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Problem:
There is a need for leaders in DBP to: 1) produce quality research, 2) teach about DBP issues to pediatric practitioners, trainees, and other health professionals, 3) provide DBP clinical excellence and 4) inform policy related to DBP issues affecting children and families.
Goals and Objectives:
Goal 1: To train Fellows to be skilled clinicians in the evaluation, care, and treatment of children with a broad range of developmental and behavioral concerns, problems, and disorders
Objective 1: At the completion of the program, the Fellow will achieve a high level of expertise in DBP to allow the Fellow to function as a skilled subspecialist.
Objective 2: At the completion of the program, the Fellow will acquire the skills to incorporate DBP into the practice of clinical pediatrics sufficient to allow the Fellow to teach such skills to general pediatricians.
Objective 3: At the completion of the program, the Fellow will become skilled in working as a contributing member of a multidisicplinary team and knowledgeable of the activities, perspectives, and unique contributions of staff in related disciplines
Goal 2: To train Fellows to be effective teachers of a comprehensive approach to pediatric care.
Objective 1: At the completion of the program, the Fellow will develop expertise in teaching Developmental Behavioral Pediatrics to general pediatricians and trainees including pediatric and medicine-pediatric residents and medical students.
Objective 2: At the completion of the program, the Fellow will demonstrate expertise as a teacher of DBP sufficient to assume a faculty position at the level of an assistant professor
Goal 3: To train Fellows to become skilled and effective child health researchers.
Objective 1: At the completion of the program, the Fellow will have completed an individual research project in the field of DBP, including prepartion of a manuscript for publication and an abstract for presentation at a national research meeting
Objective 2: At the completion of the program, the Fellow will have presented research findings at a national or regional research meeting
Goal 4: To train Fellows to become sensitive and skilled child advocates regarding the public health and social policy dimensions of developmental and behavioral issues affecting children and families.
Objective 1: At the completion of the program, the Fellow will be able to identify and describe ways in which the results of research might be applied appropriately to improve or initiate policies and social programs to benefit children
Objective 2: At the completion of the program, the Fellow will have the knowledge to be able to serve as a physician on a multidisciplinary, collaborative local agency and to provide consultation to community agencies.
Methodology:
Fellows will be trained within a three-year program by a multidisciplinary faculty. Elements of the program include: 1. A broad range of clinical training sites, many of which involve interdisciplinary teams, located within the DBP Subsection, the Yale Child Study Center, the inpatient and outpatient units of Yale-New Haven Children’s Hospital, and community sites. 2. On and off-site clinical supervision provided individually and in groups (including utilizing Collaborative Office Rounds) provided by faculty of many disciplines (e.g., DBP, child and adolescent psychiatry, psychology, social work, etc.). 3. Didactic coursework and seminars, especially within the DBP Program, the Yale Child Study Center, and the Robert Wood Johnson Clinical Scholars Program. 4. Extensive public health, policy, leadership, and advocacy training. 5. Training in cultural sensitivity, especially through education and mentorship provided by a visiting faculty member from the University of Connecticut with expertise in this area and through direct involvement within an innovative program in the Department of Pediatrics. 6. Research training involving coursework (year-long participation in Methods of Clinical Research Course provided by the Clinical Scholars Program), participation in an ongoing research project of one of the faculty and development of an independent research project, and participation and presentation of ongoing work in weekly departmental and section research seminars.
Coordination:
The Core Faculty in the Program has active relationships with Title V/MCH programs in CT and will involve the Fellows in related didactic and experiential training. The directors of pediatric residency training in all the programs within CT have agreed to enhance their ongoing collaborative efforts to pool resources for medical student, residency, and continuing medical education training in DBP and quality improvement activities for DBP clinical services offered at each of the sites.
Evaluation:
Monitoring for acquisition of clinical, teaching, and research skills is accomplished by 1) twice yearly written assessments of fellow performance by faculty supervisors 2) direct on-site clinical supervision, 3) twice yearly scholarship oversight committee evaluations of research progress and 4) faculty observations of research and teaching presentations.
Experience to Date:
Over the past year, Dr. Carol Weitzman assumed the position of Project Director after the departure of Dr. David Schonfeld. The scope of the Developmental-Behavioral Pediatric fellowship was expanded to increase the range of teaching, clinical and research activities of the fellows to include: 1) increased responsibility on the inpatient pediatric-behavioral consultation-liaison service, and 2) increased opportunities for teaching and mentoring of pediatric residents and medical students on a range of core DBP topics. Drs. Stubbe, Martin and Cardona have been added as faculty on the training project, further solidifying the relationship between the DBP subsection and the Yale Child Study Center, enhancing faculty diversity and creating further opportunity for rich training experiences. Dr. Asnes joined the faculty this year as a new member of the section of General Pediatrics with expertise in child development, family systems and psychosocial functioning. Dr. Abha Gupta transferred to our training program this year as a second year DBP fellow. She is conducting research on the genetics of autism in the laboratory of Dr. Matthew State. DBP Fellows have presented research findings this past year at the Pediatric Academic Society meeting and have also submitted manuscripts for publication.
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