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The CSHCN Medical Education Project

     

Purpose
The purpose of the Children with Special Health Care Needs (CSHCN) Medical Education
Project, conducted in 2006-2007, was to describe what and how pediatric residents in Massachusetts are taught about CSHCN and medical home, with the ultimate goal of improving resident awareness and education in these important areas.

Sponsors
The CSHCN Medical Education Project was a joint effort of the Massachusetts Consortium for Children with Special Health Care Needs and the Massachusetts Chapter of the American Academy of Pediatrics (MCAAP) Committee on Disabilities. It was developed with the input of faculty representatives from each of the five pediatric residency programs in
Massachusetts, and was administered by New England SERVE under the sponsorship of the Massachusetts Department of Public Health.

Background
In recognition of the importance of delivering care that is accessible, family-centered, continuous, comprehensive, coordinated, compassionate and culturally effective, the federal Maternal and Child Health Bureau and the American Academy of Pediatrics have advocated for the development of medical homes for all children. To support this objective, �medical home� has been defined as a domain for achieving competency in pediatric residency education.

Children with special health care needs require this kind of care delivery even more than their peers. However, little is known about what pediatric residents are taught about either medical home or the care of CSHCN, how they are taught, or what the impact of their educational experience is on the quality of care CSHCN receive.

Massachusetts has long been on the forefront for medical home activities, with multiple initiatives occurring across the state. Our state is also somewhat distinctive in that it has five separate pediatric residency programs. Yet even here there is little information available about how residents are trained to care for CSHCN, how training differs among programs, or how effective training is in preparing residents for professional practice. These conditions have set up a natural experiment that gives us the opportunity to understand the current state of the art, and how to best teach residents to care for CSHCN in a medical home.

Methods
Faculty and residents were interviewed at each of Massachusetts ' five pediatric teaching programs:

  • Baystate Children's Hospital
  • The Boston Combined Residency Program at Boston Medical Center and Children's Hospital, Boston
  • MassGeneral Hospital for Children
  • Tufts-New England Medical Center Floating Hospital for Children
  • UMass Children's Medical Center

Based on a structured survey tool, the interviews identified current curricula and teaching methods, and began to explore how they impact the experiences of pediatric residents.

Findings
Findings are described in Preparing for Practice: Addressing Special Health Care Needs in Pediatric Residency Programs. Shared with the participating programs, it is hoped that they may allow development of new approaches to teaching about CSHCN, greater consistency among programs, and ultimately improved resident training and quality of care delivered to this special population.

Contact
For further information about the CSHCN Medical Education Project, please contact Dr. Beverly Nazarian at [email protected] or New England SERVE at [email protected]