School health in pediatric residency training: 1994
B. J. Bradford
Department of Pediatrics, Mercy Children's Medical Center, The Mercy Hospital of Pittsburgh, PA. USA.
OBJECTIVE: To explore efforts of pediatric residency programs to provide
future pediatricians with appropriate school health skills (given the
growing recognition that school health programs have a positive effect on
child health). DESIGN: A survey was mailed to the directors of all 214
accredited pediatric residency programs in the United States. RESULTS:
Based on an overall response rate of 72%, a defined clinical experience in
school health is required in only 34% of programs and offered by 43%. It
usually consists of occasional half days during block rotations. Content
included consultation on children with chronic illness, classroom
observations, and participation in school-based clinics, health education
classes, and multidisciplinary team meetings. Many residency programs
viewed core topics in school health as appropriate for pediatric residency
curriculum, and many of them included such instruction. In the programs
that offered school health, dollars were generated only 16% of the time,
and the funding level was seldom significant (>$50 000). CONCLUSIONS:
Tomorrow's pediatricians will need training in comprehensive school health
(including education, service provision, and the assurance of a medical
home for some children in the school), but school health is a minor part of
the curricular experience for today's pediatric residents. Future
investigations should target barriers to comprehensive school health
training (including financial impediments) and look at alternative school
and community experiences and their effect on trainees, schools, and
school-aged children.
