TOP 6 - Building NICU Expertise: A Targeted Curriculum in Response to ACGME Changes

Publication Number: 1766.TOP 6

Olivia V. Cangellaris, Comer Children's Hospital at University of Chicago Medical Center, Chicago, IL, United States; Deborah M. Adegbosin, Comer Children's Hospital at University of Chicago Medical Center, Chicago, IL, United States; Rinky Patel, Comer Children's Hospital at University of Chicago Medical Center, Chicago, IL, United States; Brandon Trandai, Univeristy of Chicago Medical CEnter, Chicago, IL, United States; Anu Elangovan, Comer Children's Hospital at University of Chicago Medical Center, Chicago, IL, United States; Elzbieta Kalata, University of Chicago Division of the Biological Sciences The Pritzker School of Medicine, Chicago, IL, United States; Kuang Chuen Liu, Comer Children's Hospital at University of Chicago Medical Center, Chicago, IL, United States; Thomas Stringer, University of Chicago Division of the Biological Sciences The Pritzker School of Medicine, chicago, IL, United States; Christine Carlos, University of Chicago Division of the Biological Sciences The Pritzker School of Medicine, Chicago, IL, United States; Gillian Brennan, Comer Children's Hospital at University of Chicago Medical Center, Chicago, IL, United States

Background: Recent ACGME changes to pediatric residency training risk decreased trainee exposure to neonatal medicine and critical topics of ICU level care. With the overall reduction of required neonatal intensive care unit (NICU) time from 8 to 4 weeks, residents will have significantly less real-world experience with common neonatal procedures and exposure to complex neonatal pathophysiology and clinical management. In our program, residents have seen a 33-50% decrease in NICU time. With less exposure, residents may not realize how crucial understanding neonatal pathophysiology and sequela are to a general pediatrician caring for NICU graduates in clinic. We conducted a Needs Assessment of faculty, fellows, and residents to understand their perspective of the recent reduction in NICU exposure and its impact on resident training. Findings informed the creation of a structured NICU Resident Curriculum designed to strengthen core neonatal knowledge and skills despite reduced clinical time.

Objective: To determine the perceived need for a dedicated pediatric resident NICU curriculum and to evaluate the effectiveness of a focused educational program to improve resident competency and foundational neonatal knowledge.

Design/Methods: A Needs Assessment was distributed to NICU faculty and fellows, and pediatric residents (Fig 1). The anonymous results were organized and analyzed with modified Likert scale and Mann-Whitney U statistical analysis, as will be applied to the pre/post survey data. Comparison between faculty (N=13), fellows (N=9), and residents (N=23) show consensus that a dedicated NICU curriculum is needed; however, residents have markedly less conviction their ability to manage NICU emergencies will be affected (Fig 2). This discrepancy likely reflects a deeper issue: limited NICU exposure has left residents without sufficient appreciation for the complexity and critical importance of neonatal care, underscoring how lack of experience can blunt recognition of educational priorities.
A 6-lecture curriculum is given to residents at the start of their NICU rotation. Anonymous pre- and post-surveys distributed via RedCap are completed before and after the curriculum, respectively. The survey questions are identical to assess resident perceived competence regarding the lecture topics with modified Likert scale and include knowledge-check questions to quantitatively assess knowledge growth following the curriculum. These data presented are a pilot study of the curriculum. A subset of data has been analyzed (Fig 3) and analysis will be complete by mid-January 2026. This project is IRB-exempt.

Figure 1: Needs Assessment respondent demographics.
Respondent demographics of Needs Assessment. Pie charts illustrate breakdown of NICU Faculty experience in years (left); NICU Fellow year and NICU exposure from residency (middle); and Pediatric Resident post-graduate year and NICU experience in months (right).

Figure 2: Comparison of Needs Assessment results amongst faculty, fellows, and residents.
Likert scale responses of Needs Assessment results from NICU Faculty, NICU Fellows, and Pediatric Residents, plotted in stacked bar graphs. Collectively, faculty respondents indicate a strong need for a dedicated curriculum and that resident competency in managing neonatal emergencies/critical care concepts will be significantly impacted by ACGME changes. Neonatal fellows recognize a need for a dedicated curriculum, with the majority concerned that decreased NICU time will significantly impact resident competency in managing neonatal emergencies/critical care concepts. Pediatric residents recognize a need for a dedicated curriculum and perceive only moderate impact to their competency in managing neonatal emergencies/critical care concepts. Faculty have significant concern that pediatric residents' exposure to essential neonatal care principles and management will be significantly impacted; and fellows and residents have a similar breakdown in how important they feel it is that a general pediatrician is able to care for a NICU graduate, with the majority recognizing it as moderately or significantly important.

Figure 3: Impact of NICU curriculum on resident perceived competency.
Preliminary data of pre- and post-survey Likert scale responses displayed as stacked bar graph. Isolated PGY-1 (left column) and PGY-2 (right column) results are shown, demonstrating lower perceived competence and comfort pre-curriculum with overall significant improvement in perceived competence and comfort post-curriculum in all categories except procedures (intubation and umbilical line placement).