A survey of pediatric resident training programs 5 years after the task force report

Weinberger, Howard L.; Oski, Frank A.

doi:10.1016/s0002-7138(09)61118-3

Cited by 9 publications

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“…5 Studies assessing progress in the years after the Task Force Report identified that change came very slowly. 2,6 Although a 1989 survey similar to the one used by the 1978 Task Force found that graduates after 1984 thought their training was better in DBP and adolescent medicine, 50% of the 1785 member sample still considered their training insufficient in biosocial areas. 2 In comparison to these studies, UMMC residents rated themselves "well-prepared" to provide anticipatory guidance and manage common behavioral issues; employers also rated residents between "well-prepared" and "very well-prepared."…”

Section: Developmental and Behavioral Pediatrics (Dbp)/anticipatory Gmentioning

confidence: 99%

“…[1][2][3][4] Concurrent assessments of the curriculum of residency programs, beginning with the report of the American Academy of Pediatrics (AAP) Task Force on Pediatric Education in 1978, demonstrated that primary care aspects of pediatric practice were given little time and emphasis. 2,5,6 Recently, directors of managed care organizations have added their dissatisfaction with the preparedness of graduates of pediatrics residency programs to practice in their settings. 7,8 Multiple changes to the traditional residency curriculum have been proposed to address the Residency-Practice Training Mismatch.…”

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confidence: 99%

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The University of Massachusetts Medical Center Office-based Continuity Experience: Are We Preparing Pediatrics Residents for Primary Care Practice?

Roberts¹,

Starr²,

DeWitt³

1997

Pediatrics

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ABSTRACT. Objective. Surveys of residency graduates and employers have suggested that residency programs do not prepare residents well for practice. Since 1988, pediatric residents at the University of Massachusetts have been paired one-on-one with an office-based pediatrician for their 3-year continuity experience. This survey was conducted to determine if graduates of such a program are prepared to enter pediatric practice.Methodology. Graduates of the program from 1991 through 1995 who entered primary care practice were surveyed about their preparedness for practice. The questionnaire was also sent to the residents' first employers. The 32 questions were directed to overall sense of preparedness, ability to manage the pace of practice, common illnesses, common behavior problems, anticipatory guidance, office management, and subspecialty problems.Results. Data from all 25 residents who entered practice and the employers of 20 of the 25 residents were obtained and analyzed. Both groups rated overall resident preparedness to be "well-prepared" or "very wellprepared" and gave high scores on working at the pace of practice, diagnosing and treating common illnesses, diagnosing and treating common behavior problems, and providing anticipatory guidance. Areas in which residents were considered to be less well-prepared included anticipatory guidance about nutrition, managing problems by telephone, office management, gynecology, and orthopedics.Conclusions. The results suggest that continuity experiences in office practices are associated with preparation for the pace and types of visits that occur commonly in primary care practice, abilities which previous surveys of residency alumni and employers have found lacking. Some areas may benefit from a formal curriculum which may be implemented in the office practice, at the medical center, or at both sites. Preceptors may benefit from faculty development and continuing medical education that is directed not only at teaching skills but also at content areas which were not addressed in their own residencies. Pediatrics 1997;100(4). URL: http://www.pediatrics.org/ cgi/content/full/100/4/e2; education, medical, graduate; preparedness for practice; internship and residency; pediatrics/education; physicians; evaluation studies; faculty, medical; health maintenance organizations; questionnaires.ABBREVIATIONS. AAP, American Academy of Pediatrics; UMMC, University of Massachusetts Medical Center; HMO, health maintenance organization; DBP, developmental and behavioral pediatrics.

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Section: Developmental and Behavioral Pediatrics (Dbp)/anticipatory Gmentioning

confidence: 99%

mentioning

confidence: 99%

The University of Massachusetts Medical Center Office-based Continuity Experience: Are We Preparing Pediatrics Residents for Primary Care Practice?

Roberts¹,

Starr²,

DeWitt³

1997

Pediatrics

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“…26,29 Studies published in the early 1990s that targeted graduates of pediatrics programs and directors of managed care companies decried a lack of preparation for primary care pediatrics practice. [30][31][32][33][34][35][36][37][38] Most research conducted over the last decade has focused on specific topical areas rather than pediatrics residency training in its entirety. Generalists have reported discomfort managing depression, 39,40 nutrition, 41 in-office gynecology, 41 and certain areas of developmental/ behavioral pediatrics (ie, behavior problems, learning disabilities, sleep, anxiety).…”

Section: Introductionmentioning

confidence: 99%

What Can Data Tell Us About the Quality and Relevance of Current Pediatric Residency Education?

Leslie

2009

Pediatrics

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The Residency Review and Redesign (R 3 P) Project relied on both qualitative and quantitative data in developing its recommendations regarding residency education. This article reviews quantitative data in the published literature of import to the R 3 P Project as well as findings by Freed and colleagues published in this supplement to Pediatrics. Primary questions of interest to the R 3 P Project included: What factors drive decision-making regarding residency selection? Do current training programs have the flexibility to meet the needs of residents, no matter what their career choice with pediatrics? What areas need greater focus within residency training? Should the length of training remain at 36 months? Based on the available data, the R 3 P Project concluded that more diversity needs to be fostered with training programs. By promoting innovative and diverse approaches to improving pediatric residency education, members of the R 3 P Project hope to enhance learning, encourage multiple career paths within the broad field of pediatrics, and, ultimately, improve patient and family outcomes. Pediatrics 2009;123:S50-S55 T HREE ARTICLES IN this supplement to Pediatrics detail the proceedings from the Residency Review and Redesign in Pediatrics (R 3 P) Project colloquia. 1-3 These dialogue-driven sessions provided crucial qualitative data relevant to the R 3 P Project. Using strategies commonly applied for strategic planning processes in the business, policy, and technology sectors, participants in the colloquia clarified their values regarding pediatric residency education, their concerns about factors affecting training, and their hopes for solutions. The interplay between participants allowed for greater understanding of different stakeholders' perspectives regarding the developmental and historical processes influencing residency education and appreciation for the myriad social and political factors that contribute to our uncertainty regarding the state of pediatric residency education in the future.Concurrently, participants of the R 3 P Project pursued a variety of sources to identify quantifiable data that would inform its recommendations. A review of current literature provided documentation of the changing demographics and disease/disorder patterns among children and adolescents in the United States and the implications for pediatric practice. [4][5][6][7] There is a small but growing body of literature examining educational strategies and assessment measures in medical education. 8-19 R 3 P Project participants also searched for data that have captured the voices of recently trained pediatric generalists and subspecialists and current subspecialty fellows and residents regarding residency choice and career choice, adequacy of pediatric training, and early experiences in practice or as junior faculty.The picture that emerges from available data is that pediatricians who choose specialty training are more likely to be male, 20 white, 20 and interested in teaching, 21 research, 21,22 and technical ...

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“…Research focusing on the paediatric residency training programmes following the dissemination of the Task Force Report indicates certain characteristics of the learning and practice environment of paediatric residency training severely constrain the ability to achieve the objectives defined in the Task Force. An extensive survey (Weinberger & Oski 1984) of residency training programmes conducted in 1984, 5 years after the dissemination of the Task Force's recommendation, indicated scant inclusion of ‘new morbidity’ issues in the formal training and clinical practice of paediatric house officers. Training in adolescent medical care was most conspicuously underrepresented.…”

Section: Introductionmentioning

confidence: 99%

Residents' evaluation of behavioural paediatrics instruction

1989

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This study sought to explore the following questions: (1) Do residents perceive training focused on infancy and early childhood care issues as more clinically applicable than training focused on care of older children and adolescents? (2) Do residents at different training levels differ in their evaluation of behavioural paediatrics instruction? (3) What is the strength of the association between instructional style and clinical impact dimensions? and (4) Compared to the instruction provided by instructors from other medical and academic disciplines, do paediatric residents perceive differences in the teaching efficacy and clinical relevance of instruction provided by paediatricians? Data were drawn from 1341 residents' evaluations of 116 required behavioural paediatrics sessions over 3 years. The data demonstrated that house officers recognize the value of acquiring knowledge in behavioural paediatrics, regardless of the level of the house officers' training, or whether the focus concerned infants or older children. However, residents were more likely to perceive the presentations provided by paediatricians as providing instruction that was slightly more applicable to their practice needs than instruction that other faculty presented. The study results further demonstrated that the clarity and organization of instruction influences, but does not supercede, the residents' perception of the merit of instruction. The findings suggest that international recommendations for greater inclusion and acceptance of behavioural paediatric instruction can be achieved in programmes that, by requiring participation, confer equal status to behavioural paediatrics and traditional residency training. The results support residents' acceptance of a health team approach to behavioural paediatric instruction.(ABSTRACT TRUNCATED AT 250 WORDS)

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A survey of pediatric resident training programs 5 years after the task force report

Cited by 9 publications

References 0 publications

The University of Massachusetts Medical Center Office-based Continuity Experience: Are We Preparing Pediatrics Residents for Primary Care Practice?

The University of Massachusetts Medical Center Office-based Continuity Experience: Are We Preparing Pediatrics Residents for Primary Care Practice?

What Can Data Tell Us About the Quality and Relevance of Current Pediatric Residency Education?

Residents' evaluation of behavioural paediatrics instruction

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