WellBabies Resident Curriculum: Program Plan and Evaluation for Family Medicine Resident Education in Preventive Well-Child Care
Creators: name: Andrews, Laura
Publisher: name: The University of North Carolina at Chapel Hill University Libraries
Year: 2010

description: Family medicine is a medical specialty which aims to provide comprehensive health care for the individual, family, and community. The American Academy of Family Physicians (AAFP) further defines family medicine in the context of primary care, as serving a role in health promotion, disease prevention, counseling, patient education, and care for acute and chronic illness. Providing medical care and parental guidance for pediatric patients historically has been a large part of family practice. Based on a survey conducted by the AAFP in 2008, 87.9% of family medicine residency graduates participate in pediatric care. Residency programs in family medicine are structured to prepare physicians for future practice in a primary care environment. The Accreditation Council for Graduate Medical Education (ACGME) is responsible for verifying appropriate education at each residency site. The Residency Review Committee, a sub-group of the ACGME, identifies core competencies and skills for each medical specialty. Specifically regarding pediatric care, this committee requires that family medicine residents are trained in the care of neonates and infants in a structured manner through teaching and role modeling by the family medicine faculty. There are certain requirements for the number of months of training in the pediatric inpatient and outpatient settings, but individual residency programs are left to determine the practical details of the training requirements. Residency training can be measured in several ways, including physician knowledge, confidence, or practice of a given skill. In terms of practice level performance, primary care groups in North Carolina are not fully meeting recommendations for pediatric preventive services. Specifically, only 39% of children at the included practices received at least three of the four surveyed preventive services.' To further examine the practice and opinions of physicians, some authors have made comparisons between family medicine and pediatric physicians. In one such study, family medicine physicians were 5.4 times less likely to provide poison prevention counseling to parents. These family physicians cited lack of training as the primary reason for not offering this type of guidance. Aside from traditional pediatric rotations, direct patient care, and didactics, there is no formal curriculum for early childhood preventive care in the University of North Carolina (UNC) Department of Family Medicine at this time. In 2006, Dr. Cristen Page performed a needs assessment for structured pediatric training in the family medicine residency program at UNC. This assessment collected opinions of graduating family medicine residents through a brief survey. The results indicate that a majority of residents are not confident in their outpatient pediatric training and desired an increase in the amount of training they received (data not published). This needs assessment, in light of national requirements and guidelines for residency training, encouraged the development of a new curriculum in well-child care. The WellBabies Resident Curriculum is a program for UNC family medicine residents based on group well-child care. Group well-child care involves bringing several patients together for a medical visit, allowing group discussion of prevention and counseling topics. Several research groups have shown that group visits are an acceptable alternative to traditional individual care. In addition, group visits provide an environment for coverage of a greater number of prevention topics. The WellBabies Resident Curriculum involves focused didactic sessions and role-modeling by family medicine faculty, in addition to instruction in the evidence base for pediatric preventive care. The curriculum is designed to help residents increase their understanding and knowledge of the evidence for common counseling topics and build their confidence for providing such counseling to parents. This paper will present the program description of the WellBabies Resident Curriculum and the associated evaluation plan.