Clinical Fellow Yale-New Haven Children's Hospital Durham, Connecticut, United States
Background: Use of shared decision-making (SDM) and measurement of its impact on health quality and equity have been a recent focus in medicine. However, how and when to implement SDM has been a challenge in the complex milieu of pediatrics. A rapidly growing body of work is focused on improving the understanding of, training in, and implementation of pediatric SDM. Notably missing from this work are key stakeholders: pediatric trainees. Trainees are essential to our immediate understanding of the complexities of pediatric SDM as they are often the providers with the most facetime with patients and families. Trainees are also key to enacting a lasting change in the culture of SDM as they become the next generation of pediatric providers. Objective: We aimed to assess pediatric trainees’ understanding of, prior training in, comfort level using, perceived frequency of use, barriers and facilitators to use of, and perceived importance of SDM competency to overall pediatric training. Design/Methods: This is a single-institution mixed methods study using a survey and focus groups. An anonymous survey was designed, its face value established by three independent experts, and pilot testing and refinement done using cognitive interviewing. This survey will be distributed to all pediatric (categorical and combined program) residents and first-year pediatric fellows (~100 eligible participants). Analysis will include mode, median, and frequencies for likert-scale questions, frequencies and percentages for multiple-response questions, and regression analysis of any demographic factor-response correlations. Three focus groups will be run: one consisting of interns, one of senior residents and one of first-year pediatric fellows. A draft focus group guide has been generated and will be refined after survey completion in order to further explore dominant themes from the survey. Full transcripts from each group will be analyzed using the constant comparison method and then compared for overlapping and/or unique themes. This study was deemed IRB exempt. Analysis will be complete by April 1, 2024.
