PEDIATRIC RESIDENCY TRAINING IN THE NORMAL NEWBORN NURSERY - A NATIONAL SURVEY

Objective: To determine how and what pediatric residency programs are teaching residents about normal newborn care in the nursery. Design: A mailed survey distributed in 1994. Participants: All 237 known pediat ric residency programs in the United States, Canada, and Puerto Rico. Results: Survey response rate was 77% (184 of 237 questionnaires were returned and completed). In 40% of the programs, neonatologists were p rimarily responsible or co-responsible for teaching residents about ma nagement of normal newborns. A normal newborn nursery curriculum had b een developed and implemented in 56% of the programs, 30% of programs were developing one, and 13% reported no curriculum. Specific instruct ion about breast-feeding was not offered in 16% of programs. Circumcis ions were most commonly performed by obstetricians; anesthetic use was low (overall median use, 10%) but was more common (P<.002) when circu mcisions were performed by pediatricians. The hospital environment and lack of faculty time were cited as the main barriers to teaching resi dents about normal newborn care. Conclusions: Although general pediatr icians spend a substantial amount of practice time on newborn care, ne onatologists were responsible for this teaching in almost half of the pediatric residency programs. Many programs have not developed a curri culum. Instruction about breast-feeding was not universal. Most pediat ric residents do not learn to perform circumcisions. General pediatric ians should be more involved in the development, implementation, and e valuation of comprehensive newborn nursery curricula to improve traini ng in this important aspect of general pediatric practice.