Pediatric residency training in the normal newborn nursery. A national survey
C. Kelley, M. B. Edmonson and J. M. Pascoe
Department of Pediatrics, University of Wisconsin, Madison, USA.
OBJECTIVE: To determine how and what pediatric residency programs are
teaching residents about normal newborn care in the nursery. DESIGN: A
mailed survey distributed in 1994. PARTICIPANTS: All 237 known pediatric
residency programs in the United States, Canada, and Puerto Rico. RESULTS:
Survey response rate was 77% (184 of 237 questionnaires were returned and
completed). In 40% of the programs, neonatologists were primarily
responsible or co-responsible for teaching residents about management of
normal newborns. A normal newborn nursery curriculum had been developed and
implemented in 56% of the programs, 30% of programs were developing one,
and 13% reported no curriculum. Specific instruction about breast-feeding
was not offered in 16% of programs. Circumcisions were most commonly
performed by obstetricians; anesthetic use was low (overall median use,
10%) but was more common (P < .002) when circumcisions were performed by
pediatricians. The hospital environment and lack of faculty time were cited
as the main barriers to teaching residents about normal newborn care.
CONCLUSIONS: Although general pediatricians spend a substantial amount of
practice time on newborn care, neonatologists were responsible for this
teaching in almost half of the pediatric residency programs. Many programs
have not developed a curriculum. Instruction about breast-feeding was not
universal. Most pediatric residents do not learn to perform circumcisions.
General pediatricians should be more involved in the development,
implementation, and evaluation of comprehensive newborn nursery curricula
to improve training in this important aspect of general pediatric practice.
