Pediatric Residents’ Training and Preparedness: Caring for Diverse Families and Children Experiencing Racism

Frintner MP, Gottschlich EA, Haftel HM,

Presented at the 2022 Pediatric Academic Societies Annual Meeting

Background: US children are increasingly diverse, with the majority of children now non-White and large increases in Hispanic and immigrant children. Racism is an important social determinant of health. Experience as a clinician to address the needs of diverse families begins in training.

Objective: Examine graduating pediatric residents’ training and preparedness to provide care to diverse families and children experiencing racism.

Methods: A national random sample of 1,000 US 2021 graduating pediatric residents; 380 (38%) responded. Respondents estimated characteristics of patients cared for in residency: race/ethnicity, low income, limited English proficiency (LEP). They reported receipt/interest in training on topics related to racism, bias and disparities and rated their preparedness to care for diverse families (5 point scale: “poor” to “excellent”).

Results: 73% of resident respondents are female, 10% Hispanic, and 5% Black. 38% are proficient communicating in a language other than English. 13% rated their Spanish proficiency as very good or excellent.

Six in 10 residents reported the race and ethnic diversity of the patient population was essential (19%) or very important (42%) in the selection of their residency program. Residents reported caring for diverse children, including the following mean estimates: 28% Hispanic, 29% Black, 7% Asian; 64% low income families and 31% families with LEP.

About 9 in 10 residents reported receiving education or training during residency on: racial and ethnic health disparities (93%), bias and discrimination in the clinical setting (91%), implicit bias (91%), and racism and impact on child health (89%). Fewer (45%) received training on ways parents can teach their children about race and racism. Most (69-77%) reported being very interested or interested in future education or training on these topics. For example, 33% were very interested and 41% interested in future training on ways parents can teach their children about race and racism.

Residents reported excellent/very good preparation in caring for families with LEP (61%) and who immigrated to the US (47%). Fewer (29%) reported excellent/very good preparation to care for families experiencing racism (Figure).

Conclusion: Pediatric resident respondents graduating in 2021 cared for diverse patients during training. 9 in 10 received education on racism, bias and disparities. Fewer received training on ways parents can teach children about race and racism and felt prepared to care for families experiencing racism.

Figure 1. Percent of 2021 Graduating Residents Reporting Preparedness Caring for Diverse Families