Conjunctivitis is a common pediatric problem and is broadly divided into infectious and non-infectious etiologies. Bacterial conjunctivitis makes up the majority of cases in children and often presents with purulent discharge and mattering of the eyelids. Treatment is supportive with an individual approach to antibiotic use in uncomplicated cases since it may shorten symptom duration, but is not without risks. Viral conjunctivitis is the other infectious cause and is primarily caused by adenovirus, with a burning, gritty feeling and watery discharge. Treatment is supportive. Allergic conjunctivitis is largely seasonal and presents with bilateral itching and watery discharge. Treatment can include topical lubricants, topical antihistamine agents, or systemic antihistamines. Other causes of conjunctivitis include foreign bodies and non-allergic environmental causes. Contact lens wearers should always be treated for bacterial conjunctivitis and referred to evaluate for corneal ulcers. Neonatal conjunctivitis requires special care with unique pathogens and considerations. This review covers essential information for the primary care pediatric provider as they assess cases of conjunctivitis.

Background: Uncertainty is ubiquitous in medical practice. The Pediatrics Milestones from the Accreditation Council on Graduate Medical Education state that advanced learners should acknowledge and communicate about clinical uncertainty. If uncertainty is not acknowledged, patient care may suffer. There are no described curricula specifically aimed to improve learners’ ability to acknowledge and discuss clinical uncertainty. We describe an educational intervention designed to fill this gap. Methods: Second-year pediatric residents engaged in a two-phase simulation-based educational intervention designed to improve their ability to communicate about diagnostic uncertainty with patients and caregivers. In each phase, residents engaged in two simulated cases and debriefs. Performance was assessed after each simulated patient encounter using standardized metrics, along with learner perceptions of the experience. Results: Residents’ skills in communicating with patients and families about diagnostic uncertainty improved after this intervention (mean score post 3.84 vs. 3.28 pre on a five-point Likert scale, p<0.001). Residents rated the experience as relevant, challenging and positive. Conclusions: This prospective study suggests that a simulation-based intervention was effective in improving resident physicians’ skills in communicating about diagnostic uncertainty with patients and families. Further study is needed to determine how learners perform in real clinical environments.

Background : Promoting resident scholarship is important to programs. Positive Peer-Pressured Productivity (P-QUAD) is a dual incentive model that combines increased transparency through awareness of peers' engagement in scholarship, with a weighted cash lottery where tickets are earned for various dimensions of academic success (ie, 1 point/ticket for an abstract submission up to 6 for manuscript acceptance). Objective : We explored whether a weighted lottery system contributes to sustained increases in academic productivity in a residency program. Methods : We implemented P-QUAD in 1 pediatrics residency program in July 2015. Residents reported their scholarship submissions/acceptances for the prior year, establishing a program baseline. During the 2-year intervention, residents logged their academic submissions/acceptances on a web interface where they could view real-time scores and the work of their peers. At the end of each academic year, we compared P-QUAD points for each category to baseline. Results : During the intervention, 31% of residents (68 of 218) reported engaging in scholarship. Using P-QUAD was acceptable to most residents. Engagement in scholarship across the program, as measured by total P-QUAD score, increased 53% from baseline (329 versus 504 points per year). Mean submission and acceptance rates for individual residents reporting research through P-QUAD increased across all categories, ranging from 19% for abstract submissions (1.62 to 1.93 per year) to 275% (0.24 to 0.90 per year) for accepted manuscripts. Conclusions : The residency program sustained gains in academic productivity at the program-wide and participating resident level in the 2 years since implementing P-QUAD.

Team-based, interprofessional approaches to outpatient care are critical to high-quality patient care. However, few specific educational interventions promoting these skills in graduate level health care trainees have been described to date. University of Minnesota faculty from the Schools of Medicine, Pharmacy, and Nursing created an interprofessional workshop experience exploring core concepts in outpatient care for graduate level trainees in pediatrics, family medicine, medicine-pediatrics, internal medicine, graduate-level nursing, and pharmacy. We focused on four key content areas: teamwork, systems thinking, the patient-centered health care home, and patient-centered communication. The workshop included brief didactics, role-plays, team-based experiences, and interactive skill practice. Participants completed an end-of-day survey reflecting on knowledge and attitude. From 2014-2017, nine workshops reached 305 trainees. Survey results from the 2015-2016 academic year are representative of our overall results and revealed that learners found the content high yield, and that they valued the opportunity to learn with their interprofessional colleagues. Improvements in perceived knowledge were noted in all domains. Trainees also reported increased skills, with 81% reporting both increased confidence in working within the interprofessional team, and change in attitude, and 90% reporting increased interest in working with their interprofessional colleagues after the workshop. Creating an opportunity for postgraduate level trainees from a variety of disciplines and professions to convene and focus on interprofessional team-based skills can fill a gap in interprofessional learning as they enter practice. Trainees were able to draw on their everyday experiences and find common ground with their interprofessional colleagues.

Marginalized individuals in medicine face many structural inequities which can have enduring consequences on their progress. Therefore, inequity must be addressed by dismantling underlying unjust policies, environments, and curricula. However, once these injustices have been taken apart, how do we build more just systems from the rubble? Many current strategies to address this question have foundational values of urgency, solutionism, and top-down leadership. This paper explores a counternarrative: Design Justice. As a set of guiding principles, Design Justice centers the experiences and perspectives of marginalized individuals and communities. These principles include mutual accountability and transparency, co-ownership, and community-led outcomes, and honoring local, traditional, Indigenous knowledge. Rooted in critical scholarship and critical design, Design Justice recognizes the interconnectedness of various forms of marginalization and works to critically examine power dynamics that exist in every design process. These co-created principles act as practical guardrails, directing progress toward justice. This paper begins with an overview of Design Justice's history in critical scholarship and critical design, providing foundational background knowledge for medical educators, scholars, and leaders in key concepts of justice and design. We explore how the Design Justice principles were developed and have been applied across sectors, highlighting its applications, including education applications. Finally, we raise critical questions about medical education prompted by Design Justice.

Branding is a tactic which has been well described in the business literature as a way to enhance a company's reputation, promote a sense of high quality and value, and influence an individual's perception and behavior. Branding has not traditionally been explicitly used by training programs for recruitment. However, it can be used as a powerful tool to help recruit and retain candidates who will thrive in your program. Branding has become even more important since the COVID-19 pandemic with the absence of in-person experiences for most applicants and a transition to virtual interview platforms. This article discusses how to develop and use your core values to understand your brand identity, create a clear and memorable message to your applicants, and ensure a brand experience that will allow applicants to understand the essence of your training program.