GOALS & OBJECTIVES
The major goal of the Fellowship Program in DBP is to train pediatricians to become leaders in the field of DBP in order to promote the development and maintenance of optimal cognitive, social, and emotional function of children and families. Such leaders will be skilled clinicians in the evaluation, care, and treatment of children with a broad range of developmental and behavioral concerns, problems, and disorders; effective teachers of a comprehensive approach to pediatric care; skilled and effective child health researchers; and sensitive and skilled child advocates regarding the public health and social policy dimensions of developmental and behavioral issues affecting children and families, capable of assisting states and communities to plan and develop comprehensive, integrated health service systems that address the full spectrum of child health needs. At the completion of the program, it is expected that the Fellow will: 1. Achieve a high level of clinical expertise in DBP to allow the Fellow to function as a skilled subspecialist, as well as acquire the skills to incorporate DBP into the practice of clinical pediatrics sufficient to allow the Fellow to teach such skills to general pediatricians. 2. Become skilled in working as a contributing member of a multidisciplinary team and knowledgeable of the activities, perspectives, and unique contributions of staff in related disciplines. 3. Demonstrate expertise as a teacher of DBP sufficient to assume a faculty position at the level of an assistant professor. 4. Have completed an individual research project in the field of DBP, including preparation of a manuscript for publication and an abstract for presentation at a national research meeting. 5. 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, and 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
We propose a closely integrated, multidisciplinary training program that draws on the strengths of the Yale Medical Center concentrated in, but not limited to, the Department of Pediatrics and Yale-New Haven Children’s Hospital; the Child Study Center; the Department of Epidemiology and Public Health; the Clinical Scholars Program; the School of Nursing; the Bush Center for Policy Studies in Early Childhood; and Head Start and Early Head Start, the state’s largest regional special education school system, public schools, and community agencies. Fellows will be trained within a three-year program by a multidisciplinary faculty (including university-based and community-based developmental-behavioral pediatricians, adolescent medicine, child and adolescent psychiatry, education, general pediatrics, genetics, neurology, nursing, nutrition, occupational and physical therapy, physical medicine and rehabilitation, psychology, public health, social work, and speech and language). Elements of the program include: 1. A broad range of clinical training sites, many of which involve interdisciplinary teams, located within the DBP Subsection (e.g., Developmental-Behavioral Pediatric Clinic), the Yale Child Study Center (e.g., Autism Clinic, Early Child Team), the inpatient and outpatient units (e.g., Center for Children with Special Health Care Needs) of Yale-New Haven Children’s Hospital, and community sites (e.g., Lulac Head Start and Early Head Start). 2. On-site 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, nursing, 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. This program seeks to address racial and ethnic disparities in healthcare by providing pediatric residents an understanding of the importance of social, cultural, and economic factors on the health and functioning of children and families through longitudinal involvement as members of “community teams” that link residents and Fellows with citizens of the community to address cooperatively specific child health issues impacting on the community. 6. Research training involving coursework (especially the Methods of Clinical Research Course provided by the Clinical Scholars Program), participation in an ongoing research project of one of the faculty, and through the design, conduct, analysis, and reporting of an independent research project.

COORDINATION
The Core Faculty in the Program has active relationships with Title V/MCH programs in Connecticut and will involve the Fellows in related didactic and experiential training. The directors of pediatric residency training in all the programs within the state have agreed to enhance even further 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. This will include sharing of faculty and training activities for Fellows.

EVALUATION
Monitoring for acquisition of assessment, intervention, teaching, and research skills is accomplished predominantly through clinical supervision, including on-site direct observation, on-site clinical supervision predominantly through case presentation, off-site clinical supervision, group supervision (e.g., Collaborative Office Rounds), and through faculty observations of teaching and research presentations. Our overall method of program evaluation is based on the systems approach model for planning, implementing, and evaluating instruction. Using a formative/summative loop, this model allows for continuous and periodic feedback and leads to revision and reinforcement of program components. Every six months, feedback from the faculty and Fellows is obtained at a meeting that involves a review of each of the major content areas of the training program. Questions are asked about the content, the teaching methods, whether the Fellow was satisfied, and suggestions for improvement. The faculty also evaluate the curriculum and current educational methodology, especially related to appropriateness, efficacy, and practicality of teaching methods and materials and the need for other resources for continued and enhanced curriculum implementation. Feedback from these evaluation sessions is used to identify areas in need of change and suggested improvements and enhancements. Evaluation of the success of the overall Program is in large part determined by the success of our graduates – their ability to achieve subboard certification and to become active and effective leaders in the field.

ANNOTATION
The goal of the Yale Fellowship in Developmental-Behavioral Pediatrics (DBP) is to train future academicians and leaders in the field through interdisciplinary training in clinical, research, academic, and teaching skills and community and policy issues related to children and families. In addition, faculty provide training in DBP to residents, students, pediatric practitioners, other healthcare professionals, and other professional and lay groups.

KEYWORDS
behavioral pediatrics, developmental disabilities, Professional Education in Behavioral Pediatrics, Professional Education in CSHN, Professional Education in Cultural Sensitivity, Professional Education in Developmental Disabilities, Professional Education in MCH