261 - Pediatric residents’ procedural competency requirements: a national needs assessment of program directors

Poster Number: 261
Publication Number: 261.330

Elizabeth L. Nguyen, Stanford University School of Medicine, Department of Pediatrics, Mountain View, CA, United States; Kristen M. Cunanan, Ph.D., Stanford University School of Medicine, Palo Alto, CA, United States; Sarah L. Hilgenberg, Lucile Packard Children's Hosp, Stanford, CA, United States

Background: Pediatric residents are required by the Accreditation Council for Graduate Medical Education (ACGME) to be competent at performing 13 procedures by the time they graduate residency. However, treatment advances, duty hour restrictions, quality and safety requirements, and the increasing skills and presence of non-physician providers have greatly reduced procedural training opportunities for residents. Internal Medicine individualized resident procedural competency requirements to career choice in 2019. This perspective has not yet been evaluated in pediatric graduate medical education.

Objective: To capture pediatric residency program directors’ (PDs) perspectives about whether procedural requirements for graduating pediatric residents (PRs) should be reformed and individualized.

Design/Methods: This was an IRB-exempt, survey-based, mixed methods study of PDs affiliated with the Association of Pediatric Program Directors (APPD) from April-May 2021. We calculated percentage of respondents who disagreed with the list of ACGME required procedures and favored individualizing requirements. We performed logistic regression to evaluate associations between respondent and program demographic characteristics and preference for individualization of procedural training.

Results: Responses included 47% (95/203) of PDs who represented APPD membership across program setting, size, and region (average standard mean deviation 0.22). Ninety-one percent of PD respondents disagreed with the current list of ACGME required procedures and 74% favored individualizing procedural competency. Bag-mask-ventilation and lumbar puncture were perceived as important for all PRs by >79% of respondents, cited as ‘life-saving’ or ‘time-sensitive’. A majority of PDs viewed neonatal intubation and umbilical catheter placement as important for only some PRs, citing them as ‘not widely applicable.’ Preliminary findings show that the odds for favoring individualization were not significantly different across respondents’ program size, setting, and access to specialized teams such as vascular access or phlebotomy.Conclusion(s): The majority of PD respondents believe that the current ACGME procedures should be reformed and individualized to future career goals. This change would allow maximization of limited time in residency in this era of decreased opportunity. This perspective is in line with published surveys of general pediatricians and recently graduated pediatric residents.
20220103 Nguyen Liz CV.pdf