How Good is Good Enough?: Current-Day Pediatric Residency Program Directors’ Challenges in Assessing and Achieving Resident Procedural Competency

Significant gaps exist in the pediatric resident (PR) procedural experience. Graduating PRs are not achieving competency in the 13 ACGME recommended procedures. It is unclear why PR are not able to achieve competency, or how existing gaps may be addressed. We performed in-depth one-on-one semistruct...

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Bibliographic Details
Published in:Academic pediatrics 2023-03, Vol.23 (2), p.473-482
Main Authors: Forson-Dare, Zaneta, Du, Nan R., Ocran, Amanda, Tiyyagura, Gunjan, Bruno, Christie J., Johnston, Lindsay C.
Format: Article
Language:English
Subjects:
Accreditation
Child
Clinical Competence
competency assessment
Computer Simulation
Education, Medical, Graduate
Humans
Internship and Residency
pediatric residency
procedural training
qualitative
United States
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Summary:Significant gaps exist in the pediatric resident (PR) procedural experience. Graduating PRs are not achieving competency in the 13 ACGME recommended procedures. It is unclear why PR are not able to achieve competency, or how existing gaps may be addressed. We performed in-depth one-on-one semistructured interviews with 12 pediatric residency program directors (PPDs). The interviews were audio-recorded, and transcribed verbatim. Coding of the data using conventional content analysis led to generation of categories, which were validated through consensus development. We identified 4 main categories, including (1) programs struggle to ensure adequate training in procedural skills for PRs, with various barriers reported; (2) programs develop individualized strategies to address challenges in procedural skills training, and multiple options are necessary; (3) PPDs face challenges defining procedural competency and standardizing expectations; and (4) expectations for PR procedural training may require modification based upon current practice environments. Solutions include simulation, procedural boot camps, and procedural/subspecialty electives. Numerous methods to combat challenges in PR procedural training have been identified by participating PPDs, including simulation, tailoring electives, and developing institutional guidelines. However, accreditation bodies may need to update procedural expectations based on individual resident career goals and realities of current day practice.
ISSN:1876-2859
1876-2867
DOI:10.1016/j.acap.2022.11.005