Longitudinal assessment of residents' perceptions of shared decision-making, patient-centered communication, and reactions to uncertainty.

Background: Managing uncertainty is an essential element of patient-centered communication (PCC) and shared decision making (SDM), yet we know little about how residents' reactions to uncertainty are related to their perceptions of their ability to engage in these important activities. This longitudinal study assesses whether residents' self-perceived PCC and SDM skills are associated with their reactions to uncertainty throughout residency.

Methods: Data were collected using a three-year, longitudinal survey of two cohorts of pediatric residents.

Residents' Communication With Attendings About Uncertainty: A Single-Site Longitudinal Survey.

Objective: Managing uncertainty is a core competency of pediatric residents. However, discussing uncertainty with attending physicians can be challenging. Research is needed to understand residents' goals when communicating about uncertainty with attending physicians and how residents' perceptions of communication change during residency.

"I Want Them to Still Trust Me with Their Child's Care": A Longitudinal Study of Pediatric Residents' Reactions to and Communication with Parents about Medical Uncertainty across Residency.

Physicians in residency training experience high levels of medical uncertainty, yet they are often hesitant to discuss uncertainty with parents. Guided by the theory of motivated information management and a multiple goals perspective, this mixed-methods longitudinal study examines associations among residents' tolerance of and reactions to uncertainty, efficacy communicating about uncertainty, and perceptions of parents' trust in them as physicians. To contextualize these associations, we also examined residents' task, identity, and relational goals when communicating about uncertainty with parents.

Effect of osteopathic manipulative treatment on pulmonary function testing in children with asthma.

Context: Asthma is a leading cause of pediatric chronic illness, and poor disease control can lead to decreased quality of life and impaired academic performance. Although osteopathic manipulative treatment (OMT) has been shown to have positive effects on pulmonary function in adult patient populations, less is known about its impact in children.

Objectives: To evaluate changes in pulmonary function testing (PFT) in pediatric patients on the same day they received OMT compared with PFT in those who received usual care.

Impact of an osteopathic presence in a large categorical pediatric residency training program.

Context: Nationwide Children's Hospital (NCH) has a large pediatric residency program with 43 residents in the categorical pediatric program and 10 residents in the Internal Medicine-Pediatrics (IM-Peds) program per class. Of the 43 categorical pediatric residents, four are in the osteopathic recognition track (ORT) and continue their osteopathic education throughout residency. There is currently a lack of data examining the effect of an ORT, and specifically a pediatric ORT, on a residency program.

The Development of a Pediatric Osteopathic Recognition Track.

It is clear that graduates of osteopathic medical schools desire to maintain their Osteopathic Manipulative Medicine (OMM) and Osteopathic Principles and Practice (OPP) skills and mindset of their professional identity. In a recent survey, 68% of 1,523 third year osteopathic medical students indicated that it would be more appealing to attend a residency with osteopathic recognition, with more than half indicating this would play an important role in how they made their rank list. There are currently few options available to DO students that would like to maintain their OMM and OPP skills during pediatric residency programs, and with an increasing number of DO graduates each year, there may be a need to provide more opportunities for them.

Concussions and Osteopathic Manipulative Treatment: An Adolescent Case Presentation.

Concussions commonly occur in adolescents. Although the majority of adolescent patients' symptoms resolve, about 11% continue to experience symptoms at 3 months. Standard treatment options for prolonged symptoms are not available, and the role of osteopathic manipulative treatment in the management of adolescent concussions is unclear.

The Doctors Hospital and Nationwide Children's Hospital Dually Accredited Pediatric Residency Program: A Potential Best Model for Pediatric Osteopathic GME Training.

With the commitment on the part of the American Osteopathic Association, the American Association of Colleges of Osteopathic Medicine, and the Accreditation Council for Graduate Medical Education to transition to a single graduate medical education accreditation system by 2020, a legitimate concern exists about the future of pediatric residency training that maintains an osteopathic focus. The authors describe a dually accredited pediatric residency program at one of the nation's largest children's hospitals, which may serve as a potential model of how to integrate a robust osteopathic-based education into a general pediatric residency program.

An international effort towards developing standards for best practices in analysis, interpretation and reporting of clinical genome sequencing results in the CLARITY Challenge.

Background: There is tremendous potential for genome sequencing to improve clinical diagnosis and care once it becomes routinely accessible, but this will require formalizing research methods into clinical best practices in the areas of sequence data generation, analysis, interpretation and reporting. The CLARITY Challenge was designed to spur convergence in methods for diagnosing genetic disease starting from clinical case history and genome sequencing data. DNA samples were obtained from three families with heritable genetic disorders and genomic sequence data were donated by sequencing platform vendors.