736 - Not Your Typical 5 O’Clock Shadow: Evaluation of a Resident Shadowing Program for Pediatric Nurses

Publication Number: 3712.736

Erika M. Monasch, Stanford University School of Medicine, Mountain View, CA, United States; Nicole Barsanti, Children's Hospital Colorado, Denver, CO, United States; Jocelyn L. Lazaro, Stanford Medicine Children’s Health, San Francisco, CA, United States; Jennifer Vargas, Lucile Packard Children's Hospital Stanford, South San Francisco, CA, United States; Cynthia A. Smith, UCSF Benioff Children's Hospital San Francisco, San Francisco, CA, United States; Caroline X. Qin, Lucile Packard Children's Hospital Stanford, Palo Alto, CA, United States; Jennifer Mangena, Lucile Packard Children's Hospital Stanford, Concord, CA, United States; Lauren Destino, Lucile Packard Children's Hospital Stanford, Menlo Park, CA, United States; Caroline Rassbach, Stanford University School of Medicine, Palo Alto, CA, United States

Background: Collaboration between nurses and physicians has been shown to improve the quality and safety of patient care. Nurse/physician shadowing is one method of interprofessional education that can foster better understanding of roles and communication between team members. However, there is limited knowledge of the benefits of nurses observing residents' activities outside of morning rounds.

Objective: We sought to evaluate the impact of an afternoon shadowing program on role clarification, communication, and collaboration between pediatric nurses and residents.

Design/Methods: This mixed-methods, IRB-exempt, survey-based study took place at a large, university-based children's hospital during the 2024-2025 academic year. Pediatric nurses shadowed first-year residents in the inpatient, acute-care setting for four hours in the afternoon through evening sign out. We surveyed nurses and residents after the shadowing experience using an anonymous, web-based survey, containing Likert and open-ended questions as well as the Interprofessional Collaborative Competency Attainment Survey (ICCAS). We analyzed quantitative data with descriptive statistics and paired T-tests, and we performed content analysis of the qualitative data.

Results: All 39 nurses and 39 residents who participated in our shadowing program completed the post-session survey. The majority of participants reported the experience met its learning objectives (57/78, 73%) and prompted discussion of interprofessional collaboration between residents and nurses (54/78, 69%) to a large or very large extent. Both nurses and residents had higher mean ICCAS scores following the shadowing experience (Table 1). Qualitatively, participants found the experience promoted role and responsibility clarification, communication improvement, empathy-building and perspective-sharing, relationship/team-building, provider collaboration, and knowledge-sharing (Table 2).

Conclusion(s): Afternoon shadowing of pediatric residents by pediatric nurses offers a unique opportunity for both residents and nurses to learn about one another's jobs and encourages interprofessional collaboration in the academic health care setting. Further research is needed to understand the long-term impact of such a program on providers' communication skills and patient care outcomes.

Table 1: Mean Scores on the Retrospective Pre-/Post- Interprofessional Collaborative Competency Attainment Survey (ICCAS)
Items on ICCAS were scored on a five-point Likert-type scale; 1= strongly disagree, 2= slightly disagree, 3= neutral, 4= slightly agree, 5= strongly agree. The mean score was obtained by finding each participants' average score from their responses to 20 items.
For qualitative differences: "Large" = values of ≥ 0.8, "Moderate" = values between 0.50-0.79, and "Small" values between 0.2-0.49

Table 2: Selected Quotes Representing What Participants Found Helpful or Surprising About Their Experience