Original Publication
Open Access

Complex Care Curriculum: Evaluation and Management of Gastroesophageal Disease (GERD) in the Neurologically Impaired Child (NIC)

Published: March 14, 2014 | 10.15766/mep_2374-8265.9737

Included in this publication:

  • Instructor's Guide.doc
  • Module with Audio Voice-Over for Individual Self Study.zip
  • PowerPoint Slides without Audio for Small Group Teaching.pptx
  • Faclitator Guide with Notes.doc
  • Pre and Post Test Questions.doc
  • Evaluation.docx
  • Supplementary Documents.docx

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.

Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.


Introduction: Children with special health care needs are increasingly prevalent in US hospitals. The pediatric hospitalist is often the primary provider of inpatient care for these patients. However, exposure to this patient population during training varies from provider to provider. No published educational curricula are specific to the inpatient care of this population. The Complex Care Curriculum's purpose is to build a multimodal educational curriculum for providers with the overall goal of improving inpatient care for this at-risk population. Methods: This particular module focuses on gastroesophageal reflux disease (GERD) in neurologically impaired children (NIC). GERD is prevalent among NIC, and at this time, guidelines specifically for this patient population do not exist. This resource includes a multimedia, narrated PowerPoint show for asynchronous learning, a PowerPoint presentation adapted for didactic teaching, a facilitator guide, suggested multiple-choice questions with answer key, an evaluation tool, and a complete list of references and resources. The target audience is pediatric hospitalists and other general pediatric providers or trainees who care for medically complex children in an inpatient setting, although the module may also be applicable to health care providers in outpatient settings. Results: The curriculum was implemented in 2012, and a pilot study of participants was conducted. Impact on knowledge, skills, and attitudes was assessed. Fourteen study participants completed the GERD evaluation and the management in NIC module. Of these participants, 100% either agreed or strongly agreed that the module was relevant to clinical practice, and 87% either agreed or strongly agreed that the module increased their comfort with the topic. All agreed that the learning format was appropriate to their learning needs. Based on this study, the module continues to be offered to trainees and new faculty to augment their knowledge and skills in this area. Discussion: Although guidelines for GERD management in the general pediatric population are available, they do not specifically address the needs of NIC. Given the complexities of this high-risk population and the fact that GERD is prevalent within NIC, a resource that outlines the diagnostic workup and treatment options for GERD in NIC would be useful to providers. This particular resource serves as an introductory primer on evidence-based practices for GERD evaluation and management for pediatric hospitalists and pediatricians who serve as primary providers for NIC.

Educational Objectives

By the end of this module, learners will be able to:

  1. Describe signs and symptoms of gastroesophageal reflux disease (GERD) in neurologically impaired children.
  2. Discuss tests used in the evaluation of GERD.
  3. Summarize treatment options for GERD: pharmacotherapy, lifestyle modifications, and surgical therapy.
  4. Identify indications for gastrojejunal feeding and for fundoplication.
  5. Compare the risks and benefits of a gastrojejunal tube to fundoplication.

Author Information

  • Amina Khan, MD, MPH: Children's National Medical Center
  • Anil Darbari: Children's National Medical Center
  • Neha Shah: Children's National Medical Center
  • Priti Bhansali: Children's National Medical Center
  • Melanie Anspacher: Children's National Medical Center

None to report.

None to report.


Khan A, Darbari A, Shah N, Bhansali P, Anspacher M. Complex care curriculum: evaluation and management of gastroesophageal disease (GERD) in the neurologically impaired child (NIC). MedEdPORTAL. 2014;10:9737. https://doi.org/10.15766/mep_2374-8265.9737