Background: Pediatric Hospital Medicine (PHM) was recognized as its own specialty by the American Board of Medical Specialties in 2016, with the intent to assure “parents, family members and the communities we serve that their physician meets the highest standards of practice and clinical knowledge, and has completed an approved educational program”. Excluding our fellows, none of our departmental staff had completed or enrolled in a fellowship in PHM at the time our curriculum was initiated. Our staff had extensive clinical experiences in the field albeit without academic training beyond a General Pediatrics residency.
Purpose: The new PHM specialty recognized that General Pediatrics residency was insufficient to address the high care burden of currently hospitalized children. To meet this gap, we reviewed and referenced evidence-based study methods from other specialties that were historically shown to be effective in passing medical board examinations and in-training examinations (ITE). A study of 199 American general pediatric residencies demonstrated that increasing the amount of regularly scheduled lectures or conferences improved Boards pass rates on the initial certifying examination. Another study of residents at the Mayo Clinic Internal Medicine Program showed that conference attendance was associated with improved knowledge acquisition and performance on the in-training examination (ITE). An internal medicine residency with declining ITE scores demonstrated that an academic enrichment consisting of strengthened didactic curriculum and improvement in conference attendance in conjunction with use of board review questions improved ITE scores. Based on available data, we composed an academic study program for our PHM group.
Description: A combination of group and individual study was shown to be most effective in success on certifying examinations based on our literature review. Our department provided a free subscription to a gallery of board preparation questions through the American Academy of Pediatrics. Board Learning in Groups (BLInG) was meant to address the group aspect of learning, critical for success on the examination, as well as to identify content specifications that are not mainstream to our practice. We conducted a needs assessment survey to identify topics of interest and areas that were challenging for group members. We developed a curriculum based on the topics identified in the survey and also included areas with which we had limited clinical engagement eg. airway management, sedation for medical procedures, etc. We recruited relevant specialists to teach the unfamiliar content and our staff volunteered for the remaining topics. We conducted monthly lectures and stored the content in a shared folder for departmental members to access during independent study. Our departmental board pass rate was 86% in 2019 (13/15 test-takers), which is comparable to the 2019 national PHM Board pass rate of 84%.
Conclusions: We considered the combination of didactics and individual study effective since our staff did not undergo formal training or fellowship in PHM. We will continue to monitor our department’s outcome on the specialty Boards and plan to analyze the group’s performance on the 2022 boards. We will additionally continue to monitor utilization of the study materials on the shared drive, and elicit feedback to improve the effectiveness of the course.