Creation of a novel longitudinal pediatrics resident curricular program addressing the medical and social needs of children with medical complexity

OBJECTIVE: To implement a newly created, longitudinal resident program for the comprehensive care of children with medical complexity (CMC) and to evaluate change in resident confidence in both medical and social domains. 

STUDY DESIGN: Using Kern's six-step method of curriculum development, we developed and implemented a curricular program at our institution for all pediatrics residents across an academic year from 2023-2024. Program evaluation used retrospective pre- and post-surveys of pediatrics residents assessing overall confidence in completing tasks related to the care of CMC based on published entrustable professional activities. 

RESULTS: Initial needs assessment data showed that 69.7% of residents felt comfortable/very comfortable caring for CMC in the hospital. In the outpatient setting, >66.7% felt uncomfortable/very uncomfortable and 78.8% were overall uncomfortable. Retrospective pre- and post-surveys showed improved resident confidence in all 14 assessed tasks with a mean change of 0.63 as measured using a five-point Likert scale, with a P value of <0.01 for all changes. 

CONCLUSION: A novel, integrated, longitudinal curricular program addressing medical and social aspects of CMC care grounded in adult-learning theory and conceptual frameworks was associated with significant improvements in resident confidence.