New generation of paediatricians in the health care system: are paediatric residents ready to manage children without supervision? A survey using respiratory infections as a model

Objectives To measure the perceived autonomy level in managing lower respiratory tract infections (LRTIs) among paediatric residents and to compare perceived autonomy with the assessments by tutors who directly supervise and evaluate residentsDesign/setting A survey on managing LRTIs was distributed...

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Main Authors: Alfredo Guarino, Francesca Rossi, Margherita Del Bene, Alfredo Diana, Antonio Corsello, Francesco Cecere, Cristiana Indolfi, Enza Mozzillo, Francesco Nunziata, Filomena Pascarella, Michelina Sibilio, Massimo Ummarino
Format: Article
Language:English
Published: BMJ Publishing Group 2025-07-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/7/e097799.full
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author Alfredo Guarino
Francesca Rossi
Margherita Del Bene
Alfredo Diana
Antonio Corsello
Francesco Cecere
Cristiana Indolfi
Enza Mozzillo
Francesco Nunziata
Filomena Pascarella
Michelina Sibilio
Massimo Ummarino
author_facet Alfredo Guarino
Francesca Rossi
Margherita Del Bene
Alfredo Diana
Antonio Corsello
Francesco Cecere
Cristiana Indolfi
Enza Mozzillo
Francesco Nunziata
Filomena Pascarella
Michelina Sibilio
Massimo Ummarino
author_sort Alfredo Guarino
collection DOAJ
description Objectives To measure the perceived autonomy level in managing lower respiratory tract infections (LRTIs) among paediatric residents and to compare perceived autonomy with the assessments by tutors who directly supervise and evaluate residentsDesign/setting A survey on managing LRTIs was distributed among all Italian paediatric residents and tutors via Google Forms between January 1 and 31, 2024.Participants, residents and tutors were classified according to their training year and clinical setting: primary care paediatrics (PCP), emergency department (ED) and hospital ward (HW).Outcome Perceived autonomy of paediatric residents in managing LRTI in different settings; overall perceived autonomy and interest in employment.Results A total of 391 questionnaires were returned, with 273 completed by residents and 118 by tutors. Among residents, 3% in their first year felt fully capable of managing LRTIs without supervision in both ED and HW settings. This percentage remained below 25% until the third year and increased to 72% in ED and 83% in HW by the fifth year. In PCP settings, autonomy ranged from 15% in the first year to 96% in the final year. No differences were found between residents’ self-evaluations and tutors’ assessments. Confidence in skills showed no regional differences across Italy.Conclusion Most residents did not feel ready to manage winter respiratory infections in children without supervision, especially in the ED compared with the HW; however, self-confidence was higher in the PCP setting. Tutors shared similar perceptions. The location did not affect the response pattern. These findings caution against employing residents to work autonomously, particularly in emergency settings.
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spelling doaj-art-2ecc89a48582464da1a7c2d124c1c25a2025-08-20T03:13:59ZengBMJ Publishing GroupBMJ Open2044-60552025-07-0115710.1136/bmjopen-2024-097799New generation of paediatricians in the health care system: are paediatric residents ready to manage children without supervision? A survey using respiratory infections as a modelAlfredo Guarino0Francesca Rossi1Margherita Del Bene2Alfredo Diana3Antonio Corsello4Francesco Cecere5Cristiana Indolfi6Enza Mozzillo7Francesco Nunziata8Filomena Pascarella9Michelina Sibilio10Massimo Ummarino11Department of Translational Medical Sciences, Section of Pediatrics, Federico II University Hospital, Naples, Campania, ItalyDepartment of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Campania, ItalyDepartment of Translational Medical Sciences, Section of Pediatrics, Federico II University Hospital, Naples, Campania, ItalyDepartment of Translational Medical Sciences, Section of Pediatrics, Federico II University Hospital, Naples, Campania, ItalyDepartment of Pediatrics, Vittore Buzzi Children’s Hospital, Milan, Lombardia, ItalyDepartment of Environmental Biological and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta, ItalyDepartment of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Campania, ItalyDepartment of Translational Medical Sciences, Section of Pediatrics, Federico II University Hospital, Naples, Campania, ItalyGeneral Paediatrics and Immuno-Rheumatology Unit, National Specialty Hospital Santobono Pausilipon, Naples, Campania, ItalyDepartment of Pediatric Endocrinology, Azienda Ospedaliera di Caserta Sant’Anna e San Sebastiano, Caserta, Campania, ItalyUOSD Metabolic Diseases, National Specialty Hospital Santobono Pausilipon, Naples, Campania, ItalyCampania Section, Italian Society of Pediatrics, Naples, Campania, ItalyObjectives To measure the perceived autonomy level in managing lower respiratory tract infections (LRTIs) among paediatric residents and to compare perceived autonomy with the assessments by tutors who directly supervise and evaluate residentsDesign/setting A survey on managing LRTIs was distributed among all Italian paediatric residents and tutors via Google Forms between January 1 and 31, 2024.Participants, residents and tutors were classified according to their training year and clinical setting: primary care paediatrics (PCP), emergency department (ED) and hospital ward (HW).Outcome Perceived autonomy of paediatric residents in managing LRTI in different settings; overall perceived autonomy and interest in employment.Results A total of 391 questionnaires were returned, with 273 completed by residents and 118 by tutors. Among residents, 3% in their first year felt fully capable of managing LRTIs without supervision in both ED and HW settings. This percentage remained below 25% until the third year and increased to 72% in ED and 83% in HW by the fifth year. In PCP settings, autonomy ranged from 15% in the first year to 96% in the final year. No differences were found between residents’ self-evaluations and tutors’ assessments. Confidence in skills showed no regional differences across Italy.Conclusion Most residents did not feel ready to manage winter respiratory infections in children without supervision, especially in the ED compared with the HW; however, self-confidence was higher in the PCP setting. Tutors shared similar perceptions. The location did not affect the response pattern. These findings caution against employing residents to work autonomously, particularly in emergency settings.https://bmjopen.bmj.com/content/15/7/e097799.full
spellingShingle Alfredo Guarino
Francesca Rossi
Margherita Del Bene
Alfredo Diana
Antonio Corsello
Francesco Cecere
Cristiana Indolfi
Enza Mozzillo
Francesco Nunziata
Filomena Pascarella
Michelina Sibilio
Massimo Ummarino
New generation of paediatricians in the health care system: are paediatric residents ready to manage children without supervision? A survey using respiratory infections as a model
BMJ Open
title New generation of paediatricians in the health care system: are paediatric residents ready to manage children without supervision? A survey using respiratory infections as a model
title_full New generation of paediatricians in the health care system: are paediatric residents ready to manage children without supervision? A survey using respiratory infections as a model
title_fullStr New generation of paediatricians in the health care system: are paediatric residents ready to manage children without supervision? A survey using respiratory infections as a model
title_full_unstemmed New generation of paediatricians in the health care system: are paediatric residents ready to manage children without supervision? A survey using respiratory infections as a model
title_short New generation of paediatricians in the health care system: are paediatric residents ready to manage children without supervision? A survey using respiratory infections as a model
title_sort new generation of paediatricians in the health care system are paediatric residents ready to manage children without supervision a survey using respiratory infections as a model
url https://bmjopen.bmj.com/content/15/7/e097799.full
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