Claire Stewart, MD, MEd
Asst Professor of Pediatrics, Division of Critical Care Medicine
Nationwide Children's Hospital At Ohio State University, United States
Disclosure information not submitted.
Rohali Keesari, MPH, PharmD
Biostatistician-I, Biostatistics Resource
Nationwide Children's Hopsital, United States
Disclosure information not submitted.
Markita Suttle, BS, MD
Assistant Professor of Pediatrics
Nationwide Childrens Hospital
Westerville, Ohio, United States
Disclosure information not submitted.
Title: The Impact of Just-in-Time Training on Self-Efficacy in Pediatric Residents
INTRODUCTION/HYPOTHESIS: In medical education, self-efficacy describes one’s ability to take raw knowledge and apply it in a patient care context. In the ever-growing supervisory and safety culture of medical training, trainees continue to report low levels of autonomy and comfort with independent decision making, specifically with regards to acute patient decompensation. The goal of this study was to describe the self-efficacy of pediatric residents in acute care management. We hypothesized that a Just-in-Time Training (JiTT) curriculum would improve resident self-efficacy as measured by a validated self-efficacy tool.
Methods: During night float rotation, pediatric residents completed a modified Pediatric Resuscitation and Escalation of Care Self Efficacy Survey (PRSES) to obtain baseline self-efficacy data. The primary investigator led residents in JiTT educational sessions tailored to their highest acuity and most at-risk patients. These sessions included a discussion of the trainee’s mental model and suggested management, as well as procedural practice. At the end of their night float rotation, residents were asked to complete a post-intervention PRSES and satisfaction survey.
Results: Fifty-five pediatric and internal medicine/pediatric residents participated in the JiTT sessions with 37 completing pre and post PRSES (67% response). Thirty-three percent of the participants were interns, 39% second years, and 28% were third and fourth years. Forty-nine percent of participants had not rotated through the PICU and 45% had never participated in a code event. Prior to JiTT, the mean resident self-efficacy score was 38 (SD ± 4.9), slightly higher than resident scores reported in the validation study for the PRSES. Mean resident self-efficacy scores significantly increased after JiTT to 41 (SD ± 5.4, p< 0.001).
Conclusions: Baseline self-efficacy scores of pediatric residents in acute care management at our institution were slightly higher than previously reported scores. JiTT improved pediatric residents’ self-efficacy in acute care management. Further studies are warranted to explore the sustainability of self-efficacy and assess the feasibility of implementing JiTT curricula on a larger scale.