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The Anne E. Dyson Community Pediatrics Training Initiative
Columbia University
Children’s Hospital of New York
Harlem Hospital Center
Dodi Meyer, Milagros Batista, Ellen Lee
Goals and Objectives
1) To train residents to become lifelong advocates for children and communities
2) Enhance community service through partnerships with CBOs
3) Strengthen and expand the core community pediatric faculty
4) Strengthen and expand multidisciplinary collaborations
Communities of Northern Manhattan
• Assets– People– Agencies/ Institutions
• Needs– Poverty– Multiple unmet health needs
Residency Programs
• Children’s Hospital of New York– Voluntary Hospital/
Tertiary Care Center
– 60 residents
• Harlem Hospital Center– City Hospital– 20 residents
Core competencies
• Community Health
• Cultural competency
• Child Advocacy
COMMUNITY PEDIATRICS
COLUMBIA UNIVERSITY
G rand R ounds
C ontinu ity C lin ic Lectures
W orkshops
C ore Lecture Series
DIDACTICS
Ind iv idual P ro ject
Shopp ing Trips
AD VO C AC Y PR O JEC T
PROJECTS
Project D O C C
Parenting C lasses
Incarnation C hildren 's C enter
Safety C ityPS 128/Traffic Safety
La Leche League
Post-Partum C lasses
D om estic V io lence C enter
H om e V is its
W IC
V is iting N urse Serv ice (VN S)
Best Beg innings
COM M UNITY-CAM PUS PARTNERSHIPSSERVICE-LEARNING
M ETHODOLOGY OF LEARNING
Service Learning at Columbia:Identifying partners/ Best Beginnings
• Home visitation program/Primary prevention
• Partnership: Alianza Dominicana/ Columbia University/ School of Public Health/ NY Society for Prevention of Cruelty to Children
• Medical home: community based primary care site
Service Learning at Columbia: Learning Objectives
• Residents– Identify the cultural barriers that exist between
patient and and health care providers
• Family case workers– Describe the institutional culture of the medical
center
Service Learning at Columbia: Service Objectives
• Residents– Teach family case workers topics in general
pediatrics– Perform home visitations / delivery of primary
care
• Family case workers– Teach residents local health beliefs– Discuss community perception of the medical
center
Service Learning at Columbia: Structured Reflection
• Performed jointly by community and academic preceptors
• Targeted to both residents and family case workers
• What? So what? Now what?
Service Learning Potential Outcomes: Academic Perspective
• Builds community-oriented competencies
Service Learning Potential Outcomes: Academic Perspective
• Builds community-oriented competencies
• Enhances attitudes/ behaviors in health professionals
Service Learning Potential Outcomes: Academic Perspective
• Builds community-oriented competencies
• Enhances attitudes/ behaviors in health professionals
• Enhances service delivery/access to vulnerable populations
Service Learning Potential Outcomes:Academic Perspective
• Builds community-oriented competencies
• Enhances attitudes/ behaviors in health professionals
• Enhances service delivery/access to vulnerable populations
• Improves community/academic relations
Service Learning Potential Pitfalls: Academic Perspective
• Effective partnerships are labor intensive
• Needs to be realistic in service and learning outcomes: change doesn’t follow a semester plan
Service Learning Implementation Challenges: Academic Perspective
• Trust between academic center –community– History of town/gown relationships
• Buy in at a departmental/institutional level
• Buy in at a resident level
• Curriculum already overloaded
Service Learning Potential Outcomes: Community Perspective
• Improves practice / Potential community practitioners
• Enhances use of health practice
– Family feeling back at home, “back to the good old days”
– Friendly, people-centered, individualized care
Service Learning Potential Outcomes: Community Perspective
• Improves scope of knowledge in the health field
• Orients, teaches, and empowers staff to teach residents
• Opportunity to grow and develop
• Values the relevance of popular knowledge and culture
Service Learning Potential Pitfalls: Community Perspective
• Time intensive / Labor intensive
• Financial incentives need to be balanced
Service Learning Implementation Challenges: Community Perspective
• Buy in from leaders and grass root workers at the community-based organization level
• Build trust between families and institution
– Create a mediator
• Maintain the work flow
• Not only one way of learning
– Teaching and learning can happen at the same time
Service Learning Potential Outcomes: Resident Perspective
• Enhances health care delivery by improving understanding of community, including its resources
• Develops sense of involvement in community
• Provides opportunities to teach/learn in different contexts
Service Learning Potential Pitfalls:Resident Perspective
• Relationship with CBOs is not longitudinal
• Given limited time at each CBO, experiences may be highly variable
Service Learning Potential Challenges:Resident Perspective
• Need dedicated time for discussion about experiences with CBOs
• Learning how to utilize community resources appropriately
• Finding models of service-learning
Competency
Explain how beliefs, culture and ethnic practices can influence health status and health care for children in the community