A New, Experiential Curriculum in Child Advocacy for Pediatric Residents

Roth, Emily; Barreto, Patricia M.; Sherritt, Lon; Palfrey, Judith S.; Risko, Wanessa; Knight, John R.

doi:10.1367/a04-010r1.1

Cited by 33 publications

(22 citation statements)

References 4 publications

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“…While structured, case-based curricula for specific topics in ambulatory pediatric care have been developed and evaluated previously, [21][22][23][24] this is the first description of a comprehensive, longitudinal, primary care curriculum in general ambulatory pediatrics. Descriptions of similar educational interventions exist in the internal medicine literature, and our findings are in keeping with previously published reports, [25][26][27][28] including the use of ambulatory care curricula to meet ACGME competency and program requirements.…”

Section: Discussionmentioning

confidence: 99%

“…Other studies have demonstrated improvements in residents' knowledge and confidence after the introduction of novel pediatric curricula in ambulatory settings. [21][22][23][24] Faculty also may have gained knowledge by reviewing the literature on basic topics in general pediatrics. This newfound confidence in preceptors' own knowledge may have improved subsequent precepting interactions, translating to improved resident knowledge and skills.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of a Case-Based Primary Care Pediatric Conference Curriculum

Talwalkar¹,

Fenick²

2011

Journal of Graduate Medical Education

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Background Our goal was to assess the impact of a standardized residency curriculum in ambulatory pediatrics on residents' participation, satisfaction, and confidence. Methods A case-based curriculum for weekly primary care conference was developed to replace the existing free-form review of topics at the Yale Pediatrics Residency Program. Before the curricular switch, faculty preceptors and members of the academic year 2005–2006 intern class completed surveys designed to measure conference occurrence and resident attendance, participation, satisfaction, and confidence in clinical skills. One year after the curricular switch, identical surveys were completed by faculty preceptors and members of the academic year 2006–2007 intern class. Results Faculty surveys indicated that conferences took place significantly more often after the curricular switch. The number of residents at conference each day (3.18 vs 4.50; P < .01) and the percentage who actually spoke during conference (45% vs 82%, P < .01) significantly increased. There were 18 demographically similar interns in each of the 2 classes. Members of the academic year 2006–2007 intern class, having trained exclusively with the standardized curriculum, were significantly more likely to respond favorably to survey items about participation, satisfaction, and confidence. In addition, they were more likely to endorse survey items that reflected explicit goals of the standardized curriculum and the Accreditation Council for Graduate Medical Education core competencies. Conclusion Implementation of a structured curriculum for ambulatory care improved interns' self-reported participation, satisfaction, and confidence. The primary care conference occurred more dependably after the curricular change, and improvements in attendance and participation were documented. Pediatric residency programs may make better use of conference time in the ambulatory setting through the use of structured, case-based educational material.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Evaluation of a Case-Based Primary Care Pediatric Conference Curriculum

Talwalkar¹,

Fenick²

2011

Journal of Graduate Medical Education

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“…The Accreditation Council on Graduate Medical Education (ACGME) requires that pediatric residents receive training on child advocacy including SDH [8]. Previous studies have demonstrated that resident advocacy training leads to acquisition of skills and improved competency in community health issues, including identifying community resources and counseling patients [9,10]. However, only 16% of practicing physicians think there is enough time to address family psychosocial issues during well child care, highlighting the importance of training residents to be comfortable asking about these issues in an efficient manner [11].…”

Section: Introductionmentioning

confidence: 99%

Evaluating Resident Screening for Social Determinants of Health: The Development and Assessment of a Structured Direct Observation Tool

Jerardi¹

2013

TOMEDEUJ

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Background: Physicians must gain competency engaging and screening families from all socioeconomic backgrounds with the growing number of children living in poverty. Traditional medical training lacks sufficient education in screening for social determinants of health. We developed a direct observation tool to evaluate resident screening for social determinants of health, assessed its reliability, and determined if the tool could detect practice change after an educational intervention.Methods: A quasi-experimental interventional study of pediatric residents in a primary care setting using a direct observation tool during patient encounters was undertaken. Descriptive test statistics of individual question frequency and discrimination as well as overall test reliability were completed. Changes in the total time discussing social history and number of questions asked after an educational intervention were analyzed.Results: Increase in mean number of questions from 6.6 pre intervention to 8.5 post-intervention (p=.04). Residents spent a statistically significant greater amount of time (97 to 184 seconds, p=.01) discussing the social history with patients after education. Point biserial calculations for all items in the tool were positive.Conclusions: This direct observation tool was reliable and detected practice changes in this innovative pilot study. This structured tool may improve compliance with direct observation requirements and help provide residents with objective feedback.

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“…7 Addressing this requirement, advocacy curricula have been shown to improve knowledge about community heath, competency in identifying community resources, and self-reported confidence of advocacy skills in residents. [8][9][10] Expansion of the health care team to include lawyers, known as a medical legal partnership (MLP), is now used by a number of practices across the country to advocate for the nonmedical needs of patients that directly affect their ability to manage their health conditions and seek care. When an MLP was established in a resident clinic, it was found to greatly affect the residents' abilities to advocate for their patients and realized the effects that SDH have on health outcomes, thus preparing them to practice in socially complex environments.…”

Section: Introductionmentioning

confidence: 99%