ABSTRACT
OBJECTIVE: To evaluate the preparedness of pediatric residents entering accredited neonatal-perinatal medicine (NPM) fellowships in the United States. STUDY DESIGN: A multi-domain, validated survey was distributed to Program Directors (PDs) of US NPM fellowship programs. The 47-item survey explored 5 domains: professionalism, independent practice, psychomotor ability, clinical evaluation, and academia. A systematic, qualitative analysis on free-text comments was also performed. RESULTS: Sixty-one PDs completed the survey, for a response rate of 62% (61/98). For entering fellows, PDs assessed performance in professionalism positively, including 76% as communicating effectively with parents and 90% treating residents/house-staff with respect. In contrast, most PDs rated performance in psychomotor abilities negatively, including 59% and 79% as deficient in bag-and-mask ventilation and neonatal endotracheal intubation, respectively. Although 62% of PDs assessed entering fellows positively for genuine interest in academic projects, fewer than 10% responded positively that entering fellows understood research protocol design, basic statistics, or were capable of writing a cohesive manuscript well. Thematic clustering of qualitative data revealed deficits in psychomotor ability and academia/scholarship. CONCLUSIONS: On the basis of the perspective of front line educators, graduating pediatric residents are underprepared for subspecialty fellowship training in NPM. To provide the best preparation for pediatric graduates who pursue advanced training, changes to residency education to address deficiencies in these important competencies are warranted.
Subject(s)
Clinical Competence/standards , Fellowships and Scholarships/organization & administration , Internship and Residency/standards , Neonatology/education , Pediatrics/education , Biomedical Research/education , Curriculum , Humans , Surveys and Questionnaires , United StatesABSTRACT
The purpose of the study was to evaluate the impact of a school breakfast program in Sonora, Mexico. The study was conducted in four counties classified as extremely poor. Three hundred children from twelve schools pertaining to three counties under research received a school breakfast; one hundred and fifty children from four schools pertaining to a fourth county did not received school breakfast. Children were four to six years old. Attention, memory and cognition tests were applied before and after the program. Results showed an improvement for those groups receiving the breakfast program, specially on response speed and behavior executions. Group without breakfast showed better results on the pre-test, nevertheless, on the post-test, performances in both groups appear the same. At the beginning of school courses any county was different, but speed in selection and running show significatives differences for the schools. The program shows similar results on response speed, no matter social condition, nevertheless, program differentially affects the number of correct behavior executions on stimulus selection and reproduction. The breakfast program benefit children, but its effects are differentially distributed improving behavioral, repertories depending of children's group vulnerability.
