Community Longitudinal Experiences
Pediatricians serve as advocates for children in many ways. Success relies on understanding the needs of patients as individuals and as members of communities, and on the ability to form relationships and communicate well with community partners. The Community Curriculum offers residents the opportunity to develop skills and experience in these areas. As an example, please read the article on "Learning Through Experience", a sign language community program created by Christine Skurkis, MD and Sarah Schlegel, MD, when they were medical students at the University of Connecticut, and continuing into their residency and faculty careers. "Learning Through Experience".
Below are the currently offered experiences, each with a sampling of its goals, possible resident activities, and past resident projects. Each is designed as a community longitudinal experience (CLE), occurring one half day per week during each ambulatory block. Alternative scheduling, including block electives, may be possible with the consent of the faculty preceptor. The PL 1 year usually offers residents an introduction to a population, problem or skill set, and the PL 2 and PL 3 years are used to develop individual projects. Residents may also design a three year individualized, independent community elective, with appropriate faculty preceptor support. In the year of graduation, residents must present the results of their community projects in the form of a poster.
Overall Program Goals/Objectives
- Provide pediatric residents with the tools and knowledge needed to become professionals committed to improving the health of children in their communities.
- Engage pediatric residents in the communities in which they work.
- Develop meaningful partnerships between the academic department and community-based organizations (CBOs).
- Enhance pediatric training through interdisciplinary collaborations with other schools and university departments.
Individual Electives Goals/ Objectives:
Community Based Multidisciplinary Team Collaboration:
- Understand the role of the pediatrician as part of a team approach to child protection issues.
- Understand the public health and individual health approaches to child protection.
- Multidisciplinary Investigation Team
- Children’s Center / SCAN program (abuse evaluations)
- Child Protection Team
- Past Projects
- Shaken Baby Syndrome
- Nurturing Families
- Post 136/ Post Hotline (referrals)
- Morbidities of Safe Home (group foster care) residents
- Resident Education
Government Relations and Advocacy
- To understand the process by which an issue is drafted into a bill and passed into Connecticut law.
- To become comfortable with and equipped for interactions with policy makers at the city, county, state and/or federal level.
- To apply advocacy skills/lessons to a current advocacy issue.
- Meetings with CCMC’s lobbyist, legislators and other government officials at the Legislative Office Building
- Research / development of proposals and educational materials for use with and by legislators, statistics on Medicaid kids treated at CCMC to support Medicaid lobbying
- Identify opportunities to address child health problems as advocacy issues
- Past Projects
- Medicaid / Obesity data
- Medicaid / CCMC impact
- Video for obesity education in schools
Injury & Violence Prevention
- To learn the epidemiology, cost issues and public health implications of accidental and inflicted injuries.
- To understand general principles of injury prevention and the use of educational, environmental, and legal strategies to prevent injury.
- To describe a systems approach to developing a community-based injury prevention program and understand how to evaluate injury prevention programs.
- To understand the importance (magnitude, cost, preventability) of the injury problem.
- Injury Free Coalition for Kids
- Presentations in schools
- Journal Club for staff
- Violence Prevention Program
- Connecticut Safe Kids
- Past Projects
- Gun exchange (with independents)
- To understand the differences between office- and community-based health care delivery and the role of the pediatrician as a consultant to a community service.
- To understand different ways of teaching and learning in childhood.
- To learn to optimize continuity of care of children with chronic illness by cultivating communication between school clinics and community clinicians.
- To obtain greater understanding of application for and implementation of special services in a school setting as well as federal and state laws on education.
- Participate in all school health center activities.
- Attend PPT and other team meetings with school administration and health center staff.
- Follow a select group of children longitudinally to monitor progress.
- Assist school health center staff and physical education staff in after school weight loss program for obese students.
- Presentations to staff and /or students on:
- Acute and chronic illnesses
- Handling the serious illness of a classmate
- School-based obesity prevention strategies
Enhanced Primary Care: Medical-Legal Advocacy Clinic
- To learn about the basic government programs that affect and address low-income children, such as disability benefits for children, cash and food assistance programs, Medicaid and special education services.
- To learn the principles of multidisciplinary advocacy - - the concept that attorneys and physicians may combine their skills and knowledge to advocate on behalf of children in need to improve health outcomes.
- To work with an attorney to provide direct patient/client service to remedy acute issues that affect child health, including such issues as: Medicaid, disability, discrimination, special education, housing (environmental toxins), immigration, benefits (e.g. SSI eligibility), and systemic issues such as the children’s mental health crisis and Medicaid eligibility.
- To gain a basic understanding of “poverty law issues” and the role that poverty plays in the lives of low-income families.
- Attend and participate in one of the medical-legal walk-in clinics or an on-site clinic at an MLPP affiliated site (CCMC, Saint Francis, Charter Oak, HCC, etc.).
- Work on a long-term project that provides assistance in areas of education and training, or systemic advocacy.
- Work with attorney and law student intern to accomplish the following tasks in the clinic setting:
- undertake comprehensive collaborative intake
- spot the legal issues that directly affect a child’s health
- provide medical expertise in the team setting when evaluating legal issues and possible remedies for the family
- explore solutions and remedies with families regarding legal issues
- provide collaborative advice to families in the clinical setting to address acute legal issues.
- The resident will attend at least one legal “event,” such as an administrative hearing or trial appearance dealing with a legal issue affecting a child’s health, involving the MLPP.
- Past Projects
- Case work
- Guidelines for residents
- Article collaboration
- Training presentations with Medical-Legal Partnership Program staff
Office of the Child Advocate
- To learn about the systems of protection and advocacy available to children and families in the state of Connecticut and how to approach the evaluation of ‘systems failure’.
- To gain skill in communicating with individuals of different backgrounds to both investigate problems and promote solutions.
- Participation in current investigations of the OCA, accompanying the OCA representative into the field.
- Meet with legislative bodies to advocate for children and families.
- Participation with an interdisciplinary team on a research/ investigation/ advocacy project of the OCA.