Revitalizing Pediatric Resident Educational Conferences Using Kotter's Eight-Step Change Model

Resident educational conferences (i.e., morning report and noon conference) serve to increase clinical knowledge and to shape educational culture within a program. During the COVID-19 pandemic, dwindling conference attendance, decreasing participation, and a perception that formal educational time was less protected were observed at our institution, highlighting a need for culture change around trainees' educational time. Our objective was to apply Kotter's eight-step Change Model (KCM) to increase attendance and improve residents' perception of the culture of educational conferences in their residency program.

This was a mixed-methods study involving pediatric residents at a large, university-affiliated children's hospital in Palo Alto, California, United States from 2022 to 2023. A total of 113 residents were eligible to participate. We communicated the need and vision for change with stakeholders, recruited conference champions, and addressed resident-identified barriers to help facilitate attendance. Attendance was recorded daily, and residents were surveyed bi-monthly, evaluating their perception of culture using Likert scales and free-response questions. A Wilcoxon signed-rank test was used to compare pre- and post-intervention weekly median conference attendance, and change in the Conference Culture Survey was assessed using ANOVA F-tests.

Weekly median conference attendance increased by 107% from 15 to 31 (p<0.001). Pre-intervention survey response rate was 41% (n=46), while post-intervention survey response rates were 42-67% (range, 47-76). Residents perceived meaningful improvements in conference culture (p<0.001), protection from clinical obligations (p<0.001), and board exam preparation (p<0.001).

Over a 12-month period, attendance and perception of educational conference culture improved. KCM is a useful tool that can guide educators in intentionally addressing conference educational culture within their own contexts.