Discharge Education Curriculum for Residents Rotating on an Inpatient Pediatric Ward

Adult literature has demonstrated that patient preferences and understanding of discharge instructions can impact success of discharge and even predict return ER visits. There is very little data in pediatric literature describing what information should be discussed with families when providing discharge instructions, and most pediatric residents do not receive formal education on the topic. This curriculum is designed as a brief educational intervention that can improve residents’ comfort and skills in providing discharge education to families. The materials include both how to present the curriculum and tools to assess resident knowledge, behaviors and attitudes regarding discharge education as well as an objective checklist to evaluate their skills. The curriculum is designed to be presented in small group, open discussion format while residents are rotating on the inpatient pediatric ward months. This curriculum has been taught to pediatric interns, family medicine residents and psychiatry residents rotating on the inpatient pediatric wards at two large, free-standing children’s hospitals and demonstrated reproducible, statistically significant improvement in resident comfort and performance in providing discharge education. When evaluating the curriculum, resident free text comments included “it made me think of considerations I hadn’t previously thought of” and “this has made me make an effort to be present, rather than just give written instructions for the nurse to go over. The curriculum is significant because it is a brief educational intervention that can have an impact on trainee comfort and skills as well as patient care. Although not well demonstrated in pediatric literature, adult literature has shown that a patients’ preparedness for discharge can predict the risk of a return ER visit, making this an important topic to address in pediatric inpatient medicine, as improvement in the quality of discharge counseling likely impacts patient safety and overall understanding and adherence to the outpatient treatment plan. There were slight variations in the way the curriculum was executed at each institution, yet both had favorable results, demonstrating the flexibility of the curriculum and the potential for interdisciplinary collaboration in the shared goal of improving the patient experience and safety at the time of discharge. In addition, it allows for objective observation of a trainee providing direct patient care. Providing thorough discharge counseling to a family should address all 6 ACGME core competencies, and this curriculum provides for an additional way to evaluate performance. AAMC MedEdPORTAL publication ID 10079. Link to origina

How to Be a Super Model: Using Role Modeling to Become an Exemplary Educator

Over the past several years, published studies have described the qualities and skills of exemplary medical educators. Despite its inclusion in these lists, role modeling is a skill that is not often developed as a skill for use as an educational method. The purpose of this workshop is to assist participants in better understanding the characteristics of effective role modeling and create a paradigm for how to consciously incorporate role modeling into the daily education of students, residents, and colleagues in varied domains, including teaching, professionalism, communication, and patient care. In this workshop, participants are introduced to the concept of role modeling as a metacognitive process where successful educators make their thought processes and reasons for behaviors accessible to learners. Through an interactive icebreaker, participants discuss role modeling behaviors that they have encountered, and reflect on their own professional development, describing the impact of positive and negative role modeled behaviors observed through their training. Participants are then provided a succinct review of the literature on role modeling as an educational method in order to provide a framework for participants’ active experimentation in breakout sessions. During these small group sessions, participants explore the different contexts in which they currently may role model teaching, professionalism, communication, and clinical behaviors. Finally, participants collaborate to develop practical strategies for utilizing role modeling in the daily practice of education using the framework provided, and then share their strategies with the larger group. This workshop has been selected for presentation to national audiences at the Pediatric Academic Society (PAS) Meeting in 2013, The Committee on Medical Student Education in Pediatrics (COMSEP) Meeting in 2012, and the American Academy of Pediatrics Pediatric Hospital Medicine Conference (PHM) in both 2012 and 2013. In addition, this workshop has been adapted by the authors for presentation at their local institutions for Grand Rounds, a faculty development retreat, a workshop for faculty and senior medical student preceptors of a Principles of Clinical Medicine course for first and second year medical students, and for pediatric residents learning leadership and teaching skills during a Global Child Health elective. We have also adapted the small group exercise to discuss other topics, such as professionalism, breaking bad news, and working with the angry/upset family

Challenging Situations in Family Centered Rounds: Making the Best out of Worst Case Scenarios

This resource is a workshop intended for both seasoned and novice health care providers who are interested in becoming prepared for challenging scenarios that may be encountered during FCR. Case scenarios of challenging situations relating to discussing sensitive topics, correcting errors, and teaching learners in front of both parents and patients are presented. Tangible opportunities to role model communication skills, efficiency, and teaching skills for trainees are highlighted. The session will conclude with a question and answer session with a multi-specialty panel to share experiences and strategies for addressing the unexpected during FCR. By the end of the workshop, participants will take away concrete strategies that they can share with their home institutions that will enhance the FCR process. AAMC MedEdPORTAL publication ID 9728. Link to original

Pediatric resident training in the community hospital setting: A survey of program directors

BACKGROUND AND OBJECTIVE: The role of a hospitalist differs in a community hospital (CH) compared to a university/children\u27s hospital. Residents are required to practice in a variety of relevant clinical settings, but little is known about current trends regarding pediatric resident training in different hospital settings. This study explores CH rotations including their value for resident training, characteristics, benefits, and drawbacks. This study also seeks to define community hospital. METHODS: Authors conducted an online cross-sectional survey of pediatric residency program directors distributed by the Association of Pediatric Program Directors. The survey was developed and revised based on review of the literature and iterative input from experts in pediatric resident training and CH medicine. It assessed residency program demographics, availability of CH rotations, value of CH rotations, and their characteristics including benefits and drawbacks. RESULTS: Response rate was 56%. CH rotations were required at 24% of residency programs, available as an elective at 46% of programs, and unavailable at 48% of programs. Residency program directors viewed these rotations as valuable for resident training. CH rotations were found to have multiple benefits and drawbacks. Definitions of community hospital varied and can be categorized according to positive or negative characteristics. CONCLUSIONS: Resident rotations at a CH provide valuable learning opportunities with multiple potential benefits that should be weighed against drawbacks in the context of a residency program\u27s curriculum. There are many characteristics that potentially distinguish CH from university/children\u27s hospitals

Pediatric Resident Training in the Community Hospital Setting: a Survey of Program Directors.

BACKGROUND AND OBJECTIVE: The role of a hospitalist differs in a community hospital (CH) compared to a university/children\u27s hospital. Residents are required to practice in a variety of relevant clinical settings, but little is known about current trends regarding pediatric resident training in different hospital settings. This study explores CH rotations including their value for resident training, characteristics, benefits, and drawbacks. This study also seeks to define community hospital. METHODS: Authors conducted an online cross-sectional survey of pediatric residency program directors distributed by the Association of Pediatric Program Directors. The survey was developed and revised based on review of the literature and iterative input from experts in pediatric resident training and CH medicine. It assessed residency program demographics, availability of CH rotations, value of CH rotations, and their characteristics including benefits and drawbacks. RESULTS: Response rate was 56%. CH rotations were required at 24% of residency programs, available as an elective at 46% of programs, and unavailable at 48% of programs. Residency program directors viewed these rotations as valuable for resident training. CH rotations were found to have multiple benefits and drawbacks. Definitions of community hospital varied and can be categorized according to positive or negative characteristics. CONCLUSIONS: Resident rotations at a CH provide valuable learning opportunities with multiple potential benefits that should be weighed against drawbacks in the context of a residency program\u27s curriculum. There are many characteristics that potentially distinguish CH from university/children\u27s hospitals