A Block Rotation in Community Health and Child Advocacy: Improved Competency of Pediatric Residency Graduates

Context.— Despite increasing recognition of the importance of community health and child advocacy activities by pediatricians, residency programs have had little experience providing this education. There are no known reports examining the effects of such training on residency graduates. Objective.— To determine whether a program for educating residents in community health and child advocacy, Pediatric Links With the Community (PLC), improved attitudes and competencies of residency graduates. Design.— Survey of all graduates of the Rochester Pediatric Residency Program from 1991–2001. Graduates before institution of PLC (pre-PLC) were compared with graduates after institution of PLC (post-PLC). Participants.— A total of 137 (81%) of 169 graduates participated; 78 (85%) of 92 were in the pre-PLC group and 59 (77%) of 77 were in the post-PLC group. Intervention.— PLC provides all pediatric residents with a 2-week rotation working with multiple community-based organizations. Outcome Measures.— Differences between pre-PLC and post-PLC graduates in self-reported attitudes and competencies in multiple community health and child advocacy activities on 4-point Likert scales. Results.— The pre-PLC and post-PLC groups' attitudes toward community health activities were equally positive (3.4 vs 3.5, P = .08). The post-PLC group rated its competency higher in 8 of 12 activities ( P < .05); its overall rating of competency was also higher (2.8 vs 2.3, P < .001). Conclusions.— Although all pediatricians surveyed had positive attitudes toward community health and child advocacy activities, those who participated in PLC had higher self-perceived competency in most activities. Residency training programs can increase graduates' competence in community health skills.