Design and Evaluation of a Pediatric Resident Health Care Transition Curriculum

In 2011, the American Academy of Pediatrics developed a consensus statement urging physicians who provide care to youth with special health care needs to acquire the knowledge and skills to facilitate well-timed transitions to adult-oriented care. However, a minority of these youth receive the services necessary to make appropriate transitions. Two potential barriers to supporting well-planned transitions are minimal provider training and gaps in medical records.

We designed an adaptable health care transition (HCT) curriculum combinings asynchronous didactic modules and a synchronous portable medical summary (PMS) critique exercise to improve resident knowledge, skills, and behavior. Residents completed pre- and posttests to assess knowledge prior to and after viewing animated video didactic modules. Residents attempted to create a PMS, received feedback and instruction on how to create a well-written PMS, and then reattempted this activity. Residents evaluated both the didactic modules and the PMS critique exercise following delivery of the curriculum.

Over 21 months, 20 pediatric residents and hospital medicine fellows completed the curriculum during an elective complex care block rotation. Pre- and posttests revealed statistically significant (p < .001) improvement in knowledge. Learners included an average of 46% of 18 recommended PMS elements before and 98% of elements after the PMS critique exercise (p < .001). Evaluations demonstrated overwhelmingly positive learner responses.

Our adaptable HCT curriculum improves pediatric residents' knowledge, skills, and behavior in transition processes and addresses a significant gap in pediatric graduate medical education.