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Caring for Children With Medical Complexity: A Clinical, Patient-Focused Curriculum
Brittany Lattanza1, Divya Lakhaney2, Theresa Scott3
1Fellow, Department of Pediatric Nephrology, Icahn School of Medicine at Mount Sinai.
Insights
A new patient-focused curriculum significantly improved healthcare trainees' self-efficacy in managing children with medical complexity (CMC). This interactive approach enhanced skills in nutrition and pain management, outperforming standard training.
Area of Science:
- Medical Education
- Pediatric Care
- Patient-Centered Learning
Background:
- Caring for children with medical complexity (CMC) demands specialized expertise, yet training programs lack standardized curricula.
- Institutional variations in needs and resources contribute to the absence of a uniform educational approach for CMC.
Purpose of the Study:
- To develop and evaluate a patient-focused, interactive curriculum for pediatric residents and medical students on managing children with medical complexity (CMC).
- To assess the curriculum's impact on learner self-efficacy in key areas such as feeding/nutrition and pain/irritability management.
Main Methods:
- An interactive curriculum focusing on feeding/nutrition and pain/irritability was implemented over 12 months in an urban tertiary care hospital.
- Learners were divided into an intervention group receiving the CMC curriculum and a control group receiving unrelated training.
- Retrospective pre/post self-assessments were used to measure changes in self-efficacy among participants.
Main Results:
- The intervention group demonstrated significant improvements in self-efficacy across all eight learning objectives, particularly in feeding/nutrition.
- Compared to the control group, the intervention group showed substantially greater gains in self-efficacy for all measured objectives.
- A total of 72, 78, and 42 surveys were completed for the feeding/nutrition, pain/irritability, and control sessions, respectively.
Conclusions:
- The patient-focused curriculum effectively enhanced healthcare learners' self-efficacy in caring for children with medical complexity (CMC).
- This adaptable, hands-on curriculum offers a practical model for improving CMC education in various institutional settings.
- The findings support the integration of specialized curricula to address the unique needs of children with medical complexity.
Introduction:
Caring for children with medical complexity (CMC) requires specialized knowledge and skills. However, no standardized curricula are used across training programs as institutions have varying needs and resources.
Methods:
We created a patient-focused, interactive curriculum for two CMC topics: feeding/nutrition and pain/irritability. We integrated the 45-minute sessions into morning protected patient-care time on an inpatient pediatric team at an urban tertiary care hospital. Targeted toward all pediatric residents and medical students rotating in inpatient pediatrics over a 12-month period, the sessions used a mix of didactic, discussion, and hands-on activities. Learners on one of two inpatient teams received the curriculum, while those on the other received a curriculum unrelated to CMC and served as a control group. Both groups completed retrospective pre/post self-assessments to evaluate self-efficacy with respect to the learning objectives.
Results:
Over the 12-month period, 72 surveys were completed for the feeding/nutrition session, 78 surveys for the pain/irritability session, and 42 control surveys. The intervention group saw the greatest increase in self-efficacy scores generally in the feeding/nutrition session. All eight learning objectives saw significant improvement in self-efficacy scores for the intervention group. There was significantly greater improvement in self-efficacy for the intervention group compared to the control for all eight learning objectives.
Discussion:
Through this patient-focused curriculum, learners had improved self-efficacy scores compared to the natural learning occurring on the inpatient service. The curriculum could be adapted to fit the needs of other institutions and provides a practical, hands-on approach to learning about caring for CMC.
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