Enhancing situational interest in pediatrics.

BACKGROUND: Individual interest, something that persists regardless of the situation, and situational interest, finding personal value in an educational context, have not been studied in medical student education. OBJECTIVE: To determine if individualized case discussions enhance interest in pediatric medicine. METHODS: During the 2008/2009 academic year, 88 clerkship students participated in clinical case discussions. At orientation, students completed an Interest in Pediatrics (IIP) questionnaire, responding 1 = strongly disagree to 5 = strongly agree. Intervention and control groups were randomly assigned. The intervention group personalized cases to students' medical specialty interests. The control group discussed the case presentation. Groups met twice during the 8-week clerkships, completing a post-IIP at the end of the clerkship. RESULTS: Intervention group interest increased from pre-IIP, mean = 3.64, to post-IIP, mean = 4.22 (z = -2.994, p < 0.05, r = -0.44). On post-IIP, application of pediatric medicine increased for both groups; the intervention group was most significant from pre-IIP, mean = 1.09, to post-IIP, mean = 4.33 (z = -6.038, p < 0.05, r = -0.88). DISCUSSION: Enhanced interest in pediatrics from the intervention group indicates that creating a learning environment personally relevant to students' careers facilitates interest to learn.

Caffeine consumption in young children.

Two hundred twenty-eight surveyed parents reported that their 5 to 7 year old children drank approximately 52 mg of caffeine daily and their 8 to 12 year old children drank 109 mg daily. Caffeine consumption and hours slept were significantly negatively correlated, but caffeine consumption and enuresis were not significantly correlated. Spanish-speaking parents reported fewer bedwetting events than their English-speaking peers.

Quality Improvement of Primary Care Provider Communication on Hospital Discharge.

BACKGROUND AND OBJECTIVES: Effective communication between inpatient and primary care providers (PCPs) is important for safe transition of care for hospitalized patients. In 2017, communication with PCPs was prioritized for the pediatric hospital medicine division. Our primary aim was to improve documented attempted communication with PCPs within 72 hours of discharge from 41% to at least 60% by January 1, 2018, and maintain this performance through 2019. METHODS: This study included all inpatient encounters discharged by a pediatric hospital medicine provider from March 2017 to April 2020. An electronic health record phrase debuted March 2017. Successful documentation was defined as any attempt to contact the PCP, regardless of whether actual communication occurred. Group and individual audit and feedback occurred in July 2017 to April 2020. Provider communication was financially incentivized in July 2018 to June 2019. An annotated P-chart for the proportion of encounters with documented PCP communication occurring within 72 hours was established. Special-cause variation was determined by using Shewhart rules. RESULTS: The mean proportion of encounters with documented PCP communication increased from 41% at baseline (March 2017 through July 2017) to 60% in August 2017 and 66% in December 2017. After the financial incentive was removed in July 2019, documentation decreased to 54%. Phone calls with clinic staff were the most common communication method (40% to 71%). Direct conversations with the PCP occurred rarely (0% to 3%). CONCLUSIONS: Even when coupled with audit and feedback with EHR interventions, our work suggests that shifting to external financial motivation may hinder sustainability of behavior change to improve attempted documented PCP communication.