Sense of Belonging and Professional Identity Among Combined Pediatrics-Anesthesiology Residents

Brandford, Elena; Wang, Tammy; Nguyen, Clarice; Rassbach, Caroline E.

doi:10.1016/j.acap.2022.05.017

Cited by 8 publications

(10 citation statements)

References 13 publications

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“…Even fewer respondents were willing to complete PCCM fellowship if it required 3 years of training, which suggests that of the cohort of respondents who still plan to complete dual fellowship training, many of them would only do so if their subspecialty training could be abbreviated. Our results concur with other survey results conducted on similar topics, 5,6 suggesting that while there is continued interest in dual training in PA/PCCM, sustaining this interest in dual-subspecialty training through residency remains challenging. In our study, it appears that it is sometime during residency when the majority of shifts in career aspirations occur.…”

Section: Discussionsupporting

confidence: 90%

National Survey of Combined Pediatrics-Anesthesiology Residents and Graduates: Factors Contributing to Changing Career Aspirations Over Time

Liu

Jackson

Xie

et al. 2022

Anesthesia &Amp; Analgesia

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BACKGROUND: The Dual Pathway for Certification in Pediatrics and Anesthesiology was created in 2011 to develop leaders in caring for children with complex medical and surgical conditions. While existing dual-trained practitioners report continued practice in both pediatric anesthesiology (PA) and pediatric critical care medicine (PCCM), recent surveys of dual pathway trainees have shown that only one-quarter still currently plan to pursue training in PCCM, a change from their initial plans to complete training in both PA and PCCM. The aim of this study was to further characterize the motivations driving shifts in career trajectory during training as well as factors affecting the combined training experience. METHODS: We conducted an online mixed-methods survey of all individuals who had matriculated at 1 of the 7 Accreditation Council for Graduate Medical Education–accredited combined pediatrics-anesthesiology residencies from 2011 to 2018. The survey consisted of a 30-item questionnaire addressing training experience, anticipated career trajectory, and respondent demographics. Descriptive statistics were used for closed-format questions. Responses to open-ended questions were systematically analyzed through inductive iterative review by 2 of the authors to elicit a set of overarching themes. RESULTS: We achieved a response rate of 85% (n = 53/62) with respondents from 7 of 7 combined residency programs. When asked about career goals, the majority of respondents planned to pursue both PA and PCCM (60%, n = 32) at the start of residency. However, at the time of survey completion, the percentage of respondents who were still planning to (or had already completed) train in both PA and PCCM had decreased to 23% (n = 12). Factors such as lifestyle and length of training contributed more to career choices during/after training compared to before residency. Thematic analysis of open-ended questions regarding transition between specialties, impact of dual training, and general comments revealed 3 major themes: (1) challenges of transitioning between specialties, (2) dual training is mutually beneficial, and (3) the need for an established fellowship training pathway. CONCLUSIONS: While there is continued interest in dual training in PA/PCCM for residents who enter the combined pediatrics-anesthesiology residency, factors such as duration of training and lifestyle become more important during residency and alter their career trajectories, often away from PCCM. Optimization of dual-subspecialty fellowship training will be critical to sustaining interest in dual-subspecialty training in PA/PCCM.

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Section: Discussionsupporting

confidence: 90%

National Survey of Combined Pediatrics-Anesthesiology Residents and Graduates: Factors Contributing to Changing Career Aspirations Over Time

Liu

Jackson

Xie

et al. 2022

Anesthesia &Amp; Analgesia

View full text Add to dashboard Cite

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“…The perceived lack of autonomy that comes with inflexible schedules can be difficult as trainees navigate their professional and personal priorities, findings that align with existing literature 1,7 . Themes regarding social challenges also corroborate prior findings, 6 suggesting opportunities to improve a sense of relatedness among combined residents by facilitating peer and faculty mentoring. By understanding and addressing these barriers, there is potential to maximize the benefits of and satisfaction with combined training while minimizing the risk of burnout and decreased motivation 15 …”

Section: Discussionsupporting

confidence: 74%

“…However, multiple surveys of combined residents have shown attrition in the percentage of residents who desired to complete PCCM training following residency, 4 citing training duration and lifestyle factors as major barriers 5 . Additional challenges of combined residency have been identified, including social isolation and impaired sense of belonging in one or both specialties 6 . Similarly, Welch et al found that 26% of attending physicians trained in both pediatric anesthesiology and PCCM restricted their practice to one specialty or neither specialty and believed that the largest barrier for trainees wishing to pursue dual subspecialty practice was length of training, 1 a sentiment that has been emphasized multiple times in the literature 2,4,5,7 …”

Section: Introductionmentioning

confidence: 99%

“…5 Additional challenges of combined residency have been identified, including social isolation and impaired sense of belonging in one or both specialties. 6 Similarly, Welch et al found that 26% of attending physicians trained in both pediatric anesthesiology and PCCM restricted their practice to one specialty or neither specialty and believed that the largest barrier for trainees wishing to pursue dual subspecialty practice was length of training, 1 a sentiment that has been emphasized multiple times in the literature. 2,4,5,7 Interestingly, these prior studies of current combined residents and attendings who have completed both residencies demonstrate that 80%-88% would pursue dual specialty training again.…”

Section: Introductionmentioning

confidence: 99%

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Benefits and challenges of combined pediatrics‐anesthesiology residency programs: A qualitative study

Nguyen

Xie

Brandford

et al. 2023

Pediatric Anesthesia

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BackgroundThe combined pediatrics‐anesthesiology residency program was created in 2011 for trainees interested in careers within both specialties. Prior studies have cited challenges of combined training, but none have systematically identified benefits.AimsOur objective was to describe the perceived educational and professional benefits and challenges of combined pediatrics‐anesthesiology residency programs.MethodsIn this qualitative study using a phenomenological approach, all graduates of combined pediatrics‐anesthesiology residency programs from 2016 to 2021, program directors, associate program directors, and faculty mentors were invited to participate in surveys and interviews. Study members conducted interviews using a semi‐structured interview guide. Each transcript was coded inductively by two authors and themes were developed using thematic analysis through the lens of self‐determination theory.Results43 of 62 graduates and faculty responded to our survey (69% response rate), and 14 graduates and five faculty were interviewed. Survey and interview data represented seven programs, including five currently accredited combined programs. Themes emerged regarding benefits of training: it 1) fosters residents' clinical expertise in managing critically ill and medically complex children; 2) provides residents with exceptional knowledge and skills in communicating between medical and perioperative services; and 3) affords unique academic and career opportunities. Other themes emerged regarding the challenges of long duration of training and transitions between pediatrics and anesthesiology rotations.ConclusionsThis is the first study to describe the perceived educational and professional benefits of combined pediatrics‐anesthesiology residency programs. Combined training affords exceptional clinical competence and autonomy in the management of pediatric patients and the ability to skillfully navigate hospital systems, and leads to robust academic and career opportunities. However, the duration of training and challenging transitions may threaten residents' sense of relatedness to colleagues and peers, and their self‐perceived competence and autonomy. These results can inform mentoring and recruitment of residents to combined pediatrics‐anesthesiology programs and career opportunities for graduates.

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“…While there has been some literature evaluating impact of online learning on students' sense of belonging [ 6 , 9 ], none of these studies investigated clinical health science students. Promoting a sense of belonging among first year clinical health science students is especially important for developing positive motivational attitudes, professional identity [ 15 , 16 ], and professional peer relationships with future colleagues [ 17 ]. There are limited studies that have examined impact of online platforms on the development of sense of belonging amongst undergraduate first year clinical health science students and, as yet, none have provided conclusive guidance.…”

Section: Introductionmentioning

confidence: 99%

Impact of online learning on sense of belonging among first year clinical health students during COVID-19: student and academic perspectives

et al. 2023

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Background The need to belong is a fundamental human desire that provides the basis for relationships and community; it provides a sense of security that enables growth and development. This sense of belonging is pivotal to new University students, indeed, without it, students are at greater risk of failing or withdrawing from their studies. Yet developing a sense of belonging within a new cohort is complex and multi-faceted and further complicated by a sudden shift away from in-person to online learning. Using the situated-learning framework, our study explores first year clinical health students’ sense of belonging in the context of the rapid transition to online learning because of the COVID-19 pandemic. Methods We utilised a current mixed-method approach including a survey incorporating previously validated tools, demographic and open-ended qualitative questions. Data was also gathered from three focus groups: two dedicated student groups and one academic focus group. Qualitative data was subjected to thematic analysis whilst descriptive statistics were used to describe the quantitative data. Results 179 first year students complete the survey and four students, and five academics were involved in the focus groups. All participants were from clinical health science courses at an Australian university. Our qualitative results indicated a global theme of: Navigating belonging during the COVID-19 crisis: a shared responsibility; with four organising themes describing (1) dimensions of belonging, (2) individual experiences and challenges, (3) reconceptualising teaching and learning, and (4) relationships are central to belonging. Conclusion While the rapid transition to online learning did not greatly impact knowledge acquisition of first-year students in this cohort, the lack of sense of belonging highlights the need for further research into development of this essential aspect of learning in the online domain. Although contextualised in the COVID-19 pandemic, it became clear that the findings will remain relevant beyond the current situation, as a student’s need to belong will always be present in the face of challenges or change.

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Sense of Belonging and Professional Identity Among Combined Pediatrics-Anesthesiology Residents

Cited by 8 publications

References 13 publications

National Survey of Combined Pediatrics-Anesthesiology Residents and Graduates: Factors Contributing to Changing Career Aspirations Over Time

National Survey of Combined Pediatrics-Anesthesiology Residents and Graduates: Factors Contributing to Changing Career Aspirations Over Time

Benefits and challenges of combined pediatrics‐anesthesiology residency programs: A qualitative study

Impact of online learning on sense of belonging among first year clinical health students during COVID-19: student and academic perspectives

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