Research Training and Scholarly Activity during General Pediatric Residency in Canada.

OBJECTIVE: To describe the characteristics of research training and scholarly activity during pediatrics residency in Canada and identify facilitators and barriers to resident scholarly activity. STUDY DESIGN: We conducted a mixed-methods, cross-sectional survey of pediatrics residents in Canada from April to June 2023. Trainees and medical education experts developed the 55-item survey, pilot tested, and distributed electronically to residents in all 17 Canadian residency programs. Responses were complemented with program-level data from pediatrics residency program directors. RESULTS: Of 644 Canadian pediatrics residents, 230 (36%) responded. Resident respondents conducted various types of scholarly projects, including retrospective clinical study (22%), qualitative research (15%), quality improvement (13%), and medical education research (12%). Discordance between the field of career interests and primary scholarly projects was common. Among respondents, 20% had abstracts accepted at national or international conferences, and 12% had manuscripts submitted to peer-reviewed journals. Resident respondents' self-perceived progress in their scholarly projects were discrepant from their actual progress. Key themes related to barriers and facilitators to scholarly activity included protected time for research, mentorship, and research skills training. CONCLUSIONS: The research training and scholarly activity of pediatrics residents in Canada is variable. Establishing national standards, implementing progress monitoring mechanisms with tailored support, and offering flexible protected research time are important next steps.

Understanding the Procedural Skills Needed in Rural Pediatric Practices: A Survey of Rural Pediatric Providers in the State of New Mexico.

OBJECTIVES: There is little data evaluating procedural skills in current rural pediatric practices. In order to prepare a cadre of pediatricians to work in rural settings, we require an understanding of the unique procedural skills needed by rural pediatric providers. Our objective was to determine how often pediatricians performed various procedural skills, determine the importance of these skills to current practice, and how they differ between rural and urban pediatric providers. METHODS: A survey evaluating pediatrician utilization of the 13 required Accreditation Council Graduate Medical Education procedural skills in current practice was developed and distributed to pediatric providers in New Mexico. Descriptive statistics were used to profile participants and describe survey responses. Chi-square tests were used to evaluate differences by urban setting or IHS. Fisher's exact test was employed to assess differences if cell sizes were less than five. All p-values were two sided with alpha=.05. Benjamini-Hochberg method was used to control for type 1 errors. RESULTS: Fifty-two of 216 pediatric providers responded. The majority surveyed performed each of the 13 procedures less than monthly but competency in many of these procedures is important. Thirty-two respondents submitted free-text responses recommending competence with tracheostomy changes, gastrostomy-tube changes/cares, and circumcision. CONCLUSION: Majority of surveyed pediatricians performed the required procedures less than monthly but deemed several procedures to be important. Rural pediatricians recommended specific procedural skills needed in rural practice. All trainees receive procedural skills training. However, trainees interested in rural practice may need additional training in specific skills different than their non-rural counterparts.

Percepción de residentes de pediatría en cuanto a su formación en contenidos transversales. Investigación cualitativa con grupos focales / Perception of residents in pediatrics regarding their training in cross-curricular subjects. Qualitative research in focus groups

Introducción: Los programas de residencia médica son uno de los principales sistemas de formación de especialidades básicas y posbásicas. A partir del análisis "evaluación participativa" de la OPS en 2002 y el informe de la dra. M. Rosa Borrell en 2005, el Ministerio de Salud de la Nación definió bloques transversales en las bases curriculares. Los contenidos transversales abordan problemas centrales del campo de la salud y de la atención, comunes a todas las profesiones médicas. Contextualizan y determinan el ejercicio profesional. El propósito de este trabajo es contribuir a la evaluación del programa de residencias tomando como objeto de interés a los sujetos participantes de las residencias. Objetivo comprender las percepciones de los residentes de Pediatría del Hospital Garrahan sobre la formación en contenidos transversales. Población y métodos. 4 grupos focales, con 4-6 residentes de tercer y cuarto año de pediatría del Hospital Garrahan. Con ejes de discusión previamente planificados, con un tiempo de duración (120 minutos), en un ambiente no directivo, con múltiples disparadores. Análisis: los contenidos de los grupos focales se analizaron a través de la metodología de "teoría fundamentada en los datos" asistido por el programa ATLAS. Ti (versión 8). Resultados. Participaron 20 residentes, con una mediana de edad de 27 +/- 2 años. A partir de los tres ejes de discusión planificados para los grupos focales se elaboraron núcleos temáticos: normativo institucional, programa de formación, dinámicas de aprendizaje, sectores y climas de trabajo, el paciente y su familia, displicencia. En primer lugar, se reconocieron ingresando a una institución con normas de funcionamiento, en donde "la planta" se describió como la figura normativa predominante. En cuanto al programa de formación, hubo satisfacción con las capacidades alcanzadas. Sin embargo, se debatió si el perfil de profesional alcanzado permite reconocer determinantes de salud más allá de las comorbilidades estrictamente médicas. Surgieron problemáticas vinculadas a los límites del modelo médico hegemónico y la necesidad de nuevos enfoques de aprendizaje a través de la problematización del paciente en su contexto social. Definieron los casos clínicos como la mejor forma de abordar el conocimiento sobre un tema. Surgió espontáneamente el tema de la discriminación. Conclusión: a través de los grupos focales, como espacio de escucha activa de la experiencia cotidiana de trabajo de los residentes del Hospital Garrahan surgieron problemáticas vinculadas a los límites del modelo médico hegemónico y la necesidad de enfoques de aprendizaje a través de la problematización del paciente en su contexto social (AU)

Introduction: Medical residency programs are one of the main systems for the training in basic and post-basic specialties. Based on the "participatory evaluation" analysis by the PAHO in 2002 and the report by dr. M. Rosa Borrell in 2005, the National Ministry of Health defined cross-curricular groups to form the basis of the curriculum. The cross-curricular contents address core subjects in the health care field, common to all medical professions. These subjects contextualize and determine the professional practice. The aim of this study was to contribute to the evaluation of the residency program focusing on the participants in the residency programs. Objective: To assess the perceptions of the residents in Pediatric Hospital Garrahan regarding the training and crosscurricular contents. Population and methods: 4 focus groups, with 4-6 residents of the third and fourth year of Pediatrics at Garrahan Hospital using previously determined lines of discussion, in a time slot of 120 minutes, in a non-directive environment, with multiple triggers. Analysis: The contents of the focus groups were analyzed using the "grounded theory data" methodology supported by the ATLAS program, Ti (version 8). Results: 20 residents, with a median age of 27 +/- 2 years, participated in the program. Based on the three discussion lines planned for the focus groups, six core topics were developed: Institutional norms, training program, learning dynamics, sectors and work environments, the patients and their families, displeasure. In the first place, the subjects recognized they entered an institution with its proper norms, in which "the staff" describes itself as the predominant normative figures. Regarding the training program, subjects were satisfied with skills obtained. However, there was debate as to whether the professional profile achieved included knowledge on determining health factors beyond the strictly medical comorbidities. Issues came up related to the limits of the hegemonic model of the physician and the need for new learning targets through the problematization of the patient in his or her social context. Clinical cases were defined as the best way to approach the knowledge on this subject. The subject of discrimination came up spontaneously. Conclusion: Through focus groups, as an active listening space for the experience in the daily practice of the residents at Garrahan Hospital Garrahan, issues appeared related to the limits of the hegemonic model of the physician the need for new learning targets through the problematization of the patient in his or her social context (AU)