goals and expectations with a strong orientation. Autonomy, open communication and shared decision-making allowresidents to feel like team members. Residents gravitate toward welcoming, available preceptors that enthusiastically teach. More ED environment exposure increases comfort and efficiency and helps develop medical decision-making skills. Residents admit ED preconceptions and personality traits affect performance. Conclusion Residents self-identified barriers and facilitators to ED education. Educators must provide a safe and open learning environment, clear rotation expectations and goals, consistent positivity supporting shared decision making, and allow residents autonomy to build their practice styles.

Daily Dose of Development: Feasibility of an App-Based Curriculum of Normal Child Development for Pediatric Residents

Pediatric resident education in child development has historically not been taught in a formal manner despite it being identified as a priority for residency education.1 A significant proportion of children with developmental delays are not identified until they enter school, representing a lost opportunity for early intervention and underscoring the importance of targeted resident education in child development.The advent and acceleration of technology enhanced learning (TEL) led to the development of innovative educational curricula flexibly accessed by a learner. Prior TEL endeavors teaching child development relied on strategies employing passive review of videos or online material. Spaced education is a framework centered on presentation of concepts delivered longitudinally and repeated at varied intervals, improving retention of knowledge. Prior studies demonstrate improved knowledge recall, with few that examined impact on clinical care or optimal integration into clinical rotations.2Daily Dose of Development (3D) is a web or mobile application with a comprehensive database of clinical vignettes mapped to updated developmental milestones. Vignettes are presented through cycles of multimedia questions, allowing spaced interactive application of knowledge in realistic scenarios. Curriculum development was informed by 2 feasibility studies assessing different delivery mechanisms, a targeted needs assessment of resident learners, and qualitative interviews with child developmental experts.A randomized control study was performed to evaluate the feasibility, acceptability, and preliminary effectiveness of the 3D app. All pediatric residents (n=90) at a single training institution were invited to participate in the study, 30 of whom were randomized to either the app or control group. Baseline demographic data were collected prior to launch of the app curriculum, which cycled over 3 months. Control group residents participated in existing curricular opportunities in child development without access to the app until study conclusion. Feasibility was assessed using surveys at the beginning, midpoint, and end of the study period, examining comfort level in child development, app usability and impact on clinical care, and open-ended questions. App usage data from Google Analytics were also collected.Out of 30 residents, 17 were randomized to the app and 13 to the control group. Fifty-seven percent (17 of 30) of residents completed all surveys: 8 (47%) in the app and 9 (53%) in the control group. Baseline demographics were comparable between groups.All 17 residents accessed the app during the study period. Of those responding to all surveys, 63% (5 of 8) accessed daily. The mean number of responses per quiz was 8.9 (ranging from 2-16 responses). Identified features to enhance the app included ability to download content, zoom in on multimedia, reference article links, customize push notifications, and stack missed questions.At study conclusion, 100% of the app arm endorsed 3D as effective for learning child development. Statistically significant improvement in comfort with milestone recall (P=.007), development evaluation methods (P=.001), and identification of developmental delay (P=.046) were noted between groups. Fifty percent (4 of 8) of the app group reported improvement in patient developmental assessments, compared to 33% (3 of 9) in controls (P=.49). Feedback demonstrated desire for ongoing education in child development, enthusiasm, and desire for incorporation of the app into existing traditional curricula. Loss to follow-up and small sample size limited analysis.This study demonstrated feasibility, acceptability, and preliminary effectiveness of app-based spaced curriculum as an adjunct to clinical rotations. Self-reported behavior change in clinical care as a result of participation in the app curriculum is a novel area of impact for this type of curriculum and requires further study. Future iterations focused on optimal implementation strategies are needed to develop best practices of integrating TEL curricula with traditional clinical teaching.

Utilization of a Delphi Study to Determine Core Concepts for a Pediatric Residency Disaster Medicine Curriculum

Introduction:As disasters increase globally in both frequency and intensity, the vulnerability of children during disasters has become obvious. Pediatricians are often left to manage the resulting physical and mental repercussions. With minimal to no disaster medicine training offered at most U.S. pediatric residencies, the need for an easily accessible pediatric disaster medicine curriculum has been exacerbated. While this need has been highlighted in the literature, material to include or methods to sustainably incorporate disaster medicine into training programs has not been established.Method:From a thorough literature review, 19 topics were selected as potentially necessary to include in a disaster medicine curriculum for pediatric residents. Utilizing the Delphi method, subject matter experts were asked to rank these topics with an option to add others. Two independent surveys separated by time were administered with the goal of identifying ten critical core concepts for pediatric resident disaster medicine education. A virtual roundtable discussion then took place to finalize the ten core concepts, discuss objectives, and consider realistic methods of incorporating the curriculum into the residency timeline.Results:The ten core concepts identified were 1) introduction to disaster medicine, 2) patient triage, 3) surge capability, 4) mental health effects of a disaster, 5) preparedness for children with special healthcare needs, 6) communicating personal/family disaster preparedness, 7) hospital disaster mitigation, 8) reunification, 9) drills and training, and 10) disaster ethics and crisis standards of care.Experts agreed upon a longitudinal multi-modal approach with inclusion of short didactics, case scenarios, questions/answers, games, and links to further educational activities and opportunities focused on individualized needs.Conclusion:The Delphi method was a successful approach to gathering expert consensus to establish core concepts for a pediatric resident disaster medicine curriculum.

Pediatric Resident Insulin Management Education (PRIME): A Single-Session Workshop Emphasizing Active Learning.

Insulin is a high-risk medication, and errors can lead to patient morbidity and mortality. The American Board of Pediatrics recommends that all board-certified pediatricians be able to develop an insulin management plan for patients with diabetes. A needs assessment of pediatric residents revealed low self-efficacy at developing a new subcutaneous insulin plan despite didactic instruction on the topic. We created a 90-minute interactive workshop that targeted resident skills in devising subcutaneous insulin plans. Learners engaged in small-group, problem-based learning and peer teaching to promote active learning and participation. We compared self-efficacy and knowledge before and after the intervention using paired t tests and evaluated learner satisfaction. Twenty-eight pediatric interns participated, with 25 completing both the pre- and postworkshop surveys. The primary outcome was self-efficacy (an individual's confidence in the ability to perform a specific task in a given domain). There was a statistically significant improvement in self-efficacy at creating a new subcutaneous insulin plan ( p < .001) as well as knowledge ( p < .001) after course completion. Learners were highly satisfied with the course, with a mean overall conference quality rating of 4.8 (SD = 0.4) based on a 5-point Likert scale (1= poor, 5 = outstanding). An interactive workshop employing active learning methods resulted in improved self-efficacy and knowledge in first-year pediatric residents. Future work is needed to determine the impact of this workshop on patient care outcomes.

Pediatric resident education in pediatric cardiology – A needs assessment

BackgroundDetermining the topics general pediatric residents are taught during an inpatient pediatric cardiology rotation must be selected based on numerous factors, including resident career goals, core topics for board exams, and educator preferences. ObjectivesThis study aims to determine the preferred core cardiology concepts of both learners and educators as well the preferred teaching modalities of general pediatric residents while on an inpatient pediatric cardiology rotation. MethodsAll eligible residents in the Children's National Hospital pediatric residency program who had completed a cardiology rotation as well as pediatric cardiology fellows and attendings were asked to complete a survey. Participation in the study was voluntary. Respondents were asked to answer questions related to the perceived effectiveness and applicability of the cardiology curriculum, specifically inquiring about methods of teaching, the level taught, and the utility of topics selected. ResultsForty-seven (44 %) of the 106 eligible participants completed the survey. Seventeen unique topics in pediatric cardiology were ranked. The highest rated topics included congenital heart disease, murmurs, cardiac physiology, ECG interpretation, and syncope/dizziness. Participants reported the highest satisfaction with whiteboard and bedside teaching. ConclusionsThis study demonstrates a strong correlation between what learners and educators perceive should be the topics taught to residents to prepare them for their intended future career goals. These data provide a framework, both in teaching modalities and core concepts, for continued development and reassessment of inpatient pediatric cardiology rotations to optimally prepare pediatric residents with a strong foundation in pediatric cardiology.

Recommendations for Minimum Residency Training Requirements in Pediatric Hospital Medicine.

Recommendations for Minimum Residency Training Requirements in Pediatric Hospital Medicine.

RAISING AWARENESS AMONG MEDICAL RESIDENTS TO DE-LABEL PENICILLIN ALLERGY

<h3>Introduction</h3> Approximately 90% of US patients with a reported penicillin-class allergy are able to tolerate penicillin upon testing. The prevalence of these false labels have led to the use of alternative antibiotics that are more expensive, less effective, and lead to higher antibiotic resistance. We hypothesized that raising awareness of this issue to pediatric residents and patients would lead to higher referral rates to Allergy/Immunology and ultimately de-labeling. <h3>Methods</h3> The number of penicillin allergy labeled patients with an initial allergy referral was used to measure the problem. The residency program provided training for residents in the form of didactics and journal club on penicillin allergy. Patients were also educated on the importance of confirming their drug allergy with an allergist. This was achieved through the use of face-to-face presentations, videos, and handouts. <h3>Results</h3> Patients were age 1 to 18 years. A retrospective chart review of patients seen in the outpatient general pediatrics clinic for the prior 6 months was conducted to gather baseline data and then subsequently tracked by month through the electronic medical record by IT staff. Logistic regression was used for analysis. 244 charts had a penicillin allergy label pre-intervention. Of those charts, 46 had an allergist referral (19% referral rate). After 6 months, 253 charts had a penicillin allergy label post-intervention. Of those charts, 75 had an allergist referral (30% referral rate) (p=0.04). <h3>Conclusion</h3> Pediatric resident and patient education on penicillin allergy may be a useful tool to aid in referrals to Allergy/Immunology for evaluation and likely de-labeling of the penicillin allergy.

French national survey on simulation-based neonatology education of pediatric residents

The French Society of Neonatology (SFN) conducted a national questionnaire survey on the simulation-based education neonatal curriculum for pediatric residents. The response rate was 93% for the pediatric curriculum coordinators and 97% for the neonatal intensive care unit medical directors and neonatal transport teams. The average hourly volume during the curriculum was 21 ± 17 h. Overall, 89% of regional pediatric curricula offered at least one simulation session. Each simulation program involved newborn resuscitation in the delivery room but often lacked a formalized program. Additionally, half of the neonatology departments provided simulation-based education. Simulation education is now common for training pediatric residents in neonatology in France but it is heterogeneous in the French territory.

Enhancing the primary care pediatrician's role in managing psychosocial issues: a cross sectional study of pediatricians and parents in Israel

BackgroundPsychosocial issues are an integral part of children's health and well-being, and it is widely acknowledged that pediatricians should be involved in their management. We examined the current perception of the pediatrician’s role in the management of psychosocial problems in Israel from the perspective of parents and pediatricians, and identified possible barriers.MethodsWe assessed parents' and pediatricians' perspectives through a cross sectional survey. 1000 parents with children under 10 were randomly selected from a large database representing the Israeli population and phone-surveyed by a polling company. Due to a low response-rate (5.4%), there was an overrepresentation of married parents and underrepresentation of parents with primary or secondary education. 173 Pediatricians were recruited both at a medical conference and by a web-based questionnaire.Results55% of the parents reported they were concerned with at least one psychosocial problem, yet less than 50% of them discussed these issues with the pediatrician. 59.9% of the parents did not perceive psychosocial problems as relevant to the pediatrician's role. Pediatricians with some previous training related to psychosocial issues were more likely to report on a lack of professional confidence (p = .037) and insufficient available resources (p = .022) as barriers to their involvement, while pediatricians who had no training were more likely to report on the parents' perception of their role as the barrier to involvement (p = .035).ConclusionsParents tend to avoid the discussion of psychosocial concerns in pediatric settings due to their perception that it's irrelevant to the pediatrician's role. Trained pediatricians feel unconfident in their ability to manage psychosocial issues and report on a lack of suitable resources. These findings suggest current pediatric mental-health training is insufficient to equip pediatricians with the knowledge and skills required to their involvement in psychosocial problems, and imply necessary changes to environment of community-based pediatrics. In order to change the practice of pediatricians in the community to enable them to address a variety of psychological issues, appropriate training is needed, through all stages of the pediatrician’s professional life, including medical school, pediatric residency and continuous medical education.

Boarding for Youth Mental Health Conditions: How Can Hospitalists Be Part of the Solution?

Boarding for Youth Mental Health Conditions: How Can Hospitalists Be Part of the Solution?

Pediatric Residency Education During the COVID-19 Pandemic.

The coronavirus disease 2019 (COVID-19) pandemic has had profound effects on society and, in particular, on many aspects of medical care. Residency training programs are often integral parts of our medical community and consequently have experienced changes in structure, format, and content. The conversion to virtual or online learning has been nearly universal. Decreases in common pediatric diagnoses such as respiratory syncytial virus and asthma have led to less first-hand experience for residents. Limitations designed to minimize the spread of COVID-19, such as use of personal protective equipment and group size limits, have led to fewer clinic rotations, fewer clinic sessions, and fewer patient experiences. Infections of residents themselves have led to an increase in back-up call system usage and a strain on staffing. Mandatory limits on group gatherings have also impaired camaraderie and the overall well-being of trainees. [Pediatr Ann. 2021;50(12):e509-e514.].

Assessment of Pediatric Resident Knowledge and Comfort in Addressing Childhood Obesity in Clinical Practice

Background: Recent data estimate the prevalence of pediatric obesity at 19.3%. Emphasis on primary prevention and early identification is needed to avoid development of serious medical and psychosocial sequelae. The objective of this initiative is to assess baseline knowledge and comfort among trainees at an inner-city pediatric residency program in identifying children with overweight/obesity, evaluating associated risk factors and comorbidities, and providing effective counseling. Methods: Key topics from 2 major guidelines on pediatric obesity assessment, prevention, and treatment were incorporated into the development of a resident questionnaire, which consisted of 12 knowledge-based questions and a Likert scale evaluating self-perceived knowledge and comfort on 7 skills. Results: Forty-six percent of eligible residents completed the questionnaire (n = 28). The mean score on the objective knowledge-based section was 44% ± 13%, with no differences by training year. The percentage of residents with correct responses by topic ranged from 14% to 79%. The mean self-perceived knowledge rating was 3.56 ± 0.86. The mean self-perceived comfort rating was 3.53 ± 0.89. Neither the self-perceived knowledge nor comfort rating was a significant predictor of performance on the objective knowledge-based section when controlling for postgraduate year status. Conclusions: Significant gaps in knowledge were discovered among pediatric residents with regard to appropriate screening, assessment, and counseling practices related to pediatric overweight/obesity. These deficits were not consistently reflected in residents' self-perceived knowledge and comfort ratings. The results of this initiative highlight the need for incorporation of standardized curricula on childhood overweight/obesity into pediatric resident education.