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Boot Camp for Trainees: Not Just about Skill Acquisition

Tuesday, May 15
11:00 - 12:30
Location: Jupiter 1&2

Background: : Many residency and fellowship programs have developed simulation-based boot camps to help trainees learn and practice critical skills associated with new roles and responsibilities. Boot camps have been evaluated by fellows as an effective way to learn, to improve self-confidence and to prepare for new responsibilities. A recent meta-analysis showed marked improvements in clinical skill performance, knowledge, and learner confidence after participation in boot camp. However, studies do not specifically explore how participation in boot camp led to these outcomes or other potential impacts boot camp may have on learners. We developed a qualitative study in order to evaluate these questions.

Research Question: : To determine the impact of the boot camp experience on first year neonatology fellows and to determine specific elements of boot camp that lead to desirable outcomes.

Methodology: : This qualitative study uses a phenomenological approach to try and understand fellows’ experience of boot camp. IRB approval was obtained. Semi-structured phone interviews are conducted with first-year neonatology fellows after they attend the Regional Neonatology Boot Camp. The interview questions focus on the fellows’ experience of boot camp and effect on transition into fellowship. Interviews are transcribed and individually coded for themes. The authors then compare and revise the coding categories until consensus is reached.

Results: : At present, we have interviewed 10 fellows, representing 7 programs. Analysis yielded 47 codes, refined into 8 themes. The themes highlight the fellows’ process of professional identity formation. The major themes include: 1. Acquisition of skills (“During my second call, I had to needle a chest and I remembered doing it at boot camp and it was comforting”), 2. Anticipation of starting fellowship (“I was afraid that people weren’t going to think I was smart enough or good enough”), 3. Boot camp as a shared experience (“We know everyone’s in the same boat and everyone’s nervous), 4. Gaining understanding of the fellow role (“Boot camp helped you realize that now it’s you, you should be running that scenario”), and 5. Building confidence (“It made me feel more confident, like by the end of boot camp I was like ok, I know this, we are prepared). Specific elements of boot camp reported to lead to desirable outcomes included its realistic environment, supportive nature of faculty, and the feeling of camaraderie with other new fellows.

Discussion/Conclusions: : This study explores the impact of boot camp on fellows’ transition into fellowship. Our findings suggest that participation in boot camp is instrumental in facilitating fellows’ professional identity formation by allowing them to explore their new roles, engage with others, and build their confidence. Developing a strong professional identity prior to entering clinical work is a crucial and necessary step in transitioning into fellowship, as this may have a lasting effect on fellows’ social, emotional, and cognitive well-being during and after fellowship. We conclude that curriculum design for simulation-based boot camps for trainees should incorporate elements that facilitate the process of professional identity formation.





Kesi C. Yang, MD

Neonatal-Perinatal Fellow
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania

Kesi Yang is a second year fellow in Neonatalogy at The Children's Hospital of Philadelphia. She received her undergraduate and medical degrees from Yale University. She then completed her general pediatrics residency at The Children's Hospital of Philadelphia. During fellowship, she has focused on gaining expertise in simulation training and medical education.

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Helen Zhang, MD

Pediatric Resident
Children's Hospital of Philadelphia

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Anne Ades, MD, MSEd

Professor of Clinical Pediatrics
Perelman School of Medicine, University of Pennsylvania
Philadelphia

Anne Ades is a physician with a masters of medical education. She is the Director of Neonatal Education at the Children's Hospital of Philadelphia and is the Neonatology Associate Director in the Center for Simulation and Advanced Education. She is a Professor of Clinical Pediatrics at the Perelman School of Medicine at the University of Pennsylvania.

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Catherine Allan, MD

Associate Program Director - Simulator Program
Boston Children's Hospital
Boston, Massachusetts

Catherine Allan, MD is the Associate Program Director of the Simulator Program and Medical Director of the Cardiac Intensive Care Unit at Boston Children’s Hospital. Over the last 10 years she has helped to develop a robust, interdisciplinary program in ECMO Simulation at Boston Children’s Hospital. Dr. Allan has translated this model to other insitutions on both a National and International level to help these programs build new clinical ECMO Programs. She has published on the use of ECMO Simulation Skills Training and on clinical outcomes following ECMO support in the congenital heart disease population and has presented on ECMO simulation at multiple National and International Meetings.

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