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Problem:
Program addresses the need to train developmental-behavioral pediatricians to assume leadership roles in research, clinical care, teaching, advocacy, service development, based on the large numbers of children with developmental and behavioral problems.
Goals and Objectives:
Goal 1: Training in Clinical Care
Objective 1: To obtain information from children, parents, families, other professionals by interviewing/screening in culturally competent manner
Objective 2: To implement range of different treatment modalities, including counseling, behavioral management, hypnotherapy, psychopharmacology in family centered interdisciplinary framework
Objective 3: To generate comprehensive diagnoses & management plans for beh/dev problems considering biological, psychological & social factors in culturally competent manner
Goal 2: Training in Teaching Skills
Objective 1: To understand and implement interdisciplinary approaches to clinical care, teaching and research
Objective 2: To teach medical students, pediatric residents, practicing physicians, using a variety of formats (modeling, individual teaching around cases, small group discussions, seminars, formal lectures)
Objective 3: To teach allied health professionals, patients and parents, community groups using a variety of formats (modeling, individual teaching around cases, small group discussions, seminars, formal lectures)
Goal 3: Training in Reseach Skills
Objective 1: To develop skills in the essential areas of conducting research, especially research related to health services and quality of care (developing research questions, designing a study and collecting/analyzing data)
Objective 2: To develop skills in the essential areas of conducting research related to health services and quality of care (present & publish and apply for funding)
Objective 3: To develop skills in assessing the ethical aspects of research.
Goal 4: Advocacy and Service Development and Policy Planning
Objective 1: To become skilled in methods of child & family advocacy for children with behavioral and developmental problems and special health care needs.
Objective 2: To become skilled in methods of program planning for children with behavioral and developmental problems and special health care needs.
Objective 3: To become skilled in methods of analyzing budgets on the community and state level aimed at developing services and policies for children with behavioral and developmental problems and special health care needs. Methodology:
Goals will be met by a coordinated interdisciplinary team of faculty in pediatrics, psychology, neurology, psychiatry, occupational and physical therapy, anthropology, epidemiology & public health, speech pathology, nursing, social work. The program, which involves a detailed curriculum, will be organized and implemented by a training committee. Learning by doing, with intensive supervision in primary areas of teaching, research & advocacy will be emphasized along with didactic training. Case supervision, joint therapy cases, ongoing case conferences, and case reports will provide material for direct supervision. Fellows will gain experience in interdisciplinary case management and become skilled in a variety of treatment modalities. Fellows will be provided with training, experience, & feedback in various methods of teaching. Fellows will receive systematic training and mentoring in the essential areas of conducting research, including health services research, through didactic course work and mentoring. A special aspect of the training program concerns the direct instruction and supervised experience in advocacy and service development activities in a community and state level.
Coordination:
Behavioral Pediatrics Consortium:faculty participate and contribute materials; Early childhood programs of the Cuyahoga Cnty Children and Family First initiative:faculty work closely with these programs; Child & Family Health Svcs Consortium of Cuyahoga Cnty: hospital belongs to this consortium which directs expenditures of the MCHB grant funds, consortium has a broad planning initiative moving from a clinical svc model to public health model, incorporating preventative adolescent health issues
Evaluation:
Comprehensive program evaluation includes: assessment of fellows' progress; formal feedback & evaluation of program by fellows in writing (narrative & forms); checklist of fellows' completion of program requirements for residency education in developmental-behavioral pediatrics; evaluation of progress of former fellows using MCHB template for eval of leadership activities; plan for reporting requirements; information on technical assistance/collaboration and continuing education
Experience to Date:
Lynn Milliner, MD completed fellowship training in August, 2005. She joined our faculty with a joint appointment in Pediatrics and Child and Adolescent Psychiatry in September, 2005. Over the past year the program has trained two fellows: David Allison, MD and Denise Bothe, MD. Both are active in clinical, teaching & research experiences. Dr. Allison’s research project is a longitudinal study of post-traumatic stress disorder in children with traumatic brain injury compared to controls. Dr. Bothe's project is a pilot intervention of the effects of a brief stress management technique delivered by the classroom teacher in an elementary school setting. We have recruited two new fellows, Shanna Kralovic, DO and Stephanie Anderson, MD who will start in July 2006. The content & goals of the fellowship were reviewed in detail during process of applying for accreditation from ACGME. The application was reviewed in April 2005 and accredited effective July, 2005. Input from fellows was sought during this process and a new weekly seminar was instituted. Program Director Laura Sices, MD continues as Physician Liaison to the Help Me Grow Community Advisory Council. She has collaborated with leaders in Help Me Grow to recruit research participants (parents, Early Intervention specialists, primary care physicians) to participate in a focus group study to examine topic of communication between parents, Early Intervention specialists & primary care physicians on child development.
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