Pediatric Residents Address Critical Child Health Issues in the Community

Background: Practicing pediatricians are challenged to look beyond the clinical settings for local resources to address health threats to children and families. Pediatric residents' perceptions of the realities faced by families that they frequently see in the emergency room and outpatient or inpatient units are inadequate.

Objectives: The Community Pediatrics Training Initiative (CPTI) is a national initiative within the American Academy of Pediatrics designed to prepare future pediatricians to serve families from traditionally underserved communities. The three unique components of this CPTI at Children's Hospital of Wisconsin (CHW) and the Medical College of Wisconsin (MCW) support child health improvement through (1) interactive discussions with families, (2) exposure to programs in community agencies, and (3) community initiatives.

Methods: Pediatric residents, along with community partners, have implemented more than 25 community initiatives in the areas of access to care, adolescent health, child advocacy, and environmental and public health.

Results: The immediate assessment from our CPTI curriculum demonstrates community experiences significantly promote their competencies in child advocacy and system-based practice while expanding their knowledge of the impact of poverty. In 2005, a survey of 84 postgraduates (75% response rate) assessed the effectiveness of community pediatrics training. All graduates self-reported that they are moderately to greatly prepared to respond to children's culture, age, gender, and disabilities. Of the 43 (68%) graduates who are currently in practice, 10 (23%) are working directly with underserved populations.

Conclusions: The development of community initiatives by pediatric residents in partnership with community stakeholders greatly expanded residents' competencies in child health improvement.