Screening for Social Determinants of Health in Pediatric Resident Continuity Clinic.

Objective: Describe current practices in systematic screening for social determinants of health (SDH) in pediatric resident clinics enrolled in the Continuity Research Network (CORNET).

Methods: CORNET clinic directors were surveyed on demographics, barriers to screening, and screening practices for 15 SDH, including the screen source, timing of screening, process of administering the screen, and personnel involved in screening. Incidence rate ratios were tabulated to investigate relationships among screening practices and clinic staff composition.

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.

Practice procedures in models of primary care collaboration for children with ADHD.

Introduction: With nationwide movement toward an integrated medical home, evidence to support, compare, and specify effective models for collaboration between primary care and behavioral health professionals is essential. This study compared 2 models of primary care with behavioral health integration on American Academy of Pediatrics guideline adherence for attention-deficit/hyperactivity disorder (ADHD) assessment and treatment.

Method: We conducted a retrospective chart review of a random sample of children aged 6-13 years, seen for ADHD services in 2 primary care offices, 1 fully integrated model and 1 co-located service only model, comparing ADHD assessment and treatment practices.

Case-Based Workshop for Teaching Child Abuse Prevention to Resident Physicians.

Introduction: Child abuse is a ubiquitous problem with personal, interpersonal, and social consequences. Risk factors are well established, and preventive strategies have been effective in decreasing abusive parenting behaviors and child maltreatment incident reports. Curriculum tools are needed to incorporate these strategies into training programs so physicians are adequately trained to identify and prevent child maltreatment at the earliest opportunity.

Factors Associated With Resident Continuity in Ambulatory Training Practices.

Background: Continuity of care is a critical element of residents' educational experience in primary care programs.

Objective: We examined how continuity in resident practices compares to nonteaching practices, identified factors associated with increased continuity, and explored the association between continuity and quality measures.

Methods: We analyzed 117 235 patient visits to 4 resident practices (26 resident teams in internal medicine, pediatrics, family medicine, and medicine-pediatrics) and 270 242 visits to nonteaching community practices between July 2013 and May 2014.

Global Health Education in US Pediatric Residency Programs.

Background And Objective: Despite the growing importance of global health (GH) training for pediatric residents, few mechanisms have cataloged GH educational opportunities offered by US pediatric residency programs. We sought to characterize GH education opportunities across pediatric residency programs and identify program characteristics associated with key GH education elements.

Methods: Data on program and GH training characteristics were sought from program directors or their delegates of all US pediatric residency programs during 2013 to 2014.

Discordance between resident and faculty perceptions of resident autonomy: can self-determination theory help interpret differences and guide strategies for bridging the divide?

Purpose: To identify and interpret differences between resident and faculty perceptions of resident autonomy and of faculty support of resident autonomy.

Method: Parallel questionnaires were sent to pediatric residents and faculty at the University of Rochester Medical Center in 2011. Items addressed self-determination theory (SDT) constructs (autonomy, competence, relatedness) and asked residents and faculty to rate and/or comment on their own and the other group's behaviors.

Pediatric resident education in quality improvement (QI): a national survey.

Objective: To assess pediatric residents' perceptions of their quality improvement (QI) education and training, including factors that facilitate learning QI and self-efficacy in QI activities.

Methods: A 22-question survey questionnaire was developed with expert-identified key topics and iterative pretesting of questions. Third-year pediatric residents from 45 residency programs recruited from a random sample of 120 programs.

Educating residents in behavioral health care and collaboration: comparison of conventional and integrated training models.

Purpose: To determine whether former pediatric residents trained using a model of integrated behavioral health (BH) care in their primary care continuity clinics felt more comfortable managing BH care and better prepared to collaborate with BH professionals than did peers from the same residency who trained in clinics with a conventional model of BH care.

Method: University of Rochester School of Medicine and Dentistry pediatric residents were assigned to one of two continuity clinic sites. At one site, psychology fellows and faculty were integrated into the clinic teams in the mid-1990s.

Does quality of primary care vary by level of training in pediatric resident continuity practices?

Objective: The aim of this study was to compare parental perception of quality of care provided by first- versus third-year pediatric residents who served as their children's primary care providers.

Methods: The Parents' Perception of Primary Care (P3C) survey was administered to all parents who identified a pediatric resident as a primary care provider at 19 Continuity Research Network (CORNET) sites. Parent survey scores were compared between those identifying first-year pediatric residents (PL-1) versus third-year pediatric residents (PL-3) as care providers by using t tests and linear regression modeling, as well as item-specific chi-square analysis and logistic regression.

Spanish-speaking patients perceive high quality care in resident continuity practices: a CORNET study.

Prior research has demonstrated that limited English proficiency in Hispanic patients is associated with adverse health outcomes. The authors sought to compare the perception of primary care in resident practices between Spanish-speaking and English-speaking parents using a previously validated tool, the Parents' Perception of Primary Care. Using survey results from 19 CORNET sites nationwide, they compared mean scores for each primary care domain and the full scale between the groups using Student's t test.

Pain relief for neonatal circumcision: a follow-up of residency training practices.

Objective: To assess current training practices regarding the provision of effective analgesia for routine newborn circumcision.

Methods: All family practice (FP), obstetric and gynecologic (OB/GYN), and pediatric (PED) residency program directors in the United States received a mailed survey in 2003 (N = 940).

Results: Survey responses were received from 86% (811/940) of the programs (FP 88%, OB/GYN 82%, and PED 87%).