Does trainee involvement affect anticipatory guidance in well-child care?

Area of Science:

• Pediatrics
• Medical Education
• Health Services Research

Background:

• Gaps exist in anticipatory guidance during well-child visits.
• Academic teaching hospitals involve physician trainees in patient care.
• Parental perception of guidance in these settings is understudied.

Purpose of the Study:

• To assess parental perception of anticipatory guidance.
• To evaluate the impact of provider type on guidance delivery.
• To identify factors influencing the coverage of priority topics in pediatric outpatient clinics.

Main Methods:

• Prospective study involving parents of children aged 0-59 months.
• Questionnaires assessed provider encounters and guidance preferences.
• Analysis compared guidance coverage based on attending physician and trainee involvement.

Main Results:

• 40% of parents saw only the primary attending physician.
• Provider type did not correlate with the total number of topics covered.
• Seeing the primary attending alone increased the likelihood of priority topics being addressed (OR 0.31-0.35).

Conclusions:

• Well-child visits without the primary attending result in significantly less coverage of priority anticipatory guidance.
• Continuity of care with the primary physician is crucial for effective guidance.
• Emphasizing continuity and parental concerns is vital when trainees are involved in pediatric care.