Academic Pediatrics最新文献

{"title":"Remediation in Pediatric Residency Training: A National Survey of Pediatric Program Directors","authors":"Elizabeth Nelsen MD ,&nbsp;David Mills MD ,&nbsp;Nicola Orlov MD, MPH ,&nbsp;Nathaniel Goodrich MD ,&nbsp;Su-Ting T. Li MD, MPH","doi":"10.1016/j.acap.2025.102776","DOIUrl":"10.1016/j.acap.2025.102776","url":null,"abstract":"<div><h3>Background</h3><div>The goal of graduate medical education is for residents to achieve the skills and knowledge to practice medicine independently. While remediation is not uncommon in residency training, evidence is lacking to guide best practices.</div></div><div><h3>Methods</h3><div>We conducted a national survey of pediatric residency programs regarding their remediation experiences identifying struggling residents, documentating the process, and monitoring progress during remediation.</div></div><div><h3>Results</h3><div>A total of 50.8% (99/195) programs responded. Approximately 4.7% of residents underwent remediation, and 91% (262/288) of residents successfully completed remediation. Programs used data from the Clinical Competency Committee (CCC; 100%), rotation evaluations (98.9%) and direct observation (96.6%) to identify residents who need remediation. Most programs used an improvement plan to document resident progress (88.8%) and assigned a mentor or coach to support the resident (88.8%). Nearly all programs used rotation evaluations (93.3%) to monitor progress towards achieving the goals of remediation. Two-thirds (66.3%) felt their remediation process was either very effective or effective, and about half (56.2%) were very satisfied or satisfied with their remediation process. Programs with more residents who successfully completed remediation were more likely to feel satisfied with their program’s remediation processess and effectiveness.</div></div><div><h3>Conclusions</h3><div>Nearly 5% of pediatrics residents undergo remediation, with 91% successfully remediating. Two-thirds of program leaders feel their remediation practices are effective, and only half are satisfied with remediation processes in their program. Opportunities exist to improve remediation processes for pediatric residents and for programs to ensure graduation of competent pediatricians.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 3","pages":"Article 102776"},"PeriodicalIF":3.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Behavioral Health Medical-Legal Partnerships: A Novel Approach to Child and Adolescent Psychiatric Care","authors":"Shashwat Kala BA ,&nbsp;Madisen A. Swallow MS ,&nbsp;Jay Sicklick JD ,&nbsp;Yann Poncin MD ,&nbsp;Kathryn Meyer JD","doi":"10.1016/j.acap.2025.102779","DOIUrl":"10.1016/j.acap.2025.102779","url":null,"abstract":"<div><div>The state of pediatric mental health in the United States remains an ongoing challenge. Contributing to this challenge is the biopsychosocial nature of mental health – an interconnected system of biological, psychological, social, and legal factors. Consequently, addressing pediatric mental health requires interdisciplinary collaboration. Medical-legal partnerships (MLPs) integrate legal assistance into traditional health care. Though MLPs have gained momentum in general pediatric health care delivery, they are surprisingly underutilized in the pediatric mental health landscape. This current work highlights the Yale Child Study Center Medical-Legal Partnership Project (YCSC-MLPP), which is to our knowledge, the first MLP in a children’s behavioral health setting in the country. The YCSC-MLPP emerged as an interdisciplinary collaboration between the Yale Schools of Medicine and Law as well as the Center for Children’s Advocacy. Between November 2021 and October 2022, the YCSC-MLPP received 150 referrals regarding patients whose care was complicated by health-harming legal needs. Of these referrals, 70% were non-client consultations, 26% were direct consultation with families, and 4% were full legal representation. The most pertinent topics addressed included education, health, housing, individual rights, and immigration. The creation of the YCSC-MLPP sets an example for what a reimagined, interdisciplinary approach to pediatric mental health can look like.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 3","pages":"Article 102779"},"PeriodicalIF":3.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Patterns of Social Media Use in Early Adolescents","authors":"Jason M. Nagata MD, MSc ,&nbsp;Zain Memon ,&nbsp;Jonanne Talebloo BA ,&nbsp;Karen Li MPH ,&nbsp;Patrick Low BA ,&nbsp;Iris Y. Shao PhD, MPH ,&nbsp;Kyle T. Ganson PhD, MSW ,&nbsp;Alexander Testa PhD ,&nbsp;Jinbo He PhD ,&nbsp;Claire D. Brindis DrPH ,&nbsp;Fiona C. Baker PhD","doi":"10.1016/j.acap.2025.102784","DOIUrl":"10.1016/j.acap.2025.102784","url":null,"abstract":"<div><h3>Objective</h3><div>To describe patterns of social media use, including underage use (under 13 years) and sex differences, in a diverse, national sample of early adolescents in the US.</div></div><div><h3>Methods</h3><div>We analyzed the social media use data in the Adolescent Brain Cognitive Development Study (2019–2021, Year 3), which includes a national sample of early adolescents in the US. Specifically, using Chi-square and <em>t</em>-tests, we compared social media use patterns across demographic characteristics stratified by age and sex.</div></div><div><h3>Results</h3><div>In the sample of 10,092 11-to-15-year-old adolescents, 69.5% had at least one social media account; among social media users, the most common platforms were TikTok (67.1%), YouTube (64.7%), and Instagram (66.0%). A majority (63.8%) of participants under 13 years (minimum age requirement) reported social media use. Under-13 social media users had an average of 3.38 social media accounts, with 68.2% having TikTok accounts and 39.0% saying TikTok was the social media site they used the most. Females reported higher use of TikTok, Snapchat, Instagram, and Pinterest, while males reported higher use of YouTube and Reddit. Additionally, 6.3% of participants with social media accounts reported having a secret social media account hidden from their parents’ knowledge.</div></div><div><h3>Conclusions</h3><div>Our findings reveal a high prevalence of underage social media use in early adolescence. These findings can inform current policies and legislation aimed at more robust age verification measures, minimum age requirements, and the enhancement of parental controls on social media. Clinicians can counsel about the potential risks of early adolescent social media use.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 4","pages":"Article 102784"},"PeriodicalIF":3.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Child Maltreatment Evaluations Following Out-of-Hospital Cardiac Arrests","authors":"Sabrina M. Darwiche MD, MPH ,&nbsp;Cindy W. Christian MD ,&nbsp;Cody-Aaron L. Gathers MD, MSHP ,&nbsp;Ryan W. Morgan MD, MTR ,&nbsp;Maryam Y. Naim MD, MSCE ,&nbsp;Joanne N. Wood MD, MSHP","doi":"10.1016/j.acap.2025.102777","DOIUrl":"10.1016/j.acap.2025.102777","url":null,"abstract":"<div><h3>Objective</h3><div>In children admitted after an out-of-hospital cardiac arrest (OHCA), this study 1) determines the proportion that undergo physical abuse and toxin exposure evaluation, child protection team (CPT) consultation, and child protective services (CPS) referral, and 2) evaluates the association between demographic, social, clinical characteristics with CPT consultation and CPS referral.</div></div><div><h3>Methods</h3><div>A retrospective chart review was conducted of children &lt;4 years old admitted following an OHCA between November 2012 and February 2023. Associations between demographics, caregiver social risk factors, and clinical characteristics with CPT consultation and CPS referral were examined using logistic regression.</div></div><div><h3>Results</h3><div>Among 157 cases, 70 (45%) had skeletal surveys; 8 (11%) identified an occult fracture. Seventy-five (48%) children had toxicology testing; 16 of the 75 (21%) revealed a toxic ingestion. Sixteen of the 49 (33%) patients receiving ophthalmologic evaluations had significant retinal hemorrhages. Seventy-seven (49%) patients had a CPT consultation, while 74 (47%) were referred to CPS. A history concerning for ingestion perfectly predicted CPT consultation. History of ingestion, injury on exam, positive skeletal survey, and positive toxicology testing perfectly predicted CPS referral. In multivariate analyses, unsafe sleep history (84% versus 41%, <em>P</em> &lt; 0.001) and caregiver social risk factors (82% versus 31%, <em>P</em> &lt; 0.001) were associated with CPT consultation, while caregiver social risk factors (70% versus 34%, <em>P</em> &lt; 0.001) and normal medical work-up (53% versus 38%, <em>P</em> = 0.050) were associated with CPS referral.</div></div><div><h3>Conclusions</h3><div>Following OHCA, a child maltreatment evaluation may be underutilized with medical decision-making around CPT consultation and CPS referral driven by knowledge of caregiver social risk factors.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 3","pages":"Article 102777"},"PeriodicalIF":3.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolving Roles: Adolescent Perspectives on Shared Decision Making With Their Parents and Health Care Providers","authors":"Chelsey B. Anderson PhD ,&nbsp;Isabella K. Pallotto MPH ,&nbsp;Lindsay Dominguez BS ,&nbsp;Mary Anne Ammon MS ,&nbsp;Adam Carle MA, PhD ,&nbsp;Ellen A. Lipstein MD, MPH","doi":"10.1016/j.acap.2025.102778","DOIUrl":"10.1016/j.acap.2025.102778","url":null,"abstract":"<div><h3>Objective</h3><div>Shared decision making (SDM) involving adolescents presents unique challenges. To adequately support and evaluate SDM that includes adolescents, parents, and health care providers, it is imperative to understand adolescent perspectives. This study aims to describe the perspectives of adolescents with chronic health conditions regarding sharing medical decisions with their parents and health care providers.</div></div><div><h3>Methods</h3><div>Adolescents ages 12 to 17 years with chronic health conditions participated in semistructured qualitative interviews via video conference. Interview questions focused on adolescents’ decision-making experiences. Additionally, concepts of SDM were explored in depth. Transcribed interviews were coded and thematically analyzed using a combination of inductive and deductive coding.</div></div><div><h3>Results</h3><div>Sixteen adolescents participated in qualitative interviews (median age 14 years, 62% male, 62% non-white). Analysis of interviews revealed 4 themes that highlight adolescent perspectives on the process of SDM: <em>defining the adolescent’s role and degree of participation in decisions, understanding complex information, sharing the adolescent’s unique perspective</em>, and <em>coming to consensus.</em> Adolescents in this study described increasingly active participation in more complex decisions as they gained independence, experience, and understanding of health information. Adolescents discussed the importance of their perspectives being acknowledged in the final decision. They also felt it was important to identify values they have in common with their parents and health care providers.</div></div><div><h3>Conclusions</h3><div>Results from this work indicate that adolescents with chronic health conditions experience evolving roles in SDM. These data can be used to tailor and improve SDM to address adolescent needs through active engagement, personalized communication, and inclusion of adolescent values.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 4","pages":"Article 102778"},"PeriodicalIF":3.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Underrepresented in Medicine Trainees’ Sense of Belonging and Professional Identity Formation after Participation in the Leadership Education in Advancing Diversity Program","authors":"Lahia Yemane MD ,&nbsp;Carmin Powell MD ,&nbsp;Jeffrey Edwards MD, MPH ,&nbsp;Takudzwa Shumba MD MPH ,&nbsp;Al’ai Alvarez MD ,&nbsp;Belinda Bandstra MD, MA ,&nbsp;Michelle Brooks ,&nbsp;Cati Brown-Johnson PhD ,&nbsp;Wendy Caceres MD ,&nbsp;Tamara Dunn MD ,&nbsp;Carrie Johnson MBA ,&nbsp;Felipe D. Perez MD ,&nbsp;Travis Reece-Nguyen MD, MPH ,&nbsp;Reena P. Thomas MD, PhD ,&nbsp;Amelia C. Watkins MD, MS ,&nbsp;Rebecca Blankenburg MD, MPH","doi":"10.1016/j.acap.2024.08.003","DOIUrl":"10.1016/j.acap.2024.08.003","url":null,"abstract":"<div><h3>Background</h3><div>There are persistent structural barriers that threaten inclusion and retention of underrepresented in medicine (UIM) residents and fellows (trainees) as future faculty in academic medicine. We developed the Leadership Education in Advancing Diversity (LEAD) Program at a single, academic institution, to address these barriers through a 10-month longitudinal curriculum across Graduate Medical Education for trainees to develop leadership and scholarship skills in diversity, equity, and inclusion (DEI).</div></div><div><h3>Objective</h3><div>Explore how participation in LEAD impacted UIM trainees’ sense of belonging and professional identity formation in academic medicine as well as perceptions about pursuing a career in academic medicine and future leadership roles.</div></div><div><h3>Methods</h3><div>Institutional Review Board-approved qualitative study in August 2020–August 2021 with individual, semi-structured interviews of UIM LEAD graduates from the first four cohorts (2017–2021). Data were analyzed by two authors using modified grounded theory.</div></div><div><h3>Results</h3><div>Fourteen UIM trainees were interviewed; seven themes emerged. Critical aspects of the program: 1) Creation of a community of shared DEI values, 2) Mentorship, 3) Role of allies. Results of the program: 4) Deepened appreciation of personal and professional identity as UIM, 5) Fostered belonging in academic medicine, 6) Appreciation of different careers in academic medicine and how to integrate DEI interests, and 7) Inspired trainees to pursue leadership roles.</div></div><div><h3>Conclusions</h3><div>LEAD can serve as a model for other institutions that seek to support UIM trainees’ sense of belonging, professional identity formation, and perceptions about pursuing careers in academic medicine and future leadership roles.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 1","pages":"Article 102558"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental Health Outcomes Among Youth With Nonfatal Firearm Injuries","authors":"Elizabeth R. Oddo MD, MPH ,&nbsp;Ashley B. Hink MD, MPH ,&nbsp;Annie L. Andrews MD, MSCR","doi":"10.1016/j.acap.2024.06.009","DOIUrl":"10.1016/j.acap.2024.06.009","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 1","pages":"Article 102522"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tonsillectomy Utilization: Persisting Associations with Ethnicity and Race, Public Insurance, and Rurality Across Studies","authors":"Anne R. Links MS MHS ,&nbsp;Jennifer Cooper PhD ,&nbsp;Meredith Lind MD ,&nbsp;Laura J. Chavez PhD MPH ,&nbsp;Emily F. Boss MD MPH","doi":"10.1016/j.acap.2024.06.020","DOIUrl":"10.1016/j.acap.2024.06.020","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 1","pages":"Article 102533"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IMPROVING NOON CONFERENCE ATTENDANCE FOR PEDIATRIC RESIDENTS: DO QUESTIONS AND CONSEQUENCES HELP?","authors":"Hope Kile MD,&nbsp;Richa Gupta MD,&nbsp;Claire Wyman DO,&nbsp;Rachel Jones MD,&nbsp;Caren Gellin MD","doi":"10.1016/j.acap.2024.102689","DOIUrl":"10.1016/j.acap.2024.102689","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 1","pages":"Article 102689"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143306378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to Concordance in Child-Parent Reporting of Social Victimization Experiences in the Adolescent Brain Cognitive Development (ABCD) Study [Academic Pediatrics 23/4 (2023) 747–754]","authors":"Judy T. Tang MSN, RN ,&nbsp;Altaf Saadi MD, MS ,&nbsp;Erin C. Dunn ScD, MPH ,&nbsp;Kristen Choi PhD, RN, FAAN","doi":"10.1016/j.acap.2024.02.002","DOIUrl":"10.1016/j.acap.2024.02.002","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 1","pages":"Article 102459"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143353802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}