Home visits by pediatric residents. A valuable educational tool
J. S. Steinkuller
Department of Pediatrics, Baylor College of Medicine, Houston, Tex 77030.
OBJECTIVE--To establish how many pediatric residency programs offer home
visits, to assess the feasibility of making home visits as part of
pediatric training, and to determine whether residents perceive home visits
as worthwhile learning experiences. DESIGN--A questionnaire was mailed to
all medical school pediatric departments in the United States and Puerto
Rico to determine the prevalence of home visits during residency training.
To study the feasibility of residents making home visits, a pilot program
was instituted. PARTICIPANTS--Fourteen pediatric residents participated in
the study. Each resident visited a house, trailer, apartment, or shelter
for the homeless that was within a 20-minute radius from the medical
center. To determine the educational value of home visits, each resident
wrote a one-page report immediately on his or her return to the hospital.
After about 6 months, all participating residents completed a questionnaire
retrospectively evaluating their home visits. SELECTION PROCEDURES--Interns
who were neither on-call nor postcall the day of the visits were invited to
participate. Patients were selected because they were homebound (eg,
ventilator-dependent), had missed follow-up appointments, or had
transportation difficulties. RESULTS--Thirteen percent of the pediatric
residency programs surveyed currently include home visits. In all 14 of the
pilot visits, the home was located without difficulty and the patient was
at home. In each case, the family welcomed the visit. All the pediatric
residents believed that the home visit was a worthwhile learning
experience. CONCLUSIONS--Although very few programs (13%) currently offer
home visits as part of pediatric residency training, such visits are
feasible within a large urban area. Residents are enthusiastic about seeing
how and where their patients live, and consider home visits a worthwhile
learning experience.
