421 - Development, Implementation and Mixed-Methods Evaluation of a Blended Complex Care Curriculum for Pediatric Residents

Poster Number: 421
Publication Number: 421.1530

Background: Children with medical complexity (CMC) represent an increasing proportion of hospitalized patients. There is a critical need for formal training opportunities in pediatrics residency to ensure learners are prepared to care for CMC. Blending online modules with hands-on sessions may maximize learning opportunities in a busy clinical rotation.

Objective: To 1) develop a multi-modal, interprofessional complex care (CC) curriculum, 2) identify changes in residents’ confidence and skills in inpatient care of CMC, and 3) determine if changes are sustained over time.

Design/Methods: Using CC Entrustable Professional Activities as a framework, a CC curriculum with online modules and hands-on sessions was co-developed by nurse practitioners, nurses and physicians. Topics included pain in CMC and care for medical technology (Fig 1). Residents participated in the curriculum during a 2-week inpatient CC clinical rotation at a quarternary children’s hospital. We performed a prospective pre-post intervention study July 2022-Oct 2023. Residents reported confidence, ability to perform clinical activities in the care of CMC and changes in practice via an e-survey. Data was collected before, immediately after and 2 months after the intervention. Knowledge was evaluated using pre-post online module tests. Confidence and knowledge question scores were compared using Wilcoxon signed-rank tests. Free-text answers were analyzed using qualitative content analysis.

Results: The curriculum was delivered to 50 residents; 24 (48%) participated in the study. Most were second year and all reported prior inpatient care of CMC (Fig 2). Completion rate for the pre-, post-, and delayed post-intervention surveys were 48%, 32%, and 20%, respectively. Residents’ mean self-reported confidence to perform clinical activities in the care of CMC increased significantly after the curriculum (1.92 to 3.0 on 5-point Likert scale, all p< 0.05) (Fig 3). Changes were sustained 2 months after intervention. Combined knowledge scores for online modules showed significant improvement (mean score 7.1 to 9.2, p=0.03). Qualitative analysis of reported changes to practice is in progress.

Conclusion(s): This study provides insights into the feasibility and effectiveness of educational strategies in inpatient CC for pediatric residents. Participation in a novel multi-modal CC curriculum was associated with a sustained increase in self-reported ability to perform essential clinical activities in the care of CMC, with reported changes to practice. Further studies should include corroborating clinical skills assessments after participation in the curriculum.