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Problem:
Many of the health problems facing our country's children, and families are strongly related to developmental and biopsychosocial problems. This training program serves to better prepare pediatricians to assist children and families in the management of these health problems.
Goals and Objectives:
Goal 1: Prepare fellowship trainees to provide high quality, comprehensive, compassionate, family-centered, and culturally competent care to children and families with developmental and/or behavioral problems
Objective 1.1 Fellows will complete a structured developmental and behavioral pediatrics curriculum covering the 21 core knowledge areas specified in the Requirements for Residency Education in Developmental-Behavioral Pediatrics of the ACGME by the end of their second year
Objective 1.2 Fellows will complete courses on family-centered care and cultural competence by the end of their fist year of training
Objective 1.3 Fellows will demonstrate the ability to evaluate and manage developmental and behavioral problems in a manner that respects and honors divergent opinions and individual, family, and cultural differences
Goal 2: Prepare fellowship trainees for leadership positions in the field of Developmental-Behavioral Pediatrics
Objective 2.1 Fellows will participate in educational experiences that teach them the civil and educational rights of children with disabilities and chronic illnesses by the end of the first year of training
Objective 2.2 Fellows will effectively collaborate with interdisciplinary teams in the care of children and families with developmental and behavioral problems during the first and second year clinical rotations
Objective 2.3 Fellows will collaborate with a faculty member on a project partnering with or providing technical assistance to a Title V or other community based program, or state or local government
Goal 3: Prepare fellowship trainees to perform and evaluate research
Objective 3.1 Fellows will complete a research course during their first year of training
Objective 3.2 Fellows will develop a research proposal that demonstrates an understanding of relevant background information, research hypotheses, and experimental methodology by middle of the second year of training
Objective 3.3 Fellows will implement, appropriately analyze, and interpret the data by the end of the training program
Goal 4 Prepare pediatric resident physicians to detect, diagnose, and manage or appropriately refer children with developmental or behavioral concerns and acquaint medical students with these concerns
Objective 4.1Pediatric residents in their first year of training will complete a didactic curriculum introducing them to theories of development and common developmental and behavioral concerns
Objective 4.2 Pediatric residents will visit schools and community-based agencies in order to better understand the role of these providers in the care of children with or at-risk for developmental and behavioral problems
Objective 4.3 Developmental-behavioral pediatric faculty participate in medical student clinical clerkships to educate them about typical and atypical child development and behavior
Goal 5 To provide continuing education and technical assistance to community-based practitioners, Title V funded organizations, and other community-based programs
Objective 5.1 Implement a regular Collaborative Office Rounds series for primary care physicians
Objective 5.2Faculty and fellows will provide at least 2 educational programs per year for community-based practitioners, Title V funded organizations, or other community-based programs
Objective 5.3 Faculty will provide technical assistance or develop ongoing collaborative relationships with Title V funded programs or other community-based programs throughout the implementation of this training grant
Methodology:
Fellows and residents rotate through clinical training sites where they care for highly diverse, underserved, and at-risk children and families. In these settings fellows and residents participate in an array of didactic experiences, directed readings, clinical preceptorships, and observations designed to teach principles of child development and behavior, interviewing, assessment, and management skills. These experiences are mentored by faculty aspiring to deliver family-centered, and culturally competent care. Furthermore, we emphasize the scientific and technological advances upon which current best practices are increasingly based. Trainees are introduced to the many advantages of interdisciplinary approaches to care through participation in inpatient and outpatient service teams. Fellows participate in structured teaching experiences and collaborations with community-based organizations designed to enhance leadership skills such as interpersonal dynamics, communication, needs assessment, program design and evaluation, and advocacy skills. A priority is assigned to guiding fellows towards mastery of research methodologies through didactic experiences and the faculty mentored research projects. Education of medical students occurs largely through didactic presentations, directed readings, and clinical observations. Continuing education for community-based practitioners occurs through many venues including a Collaborative Office Rounds study group.
Coordination:
Our trainees participate in educational programs on legal rights and advocacy sponsored by community-based organizations such as the Education Law Center, the Disabilities Law Project, and Philadelphia Citizens for Children and Youth. In collaboration with the Pennsylvania Council of Children, Youth, and Family Services, we have provided education about behavior problems to the staffs of over 50 different community agencies including the Department of Human Services of the City of Philadelphia.
Evaluation:
A major goal of our proposed training project is to implement valid and feasible methods for evaluating the performance of individual trainees and preceptors and evaluating the quality and impact of our training program. Our major evaluation methodologies include: self-assessment by trainees, a clinical encounters diary documenting breadth and depth of trainee experiences, direct observation of trainee performance, and written evaluation reports. Other indices include ratings of faculty performance by students, submission and disposition of research abstracts and manuscripts, the development and dissemination of educational resources, and the post fellowship positions and career paths of our trainees.
Experience to Date:
We have had two third year, one second year, and one first year fellow in our developmental-behavioral pediatrics fellowship training program this year. One of these fellows was funded by this grant. We have successfully recruited two fellows to begin our 3 year training program in July of 2006. In addition, during the past year we contributed substantively to the developmental and behavioral pediatrics education of over 100 pediatric residents and participated in the education of medical students. We have participated in the education of trainees in multiple disciplines including: child and adolescent psychiatry, nursing, pediatric psychology, physical therapy, occupational therapy, social work, speech and language therapy, and other disciplines. We continue to run a successful Collaborative Office Rounds continuing education program for primary care physicians. We have participated in other continuing education events for hundreds of health professionals. We have continued to provide consultation and technical assistance to Title V programs, schools, and community agencies.
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