81. COMFORT AND PERCEIVED VALUE: PARENT VIEWS OF TRAINEE PARTICIPATION IN PEDIATRIC CARE

• Published in: Academic pediatrics Vol. 19; no. 6; p. e37
• Main Authors: Babal, Jessica C., Sklansky, Daniel J., Moreno, Megan A.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01-08-2019
• ISSN: 1876-2859; 1876-2867
• DOI: 10.1016/j.acap.2019.05.095

Trainees require progressive autonomy to prepare for unsupervised practice as physicians. Studies show that patients largely accept trainee participation in their own medical care, but little is known about parental perceptions of medical student and resident engagement in pediatric care.
We conducted a national cross-sectional online survey of parents with at least one child under 18 years. The survey used 5-point Likert scale to explore acceptability, desirability, and perceived value of medical student and resident involvement in pediatric care. The survey also assessed parent comfort with progressive trainee autonomy in the clinical encounter. The Wilcoxon rank sum test was used to compare means for Likert scale responses, p<0.01.
A total of 3,000 parents completed the survey, of whom 87.9% were female, 82.5% were white, 32.3% had prior experience with medical students and 38.4% had experience with residents in their child's care. Parents appreciated the importance of trainee participation (4.0±1.1 for students, 3.9±1.0 for residents) and enjoyed having trainees present (3.8±1.0 for students, 3.9±1.1 for residents). Parents, regardless of exposure to trainees, were more comfortable with resident autonomy than student autonomy at each stage of the clinical encounter (p<0.0001); were more comfortable having a clinic visit last longer if a resident was involved than if a student was involved (p<0.01); and perceived that residents improved pediatric care more than did students, (p<0.0001). Parents who had experience with students reported increased comfort with student autonomy at all stages of the clinical encounter compared to parents who had never experienced pediatric care with students (p<0.0001). Similarly, parents exposed to residents reported increased comfort with resident autonomy at all stages of the clinical encounter compared to parents who had never experienced care with residents (p<0.0001).
Parents valued and enjoyed trainee participation in the care of their children and were more comfortable with progressive autonomy for residents than students. Prior exposure to students or residents increased parental comfort with autonomy for respective trainee types. Further studies should investigate how parent and child characteristics correlate with how parents view trainee involvement in pediatric care.