Studies Currently Ongoing

Defining Key Factors in Burnout and Resilience in Pediatric Residents and the Relationship to Performance

PIs: John Mahan, MD and Maneesh Batra, MD for The Pediatric Resident Burnout-Resilience Study Consortium

Synopsis: Create and support a consortium to:

  1. Describe the epidemiology and relationships between burnout, resilience, empathy, and confidence in providing compassionate care in pediatric and medicine-pediatric (P/M-P) residents.
  2. Define the natural history of these parameters over time in P/M-P residents during training
  3. Identify modifiable factors that increase or decrease the risk of developing burnout and promoting positive wellness factors
  4. Develop and test different interventions (such as in-person seminars, on-line mind-body skills training, and individualized curricula such as global health electives) to affect burnout, resilience, empathy, compassion and wellness

Status: Data collection in progress.

How trainees perform on general pediatric EPAs using a rating scale of level of supervision leading up to entrustment

PIs: Dan Schumacher, MD, MEd; Carol Carraccio, MD

Collaborators: American Board of Pediatrics


  1. Determine expectations for level of supervision needed by the majority of trainees over the course of and at the completion of residency training with the intention of using data to guide the value of the current list of EPAs in learner assessment.
  2. Assess the feasibility of using an educational intervention to meet Part 4 MOC requirements for a quality improvement project.

Status: Data collection in progress

Assessing the Association between Entrustable Professional Activities (EPAs), Competencies, and Milestones in the Pediatric Subspecialties

Collaborators: APPD LEARN, Council of Pediatric Subspecialties, American Board of Pediatrics

Synopsis: The specific objectives are 1) to determine if there is a specific milestone level that must be reached for each of the subcompetencies within a specific EPA to judge that a fellow is deemed entrustable, 2) to compare the milestone level at which fellows are deemed entrustable across the pediatric subspecialties and to determine if any specific subcompetencies are more influential in the entrustment decision than others and 3) to compare the initial overall impression of fellow level of entrustment for a given EPA made by the Fellowship Program Director with that determined by the Clinical Competency Committee (CCC) after the milestone levels for that EPA are assigned.

Status: Data collection in process

Pediatrics Milestones Assessment Collaborative (PMAC) - Module 2

Collaborators: APPD LEARN, American Board of Pediatrics, National Board of Medical Examiners

Project Director: Patricia Hicks, MD, MHPE

Synopsis: This study assesses residents based on a subset of Pediatric Milestones that might inform residency faculty decisions about medical student and resident readiness to serve as a resident in the inpatient setting with the presence and direct oversight of a supervisor.

Specific aims are (1) evaluate reactions of pediatric faculty, residents, and nurses to a subset of Pediatric Milestones based on participation in related assessment and feedback conversations and surveys (2) assess Milestones with new multisource feedback (MSF) and structured clinical observations (SCOs) instruments (3) compare the value of new Pediatrics Milestones-based instruments and reports with previously-used processes

Status: Data collection in progress.

Past Studies

Characteristics of Clinical Competency Committee (CCC) Member Milestone Level Assignments and Recommended Advancement Decisions

PI: Dan Schumacher, MD, MEd

Synopsis: Studies the relationship between individual CCC member judgments and and reported milestones and advancement decisions. Investigates whether program and CCC member factors moderate that relationship.

Status: Data collection complete, analysis in progress.

Validity of resident self-assessment using Pediatrics Milestones

PIs: Su-Ting Li (UC Davis) and Kimberly Gifford (Dartmouth-Hitchcock)

Synopsis: This study seeks to describe pediatric resident self-assessment of competence using the Pediatrics Milestones for 21 ACGME-selected sub-competencies, and characterize and explain variation in agreement between pediatric resident self-assessment, external assessments based on Pediatrics Milestones, and overall summative assessments of resident performance.

Status: Data collection complete.

Pediatrics Milestones Assessment Collaborative (PMAC) - Module 1

Collaborators: APPD LEARN, American Board of Pediatrics, National Board of Medical Examiners

Project Director: Patricia Hicks, MD, MHPE

Synopsis: Develop a national Pediatrics Milestones-based Assessment System - an assessment system that will provide meaningful, feasible assessment evidence that can be used by the program leadership and clinical competency committee members to guide decisions for progression through increasing levels of responsibility and independence.

Status: Data collection complete

Striving for the Optimal Balance Between Service and Education

PIs: Debra Boyer, MD (Harvard), Jennifer Kesselheim, MD (Harvard)

Synopsis: Survey residents and program directors to (1) establish each cohorts' assessment of the balance of service and education in their training programs, (2) measure program directors' and residents' perceptions of the amount of service and education inherent in common scenarios encountered during pediatric residency training, and (3) elucidate definitions of service and education, endorsed by both program directors and trainees, that can serve as a useful foundation for curriculum development during residency training

Synopsis: Data collection complete

New Professionalism Challenges in Medical Training: An Exploration of Social Networking

PI: Jennifer Kesselheim (Harvard)

Synopsis: This study surveys pediatric trainees to explore their perceptions of and experiences with social networking sites and training program policies around social media.

Status: Data collection is complete for this study.

Assessment of Pediatrics Milestones Pilot

PI: Patricia Hicks, MD (CHOP); Steve Clyman, PhD (NBME); Alan Schwartz, PhD (UIC)

Synopsis: In partnership with the NBME, this study seeks to test the feasibility of a set of assessment instruments constructed from nine Pediatrics Milestones. Instruments are designed to inform decisions about readiness to serve in the inpatient pediatric wards, based on ratings of direct observations recorded on handheld devices. Study instruments include: structured clinical observations for rounds and history taking; a multisource feedback instrument; and, Pediatrics Milestones Classification assessment form. Study learners include interns and sub-interns, with faculty, residents, and nurses serving as raters. Features include collection of de-identified learner data in APPD LEARN, individualized learner feedback, faculty development materials for rater and feedback provider training. Outcomes from this study will be used to inform further development of the Pediatrics Milestones and APPD LEARN.

Status: Data collection ended June 2013.

The New Duty Hour Regulations--Were Changes Necessary? A Survey of Pediatric Program Directors

PI: Hilary Haftel, MD (University of Michigan)

Synopsis: This study seeks to identify what, if any, changes in Pediatric Residency Program structure were necessary to achieve compliance with the new DHR by July 2011. This specifically includes any changes to the amount or periods of resident work hours, changes in supervision, and changes in external or internal moonlighting

Status: Data collection complete.