The APPD Pediatric Residency Investigators in Medical Education (APPD PRIME) network was APPD LEARN's first network and focuses on research on Pediatric residents and residency programs.
Relationship between ACGME milestone scores and pediatric resident remediation
PI: Eric Zwemer
Synopsis: This study aims to determine the time of initiation and outcomes of formal remediation for pediatric residents. As well as to describe the skill deficit(s) experienced by pediatric residents who undergo formal remediation as demonstrated by differences between ACGME milestone scores of residents who undergo formal remediation and those who do not.
Status: Planning
Characteristics of residents who withdraw or are dismissed from pediatric residency programs
PI: Eric Zwemer
Synopsis: This study aims to determine the rate of dismissal and withdrawal from pediatric residency programs in the United States. As well as to characterize the deficit(s) present in the ACGME milestone scores of these residents at the time of dismissal by comparing milestones of these residents to those of residents who graduate from the same programs.
Status: Planning
Resident and Program Characteristics Associated with Performance on General Pediatric Certifying Exam
PI: Rebecca Wallihan
Synopsis: This survey aims to investigate the relationship between individual resident and residency program characteristics and performance on the ABP CE, with the ultimate goal of accurately identifying residents who may be at risk of failing the exam and determining effective strategies to support them. This survey complements a program-level survey regarding board preparation curricula.
Status: Planning
Current Studies:
Politics and Pediatrics: Exploring the impact of state political policies on pediatric residency application and match preferences
PI: Rebecca Hart
Synopsis: The objectives of this study are to describe factors that influence decision-making related to residency program applications, ranking, and future practice among pediatric residents; To determine the number/proportion of applicants who list state political policies as an influential factor in decision-making; To explore how/why these policies may affect applicants’ decision-making around residency applications, future practice, and personal decisions (such as family planning); To describe differences in the influence of state policies on residency application and ranking decisions based on program- or applicant-level factors.
Status: Recruiting
National Pediatric Resident Breastfeeding and Lactation Education Study
PI: Christine Mikesell
Synopsis: The objective of this study is to assess the current state of breastfeeding and lactation-related education and pediatric resident experiences, education, and knowledge to understand current needs and identify areas for future intervention.
Status: Recruiting
Disability Prevalence, Accommodations and Belonging in Pediatric Residents
PI: Bridget Boyd
Synopsis: The objectives of this study include calculating the prevalence of disability representation, by category of disability, among pediatric residents; identify the prevalence of accommodation, use among pediatric residents; identify drivers of non-disclosure and non-accommodation use in pediatric residents; assess pediatric residents with disabilities’ perceptions of belonging and inclusion; and identify differences in non-disclosure, non-accommodation and perceptions of belonging for URiM pediatric residents with disabilities. The estimated time to participate is 8 minutes. All pediatric program directors and residents are eligible to participate.
Status: Data collection
Podcast Journal Club: A Novel Approach to Teaching EBM Skills to Pediatric Trainees- Round 2
PI: Lynn Thoreson
Synopsis: This is a self-directed, evidence-based medicine (EBM) and biostatistics curriculum delivered via a podcast to pediatric trainees to improve skills in EBM and biostatistics compared to pediatric trainees not utilizing the podcast. The study will be completed from July 2024 to January 2025. Enrolled programs will be randomized to the intervention or control group. All programs will complete a pre- and post-survey regarding current EBM education and submit learner-deidentified milestones for PBLI-1 from July 2024 to January 2025. All trainees will complete pre- and post-surveys, pre- and post-biostatistics skills test, and a pre- and post-EBM tool. Trainees in the intervention group will have access to a 6-month EBM/biostatistics podcast curriculum with approximately 40 minutes of content per month. The curriculum can be utilized in addition to other current program curricula for EBM/biostatistics. The control group will gain access to the podcast materials after the study has ended.
Status: Data collection
Defining Key Factors in Burnout and Resilience in Pediatric Residents and the Relationship to Performance
PIs: John Mahan and Maneesh Batra for The Pediatric Resident Burnout-Resilience Study Consortium
Synopsis: Create and support a consortium to:
- Describe the epidemiology and relationships between burnout, resilience, empathy, and confidence in providing compassionate care in pediatric and medicine-pediatric (P/M-P) residents.
- Define the natural history of these parameters over time in P/M-P residents during training
- Identify modifiable factors that increase or decrease the risk of developing burnout and promoting positive wellness factors
- Develop and test different interventions (such as in-person seminars, on-line mind-body skills training, and individualized curricula such as global health electives) to affect burnout, resilience, empathy, compassion and wellness
Status: Recruiting for 2025 Survey
Crosswalk Study and Prospective Entrustment Decision Making Study
PI: Daniel Schumacher
Synopsis: Understand the association between ACGME Milestone assignments and EPA prospective entrustment decisions made by CCCs; explore factors that influence and determine prospective entrustment decisions.
Status: Data Analysis
Understanding the Experience and Impact of Parenting Electives on Pediatric Residents and Their Return to Work
PI: Sabrina Ben-Zion
Synopsis: Determine if there are associations between utilization of a parenting elective with satisfaction with transition back to work, post-partum depression, post-partum burnout, breastfeeding duration, and perception of support
Status: Data analyses in progress
Training Opportunities for Sexual and Reproductive Health: A National Survey of Pediatric Residents
PI: Sarah Golub
Synopsis: Understand the extent of education and training in sexual and reproductive health (SRH) care for adolescent assigned females at birth (from here on referred to as “females”) that pediatric residents in the United States receive during their residency.
Status: Data analyses in progress
Does a Gap Year in Medical Training Lead Trainees to Have an Overall Better Sense of Wellness?
PI: Masrur Khan
Synopsis: Assessing the impact of taking time off, including anticipated gap years and unanticipated time off, during training on wellness.
Status: Manuscript drafting
Pediatric Resident Insulin Management Education: A National Needs Assessment
PI: Ellen Laves
Synopsis: Characterize the experience of pediatric residents with diabetes management tasks, including caring for patients with diabetes requiring insulin and ordering insulin in the inpatient and outpatient settings.
Status: Data analyses in progress
Enhancing Learning with Daily Text Message PREP Questions
PI: Adin Nelson & Erika Abramson
Synopsis: The primary aim of this study is to test a program of daily spaced retrieval practice with exam style multiple choice questions. This study will consist of daily text messages sent to enrolled residents prompting them to log in to PREP and answer one specific practice question. Enrolled residents' responses will be linked to their ITE scores, which will be provided by ABP.
Status: Data analyses in progress
Are Final Residency Milestones Predictive of Early Fellowship Performance in Pediatrics?
PI: Suzanne Reed
Synopsis: Assess the correlation between Milestone levels achieved by fellowship-bound residents at the end of residency with Milestone levels achieved as first-year fellows. Determine factors associated with improved correlation between final residency Milestones and early fellowship Milestones.
Status: Data analyses in progress
Scaling the Harmonized Milestones 2.0
PI: Alan Schwartz
Synopsis: Develop response process validity evidence for the harmonized (cross-specialty) ACGME milestones 2.0. Investigate subjective differences in competence between milestones levels and tests the hypothesis that they can be considered equal intervals.
Status: Data analyses in progress
Defining Pediatric Resident Wellbeing: A Group Concept Mapping Study
PI: Jessica Babal
Synopsis: Create a conceptual model of pediatric resident wellbeing and identify differences in how stakeholder subgroups prioritize elements of pediatric resident physician wellbeing.
Status: Data analyses in progress
Assessing the Association between Entrustable Professional Activities (EPAs), Competencies, and Milestones in the Pediatric Subspecialties
Collaborators: APPD LEARN, Council of Pediatric Subspecialties, American Board of Pediatrics
Synopsis: The specific objectives are 1) to determine if there is a specific milestone level that must be reached for each of the subcompetencies within a specific EPA to judge that a fellow is deemed entrustable, 2) to compare the milestone level at which fellows are deemed entrustable across the pediatric subspecialties and to determine if any specific subcompetencies are more influential in the entrustment decision than others and 3) to compare the initial overall impression of fellow level of entrustment for a given EPA made by the Fellowship Program Director with that determined by the Clinical Competency Committee (CCC) after the milestone levels for that EPA are assigned.
Status: Data collection complete
Pediatrics Milestones Assessment Collaborative (PMAC)
Collaborators: APPD LEARN, American Board of Pediatrics, and National Board of Medical Examiners
Project Director: Patricia Hicks
Synopsis: Develop a national Pediatrics Milestones-based Assessment System - an assessment system that will provide meaningful, feasible assessment evidence that can be used by the program leadership and clinical competency committee members to guide decisions for progression through increasing levels of responsibility and independence.
Status: Data collection complete; analyses in progress
Impact of Academic Half Days on Board Pass Rates
PI: Emily Borman-Shoap
Synopsis: Determine if there is an association between the use of academic half-days in pediatric residency programs and passage of ABP examination in the first attempt.
Status: Data collection complete; analyses in progress
Striving for the Optimal Balance Between Service and Education
PIs: Debra Boyer and Jennifer Kesselheim
Synopsis: Survey residents and program directors to (1) establish each cohorts' assessment of the balance of service and education in their training programs, (2) measure program directors' and residents' perceptions of the amount of service and education inherent in common scenarios encountered during pediatric residency training, and (3) elucidate definitions of service and education, endorsed by both program directors and trainees, that can serve as a useful foundation for curriculum development during residency training
Synopsis: Data collection complete; analyses in progress
ABS Pilot Study of Entrustable Professional Activities (EPAs)
PI: Jo Buyske
Synopsis: Collect entrustable professional activity assessment data on general surgery resident in approximately 25 residency program
Status: Data collection complete; analyses in progress
Understanding Pediatric Trainee Attitudes Towards Incorporating a Climate Change Curriculum Into Medical Training
PI: Jonathan Cogen & Mollie Grow
Synopsis: Assess pediatric knowledge on the impact of climate change and its effects on health; evaluate pediatric trainee perceived interest in the importance of incorporating a climate change curriculum into their pediatric training program.
Status: Data collection complete; analyses in progress
Identifying ERAS Filters that Predict Medical Student Success in Pediatric Residency
PI: Jessica DeBord
Synopsis: Identify medical school metrics reported via the Electronic Residency Application Service (ERAS) that predict success during pediatric residency. Involves retrospective data collection of medical school metrics.
Status: Data collection complete; analyses in progress
Childbearing and parenthood decisions in Pediatrics
PI: Kelly Dundon
Synopsis: Characterize the variability in use and length of parental leave in Pediatrics residency programs and associations with educational and parenting outcomes.
Status: Data collection and analyses complete; manuscript published
Using text messaging to help learners develop self-regulated learning skills
PI: Kimberly Gifford
Synopsis: Randomized controlled trial of text messaging to teach and assess self-regulated learning.
Status: Data collection complete; analyses in progress
The New Duty Hour Regulations--Were Changes Necessary? A Survey of Pediatric Program Directors
PI: Hilary Haftel, MD (University of Michigan)
Synopsis: This study seeks to identify what, if any, changes in Pediatric Residency Program structure were necessary to achieve compliance with the new DHR by July 2011. This specifically includes any changes to the amount or periods of resident work hours, changes in supervision, and changes in external or internal moonlighting
Status: Data collection complete
Sustainable Pediatric Nephrology Workforce Project (SUPERPOWER)
PI: Susan Halbach
Synopsis: Further understand resilience and burnout as well as factors contributing to physician wellness in both pediatric nephrology fellows and faculty
Status: Data collection complete
Assessment of Pediatrics Milestones Pilot
PI: Patricia Hicks, Steve Clyman, and Alan Schwartz
Synopsis: In partnership with the NBME, this study seeks to test the feasibility of a set of assessment instruments constructed from nine Pediatrics Milestones. Instruments are designed to inform decisions about readiness to serve in the inpatient pediatric wards, based on ratings of direct observations recorded on handheld devices. Study instruments include: structured clinical observations for rounds and history taking; a multisource feedback instrument; and, Pediatrics Milestones Classification assessment form. Study learners include interns and sub-interns, with faculty, residents, and nurses serving as raters. Features include collection of de-identified learner data in APPD LEARN, individualized learner feedback, faculty development materials for rater and feedback provider training. Outcomes from this study will be used to inform further development of the Pediatrics Milestones and APPD LEARN.
Status: Data collection completed June 2013; data analyses and manuscript writing in progress
New Professionalism Challenges in Medical Training: An Exploration of Social Networking
PI: Jennifer Kesselheim (Harvard)
Synopsis: This study surveys pediatric trainees to explore their perceptions of and experiences with social networking sites and training program policies around social media.
Status: Data collection complete
Validity of resident self-assessment using Pediatrics Milestones
PIs: Su-Ting Li and Kimberly Gifford
Synopsis: This study seeks to describe pediatric resident self-assessment of competence using the Pediatrics Milestones for 21 ACGME-selected sub-competencies, and characterize and explain variation in agreement between pediatric resident self-assessment, external assessments based on Pediatrics Milestones, and overall summative assessments of resident performance.
Status: Data collection complete
Developing Evidence for a Model for Equity in Assessment Based on the Anti-Deficit Framework Using Discrete Choice Experiments
PI: Margaret McNamara & Arianne Teherani
Synopsis: Test model of equitable assessment that avoids peer comparison, values narrative assessment, focuses on contributions to patient care beyond medical knowledge, captures learner growth, trains clinical supervisors to mitigate bias, and appreciates learner identity among self-identified underrepresented in medicine learners across institutions, clinical settings, and levels of clinical training.
Status: Data collection complete; analyses in progress
COMLEX Scores and Performance on ABP Certifying Examination
PI: Elizabeth Rodriguez-Lien
Synopsis: Retrospective data collection to investigate the relationship between COMLEX scores and performance on the ABP certifying examination.
Status: Data collection complete, data analysis in progress
Promoting Med-ed Insight into Supportive Environments (PROMISE)
PI: Jyothi Marbin
Synopsis: Describe the experiences of Under-Represented Minority residents around feelings of belonging, inclusion and community. Compare the relationship between URM resident sense of belonging and wellness. Involves surveying residents.
Status: Data collection complete; analyses in progress
Do pediatric boot camps improve performance during early internship?
PI: Molly Rideout
Collaborators: COMSEP
Synopsis: The specific aim of this project is to investigate whether participation in a pediatric-specific boot camp improves performance during initial inpatient Pediatrics or NICU rotations and after 6 months of internship, as reflected on intern performance ratings assessed with Pediatric Milestones.
Status: Data collection and analysis complete; manuscript complete
Characteristics of Clinical Competency Committee (CCC) Member Milestone Level Assignments and Recommended Advancement Decisions
PI: Dan Schumacher
Synopsis: Studies the relationship between individual CCC member judgments and and reported milestones and advancement decisions. Investigates whether program and CCC member factors moderate that relationship.
Status: Data collection complete; analyses in progress
How trainees perform on general pediatric EPAs using a rating scale of level of supervision leading up to entrustment
PIs: Dan Schumacher and Carol Carraccio
Collaborators: American Board of Pediatrics
Synopsis:
- Determine expectations for level of supervision needed by the majority of trainees over the course of and at the completion of residency training with the intention of using data to guide the value of the current list of EPAs in learner assessment.
- Assess the feasibility of using an educational intervention to meet Part 4 MOC requirements for a quality improvement project.
Status: Data collection complete
Assessment of Pediatric Emergency Medicine Fellow Milestones Benchmarks and Association with Passing of Certification Exams
PI: Paria Wilson
Synopsis: Determine if benchmark levels of competence can be defined for the 6 ACGME competency domains and 23 individual ACGME Milestones for each year of pediatric emergency medicine (PEM) fellowship; identify if Milestones ratings at graduation from PEM fellowship are a reliable proxy for passing the PEM ABP exam.
Status: Data collection complete; analyses in progress
Virtual Recruitment during the COVID-19 Pandemic: Temporary Solution or Necessary Evolution?
PI: Zachary Winthrop, Kelly McCullagh, & Debra Boyer
Synopsis: Assesses the use of virtual recruitment versus in-person recruitment modalities during interview days in residency and fellowship programs
Status: Data collection complete; analyses in progress
