A new, experiential curriculum in child advocacy for pediatric residents.

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.