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Learnings From the Pilot Implementation of Mobile Medical Milestones Application.

BACKGROUND Implementation of the educational milestones benefits from mobile technology that facilitates ready assessments in the clinical environment. We developed a point-of-care resident evaluation tool, the Mobile Medical Milestones Application (M3App), and piloted it in 8 North Carolina family medicine residency programs. OBJECTIVE We sought to examine variations we found in the use of the tool across programs and explored the experiences of program directors, faculty, and residents to better understand the perceived benefits and challenges of implementing the new tool. METHODS Residents and faculty completed presurveys and postsurveys about the tool and the evaluation process in their program. Program directors were interviewed individually. Interviews and open-ended survey responses were analyzed and coded using the constant comparative method, and responses were tabulated under themes. RESULTS Common perceptions included increased data collection, enhanced efficiency, and increased perceived quality of the information gathered with the M3App. Residents appreciated the timely, high-quality feedback they received. Faculty reported becoming more comfortable with the tool over time, and a more favorable evaluation of the tool was associated with higher utilization. Program directors reported improvements in faculty knowledge of the milestones and resident satisfaction with feedback. CONCLUSIONS Faculty and residents credited the M3App with improving the quality and efficiency of resident feedback. Residents appreciated the frequency, proximity, and specificity of feedback, and faculty reported the app improved their familiarity with the milestones. Implementation challenges included lack of a physician champion and competing demands on faculty time.

Special Population: Children and Adolescents

Prevalence rates of chronic illness in childhood have increased steadily over the last several decades. Caring for the child with chronic illness is a complex task that requires a multidisciplinary approach across multiple care settings. In addition to the medical settings of outpatient clinics, emergency rooms, and hospitals, children with chronic illness receive care in their homes, schools, and communities. Chronic illness and frequent or prolonged hospitalizations can negatively affect a child’s physical, cognitive, emotional, and psychological development. Health-care providers can identify problems and mitigate negative consequences. Chronic illness in children has a significant impact on their future adult health. Health-care models must maximize the health potential of children with chronic illness.