Impact of a Multifaceted Complex Care Rotation 

on Pediatric Residents and Hospital Medicine Fellows

Tanuja Kothinti, MDa, Jacqueline Battistelli, MDb, Ruchi Kaushik, MD, MPHc


BACKGROUND: Pediatric residents typically do not receive formal training in the care of children with medical complexity (CMC) in a medical home setting. Interest and momentum in the design of complex care curricula to achieve recently published complex care EPAs is building; however, an understanding of which facets of such a curriculum are effective is unknown. 

OBJECTIVES: We aimed to conduct a qualitative evaluation of pediatric resident and hospital medicine fellow perceptions of a multifaceted complex care rotation. Utilizing Kolb’s experiential learning cycle as a framework, we designed a complex care rotation that incorporated clinical, didactic, and experiential modalities. Upon completion of a complex care rotation, trainees wrote a one-page Reflection. 

ELECTIVE OUTCOMES: Of 47 trainees who participated in the rotation, 34 (72%) completed Reflections from which we identified five themes: 1) Medical Home; 2) Communication; 3) Education; 4) Advocacy; and 5) Humanism. Furthermore, we describe lessons learned while delivering iterations of the curriculum over six years.

CONCLUSION: A multifaceted complex care rotation reveals insightful resident perceptions of its educational benefits. Facilitators and opportunities to support trainee learning inform complex care educators as they begin to design local institutional curricula.

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