Study finds most pediatric residents satisfied with primary care training

01/27/04

Bright future for pediatrics: Study finds most pediatric residents satisfied with primary care training

Researchers at Johns Hopkins Children's Center and 35 other institutions nationwide report that two-thirds of current pediatric residents in the United States are satisfied with their required pediatric primary care training. Resident satisfaction was found to be most closely tied to the resident's preceptor, or mentor, and as a result, satisfied residents are more likely to identify good mentors, the researchers say.

The study, published in the January/February issue of Ambulatory Pediatrics, is believed to be the first nationwide look at pediatric resident satisfaction with such training.

"This information emphasizes the importance of preceptor selection and the value of soliciting preceptors who have already been identified by residents as good teachers as well as those who want to be good teachers," says the study's lead author, Janet Serwint, M.D., a pediatrician at the Children's Center.

"Overall, the findings of this study are critical to residency programs facing fiscal constraints and reductions in residency training hours in the coming years," she adds. "Hopefully this information can help residency programs identify and prioritize components of the continuity experience while striving to maintain and improve educational experiences."

The three-year requirement of all pediatric residency programs in the United States, the so-called "continuity experience," is designed to expose residents to general pediatric primary care. During this time, residents follow patients over time as the primary care physician in clinics at hospitals, private practices, and community health centers. They also learn aspects of practice management.

The study's findings are based on anonymous surveys completed by 1,155 pediatric residents currently in training at 36 hospitals across the country, representing 15 percent of all medical residents nationwide. More than two-thirds of the residents had continuity at hospital-based sites, 22 percent at private practices or health maintenance organizations, and 9 percent at community health centers. Residents were asked to base their responses on their experiences over the prior academic year.

Almost all of the pediatric residents surveyed (97 percent of respondents) said the value of their faculty preceptor as a good role model played a more important part in their continuity satisfaction than the preceptor's availability or the actual help the resident received from the preceptor, two factors residency review committees considered more important.

About 85 percent of residents also said their continuity experience satisfaction was associated with receiving the "appropriate amount of teaching." However, Serwint says further studies are needed to understand what residents consider the appropriate amount of teaching and, more importantly, what methods lead to the best educational outcomes.

Other factors associated with resident satisfaction involve service-related issues, such as a resident's involvement during a patient's hospitalization, good balance of patients, having served as a patient advocate, and receiving appropriate nursing support.

The study was conducted by investigators with the Ambulatory Pediatric Association's (APA) Continuity Research Network (CORNET). The APA is an organization of academic general pediatric health professionals who create, disseminate and advocate excellence and innovation in education, research and health care delivery activities that enhance the health and well-being of infants, children and adolescents in the context of their families and communities.

Co-authors of this study were Susan Feigelman, M.D., and Min Zhan, Ph.D., of the University of Maryland; Marilyn Dumont-Driscoll, M.D., Ph.D., of the University of Florida; Diane Kittredge, M.D., of Dartmouth Medical School, and Rebecca Collins, M.D., of the University of Kentucky.

Other participating CORNET sites were Atlantic Health Systems, New Jersey; Baylor College of Medicine, Texas; Brody School of Medicine at East Carolina University; Children's Hospital, Pittsburgh; Children's Memorial Hospital, Northwestern University; Children's National Medical Center, Washington, D.C.; University of Connecticut; East Virginia Medical School; Driscoll Children's Hospital, Texas; Indiana University; University of Iowa; Loma Linda University; Lucille Packard Children's Hospital, Stanford; Maimonides Medical Center, New York; Medical College of Virginia; Naval Medical Center, San Diego; Westchester Medical Center/New York Medical College; Oregon Health Sciences University; Rush's Children's Hospital, Chicago; Uniformed Services, University of Health Sciences, Washington, D.C.; University of Arizona; University of Kansas; University of Nebraska and Creighton University; University of South Florida; University of Texas-Houston Medical School; University of Vermont; Washington University School of Medicine, St. Louis; Winthrop University, New York; University of Wisconsin; and Yale University.

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