
The APPD Subspecialty Pediatrics Investigator Network (APPD SPIN) is a medical education research network for the Pediatric Subspecialties to evaluate the education and assessment of fellows. SPIN began as a collaborative effort of the American Board of Pediatrics, the APPD Fellowship Committee, APPD LEARN, the Council of Pediatric Subspecialties and each pediatric subspecialty's program director network. In 2020, SPIN became APPD SPIN, a network of APPD LEARN.
The Advanced Practice Provider’s (APP's) Role in Fellow Medical Education and Training: A Mixed Methods
Survey to Evaluate Current Educational Interactions, Perspectives, and Models
PI: Jennifer Berger
Synopsis: The goal of this project is to gain an understanding of how APPs and fellows interact in the pediatric
practice setting including fellow-specific surveys and program director surveys.
Status: Planning
Studies Currently Ongoing
Preparing Subspecialist to Meet the Mental Health Needs of Their Patients: An Assessment of Fellowship Training
PI: Rebecca Sanders
Synopsis: This survey aims to determine attitudes of fellowship program directors and recent fellowship graduates regarding the importance of mental health care as part of subspecialty care, the importance of mental health care in fellowship, and the perceived adequacy of mental health care training in fellowship. It also aims to determine the different types of mental health conditions seen by subspecialists in training and in practice, and the proportion of patients who have those mental health conditions.
Status: Data Collection
Well-Being, Stress, and Burnout in Fellows
PI: John Mahan
Synopsis: This survey aims to assess burnout, well-being, and stress in fellowships. Aims include describing the epidemiology and relationships between burnout, resilience, empathy, and confidence in providing compassionate care in pediatric fellows; Defining the natural history of these parameters over time in fellows during training; Identifying the modifiable factors that increase or decrease the risk of developing burnout and promoting positive wellness factors; and developing and testing different interventions (such as in-person seminars, online mind-body skills training, and individualized curricula such as global health electives) to affect burnout, resilience, empathy, compassion, and wellness. The estimated time to participate is about 10 minutes. All fellowship program directors and fellows in ALL subspecialties are eligible to participate.
Status: Recruiting for Spring 2025 Survey
Influence of Scholarly Activity on the Academic Identity Formation During Pediatric Subspecialty Training
PI: Nicolle Fernandez Dyess
Synopsis: This survey is being conducted to detail the experience with and opinions of scholarly activity during pediatric subspecialty training. We are interested in the views of all current pediatric fellows, regardless of what type of scholarly activity they are pursuing.
Status: Data analyses in progress
Understanding In-Person Second Looks in Pediatric Subspecialty Recruitment
PI: Debra Boyer
As we have moved towards virtual interviewing in pediatric subspecialties, this study seeks to understand the logistics, benefits, and challenges of offering in-person second looks to our applicants. Two surveys will be distributed: one for FPDs and another for newly matched fellows.
Status: Data analyses in progress
Relationship between Mechanical Ventilator Test Performance with Pediatric Critical Care Fellow Entrustment for Ventilatory Management
PI: Richard Mink
Synopsis: Examine whether a test of mechanical ventilation (for which validity evidence was previously obtained) can accurately predict fellow entrustment for managing the ventilator of seriously ill infants and children; determine if the percent of correct answers on a test of knowledge of mechanical ventilation can predict entrustment of pediatric critical care fellows to manage the ventilation of seriously ill infants and children and is correlated with the fellow’s assigned LOS for managing a mechanical ventilator
Status: Data analysis
Career Development for Fellowship Program Directors
PI: Jennifer Kesselheim
Synopsis: Determine how fellowship program directors (FPDs) prepare for and are supported in the role; determine the influence that being an FPD has on individual professional development more broadly
Status: Data analysis
Validation of a Novel Task Specific Checklist for Transport Medical Control Performance by Pediatric Subspecialty Fellows
PI: Ryan Good
Synopsis: Assess the internal structure of the newly developed transport medical control (TMC) task-specific checklist for pediatric acute care subspecialty fellows; measure faculty reaction to the TMC task-specific checklist; measure the association between scores on the TMC task specific checklist and faculty level of supervision
Status: Data analysis
Understanding Program Efforts to Improve Recruitment of Underrepresented Medicine Residents to Pediatric Subspecialities
PI: Jennifer Kesselheim
Synopsis: Understand how pediatric subspecialty fellowship program directors attend to data about applicants’ diversity in the fellowship recruitment process; describe what efforts pediatric subspecialty fellowship program directors take towards recruiting a diverse fellowship class; Identify the barriers pediatric subspecialty fellowship program directors face in recruiting a diverse fellowship class.
Status: Manuscript drafting
Longitudinal Evaluation of the Required Level of Supervision for Pediatric Fellows
PI: Rich Mink, MD, MACM
Synopsis:
The specific aims of this project are:
- To obtain validity evidence for the subspecialty‐specific and scholarship EPA level of supervision scales
- To determine the developmental progression of levels of supervision for all EPAs (common and subspecialty‐specific) during the 3 years of fellowship and
- To investigate whether graduating pediatric fellows are meeting the previously defined minimum levels of supervision
- To determine if the time in training at which pediatric fellows meet the previously defined minimum levels of supervision differ among the subspecialties
- To determine if there is a level of supervision for any EPA below which remediation for poor performance is performed
- For learners in which remediation was initiated, to determine if the level of supervision rating guided the decision to do so.
- To compare level of supervision assessments made by the Clinical Competency Committee (CCC) with those of the pediatric fellow
- For the Scholarship EPA, to examine the association between the level of supervision rating and the milestone level of the competencies mapped to the EPA
- To investigate the thought process of the rater in deciding what constitutes a simple versus complex case
- For the 5 EPAs that cross the generalist to subspecialist roles, to compare the level of supervision assigned to a resident at graduation to the level assigned at first assessment as a fellow
Status: Manuscript drafting
Scholarly Activity Training During Fellowship
PI: Erika Abramson, MD, MS
Synopsis:
The specific aims for this project are:
- Understand resources available across fellowship programs to support fellow scholarly activity and identify perceived barriers to effective scholarly activity training
- Understand fellowship program director attitudes toward scholarly activity training during fellowship generally and satisfaction with current fellow experiences in their own program
- Identify factors associated with a) scholarly productivity during fellowship and b) fellowship director satisfaction with scholarly activity training in their program
Status: Data collection and analyses complete; manuscript published
Central Venous Catheter Insertion Competency in Pediatric Critical Care Medicine Fellows
PI: Donald Boyer
Synopsis: Determine how a central venous catheter insertion (CVC) competency checklist performs compared to other standards of CVC insertion competency assessment in clinical practice.
Status: Data collection complete; analyses in progress
A Novel Leadership Assessment Tool for Pediatric Critical Care Fellows
PI: Angela Czaja
Synopsis: Assess the internal structure of the newly developed leadership assessment tool for pediatric critical care fellows; measure the association between scores on the leadership tool and other measures of leadership competency such as Milestones or EPAs.
Status: Data collection complete; analyses in progress
A Characterization of ECMO Training Practices in Pediatric Fellowships: Are We Doing Enough?
PI: Loren Farley
Synopsis: Characterize the currently used methods of teaching ECOM to fellows; compare training methods across specialties; investigate potential gaps
Status: Data collection complete; analyses in progress
Assessing the Association Between EPAs, Competencies and Milestones in the Pediatric Subspecialties
PIs: Bruce Herman, MD and Rich Mink, MD, MACM
Synopsis:
- For six of the seven common EPAs, to determine if there is a specific milestone level at which a fellow is deemed entrustable.
- For six of the seven common EPAs, to compare the milestone level at which fellows are deemed entrustable across the pediatric subspecialties and to determine if any specific competencies are more influential in the entrustment decision than others.
- For six of the seven common EPAs, to compare the initial overall impression of fellow level of entrustment made by the Fellowship Program Director with that determined by the Clinical Competency Committee after the milestone levels are assigned
Status: Data collection complete; analyses and manuscripts in progress
Level of Supervision for Graduating Fellows
PI: Rich Mink, MD, MACM
Synopsis:
For each of the 7 EPAs, determine the opinion of fellowship program directors (FPD) about:
- The minimum level of supervision a fellow must achieve to complete fellowship
- Whether a fellow should be allowed to graduate if this level is not met
Status: Data collection and analyses complete; manuscripts published
Utilization of EPAs in the Pediatric Subspecialties and Barriers to their Use
PI: Rich Mink, MD, MACM
Synopsis:
Primary Aim:
- To identify the facilitators and barriers to using EPAs to assess pediatric fellows
Secondary Aims:
- To determine how EPAs are currently being utilized in pediatric fellowships
- To examine the process used by CCCs in assigning the EPA level of supervision for their fellows, the time the CCC devotes to making the decision and the information used to make the decision
- To gauge FPD opinions about the value of using EPAs versus milestones to assess fellow progress in training
- To describe how a FPD’s assignment of level of supervision for the various EPAs factors into the determination of fellow readiness for graduation
- To compare and contrast responses among the subspecialties
Status: Data collection complete; analyses in progress
The Effect of the COVID-19 Pandemic on Pediatric Fellowship Training
PI: Monique Naifeh
Synopsis: Examine the impact of the COVID-19 pandemic on the education of pediatric fellows with a specific focus on clinical care, including redeployment of fellows and impact on procedural experience; educational conference structures and adaptations; and scholarly activity. Examine the impact of the COVID-19 pandemic on fellow wellness/fellowship program morale.
Status: Data collection complete; analyses in progress
National Needs Assessment of Telemedicine in Pediatric Fellowship Training
PI: Nicole Paradise Black
Synopsis: The study aims to ascertain 1) current fellow trainee exposure to telemedicine; 2) fellowship program use of formalized curriculum for telemedicine instruction and exposure; 3) barrier to implementation of telemedicine; 4) fellowship director interest in curriculum development and national collaboration.
Status: Data collection complete; analyses in progress
Residency Milestones in Fellowship Programs
PI: Suzanne Reed, MD
Synopsis:
The purpose of this study is to:
- Determine the extent to which fellowship programs utilize residency milestones for their newly entering fellows.
- Determine the perceived value of residency milestones in fellowship programs for use with newly entering fellows.
Status: Data completion and analyses complete; manuscripts published
Each subspecialty may designate up to two representatives who serve on the SPIN Steering Committee and are responsible for recruitment and communication within their subspecialty.
Subspecialty | Representative 1 | Representative 2 |
Adolescent Medicine | Sarah Pitts | Orquidia Torres |
Cardiology | Brad Robinson | Ruchika Karnik |
Child Abuse | Bruce Herman | Mary Moffatt |
Critical Care Medicine | Angela Czaja | Don Boyer |
Developmental and Behavioral Pediatrics | Jill Fussell | Pam High |
Emergency Medicine | Deborah Hsu | Melissa Langhan |
Endocrinology | Diane Stafford | Tandy Aye |
GI | Cary Sauer | Daniel Kamin |
Hematology-Oncology | Scott Moerdler | Mark Atlas |
Hospital Medicine | Vanessa McFadden | Michelle Lopez |
Infectious Diseases | Scott James | Kammy McGann |
Neonatology | Christiane Dammann | Patricia Chess |
Nephrology | John Mahan | George Roshan |
Pulmonary Medicine | Pnina Weiss | Jennifer Rama |
Rheumatology | Megan Curran | Stacey Tarvin |
ABP | David Turner | |
APPD LEARN | Alan Schwartz | |
Anna Sombrio | ||
Avery Ulrich | ||
Richard Mink |