Caroline E. Rassbach

All Publications

• A Mixed Methods Approach to Understanding Curricular Impact of a Capstone Course on the Self-Efficacy of Fourth-Year Medical Students CUREUS Jacobs, K. G., Kugler, J., Chi, J., Stuart, E., Merrell, S., Rassbach, C. 2020; 12 (8)

  View details for DOI 10.7759/cureus.9537

  View details for Web of Science ID 000554830700009

• Fixing the leaky pipeline: identifying solutions for improving pediatrician-scientist training during pediatric residency. Pediatric research Burns, A. M., Ackerman, K., Thammasitboon, S., Rassbach, C., Ward, M. A., Blankenburg, R., Forster, C. S., McPhillips, H., Wenger, T., Powell, W., Heyman, M. B., Hogarty, M., Boyer, D., Hostetter, M., Weiss, P., Nguyen, S., Parsons, D. W., Moore, D. J., Byrne, B., French, A., Orange, J. S. 2020

  View details for DOI 10.1038/s41390-020-0837-2

  View details for PubMedID 32179872

• What are the Unique Mentorship Needs of Fourth Year Medical Students Applying to Pediatrics Residency? Academic pediatrics Lester, T. R., Rassbach, C. E., Blankenburg, R. 2020

  Abstract

  The qualities of good medical school mentors have been well-described. However, there is little written about the mentoring needs of medical students applying to pediatrics residency.In order to characterize pediatrics interns' perspectives on the mentorship needs of fourth year medical students applying to residency, the authors conducted an IRB-approved, qualitative modified grounded-theory study using a brief survey and semi-structured focus groups of pediatric interns in January and February 2018. Two investigators independently coded the focus group transcripts and reconciled codes to develop categories and themes using constant comparison, which were then reviewed by the third author for validation. To further ensure trustworthiness of analysis, participants were asked to comment on the themes' accuracy.Eighteen pediatrics interns participated, representing 15 medical schools. Four major themes emerged: 1) Effective mentors guide medical students to self-reflect and find their own answers about what is important to them in a residency program; 2) Multiple mentors are helpful during the residency application process; 3) Several key components of advising are often missing during the residency application process; 4) Students find it difficult to be honest with their mentors if there is a perceived conflict of interest.Medical students applying for pediatrics residency have specific mentorship needs and cite opportunities to improve this area of mentorship. Several key recommendations include utilizing multiple mentors and providing emotional support during the residency application process. In addition, near-peer mentorship is important for medical students applying to residency and should be facilitated by medical schools.

  View details for DOI 10.1016/j.acap.2020.05.002

  View details for PubMedID 32389758

• Factors and Behaviors Related to the Promotion of Pediatric Hospital Medicine Fellow Autonomy: A Qualitative Study of Faculty ACADEMIC PEDIATRICS Maniscalco, J., Davis, E., Gay, A., Ward, V., Truckenbrod, J., Denniston, S. F., Rassbach, C. E. 2019; 19 (6): 703?11

  View details for Web of Science ID 000481567900018

• The Challenges of Multisource Feedback: Feasibility and Acceptability of Gathering Patient Feedback for Pediatric Residents ACADEMIC PEDIATRICS Mahoney, D., Bogetz, A., Hirsch, A., Killmond, K., Phillips, E., Bhavaraju, V., McQueen, A., Orlov, N., Blankenburg, R., Rassbach, C. E. 2019; 19 (5): 555?60

  View details for DOI 10.1016/j.acap.2018.12.002

  View details for Web of Science ID 000475720600014

• Breaking a Cycle of Dependence to Improve Neurology Education: A Qualitative Study Exploring Pediatric Residents' Perspectives. Clinical pediatrics Nguyen, T., Pavitt, S., Wusthoff, C., Rassbach, C. 2019: 9922819870557

  Abstract

  Objective. To understand pediatric residents' experiences and attitudes toward learning neurology; and to identify facilitators and barriers to learning neurology during residency. Study Design. Qualitative study using focus groups of pediatric residents at Stanford during November 2017. Focus groups were audio-recorded and transcribed verbatim. Investigators independently coded the transcripts and reconciled codes to develop themes using constant comparison associated with grounded theory. Results. Eighteen pediatric residents participated in 3 focus groups. Four themes emerged: (1) residents feel unprepared and uncomfortable; (2) intrinsic and extrinsic factors contribute to residents' dependence on neurologists; (3) residents desire more teaching; and (4) residents are motivated to overcome their dependence on neurologists and optimize their learning. Conclusion. Pediatric residents are motivated to acquire more skills to assess and manage patients with neurological conditions. They recognize key factors that contribute to a cycle of dependence that impedes their learning and offer strategies to overcome these barriers.

  View details for DOI 10.1177/0009922819870557

  View details for PubMedID 31455089

• Factors and Behaviors Related to the Promotion of Pediatric Hospital Medicine Fellow Autonomy: A Qualitative Study of Faculty. Academic pediatrics Maniscalco, J., Davis, E., Gay, A. C., Ward, V., Truckenbrod, J., Denniston, S. F., Rassbach, C. E. 2019

  Abstract

  To identify factors that influence faculty to promote or reduce the expression of autonomy for pediatric hospital medicine (PHM) fellows and describe behaviors faculty employ to support fellow autonomy in the clinical setting.This is a multi-center, qualitative study utilizing semi-structured interviews with core faculty in PHM fellowships. Data were transcribed verbatim and analyzed using a phenomenological approach. Each transcript was coded independently by two trained reviewers who then met to reconcile differences. Codes were identified using an iterative approach and organized into themes. Investigators engaged in peer debriefing during data collection, and member checking confirmed the results.Interviews were conducted December 2016 to January 2017 with 20 faculty from five PHM fellowships. Most participants were female (12, 60%) and assistant (13, 65%) or associate (6, 30%) professors. Data analysis yielded six themes. Themes reflect the importance of faculty experience, style, and approach to balancing patient care with education in the provision of autonomy for PHM Fellows. Faculty appreciation for the role of autonomy in medical education, investment in their roles as educators, and investment in PHM fellowship training are also influential factors. Finally, fellow clinical, educational, leadership, and communication skills influence the provision of autonomy. Faculty employ various levels of supervision, scaffolding techniques, and direct observation with feedback to support fellow autonomy. Professional development was considered essential for developing these skills.We identified six themes related to faculty provision of autonomy to PHM fellows, as well as strategies employed by faculty to support fellow autonomy.

  View details for PubMedID 31077880

• The Challenges of Multisource Feedback: Feasibility and Acceptability of Gathering Patient Feedback for Pediatric Residents. Academic pediatrics Mahoney, D., Bogetz, A., Hirsch, A., Killmond, K., Phillips, E., Bhavaraju, V., McQueen, A., Orlov, N., Blankenburg, R., Rassbach, C. E. 2018

  Abstract

  OBJECTIVE: The ACGME calls for residency programs to incorporate multisource feedback, which may include patient feedback, into resident competency assessments. Program directors face numerous challenges in gathering this feedback. This study assesses the feasibility and acceptability of patient feedback collection in the inpatient and outpatient setting at three institutions.METHODS: Patient feedback was collected using a modified version of the Communication Assessment Tool (CAT). Trained research assistants (RAs) administered the CAT to eligible patients/families in pediatric ward, intensive care (ICU), and outpatient settings from July-October 2015. Completion rates and reasons for non-completion were recorded. Patient satisfaction with the CAT was assessed on a five-point Likert scale.RESULTS: 860/1413 (61%) patients completed the CAT. Completion rates in the pediatric ward and ICU settings were 45% and 38% respectively, compared to 91% in the outpatient setting. In inpatient settings, survey non-completion was typically due to participant unavailability; this was rarely a reason in the outpatient setting. 93.4% of patients were satisfied or very satisfied with using the CAT. 6.36 hours of RA time would be required to gather a valid quantity of patient feedback for a single resident in the outpatient setting, compared to 10.14 hours in the inpatient setting.CONCLUSIONS: While collecting feedback using our standardized protocol is acceptable to patients, obtaining sufficient feedback requires overcoming several barriers and a sizable time commitment. Feedback collection in the outpatient setting may be higher-yield than the inpatient setting due to greater patient/family availability. Future work should focus on innovative methods to gather patient feedback in the inpatient setting to provide program directors with a holistic view of their residents' communication skills.

  View details for PubMedID 30576788

• THE EFFECT OF FACULTY COACHING ON RESIDENT ATTITUDES, CONFIDENCE, AND PATIENT-RATED COMMUNICATION: A MULTI-INSTITUTION STUDY. Academic pediatrics Rassbach, C. E., Bogetz, A. L., Orlov, N., McQueen, A., Bhavaraju, V., Mahoney, D., Leibold, C., Blankenburg, R. L. 2018

  Abstract

  OBJECTIVE: Despite a national focus on physician-patient communication, there is a paucity of literature on how patient and family feedback (PFF) can be used as a tool to help residents learn communication skills. The purpose of this study was to assess the effect of coaching on residents' attitudes towards PFF, self-confidence in communication, and patient-rated communication skills.METHODS: This was an IRB-approved, randomized-controlled trial with pediatric residents at three institutions in 2015-2016. Pre- and post-intervention, residents completed a self-assessment of their attitudes and self-confidence in communication. PFF was collected for each resident using the Communication Assessment Tool (CAT), which has been validated in other medical disciplines. Intervention group residents reviewed their baseline PFF with a faculty coach; control group residents reviewed their PFF independently.RESULTS: 114 residents completed the study, 57 in each arm. Intervention group residents were significantly more likely to ask for PFF compared with control group residents (mean change 0.36 vs. -0.11, p=.01). There were no other significant differences in resident attitudes, confidence, or patient-rated communication between groups. Both groups had increased self-confidence over time and with increasing PGY level. Patient ratings of resident communication did not differ over time or between groups.CONCLUSIONS: Residents who reviewed PFF with a faculty coach were significantly more likely to report they would ask patients for feedback than residents who reviewed PFF independently, suggesting review of feedback with a coach may enhance appreciation of patient feedback. Though self-confidence improved over time in both groups, patient ratings of resident communication skills were not significantly different over time or between groups.

  View details for DOI 10.1016/j.acap.2018.10.004

  View details for PubMedID 30368034

• How Residents Learn From Patient Feedback: A Multi-Institutional Qualitative Study of Pediatrics Residents' Perspectives. Journal of graduate medical education Bogetz, A. L., Orlov, N., Blankenburg, R., Bhavaraju, V., McQueen, A., Rassbach, C. 2018; 10 (2): 176?84

  Abstract

  Residents may view feedback from patients and their families with greater skepticism than feedback from supervisors and peers. While discussing patient and family feedback with faculty may improve residents' acceptance of feedback and learning, specific strategies have not been identified.We explored pediatrics residents' perspectives of patient feedback and identified strategies that promote residents' reflection on and learning from feedback.In this multi-institutional, qualitative study conducted in June and July 2016, we conducted focus groups with a purposive sample of pediatrics residents after their participation in a randomized controlled trial in which they received written patient feedback and either discussed it with faculty or reviewed it independently. Focus group transcripts were audiorecorded, transcribed, and analyzed for themes using the constant comparative approach associated with grounded theory.Thirty-six of 92 (39%) residents participated in 7 focus groups. Four themes emerged: (1) residents valued patient feedback but felt it may lack the specificity they desire; (2) discussing feedback with a trusted faculty member was helpful for self-reflection; (3) residents identified 5 strategies faculty used to facilitate their openness to and acceptance of patient feedback (eg, help resident overcome emotional responses to feedback and situate feedback in the context of lifelong learning); and (4) residents' perceptions of feedback credibility improved when faculty observed patient encounters and solicited feedback on the resident's behalf prior to discussions.Discussing patient feedback with faculty provided important scaffolding to enhance residents' openness to and reflection on patient feedback.

  View details for DOI 10.4300/JGME-D-17-00447.1

  View details for PubMedID 29686757

  View details for PubMedCentralID PMC5901797

• Development of a Curricular Framework for Pediatric Hospital Medicine Fellowships. Pediatrics Jerardi, K. E., Fisher, E., Rassbach, C., Maniscalco, J., Blankenburg, R., Chase, L., Shah, N. 2017; 140 (1)

  Abstract

  Pediatric Hospital Medicine (PHM) is an emerging field in pediatrics and one that has experienced immense growth and maturation in a short period of time. Evolution and rapid expansion of the field invigorated the goal of standardizing PHM fellowship curricula, which naturally aligned with the field's evolving pursuit of a defined identity and consideration of certification options. The national group of PHM fellowship program directors sought to establish curricular standards that would more accurately reflect the competencies needed to practice pediatric hospital medicine and meet future board certification needs. In this manuscript, we describe the method by which we reached consensus on a 2-year curricular framework for PHM fellowship programs, detail the current model for this framework, and provide examples of how this curricular framework may be applied to meet the needs of a variety of fellows and fellowship programs. The 2-year PHM fellowship curricular framework was developed over a number of years through an iterative process and with the input of PHM fellowship program directors (PDs), PHM fellowship graduates, PHM leaders, pediatric hospitalists practicing in a variety of clinical settings, and other educators outside the field. We have developed a curricular framework for PHM Fellowships that consists of 8 education units (defined as 4 weeks each) in 3 areas: clinical care, systems and scholarship, and individualized curriculum.

  View details for DOI 10.1542/peds.2017-0698

  View details for PubMedID 28600448

• A Novel Pediatric Residency Coaching Program: Outcomes After One Year. Academic medicine : journal of the Association of American Medical Colleges Rassbach, C. E., Blankenburg, R. 2017

  Abstract

  The ACGME requires all residency programs to assess residents on specialty-specific milestones. Optimal assessment of competence is through direct observation of performance in clinical settings, which is challenging to implement.The authors developed the Stanford Pediatric Residency Coaching Program to improve residents' clinical skill development, reflective practice, feedback, and goal setting, and to improve learner assessment. All residents are assigned a dedicated faculty coach who coaches them throughout their training in various settings in an iterative process. Each coaching session consists of four parts: (1) direct observation, (2) facilitated reflection, (3) feedback from the coach, and (4) goal setting. Coaches document each session and participate in the Clinical Competency Committee. Initial program evaluation (2013 -2014) focused on the program's effect on feedback, reflection, and goal setting. Pre- and postintervention surveys of residents and faculty assessed the quantity and quality of feedback provided to residents and faculty members' confidence in giving feedback.Review of documented coaching sessions showed that all 82 residents had 3 or more direct observations (range: 3-12). Residents and faculty assessed coaches as providing higher-quality feedback and incorporating more reflection and goal setting than noncoaches. Coaches, compared with noncoaches, demonstrated increased confidence in giving feedback on clinical reasoning, communication skills, and goal setting. Noncoach faculty reported giving equal or more feedback after the coaching program than before.Further evaluation is under way to explore how coaching residents can affect patient-level outcomes, and to better understand the benefits and challenges of coaching residents.

  View details for DOI 10.1097/ACM.0000000000001825

  View details for PubMedID 28700460

• Exploring the Educational Value of Patient Feedback: A Qualitative Analysis of Pediatric Residents' Perspectives ACADEMIC PEDIATRICS Bogetz, A. L., Rassbach, C. E., Chan, T., Blankenburg, R. L. 2017; 17 (1): 4-8

  View details for Web of Science ID 000391349100002

  View details for PubMedID 27965014

• Subacute Sclerosing Panencephalitis: The Foothold in Undervaccination JOURNAL OF PEDIATRICS Holt, R. L., Kann, D., Rassbach, C. E., Schwenk, H. T., Ritter, J. M., Rota, P. A., Elbers, J. 2016; 179: 259-262

  Abstract

  Subacute sclerosing panencephalitis (SSPE) is a fatal complication of measles infection. We present a case of a fully vaccinated 3-year-old boy who was diagnosed with and treated for autoimmune encephalitis before arriving at a diagnosis of SSPE. We discuss the challenges of diagnosing SSPE in developed countries.

  View details for DOI 10.1016/j.jpeds.2016.08.051

  View details for PubMedID 27634625

• The Current State of Pediatric Hospital Medicine Fellowships: A Survey of Program Directors JOURNAL OF HOSPITAL MEDICINE Shah, N. H., Rhim, H. J., Maniscalco, J., Wilson, K., Rassbach, C. 2016; 11 (5): 324-328

  Abstract

  Pediatric hospital medicine (PHM) fellowship programs have grown rapidly over the last 20 years and have varied in duration and content. In an effort to standardize training in the absence of a single accrediting body, PHM fellowship directors now meet annually to discuss strategies for standardizing and enhancing training.To explore similarities and differences in curricular structure among PHM fellowship programs in an effort to inform future curriculum standardization efforts.An electronic survey was distributed by e-mail to all PHM fellowship directors in April 2014. The survey consisted of 30 multiple-choice and short-answer questions focused on various curricular aspects of training developed by the authors.Twenty-seven of 31 fellowship programs (87%) responded to the survey. Duration of most programs was 2 years (63%), with 6, 1-year programs (22%) and 4 (15%) 3-year programs making up the remainder. The average amount of clinical time among programs was 50% (range approximately 20%-65%). In addition to general inpatient pediatric service time, most programs require other clinical rotations. The majority of programs allow fellows to bill independently for their services. Most programs offer certificate courses, courses for credit or noncredit courses, with 11 programs offering masters' degrees. Twenty-one (81%) programs provide a scholarship oversight committee for their fellows. Current fellows' primary areas of research are varied.Though variability exists regarding program length, clinical composition, and nonclinical offerings, several common themes emerged that may help inform the development of a standard curriculum for use across all programs. This information provides a useful starting point if pediatric hospital medicine obtains formal subspecialty status. Journal of Hospital Medicine 2016;11:324-328. © 2016 Society of Hospital Medicine.

  View details for DOI 10.1002/jhm.2571

  View details for PubMedID 27042818

• A Strategic Approach to Implementation of Medical Mentorship Programs. Journal of graduate medical education Caruso, T. J., Steinberg, D. H., Piro, N., Walker, K., Blankenburg, R., Rassbach, C., Marquez, J. L., Katznelson, L., Dohn, A. 2016; 8 (1): 68-73

  Abstract

  Mentors influence medical trainees' experiences through career enhancement and psychosocial support, yet some trainees never receive benefits from involved mentors.Our goals were to examine the effectiveness of 2 interventions aimed at increasing the number of mentors in training programs, and to assess group differences in mentor effectiveness, the relationship between trainees' satisfaction with their programs given the presence of mentors, and the relationship between the number of trainees with mentors and postgraduate year (PGY).In group 1, a physician adviser funded by the graduate medical education department implemented mentorships in 6 residency programs, while group 2 involved a training program with funded physician mentoring time. The remaining 89 training programs served as controls. Chi-square tests were used to determine differences.Survey responses from group 1, group 2, and controls were 47 of 84 (56%), 34 of 78 (44%), and 471 of 981 (48%, P?=?.38), respectively. The percentages of trainees reporting a mentor in group 1, group 2, and the control group were 89%, 97%, and 79%, respectively (P?=?.01). There were no differences in mentor effectiveness between groups. Mentored trainees were more likely to be satisfied with their programs (P?=?.01) and to report that faculty supported their professional aspirations (P?=?.001). Across all programs, fewer first-year trainees (59%) identified a mentor compared to PGY-2 through PGY-8 trainees (84%, P?

  View details for DOI 10.4300/JGME-D-15-00335.1

  View details for PubMedID 26913106

  View details for PubMedCentralID PMC4763391

• Training Health Care Professionals for 21st-Century Practice: A Systematic Review of Educational Interventions on Chronic Care ACADEMIC MEDICINE Bogetz, J. F., Rassbach, C. E., Bereknyei, S., Mendoza, F. S., Sanders, L. M., Braddock, C. H. 2015; 90 (11): 1561-1572

  Abstract

  To systematically review the evidence for high-quality and effective educational strategies to train health care professionals across the education continuum on chronic disease care.A search of English-language publications and conference proceedings was performed in November 2013 and updated in April 2014. Studies that evaluated a newly developed curriculum targeting chronic disease care with learner outcomes were included. Two primary reviewers and one adjudicating reviewer evaluated the studies and assessed their quality using the validated Medical Education Research Study Quality Instrument (MERSQI). Studies were also mapped onto elements of Wagner's chronic care model (CCM) to evaluate their use of established evidence-based models for chronic care delivery. Miller's classification of clinical competence was used to assess the quality of learner achievements for each educational intervention.A total of 672 articles were found for this review. Twenty-two met criteria for data extraction. The majority of studies were of moderate quality according to MERSQI scoring. Only three studies reported both learner and patient outcomes. The highest-quality studies incorporated more elements of Wagner's CCM and showed high-level learner competence according to Miller's classification. Successful interventions redesigned health care delivery systems to include team-based care, emphasized training of health care professionals on patient self-management, and included learner-based quality improvement initiatives.The growing number of children and adults with chronic disease necessitates improved educational interventions for health care professionals that involve evidence-based models for restructuring chronic care delivery, aim for high-level learner behavioral outcomes, and evolve through quality improvement initiatives.

  View details for DOI 10.1097/ACM.0000000000000773

  View details for PubMedID 26039140

• Caring for Children With Medical Complexity: Challenges and Educational Opportunities Identified by Pediatric Residents ACADEMIC PEDIATRICS Bogetz, J. F., Bogetz, A. L., Rassbach, C. E., Gabhart, J. M., Blankenburg, R. L. 2015; 15 (6): 621-625

  Abstract

  High-quality care for children with medical complexity (CMC) is in its infancy. Residents have the opportunity to view care for CMC with a fresh perspective that is informed by their work across diverse health care settings and significant time spent at the bedside. This study aimed to identify the challenges and potential solutions for complex care delivery and education from their perspectives.We conducted three 60-minute focus groups with a purposeful sample of residents and recent graduates at a US tertiary-care medical center. Data were transcribed verbatim, and themes were identified using an iterative approach and modified grounded theory.Sixteen participants identified 4 major challenges to caring for CMC: 1) lack of care coordination; 2) complex technology management; 3) patients' pervasive psychosocial needs; and 4) lack of effective health care provider training. Participants identified 3 solutions: 1) greater integration of primary care providers; 2) attention to psychosocial needs through shared decision making; and 3) integration of longitudinal patient relationships into provider training. We found that residents who experienced longitudinal relationships with CMC felt more efficacious and better equipped to handle challenges of caring for CMC as a result of their broader understanding of patients' priorities and of their role as providers.Residents recognize important challenges and offer thoughtful solutions to caring for CMC. Although multiple solutions exist, formal integration of longitudinal patient experiences into residency training may better prepare residents to understand patient priorities and identify when their own attitudinal changes can guide them into more efficacious roles as providers.

  View details for Web of Science ID 000364802300009

  View details for PubMedID 26409304

• Caring for Children With Medical Complexity: Challenges and Educational Opportunities Identified by Pediatric Residents. Academic pediatrics Bogetz, J. F., Bogetz, A. L., Rassbach, C. E., Gabhart, J. M., Blankenburg, R. L. 2015; 15 (6): 621-625

  Abstract

  High-quality care for children with medical complexity (CMC) is in its infancy. Residents have the opportunity to view care for CMC with a fresh perspective that is informed by their work across diverse health care settings and significant time spent at the bedside. This study aimed to identify the challenges and potential solutions for complex care delivery and education from their perspectives.We conducted three 60-minute focus groups with a purposeful sample of residents and recent graduates at a US tertiary-care medical center. Data were transcribed verbatim, and themes were identified using an iterative approach and modified grounded theory.Sixteen participants identified 4 major challenges to caring for CMC: 1) lack of care coordination; 2) complex technology management; 3) patients' pervasive psychosocial needs; and 4) lack of effective health care provider training. Participants identified 3 solutions: 1) greater integration of primary care providers; 2) attention to psychosocial needs through shared decision making; and 3) integration of longitudinal patient relationships into provider training. We found that residents who experienced longitudinal relationships with CMC felt more efficacious and better equipped to handle challenges of caring for CMC as a result of their broader understanding of patients' priorities and of their role as providers.Residents recognize important challenges and offer thoughtful solutions to caring for CMC. Although multiple solutions exist, formal integration of longitudinal patient experiences into residency training may better prepare residents to understand patient priorities and identify when their own attitudinal changes can guide them into more efficacious roles as providers.

  View details for DOI 10.1016/j.acap.2015.08.004

  View details for PubMedID 26409304

• Outcomes of a Randomized Controlled Educational Intervention to Train Pediatric Residents on Caring for Children With Special Health Care Needs CLINICAL PEDIATRICS Bogetz, J. F., Gabhart, J. M., Rassbach, C. E., Sanders, L. M., Mendoza, F. S., Bergman, D. A., Blankenburg, R. L. 2015; 54 (7): 659-666

  Abstract

  Objective. To evaluate an innovative curriculum meeting new pediatric residency education guidelines, Special Care Optimization for Patients and Education (SCOPE). Methods. Residents were randomized to intervention (n = 23) or control (n = 25) groups. Intervention residents participated in SCOPE, pairing them with a child with special health care needs (CSHCN) and faculty mentor to make a home visit, complete care coordination toolkits, and participate in case discussions. The primary outcome was resident self-efficacy in nine skills in caring for CSHCN. Secondary outcomes included curriculum feasibility/acceptance, resident attitudes, and family satisfaction. Results. Response rates were ?65%. Intervention residents improved in their self-efficacy for setting patient-centered goals compared with controls (mean change on 4-point Likert-type scale, 1.36 vs 0.56, P < .05). SCOPE was feasible/acceptable, residents had improved attitudes toward CSHCN, and families reported high satisfaction. Conclusion. SCOPE may serve as a model for efforts to increase residents' self-efficacy in their care of patients with chronic disease.

  View details for DOI 10.1177/0009922814564050

  View details for PubMedID 25561698

• Continuing education needs of pediatricians across diverse specialties caring for children with medical complexity. Clinical pediatrics Bogetz, J. F., Bogetz, A. L., Gabhart, J. M., Bergman, D. A., Blankenburg, R. L., Rassbach, C. E. 2015; 54 (3): 222-227

  Abstract

  Objective. Care for children with medical complexity (CMC) relies on pediatricians who often are ill equipped, but striving to provide high quality care. We performed a needs assessment of pediatricians across diverse subspecialties at a tertiary academic US children's hospital about their continuing education needs regarding the care of CMC. Methods. Eighteen pediatricians from diverse subspecialties were asked to complete an online anonymous open-ended survey. Data were analyzed using modified grounded theory. Results. The response rate was 89% (n = 16). Of participants, 31.2% (n = 5) were general pediatricians, 18.7% (n = 3) were hospitalists, and 50% (n = 8) were pediatric subspecialists. Pediatricians recognized the need for skills in care coordination, giving bad news, working in interprofessional teams, and setting goals of care with patients. Conclusions. Practicing pediatricians need skills to improve care for CMC. Strategically incorporating basic palliative care education may fill an important training need across diverse pediatric specialties.

  View details for DOI 10.1177/0009922814564049

  View details for PubMedID 25561699

• Pediatric primary care providers' perspectives regarding hospital discharge communication: a mixed methods analysis. Academic pediatrics Leyenaar, J. K., Bergert, L., Mallory, L. A., Engel, R., Rassbach, C., Shen, M., Woehrlen, T., Cooperberg, D., Coghlin, D. 2015; 15 (1): 61-68

  Abstract

  Effective communication between inpatient and outpatient providers may mitigate risks of adverse events associated with hospital discharge. However, there is an absence of pediatric literature defining effective discharge communication strategies at both freestanding children's hospitals and general hospitals. The objectives of this study were to assess associations between pediatric primary care providers' (PCPs) reported receipt of discharge communication and referral hospital type, and to describe PCPs' perspectives regarding effective discharge communication and areas for improvement.We administered a questionnaire to PCPs referring to 16 pediatric hospital medicine programs nationally. Multivariable models were developed to assess associations between referral hospital type and receipt and completeness of discharge communication. Open-ended questions asked respondents to describe effective strategies and areas requiring improvement regarding discharge communication. Conventional qualitative content analysis was performed to identify emergent themes.Responses were received from 201 PCPs, for a response rate of 63%. Although there were no differences between referral hospital type and PCP-reported receipt of discharge communication (relative risk 1.61, 95% confidence interval 0.97-2.67), PCPs referring to general hospitals more frequently reported completeness of discharge communication relative to those referring to freestanding children's hospitals (relative risk 1.78, 95% confidence interval 1.26-2.51). Analysis of free text responses yielded 4 major themes: 1) structured discharge communication, 2) direct personal communication, 3) reliability and timeliness of communication, and 4) communication for effective postdischarge care.This study highlights potential differences in the experiences of PCPs referring to general hospitals and freestanding children's hospitals, and presents valuable contextual data for future quality improvement initiatives.

  View details for DOI 10.1016/j.acap.2014.07.004

  View details for PubMedID 25444655

• Pediatric discharge content: a multisite assessment of physician preferences and experiences. Hospital pediatrics Coghlin, D. T., Leyenaar, J. K., Shen, M., Bergert, L., Engel, R., Hershey, D., Mallory, L., Rassbach, C., Woehrlen, T., Cooperberg, D. 2014; 4 (1): 9?15

  Abstract

  Professional medical societies endorse prompt, consistent discharge communication to primary care providers (PCPs) on discharge. However, evidence is limited about what clinical elements to communicate. Our main goal was to identify and compare the clinical elements considered by PCPs and pediatric hospitalists to be essential to communicate to PCPs within 2 days of pediatric hospital discharge. A secondary goal was to describe experiences of the PCPs and pediatric hospitalists regarding sending and receiving discharge information.A survey of physician preferences and experiences regarding discharge communication was sent to 320 PCPs who refer patients to 16 hospitals, with an analogous survey sent to 147 hospitalists. Descriptive statistics were calculated, and ?(2) analyses were performed.A total of 201 PCPs (63%) and 71 hospitalists (48%) responded to the survey. Seven clinical elements were reported as essential by >75% of both PCPs and hospitalists: dates of admission and discharge; discharge diagnoses; brief hospital course; discharge medications; immunizations given during hospitalization; pending laboratory or test results; and follow-up appointments. PCPs reported reliably receiving discharge communication significantly less often than hospitalists reported sending it (71.8% vs 85.1%; P < .01), and PCPs considered this communication to be complete significantly less often than hospitalists did (64.9% vs 79.1%; P < .01).We identified 7 core clinical elements that PCPs and hospitalists consider essential in discharge communication. Consistently and promptly communicating at least these core elements after discharge may enhance PCP satisfaction and patient-level outcomes. Reported rates of transmission and receipt of this information were suboptimal and should be targeted for improvement.

  View details for DOI 10.1542/hpeds.2013-0022

  View details for PubMedID 24435595

• Special Care Optimization for Patients and Education (SCOPE): Training Pediatric Residents About Children With Special Health Care Needs. Available from: www.mededportal.org/publication/9627 MedEdPORTAL Bogetz, J., Gabhart, J., Rassbach, C., Sanders, L., Mendoza, F., Bergman, D., Blankenburg, R. 2013
• A 6-Year-Old Girl with Extensive Bullous Skin Lesions PEDIATRIC ANNALS Rassbach, C., Shah, N., Davis, A. 2012; 41 (6): 229-231

  View details for DOI 10.3928/00904481-20120525-05

  View details for Web of Science ID 000306363600012

  View details for PubMedID 22694233

• A boy with fever and vomiting. Infectious Diseases in Children. Rassbach C, Jantausch B 2008; August
• Streptococcal pyomyositis of the psoas - Case reports and review PEDIATRIC EMERGENCY CARE Kern, L., Rassbach, C., OTTOLINI, M. 2006; 22 (4): 250-253

  Abstract

  We present two unusual cases of pyomyositis of the psoas muscle caused by Group A beta-hemolytic streptococcus (GABHS) in children presenting with fever, emesis and leg pain. Pyomyositis secondary to GABHS is rare in children and cases involving the psoas muscle have not been previously reported. In our discussion, we review the epidemiology, presentation, diagnosis and treatment of GABHS psoas myositis in comparison with staphylococcal pyomyositis. Prompt recognition of the signs and symptoms of GABHS psoas pyomyositis is essential for treatment of this life-threatening infection.

  View details for Web of Science ID 000237260600010

  View details for PubMedID 16651916

• Lyme disease, a review. Infectious Diseases in Children. Rassbach C, Jantausch B 2006; February