The Anne E. Dyson Community Pediatrics Training Initiative

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The Anne E. Dyson Community Pediatrics Training
Initiative

• Columbia University
• Childrens Hospital of New York
• Harlem Hospital Center
• Dodi Meyer, Milagros Batista, Ellen Lee

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Goals and Objectives

• 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

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Communities of Northern Manhattan

• Assets
• People
• Agencies/ Institutions
• Needs
• Poverty
• Multiple unmet health needs

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Residency Programs

• Childrens Hospital of New York
• Voluntary Hospital/ Tertiary Care Center
• 60 residents

• Harlem Hospital Center
• City Hospital
• 20 residents

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Core competencies

• Community Health
• Cultural competency
• Child Advocacy

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COMMUNITY PEDIATRICS
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Service Learning at ColumbiaIdentifying
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

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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

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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

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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?

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Service Learning Potential Outcomes Academic
Perspective

• Builds community-oriented competencies

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Service Learning Potential Outcomes Academic
Perspective

• Builds community-oriented competencies
• Enhances attitudes/ behaviors in health
  professionals

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Service Learning Potential Outcomes Academic
Perspective

• Builds community-oriented competencies
• Enhances attitudes/ behaviors in health
  professionals
• Enhances service delivery/access to vulnerable
  populations

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Service Learning Potential OutcomesAcademic
Perspective

• Builds community-oriented competencies
• Enhances attitudes/ behaviors in health
  professionals
• Enhances service delivery/access to vulnerable
  populations
• Improves community/academic relations

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Service Learning Potential Pitfalls Academic
Perspective

• Effective partnerships are labor intensive
• Needs to be realistic in service and learning
  outcomes change doesnt follow a semester plan

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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

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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

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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

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Service Learning Potential Pitfalls Community
Perspective

• Time intensive / Labor intensive
• Financial incentives need to be balanced

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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

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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

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Service Learning Potential PitfallsResident
Perspective

• Relationship with CBOs is not longitudinal
• Given limited time at each CBO, experiences may
  be highly variable

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Service Learning Potential ChallengesResident
Perspective

• Need dedicated time for discussion about
  experiences with CBOs
• Learning how to utilize community resources
  appropriately
• Finding models of service-learning

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Competency

• Explain how beliefs, culture and ethnic
  practices can influence health status and health
  care for children in the community