WIP 6 - An Observational Study Assessing the Relationship Between Resident Postgraduate Year and Discharge Communication Competency Within the Pediatric Emergency Department

Poster Number: WIP 6
Publication Number: WIP 6.2394

Background: Residents receive little formal training involving communication with patients and caregivers at hospital discharge. A discharge education curriculum introducing the DISCHARGE mnemonic (Diagnosis, Instructions for home, Sit, Communication, How to take medications, Ability to follow up, Return precautions, Go over questions, Ensure understanding) and observational checklist was previously created and reproduced, showing improved resident comfort and competency in communication at inpatient hospital discharge. The checklist contains nine "yes" or "no" items covering essential components of discharge counseling, with a composite score calculated out of nine. The checklist has not been tested in the emergency department (ED) context or against the ACGME's Milestones 2.0, which have demonstrated consistent improvement in patient- and family-centered communication as residents progress in training.

Objective: This study aims to assess the relationship between resident postgraduate year and discharge communication competency within the Pediatric ED.

Design/Methods: Residents of all training levels from University of Pittsburgh School of Medicine's Pediatrics and Emergency Medicine residency programs were selected via convenience sampling. Informed consent was obtained.

Sixty enrolled residents completed a demographic survey and were video recorded providing discharge counseling to caregivers of pediatric patients who presented to the ED with a chief complaint of fever and were found safe for discharge. Each video was independently assessed by two trained residents using the DISCHARGE checklist and a composite score was calculated.

Multivariable analysis will be used to assess the relationship between resident training level and checklist composite scores while controlling for potential confounders, including residency program and prior training. The interrater and test-retest reliability of the checklist will be reviewed. Cronbach’s alpha will be calculated.

The project was submitted to University of Pittsburgh's IRB and did not meet criteria for human subjects research.