Background/Purpose: Pediatric rheumatology faces many challenges due to the shortage of board certified physicians in the field and the imbalance in their geographic distribution.  This shortage has required primary care physicians and adult rheumatologists to assume the care of children with rheumatologic diseases, though these physicians report significant discomfort doing so. We are addressing this issue through the development of a novel web-based curriculum aimed at primary care physicians, employing a needs assessment survey to help guide the curriculum. 

Methods: Tenants of adult learning theory stress activating the learners’ prior knowledge and engaging the learner in determining personal educational goals. We therefore distributed a needs assessment survey to Vanderbilt Pediatric residency graduates (1981-2010) working in primary care who kept an address on file with the Vanderbilt Medical Alumni Association. Our goals were to understand perceptions of what the needs are and what educational interventions would be most effective.

Results: Of 152 surveys sent successfully via Survey Monkey, we received 28 responses (18.4%).   When asked the question “On completion of your residency training were you comfortable recognizing the following diseases in children?”, the self-reported ability to recognize chronic arthritis on completing residency was high (71.4%), while confidence in recognizing other chronic autoimmune diseases was low, with only 64.3% comfortable recognizing lupus, the majority uncomfortable recognizing juvenile dermatomyositis (53.6%), localized scleroderma (75%), systemic sclerosis (82.1%), Behcet’s Disease (75%) and sarcoidosis (82.1). (Figure 1) We also found primary care physicians to have interest in practical, problem oriented educational resources, including action plans for common rheumatologic complaints (71.4%) and emergencies by specific disease (67.9%).  (Figure 2)

Conclusion: Our needs assessment survey of primary care physicians found a high self-reported ability to recognize chronic arthritis when leaving residency training, though low confidence in recognizing rarer but potentially more serious or life-threatening autoimmune diseases. Our results also indicate that primary care physicians have interest in practical, problem oriented educational resources to assist them in caring for children with rheumatologic diseases. We will utilize our survey results to develop a learner centered web-based curriculum in pediatric rheumatology, with the ultimate goal of improving care for children with autoimmune diseases.