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What's New Communication of medical students' pediatric milestone assessments and individual learning plans from medical schools to pediatric residency directors allows for effective educational handovers promoting the continuum of education. Existing undergraduate medical education assessments can provide meaningful data to determine most pediatric milestone levels.

Introduction The requirements for successful completion of Pediatric Residency is clear, but until recently there was very little guidance regarding physician work-life integration. Given the growing awareness of physician burnout and the increased physician suicide rate compared to the general public (American Journal of Psychiatry.2004. 161(12), 2295-2302), our program deemed it necessary to implement a curriculum focused on wellness early in medical training. Methods Our program implemented a Professional Development and Wellness Week (7 days) during intern year. During this week, interns are required to meet with their adviser, shadow an inpatient nurse, and create a “chalk talk”. Otherwise, they are provided a menu of personal and professional activity suggestions. Interns complete a survey at the end of their week documenting the completed activities. Outcomes Thus far, 13 of 24 (54%) Pediatric residents have completed their PDW week and post-completion survey. The most commonly selected activities included: completing outstanding MedHub evaluations (100%), engaging in a favorite hobby (100%), attending a health-related appointment (92%), and organizing email/EMR (76%). Results The most common optional activities that residents completed during protected personal development time include administrative tasks (email and evaluations) and healthcare-related activities. Conclusions When provided unstructured time for personal development, interns may prioritize completing outstanding administrative tasks and health-related appointments. This suggests that a longitudinal administrative “half-day” experience may be beneficial. Future directions also include collecting data related to administrative tasks and burnout.

Background Large amounts of information are provided to applicants during the residency interview process. It is important to share this information in an efficient, environmentally sound, and engaging manner. Preparing information packets requires significant administrative time and results in discarded paper or unused flash-drives. OBJECTIVE We sought to eliminate paper documents, minimize administrative effort, and streamline communication during interview season. Methods With the assistance of LegitApps Company we designed an app for Android and Apple devices that allows us to communicate in real time with applicants. The app delivers all required documentation prior to the applicant's arrival. It provides interview day schedule details and logistics, maps to their specific pre-interview dinner, and helps with navigating our city (finding hotels, identifying places to eat, highlighting fun things to do, etc). An easy to complete interview day survey is automatically pushed to all applicants at the end of the day. After initial programming, only minimal maintenance was needed by our administrative staff throughout the season. Results The app was downloaded 522 times this season. Based on results from the end-of-the-day survey, almost all 353 applicants downloaded the app. They appreciated the streamlined communication and hub for information. They used it to find Uber rides, book hotels, explore the city, and to prepare for their interview day. By eliminating paper, we saved money and manpower, allowing our staff to dedicate their time to the applicant experience. Survey comments include: “I appreciated the UM Pediatrics App, as it made the resources easy to access and reference throughout the day” and “I liked the App and that you tried to save some trees and not print out all of the information.” Conclusion The app successfully conveyed information efficiently to applicants and decreasing the administrative workload. We plan to expand the app to include our fellowship programs and are working with other programs at our institution to develop similar apps for their programs.

Objectives To characterize pediatric patient contacts with their primary care clinic in the 2 days preceding a visit to the emergency department (ED) and explore how the type of clinic contact relates to ED resource use. Study design We conducted a retrospective chart review of 368 pediatric ED visits in the first 7 days of each month, from September 2012 to August 2013. Visits were included if the family contacted their child's general pediatric clinic in the study health system in the 2 days preceding the ED visit. Descriptive statistics were calculated. Primary outcomes were ED resource use (tests, treatments) and disposition (admission or discharge). Outcomes by type of clinic contact were compared with χ 2 statistics. Results Of 1116 records with ED visits in the 12 study weeks extracted from the electronic medical record, 368 ED visits met inclusion criteria. Most ED visits followed a single clinic contact (78.8%). Of the 474 clinic contacts, 149 were in-person visits, 216 phone calls when clinic was open, and 109 phone calls when clinic was closed. ED visits that followed an in-person clinic contact with advice to go to the ED had significantly greater rates of testing and admission than those advised to go to the ED after phone contact and those never advised to go to the ED. Conclusions In-person clinic visits with advice to go to the ED were associated with the greatest ED resource use. Limitations include a study of a single health system without a uniform process for triaging patients to the ED across clinics.