PC2076: Assessing and Improving Resident Knowledge Gaps in Evidence Based Anticipatory Guidance Due to COVID-19 Pandemic Restrictions

Background: Community pediatric clinical volume around the country decreased initially in the pandemic for resident learners which led to a decrease in resident clinical experience. This held true in our community pediatric clinic where our residents spend most of their community pediatrics rotations. For safety during the pandemic, our community pediatrics learning went virtual, leading to less hands-on anticipatory guidance. This has come at a time where national pediatrics board exam scores decreased from 87% to 81% from 2020 to 2021. With the number of changes made in our program’s community pediatrics rotation during the COVID-19 pandemic, our program sought to evaluate the resident use of evidence based anticipatory guidance, specifically from Bright Futures, a topic that comprises approximately 8% of pediatrics boards. Through this evaluation, we hope to meet the needs of our residents by creating an innovative resource that may bridge the gap in our program’s community pediatrics education.

Methods: A REDCap survey was distributed to 70 pediatric residents in our program. The survey was designed to assess the most frequently discussed anticipatory guidance topics during well child checks as well as resident comfort with these topics. Data was collected anonymously over several weeks in 2021 and categorical results are shown as counts and percentages.

Results: Of the 28(40%) residents who responded to the survey, 12(42.9%) were PGY-1, 8(28.6%) were PGY-2, and 8(28.6%) were PGY-3. The top 3 most discussed topics at well child checks were nutrition (24, 85.7%), sleep (11, 39.3%), and safety (6, 21.4%). When broken down by class, 6(50%) of the PGY-1, 4(50%) of the PGY-2, and 1(12.5%) of the PGY-3 residents felt less than comfortable discussing nutrition with families. 4(33.3%) PGY-1, 2(25%) PGY-2, and 2(25%) PGY-3 residents felt less than comfortable discussing with sleep with families. For safety, 4(33.3%) PGY-1, 2(25%) PGY-2, and 1(12.5%) PGY-3 residents felt less than comfortable. 22(78.6%) residents of all years knew of Bright Futures. Only 7(25%) of the residents used Bright Futures as their primary source of anticipatory guidance education. The majority, 17(60.7%) relied on anecdotal evidence.

Conclusion: Overall, we found that residents display some comfort in providing outpatient pediatric education. However, Bright Futures was not the main educational source for residents. Furthermore, resident comfort in all three of the major topics discussed in well child checks was equivalent between the PGY-1 and PGY-2 class; whereas one might expect the second-year class to have increased comfort in a non-pandemic setting. This survey supported the creation of an online resource for residents that combines and summarizes anticipatory guidance rooted in AAP guidelines and board relevant information in an easy to access question and answer format. We hope to track the use of this resource, and gauge how this may change repeat survey data.