148 - From Overwhelmed to Prepared: the Impact of a Complex Care Inpatient Rotation on Pediatric Trainees

Publication Number: 4145.148

Andrew Watson, University of Alabama at Birmingham, Birmingham, AL, United States; Elizabeth Nichols, University of Alabama School of Medicine, Homewood, AL, United States; Ann Kennon Ulicny, Children's of Alabama, Birmingham, AL, United States; Erinn O.. Schmit, University of Alabama School of Medicine, Birmingham, AL, United States; Madhura Hallman, University of Alabama at Birmingham, Birmingham, AL, United States; Meghan Harrison, University of Alabama School of Medicine, Birmingham, AL, United States; Jordan Lowell, Children's of Alabama, Hoover, AL, United States; Cherith Parrish, Children's of Alabama, Birmingham, AL, United States; Marie Pfarr, Uni, Hoover, AL, United States

Background: Children with medical complexity (CMC) represent a growing population that requires specialized knowledge, effective communication, and coordinated longitudinal care from their pediatric providers. Despite the high healthcare utilization of CMC, which offers frequent and valuable learning opportunities for trainees, the skills required to deliver high-value care to this group have been historically underemphasized in many pediatric residency programs. To address this, our institution developed an inpatient complex care rotation to provide residents with dedicated exposure to CMC, including structured learning through daily rounds, targeted small-group didactics, access to high-yield resources (online modules, “CMC handbook”), simulations with high-fidelity manikins, morning report case presentations, debriefings with trained counselors, and lived-experience sessions with caregivers.

Objective: To augment pediatric residents' confidence, attitudes, and knowledge in providing high-quality, evidence-based, and coordinated care for CMC

Design/Methods: We conducted a literature review and incorporated published entrustable professional activities on caring for CMC into a survey using 5-point Likert-scale questions to assess attitudes, readiness, and comfort caring for CMC, as well as a seven-item knowledge assessment. Between April and October 2025, we surveyed residents at our categorical pediatrics and combined internal medicine-pediatrics residency program.

Results: The survey had 56 respondents (58% response rate among 97 total residents). We then divided respondents into two cohorts: Group A (exposed to the Complex Care rotation, n=12) and Group B (unexposed, n=44) (Table 1). Residents in Group A demonstrated higher scores in several domains with statistical significance (p < 0.05), most notably: feeling adequately prepared to care for CMC; belief that participation in a dedicated complex care rotation solidifies knowledge; enjoyment in caring for CMC; perceived adequacy of time to care for CMC; and comfort managing general inpatient care, feeding and nutritional issues, and motility disorders. Unexposed residents reported higher feelings of being overwhelmed when caring for CMC. Knowledge-based accuracy trended higher among exposed residents, though differences were not statistically significant.

Conclusion(s): An inpatient complex care rotation improved pediatric trainees’ confidence, comfort, and attitudes toward caring for CMC, offering a reproducible model for education on this important population.

Table 1
Table 1 - CMC Med Ed Survey Results.pdfSurvey Results