Contextualization of care in pediatric residency - converted audio recording for Salehi-Weiner-Schwartz-2024

We designed a pilot study in our pediatric residency program at the University of Illinois at Chicago (UIC) categorical pediatrics program in which visits with patients during regularly scheduled continuity clinics were recorded with consent both residents and parents or other caregivers, and assent of patients ages 12 or up.

Following the visit, caregivers returned the device, and audio was uploaded to a secure server approved for the storage of patient sensitive data. It was then listened to by a member of the research team trained in 4C. The listener, a board-certified pediatrician and clinician educator (JS), 4C coded each encounter, and also notated on a spreadsheet any additional pediatric resident patient/family interactions that he identified as learning opportunities either because they represented positive behaviors that should be reinforced or opportunities to improve care.

Midpoint in the study one of the investigators (JS) provided feedback to the residents on the findings from the 4C coding, both in the form of an in person and emailed presentation of the data showing examples of both successful and missed opportunities to identify and address contextual factors in patient’s lives that appeared relevant to planning their care (e.g., asking about frequent missed appointments).