Connecting Residents and Children with Severe Neurological Impairment Using a Novel Personal History Tool.

Abstract

Residents lack confidence caring for children with severe neurological impairment (SNI). The novel personal history tool, SHINE (Self, Happy, Ill, Names, and Extra), was codeveloped by families and residents to strengthen residents' confidence in connecting with children with SNI and their families. To describe SHINE's use among residents and its impact on residents' burnout, meaningful work, and confidence in caring for children with SNI. Residents at an academic children's hospital in the United States received small-group teaching on the use of SHINE. Participants completed baseline, one-, and three-month post-intervention surveys, which included resident demographics; self-reported tool use; and resident burnout, meaningful work, and confidence in caring for children with SNI. Data were analyzed descriptively and using Pearson's chi-square tests. Briefly, 88% (<i>n</i> = 37/42) of eligible residents participated (25 interns [67%], 12 senior residents [32%]). After one month, respondents reported they found the tool helpful/very helpful (<i>n</i> = 11, 92%), were likely/very likely to continue using it (<i>n</i> = 11, 92%), and recommended it to future residents (<i>n</i> = 16, 100%). At baseline, residents reported low confidence caring for children with SNI (mean = 2.08, standard deviation (SD) : 0.84 on a 1 = low to 4 = high Likert scale). After one month, respondents reported improvements in (1) understanding the nonmedical needs of patients (mean increase: 0.71, SD: 0.85, <i>p</i> value = 0.006) and (2) understanding life outside the hospital (mean increase: 0.94, SD: 0.87, <i>p</i> value = 0.003). Respondents reporting higher use of the tool experienced larger gains. No significant differences were seen in burnout or meaningful work. SHINE may improve resident self-reported confidence in caring for children with SNI.