A Comprehensive Outpatient Pediatric Resident Complex Care Curriculum

INTRODUCTION: Pediatric resident training typically prepares learners to care for children with medical complexity (CMC) when acutely ill; however, residents often do not receive formal primary care training for this population. We designed a curriculum to improve pediatric resident knowledge, skills, and behavior when providing a medical home for CMC. METHODS: Guided by Kolb's experiential cycle, we designed and offered a complex care curriculum as a block elective to pediatric residents and pediatric hospital medicine fellows. Participating trainees completed a prerotation assessment to establish baseline skills and self-reported behaviors (SRB) and four pretests to document baseline knowledge and skills. Residents viewed online didactic lectures weekly. During four half-day patient care sessions per week, faculty reviewed documented assessments and plans. Additionally, trainees attended community-based site visits to appreciate the socioenvironmental perspective of CMC families. Trainees completed posttests and a postrotation assessment of skills and SRB. RESULTS: Between July 2016 and June 2021, 47 trainees participated in the rotation, with data available for 35 trainees. Residents demonstrated significant improvement in knowledge (p < .001), self-assessed skills (average Likert-scale rating prerotation = 2.5 vs. postrotation = 4.2), and SRB (average Likert-scale rating prerotation = 2.3 vs. postrotation = 2.8) based on test scores and trainees’ postrotation self-assessments. Learner evaluations of the rotation site visits (15 out of 35, 43%) and video lectures (eight out of 17, 47%) demonstrated overwhelmingly positive reaction. DISCUSSION: This comprehensive outpatient complex care curriculum addressing seven of 11 nationally recommended topics demonstrated improvement in trainees’ knowledge, skills, and behaviors.