The evolution of graduate medical education over the past decade: Building a new pediatric residency program in an era of innovation

Hernandez, Raquel; Hopkins, Akshata; Dudas, Robert A.

doi:10.1080/0142159x.2018.1455969

Cited by 9 publications

(6 citation statements)

References 35 publications

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“…Focused programmatic and clinical changes such as those proposed by study participants could benefit future trainees and provide evidence for program leaders to advocate for critically needed investments. We identified that key resources including on-site bilingual clinical staff, language-concordant patient resources, newly developed Spanish-language proficiency tools, integrated and self-directed medical Spanish curricula, 26,30 simulated patient scenarios, 31 and Spanish-language coaching 32,33 could have significant impact on trainees and their SLCC patient care. Innovative models by which best practices surrounding how these resources may be included in clinical training may be modeled from existing GME programs including the CHICOS clinic, 32 Centro Sol, 34 and Si Tu Puedes (translated: "Yes, you can").…”

Section: Discussionmentioning

confidence: 99%

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

Hernandez

Tanaka

McPeak

et al. 2022

Clin Pediatr (Phila)

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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.

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Section: Discussionmentioning

confidence: 99%

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

Hernandez

Tanaka

McPeak

et al. 2022

Clin Pediatr (Phila)

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“…Our institution’s residency program consists of 36 total pediatric residents with 12 residents per Post-Graduate-Year (PGY). Two cohorts of PGY-1 and PGY-3 residents participated in all simulation experiences as part of a required didactic and experiential curriculum teaching on cultural competency, implicit biases, and health inequity in the fall of 2018 and 2019 [ 15 ]. Of note, PGY-3 residents from the first cohort had already received a 45-minute didactic-based training on the recognition and effects of ACEs on child health as part of a project targeting screening for ACEs in the outpatient clinic setting [ 16 ].…”

Section: Methodsmentioning

confidence: 99%

Using simulation to increase resident comfort discussing social determinants of health

et al. 2021

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Background Social determinants of health (SDoH) play an important role in pediatric health outcomes. Trainees receive little to no training on how to identify, discuss and counsel families in a clinical setting. The aim of this study was to determine if a simulation-based SDoH training activity would improve pediatric resident comfort with these skills. Methods We performed a prospective study of a curricular intervention involving simulation cases utilizing standardized patients focused on four social determinants (food insecurity, housing insecurity, barriers to accessing care, and adverse childhood experiences [ACEs]). Residents reported confidence levels with discussing each SDoH and satisfaction with the activity in a retrospective pre-post survey with five-point Likert style questions. Select residents were surveyed again 9–12 months after participation. Results 85% (33/39) of residents expressed satisfaction with the simulation activity. More residents expressed comfort discussing each SDoH after the activity (Δ% 38–47%; all p < .05), with the greatest effect noted in post-graduate-year-1 (PGY-1) participants. Improvements in comfort were sustained longitudinally during the academic year. More PGY-1 participants reported engaging in ≥ 2 conversations in a clinical setting related to food insecurity (43% vs. 5%; p = .04) and ACEs (71% vs. 20%; p = .02). Discussion Simulation led to an increased resident comfort with discussing SDoH in a clinical setting. The greatest benefit from such a curriculum is likely realized early in training. Future efforts should investigate if exposure to the simulations and increased comfort level with each topic correlate with increased likelihood to engage in these conversations in the clinical setting.

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“…An innovative postgraduate pediatric programme at Johns Hopkins All Children's Hospital in Florida has been designed to foreground individualized learning plans and achieve a more equitable balance between clinical commitments and the educational needs of learners (Hernandez et al 2018; see also Kuzma et al 2016). 'Learning communities' bring together a group of postgraduate residents and faculty mentors to support residents in pursuing and refining their learning plans, with the aid of peer and faculty feedback.…”

Section: Example Twomentioning

confidence: 99%

Feedback in Postgraduate Online Learning: Perspectives and Practices

Hounsell

2021

Online Postgraduate Education in a Postdigital World

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The evolution of graduate medical education over the past decade: Building a new pediatric residency program in an era of innovation

Abstract: Although a full evaluation of our program is only possible after many years, this article presents the core tenets which guided curricular development and discusses our experiences thus far. We provide lessons learned for programs considering similar innovations.

Cited by 9 publications

References 35 publications

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

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

Using simulation to increase resident comfort discussing social determinants of health

Feedback in Postgraduate Online Learning: Perspectives and Practices

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