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Thomson JE, Rassbach CE, Shah N, Walker J, Wilson K, Shah SS, Jerardi K. Development of Scholarship Core Competencies for Pediatric Hospital Medicine Fellowship Programs. Hosp Pediatr 2024; 14:e66-e74. [PMID: 38073321 DOI: 10.1542/hpeds.2023-007360] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2024]
Abstract
The Pediatric Hospital Medicine (PHM) Fellowship Directors, recent fellowship graduates, and senior leaders in PHM have long identified training in scholarly activities as a key educational priority for fellowship training programs. We led a 2-day conference funded by the Agency for Healthcare Research and Quality to develop scholarship core competencies for PHM fellows. Participants included fellowship directors, national experts in PHM research, and representatives from key stakeholder organizations. Through engagement in large group presentations and small group iterative feedback and editing, participants created and refined a set of scholarship core competencies. After the conference, goals and objectives were edited and harmonized by conference leaders incorporating feedback from conference participants. Core competency development included 7 domains: (1) study design and execution, (2) data management, (3) principles of analytics, (4) critical appraisal of the medical literature, (5) ethics and responsible conduct of research, (6) peer review, dissemination, and funding, and (7) professionalism and leadership. Specific objectives for each goal were further organized into 3 levels to indicate core skills for all fellowship trainees (level 1), specialized and specific skills determined by fellow scholarly focus (level 2), and advanced skills for fellows interested in a clinical investigator career path (level 3). These newly developed scholarship core competencies provide a foundation for curricular development and implementation to ensure that the field continues to expand academically, given the 2-year training period and variable infrastructure across programs.
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Affiliation(s)
- Joanna E Thomson
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Caroline E Rassbach
- Division of Hospital Medicine, Department of Pediatrics, Stanford School of Medicine, Palo Alto, California
| | - Neha Shah
- Division of Hospital Medicine, Children's National Hospital, Washington, District of Columbia
- Department of Pediatrics, the George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | - Jacqueline Walker
- Department of Pediatrics, Children's Mercy Hospital, Kansas City, Missouri and University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
| | - Karen Wilson
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York
- UR Medicine Golisano Children's Hospital, Rochester, New York
| | - Samir S Shah
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Karen Jerardi
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
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Carney L, Hall M, Heller K, Kennedy C. Development, implementation, and evaluation of a simulation-based educational curriculum for pediatric hospitalists. J Hosp Med 2022; 17:967-974. [PMID: 36222435 DOI: 10.1002/jhm.12981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND OBJECTIVES Minimal published simulation-based educational training exists for practicing pediatric hospitalists. Our aim was to determine specific pediatric hospital medicine (PHM) knowledge, skill, and competency needs aligned with our scope of practice and evaluate the impact of a simulation-based training curriculum. DESIGN AND METHODS Baseline and post-training surveys were administered to 48 physicians providing self-ratings on a 5-point scale from Novice to Expert on published PHM competencies. Results were used to develop a targeted simulation curriculum. Participants were considered competent in a domain if their mean score was 3 or greater. We categorized participant responses to individual questions into nine domain scores on survey self-assessments. Score analysis was performed using the signed-rank test and McNemar's test. Post-training evaluations solicited curriculum acceptance and perceived clinical value. RESULTS The baseline response rate was 98% and the post-training response rate was 85%. Areas with the lowest competency on baseline self-assessment included advanced airway management (38%), vascular access and emergency medications (38%), code cart skills (19%), team communication (51%), and medically complex care (49%). Post-training scores improved significantly for five of nine domains, with the largest gains in the "not competent" at baseline group. Percent competent (% with mean score >3) increased significantly in three domains (advanced airway management, code cart skills, and complex care). Participants rated educational sessions favorably (98%) and most (95%) reported using knowledge/skills learned for patient care. CONCLUSION Baseline self-assessment results were instrumental in curriculum design. Post-training analysis revealed gains in multiple domains and identified opportunities for future interventions. Most hospitalists reported participation positively impacted patient care with high learner satisfaction.
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Affiliation(s)
- Lisa Carney
- Pediatric Hospital Medicine, Children's Mercy Hospital and Clinics, Kansas City, Missouri, USA
| | - Matt Hall
- Children's Hospital Association, Lenexa, Kansas, USA
| | - Kayla Heller
- Pediatric Hospital Medicine, Children's Mercy Hospital and Clinics, Kansas City, Missouri, USA
| | - Chris Kennedy
- Pediatric Emergency Medicine, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, USA
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Al Maawali A, Puran A, Schwartz S, Johnstone J, Bismilla Z. The current state of general paediatric fellowships in Canada. Paediatr Child Health 2021; 26:353-357. [PMID: 34630782 DOI: 10.1093/pch/pxaa136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 12/22/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction The field of Paediatric Medicine has grown tremendously over the last two decades. Several niche areas of practice have emerged, and opportunities for focused training in these areas have grown in parallel. The landscape of 'General Paediatric Fellowship' (GPF) Programs in Canada is not well described; this knowledge is needed to promote standardization and high-quality training across Canada. This study explores the structure and components of existing GPFs in Canada and identifies the interest and barriers to providing such programs. Methods A questionnaire was created to explore the landscape of GPF Programs in Canada. Invitations to participate were sent to leaders of General Paediatric Divisions across Canada, with a request to forward the survey to the most appropriate individual to respond within their local context. Results A total of 19 responses (95%) representing 17 different Canadian universities were obtained. Eight universities offered a total of 13 GPF Programs in 2019, with one additional university planning to start a program in the coming year. Existing programs were variable in size, structure and curriculum. Most programs identified as Academic Paediatric Programs, with an overlap in content and structure between Academic Paediatrics and Paediatric Hospital Medicine programs. The majority of respondents felt there was a need for GPF Programs in Canada but cited funding as the most common perceived barrier. Conclusion A growing number of GPF Programs exist in Canada. Current fellowship programs are variable in structure and content. Collaboration between programs is required to advance GPF training in Canada.
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Affiliation(s)
- Ali Al Maawali
- Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario
| | - Allan Puran
- Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario
| | - Sarah Schwartz
- Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario
| | - Julie Johnstone
- Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario
| | - Zia Bismilla
- Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario
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Tseng AS, Fromme HB, Maniscalco J, Jerardi KE, Lockeman KS, Ryan MS. How Do Pediatric Hospital Medicine Fellowships Prepare Graduates as Educators? A Survey of Program Directors and Graduates in the United States. MEDICAL SCIENCE EDUCATOR 2020; 30:749-765. [PMID: 34457733 PMCID: PMC8368768 DOI: 10.1007/s40670-020-00945-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Pediatric hospital medicine (PHM) is the newest recognized subspecialty in pediatrics within the United States. While fellowships in PHM have been available for several years, completion of a 2-year fellowship has become a requirement for subspecialty certification. Pediatric hospitalists provide substantial teaching to trainees, and therefore, PHM fellowships must include dedicated training around teaching and medical education. The purpose of this study was to determine how current PHM fellowships prepare graduates for their roles as medical educators. Two surveys were developed from the published PHM core competencies and Entrustable Professional Activities for pediatric subspecialties. One survey was disseminated to all active PHM program directors and the second was disseminated to all PHM fellowship graduates who completed training between 2012 and 2016. Items included those related to program structure and training/assessment in medical education. A total of 21 program directors (response rate = 58%) and 46 fellowship graduates (response rate = 46%) participated in the survey. All graduates (100%) reported teaching learners in their current setting. Many (67%) fellowship programs offered formal training in medical education, and this is greater than the 50% that was previously described. Direct observation (71%) was the most common method of assessment. Most graduates reported their fellowship provided optimal training in feedback and teaching during family centered rounds but suboptimal training in other skills such as curriculum development. The results of this study highlight areas for improvement in fellowship curriculum and assessment to better prepare fellows for their roles as educators.
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Affiliation(s)
- Ashlie S. Tseng
- Department of Pediatrics, Virginia Commonwealth University School of Medicine, PO Box 980325, Richmond, VA 23298 USA
| | - H. Barrett Fromme
- Department of Pediatrics, University of Chicago Pritzker School of Medicine, Chicago, IL USA
| | - Jennifer Maniscalco
- Department of Pediatrics, Johns Hopkins-All Children’s Hospital, St. Petersburg, FL USA
| | - Karen E. Jerardi
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA
| | - Kelly S. Lockeman
- Office of Assessment, Evaluation, and Scholarship, Virginia Commonwealth University School Medicine, Richmond, VA USA
| | - Michael S. Ryan
- Department of Pediatrics, Virginia Commonwealth University School of Medicine, PO Box 980325, Richmond, VA 23298 USA
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Jerardi KE, Fisher E, Rassbach C, Maniscalco J, Blankenburg R, Chase L, Shah N. Development of a Curricular Framework for Pediatric Hospital Medicine Fellowships. Pediatrics 2017; 140:peds.2017-0698. [PMID: 28600448 DOI: 10.1542/peds.2017-0698] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/13/2017] [Indexed: 11/24/2022] Open
Abstract
Pediatric Hospital Medicine (PHM) is an emerging field in pediatrics and one that has experienced immense growth and maturation in a short period of time. Evolution and rapid expansion of the field invigorated the goal of standardizing PHM fellowship curricula, which naturally aligned with the field's evolving pursuit of a defined identity and consideration of certification options. The national group of PHM fellowship program directors sought to establish curricular standards that would more accurately reflect the competencies needed to practice pediatric hospital medicine and meet future board certification needs. In this manuscript, we describe the method by which we reached consensus on a 2-year curricular framework for PHM fellowship programs, detail the current model for this framework, and provide examples of how this curricular framework may be applied to meet the needs of a variety of fellows and fellowship programs. The 2-year PHM fellowship curricular framework was developed over a number of years through an iterative process and with the input of PHM fellowship program directors (PDs), PHM fellowship graduates, PHM leaders, pediatric hospitalists practicing in a variety of clinical settings, and other educators outside the field. We have developed a curricular framework for PHM Fellowships that consists of 8 education units (defined as 4 weeks each) in 3 areas: clinical care, systems and scholarship, and individualized curriculum.
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Affiliation(s)
- Karen E Jerardi
- Department of Pediatrics, Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio;
| | - Erin Fisher
- Department of Pediatrics, University of California San Diego, San Diego, California
| | - Caroline Rassbach
- Department of Pediatrics, Stanford School of Medicine, Stanford, California
| | - Jennifer Maniscalco
- Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California
| | | | - Lindsay Chase
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and
| | - Neha Shah
- Department of Pediatrics, Children's National Medical Center, Washington, DC
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Oshimura JM, Bauer BD, Shah N, Nguyen E, Maniscalco J. Current Roles and Perceived Needs of Pediatric Hospital Medicine Fellowship Graduates. Hosp Pediatr 2016; 6:633-637. [PMID: 27664087 DOI: 10.1542/hpeds.2016-0031] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Pediatric hospitalists report the need for additional training in clinical and nonclinical domains. Pediatric hospital medicine (PHM) fellowships seek to provide this training and produce leaders in the field. Our objective is to describe current roles and perceived training needs of PHM fellowship graduates. METHODS In 2014, all PHM fellowship graduates were asked to complete a Web-based survey. Survey questions addressed demographics, past training, current roles, and training needs in clinical care, research, education, and administration. Associations between fellowship experiences and outcomes were examined. RESULTS Fifty-one of 61 eligible individuals completed the survey. Average duration as a pediatric hospitalist was 5 years. Ninety percent completed pediatric categorical residency, whereas 10% completed an Internal Medicine-Pediatrics Residency. Most respondents completed a 1- (38%) or 2-year (46%) fellowship program. Ninety-six percent of respondents currently work in academic environments. The perceived need for additional clinical training was low, except procedures (44%). Nearly all teach medical students and pediatric residents, reporting adequate training in variety of teaching strategies. The majority of respondents conduct research, most commonly quality improvement (QI; 67%) and education (52%). Two-thirds are first authors on at least 1 peer-reviewed article. Research training needs include QI methodology (44%), biostatistics (43%), and obtaining funding (54%). A considerable number of respondents have academic leadership positions. CONCLUSIONS PHM fellowship graduates are academic hospitalists with diverse responsibilities. Despite a short average career span, many have achieved leadership roles and been academically productive. Future curriculum development should focus on procedures, QI, and research training.
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Affiliation(s)
- Jennifer M Oshimura
- Division of Hospital Medicine, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Indiana; Division of Hospital Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia;
| | - Benjamin D Bauer
- Division of Hospital Medicine, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Indiana
| | - Neha Shah
- Division of Hospitalist Medicine, Children's National Health System, Washington, District of Columbia; and
| | - Eugene Nguyen
- Division of Hospital Medicine, Children's Hospital Los Angeles, Los Angeles, California
| | - Jennifer Maniscalco
- Division of Hospital Medicine, Children's Hospital Los Angeles, Los Angeles, California
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Shah NH, Rhim HJH, Maniscalco J, Wilson K, Rassbach C. The current state of pediatric hospital medicine fellowships: A survey of program directors. J Hosp Med 2016; 11:324-8. [PMID: 27042818 DOI: 10.1002/jhm.2571] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 10/23/2015] [Accepted: 12/04/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND Pediatric hospital medicine (PHM) fellowship programs have grown rapidly over the last 20 years and have varied in duration and content. In an effort to standardize training in the absence of a single accrediting body, PHM fellowship directors now meet annually to discuss strategies for standardizing and enhancing training. OBJECTIVES To explore similarities and differences in curricular structure among PHM fellowship programs in an effort to inform future curriculum standardization efforts. METHODS An electronic survey was distributed by e-mail to all PHM fellowship directors in April 2014. The survey consisted of 30 multiple-choice and short-answer questions focused on various curricular aspects of training developed by the authors. RESULTS Twenty-seven of 31 fellowship programs (87%) responded to the survey. Duration of most programs was 2 years (63%), with 6, 1-year programs (22%) and 4 (15%) 3-year programs making up the remainder. The average amount of clinical time among programs was 50% (range approximately 20%-65%). In addition to general inpatient pediatric service time, most programs require other clinical rotations. The majority of programs allow fellows to bill independently for their services. Most programs offer certificate courses, courses for credit or noncredit courses, with 11 programs offering masters' degrees. Twenty-one (81%) programs provide a scholarship oversight committee for their fellows. Current fellows' primary areas of research are varied. CONCLUSION Though variability exists regarding program length, clinical composition, and nonclinical offerings, several common themes emerged that may help inform the development of a standard curriculum for use across all programs. This information provides a useful starting point if pediatric hospital medicine obtains formal subspecialty status. Journal of Hospital Medicine 2016;11:324-328. © 2016 Society of Hospital Medicine.
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Affiliation(s)
- Neha H Shah
- Division of Hospitalist Medicine, Children's National Health System, Washington, DC
| | - Hai Jung H Rhim
- Division of Hospital Medicine, Children's Hospital at Montefiore, Bronx, New York
| | - Jennifer Maniscalco
- Division of Hospital Medicine, Children's Hospital Los Angeles, Los Angeles, California
| | - Karen Wilson
- Division of Hospital Medicine, Children's Hospital Colorado, Aurora, Colorado
| | - Caroline Rassbach
- Division of Pediatric Hospital Medicine, Stanford University, Palo Alto, California
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Freed GL, McGuinness GA, Althouse LA, Moran LM, Spera L. Long-term Plans for Those Selecting Hospital Medicine as an Initial Career Choice. Hosp Pediatr 2015; 5:169-74. [PMID: 25832971 DOI: 10.1542/hpeds.2014-0168] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND The proportion of the newly graduated pediatric workforce that becomes hospitalists has been increasing slightly over the past decade. However, it is unknown what proportion of those who accept hospitalist positions as their first job intend to remain in the field longer term. This is important to workforce projections regarding the magnitude of those who will function in this role. METHODS The American Board of Pediatrics incorporated a structured questionnaire within the online application process to the General Pediatrics certification application. Respondents identified as residents or chief residents who selected "hospitalist position" as their immediate postresidency plan were the focus this study. We compared survey responses by gender and location of the medical school attended. RESULTS Since the initiation of the general pediatrics certification examination application survey, 6335 completed the questionnaire. 79% (n=5001) were either in residency training or were a chief resident. Of those, 8% (n=376) reported they planned to work as a pediatric hospitalist immediately after completing residency. Fewer than half (43%; n=161) reported this to be their long-term career plan. This finding varied by both medical school type and by gender. CONCLUSIONS The majority of pediatric residents and chief residents who take hospitalist positions immediately after training do not intend for hospital practice to be the long-term focus of their careers. As the field of hospital medicine continues to develop, understanding career trajectories can help inform current and future efforts regarding the potential for different mechanisms for training and certification.
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Affiliation(s)
- Gary L Freed
- Child Health Evaluation and Research Unit, Division of General Pediatrics, Department of Pediatrics and Communicable Diseases, and Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan; and
| | | | | | - Lauren M Moran
- Child Health Evaluation and Research Unit, Division of General Pediatrics, Department of Pediatrics and Communicable Diseases, and
| | - Laura Spera
- Child Health Evaluation and Research Unit, Division of General Pediatrics, Department of Pediatrics and Communicable Diseases, and
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Frintner MP, Cull WL, Byrne BJ, Freed GL, Katakam SK, Leslie LK, Miller AA, Starmer AJ, Olson LM. A Longitudinal Study of Pediatricians Early in Their Careers: PLACES. Pediatrics 2015. [PMID: 26216329 DOI: 10.1542/peds.2014-3972] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The American Academy of Pediatrics (AAP) launched the Pediatrician Life and Career Experience Study (PLACES), a longitudinal study that tracks the personal and professional experiences of early career pediatricians, in 2012. We used a multipronged approach to develop the study methodology and survey domains and items, including review of existing literature and qualitative research with the target population. We chose to include 2 cohorts of US pediatricians on the basis of residency graduation dates, including 1 group who were several years out of residency (2002-2004 Residency Graduates Cohort) and a second group who recently graduated from residency at study launch (2009-2011 Residency Graduates Cohort). Recruitment into PLACES was a 2-stage process: (1) random sample recruitment from the target population and completion of an initial intake survey and (2) completion of the first Annual Survey by pediatricians who responded positively to stage 1. Overall, 41.2% of pediatricians randomly selected to participate in PLACES indicated positive interest in the study by completing intake surveys; of this group, 1804 (93.7%) completed the first Annual Survey and were considered enrolled in PLACES. Participants were more likely to be female, AAP members, and graduates of US medical schools compared with the target sample; weights were calculated to adjust for these differences. We will survey PLACES pediatricians 2 times per year. PLACES data will allow the AAP to examine career and life choices and transitions experienced by early-career pediatricians.
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Affiliation(s)
- Mary Pat Frintner
- Department of Research, American Academy of Pediatrics, Elk Grove Village, Illinois;
| | - William L Cull
- Department of Research, American Academy of Pediatrics, Elk Grove Village, Illinois
| | - Bobbi J Byrne
- Section of Neonatal-Perinatal Medicine, Department of Pediatrics, Indiana University, Indianapolis, Indiana
| | - Gary L Freed
- Department of Pediatrics and Child Health Evaluation and Research Unit, University of Michigan, Ann Arbor, Michigan
| | - Shesha K Katakam
- Department of Pediatrics, Indiana University Health La Porte, La Porte, Indiana
| | - Laurel K Leslie
- Department of Pediatrics, Tufts Medical Center Floating Hospital for Children, Boston, Massachusetts
| | - Ashley A Miller
- Department of Pediatrics New London Hospital, New London, New Hampshire
| | - Amy J Starmer
- Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts; and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Lynn M Olson
- Department of Research, American Academy of Pediatrics, Elk Grove Village, Illinois
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Srivastava R, Landrigan CP. Development of the Pediatric Research in Inpatient Settings (PRIS) Network: lessons learned. J Hosp Med 2012; 7:661-4. [PMID: 23033225 DOI: 10.1002/jhm.1972] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Teufel RJ, Bekmezian A, Wilson K. Pediatric hospitalist research productivity: predictors of success at presenting abstracts and publishing peer-reviewed manuscripts among pediatric hospitalists. Hosp Pediatr 2012; 2:149-160. [PMID: 24319919 DOI: 10.1542/hpeds.2012-0005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To identify factors associated with research productivity among pediatric hospitalists. METHODS We performed a cross-sectional online survey of pediatric hospitalists recruited from the American Academy of Pediatrics Section on Hospital Medicine from May to August 2009. We used abstract presentations at a national meeting (intermediate outcome) and 22 first-author peer-reviewed manuscripts (primary outcome) to measure research productivity. Information was also collected on environmental and physician characteristics. Stepwise logistic regression was performed to identify independent associations with research productivity. RESULTS Two hundred fifteen pediatric hospitalists completed the survey. The respondents included 82% in an academic environment, 150% fellowship trained, 25% with additional degrees, and 67% with no protected time for research. Fifty-six percent presented an abstract, and 17% had 2 or more publications. After adjusting for potential confounders, pediatric hospitalists were more likely to have presented an abstract if they had fellowship training, an additional degree, were "very interested" or "interested" in performing research, or worked in a free-standing children's hospital or children's hospital within a hospital. Pediatric hospitalists were more likely to have 2 or more publications if they had an additional degree or had presented an abstract. CONCLUSIONS Among pediatric hospitalists, obtaining an additional degree and presenting an abstract at a national meeting are associated with research productivity. A minority of this group of pediatric hospitalists had fellowship training, degree training, or 2 or more first-author manuscripts published even though the majority are in an academic environment. These results suggest that structured training and a focus on abstract presentations at meetings could be a programmatic solution.
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Affiliation(s)
- Ronald J Teufel
- Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina 29401, USA.
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Heydarian C, Maniscalco J. Pediatric hospitalists in medical education: current roles and future directions. Curr Probl Pediatr Adolesc Health Care 2012; 42:120-6. [PMID: 22483082 DOI: 10.1016/j.cppeds.2012.01.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Accepted: 01/16/2012] [Indexed: 11/25/2022]
Abstract
As the field of pediatric hospital medicine has evolved, pediatric hospitalists have become increasingly involved in medical student and resident education--providing direct education during clinical rotations, developing novel curricula to meet the demands of the new educational environment, occupying leadership roles in medical education, and more. The literature suggests that hospitalists possess the essential skills for teaching effectively, yet most hospitalists feel that additional training beyond residency is necessary to refine their knowledge and skills in education and in other essential domains. Several pediatric hospital medicine fellowships and continuing medical education activities have been developed in the last decade to meet this growing need. The recent publication of the Pediatric Hospital Medicine Core Competencies will help define the roles and expectations of practicing pediatric hospitalists, and will serve as a framework for future curriculum development in both graduate and continuing medical education.
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Affiliation(s)
- Cyrus Heydarian
- Department of Pediatrics, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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Abstract
OBJECTIVE To assess the current state of research productivity, goals, obstacles, and needs of pediatric hospitalists. METHODS The American Academy of Pediatrics Section on Hospital Medicine performed a cross-sectional online survey of pediatric hospitalists. Questions assessed demographics, research productivity, system-level factors, research interests, goals and obstacles, and the perceived need for research training and support. RESULTS Two hundred twenty pediatric hospitalists in the United States completed the survey. Of these, 56% had presented at a national meeting, 24% were first authors of an article in a peer-reviewed journal, 8% had more than publications, and 12% had secured external grant support. While 90% of respondents had spent 10% or less time in research, 64% had an academic appointment at the assistant professor level or above. Nearly 40% felt that their institution expected them to do research, and 56% were interested and another 27% were very interested in conducting research. The main research interest was quality improvement (QI) evaluation. Common obstacles to research were lack of time, mentorship, and resources. CONCLUSIONS Pediatric hospitalists want to conduct research to improve the quality of inpatient care but face significant obstacles including lack of dedicated time for research and mentorship. Coordinated efforts to improve access to academic resources are important for career development and academic growth of the field. National organizations and hospital programs interested in improving the quality of care for hospitalized children can provide support to meet the field's professional needs for research.
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Affiliation(s)
- Arpi Bekmezian
- Department of Pediatrics, University of California, San Francisco, CA
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Abstract
PURPOSE OF REVIEW The present review focuses on the latest evidence from the past 18 months related to pediatric hospitalist medicine. RECENT FINDINGS The number of hospitalists continues to increase despite many programs not being financially self-supporting. Reports in the past have shown decreased length of stay, resource utilization, and costs with the hospitalist model. There are an increasing number of studies examining patient safety, quality initiatives, and communication issues such as 'handoffs' and family-centered rounds. The teaching role continues to broaden in scope and is highly valued by trainees. Pediatric hospitalist fellowship training programs are in an early stage of development. A list of core competencies as a framework for a pediatric hospital medicine curriculum has recently been published and should help to facilitate and standardize training. Recent publications suggest that there is still significant variation in the approach to and management of many common inpatient illnesses. SUMMARY In general, there continue to be reports of positive outcomes as a result of the introduction of the hospitalist model in pediatrics. Much of the current literature is geared toward reporting on alternative models of care, inpatient quality and safety initiatives, and hospitalist teaching. What is still somewhat lacking is multicenter collaborative prospective clinical trials for common inpatient general pediatric conditions. The variation reported in the management of common conditions presents an opportunity for improving the quality, safety, resource utilization, and appropriateness of care.
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Abstract
The success of the evolving filed of pediatric hospitalist medicine should be judged on the health outcomes achieved for the more than 6 million children who are hospitalized annually. The focused approach hospitalists bring to defining the best knowledge that their role is important but is limited in the overall health of most children. In order to achieve the best health outcomes, hospitalists must fully partner with the child's primary care provider. By consistently communicating well during pre-admission, hospitalization, and discharge intervals, hospitalists and primary care pediatricians can enhance learning, as well as maximize outcomes for shared patients.
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Manicone PE. In response to: characteristics of pediatric hospital medicine fellowships and training program. J Hosp Med 2009; 4:391-2; author reply 393. [PMID: 19670367 DOI: 10.1002/jhm.557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Percelay JM. Toto, I don't think we're on the adult inpatient unit anymore. J Hosp Med 2009; 4:145-8. [PMID: 19301405 DOI: 10.1002/jhm.511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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