Social pediatrics training: Reflections of pediatric residents embedded in a CAC with an integrated model of practice

Objective: This was the second part of the project that involved creating a mandatory four week Social Pediatrics rotation at a CAC, for University of Calgary pediatric residents . The goal was to evaluate the rotation from... [ view full abstract ]

Objective: This was the second part of the project that involved creating a mandatory four week Social Pediatrics rotation at a CAC, for University of Calgary pediatric residents . The goal was to evaluate the rotation from a resident perspective, including the expected impact of the curriculum on future practice.

Methods: During the rotation residents worked with the multidisciplinary Child Protection teams based at the Sheldon Kennedy Child Advocacy Centre and attended clinics for children from low income inner city families (medical and dental), street youth, children in care, aboriginal children and refugees. In addition they attended residential treatment programs for children, school based developmental assessments, transition workshops and a telephone call centre for Social Services. The residents kept a logbook and created written reflections for each component of the rotation. The reflections were then analysed to identify the major themes.

Results: Broadly, the residents indicated that they had developed a deeper understanding of the social determinants of health. Themes included better awareness of the roles that poverty, isolation, lack of transportation, language barriers and homelessness play in the ability of families to access adequate healthcare, and increased awareness of the relationship of these stressors to child abuse and neglect. More specifically, residents also gained a better understanding of the value of an integrated model of managing child maltreatment as well as an increased awareness of the resources available in the local community.

Conclusions: Having a defined curriculum that addresses the concept of Social Pediatrics increases resident awareness of the social determinants of health. The interaction with other disciplines (police, social services, public health, education) provided a new lens for the holistic view of the child. The residents view this as a valuable rotation experience that will aid in their ability to deliver pediatric care in the future.