“The residents enjoy this type of program to help them become better pediatricians and have a better understanding of all of these issues that they don’t experience themselves.”
– Survey respondent, residency program receptor
Parents often seek advice from their pediatricians on how to help their children reach milestones for healthy development. In fact, medical professionals — including pediatricians and family medicine physicians — are the second most looked-to resource for parents seeking advice, information, or guidance. But most graduating pediatric residents don’t feel adequately equipped to advise parents on ways to promote early childhood development, a major survey found.
As part of our work to promote birth to early childhood development in New Jersey, the Burke Foundation partnered with the New Jersey Chapter of the American Academy of Pediatrics (NJAAP) to provide funding to implement an early childhood curriculum for pediatric residents in all nine of New Jersey’s pediatric residency programs. The New Jersey Pediatric Residency Advocacy Collaborative facilitated the program’s piloting and statewide roll-out as part of its ongoing advocacy, training, and educational outreach activities.
The curriculum, created by the Mount Sinai Parenting Center, addresses such developmental keystones as secure attachment, autonomy, self-regulation, perspective taking, problem solving, and academic knowledge. It focuses on increasing residents’ knowledge and confidence, as well as improving counseling behaviors to promote positive parenting practices in well-child visits.
The program includes curricular modules focused on six developmental keystones of early childhood and a complementary lecture series for residents and program directors featuring national experts on early childhood development. Implementation of the curriculum began in 2020 through two pilot sites at Rutgers Robert Wood Johnson Medical School in New Brunswick and Rutgers New Jersey Medical School’s Pediatric Residency Program in Newark. After reaching the seven remaining residency programs in the state by 2021, NJAAP then expanded the curriculum to 12 family medicine residency programs and received funding from the state Department of Children and Families to introduce the curriculum to experienced pediatricians, too.
Secure Attachment
Autonomy
Self-Regulation
Perspective Taking
Problem Solving
Academic Knowledge
To support continued adoption, the Burke Foundation developed a Keystones Replication Guide, offering practical lessons and strategies to help implement the model. An accompanying infographic highlights key results, including significant increases in residents’ confidence and effectiveness in promoting positive parenting behaviors.
76% of graduating pediatric residents felt unprepared to advise parents on ways to promote early childhood development.
Each pediatric resident who benefits from this curriculum has the ability to influence the primary care of more than 1,500 children a year, which translates to nearly 200,000 children annually statewide.
Preliminary data shows statistically significant improvement in resident knowledge, confidence, and self-reported behaviors. Participants and faculty widely praise the curriculum.
Resident Survey Results
Change in resident behaviors, knowledge, and attitudes.
81% of residents strongly agreed or agreed that the Keystones curriculum was useful to their development as pediatricians.
Well-child Visits
Between pre- and post-surveys of participating residents, results showed statistically significant improvement in resident behaviors.
79% increase in discussing early child development topics with caregivers
73% increase in modeling positive interactions with children
52% increase in praising caregiver behaviors
General Knowledge
Residents answered 10 general knowledge questions about early childhood development, pre- and post-survey. The average number of correct responses to 10 questions increased significantly after completing the curriculum (4.9 to 6.5).
Pre-survey knowledge
Post-survey knowledge
Resident Attitudes
Residents rated how much they agreed with statements related to their comfort in discussing parenting behaviors and giving advice to caregivers. A perceptions scale based on participants’ mean response to all statements (1-Strongly Disagree to 5-Strongly Agree) showed a statistically significant increase in positive perceptions from pre- to post-survey (3.4 to 3.7).General Knowledge
Pre-survey perception
Post-survey perception
