Operation Homefront: Meeting Clerkship Competencies with Home Visits to Families of Children With Special Needs

• Published in: Academic pediatrics Vol. 19; no. 2; pp. 170 - 176
• Main Authors: Anderson, Emily E., Boyd, Bridget, Qureshi, Nadia K., Stirling, Jerold M., McCarthy, Virginia, Kuczewski, Mark G.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-03-2019
• Subjects: Attitude of Health Personnel; Child; children with special needs; clerkship competencies; Clinical Clerkship; Clinical Competence; Communication; community-based experience; Disabled Children; Family; Health Services Accessibility; home visit; House Calls; Humans; Nonverbal Communication; Patient Education as Topic; Pediatrics - education; Physician's Role; Respect; written reflection; home visit; clerkship competencies; community-based experience; written reflection; children with special needs
• ISSN: 1876-2859; 1876-2867
• DOI: 10.1016/j.acap.2018.09.002

We assessed how third-year medical students’ written reflections on home visit experiences with families of children with special needs demonstrate evidence of exposure to 9 selected competencies for pediatric clerkships designated by the Council on Medical Student Education in Pediatrics.
We reviewed written reflections from 152 third-year medical students. For each competency (2 related to communication were combined), we tabulated the number of reflections in which a given competency was demonstrated. Within each competency, themes are described and presented with exemplary quotes to provide a more robust picture of students’ exposure and experience.
Of 152 reflections, 100% demonstrated at least 1 of the 8 expected competencies. Each reflection exhibited an average of 3 (3.1) competencies (range: 1–7). The competencies most frequently mentioned were demonstration of respect for patient, parent, and family attitudes, behaviors, and lifestyles (90%) and demonstration of positive attitude toward education (76%). Less frequently mentioned competencies included demonstration of behaviors and attitudes that promote patients’ and families’ best interests (41%), demonstration of effective verbal and nonverbal communication skills (a combination of 2 communication-related competencies) (33%), and description of barriers that prevent children from accessing health care (37%). The following competencies were least often mentioned: description of a pediatrician's role and responsibility in advocating for patients’ needs (10%), description of the important role of patient education (8%), or description of the types of problems that benefit from a community approach (17%).
Our analysis demonstrates that community-based home visits can provide medical students with opportunities to meet required pediatric clerkship competencies.