An interdisciplinary group for parents of children with hemangiomas.

Parents are shocked by the unexpected appearance and growth of hemangiomas, the most common benign tumors of childhood, yet parents' psychosocial needs are largely ignored. A psychoeducational/self-help pilot group for parents is described in this article. The Mental Health Inventory and a 44-item questionnaire were used to gather pertinent biopsychosocial data. Parents were more distressed and had less of a sense of well-being than the general population. Medical complications were significantly associated with the couple's distress (P < 0.05). Parental perception of hemangiomal surface area or site was not correlated with parental distress. Therapists clinically assessed parental distress, presented coping strategies for parents and families, and discussed medical information about hemangiomas and normal childhood development.

Physicians' attitudes toward and knowledge of child care.

A questionnaire designed to elicit information about training in child-care issues, frequency of discussion during office visits, and attitudes regarding specific medical and developmental issues of child care was sent to randomly chosen board-certified family practitioners and pediatricians in District 3 of the American Academy of Pediatrics. Among respondents, 39% said they felt uncomfortable discussing child-care issues and 85% felt that their training in this area was inadequate. Forty-three percent reported rarely or never discussing child care during an initial visit. More formal training is needed to address issues of child care.

Confidence weighted answer technique in a group of pediatric residents.

Physicians who are excessively underconfident or overconfident about their knowledge may have impaired clinical judgement. Confidence weighting of multiple choice examinations asks test-takers to state how confident they are that the answers they selected are correct. This previously described method allows the examinee to receive 'overconfidence' and 'underconfidence' scores. This study was designed to test the hypothesis that these scores would correlate with faculty assessment of pediatric residents' confidence level as observed in the clinical setting. Thirty-three pediatric residents took an examination of general pediatric knowledge using confidence weighting method. Percentage of questions answered correctly ranged from 40 to 81%. There was an association between increasing overconfidence and lower examination scores (r = 0.58; p = 0.001). Increasing overconfidence was also associated with decreasing underconfidence (r = 0.38; p = 0.04). Five faculty members, the program director and the chief resident were asked to rate their perceptions of the residents' confidence on a Likert-type scale. The period of observation ranged from 9 months to 3 years. Linear regression demonstrated an association between underconfidence indices and observed confidence in the clinical setting (r = 0.39; p = 0.03). In addition, three of four residents who left the program had either over- or underconfidence indices greater than one standard deviation from the mean. These results indicate that the multiple choice examination with confidence weighting can predict residents who will be judged as underconfident by clinical preceptors. This finding is important in light of our impression that such house officers often have difficulties later during their residencies.