Assessing the Educational Landscape of Culturally Responsive Education in Pediatric Critical Care Fellowships

Health disparities persist among marginalized racial, ethnic, and lower socioeconomic status groups, extending to pediatric intensive care units. Complex interactions between structural forces and provider biases influence patients' risk for critical illness, access, timing, and quality of care. An understanding of how these social influencers of health directly impact health outcomes should be necessary components of pediatric critical care medicine (PCCM) fellowship. Currently, no uniform guidelines exist that provide training in diversity, equity, and inclusion (DEI) in PCCM. We therefore sought to describe the current state of DEI education in PCCM fellowship programs from the program director (PD) perspective.

A national survey was conducted among Accreditation Council for Graduate Medical Education-accredited PCCM fellowship PDs to evaluate the state of DEI education. The survey, developed collaboratively and iteratively, encompassed program details, DEI teaching modalities, barriers, and PD perspectives. Statistical analysis was performed using descriptive statistics.

Of the 76 PDs surveyed, 47 responded (62% response rate). Although 57% of PDs recognized DEI education as a divisional priority, only 34% had a formal DEI curriculum. Barriers to DEI education included lack of trained faculty, attending time, and engagement. Notably, PDs expressed concerns about faculty competence in delivering DEI education and the scarcity of underrepresented in medicine physicians across trainees and faculty.

The findings reveal significant gaps in DEI education within PCCM fellowship programs. Despite recognition of DEI importance, formalized curricula are lacking. The study underscores the necessity for tailored educational interventions and strategies to optimize care.