Changes in Pediatric Residents' Perceptions of Their Continuity Experience During Their Training: A National Study

• Published in: Ambulatory pediatrics : the official journal of the Ambulatory Pediatric Association Vol. 5; no. 4; pp. 221 - 227
• Main Authors: Feigelman, Susan, Olsson, John, Drutz, Jan, Dungy, Claibourne I., Lopreiato, Joseph, Serwint, Janet R.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2005; Elsevier Science Ltd
• Subjects: Accreditation Council for Graduate Medical Education; Ambulatory Care - methods; Attitude of Health Personnel; competencies; Continuing education; continuity; Continuity of Patient Care - statistics & numerical data; Cross-Sectional Studies; Humans; Internship and Residency; Medical residencies; Occupational training; Pediatrics; Pediatrics - education; Pediatrics - organization & administration; Physician-Patient Relations; Practice Management, Medical; Preceptorship - standards; Preceptorship - statistics & numerical data; Primary care; Primary Health Care - methods; Professional Autonomy; resident education; Social Responsibility; Surveys and Questionnaires; Time Factors; training level; United States; United States; continuity; competencies; training level; resident education; Accreditation Council for Graduate Medical Education
• ISSN: 1530-1567; 1876-2859; 1539-4409; 1876-2867
• DOI: 10.1367/A04-137R1.1

Objective.— To determine how pediatric residents' perceptions of continuity clinic experiences vary by level of training, after controlling for the effect of continuity setting. Method.— Cross-sectional survey of pediatric and combined pediatric trainees in US residency programs. Results.— Survey responses were received from 1355 residents in 36 training programs. Residents' continuity experiences were in hospital-based and community settings. Numbers of patients seen increased between PGY-1 and PGY-3 years, but not in the PGY-4 and PGY-5 years. Compared to PGY-1 residents, PGY-2 and PGY-3 residents were more likely to report more encounters with established patients, but were not more likely to feel like the primary care provider. There were no significant differences by training level in terms of involvement in panel patients' laboratory results, hospitalizations, or telephone calls, although nursery involvement decreased with increasing training level. Autonomy was directly related to training level. The perception of having the appropriate amount of exposure to practice management issues was low for all respondents. Conclusions.— Residents perceived that they had greater autonomy and continuity with patients as they become more senior, yet they were not more likely to feel like the primary care provider. Lack of increased involvement in key patient care and office responsibilities across training years may reflect a need for changes in resident education. These data may be helpful in formulating recommendations to program directors with regard to determining which Accreditation Council for Graduate Medical Education competencies should be emphasized and evaluated in the continuity experience.