Training of pediatricians in care of physical disabilities in children with special health needs: Results of a two-state survey of practicing pediatricians and national resident training programs

Objective. One goal of the American Academy of Pediatrics' Future of Pediat ric Education II Project is to establish guidelines in training physicians to care for children with special health care needs (CWSN). Assessment of c urrent practices in prescribing therapies and devices is necessary to meet this goal. Although much has been written about CWSN, there is a paucity of literature describing pediatricians' preparedness in prescribing such ther apies and devices to children with physical disabilities. In an effort to a ssess physician preparedness, we surveyed pediatric residents nationwide an d practicing pediatricians from 2 states, 1 urban and 1 rural. Methods. A questionnaire aimed at identifying areas of concern regarding pr eparedness of physicians in practice and in training was prepared and maile d to prospective participants in Ohio and Mississippi. After follow-up mail ings to nonresponders, similar to 59% responded. Summary statistics were re ported as proportions with 95% confidence intervals. Results. Among those polled, >70% reported no training in prescribing certa in durable medical equipment and over 50% reported no training in prescribi ng certain therapies. In addition, at least 20% reported no training in tre ating some of the more common childhood physical disabilities. Nearly three fourths of the respondents indicated that they did not believe that they w ere adequately prepared to take an active role in prescribing therapies and durable medical equipment. Fewer respondents believed that they should be the sole providers of these therapies and durable medical equipment. Conclusions. The results of the survey indicate a lack of specific training and physician confidence in prescribing therapies and devices to CWSN, est ablishing the necessity of expanding training programs to better ensure qua lity health care for special needs children. Although additional ongoing re search is necessary to fully evaluate the preparedness of physicians in car ing for CWSN, this survey does help to identify areas of physician training that require improvement to provide quality health care for CWSN.