121 - Exploratory Study for the Development of an Innovative Neonatal Health Inequities Curriculum

Poster Number: 121
Publication Number: 121.216

Christina M. Konecny, Lucile Packard Children's Hospital Stanford, Palo Alto, CA, United States; Evangelina Molina, Lucile Packard Children's Hospital Stanford, Redwood City, CA, United States; Shamita Punjabi, Lucile Packard Children's Hospital Stanford, Palo Alto, CA, United States; Rebecca Blankenburg, Stanford University School of Medicine, Palo Alto, CA, United States; Elizabeth M. Blecharczyk, Stanford University, San Francisco, CA, United States

Background: Inequities in health care have been a well-identified contributor to adverse outcomes in neonates of vulnerable populations. There is a need to design and implement a curriculum to address not only health inequities but also the role of implicit bias to enhance equitable care, specifically in the neonatal population. Though this is an important problem, resident experiences and perspectives regarding how to learn best about neonatal health inequities is unknown.

Objective: To explore pediatric residents’ knowledge, perspectives, and experiences with neonatal health inequities, with the goal of developing a novel resident curriculum.

Design/Methods: In this exploratory, qualitative, IRB-approved study, we conducted three focus groups to explore pediatrics residents’ perspectives on clinical experiences, prior education, preferred learning method and curricular design as related to neonatal health inequities. Using modified grounded theory, we developed codes, categories and themes through constant comparison. We will ensure trustworthiness through member checking. We have continually considered our own perspectives and reflected on the ways in which our lens impacts our interpretation of qualitative data in line with the process of reflexivity.

Results: Three focus groups were conducted with seventeen total residents participating. One of the three focus groups specifically recruited residents who identified as underrepresented in medicine and had four participants. Four themes were identified (Table 1) including: 1) Residents spotlight inequities such as challenges with interpreter services and standardization of care but find it difficult to address them in real-time due to systems-level barriers, lack of time, and limited action-oriented knowledge. 2) Residents express a high level of moral distress given perceived inability to fully address these inequities in the clinical setting. 3) Residents desire weekly protected time for action-oriented education around inequities. 4) Residents emphasize importance of faculty knowledge, approach to, and role-modeling of addressing inequities, highlighting a need for ongoing faculty development.Conclusion(s): The hidden curriculum of health inequities is pervasive and distressing, and will require transformative educational and systems level changes to address. Residents’ perspectives are critically important as we design curricular and systems level interventions.
Table 1. Resident perspectives on current state of education surrounding inequities in the newborn nursery and intermediate care nursery setting.