What Procedures Are Important to General Pediatricians and Why.

Abstract Background/Objective Pediatric residents must demonstrate competence prior to graduation in Accreditation Council for Graduate Medical Education (ACGME) required procedures. Recent literature shows general pediatricians (GPeds) infrequently perform these procedures yet believe them important to learn. The purpose of this study was to determine why GPeds believe learning procedures was important, what barriers prevent them from developing and maintaining procedural skills, and what procedures they believe should be included in training. Methods Fifty-one GPeds from the American Board of Pediatrics General Examination Committee and the central Ohio region participated in 30-minute semi-structured recorded phone interviews that probed their use of procedures across training and current practice. Participants represented urban, suburban, and rural geographic regions and practiced in a variety of settings. We conducted a thematic analysis of transcribed interviews. Results GPeds believed currently required ACGME procedures were crucial to learn for five reasons: 1) adaptation to change in practice type or location, 2) emergency preparedness, 3) counseling patients and families, 4) distance from a tertiary care center and specialists, 5) professional identity as a pediatrician. Numerous barriers, particularly never learning the procedures, prevented GPeds from performing procedures in practice. Recommended procedures to be taught included high-(e.g., circumcision), and low-risk (e.g., cerumen removal, nasopharyngeal swabs, umbilical cauterization) skills. Conclusions GPeds believed procedural training was important, however may never have learned certain procedures. These findings suggest that teaching methods should be adapted or customized procedural education be implemented to ensure relevancy of skills learned for clinical practice.