O3206: Advocacy Skills for PICU Fellows: A Survey of Experiences, Interests, and Needs

Background: Child advocacy is an integral aspect of pediatric training and practice and is emphasized in pediatric residency programs by the program requirements set by the Accreditation Council for Graduate Medical Education (ACGME) around advocacy at both the patient and the health systems level. Many residencies have incorporated advocacy curricula ranging from universal education to specific advocacy tracks. However, the same focus is less present in pediatric fellowship training: no clinical competencies around advocacy exist for pediatric fellows, and no literature guides the development of advocacy curricula in Pediatric Intensive Care Unit (PICU) fellowship.

Project Description: This study aims to explore PICU and other pediatric subspecialty fellows’ perspectives on advocacy. A survey of postdoctoral fellows in all areas of pediatric subspecialty training, including pediatric critical care, was conducted following institutional approval. Fellows were asked about prior advocacy education, prior experiences with advocacy and how confident they feel engaging in those activities independently. They also provided feedback about areas of interest for further education and projects. Quantitative analysis of data using descriptive statistics as well as subgroup analysis will be done when survey results are finalized.

Discussion: Pediatric intensivists, like all pediatricians in both general and specialized fields, are important advocates for children, and offer a unique perspective from their work with children and families in times of critical illness. Early analyses indicate that advocacy training and education is important for PICU trainees to build the knowledge and skills needed to become effective intensivist advocates. Trainees indicate interest in specific experiences including gaining familiarity with existing local advocacy efforts, partnering with local organizations, and participating in state policy advocacy. Trainees also express a desire for collaborative, longitudinal advocacy projects that can be balanced with a busy clinical schedule.

Conclusion: Understanding trainees’ prior experiences and interests within the context of pediatric subspecialty trainees is needed to build effective advocacy curricula for fellows in pediatric critical care. The results of this survey will be used to develop a curriculum responsive to the needs of pediatric fellowship trainees. Future work will examine the effect of this education on trainee competence and engagement in advocacy.