536 - Behavioral Health in the Acute Care Setting: An Urgently Needed Curriculum for Pediatric Residents

Poster Number: 536
Publication Number: 536.324

Andrea L. Dean, Baylor College of Medicine/Texas Children’s Hospital, Houston, TX, United States; Samantha Severson, Baylor College of Medicine, Houston, TX, United States; Jason V.. Lambrese, Cleveland Clinic Children's, Cleveland Heights, OH, United States; Samantha Crowley, Baylor College of Medicine, Houston, TX, United States; Meghan McClure, Baylor College of Medicine, Houston, TX, United States

Background: Pediatric behavioral health hospitalizations have surged, underscoring the American Academy of Pediatrics’ longstanding call to train pediatricians to provide child and adolescent mental health care. However, pediatric hospitalists have, until recently, lacked experience and confidence in caring for these patients and, by extension, struggle to teach and support trainees around this topic. A needs assessment from our institution indicated residents received little guidance and felt underprepared to serve as the frontline provider for these hospitalized patients and, as a result, experienced high levels of stress.

Objective: We aimed to develop, implement, and evaluate a didactic curriculum to improve pediatric residents' comfort and knowledge in managing behavioral health diagnoses in the acute care setting.

Design/Methods: A national team of hospitalists, trainees, and psychiatrist developed the four 50-minute session curriculum with input where appropriate by social workers, child life specialists, psychologists, ethicist and layers. The session topics were: (1) The Behavioral Health Hospitalization, (2) De-escalation, (3) Restraints, and (4) Psychopharmacology. In accordance with Kolb’s theory of learning, there were opportunities for interaction and application of knowledge. Session evaluations were reviewed. Pre and post comfort and knowledge assessments were compared.

Results: Sessions were given over the 2021-2022 academic year during pediatric resident noon conference, to which attendance is required. Sessions were attended by 16-26 residents. Participants rated the lectures favorably with an average 4.9 rating out of 5. Comparison of pre and post-levels of confidence showed an increase from 2.4 to 3.6 out of 5 (n=104, p< 0.01). Knowledge assessment scores improved from an average of 0.8/3 to 1.5/3 correct (p< 0.01).

Conclusion(s): This targeted didactic curriculum served to fill an urgent and rising need in pediatric training. The sessions were well received by residents and effective at improving confidence in caring for hospitalized behavioral health patients. Knowledge also improved, though less so, and may reflect challenges of virtual learning. This curriculum can be used for pediatric education nationwide, including for faculty development. Next steps include ongoing use of the didactic sessions within our institution for resident and inter professional education as well as dissemination of the curriculum.