A New, Experiential Curriculum in Child Advocacy for Pediatric Residents

Roth, Emily J.; Barreto, Patricia; Sherritt, Lon; Palfrey, Judith S.; Risko, Wanessa; Knight, John R.

doi:10.1367/A04-010R1.1

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Volume 4, Issue 5 , Pages 418-423, September 2004

A New, Experiential Curriculum in Child Advocacy for Pediatric Residents

Emily J. Roth, MD
- Address correspondence to Emily J. Roth, MD, Boston Childrens Hospital Primary Care Center, 300 Longwood Ave, Boston, MA 02115
Patricia Barreto, MD, MPH
- From the Department of Pediatrics (Dr Roth, Mr Sherritt, Drs Palfrey, Risko, and Knight), Harvard Medical School, Boston, Mass; the Division of General Pediatrics (Dr Roth, Mr Sherritt, Drs Palfrey, Risko, and Knight), Children's Hospital Boston, Boston, Mass; and the Department of General Pediatrics (Dr Barreto), University of California, Los Angeles, Calif
Lon Sherritt, MPH
- From the Department of Pediatrics (Dr Roth, Mr Sherritt, Drs Palfrey, Risko, and Knight), Harvard Medical School, Boston, Mass; the Division of General Pediatrics (Dr Roth, Mr Sherritt, Drs Palfrey, Risko, and Knight), Children's Hospital Boston, Boston, Mass; and the Department of General Pediatrics (Dr Barreto), University of California, Los Angeles, Calif
Judith S. Palfrey, MD
- From the Department of Pediatrics (Dr Roth, Mr Sherritt, Drs Palfrey, Risko, and Knight), Harvard Medical School, Boston, Mass; the Division of General Pediatrics (Dr Roth, Mr Sherritt, Drs Palfrey, Risko, and Knight), Children's Hospital Boston, Boston, Mass; and the Department of General Pediatrics (Dr Barreto), University of California, Los Angeles, Calif
Wanessa Risko, MD, DSc
- From the Department of Pediatrics (Dr Roth, Mr Sherritt, Drs Palfrey, Risko, and Knight), Harvard Medical School, Boston, Mass; the Division of General Pediatrics (Dr Roth, Mr Sherritt, Drs Palfrey, Risko, and Knight), Children's Hospital Boston, Boston, Mass; and the Department of General Pediatrics (Dr Barreto), University of California, Los Angeles, Calif
John R. Knight, MD
- From the Department of Pediatrics (Dr Roth, Mr Sherritt, Drs Palfrey, Risko, and Knight), Harvard Medical School, Boston, Mass; the Division of General Pediatrics (Dr Roth, Mr Sherritt, Drs Palfrey, Risko, and Knight), Children's Hospital Boston, Boston, Mass; and the Department of General Pediatrics (Dr Barreto), University of California, Los Angeles, Calif

Received 17 January 2004; accepted 18 May 2004.

Objective.—To design, implement, and evaluate an experiential child advocacy curriculum for pediatric residents.

Design.—Pilot study including before-after 2-group trial of an educational intervention and a qualitative component.

Setting.—A large, hospital-based, urban resident continuity clinic.

Participants.—General pediatrics residents (N = 29 [PGY: 1–4]).

Intervention.—Residents and faculty designed a longitudinal curriculum in child advocacy for the continuity clinic, which included community-based and legislative experiences for individual residents as well as clinic-based group activities. Residents reported their experiences to their clinic group at weekly preclinic conferences. In addition, residents presented posters at their year-end residency retreat and wrote grants to fund community projects based on their original findings.

Evaluation.—We used a quantitative assessment of child advocacy knowledge, attitudes, skills, and self-reported practices, which residents completed pre- and postintervention (2 clinics) or, for comparison residents, at the beginning and end of the academic year (3 clinics). In addition, we conducted focus-group discussions with residents in the 2 intervention groups to explore unanticipated responses to the new curriculum.

Results.—Residents who received the intervention (n = 13) had a greater increase in advocacy knowledge (2.62 vs 0.19, P = .005), ability to identify community resources (0.62 vs 0.16, P = .03), self-reported advocacy skills (2.0 vs −0.21, P = .002), and perceived value of advocacy training (0.31 vs −0.19, P = .03) compared with residents who did not (n = 16). In focus groups, intervention residents (n = 17) reported being surprised by community groups' and legislators' responsiveness to resident inquiries, and they expressed enhanced confidence in engaging these groups in dialogue about child policy issues.

Conclusions.—A longitudinal continuity clinic–based curriculum in child advocacy had significant positive impact on pediatric residents.

KEY WORDS: child advocacy , policy , resident education