Pediatric Residents’ Perspectives on CenteringParenting Group Well Child Care

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ESPR131
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Abstract: :

Background: CenteringParentingR (Centering) is an innovative model of group well child visits with limited uptake in academic centers. Little is known about pediatric residents' experience with and perspectives of this model.

Objective: To explore pediatric residents' perspectives of Centering compared to individual well visits.

Design/Methods: In Centering a cohort of 6-8 infant/parent dyads meet with a pediatric provider for shared well child visits and group discussion for the first two years of life. Providers receive training in group facilitation and visits follow a prescribed curriculum. In 12/2014, we initiated Centering in an academic medical center with full participation of faculty and residents. In 11/2016 and 11/2019 we invited two non-overlapping cohorts of residents to participate in an anonymous online survey on their perceptions of group and individual well child visits. Responses were on a 5-point Likert scale. We also asked for comments on: "What is the best thing about Centering?" and "What would you like to change about Centering?"

Results: Resident response rate was 82% (28/34) in 2016 and 90% (27/30) in 2019, for a study sample of 55. Responses were not significantly different between the cohorts. Over 90% felt comfortable facilitating groups and 65% felt more enjoyment and satisfaction providing care in group visits than in individual visits (p<0.01). Most (90%) felt continuity and provision of anticipatory guidance were better in group visits compared to individual visits (p<0.01); 75% agreed Centering provided benefit to patients/families and should be continued. Over half (55%) felt group visits were better as a learning experience than individual visits (p<0.01).

Resident responses to "What is the best thing about Centering" fell into four categories: continuity and getting to know families, support among members of the group, providing anticipatory guidance and empowering families, and efficiency. Responses to "What would you like to change about Centering?" were divided into three categories: privacy and time to address individual patient concerns, care of the child with medical concerns, and more training in facilitation skills.

Conclusion: Pediatric residents perceive group well child visits provide better continuity of care and anticipatory guidance than individual visits and are a positive learning experience. Our experience shows Centering is an innovative primary care model with high educational value in a pediatric residency program.

Einstein Medical Center Philadelphia
Albert Einstein Medical Center
Greater Philadelphia Health Action, Inc.
Einstein Medical Center Philadelphia

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