Understanding resident wellness: A path analysis of the clinical learning environment at three institutions.

Purpose: The clinical learning environment (CLE) affects resident physician well-being. This study assessed how aspects of the learning environment affected the level of resident job stress and burnout.

Materials And Methods: Three institutions surveyed residents assessing aspects of the CLE and well-being via anonymous survey in fall of 2020 during COVID.

Association Between In-Training Exam Scores and Clinical Exposure During the COVID-19 Pandemic.

Background: We sought to evaluate changes in In-Training Examination (ITE) scores and associations with clinical work during the COVID-19 pandemic. We hypothesized that residents saw a decrease in clinical encounters during the pandemic and that this would be associated with smaller gains in ITE scores.

Methods: We compared ITE score changes with data on patient notes for three classes of pediatric residents at four residency programs: one not exposed to the pandemic during their intern year who entered residency in 2018, one partially exposed to COVID-19 in March of their intern year (2019-2020), and one that was fully exposed to the pandemic, starting residency in June of 2020.

Educational roles impact burnout in paediatric undergraduate medical educators.

Background: Physician burnout impacts all levels of medical education and has a relatively unknown impact on those responsible for medical student education, particularly in paediatrics. This study examines the prevalence of burnout among paediatric undergraduate medical educators and explores the impact of roles in medical education on medical educator burnout.

Methods: This cross-sectional mixed-methods study utilised a binational survey of paediatricians involved in undergraduate medical education.

Clinical Decision Support Tool for Elevated Pediatric Blood Pressures.

Under-diagnosis of pediatric hypertension remains pervasive due to difficulty recognizing elevated systolic blood pressures (SBPs). We performed a retrospective review comparing recognition of and response to elevated SBPs ≥95th percentile before and after development of a clinical decision support tool (CDST) in an academic pediatric system. Of 44,351 encounters, 477 had elevated SBPs with documented recognition of an elevated SBP in 17.

Parent Preferences for Neonatal Intensive Care Unit Physician Attire: A Cross-Sectional Study.

Objective: Physician attire may influence the parent-provider relationship. Previous studies in adult and outpatient pediatrics showed that formal attire with a white coat was preferred. We aimed to describe parent preferences for physician attire in the neonatal intensive care unit (NICU).

Speaker Introductions at Grand Rounds: Differences in Formality of Address by Gender and Specialty.

Despite increasing representation of women in medicine, gender bias remains pervasive. The authors sought to evaluate speaker introductions by gender in the grand rounds of multiple specialties at a large academic institution to understand the cultural context of this behavior and identify predictors of formality. The authors reviewed grand rounds recordings of speakers with doctorates presenting to the departments of family medicine, general surgery, internal medicine, obstetrics and gynecology, and pediatrics at one institution from 2014 to 2019.

Adopting otitis media practice guidelines increases adherence within a large primary care network.

Aim: Unnecessary antibiotic prescriptions to treat otitis media (OM) contribute to adverse drug reactions, increased cost and antibiotic resistance. Clinical care guidelines can help promote consistent treatment of conditions such as OM. This study evaluates adherence before and after implementation of an institutional guideline for the diagnosis and treatment of paediatric OM.

Implementing Resident Team Assistant Programs at Academic Medical Centers: Lessons Learned.

Background: Excessive inpatient administrative tasks can lead to adverse consequences for residents and their patients. Furthermore, this burden has been linked to depersonalization, a major component of physician burnout.

Objective: To describe the development, implementation, feasibility, acceptability, and early outcomes of Resident Team Assistant (RTA) programs.

Perceptions of Parenting Challenges and Career Progression Among Physician Faculty at an Academic Hospital.

This survey study compares the perceptions of male and female physician faculty members who have children regarding parenting challenges and career progression at an academic hospital.

Incidence of resident mistreatment in the learning environment across three institutions.

Introduction: Mistreatment in the learning environment is associated with negative outcomes for trainees. While the Association of American Medical Colleges (AAMC) annual Graduation Questionnaire (GQ) has collected medical student reports of mistreatment for a decade, there is not a similar nationally benchmarked survey for residents. The objective of this study is to explore the prevalence of resident experiences with mistreatment.

Planning for Virtual Interviews: Residency Recruitment During a Pandemic.

Recent directives from The Coalition for Physician Accountability, Association of Pediatric Program Directors, Council on Medical Student Education in Pediatrics, and Association of Medical School Pediatric Department Chairs recommend virtual recruitment for graduate medical education (GME) programs this year. Driven by concerns for safety, equity and financial pressures, virtual interviewing will require a thoughtful approach to achieve the desired goals of recruitment. Drawing on the fields of communication and human resources management, we examine the potential effects of web-based interviews on communication through the lens of several communication theories: media richness, media naturalness, and signaling.

Differing Experiences with Breastfeeding in Residency Between Mothers and Coresidents.

Returning to work and lack of support for expressing breast milk (pumping) at work is often cited as a reason that mothers discontinue breastfeeding, particularly among female physicians. It is unclear how these perceived difficulties affect resident mothers and how resident teams perceive coresidents who choose to pump at work. The goal of this study was to identify differences in perception of resident mothers and their coresidents about breastfeeding residents pumping.

Motivational Advising Workshop: Utilizing Motivational Interviewing Theory to Facilitate and Engage Intrinsic Motivation to Change Learners' Behavior.

Introduction: Motivational interviewing (MI) is a counseling method that utilizes a patient's own motivation to effect personal change. MI has been applied routinely and successfully to managing medical conditions (e.g.

Lotus Birth: A Case Series Report on Umbilical Nonseverance.

Lotus birth is the practice of leaving the umbilical cord uncut until separation occurs naturally. Our case series report describes delivery characteristics, neonatal clinical course, cord and placenta management, maternal reasons for a lotus birth, and desire for future lotus births. Between April 2014 and January 2017, six lotus births occurred.

SAFEST: Use of a Rubric to Teach Safety Reporting to Pediatric House Officers.

Background: Among the many modalities of error detection in academic pediatric hospitals, patient safety reporting is an important component, particularly for unexpected events. Residents recognize the importance of reporting but cite some barriers to doing so. A rubric was developed to guide resident reporting and streamline information gathering in patient safety reports.

Responsible Milestone-Based Educational Handover With Individualized Learning Plan From Undergraduate to Graduate Pediatric Medical Education.

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.

Pediatric Emergency Department Resource Utilization among Children with Primary Care Clinic Contact in the Preceding 2 Days: A Cross-Sectional Study.

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.