Early relational health training in Canadian paediatric residency programs: A national program director survey

Early Relational Health (ERH)-a foundational determinant of lifelong mental and physical health-is emerging as a critical component of paediatric practice. However, its integration into Canadian paediatric residency training remains poorly defined. This study conducted an environmental scan of Canadian paediatric residency programs to examine the current state of ERH education, as reported by Program Directors (PDs).

PDs from Canadian paediatric residency programs were invited to complete an anonymous survey (September-December 2023). The survey explored PDs' definitions of ERH, existing training opportunities, perceptions of how well ERH is addressed, and motivators for incorporating structured curricula. Data were analyzed using descriptive statistics.

Ten PDs completed the survey (37% response rate). All (100%) General Pediatrics PDs reported their program teaches positive parenting and early child development "Not Very Well," compared with 20% of subspecialty PDs. Sixty per cent of General Pediatrics PDs and all Subspecialty PDs rated an ERH curriculum as "Very Important" for their learners. Nearly all respondents expressed interest in implementing a structured, evidence-based, self-guided ERH curriculum to improve resident knowledge and skills.

This is the first study to evaluate ERH training within Canadian paediatric residency programs. While some subspecialty programs have integrated ERH content, most General Pediatrics programs identified clear training gaps. All PDs recognized ERH as an essential topic despite limited formal education opportunities. Development of a structured, competency-based ERH curriculum represents a key next step in advancing paediatric training and care quality in Canada.