1 / 49

Competency-Based Approach to Community Pediatrics: Service Learning Methodology Community Pediatrics Program, Columbia

Competency-Based Approach to Community Pediatrics: Service Learning Methodology Community Pediatrics Program, Columbia University Dodi Meyer; Patricia Hametz; Vicki LeBlanc; Milagros Batista; Neil Goldberg . Workshop outline. Designing a competency based curriculum

edda
Download Presentation

Competency-Based Approach to Community Pediatrics: Service Learning Methodology Community Pediatrics Program, Columbia

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Competency-Based Approach to Community Pediatrics: Service Learning Methodology Community Pediatrics Program, Columbia University Dodi Meyer; Patricia Hametz; Vicki LeBlanc; Milagros Batista; Neil Goldberg

  2. Workshop outline • Designing a competency based curriculum • Choosing a methodology: Service learning as an example • Designing an appropriate evaluation • Open discussion

  3. Frustrations with a lack of defined curriculum • Little preparation / knowledge of role • Unclear, one-sided objectives • Evaluation limited to knowledge acquired • Learning is often passive

  4. What is a curriculum?

  5. Key components of a curriculum • Enrollment process:Who are we teaching? • Competencies: What are we teaching? • Methodology and Resources: How are we teaching? • Outcomes Evaluation: Did they learn it? • Process Evaluation: Did we teach as we said we would?

  6. Traditional: *Discipline-based *Teacher-centered *Historical *Academically neutral *Not multidisciplinary Competency-Based: *Resident-centered *Future-oriented *Set Priorities *Multidisciplinary Competency-based vs. Traditional curriculum

  7. What is a competency statement?

  8. What is a competency statement? What do we mean by “competent”? Beginner Novice Competent Proficient Expert

  9. What is a Competency? A competency statement describes precisely an essential skill, combined with appropriate knowledge and attitude, that the resident will be able to perform reliably upon completion of training, in real settings and without assistance, in order to be ready for beginning independent practice.

  10. Example of a competency statement Prescribe medications to treat a patient’s respiratory distress appropriately *skill component *knowledge component *attitude component

  11. How do we develop a competency-based curriculum? 1) Write competencies 2) Consider appropriate methodology 3) Determine evaluation tools

  12. How to write a competency statement • Statement of specific behavior or task • Requires both understanding and application of the materials to real work settings • Behavior or task should be something that can be evaluated

  13. Examples 1. Understand how culture applies to the health of children.

  14. Examples 1. Understand how culture applies to the health of children. 2. Explain how beliefs, culture and ethnic practices can influence health status and health care for children of the community.

  15. Examples 1. Understand how culture applies to the health of children. 2. Explain how beliefs, culture and ethnic practices can influence health status and health care for children of the community. 3. Explain how a health care belief system can influence where and what type of health care is sought, and how that decision affects the health status of a child.

  16. Examples of Verbs for Competencies

  17. Community Pediatrics • “Community Pediatrics takes responsibility for all children in a community, providing preventative and curative services, and understanding the determinants and consequences of child health and illness, as well as the effectiveness of services provided….The unique feature of Community Pediatrics is its concern for all of the population.” • Robert Haggerty, MD

  18. Examples 1. Understand how culture applies to the health of children. 2. Explain how beliefs, culture and ethnic practices can influence health status and health care for children of the community. 3. Explain how a health care belief system can influence where and what type of health care is sought, and how that decision affects the health status of a child.

  19. Theoretical framework: Service Learning • Established educational methodology • Integrates community service with explicit learning objectives • Responds to community needs, building on its own perceived assets

  20. Service Learning • Involves community as active partner in program design and implementation • Emphasis on critical reflection: What? So What? Now What?

  21. Service Learning: Steps for implementation • Identify partners: negotiate different agendas, expectations, roles and responsibilities • Learning competencies for residents and community members • Service objectives for residents and community members • Structured reflection

  22. Service Learning at Columbia: 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

  23. Service Learning at Columbia: Learning Competencies • 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

  24. 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

  25. 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?

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

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

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

  29. 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

  30. 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

  31. 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

  32. 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

  33. 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

  34. Service Learning Potential Pitfalls: Community Perspective • Not only one way of learning • Teaching and learning can happen at the same time • Time intensive / Labor intensive • Financial incentives need to be balanced

  35. 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

  36. Service Learning: Steps for implementation • Identify partners: negotiate different agendas, expectations, roles and responsibilities • Learning competencies for residents and community members • Service objectives for residents and community members • Structured reflection

  37. Evaluation When determining the competencies and methodology, we need to keep in mind the evaluation of the curriculum

  38. Two components to evaluation Process evaluation: Are we doing what we set out to do? -focus groups -satisfaction surveys -documenting activities Outcome evaluation: Are the residents learning what we want them to learn?

  39. Outcomes Evaluation How do you measure a competency? Three components: -Knowledge -Skills -Attitudes

  40. Examples of Evaluation “Prescribe medications to treat a patient’s respiratory distress” Knowledge: Residents should be able to describe the medications that can be used to treat respiratory distress.

  41. Examples of Evaluation “Prescribe medications to treat a patient’s respiratory distress” Knowledge: Residents should be able to describe the medications that can be used to treat respiratory distress. Evaluation: Describe the medications that can be used to treat respiratory distress, and discuss their side effects.

  42. Examples of Evaluation “Prescribe medications to treat a patient’s respiratory distress” Skill: Residents should be able to assess the degree of respiratory distress.

  43. Examples of Evaluation “Prescribe medications to treat a patient’s respiratory distress” Skill: Residents should be able to assess the degree of respiratory distress. Evaluation: Describe the steps required to assess the respiratory distress of a 7-year old child.

  44. Examples of Evaluation “Prescribe medications to treat a patient’s respiratory distress” Skill: Residents should be able to assess the degree of respiratory distress. Evaluation: Describe the steps required to assess the respiratory distress of a 7-year old child. Performance evaluation of a resident conducting a physical examination on a child with respiratory distress.

  45. Examples of Evaluation “Prescribe medications to treat a patient’s respiratory distress” Attitude: Residents should recognize the importance of eliciting the patient’s understanding of asthma in order to identify barriers to implementing the treatment plan.

  46. Examples of Evaluation “Prescribe medications to treat a patient’s respiratory distress” Attitude: Residents should recognize the importance of eliciting the patient’s understanding of asthma in order to identify barriers to implementing the treatment plan. Evaluation: Video-taped interview of a resident discharging a 7-year old with respiratory distress from the emergency room.

  47. Examples of Appropriate Evaluation Methods • Knowledge • -tests (Multiple choice, true or false, essay) • -literature review • Skills • -simulations • -rating scales of clinical encounters • Attitudes -journals -videotaped encounters

  48. Example of Evaluation at Columbia: • Knowledge component • Competency: • Explain how beliefs, cultures, and ethnic practices can influence health status and care for children in the community. • Method: • Service Learning • Evaluation: • Short answer test

  49. Examples of Appropriate Evaluation Methods • Knowledge • -tests (Multiple choice, true or false, essay) • -literature review • Skills • -simulations • -rating scales of clinical encounters • Attitudes -journals -videotaped encounters

More Related