Minkovitz Cynthia S, Goldshore Matt, Solomon Barry S, Guyer Bernard, Grason Holly
Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; andPediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; and.
Pediatrics. 2014 Jul;134(1):83-90. doi: 10.1542/peds.2013-3357.
To compare community involvement of pediatricians exposed to enhanced residency training as part of the Dyson Community Pediatrics Training Initiative (CPTI) with involvement reported by a national sample of pediatricians.
A cross-sectional analyses compared 2008-2010 mailed surveys of CPTI graduates 5 years after residency graduation with comparably aged respondents in a 2010 mailed national American Academy of Pediatrics survey of US pediatricians (CPTI: n = 234, response = 56.0%; national sample: n = 243; response = 59.9%). Respondents reported demographic characteristics, practice characteristics (setting, time spent in general pediatrics), involvement in community child health activities in past 12 months, use of ≥1 strategies to influence community child health (eg, educate legislators), and being moderately/very versus not at all/minimally skilled in 6 such activities (eg, identify community needs). χ(2) statistics assessed differences between groups; logistic regression modeled the independent association of CPTI with community involvement adjusting for personal and practice characteristics and perspectives regarding involvement.
Compared with the national sample, more CPTI graduates reported involvement in community pediatrics (43.6% vs 31.1%, P < .01) and being moderately/very skilled in 4 of 6 community activities (P < .05). Comparable percentages used ≥1 strategies (52.2% vs 47.3%, P > .05). Differences in involvement remained in adjusted analyses with greater involvement by CPTI graduates (adjusted odds ratio 2.4, 95% confidence interval 1.5-3.7).
Five years after residency, compared with their peers, more CPTI graduates report having skills and greater community pediatrics involvement. Enhanced residency training in community pediatrics may lead to a more engaged pediatrician workforce.
比较作为戴森社区儿科学培训计划(CPTI)一部分接受强化住院医师培训的儿科医生的社区参与度与全国儿科医生样本报告的参与度。
一项横断面分析将CPTI毕业生在住院医师毕业后5年的2008 - 2010年邮寄调查结果,与2010年美国儿科学会对美国儿科医生进行的全国邮寄调查中年龄相仿的受访者进行比较(CPTI:n = 234,回复率 = 56.0%;全国样本:n = 243;回复率 = 59.9%)。受访者报告了人口统计学特征、执业特征(环境、在普通儿科学方面花费的时间)、过去12个月参与社区儿童健康活动的情况、使用≥1种策略影响社区儿童健康(如教育立法者),以及在6项此类活动(如识别社区需求)中技能为中等/非常熟练与完全不熟练/最低限度熟练的情况。χ(2)统计量评估组间差异;逻辑回归模型在调整个人和执业特征以及对参与的看法后,模拟CPTI与社区参与度之间的独立关联。
与全国样本相比,更多CPTI毕业生报告参与社区儿科学(43.6%对31.1%,P <.01),并且在6项社区活动中的4项中技能为中等/非常熟练(P <.05)。使用≥1种策略的比例相当(52.2%对47.3%,P >.05)。在调整分析中,参与度差异仍然存在,CPTI毕业生的参与度更高(调整后的优势比为2.4,95%置信区间为1.5 - 3.7)。
住院医师培训5年后,与同龄人相比,更多CPTI毕业生报告具备技能且更多地参与社区儿科学。社区儿科学强化住院医师培训可能会造就更积极参与的儿科医生队伍。