Subject(s)
Ambulatory Care/organization & administration , Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Delivery of Health Care/organization & administration , Pneumonia, Viral/diagnosis , Adolescent , Adult , Betacoronavirus , COVID-19 , COVID-19 Testing , Child , Child, Preschool , Efficiency, Organizational , Female , Health Personnel , Humans , Infant , Infant, Newborn , Male , Middle Aged , Nasopharynx/virology , Pandemics , Personal Protective Equipment , Personnel Staffing and Scheduling , Public Health , SARS-CoV-2 , Young AdultABSTRACT
OBJECTIVE: To identify existing challenges and potential strategies for providing complex care training to future pediatricians from a national group of educators. METHODS: Data were collected from pediatric educators involved in complex care at the Pediatric Educational Excellence Across the Continuum national meeting. Participants completed an anonymous 15-item survey adapted from the Association of American Medical Colleges (AAMC) Best Practices for Better Care initiative and participated in a focus group to understand the challenges and potential solutions to pediatric complex care education. Data were analyzed using grounded theory. RESULTS: Of the 15 participants, 9 (60%) were in educational leadership positions. All participants provided care to children with medical complexity (CMC), although 80% (n = 12) reported no formal training. Thematic analysis revealed learners' challenges in 2 domains: 1) a lack of ownership for the patient because of decreased continuity, decision-making authority, and autonomy, as a result of the multitude of care providers and parents' distrust; and 2) a sense of being overwhelmed as a result of lack of preparedness and disruptions in work flow. Participants suggested 3 mitigating strategies: being candid about the difficulties of complex care, discussing the social mandate to care for CMC, and cultivating humility among learners. CONCLUSIONS: Residency education must prepare pediatricians to care for all children, regardless of disease. Training in complex care involves redefining the physician's role so that they are better equipped to participate in collaboration, empathy and advocacy with CMC. This study is the first to identify specific challenges and offer potential solutions to help establish training guidelines.
Subject(s)
Education, Medical, Graduate/standards , Pediatrics/education , Clinical Competence , Congresses as Topic , Focus Groups , Guidelines as Topic , Humans , Internship and Residency , Surveys and Questionnaires , United StatesSubject(s)
Clinical Competence/standards , Competency-Based Education/methods , Hospitalists/education , Hospitals, Pediatric/standards , Pediatrics/education , Adolescent , Child , Child, Preschool , Competency-Based Education/standards , Curriculum/standards , Curriculum/trends , Hospitalists/standards , Humans , Infant , Infant, Newborn , Pediatrics/methods , Pediatrics/standards , WorkforceABSTRACT
Caring for children who have a chronic life-limiting illness can be emotionally and physically challenging. Just as families may struggle with whether they are making the right decisions, care providers struggle with whether they are giving the right advice, predicting the medical course correctly, and making the correct medical decisions. Uncertainty is a constant for the family and the care provider. The willingness of the care provider to develop a relationship with the family that involves continuing communication and re-evaluation of the child's condition and the family's perspective can relieve some of the emotional and physical suffering associated with a chronic disease and support the family in times of hope and grief.