Learning Priorities of Pediatric and Emergency Medicine Residents in a Pediatric Intensive Care Unit

Introduction: The ACGME does not specify learning goals for pediatric and emergency medicine (EM) residents rotating in the pediatric intensive care unit (PICU). We sought to compare learning expectations of residents with faculty expectations and develop and evaluate a structured PICU resident curriculum based on faculty and ACGME expectations.


Methods: We conducted a multi-phase study (pre-intervention survey, curriculum development, and post-intervention survey) in a quaternary academic PICU. Surveys contained a needs assessment of medical topics and procedures, resident experience survey, and a knowledge test. The needs assessment reflected ACGME requirements and program-specific PICU rotation learning objectives.


Results: Participants included 13 PICU attendings, 91 pre-intervention residents, and 89 post-intervention residents. Resident priorities that were not prioritized by faculty included ARDS, non-invasive ventilation, and TBI. Shared topic priorities between faculty and residents included sepsis/shock, resuscitation, and asthma. We implemented a recurring 4-week didactic and simulation curriculum and repeated identical surveys for 6 months. Post-rotation residents in both phases had higher confidence in knowledge and initial management of critically ill children (Fisher’s exact test, p-values < 0.01). The curriculum significantly increased frequency of formal education (p < 0.001); reported resident satisfaction with and applicability of PICU education did not significantly change (>75% before and after intervention). There was no significant change in prioritized resident learning topics after the intervention with the exceptions of resuscitation (less frequently prioritized, p< 0.001) and nutrition (more frequently prioritized, p=0.025).


Conclusions: Our study highlights significant differences between trainee and faculty learning expectations for residents in the PICU. While the implemented curriculum increased frequency of education and maintained resident satisfaction, this curriculum based on faculty priorities, ACGME requirements, and rotation objectives did not change the trainees’ learning priorities. This emphasizes the importance of further methodologic advances in curriculum development to identify learning objectives and target education for trainees.