261 - Preparing Them to Practice: a needs assessment regarding the lack of practice management curriculum in Pediatric Residencies

Poster Number: 261
Publication Number: 261.419

Kathleen Lima, Loma Linda University Children's Hospital, Moreno Valley, CA, United States

Background: Though most pediatric residents will go into primary care, there is very little training in practice management, with one study reporting it to be the “least covered topic”. This training gap has been demonstrated multiple times by input from trainees and residency program leadership. Several specialties have created curricula, but there is no consensus on what to include.

Objective: In preparation for the development of a practice management curriculum, this needs assessment was conducted to further explore this gap by gaining perspective of continuity clinic directors, recent graduates, and physician employers.

Design/Methods: A survey was sent to the Continuity Clinic Special Interest Group (SIG) from the APA. Participants were asked if their program had a practice management curriculum and who received it. They were asked what topics should be included and to rank their importance. One on one interviews were conducted with three employers of pediatric graduates to look for common themes. A focus group with graduates from a Pediatric Primary Care Track residency was conducted with a semi-structured interview format to assess perceived gaps in their training.

Results: The survey of the Continuity Clinic SIG had 23 respondents. Of these, 73% did not have a practice management curriculum. The list of topics respondents felt should be included were billing and coding (57%), operations/costs/vaccine costs (26%), leading multi-disciplinary team and hiring personnel (26%), scheduling/efficiency/patient throughput (22%). Common themes were found during the employers’ interviews covered similar topics. The most consistent theme was the need for more training in billing and coding and proper documentation. Employers also cited the number of patients new hires need to see in primary care. The focus group echoed the two previous groups regarding billing, coding, and documentation, and identified the need to learn more about clinic operations. A topic introduced by this group was the need to have more practice in minor outpatient procedures.Conclusion(s): As shown by the literature and the participants in this needs assessment, a practice management curriculum is missing from many pediatric residencies. Employers, graduates, and continuity clinic directors can identify several areas that may be included in this curriculum, but there is no agreed upon goals and objectives. Next steps could include a Delphi method survey to reach expert consensus about the goals and objectives for pediatric residencies to use as they develop curricula at their institutions.