Educating Pediatric Residents About Parenting: A Survey of Residency Program Leaders

Trauma-Informed Positive Parenting in Primary Care as a Tool to Support Child and Family Well-Being

Factors affecting caregiver health and wellbeing, such as trauma and stress, can have significant negative impact on parenting behaviors and on subsequent child physical and mental health. Trauma-informed positive parenting (TIPP) is an effective tool that acknowledges and addresses a family's unique journey and needs, while promoting both nurturing caregiver-child interactions and appropriate limit setting. Primary care practices are in unique positions to provide such interventions, due to their long-standing and trusted involvement with families. Therefore, we propose that TIPP can feasibly be incorporated into the pediatric primary care setting to support overall family health and well-being. [Pediatr Ann. 2024;53(10):e360-e365.].

Resident Training Experiences Providing Spanish-Language Concordant Care: Implications for Growing Health Equity Efforts Within Graduate Medical Education

Training experiences where residents provide Spanish-language concordant care (SLCC) have not been widely described despite their increasing need and prevalence in graduate medical education. In this qualitative study, we enrolled nonnative Spanish-speaking residents (n = 21) within SLCC training clinics from 3 geographically unique programs. Participants completed semistructured interviews focused on their overall SLCC training experience. Major themes identified included (1) high levels of satisfaction in their SLCC experience, (2) concern about ongoing language barriers, (3) demonstration of high levels of cultural humility in caring for patients with limited English proficiency, and (4) identification of several valuable programmatic and clinical resources. Based on these findings, we conclude that SLCC training experiences are of significant value to trainees in becoming pediatricians able to promote health equity. Themes identified could help inform how graduate medical education programs utilize SLCC to grow health-equity based efforts to deliver more effective and compassionate care to our linguistically diverse populations.

Evaluating the Keystones of Development - An Online Curriculum for Residents to Promote Positive Parenting in Primary Care

OBJECTIVE

This pilot outcome evaluation assesses the effectiveness of an online curriculum, the Keystones of Development, aimed at improving residents' knowledge, attitudes, and reported behaviors around promoting positive parenting and childhood development in well-child visits.

METHODS

We used an explanatory mixed-methods approach, including a single-arm pre-posttest of intervention effects on self-reported behavioral outcomes (discussing, modeling, and praising) and secondary outcomes (knowledge, perceived barriers, attitudes, and self-efficacy). Following this, a subset of residents participated in in-depth interviews to describe participant responses to the intervention.

RESULTS

The study was conducted at 8 pediatric residency programs across the United States with 67 pediatric residents (mean age = 29; 79% female; 57% PGY1). Within one month postintervention, there was a statistically significant increase in the behaviors that promote positive parenting: discussing (P < .01;d = 0.73) and modeling (P < .01;d = 0.61) but not praising (P = .05; d = 0.3). Significant changes in the secondary outcomes: knowledge (P < .01), perceived barriers, (P < .01), and retrospective self-efficacy (P < .01) were seen. Interviews revealed that integration of curriculum content into clinical practice was due to the relevance of the material to primary care and the modeling of how to apply in the clinical setting. Curriculum format, content, and clinical application helped participants weave recommendations into the well-child visit.

CONCLUSIONS

In this study, we demonstrated that the online curriculum, Keystones of Development, increased resident behaviors, knowledge, and self-efficacy, and decreased perceived barriers to promote parenting behaviors associated with improved child development outcomes in well-child visits. These findings were observed across participants demonstrating equal success regardless of demographic characteristics or study site.