Targeted Training for Subspecialist Care in Children With Medical Complexity
BackgroundChildren with medical complexity (CMC) are prone to medical errors and longer hospital stays, while residents do not feel prepared to provide adequate medical care for this vulnerable population. No educational guidance for the training of future pediatric tertiary care specialists outside...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Pediatrics |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2022.851033/full |
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| author | Fabian Eibensteiner Fabian Eibensteiner Valentin Ritschl Valentin Ritschl Isabella Valent Rebecca Michaela Schaup Axana Hellmann Lukas Kaltenegger Lukas Kaltenegger Lisa Daniel-Fischer Lisa Daniel-Fischer Krystell Oviedo Flores Stefan Brandstaetter Stefan Brandstaetter Tanja Stamm Tanja Stamm Eva Schaden Eva Schaden Christoph Aufricht Michael Boehm |
| author_facet | Fabian Eibensteiner Fabian Eibensteiner Valentin Ritschl Valentin Ritschl Isabella Valent Rebecca Michaela Schaup Axana Hellmann Lukas Kaltenegger Lukas Kaltenegger Lisa Daniel-Fischer Lisa Daniel-Fischer Krystell Oviedo Flores Stefan Brandstaetter Stefan Brandstaetter Tanja Stamm Tanja Stamm Eva Schaden Eva Schaden Christoph Aufricht Michael Boehm |
| author_sort | Fabian Eibensteiner |
| collection | DOAJ |
| description | BackgroundChildren with medical complexity (CMC) are prone to medical errors and longer hospital stays, while residents do not feel prepared to provide adequate medical care for this vulnerable population. No educational guidance for the training of future pediatric tertiary care specialists outside their field of expertise involving the multidisciplinary care of CMC exists. We investigated pediatric residents past educational needs and challenges to identify key learning content for future training involving care for CMC.MethodsThis was a prospective mixed-methods study at a single pediatric tertiary care center. Qualitative semi-structured interviews with residents were conducted, submitted to thematic content analysis, linked to the American Board of Pediatrics (ABP) general pediatrics content outline, and analyzed with importance performance analysis (IPA). Quantitative validation was focused on key themes of pediatric nephrology within the scope of an online survey among pediatric residents and specialists.ResultsA total of 16 interviews, median duration 69 min [interquartile range IQR 35], were conducted. The 280 listed themes of the ABP general pediatrics content outline were reduced to 165 themes, with 86% (theoretical) knowledge, 12% practical skills, and 2% soft skills. IPA identified 23 knowledge themes to be of high importance where improvement is necessary and deemed fruitful. Quantitative validation among 84 residents and specialists (response rate 55%) of key themes in nephrology yielded high agreement among specialists in pediatric nephrology but low interrater agreement among trainees and “trained” non-nephrologists. The occurrence of themes in the qualitative interviews and their calculated importance in the quantitative survey were highly correlated (tau = 0.57, p = 0.001). Two clusters of high importance for other pediatric specialties emerged together with a contextual cluster of frequent encounters in both in- and outpatient care.ConclusionRegarding patient safety, this study revealed the heterogeneous aspects and the importance of training future pediatric tertiary care specialists outside their field of expertise involving the multidisciplinary care of CMC. Our results may lay the groundwork for future detailed analysis and development of training boot camps that might be able to aid the improvement of patient safety by decreasing preventable harm by medical errors, especially for vulnerable patient groups, such as CMC in tertiary care pediatrics. |
| first_indexed | 2024-04-12T11:50:02Z |
| format | Article |
| id | doaj.art-0117de2314b34c1a807a4916f79bc74f |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-04-12T11:50:02Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-0117de2314b34c1a807a4916f79bc74f2022-12-22T03:34:13ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602022-05-011010.3389/fped.2022.851033851033Targeted Training for Subspecialist Care in Children With Medical ComplexityFabian Eibensteiner0Fabian Eibensteiner1Valentin Ritschl2Valentin Ritschl3Isabella Valent4Rebecca Michaela Schaup5Axana Hellmann6Lukas Kaltenegger7Lukas Kaltenegger8Lisa Daniel-Fischer9Lisa Daniel-Fischer10Krystell Oviedo Flores11Stefan Brandstaetter12Stefan Brandstaetter13Tanja Stamm14Tanja Stamm15Eva Schaden16Eva Schaden17Christoph Aufricht18Michael Boehm19Division of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, AustriaLudwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, AustriaSection for Outcomes Research, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, AustriaLudwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, AustriaDivision of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, AustriaDivision of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, AustriaDivision of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, AustriaDivision of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, AustriaCenter for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, AustriaDivision of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, AustriaChristian Doppler Laboratory for Molecular Stress Research in Peritoneal Dialysis, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, AustriaDivision of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, AustriaDivision of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, AustriaLudwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, AustriaSection for Outcomes Research, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, AustriaLudwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, AustriaLudwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, AustriaDivision of General Anaesthesia and Intensive Care Medicine, Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Vienna, AustriaDivision of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, AustriaDivision of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, AustriaBackgroundChildren with medical complexity (CMC) are prone to medical errors and longer hospital stays, while residents do not feel prepared to provide adequate medical care for this vulnerable population. No educational guidance for the training of future pediatric tertiary care specialists outside their field of expertise involving the multidisciplinary care of CMC exists. We investigated pediatric residents past educational needs and challenges to identify key learning content for future training involving care for CMC.MethodsThis was a prospective mixed-methods study at a single pediatric tertiary care center. Qualitative semi-structured interviews with residents were conducted, submitted to thematic content analysis, linked to the American Board of Pediatrics (ABP) general pediatrics content outline, and analyzed with importance performance analysis (IPA). Quantitative validation was focused on key themes of pediatric nephrology within the scope of an online survey among pediatric residents and specialists.ResultsA total of 16 interviews, median duration 69 min [interquartile range IQR 35], were conducted. The 280 listed themes of the ABP general pediatrics content outline were reduced to 165 themes, with 86% (theoretical) knowledge, 12% practical skills, and 2% soft skills. IPA identified 23 knowledge themes to be of high importance where improvement is necessary and deemed fruitful. Quantitative validation among 84 residents and specialists (response rate 55%) of key themes in nephrology yielded high agreement among specialists in pediatric nephrology but low interrater agreement among trainees and “trained” non-nephrologists. The occurrence of themes in the qualitative interviews and their calculated importance in the quantitative survey were highly correlated (tau = 0.57, p = 0.001). Two clusters of high importance for other pediatric specialties emerged together with a contextual cluster of frequent encounters in both in- and outpatient care.ConclusionRegarding patient safety, this study revealed the heterogeneous aspects and the importance of training future pediatric tertiary care specialists outside their field of expertise involving the multidisciplinary care of CMC. Our results may lay the groundwork for future detailed analysis and development of training boot camps that might be able to aid the improvement of patient safety by decreasing preventable harm by medical errors, especially for vulnerable patient groups, such as CMC in tertiary care pediatrics.https://www.frontiersin.org/articles/10.3389/fped.2022.851033/fullnephrologymedical educationtrainingmedical complexitychildren with medical complexity (CMC)residency |
| spellingShingle | Fabian Eibensteiner Fabian Eibensteiner Valentin Ritschl Valentin Ritschl Isabella Valent Rebecca Michaela Schaup Axana Hellmann Lukas Kaltenegger Lukas Kaltenegger Lisa Daniel-Fischer Lisa Daniel-Fischer Krystell Oviedo Flores Stefan Brandstaetter Stefan Brandstaetter Tanja Stamm Tanja Stamm Eva Schaden Eva Schaden Christoph Aufricht Michael Boehm Targeted Training for Subspecialist Care in Children With Medical Complexity Frontiers in Pediatrics nephrology medical education training medical complexity children with medical complexity (CMC) residency |
| title | Targeted Training for Subspecialist Care in Children With Medical Complexity |
| title_full | Targeted Training for Subspecialist Care in Children With Medical Complexity |
| title_fullStr | Targeted Training for Subspecialist Care in Children With Medical Complexity |
| title_full_unstemmed | Targeted Training for Subspecialist Care in Children With Medical Complexity |
| title_short | Targeted Training for Subspecialist Care in Children With Medical Complexity |
| title_sort | targeted training for subspecialist care in children with medical complexity |
| topic | nephrology medical education training medical complexity children with medical complexity (CMC) residency |
| url | https://www.frontiersin.org/articles/10.3389/fped.2022.851033/full |
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