Addressing gaps in pediatric resident education on the management of intestinal failure in the United States: Creation and implementation of a targeted curriculum

Introduction: Pediatric residents at our institution manage patients with intestinal failure (IF), but report associated anxiety due to clinical inexperience and lack of formal education in this field. This pilot project aimed to identify knowledge gaps and address them through a targeted educational intervention. Methods: A needs assessment survey was distributed to all pediatric residents via QR codes and email. The survey included Likert-scale, multiple-choice, open-ended, and rating questions to assess confidence in IF-related care. Survey results informed a targeted curriculum that addressed key deficit areas through an in-person lecture, workshops, and a reference guide aligned with residents' preferred learning formats. A post-intervention survey, modeled after the initial assessment, was distributed five months later to evaluate the curriculum's impact. Results: Of the 131 residents, 40 (31%) completed the initial survey. Residents reported lowest confidence (<4/10) in calculating and ordering home Total Parenteral Nutrition (TPN) and TPN-like fluids, understanding remaining anatomy, managing central access loss and poor catheter blood flow, identifying signs of D-lactic acidosis and small intestinal bacterial overgrowth (SIBO), and ensuring proper stoma care. Conversely, they felt more confident managing feeding intolerance and central line-associated infections (5-6/10), and signs of shock (>7/10). Five months post-implementation, twenty residents (15%) completed the post-intervention survey, showing improved confidence in managing IF patients, particularly in TPN management (p = 0.0083) and enteral/stoma care (p = 0.0393). Interest in IF education increased from 64% to 85%. Conclusion: The needs assessment highlighted critical gaps in resident IF education. A targeted, resident-informed curriculum improved confidence and engagement. Next step is national dissemination.