Perspectives on Complex Care Training in a Large Academic Pediatric Training Program.

Area of Science:

• Pediatric Medicine
• Medical Education
• Complex Care

Background:

• Children with medical complexity (CMC) require specialized care.
• Pediatric residency programs aim to equip future physicians with essential skills for managing CMC.
• Gaps in current training may hinder resident preparedness in complex care.

Purpose of the Study:

• To identify gaps and opportunities in complex care training for pediatric residents.
• To assess resident self-entrustment in key clinical activities related to complex care.
• To gather recommendations for improving pediatric complex care curricula.

Main Methods:

• A survey was administered to residents in an academic pediatric residency program.
• Data collected included training experiences, self-entrustment levels, and desired educational strategies.
• Quantitative data were analyzed using descriptive statistics, and free-text responses underwent content analysis.

Main Results:

• Most residents (96%) had exposure to CMC, yet mean self-entrustment was low across all postgraduate years.
• Highest self-entrustment was in evaluating aspiration, nutrition, care coordination, and pain.
• Lowest self-entrustment was in transition to adult care, medical technology management, and safety planning.

Conclusions:

• Pediatric residents demonstrate limited self-entrustment in critical complex care activities.
• Curriculum enhancement should focus on expert preceptor-led clinical encounters.
• Partnership with patients/families and hands-on simulation are crucial for improving complex care competency.