Teaching Community Pediatrics to Pediatric Residents: Strategic Approaches and Successful Models for Education in Community Health and Child Advocacy

Abstract

ABSTRACT. To improve child health at a community level, pediatricians require knowledge and skills that have not been traditionally included in residency training. Recent policy statements from the American Academy of Pediatrics and requirements from Accreditation Council for Graduate Medical Education Residency Review committees emphasizing the importance of community pediatrics training have provided additional incentive for pediatric residency programs to actively explore methods of teaching the principles and promoting the practice of community pediatrics to resident trainees. With a growing number of diverse educational models in various stages of practice or development, common themes and approaches to promote successful teaching of community health and child advocacy can be described. This article defines strategies for 2 critical elements of community pediatrics training, engaging residents and building strong community partnerships, then highlights a number of educational models that illustrate key curricular components and methods. Published results from evaluations of some programs suggest that community pediatrics training of this caliber will cultivate a cadre of pediatricians (academic and community based, generalists and subspecialists, researchers and practitioners) who understand child health in the context of community and have the leadership and collaborative skills to improve the health of children in their communities.

Community Engagement and its Impact on Child Health Disparities: Building Blocks, Examples, and Resources

“…Examples in the literature of physicians who have engaged the community and the focus areas of this engagement include private practitioners addressing fragmentation of care, 19 academic faculty members meeting the needs of uninsured adolescents, 20 and a resident targeting the negative effects of juice consumption in young children. 21 These examples involve advocacy projects with realizable goals focused on a particular issue and offer potential approaches to community advocacy and engagement. 20,22 Projects such as these can form the basis for building lasting relationships with community members, community-based organizations (CBOs), state agencies, schools, and other community-based associations.…”

“…As the relationship matures, the pediatrician and community can identify other assets within or outside the community (including in the health care system) that can be used to execute a strategy. Furthermore, as pediatric and other primary care residents, 21 academic departments, and children's hospitals join the broad effort, the community's access to resources improves, and the potential for building trusting relationships with large institutions increases.…”

“…All too often, researchers have had a "helicopter," 32 "hitand-run," or "parachute" relationship with communities, visiting the community only to obtain grant funding to sustain their research and not to help the community over the long-term. Again, child health care providers can turn to several sources to learn about conceptual frameworks for engaging in and evaluating community-based efforts, 33 proposed models for university-or agency-community collaborations, 34 and guidelines 21 or strategies 34 for creating and maintaining community partnerships.…”

Community paediatrics: Soft science or firm foundations?

“…Shipley et al recognised the need for high caliber training programmes to 'cultivate a cadre of pediatricians (academic and community based, generalists and subspecialists, researchers and practitioners) who understand child health in the context of community and have the leadership and collaborative skills to improve the health of children in their communities'. 19 Whilst the RACP Education Strategy addresses these concerns it remains the task of the hospitals and universities to implement recommended changes while balancing competing demands for service provision and provision of training.…”

The Best of Both Worlds: Resident Experiences of Urban and Regional Contexts in a Hybrid Pediatrics Residency Program

“…6,7 Rather than creating parallel community-only programs, most residency programs seem to have expanded to include both community and urban tertiary experiences, as indicated by descriptions of the introduction of community experiences to existing programs. 8,9 From a resident perspective, augmentation would appear to be the more useful model, as the additional training contexts allow for a more comprehensive learning experience. There is evidence to indicate that residents require a broad range of experiences to be able to meet the requirements of competency-based programs.…”