Medical Student Training in Pediatric Hospital Medicine: A National Survey of Pediatric Clerkships.

BACKGROUND AND OBJECTIVES: Medical student electives offer opportunities for career exploration; it is unknown if electives exist for the newest pediatric subspecialty, pediatric hospital medicine (PHM), or how PHM competencies are already addressed in required medical student training. Our objectives for this study were (1) to determine the prevalence of exposure to PHM competencies in medical school and (2) to inform a needs assessment for a PHM elective. METHODS: A 5-item survey was distributed to members of the Council on Medical Student Education in Pediatrics as part of a larger survey in 2018. Descriptive statistics were used to report responses as proportions. Responses to 1 open-ended question were coded and grouped into categories. RESULTS: Of 152 total respondents, 118 (77.6%) answered at least 1 question. Respondents felt that quality improvement was addressed in preclinical years (40.4%), whereas systems-based practice was incorporated into core clerkships (32.1%). Although most indicated that leadership and education should be taught at the subinternship level (29.6% and 25%, respectively), those competencies are not currently integrated into subinternship rotations (7.4% and 4.8%, respectively). Approximately half (n = 58; 49.5% each) reported that their institution offers a PHM elective. Lack of a standardized curriculum (16%) was seen as a barrier, and in free-text responses (n = 33), respondents also noted concerns regarding saturation of inpatient settings and redundancy with required rotations. CONCLUSIONS: How to become a good leader and how to become a good educator were identified as PHM competencies that should be, but are not currently, taught at the fourth-year medical student level. A standardized curriculum and strategies to mitigate redundancy with existing rotations may increase satisfaction of students.

Medical Student Participation in Patient- and Family-Centered Rounding: A National Survey of Pediatric Clerkships.

OBJECTIVE: Pediatrics rotations may be medical students' only experience with patient- and family-centered rounding (PFCR). It is unclear how students participate in or are prepared for PFCR. We surveyed national pediatrics clerkships to determine the prevalence of PFCR and the proportion providing orientation in order to inform a needs assessment for PFCR orientation. METHODS: A 5-item peer-reviewed survey was distributed to the Council on Medical Student Education in Pediatrics (COMSEP) membership as part of a larger survey in 2017. Institutional differences among programs performing PFCR were compared using chi-square and t-tests. Responses to 1 open-ended question were coded and grouped into broad categories using content analysis. RESULTS: The full COMSEP survey received answers from 190 participants representing 103 medical schools. Our questions received 174 responses representing 94 schools (98 training sites) and had an 85% (83/98) prevalence of student PFCR participation. Although most (n = 108; 85%) reported that their students received PFCR orientation, half (n = 62; 49%) considered orientation "informal," and only 2 reported using published curricula. After didactics, the most common orientation materials were handouts (n = 33; 26%), videos (n = 13; 10%), and role play (n = 7; 6%). Orientation was most commonly initiated at the start of clerkship (n = 62; 49%) by clerkship administration (n = 38; 30%), but 20% (n = 26) reported resident-led orientation. Qualitative responses (n = 98) were coded and organized into 4 themes; the greatest perceived challenges for medical students on PFCR were communication and anxiety. CONCLUSIONS: Although most students participate in and receive orientation to PFCR, there is wide variability in the content, timing, and administration of orientation. A nationally disseminated, evidence-based orientation curriculum may reduce educational variability and better prepare students for PFCR.