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Teaching Residents About Development and Behavior
Meeting the New Challenge
Carolyn Frazer, MD;
S. Jean Emans, MD;
Elizabeth Goodman, MD;
Maria Luoni;
Terrill Bravender, MD;
John Knight, MD
Arch Pediatr Adolesc Med. 1999;153:1190-1194.
Objective To determine the teaching methods, materials currently used, and unmet needs for teaching developmental-behavioral pediatrics (DBP) at pediatric training programs in the United States.
Design Cross-sectional survey of US pediatric residency training programs. The survey questionnaire consisted of 3 instruments: a program director survey, a developmental-behavioral pediatrics survey, and an adolescent medicine survey.
Participants Survey packets were mailed in January 1997 to 211 programs identified by mailing labels from the Association of Pediatric Program Directors.
Results Data from 148 programs (70%) completing both the DBP survey and program director survey were analyzed. Ninety-five percent of programs reported a block rotation, and 95% of those stated that the rotation was mandatory. Eighty-seven percent had a formal curriculum. Most programs reported using articles, lecture outlines, and precepting for teaching DBP. Few programs used standardized case-based or computerized materials. Most programs, however, indicated a desire for these materials. Few programs felt that 4 topics were covered adequately: adoption (12%), violence (24%), substance use (28%), and conduct problems (41%). Programs that perceived that they covered these topics adequately were more likely to use written cases as part of their curriculum (Mann-Whitney test, 1373.5; P = .04). Barriers to teaching included lack of adequate faculty, time, money, and curricular resources.
Conclusions Pediatric residency programs have made significant gains in mandatory DBP training. However, many programs report a lack of adequate faculty, teaching materials, and methods. Responding programs indicated an interest in case-based materials. This approach may represent an alternative and underutilized resource for teaching DBP.
From the Divisions of General Pediatrics (Drs Frazer and Knight) and Adolescent/Young Adult Medicine (Dr Emans, Goodman, and Bravender and Ms Luoni), Children's Hospital and the Department of Pediatrics, Harvard Medical School (Dr Frazer, Emans, Goodman, Bravender, and Knight and Ms Luoni), Boston, Mass.
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