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Joel A. Fein, MD; Jane M. Lavelle, MD; Kenneth R. Ginsburg, MD, MSEd; Angelo P. Giardino, MD, MSEd

Arch Pediatr Adolesc Med. 1997;151(8):840-844.

Abstract
Objective
To develop a structured process to gain resident input into the improvement of their educational experience by (1) taking a small amount of resident time and effort, (2) fostering the generation of new ideas, (3) allowing the prioritization of ideas, (4) generating implementation plans for the ideas, and (5) offering the participants relative anonymity.

Design
Cross-sectional survey and group sessions.

Setting
Urban, university-based children's hospital.

Participants
Members of the pediatric residency program in the 1993-1994 academic year.

Interventions and Results
The process was piloted for an emergency department rotation and borrows aspects of the Delphi Technique, Nominal Group Technique, and focus group methods. A survey regarding an emergency department rotation was distributed to all pediatric residents, and the 10 most commonly noted problems were compiled. These problems were brought to group sessions held for each level of training. Problems not listed were added if they were mentioned during the session; however, no problem was removed from the list. The sessions, designed to offer relative anonymity to the residents, included an initial clarification period, a roundrobin prioritization of ideas, and an open discussion designed to generate solutions. Resident-generated solutions resulting from the group sessions were reviewed by the attending staff, and changes were implemented during the next year.

Conclusion
The technique that we developed is a practical and time-efficient method of incorporating resident perspectives into the improvement of a rotation.

Arch Pediatr Adolesc Med. 1997;151:840-844

Author Affiliations
From the Division of Emergency Medicine (Drs Fein and Lavelle), Section of Adolescent Medicine, General Pediatrics (Dr Ginsburg), The Children's Hospital of Philadelphia; the Division of Child Development and Rehabilitation, the Children's Seashore House (Dr Giardino); and the Department of Pediatrics, the University of Pennsylvania School of Medicine (Drs Fein, Lavelle, Ginsburg, and Giardino), Philadelphia, Pa.

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