All residents included in this study provided informed consent for participation in the study. It was approved by the Institutional Review Board of Geisinger Medical Center (IRB no., 2015-0432).

The survey participants consisted of 40 of the 42 pediatric residents at Geisinger Medical Center, Danville, Pennsylvania, USA (14 of the 14 first-year residents, 13 of the 14 second-year residents, and 13 of the 14 third-year residents). The 2 missing residents were excluded by chance (scheduled vacation or off day). Surveys were administered during residents’ morning report time slot during the July 2016 to July 2017 training year. The participants completed the Attitudes and Experiences in School Health Collaboration survey (Table 1). This survey consisted of 9 total items and took approximately 6 minutes to complete. Data were analyzed descriptively to evaluate how often the participants endorsed the 4-point Likert-type scale items pertaining to “attitudes” and the items pertaining to “experiences” in school health collaboration. Item no. 6 was an open-ended question asking participants to list the barriers that they perceived in collaborating with school personnel. (“What barriers, if any, are there in collaborating with school personnel?”) These items were grouped into a total of 6 categories that were created for each set of similar responses.

The survey results are presented in Table 1. Raw data were available from Supplement 1. More than half of the respondents collaborated and/or communicated with school personnel. Four-fifths strongly or very strongly felt that collaboration/communication with schools contributed to improved patient care. The most important topic of communication with schools was reported to be ADHD.

Based on the results from the open-ended item, the following themes, which were reflected by more than 1 response, were identified: lack of time (n= 22), incompatibility of work schedules (n= 7), do not know who to contact (n= 8), do not know how to contact (n= 6), perception of schools as unable to provide adequate support (n= 4), and privacy/Health Insurance Portability and Accountability Act concerns (n=2). Specific responses are available in Supplement 1.

The results should be interpreted in light of the limitations of this study. The survey instrument was developed by the author, and a psychometric validation of the measure was not conducted due to the small sample size. Data were self-reported. Although these findings are from a single pediatric residency training program in the United States, they offer some interesting findings and suggest the need for further exploration. Residents generally recognized the value of collaborating/communicating with schools regarding patient care and believed that doing so contributed to a higher standard of care (Table 1). Early exposure to the local schools and school personnel through school-based immersion experiences should be provided through methods such as shadowing, presentations, and shared-care projects with medical and school providers. Activities of this type may provide an imprinting function by demonstrating the relevant school personnel and through the choice of a topic that is ideal for collaboration. Sufficient time for communicating with school teachers, school nurses, counselors, or school psychologists should be allocated during the pediatric resident training program.