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This study assessed pediatric residents’ reported knowledge of and self-confidence in identifying/treating 8 vaccine-preventable diseases. Pediatric residents nationwide (n = 385) reported (1) if they had previously diagnosed measles, mumps, rubella, diphtheria, tetanus, pertussis, varicella, and/or polio; (2) their comfort level in treating these diseases; (3) the likelihood of identifying symptoms; and (4) 16 disease-related statements as true/false. More than 25% of residents were not comfortable treating 5 of the 8 diseases. More than 25% reported themselves as unlikely/extremely unlikely to identify symptoms of 3 of these diseases. Third- or fourth-year residents did not feel more confident in identifying disease symptoms than first-year residents, except for pertussis ( P ≤ .01). True/false statement accuracy ranged from 56.8% correct (polio) to 94.6% correct (pertussis). Most residents (73.3%) were “extremely concerned” regarding parental vaccine refusal, and 96.0% felt that they would benefit from receiving more information. Increased emphasis on this subject in residency education is essential for the management of potential disease outbreaks.

The objective of the study was to examine differences in pediatric resident perceptions and practices related to child mental health conditions in continuity clinic settings with versus without on-site mental health professionals (MHPs). A 20-item questionnaire, based on the American Academy of Pediatrics Periodic Survey Number 59, was administered to pediatric residents in a medium-sized program from 2008 to 2011. Of 130 residents surveyed, compared with their peers, those practicing with the on-site MHPs were more likely to report mental health services as very available in their clinic (odds ratio [OR] = 39.7; P = .000). Residents with on-site MHPs inquired more frequently about attention-deficit/hyperactivity disorder (ADHD; OR = 2.96; P = .029) and referred more frequently for ADHD (OR = 3.68; P = .006), depression (OR = 2.82; P = .030), and behavioral problems (OR = 3.04; P = .012). On-site MHPs in continuity clinics offer great potential to improve resident education and patient care. Additional research is necessary to further understand their impact.

Purpose. Although family-centered rounds (FCRs) are recommended as standard practice, limited data address pediatric residents’ opinions of FCRs. In the present study, we assessed residents’ perceptions with respect to rounding experience and postgraduate year (PGY). Methods. An anonymous online questionnaire was distributed to pediatric residents from nine accredited programs in New Jersey. Results. Of 95 residents who completed questionnaires, 69.5% participated in FCRs and traditional rounds, 17.9% in FCRs, and 12.6% in traditional rounds. Irrespective of rounding experience and PGY, the majority believed that FCRs benefit families and pediatric training, felt that an attending’s style greatly affects their experience, report discomfort sharing sensitive information and answering questions, and did not support the superiority of FCRs for efficiency and professional satisfaction. Conclusions. Concerns regarding discomfort, attending approach and efficiency are potential barriers to residents’ full acceptance of FCRs that should be addressed to improve the efficacy of postgraduate pediatric training.

Objective. To assess the impact of the 16-duty hour restriction on pediatric interns’ neonatal education. Method. Survey of interns clinical and educational experiences during their neonatal rotations. Results. A total of 316 respondents in 2011, who worked >16 hours, were compared with 509 respondents in 2012, who worked ≤16 hours. The average work week decreased from 67.3 ± 9.6 to 59.3 ± 8.1 hours ( P < .0001). The 2012 cohort attended fewer didactic lectures (−16%, P < .0001), grand rounds (−27%, P < .0001), and mock resuscitations (−16%, P < .005). There were no significant differences in the number of (1) patients on service, (2) deliveries attended, or (3) procedures. There was no significant difference in the median number of correct responses (4) on 10 knowledge-based multiple-choice questions. Conclusions. The decrease in duty hours was achieved without significantly affecting interns’ knowledge or clinical experience.

Introduction. Well child care is taught with individual visits in pediatric residency. Teaching residents how to deliver well child care efficiently is critical. Group well child care brings multiple families together for visits. The authors piloted group visits in pediatric residency clinic. Methods. The authors conducted group visits for 1- to 12-month old children. Seven families completed the group visits and were surveyed. Nine residents (intervention group) conducted group visits. Eighteen months after implementation, the intervention and control groups in the same clinic surveyed. Results. All families recommended group visits. The intervention group residents reported significantly more direct observations ( P < .05). Trends toward improvement of teaching and role modeling for the intervention group were also observed. Discussion. The authors’ continuity clinic had success implementing group visits, and families were recommended the visits. Group visits offer a natural environment to observe residents while exposing them to another way to deliver well child care.

This study investigated the feasibility and effectiveness of training pediatric residents to conduct a brief clinic-based behavioral intervention in coordination with community dissemination of a health promotion message developed by the Consortium for Lowering Obesity in Chicago Children. A total of 113 residents completed a short (

Background: Within pediatrics, there is a paucity of data on pediatric resident handoff systems. Methods: Seventy-seven of 139 eligible pediatric housestaff participated in a cross-sectional survey that was distributed at an annual residency fall retreat in September 2007. Results: Seventy-three percent of the respondents noted uncertainty regarding patient care plans due to receipt of an incomplete verbal handoff. Nursing questions, phone, and page interruptions were noted barriers to giving an effective verbal sign-out. Personal fatigue was also reported to affect the accuracy of housestaff’s written sign-outs more than verbal sign-outs (43% vs 23%, P = .026). Only 19% of the residents reported that written sign-outs were reflective of current patient information and care plans. Conclusion: Written and verbal patient handoffs were perceived by pediatric housestaff to be important parts of patient care but often incomplete. New systems that provide a more protected handoff environment, reduce housestaff fatigue, and standardize the handoff procedure may be useful.

Objective. Given that pediatricians cite low competency in developmental screening, this study aims to effectively teach screening to residents. Design. Using a quasiexperimental design, residents received an educational module and one-on-one teaching of 3 validated developmental screeners (Denver II, ASQ [Ages and Stages Questionnaire], and PEDS [Parents’ Evaluation of Developmental Status]), with subsequent independent use with all 3 screeners with their own continuity patients. Outcome measures included changes in knowledge, skills, and preferences. Results. All residents achieved significantly increased skills with all screeners. They strongly preferred the ASQ (70%), citing that this taught them normal (30.2%) and pathological (27.9%) development while negatively noting time (72.1%), scheduling issues (30.2%), and difficulties with child cooperation (20.9%). Knowledge specifics did not significantly increase. Conclusions. In-depth developmental screening education revealed marked improvement in skills and preferences. These evaluations led to full adoption of the ASQ in resident clinics. Future research must test if effective development teaching in residency leads to increased routine screenings in practice.

To assess confidence in resuscitation skills among pediatric residents and its relationship to training and experience, all pediatric residents at one institution were surveyed regarding their confidence in technical and leadership resuscitation skills and their prior experience with real and mock codes. Respondents (61/82, 74%) reported participation in 4.9 ± 3.6 mock and 3.9 ± 5.0 real codes. Confidence score for all skills was 2.7 ± 0.6 (scale 1-5). Senior residents were more confident than interns (2.8 ± 0.5 vs 2.3 ± 0.5). Residents were more confident in basic (3.9 ± 0.6) than in advanced (2.6 ± 0.6) or expert resuscitation skills (1.6 ± 0.7). Confidence correlated with mock codes ( r = 0.52) and to a lesser degree with real codes attended ( r = 0.36). Performance of active roles and debriefing occurred more commonly with mock than with real codes. The data indicate that pediatric residents have limited confidence in resuscitation skills and that mock code training with active participation and debriefing may be an effective educational tool.

Barriers to early identification of children with developmental delays include time constraints during well-child visits and lack of easily administered, quantitative measures that can be used by pediatricians. This study assesses the ease of administration of the Cognitive Adaptive Test/Clinical Linguistic and Auditory Milestone Scale (CAT/CLAMS) during well-child visits from 2 to 36 months of age. During a single visit 177 children were assessed by either a developmental pediatrician (n = 121) or a third-year pediatric resident (n = 56). The mean time required to complete the CAT/CLAMS for all subjects was 6 minutes and 10 seconds (SD 2 minutes 44 seconds); less than 10 minutes was required in 92% of children assessed. There were no significant differences in the time required by the 2 examiners at any age level. Its ease of administration and psychometric properties make the CAT/CLAMS an excellent choice for the assessment of early development by primary care pediatricians.

By actively participating in family interviews, pediatric resident trainees sharpen their skills, discover the importance of intra- family dynamics, observe the interaction of biologic and psycho social factors in illnesses and develop an awareness of their own potentialities and weaknesses for dealing with clinical problems referable to the behavioral and emotional aspects of pediatrics.