17 Top Curricular Priorities for Pediatric Residents in the Care of Children with Medical Complexity: A National Delphi Study
Bibliographic record
Abstract
Previous studies of pediatric residents have identified educational gaps and lack of comfort caring for children with medical complexity (CMC). There is variable clinical exposure and training opportunity in complex care across residency programs. Defining core curricular topics in complex care is a priority in medical education. The purpose of this study is to identify essential topics to be included in a standard complex care curriculum for pediatric residents. An initial topic list was generated through literature review and proceedings of national complex care special interest group meetings. Expert panelists were identified based on experience in complex care and residency education. Using the Delphi method to determine group consensus, an electronic survey was developed asking expert panelists to identify 10–15 curricular topics as essential for pediatric residents. Consensus was defined as >70% identifying a topic as essential. There was a predefined maximum of three rounds with an iterative approach and feedback provided to participants between each round. Sixteen experts were approached and agreed to participate. Response rate was 100% for all three rounds. Experts were from Canada (56%) and the United States (44%), most were affiliated with an academic center (96%) and practiced in both inpatient and outpatient settings (69%). Topics identified as essential in the first round were feeding difficulties, pain and irritability, transition, feeding tube management, difficult discussions, and team management/care coordination. Topics identified by 50–70% of participants as being essential were included in the second round, with revisions based on participant comments. Topics identified as essential in the second round were dysmotility, aspiration and safety/emergency planning. Topics that did not meet consensus were included in a third and final round with additional revisions. Two additional topics were identified as essential in the third round: neuromuscular and skeletal issues and advocacy. Essential topics were organized using the International Classification of Functioning, Disability and Health (ICF). Eleven curricular priorities in the care of CMC were identified across multiple domains of the ICF framework. These topics can be used as a guide for curriculum development for pediatric residents. The Delphi method can be replicated to establish educational priorities for other health professions who care for CMC.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".