SHM Converge Scientific Abstract ePoster Gallery-Comparison of Pediatric and Internal Medicine Resident Confidence in Caring for Young Adults With Medical Complexity

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This study compared confidence levels between pediatric and internal medicine (IM) residents in caring for young adults with medical complexity. As more medically complex young adults are treated in pediatric hospitals, transitioning them to adult care can be difficult because IM providers may feel unprepared.<br /><br />An anonymous survey was given in Fall 2020 to pediatric and IM residents. Residents rated their confidence, on a 1–5 Likert scale, in performing eight key care skills, including reconciling feeding and airway clearance orders, assessing ventilator settings, evaluating developmental/cognitive abilities and capacity, engaging patients and families in goals of care, locating prior pediatric providers, and restarting home care orders and durable medical equipment at discharge. Confidence between PGY1 and PGY2/3 residents was compared using Wilcoxon rank sum tests.<br /><br />There were 24 pediatric residents surveyed (11 PGY1, 13 PGY2/3) and 24 IM residents (7 PGY1, 17 PGY2/3). Among pediatric residents, confidence significantly improved with training in several areas, including reconciling G-tube feeds, airway clearance orders, assessing ventilator settings, evaluating capacity, engaging in goals-of-care discussions, and locating prior care providers. However, pediatric residents were already relatively confident in some tasks, such as assessing developmental/cognitive abilities and restarting discharge orders. In contrast, IM residents did not show significant increases in confidence from PGY1 to PGY2/3 for any of the listed skills.<br /><br />The authors conclude that pediatric residency experience appears to improve confidence in these complex care skills, while IM residency training does not. This highlights an educational gap and an opportunity to develop targeted IM residency workshops and med-peds inpatient educational materials to improve transitions from pediatric to adult acute care.

Asset Subtitle

Lauren McIntosh

Meta Tag

Author List Eleanor Comfort, Jacob Thomas, Kimberly O'Hara, Lauren McIntosh, Mark Brittan, Samantha Robin

Category Research

Concept Confidence

Concept Medically Complex Young Adult

Concept Clinical Skills

Concept Transitional Care

Concept Pediatric Residency

Distinguished Non-Finalist

Presenter Organization Children's Hospital Colorado

Presenting Author Lauren McIntosh

Track Education

Keywords

pediatric residents

internal medicine residents

young adults with medical complexity

confidence levels

transition to adult care

residency training

care skills

goals of care

survey study

educational gap

Confidence

Medically Complex Young Adult

Clinical Skills

Transitional Care

Pediatric Residency