Division of General and Community Pediatrics (OO Falusi, J Weisz, D Coddington), Children's National Hospital, Washington, DC; Pediatric Residency Program (OO Falusi), Children's National Hospital, Washington, DC; Child Health Advocacy Institute (OO Falusi, I Clarence, L Beers), Children's National Hospital, Silver Spring, Md.
Division of General and Community Pediatrics (OO Falusi, J Weisz, D Coddington), Children's National Hospital, Washington, DC.
Acad Pediatr. 2022 Jul;22(5):850-857. doi: 10.1016/j.acap.2022.02.009. Epub 2022 Feb 17.
To evaluate the effectiveness of a multimodal child poverty curriculum for pediatric residents.
The Trainee Education in Advocacy and Community Health (TEACH) curriculum trains residents to recognize and address the effects of child poverty, utilizing learning objectives modified from the US Child Poverty Curriculum, new interactive web-based modules, experiential learning, and reflection. This mixed-methods evaluation of the first component, "Epidemiology of Child Poverty," includes nearly 2 years of resident participation. Pre/post knowledge and attitudes regarding child poverty were assessed. Behavior change was evaluated in a subset of participants using an Objective Structured Clinical Examination (OSCE), comparing intervention and control groups of residents. Residents' experience with the curriculum was assessed using qualitative analysis of debrief sessions with faculty.
Fifty-two residents completed the curriculum between June 2018 and March 2020. Residents increased in knowledge (P < .001) and confidence (P < .0001) in recognizing and addressing poverty. They also self-reported greater preparedness (P < .001) and effectiveness (P < .001) in addressing social determinants of health. Early data from the OSCE have not shown a statistically significant change in skills compared with a control group. Qualitative themes included an increase in empathy for, understanding of, and responsibility to address the effects of poverty in caring for patients.
The multimodal "Epidemiology of Child Poverty" portion of the TEACH curriculum increased resident knowledge, confidence, and empathy. Given the ubiquitous nature of poverty and the generalizability of the online modules, the TEACH curriculum can be a resource for other residency programs.
评估多模式儿童贫困课程对儿科住院医师的效果。
培训生倡导和社区卫生教育（TEACH）课程培训住院医师识别和解决儿童贫困的影响，利用美国儿童贫困课程的学习目标修改版、新的互动网络模块、体验式学习和反思。该课程的第一个组成部分“儿童贫困流行病学”的混合方法评估包括近 2 年的住院医师参与。通过预/后评估，了解他们对儿童贫困的知识和态度。在一个客观结构化临床考试（OSCE）中，通过比较干预组和对照组住院医师，评估行为变化。使用教师小组讨论的定性分析评估住院医师对课程的体验。
2018 年 6 月至 2020 年 3 月期间，52 名住院医师完成了课程。住院医师在识别和解决贫困方面的知识（P <.001）和信心（P <.0001）有所提高。他们还自我报告在解决健康的社会决定因素方面有更强的准备（P <.001）和效果（P <.001）。OSCE 的早期数据与对照组相比，在技能方面没有显示出统计学上的显著变化。定性主题包括对患者护理中贫困的影响的同理心、理解和责任感的增加。
TEACH 课程的多模式“儿童贫困流行病学”部分增加了住院医师的知识、信心和同理心。鉴于贫困的普遍存在和在线模块的可推广性，TEACH 课程可以成为其他住院医师课程的资源。
