703 - Assessing the Role of Fellowship Training in Pediatric Urgent Care: A Multi-Stakeholder Survey

Publication Number: 2686.703

Aaron Maki, Nationwide Children's Hospital, Gahanna, OH, United States; Deena Berkowitz, Children's National Health System, Washington, DC, United States; Jordan Hammond, Humanitas University, Milan, Lombardia, Italy; Natan Cramer, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States

Background: Several pediatric urgent care fellowship programs in the past 5 years have been created to meet the demand of a growing field, with some achieving APA accreditation. However, their role in preparing pediatricians for practice remains unclear. We conducted a national survey of pediatric urgent care fellowship program directors, fellowship graduates, and non-fellowship urgent care pediatricians to assess the perceived value and impact of fellowship education.

Objective: To inform future fellowship training and workforce development in Pediatric Urgent Care.

Design/Methods: We conducted cross-sectional surveys (RedCap©) by email of 3 primary stakeholders, including leadership of 5 established fellowship programs, all known fellowship graduates, and to pediatric urgent care pediatricians. The survey consisted of 32 questions with domains covering demographics, pediatric residency education, and leadership skills training. Pilot studies by multiple members and a medical education specialist were conducted. This study was approved by Children's National IRB.

Results: Thus far, 38% (29/76) participants have responded; data collection continues. Most respondents work in an academic setting and are non-fellowship trained pediatric urgent care pediatricians (17/29, 59%) (Table 1). Almost half of this cohort (8/17 47%) sought supplemental training post-residency. While most physicians (27/29, 93%) reported career satisfaction, the majority (62%) felt that structured training post-residency would be helpful and enhance confidence (77%) in early-career urgent care practice.
While pediatric residencies emphasize patient communication, 66% reported inadequate procedural experience (Figure 2), especially in orthopedic procedures and point-of-care ultrasound. Procedural competence was the most common benefit of pediatric urgent care fellowship training identified by fellowship graduates (9/9) and leaders (9/10).
From a leadership standpoint, residency fosters strong teaching and communication skills (Figure 3), and 70% of leaders view communication as a core competency for pediatric urgent care providers.

Conclusion(s): While most respondents were non-fellowship trained physicians, most report a perceived benefit to pediatric urgent care fellowship in supplementing training gaps from pediatric residency. While residency provides the adequate training in patient communication, fellowship adds on significant procedural experience to ensure competence. We recommend further evaluation of training details to overcome knowledge gaps of recent pediatric residency graduates.

Table 1
Demographics of Respondents. N=29

FIgure 2
Clinical Skills for which Pediatric Residency Provides Adequate Training. N=29

Figure 3
Leadership Skills for which Pediatric Residency Provides Adequate Training. N=29