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Associations Between Residency Program Size and Readiness for Unsupervised Practice in Pediatrics.

Daniel J Schumacher¹, Ariel S Winn², Joni Hemond³

¹Department of Pediatrics (DJ Schumacher, B Kinnear and A Martini), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Internal Medicine (DJ Schumacher and B Kinnear), University of Cincinnati College of Medicine, Cincinnati, Ohio.

Academic Pediatrics

|March 10, 2025

Summary

This summary is machine-generated.

Small pediatrics residency programs are more likely to deem graduating residents ready for unsupervised practice in specific areas compared to larger programs. This suggests program characteristics influence entrustment decisions for key professional activities.

Keywords:

competency-based medical education entrustable professional activities resident assessment

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Published on: February 25, 2016

Area of Science:

Medical Education Research
Pediatrics Residency Training
Competency-Based Medical Education

Background:

Entrustable Professional Activities (EPAs) are crucial for assessing resident readiness for unsupervised practice.
Residency program size may influence how EPAs are supervised and residents are entrusted.

Purpose of the Study:

To investigate if residency program size affects the entrustment-supervision levels of graduating pediatric residents for General Pediatrics EPAs.
To identify differences in EPA entrustment based on program size categories: small, medium, large, and very large.

Main Methods:

Analysis of entrustment-supervision levels for 17 General Pediatrics EPAs from 48 programs over three academic years.
Mixed-effects logistic regression models were used to predict readiness for unsupervised EPA execution, considering program size and EPA.
Models assessed main effects of program size and EPA, and the interaction between program size and EPA.

Main Results:

Data included 33,335 entrustment-supervision levels for 2285 graduating residents.
Small programs reported higher likelihoods of residents being ready for unsupervised practice in 4 specific EPAs.
These EPAs included health screening, well newborn care, recognizing/referring surgical problems, and managing information.

Conclusions:

Smaller pediatrics residency programs may have characteristics that foster earlier entrustment of graduating residents for unsupervised practice in certain EPAs.
Further research is needed to understand the specific program characteristics contributing to these differences.