Use of Health Care Services by Pediatrics Residents: A CORNET Study.

BACKGROUND: The personal health practices of residents and their access to health care has not been well explored. Suboptimal personal health care habits and practices among many physicians may evolve during residency. OBJECTIVE: To identify the nature and extent of pediatrics resident health care use and the factors that restrict or facilitate use. METHODS: A web-based survey was sent to pediatrics residents from 19 continuity practice sites enrolled in the nationwide Continuity Research Network (CORNET) during April through June 2010. Outcome measures included self-report of health care use, involvement in an established care relationship with a primary care provider, and barriers residents encountered in receiving care. RESULTS: Of 1210 eligible residents, 766 (63%) completed the survey. Respondents were 73% women; each postgraduate training year was equally represented. More than one-half of residents (54%) stated they had an established care relationship (ECR) with a primary care provider. Interns were less likely to have an ECR when compared with upper level residents; female residents were twice as likely to have an ECR compared with male residents. Although 22% (172 of 766) of the respondents reported they had a chronic health condition, only 69% (118 of 172) of those individuals had an established care provider. The most significant barrier to obtaining health care was resident concern for time away from work and the potential increased workload for colleagues. CONCLUSIONS: A slight majority of pediatrics residents stated they had an established relationship with a primary care provider. The most common barriers to seeking routine and acute care were work related.

The prevalence and practice of academies of medical educators: a survey of U.S. medical schools.

PURPOSE: Academies of medical educators can be defined as formal organizations of academic teaching faculty recognized for excellence in their contributions to their school's education mission and who, as a group, serve specific needs of the institution. The authors studied the characteristics of academies, including the processes for admission, selection, and retention of academy members; the types of faculty who are academy members; program goals; benefits offered by academies to the individual and to the institution; funding sources and amounts; and the rapid increase in academies since 2003. METHOD: In 2008, the authors sent an online questionnaire to 127 U.S. medical schools. Responses were analyzed using descriptive statistics. To determine differences between groups, multivariate analysis of variance was performed. Correlation analysis (Pearson r) was used to identify association between variables. Effect size was determined using eta squared (eta2). RESULTS: Thirty-six of the 122 responding schools (96% response rate) reported having academies; 21 schools had initiated academies since 2003, and 33 schools were planning or considering academies. There was a statistically significant difference between academies established before 2004 and in 2004 regarding benefits offered to individuals, membership terms and maintenance requirements, and goals. CONCLUSIONS: Rogers' theory of the diffusion of innovation may explain the recent spread of academies. When beginning or reexamining existing academy programs, institutions should consider goals, application process, benefits offered to members as well as the institution, expendable resources, and means of support, because the final product depends on the choices made at the beginning.

Changes in pediatric residents' perceptions of their continuity experience during their training: a national study.

OBJECTIVE: To determine how pediatric residents' perceptions of continuity clinic experiences vary by level of training, after controlling for the effect of continuity setting. METHOD: Cross-sectional survey of pediatric and combined pediatric trainees in US residency programs. RESULTS: Survey responses were received from 1355 residents in 36 training programs. Residents' continuity experiences were in hospital-based and community settings. Numbers of patients seen increased between PGY-1 and PGY-3 years, but not in the PGY-4 and PGY-5 years. Compared to PGY-1 residents, PGY-2 and PGY-3 residents were more likely to report more encounters with established patients, but were not more likely to feel like the primary care provider. There were no significant differences by training level in terms of involvement in panel patients' laboratory results, hospitalizations, or telephone calls, although nursery involvement decreased with increasing training level. Autonomy was directly related to training level. The perception of having the appropriate amount of exposure to practice management issues was low for all respondents. CONCLUSIONS: Residents perceived that they had greater autonomy and continuity with patients as they become more senior, yet they were not more likely to feel like the primary care provider. Lack of increased involvement in key patient care and office responsibilities across training years may reflect a need for changes in resident education. These data may be helpful in formulating recommendations to program directors with regard to determining which Accreditation Council for Graduate Medical Education competencies should be emphasized and evaluated in the continuity experience.