Attending and Fellow Perspectives on Pediatric Hospital Medicine Fellow Supervision

Abstract

Background: Pediatric Hospital Medicine (PHM) is one of the newest pediatric subspecialties, and the number of PHM fellowship programs continues to grow rapidly. Many PHM attendings have limited experience supervising fellows. Currently, the PHM fellowship program at Boston Children’s Hospital lacks a structured curriculum to prepare attendings for clinical supervision. This study aims to conduct an organizational needs assessment among PHM attendings and fellows to identify faculty development needs related to fellow supervision. This assessment represents the second step in Kern’s six-step approach to curriculum development, as incorporating faculty and fellow input is essential for designing a curriculum that meets attendings’ needs. Methods: This cross-sectional study utilized three surveys targeting: (1) attendings at the main academic site (BCH), (2) attendings at the community site (SSH), and (3) current and graduated PHM fellows. The attending surveys assessed overall preparedness for fellow supervision, key topics to include in a curriculum, and overall interest in a curriculum. Fellow surveys explored their experiences working with attendings. Surveys were distributed anonymously via Qualtrics. Data analysis included descriptive statistics and a modified qualitative analysis using the framework method for free-response questions. Results: Results from BCH and SSH surveys varied given the inherent differences in training environments. The academic site (BCH) had a survey completion rate of 71.1% (32/45). Attendings expressed a need for more training on supervising both residents and fellows while tailoring teaching to the fellow’s level. Additionally, the majority of attendings at both sites shared interest in participating in a curriculum on fellow supervision. At the community site, the completion rate was 53.8% (7/13), with attendings identifying teaching to the fellow’s level and providing feedback as key training needs. The fellow survey had a completion rate of 78.6% (11/14). Fellows identified promoting fellow autonomy as a critical topic at both training sites. Qualitative responses highlighted the need to educate community site faculty on the overall goals of fellowship training. Across all groups, the preferred curriculum delivery method was a shared document or resource folder. Conclusion: Our organizational needs assessment highlights the need for enhanced attending training on PHM fellow supervision from the perspectives of both attendings and fellows. While training priorities may differ between the academic and community sites due to the inherent differences in training environment, ongoing faculty development is essential for effectively preparing the next generation of PHM fellows.