Design and Evaluation of an Interprofessional Preceptor Development Mini-Fellowship Program.

Introduction: Health professions preceptors require skills and knowledge to effectively meet the educational needs of interprofessional students in clinical environments. We implemented a mini-fellowship program to enhance the knowledge, skills, and self-efficacy of preceptors teaching students and applying quality improvement (QI) methods across disciplines and patient care settings.

Methods: The design, implementation, and evaluation of the program were informed by the faculty development literature, principles of adult learning, and preceptor needs.

Caregiver Inclusivity and Empowerment During Family-Centered Rounds.

Objective: Despite widespread adoption of family-centered rounds, few have investigated differences in the experience of family-centered rounds by family race and ethnicity. The purpose of this study was to explore racial and ethnic differences in caregiver perception of inclusion and empowerment during family-centered rounds.

Methods: We identified eligible caregivers of children admitted to the general pediatrics team through the electronic health record.

Initial Modified Pulmonary Index Score Predicts Hospital Length of Stay for Asthma Subjects Admitted to the Pediatric Intensive Care Unit.

Background: Scoring systems are frequently used to assess the severity of pediatric asthma exacerbations. The modified pulmonary index score (MPIS) has been found to be highly correlated with length of stay (LOS) in the pediatric intensive care unit (PICU). We sought to evaluate the use of the MPIS to predict hospital LOS for patients admitted to our PICU.

Faculty and Resident Perspectives on Teaching Pediatric Evidence-Based Medicine in the Clinical Setting: A Qualitative Study.

Purpose: To describe how pediatric educators effectively teach evidence-based medicine (EBM) in the clinical setting. Secondarily, to identify barriers hindering effective practice and teaching of EBM and strategies to overcome these barriers.

Methods: The authors conducted a cross-sectional multi-institutional qualitative study from July 2016 to December 2017 in which they interviewed pediatric educators across many subspecialties who were identified as exemplary teachers of EBM at 3 academic pediatric residency programs.

A Respiratory Therapist-Driven Asthma Pathway Reduced Hospital Length of Stay in the Pediatric Intensive Care Unit.

Background: Asthma is a common reason for admissions to the pediatric intensive care unit (PICU). Since June 2014, our institution has used a pediatric asthma clinical pathway for all patients, including those in PICU. The pathway promotes respiratory therapist-driven bronchodilator weaning based on the Modified Pulmonary Index Score (MPIS).

Key Factors in Clinical Competency Committee Members' Decisions Regarding Residents' Readiness to Serve as Supervisors: A National Study.

Purpose: Entrustment has become a popular assessment framework in recent years. Most research in this area has focused on how frontline assessors determine when a learner can be entrusted. However, less work has focused on how these entrustment decisions are made.

Milestone Ratings and Supervisory Role Categorizations Swim Together, but Is the Water Muddy?

Objective: This single-specialty, multi-institutional study aimed to determine 1) the association between milestone ratings for individual competencies and average milestone ratings (AMRs) and 2) the association between AMRs and recommended supervisory role categorizations made by individual clinical competency committee (CCC) members.

Methods: During the 2015-16 academic year, CCC members at 14 pediatric residencies reported milestone ratings for 21 competencies and recommended supervisory role categories (may not supervise, may supervise in some settings, may supervise in all settings) for residents they reviewed. An exploratory factor analysis of competencies was conducted.

Thresholds and interpretations: How clinical competency committees identify pediatric residents with performance concerns.

Background: Clinical competency committee (CCC) identification of residents with performance concerns is critical for early intervention.

Methods: Program directors and 94 CCC members at 14 pediatric residency programs responded to a written survey prompt asking them to describe how they identify residents with performance concerns. Data was analyzed using thematic analysis.

Improving the Efficiency of Care for Pediatric Patients Hospitalized With Asthma.

Background: Asthma exacerbations are a leading cause of hospitalization among children. Despite the existence of national pediatric asthma guidelines, significant variation in care persists. At Duke Children's Hospital, we determined that our average length of stay (ALOS) and cost for pediatric asthma admissions exceeded that of our peers.

Milestone-Based Assessments Are Superior to Likert-Type Assessments in Illustrating Trainee Progression.

Background: The Pediatrics Milestone Project uses behavioral anchors, narrative descriptions of observable behaviors, to describe learner progression through the Accreditation Council for Graduate Medical Education competencies. Starting June 2014, pediatrics programs were required to submit milestone reports for their trainees semiannually. Likert-type scale assessment tools were not designed to inform milestone reporting, creating a challenge for Clinical Competency Committees.

Using an innovative curriculum evaluation tool to inform program improvement: the clinical skills fair.

Background: Program evaluation is important for assessing the effectiveness of the residency curriculum. Limited resources are available, however, and curriculum evaluation processes must be sustainable and well integrated into program improvement efforts.

Intervention: We describe the pediatric Clinical Skills Fair, an innovative method for evaluating the effectiveness of residency curriculum through assessment of trainees in 2 domains: medical knowledge/patient care and procedure.