1. The Anne E. Dyson Community Pediatrics Training Initiative Columbia University Children’s Hospital of New York Harlem Hospital Center Dodi Meyer, Milagros Batista, Ellen Lee

2. Goals and Objectives 1)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

3. Communities of Northern Manhattan Assets –People –Agencies/ Institutions Needs –Poverty –Multiple unmet health needs

4. Residency Programs Children’s Hospital of New York –Voluntary Hospital/ Tertiary Care Center –60 residents Harlem Hospital Center –City Hospital –20 residents

5. Core competencies Community Health Cultural competency Child Advocacy

6. COMMUNITY PEDIATRICS

7. Service Learning at Columbia: Identifying 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

8. 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

9. 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

10. 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?

11. Service Learning Potential Outcomes: Academic Perspective Builds community-oriented competencies

12. Service Learning Potential Outcomes: Academic Perspective Builds community-oriented competencies Enhances attitudes/ behaviors in health professionals

13. Service Learning Potential Outcomes: Academic Perspective Builds community-oriented competencies Enhances attitudes/ behaviors in health professionals Enhances service delivery/access to vulnerable populations

14. Service Learning Potential Outcomes: Academic Perspective Builds community-oriented competencies Enhances attitudes/ behaviors in health professionals Enhances service delivery/access to vulnerable populations Improves community/academic relations

15. Service Learning Potential Pitfalls: Academic Perspective Effective partnerships are labor intensive Needs to be realistic in service and learning outcomes: change doesn’t follow a semester plan

16. 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

17. 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

18. 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

19. Service Learning Potential Pitfalls: Community Perspective Time intensive / Labor intensive Financial incentives need to be balanced

20. 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

21. 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

22. Service Learning Potential Pitfalls: Resident Perspective Relationship with CBOs is not longitudinal Given limited time at each CBO, experiences may be highly variable

23. Service Learning Potential Challenges: Resident Perspective Need dedicated time for discussion about experiences with CBOs Learning how to utilize community resources appropriately Finding models of service-learning

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