Jennifer L. Trainor, MD, Department of Pediatrics, Northwestern University, Chicago, IL, Rebekah Burns, MD, Department of Pediatrics, University of Washington, Seattle, WA, Mark Adler, MD, Department of Pediatrics, Northwestern University, Chicago, IL
Transitioning from medical student to intern is challenging. Relatively little time is devoted to pediatrics (PED) in undergraduate medical education and published literature indicates that program directors routinely identify deficits in incoming trainees.
Develop a focused curriculum to prepare students entering pediatric training and assess outcomes and participant satisfaction.
A 5-day boot camp (BC) elective was developed using input from education experts, recent graduate feedback, and literature review and offered to MS4s matching in PED or family practice (FP) in 2013. We used a combination of brief didactics, small group discussions, role play, facilitated debriefing, and simulation. Previously published instruments were used to evaluate communication, handoff, and lumbar puncture (LP) skills. Each participant completed an OSCE using a standardized patient and task-trainer, requiring synthesis of multiple BC elements. Pre and post-assessment data was evaluated using paired t-tests. Detailed course evaluations using a 5-point Likert scale (1=strongly disagree, 5=strongly agree) were collected and analyzed by calculating means and standard deviations.
16 graduating medical students participated in the BC: 12 entering PED (75%), 3 FP (19%) and 1 IM/PED residencies (6%). Students became interns at 15 different institutions. 14 (88%) participated in the pre-BC assessment, 15 in the post-BC OSCE (94%), and all in the infant LP assessments. Signout/Handoffs: Mean pre-intervention score was 2.5 (SD 1.0), post-intervention was 3.9 (SD 1.1) (p=0.003, 95% CI 0.6-2.3) Infant LP: The mean pre-intervention score was 47.2% (SD 0.09), post-intervention was 80.0% (SD 0.15) (p<0.001, 95% CI 0.19, 0.41). Feedback: All agreed, “The facilitators presented the material in an effective manner,” “I took away ideas I plan to implement in internship,” and “I think all students should participate in a similar experience.” When asked to assess the usefulness of individual modules, all except order writing received a mean Likert score >4 and >50% had mean scores ≥4.7.
A focused BC addressing key knowledge and skills required for PED-related residencies led to improvements in signout/handoffs and infant LP, but did not appear to impact other communication skills. It was highly valued by graduating medical students entering into PED-related residencies.