Jessica Moriarty

All Publications

• "The Most Difficult Conversations We Have": Resident Experiences With Pediatric Neuroprognostication. Annals of the Child Neurology Society Lin, G. L., White, B. D., Burk, S. D., Moriarty, J. A., Mauser, D. B., Wakefield, C. E., Wusthoff, C. J., Baker, J. N. 2026; 4 (3): 227-238

  Abstract

  Pediatric neuroprognostication is often complicated by uncertainty and embedded in high-stakes medical decisions. For child neurology residents, participation in neuroprognostication can represent key learning experiences but also comes with emotional and ethical challenges, which poses a risk of moral distress. This study sought to describe contextual influences and impacts on residents participating in neuroprognostication.One-on-one, semi-structured virtual interviews were conducted with senior (postgraduate year 5-6) child neurology residents. Deidentified transcripts were iteratively analyzed to develop themes and generate a narrative of resident experiences. Initial themes were shared with participants for additional feedback. Final themes were synthesized to characterize contextual influences and the emotional and professional impacts of participating in neuroprognostication.Fifteen residents from 12 institutions across 10 states participated, representing a range of program sizes and geographic locations across the United States. Qualitative analysis identified five themes: (1) Serious neurologic pathology and decisions with high stakes, highlighting neurology teams' roles in major medical decisions; (2) Navigating uncertainty and hope, describing the difficulty of limited data; (3) Systemic barriers and challenges to prognostic communication, underscoring team- and institution-level factors; (4) Negative emotional impacts, with concerns of developing emotional exhaustion; and (5) The importance of neuroprognostication, emphasizing the gravity of this responsibility and distress when residents felt ineffective in this role.Residents describe neuroprognostication as an emotionally salient experience carrying a strong sense of responsibility. This narrative highlights opportunities to support residents in training, improve prognostic communication, and address potential threats to resident well-being.

  View details for DOI 10.1002/cns3.70080

  View details for PubMedID 42751260

  View details for PubMedCentralID PMC13580348

• Education Research: Learning to Prognosticate: An Educational Needs Assessment with Senior Child Neurology Residents. Neurology. Education Lin, G. L., Burk, S. D., White, B. D., Moriarty, J. A., Mauser, D. B., Wakefield, C. E., Wusthoff, C. J., Baker, J. N. 2026; 5 (2): e200306

  Abstract

  Background and Objectives: Pediatric neuroprognostication is technically challenging and ethically complex. Despite its importance, little is known about how child neurology residents learn to estimate and communicate neurologic prognosis. Current educational interventions focus on communication but lack pediatric-specific focus. This exploratory qualitative study sought to describe how graduating residents conceptualize pediatric neuroprognostication, their educational experiences, and what gaps they identify in learning to prognosticate.Methods: Semistructured, one-on-one virtual interviews with senior child neurology residents (postgraduate year 5 or 6) were audio-recorded, transcribed, and deidentified. Participants also completed a postinterview survey on exposure to and perceived effectiveness of different learning modalities. Transcripts were analyzed iteratively using a constructivist grounded theory approach with regular consensus meetings. Preliminary themes and subthemes were presented to participants with opportunity for feedback using a standardized set of member checking questions. The findings of the study were mapped to elements of a targeted needs assessment in Kern's six-step model for curriculum development to help inform future educational efforts.Results: Fifteen residents representing 12 institutions across 10 states participated, representing diverse program sizes and geographic regions. Residents most frequently reported learning neuroprognostication through observation of attending physicians and clinical practice, while coaching/direct mentorship was also felt to be effective but less available. Qualitative analysis yielded 4 themes: conceptualizing content of neuroprognostication (for example, framing around common outcome domains), educational contributors (emphasizing the importance of effective modeling and graded autonomy), perceived efficacy in prognostication (such as relying on structured approaches), and identified gaps in education (including specific topics and modalities). These themes were then mapped to elements of a targeted needs assessment using Kern's six-step approach to curriculum development, highlighting opportunities and gaps in current educational approaches.Discussion: This qualitative study provides important context for considering strategies to improve resident education on neuroprognostication. The identified gaps highlight needs for structured debriefing and feedback with a particular opportunity for coaching-based strategies, consideration of simulation or roleplay-based modules, and focusing content development on pediatric disease-specific and ethical considerations. Limitations include the need for future work focused on educator perspectives. These findings provide a basis for developing neuroprognostication curricula for child neurology residents.

  View details for DOI 10.1212/NE9.0000000000200306

  View details for PubMedID 42088099

• Respecting Spirituality During Extubations: Holding Spacefor Miracles and Legacy with Reactive Comfort Plans Morvant, A., Mauser, D., Moriarty, J., Norvell, M., Baker, J., Ammon, E. H. ELSEVIER SCIENCE INC. 2024: E663-E664

  View details for Web of Science ID 001282805300257

• Righting the Autonomy-Supervision Pendulum: Understanding the Impact of Independent Rounds on Medical Students, Residents, and Faculty. Academic medicine : journal of the Association of American Medical Colleges Moriarty, J. A., Vellanki, S. n., Trope, L. A., Hilgenberg, S. L., Blankenburg, R. L. 2020

  Abstract

  To explore trainee and faculty perspectives on an independent rounding intervention on general pediatrics wards at 2 institutions.In July 2018, the authors introduced independent rounds 1 to 2 times a week at 2 training sites. In this qualitative study, the authors conducted semi-structured focus groups with a purposive sample of junior trainees (clerkship medical students and PGY1 residents), senior trainees (PGY2 and PGY3-5 residents), and hospital medicine faculty between October 2018 and May 2019. Focus groups were audio-recorded, transcribed verbatim, and analyzed for themes using the constant comparative approach associated with grounded theory.Focus groups included 27 junior trainees, 20 senior trainees, and 18 faculty. Six themes emerged: (1) Independent rounds contributed to all trainees' development; (2) Senior residents described increased motivation to take full ownership of their patients and educational needs of the team; (3) Faculty expressed concerns about decreased opportunities for teaching and feedback, however all trainees reported unique learning from having faculty both present and absent from rounds; (4) No significant patient safety events were reported; (5) All participants identified communication and patient progression concerns; (6) A tension emerged between decreased faculty and enhanced trainee career satisfaction. Participants identified solutions to identified barriers to further improve this educational intervention.As a result of independent rounding, trainees described increased motivation to take ownership of their patients and team. Both rounding experiences contributed to their development as physicians in different ways. Further studies should explore patient and caregiver perspectives and concerns about communication and patient care progression when designing future interventions to promote resident autonomy.

  View details for DOI 10.1097/ACM.0000000000003645

  View details for PubMedID 32769470