Background: Twenty-one percent of U.S. children live in poverty. Population-based studies indicate an association between poverty and higher emergency department (ED) utilization rates. Given that EDs serve as continuous points of access within our nation’s health care system--for social as well as medical emergencies—providers must be well-equipped to understand and meet the specific needs of children living in poverty and to effectively address their social determinants of health (SDH) in the ED setting. The Accreditation Council on Graduate Medical Education (ACGME) does not specify requirements for training related to child poverty or SDH in PEM fellowships; currently, there is no “standard” curriculum focused on these topics for PEM fellows. Enhanced training related to these topic areas could result in better-equipped PEM physicians and improve care for vulnerable children. Methods: An IRB-approved survey study to inform development of a curriculum in child poverty and SDH for PEM fellows was completed in a single PEM fellowship program associated with an urban, tertiary children’s hospital. The study sought to answer 3 key questions: (1) Do PEM fellows perceive a need for additional training related to child poverty and SDH?; (2) What specific topic areas do they perceive are most important and encountered most frequently in the clinical setting; and (3) What educational methods would be preferred for learning about these topics? Utilizing Kern’s 6-Step Curriculum Development Approach as a theoretical framework, a targeted needs assessment was completed within a single PEM fellowship program. An anonymous, electronic questionnaire was developed to collect both quantitative and qualitative data from respondents. Survey item generation was informed by a literature search and review of published curricula related to poverty and SDH, as well as through interviews with child health professionals representing multiple disciplines, including PEM. The survey was pilot tested by faculty and trainees at our institution, with revisions made based on feedback. Descriptive statistics were used to analyze responses to quantitative survey items, and qualitative responses were analyzed for themes. Results: The study target population included all fellows within a single PEM program. All (6/6; 100%) members of the target population completed the study questionnaire. Five of six (83.3%) respondents were “very interested” in a proposed curriculum related to child poverty and SDH. From a list of 20 proposed topic areas, 6 emerged as being most “high-yield,” based on a high level of agreement among respondents that these areas were “highly important,” encountered frequently in clinical practice, and were less familiar to them. The proposed educational methods most preferred by respondents included: (1) case-based discussions; (2) discussion of relevant videos/films; and (3) traditional didactic presentations. Conclusions: Responding fellows indicated a high level of interest in a proposed curriculum related to child poverty and SDH in PEM; several topic areas emerged as “high priority” for fellows at a single institution based on survey responses. Study limitations include its small sample size, and that respondents represent only a single program. Further study is warranted to assess interest in a proposed curriculum related to child poverty and SDH among PEM fellows nationally, and to identify “high-yield” topic areas based on responses from a larger and broader sample of PEM fellows.
Assessing the Learning Needs of Pediatric Emergency Medicine Fellows Related to Child Poverty and Social Determinants of Health: a Curricular Needs Assessment Study
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Jerri A. Rose; Assessing the Learning Needs of Pediatric Emergency Medicine Fellows Related to Child Poverty and Social Determinants of Health: a Curricular Needs Assessment Study. Pediatrics January 2018; 141 (1_MeetingAbstract): 339. 10.1542/peds.141.1MA4.339
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