125 - Needs Assessment for an Inpatient Curriculum for Pediatric Residency

Publication Number: 4123.125

Natalia A. Kot, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States; Heidi Kloster, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States; Kristina Singh-Verdeflor, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States; Daniel Sklansky, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States

Background: The Accreditation Council for Graduate Medical Education (ACGME) changed pediatric residency requirements, beginning July 1, 2025, with the effect of adding 12 weeks of ambulatory and mental health experiences. Many programs reduced inpatient experiences by 12 weeks to meet that need.

Objective: We developed a targeted needs assessment of stakeholders within our pediatrics department to determine if a curricular intervention is necessary, especially for learners pursuing careers in inpatient pediatrics.

Design/Methods: Using an Entrustable Professional Activities (EPAs) framework, we designed a survey to determine senior fellow and faculty perceptions and predictions of fellow preparedness in current and future states, respectively. The survey also included Likert-based questions for residents regarding content, delivery, and feasibility of an optional inpatient curriculum. Faculty were recruited through visits to division meetings; and trainees were recruited through visits to block conferences, with emailed survey links and reminder emails. Survey results were analyzed using descriptive statistics and Fisher's Exact Test. Logistic regression models were conducted to assess for differences in EPA skill level by specialty.

Results: Surveys were completed during the summer of 2025. A total of 85 responses were collected: 25 residents, 11 senior fellows, and 49 faculty members. The response rate for residents, senior fellows and faculty was 52%, 69%, and 58% respectively. 54% of residents said they were interested in an inpatient curriculum (p = 0.029, CI 0.30 - 0.70) and the most popular content delivery methods were procedure labs (91%) and simulations (87%). Over 90% of faculty and fellows predicted an inpatient curriculum would benefit incoming fellows (p = 0.022, CI 0.76 - 0.96). Table 1 shows EPAs in which beginning fellows are already behind expected levels, most notably in EPAs 2, 4, 9, and 11. Table 2 shows the breakdown of responses to these EPAs by subspecialty. The intensive care specialties were the most critical of their incoming fellows' skills, though not significantly. Table 3 delineates which EPAs were anticipated to be most negatively impacted by the ACGME changes, specifically EPAs 6, 9, and 10.

Conclusion(s): Inpatient-specific learner skills may be impacted by the 2025 ACGME requirements. This study provides an EPA-informed roadmap to improve trainee preparedness based on current and projected gaps, as well as early framework for content delivery. It will be important to measure actual gaps in EPA attainment once trainees experiencing ACGME changes reach fellowship and early employment.

Table 1: EPA Skill Performance Perception by Fellows and Faculty
Please note: the EPAs for pediatric fellowship have been rewritten by the American Board of Pediatrics since the administration of our survey.

Table 2: Breakdown of EPAs 2, 4, 9, and 11 by Subspecialty


Table 3: EPA Skills Perceived to be Negatively Impacted by ACGME Changes
Question was only presented to respondents who previously indicated that ACGME changes may negatively impact EPA skills.