Creating the Subspecialty Pediatrics Investigator Network
2017; Elsevier BV; Volume: 192; Linguagem: Inglês
10.1016/j.jpeds.2017.09.079
ISSN1097-6833
AutoresRichard Mink, Alan Schwartz, Carol Carraccio, Pamela High, Christiane E.L. Dammann, Kathleen A. McGann, Jennifer C. Kesselheim, Bruce E. Herman, Sarah Pitts, Gina Baffa, Bruce E. Herman, David Turner, Jill J. Fussell, Pam High, Deborah Hsu, Diane Stafford, Tandy Aye, Cary G. Sauer, Jennifer C. Kesselheim, Angie Myers, K. Patricia McGann, Christiane E.L. Dammann, Patricia R. Chess, John D. Mahan, Pnina Weiss, Megan L. Curran, Alan Schwartz, Carol Carraccio, Bruce E. Herman, Richard Mink, Vinod Havalad, Joaquim Pinheiro, Elizabeth M. Alderman, Mamta Fuloria, Megan McCabe, Jay Mehta, Yolanda Rivas, Maris Rosenberg, Cara Doughty, Albert C. Hergenroeder, Arundhati S. Kale, YoungNa Lee‐Kim, Jennifer A. Rama, Phil Steuber, Bob Voigt, Karen Hardy, Samantha Johnston, Debra Boyer, Carrie Mauras, Alison Schonwald, Tanvi Sharma, Christine Barron, Penelope H. Dennehy, Elizabeth Jacobs, Jennifer Welch, Deepak Kumar, Katherine Mason, Nancy Roizen, Jerri A. Rose, Brooke Bokor, Jennifer Chapman, Lowell H. Frank, Iman Sami, Jennifer Schuette, R. Esther Lutes, Stephanie Savelli, Rambod Amirnovin, Rula Harb, R. Kato, Karen Marzan, Roshanak Monzavi, Doug Vanderbilt, Lesley Doughty, Constance McAneney, Ward R. Rice, Lea E. Widdice, Fran Erenberg, Blanca E. Gonzalez, Deanna Adkins, Deanna Green, Aditee Narayan, Kyle J. Rehder, Joel Clingenpeel, Suzanne P. Starling, Heidi Karpen, Kelly Rouster‐Stevens, Jatinder Bhatia, John S. Fuqua, Jennifer Anders, Maria Trent, Rangasamy Ramanathan, Yona Nicolau, Allen J. Dozor, T. Bernard Kinane, Takara L. Stanley, Amulya Nageswara Rao, Meredith Bone, Lauren Camarda, Viday Heffner, Olivia Kim, James J. Nocton, Angela L. Rabbitt, Richard L. Tower, Michelle Amaya, Jennifer Jaroscak, James Kiger, Michelle M. Macias, Olivia Titus, Modupe Awonuga, Karen Vogt, Anne B. Warwick, Dan Coury, Mark A. Hall, Megan M. Letson, Melissa J. Rose, Julie S. Glickstein, Sarah Shrager Lusman, Cindy G. Roskind, Karen Soren, Jason Katz, Lorena M. Siqueira, Mark Atlas, Andrew D. Blaufox, Beth Gottleib, David L. Meryash, Patricia Vuguin, Toba Weinstein, Laurie B. Armsby, Lisa Madison, Brian Scottoline, Evan Shereck, M. Henry, Patricia A. Teaford, Sarah S. Long, Laurie Varlotta, Alan B. Zubrow, Courtenay B. Barlow, Heidi M. Feldman, Hayley Ganz, Paul C. Grimm, Tzielan Lee, Leonard B. Weiner, Zarela Molle‐Rios, Nicholas Slamon, Úrsula Guillén, Karen Miller, Myke Federman, Randy Q. Cron, Wyn Hoover, Tina Simpson, Margaret K. Winkler, Nada Harik, Ashley Ross, Omar Alibrahim, Frank P. Carnevale, Wayne R. Waz, Fayez Bany-Mohammed, Jae Hwan Kim, Beth F. Printz, Mike Brook, Michelle L. Hermiston, Erica Lawson, Sandrijn van Schaik, Alisa McQueen, Karin Vander Ploeg Booth, Melissa Tesher, J. C. Barker, Sandra Friedman, Ricky Mohon, Andrew Sirotnak, John C. Brancato, Wael N. Sayej, Nizar Maraqa, Michael J. Haller, Brenda Stryjewski, Pat Brophy, Riad Rahhal, Benjamin E. Reinking, Paige Volk, Kristina A. Bryant, Melissa Currie, Katherine E. Potter, Alison Falck, Joel Weiner, Michele Carney, Barbara T. Felt, Andrew J. Barnes, Catherine M. Bendel, Bryce A. Binstadt, Karina M. Carlson, Carol B. Garrison, Mary E. Moffatt, John M. Rosen, Jotishna Sharma, Kelly S. Tieves, Hao Hsu, John D. Kugler, Kari Simonsen, Rebecca K. Fastle, Doug Dannaway, Sowmya Krishnan, Laura McGuinn, Mark E. Lowe, Selma F. Witchel, Loreta Matheo, Rebecca Abell, Mary T. Caserta, Emily Nazarian, Susan M. Yussman, Alicia Diaz-Thomas, David S. Hains, Ajay J. Talati, Elisabeth E. Adderson, N Kellogg, Margarita Vásquez, Coburn H. Allen, Luc P. Brion, Michael Green, Janna M. Journeycake, Kenneth Yen, Ray Quigley, Anne J. Blaschke, Susan L. Bratton, Christian C. Yost, Susan P. Etheridge, Toni Laskey, John F. Pohl, Joyce V. Soprano, Karen D. Fairchild, Vicky Norwood, Troy A. Johnston, Eileen J. Klein, Matthew P. Kronman, Kabita Nanda, Lincoln Smith, David E. Allen, John G. Frohna, Neha Patel, Cristina Estrada, Geoffrey M. Fleming, Maria Gillam-Krakauer, Paul Moore, Joseph Khoury, Jennifer Helderman, Greg Barretto, Kelly Levasseur, Lindsay Johnston,
Tópico(s)Health and Medical Research Impacts
ResumoOne challenge to research in the education of pediatric fellows is the need for large sample sizes so that innovative approaches can be assessed adequately and results are meaningful. Furthermore, trainees need to be evaluated in different educational settings to understand what works well in which environment, and why or why not. In addition, the information provided by studies with a limited number of programs may not be generalizable throughout the subspecialty or to other subspecialties. This is especially true for the pediatric subspecialties in which the number of trainees is generally small. A network for educational research will enable discovery and dissemination to improve the teaching and assessment of pediatric subspecialty trainees and establish best practices in medical education.1Schwartz A. Young R. Hicks P.J. Medical education practice-based research networks: facilitating collaborative research.Med Teach. 2014; 38 (for; APPD LEARN): 64-74Crossref PubMed Scopus (36) Google Scholar The Subspecialty Pediatrics Investigator Network (SPIN) was created to advance these goals. SPIN was formed as a collaborative effort between the Council of Pediatric Subspecialties, the Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network,1Schwartz A. Young R. Hicks P.J. Medical education practice-based research networks: facilitating collaborative research.Med Teach. 2014; 38 (for; APPD LEARN): 64-74Crossref PubMed Scopus (36) Google Scholar the American Board of Pediatrics (ABP), and the APPD Fellowship Directors' Executive Committee, taking advantage of the expertise of each group. Through the Council of Pediatric Subspecialties, each subspecialty identified up to 2 SPIN representatives and these individuals, along with the organizational leaders, comprise the SPIN Steering Committee (Appendix 1; available at www.jpeds.com). As the network was being developed, specific roles for each group were defined (Table I). Reflecting its “senate-like” structure, the main function of the Council of Pediatric Subspecialties was to coordinate the efforts of the subspecialties. The Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network, which already had a robust data infrastructure and network research expertise, assisted with institutional review board submission and data management and analysis. Recruitment and communication within each subspecialty were the responsibility of the SPIN subspecialty representatives because these individuals work directly with their respective subspecialty program directors. All SPIN Steering Committee members provided input into study design and participated in manuscript preparation. SPIN's mission is “to improve the health of children by enhancing pediatric subspecialty training through innovation and research that establish best practices in education and assessment.”2Subspecialty Pediatrics Investigator Network (SPIN).http://pedsubs.org/SPIN/index.cfmDate accessed: February 4, 2017Google ScholarTable IOrganizational rolesCoPSAPPD LEARNABPAPPD Fellowship Directors' Executive CommitteeSPIN Subspecialty RepresentativesProvide overall supervision of recruitment of programsMaintain list of participating programsCoordinate IRB application within institutionsServe as point of contact for subspecialtiesOrganize calls and meetingsPrepare data for presentationsSupervise manuscript and abstract submissionProvide template and guidance for IRB applicationInstruct how to create subject LEARN identifiersCreate web-based data collection toolsServe as a database repositoryManage and “cleanup” dataPerform data analysisProvide expertise regarding study question(s) and designAssist with obtaining MOC credit for those engaged in data quality improvementAssist with subspecialty and program recruitmentProvide a forum for discussion about the projectDisseminate information about the projectProvide instruction to programs about the study at organizational/ society meetingsRecruit programs within their subspecialtyProvide input into data collection toolsAssist with IRB submissionAssist with program compliance in submitting dataAPPD LEARN, Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network; CoPS, Council of Pediatric Subspecialties; IRB, institutional review board; MOC, maintenance of certification. Open table in a new tab APPD LEARN, Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network; CoPS, Council of Pediatric Subspecialties; IRB, institutional review board; MOC, maintenance of certification. For its initial project, SPIN conducted a study evaluating entrustment decisions for 6 of the 7 common pediatric subspecialty Entrustable Professional Activities (EPAs).3Entrustable professional activities for subspecialties.https://www.abp.org/subspecialty-epasDate accessed: February 4, 2017Google Scholar All subspecialties for which ABP certification is offered were invited to participate. Institutional review board approval was obtained at each site. For each of the EPAs, fellowship program directors and Clinical Competency Committees rated the required level of supervision for each of their fellows.4Assessing the association between EPAs, competencies and milestones in the pediatric subspecialties.http://pedsubs.org/SPIN/PDFs/ProjectSummary.pdfDate accessed: February 4, 2017Google Scholar In addition, the Clinical Competency Committees also assigned milestone levels to each fellow for each of the competencies mapped to these EPAs. Sample size estimates indicated that data from a minimum of 106 fellows from 6 subspecialties was required. However, the SPIN Steering Committee set an overall goal to involve all 14 subspecialties with the participation of at least 20% of programs in each subspecialty. Data were collected in the fall and spring of 2014 and 2015, respectively. As a part of an ongoing effort to continually improve data collection throughout the study, SPIN Steering Committee members were also eligible to obtain Part 4 Maintenance of Certification credit. Program directors who contributed data were considered collaborators (Appendix 2; available at www.jpeds.com). In the fall and spring, 208 and 209 pediatric subspecialty programs from 78 and 81 different institutions, respectively, participated in the study representing approximately one-quarter of all Accreditation Council for Graduate Medical Education approved pediatric fellowships.5Mink R.B. Carraccio C.L. Schwartz A. Dammann C.E. High P. Kesselheim J.C. et al.Establishing a medical education research network for the pediatric subspecialties. Pediatric Academic Societies, Baltimore (MD)2016Google Scholar All 14 subspecialties with ABP certification contributed data, which included the ratings of more than 1000 fellows at each data collection period. In both periods, neonatology and critical care had the greatest number of programs participating (Table II). However, developmental-behavioral pediatrics enrolled the greatest percentage of programs followed by child abuse pediatrics. At each time point, 12 of 14 pediatric subspecialties (86%) met the goal participation rate of 20%, although there were some differences in the specific subspecialties that met the threshold. The reasons for this variability in participation are unknown. Results from this first study presenting validity evidence for the level of supervision scales have been published.6Mink R.B. Schwartz A. Herman B. Turner D. Curran M. Myers A. et al.Validity of level of supervision scales for assessing pediatric fellows on the common pediatric subspecialty entrustable professional activities.Acad Med. 2017; (and the; Steering Committee of the Subspecialty Pediatrics Investigator Network (SPIN)) (in press. doi:10.1097/ACM.0000000000001820)Crossref PubMed Scopus (47) Google ScholarTable IIACGME-approved pediatric subspecialty programs participating in the EPAs StudySubspecialtiesFall 2014Spring 2015Adolescent medicine10 (36)11 (39)Cardiology14 (25)12 (21)Child abuse pediatrics10 (40)10 (40)Critical care medicine24 (38)21 (33)Developmental and behavioral pediatrics17 (46)18 (49)Emergency medicine19 (26)19 (26)Endocrinology12 (18)14 (21)Gastroenterology11 (19)10 (18)Hematology-oncology14 (20)13 (19)Infectious diseases14 (23)16 (26)Neonatology33 (34)35 (36)Nephrology7 (16)6 (13)Pulmonary medicine12 (23)13 (25)Rheumatology11 (32)11 (32)ACGME, Accreditation Council for Graduate Medical Education.Values are n (%). Open table in a new tab ACGME, Accreditation Council for Graduate Medical Education. Values are n (%). Although SPIN provides a critical infrastructure for evaluating the training of subspecialty fellows, creation of the network shows something equally important, the interest of all the pediatric subspecialties in working together to improve fellow education. Despite the added task of providing level of supervision ratings at a time when fellowships were submitting their first set of Accreditation Council for Graduate Medical Education milestone data, a large number of programs across all subspecialties participated in this initial project. The second SPIN study is well-underway, and involves a survey of fellowship program directors to determine the least amount of supervision required for a trainee to satisfactorily complete fellowship for all the pediatric common and subspecialty-specific EPAs. A third study is planned to obtain validity evidence for the scholarship and subspecialty-specific EPAs as well as evaluate fellows longitudinally over their 3 years of fellowship. As SPIN develops, other pediatric subspecialties will be welcome to join. This includes hospital medicine as well as other non–ABP-certified pediatric subspecialties. Based on its first study, we expect SPIN's contributions to improve the education of our pediatric fellows to be significant and sustained. SPIN thanks Alma Ramirez for her assistance with this project. Members of the Steering Committee of the Subspecialty Pediatrics Investigator Network. All members of the SPIN Steering Committee are to be considered authors. SPIN Subspecialty Representatives Adolescent Medicine: Sarah Pitts; Cardiology: Gina Baffa; Child Abuse: Bruce Herman; Critical Care Medicine: David A. Turner; Developmental and Behavioral Pediatrics: Jill Fussell and Pam High; Emergency Medicine: Deborah Hsu; Endocrinology: Diane Stafford and Tandy Aye; Gastroenterology: Cary Sauer; Hematology-Oncology: Jennifer Kesselheim; Infectious Diseases: Angie Myers and Kammy McGann; Neonatology: Christiane Dammann and Patricia Chess; Nephrology: John Mahan; Pulmonary Medicine: Pnina Weiss; Rheumatology: Megan Curran SPIN Organizational Representatives Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network: Alan Schwartz; ABP: Carol Carraccio; Association of Pediatric Program Directors' Fellowship Committee: Bruce Herman; Council of Pediatric Subspecialties: Richard Mink Fellowship Program Director Collaborators Advocate Lutheran General Hospital: Vinod Havalad; Albany Medical Center: Joaquim Pinheiro; Albert Einstein College of Medicine/Montefiore Medical Center: Elizabeth Alderman, Mamta Fuloria, Megan E. McCabe, Jay Mehta, Yolanda Rivas, and Maris Rosenberg; Baylor College of Medicine: Cara Doughty, Albert Hergenroeder, Arundhati Kale, YoungNa Lee-Kim, Jennifer A. Rama, Phil Steuber, and Bob Voigt; Benioff Children's Hospital Oakland/UCSF: Karen Hardy and Samantha Johnston; Boston Children's Hospital/Children's Hospital: Debra Boyer, Carrie Mauras, Alison Schonwald, and Tanvi Sharma; Brown University/Rhode Island Hospital-Lifespan: Christine Barron, Penny Dennehy, Elizabeth S. Jacobs, and Jennifer Welch; Case Western Reserve University/Metro Health: Deepak Kumar; Case Western Reserve University/Rainbow Babies and Children's Hospital: Katherine Mason, Nancy Roizen, and Jerri A. Rose; Children's National Medical Center/George Washington University: Brooke Bokor, Jennifer I. Chapman, Lowell Frank, Iman Sami, and Jennifer Schuette; Children's Hospital Medical Center of Akron: Ramona E. Lutes and Stephanie Savelli; Children's Hospital of Los Angeles: Rambod Amirnovin, Rula Harb, Roberta Kato, Karen Marzan, Roshanak Monzavi, and Doug Vanderbilt; Cincinnati Children's Hospital Medical Center: Lesley Doughty, Constance McAneney, Ward Rice, and Lea Widdice; Cleveland Clinic Children's Hospital: Fran Erenberg and Blanca E. Gonzalez; Duke University Medical Center: Deanna Adkins, Deanna Green, Aditee Narayan, and Kyle Rehder; Eastern Virginia Medical School: Joel Clingenpeel and Suzanne Starling; Emory University School of Medicine: Heidi Eigenrauch Karpen and Kelly Rouster-Stevens; Georgia Regents University/Medical College of Georgia: Jatinder Bhatia; Indiana University Medical Center-Riley Hospital for Children: John Fuqua; Johns Hopkins University: Jennifer Anders and Maria Trent; LAC+USC Medical Center: Rangasamy Ramanathan; Loma Linda University Children's Hospital: Yona Nicolau; Maria Fareri Children's Hospital Westchester Medical Center/New York Medical College: Allen J. Dozor; Massachusetts General Hospital: Thomas Bernard Kinane and Takara Stanley; Mayo Clinic College of Medicine (Rochester): Amulya Nageswara Rao; McGaw Medical Center of Northwestern University/Lurie Children's Hospital of Chicago: Meredith Bone and Lauren Camarda; Medical College of Wisconsin, Children's Hospital of Wisconsin: Viday Heffner, Olivia Kim, Jay Nocton, Angela L. Rabbitt, and Richard Tower; Medical University of South Carolina: Michelle Amaya, Jennifer Jaroscak, James Kiger, Michelle Macias, and Olivia Titus; Michigan State University: Modupe Awonuga; National Capital Consortium (Walter Reed): Karen Vogt and Anne Warwick; Nationwide Children's Hospital/Ohio State University: Dan Coury, Mark Hall, Megan Letson, and Melissa Rose; New York Presbyterian Hospital-Columbia Campus/Morgan Stanley Children's Hospital: Julie Glickstein, Sarah Lusman, Cindy Roskind, and Karen Soren; Nicklaus Children's Hospital-Miami Children's Hospital: Jason Katz and Lorena Siqueira; North Shore-LIJ/Cohen Children's Medical Center of New York: Mark Atlas, Andrew Blaufox, Beth Gottleib, David Meryash, Patricia Vuguin, and Toba Weinstein; Oregon Health and Science University Hospital: Laurie Armsby, Lisa Madison, Brian Scottoline, and Evan Shereck; Phoenix Children's Hospital: Michael Henry and Patricia A. Teaford; St. Christopher's Hospital for Children: Sarah Long, Laurie Varlotta, and Alan Zubrow; Stanford University/Lucile Packard Children's Hospital: Courtenay Barlow, Heidi Feldman, Hayley Ganz, Paul Grimm, and Tzielan Lee; SUNY Upstate Medical University: Leonard B. Weiner; Thomas Jefferson University Hospital/duPont Hospital for Children Program: Zarela Molle-Rios and Nicholas Slamon; Thomas Jefferson University Hospital/duPont Hospital for Children Program/Christiana: Ursula Guillen; Tufts Medical Center: Karen Miller; UCLA Medical Center/Mattel Children's Hospital: Myke Federman; University of Alabama Medical Center at Birmingham: Randy Cron, Wyn Hoover, Tina Simpson, and Margaret Winkler; University of Arkansas for Medical Sciences: Nada Harik and Ashley Ross; University of Buffalo-Women and Children's Hospital of Buffalo: Omar Al-Ibrahim, Frank P. Carnevale, and Wayne Waz; University of California Irvine/Miller Children's Hospital: Fayez Bany-Mohammed; University of California San Diego Medical Center, Rady Children's Hospital: Jae H. Kim and Beth Printz; University of California San Francisco: Mike Brook, Michelle Hermiston, Erica Lawson, and Sandrijn van Schaik; University of Chicago Medical Center: Alisa McQueen, Karin Vander Ploeg Booth, and Melissa Tesher; University of Colorado School of Medicine/Children's Hospital Colorado: Jennifer Barker, Sandra Friedman, Ricky Mohon, and Andrew Sirotnak; University of Connecticut/Connecticut Children's Medical Center: John Brancato and Wael N. Sayej; University of Florida College of Medicine at Jacksonville: Nizar Maraqa; University of Florida College of Medicine-J Hillis Miller Health Center: Michael Haller; University of Hawaii/Tripler Army Medical Center: Brenda Stryjewski; University of Iowa Hospitals and Clinics: Pat Brophy, Riad Rahhal, Ben Reinking, and Paige Volk; University of Louisville: Kristina Bryant, Melissa Currie, and Katherine Potter; University of Maryland School of Medicine: Alison Falck; University of Massachusetts Memorial Medical Center: Joel Weiner; University of Michigan Medical Center: Michele M. Carney and Barbara Felt; University of Minnesota Medical Center: Andy Barnes, Catherine M. Bendel, and Bryce Binstadt; University of Missouri at Kansas City/Children's Mercy Hospital: Karina Carlson, Carol Garrison, Mary Moffatt, John Rosen, Jotishna Sharma, and Kelly S. Tieves; University of Nebraska Medical Center: Hao Hsu, John Kugler, and Kari Simonsen; University of New Mexico School of Medicine: Rebecca K. Fastle; University of Oklahoma Health Sciences Center: Doug Dannaway, Sowmya Krishnan, and Laura McGuinn; University of Pittsburgh Medical Center/Children's Hospital of Pittsburg: Mark Lowe, Selma Feldman Witchel, and Loreta Matheo; University of Rochester School of Medicine, Golisano Children's Hospital: Rebecca Abell, Mary Caserta, Emily Nazarian, and Susan Yussman; University of Tennessee College of Medicine/Le Bonheur Children's Hospital: Alicia Diaz Thomas, David S. Hains, and Ajay J. Talati; University of Tennessee College of Medicine/St. Jude Children's Research Hospital: Elisabeth Adderson; University of Texas Health Science Center School of Medicine at San Antonio: Nancy Kellogg and Margarita Vasquez; University of Texas Austin Dell Children's Medical School: Coburn Allen; University of Texas Southwestern Medical School: Luc P. Brion, Michael Green, Janna Journeycake, Kenneth Yen, and Ray Quigley; University of Utah Medical Center: Anne Blaschke, Susan L. Bratton, Christian Con Yost, Susan P. Etheridge, Toni Laskey, John Pohl, and Joyce Soprano; University of Virginia Medical Center: Karen Fairchild and Vicky Norwood; University of Washington/Seattle Children's Hospital: Troy Alan Johnston, Eileen Klein, Matthew Kronman, Kabita Nanda, and Lincoln Smith; University of Wisconsin School of Medicine and Public Health: David Allen, John G. Frohna, and Neha Patel; Vanderbilt University Medical Center: Cristina Estrada, Geoffrey M. Fleming, Maria Gillam-Krakauer, and Paul Moore; Virginia Commonwealth University Health System: Joseph Chaker El Khoury; Wake Forest University School of Medicine: Jennifer Helderman; West Virginia University: Greg Barretto; William Beaumont Hospital: Kelly Levasseur; Yale University School of Medicine: Lindsay Johnston. Corrigendum to ‘Creating the Subspecialty Pediatrics Investigator Network’The Journal of PediatricsVol. 207PreviewIn the article “Creating the Subspecialty Pediatrics Investigator Network,” by Mink et al (J Pediatr 2018;192:3-4), all of the authors listed in the appendix as members of the Steering Committee of the Subspecialty Pediatrics Investigator Network should have been listed as co-authors. Full-Text PDF
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