Resident Surveillance of Pediatric Patient Developmental Status at the Two Month Preventive Care Visit
Study Details
Study Description
Brief Summary
The purpose of this study is to evaluate the efficacy of individualized performance feedback coupled with an educational module in improving resident performance of the physical and developmental examination component of developmental surveillance of infants at the two month preventive care visit.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
Many children in the United States have developmental or behavioral disabilities. The American Academy of Pediatrics recently published a policy statement outlining recommendations for developmental surveillance and screening of infants and young children. One of the Academy's recommendations was for inclusion of developmental surveillance during all preventive care visits. The five components of developmental surveillance include elicitation and attendance to parental concerns, maintenance of the developmental history, observation of the child through physical and developmental examinations, identification of risk and protective factors, and documentation of surveillance findings and process (referral, follow-up, etc.).
As a result of concerns expressed by the public regarding accountability in medical education and health care, the Accreditation Council for Graduate Medical Education and the American Board of Medical Specialties mandated that training programs shift to a competency based assessment system. The focus of this study will be to assess the impact of performance feedback (based upon video recorded observation) coupled with an educational module on resident demonstration of competency in regard to the physical and developmental examinations component of developmental surveillance of infants at the two month preventive care visit.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| No Intervention: Baseline Performance Observation of baseline performance |
|
| Experimental: Post-intervention Performance Observation of performance post-intervention |
Procedure: performance feedback with an educational module
individual performance feedback with an educational module
|
Outcome Measures
Primary Outcome Measures
- Presence of Resident Surveillance Behaviors of Specific Aspects of Developmental Status at the Two Month Preventive Care Visit [Residents were observed during each of the eligible preventive care visits. Each visit was an average of 20 minutes in length. Preventive care visits were observed over a 13 month time period.]
Residents were observed to determine whether specific aspects of infant developmental status, as part of developmental surveillance, were assessed during the two-month preventive care visit. The components of developmental surveillance observed were: assessment of the infant's ability to follow past midline, assessment of the infant's ability to lift his/her head off of the table in prone, assessment of the infant's ability to hold an object placed in his/her hand, assessment of the infant's ability to coo, and assessment of the infant's ability to demonstrate a social smile.
Eligibility Criteria
Criteria
Inclusion Criteria:
- Categorical pediatric residents in their second year of training at Children's Mercy Hospitals and Clinics who are scheduled to see infants for a two month preventive care visit.
Exclusion Criteria:
-
Preventive care visits for infants who have parents/guardians who do not speak English fluently
-
Preventive care visits for infants who have a previously identified genetic or other medical syndrome or developmental delay
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Children's Mercy Hospitals and Clinics | Kansas City | Missouri | United States | 64108 |
Sponsors and Collaborators
- Children's Mercy Hospital Kansas City
Investigators
- Principal Investigator: Sarah S Nyp, MD, Children's Mercy Hospital Kansas City
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 07 02-027E
Study Results
Participant Flow
| Recruitment Details | Recruitment Period: August 2007-July 2008 Location: Academic medical center |
|---|---|
| Pre-assignment Detail | Seven participants were enrolled. Four participants did not complete the study due to personal issues. |
| Arm/Group Title | Intervention |
|---|---|
| Arm/Group Description | Performance after receiving feedback and educational module |
| Period Title: Baseline Assessment | |
| STARTED | 7 |
| COMPLETED | 3 |
| NOT COMPLETED | 4 |
| Period Title: Baseline Assessment | |
| STARTED | 3 |
| COMPLETED | 3 |
| NOT COMPLETED | 0 |
Baseline Characteristics
| Arm/Group Title | Intervention |
|---|---|
| Arm/Group Description | Performance after receiving feedback and educational module |
| Overall Participants | 7 |
| Age (Count of Participants) | |
| <=18 years |
0
0%
|
| Between 18 and 65 years |
7
100%
|
| >=65 years |
0
0%
|
| Age (years) [Mean (Standard Deviation) ] | |
| Mean (Standard Deviation) [years] |
28
(2)
|
| Sex: Female, Male (Count of Participants) | |
| Female |
5
71.4%
|
| Male |
2
28.6%
|
| Region of Enrollment (participants) [Number] | |
| United States |
7
100%
|
Outcome Measures
| Title | Presence of Resident Surveillance Behaviors of Specific Aspects of Developmental Status at the Two Month Preventive Care Visit |
|---|---|
| Description | Residents were observed to determine whether specific aspects of infant developmental status, as part of developmental surveillance, were assessed during the two-month preventive care visit. The components of developmental surveillance observed were: assessment of the infant's ability to follow past midline, assessment of the infant's ability to lift his/her head off of the table in prone, assessment of the infant's ability to hold an object placed in his/her hand, assessment of the infant's ability to coo, and assessment of the infant's ability to demonstrate a social smile. |
| Time Frame | Residents were observed during each of the eligible preventive care visits. Each visit was an average of 20 minutes in length. Preventive care visits were observed over a 13 month time period. |
Outcome Measure Data
| Analysis Population Description |
|---|
| [Not Specified] |
| Arm/Group Title | Intervention |
|---|---|
| Arm/Group Description | Performance after receiving feedback and educational module |
| Measure Participants | 3 |
| Number [Participants] |
3
42.9%
|
Adverse Events
| Time Frame | May 2007-July 2008 | |
|---|---|---|
| Adverse Event Reporting Description | No serious or non-serious adverse events were assessed. | |
| Arm/Group Title | Intervention | |
| Arm/Group Description | Performance after receiving feedback and educational module | |
All Cause Mortality |
||
| Intervention | ||
| Affected / at Risk (%) | # Events | |
| Total | / (NaN) | |
Serious Adverse Events |
||
| Intervention | ||
| Affected / at Risk (%) | # Events | |
| Total | 0/0 (NaN) | |
Other (Not Including Serious) Adverse Events |
||
| Intervention | ||
| Affected / at Risk (%) | # Events | |
| Total | 0/0 (NaN) | |
Limitations/Caveats
More Information
Certain Agreements
All Principal Investigators ARE employed by the organization sponsoring the study.
There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.
Results Point of Contact
| Name/Title | Sarah S. Nyp |
|---|---|
| Organization | Children's Mercy Hospitals and Clinics |
| Phone | 816-234-3000 |
| ssnyp@cmh.edu |
- 07 02-027E