By graduation, the residents will demonstrate the knowledge, attitude, and skills
necessary to manage effectively in multiple, diverse, complex systems of care to provide
effective assessments, treatment, consultation, and advocacy for children, adolescents,
families, and child related agencies. Residents are expected to exhibit progressive
improvement in their level of knowledge and skill throughout their training. Methods
of demonstration may include the care of patients/ families, participation in didactics
and clinical conferences, presentations, or exams.
Knowledge
Definition
Residents must have
an awareness of and responsiveness to the larger context and system of health care
with the ability to effectively utilize system resources to provide optimal patient
care
a theoretical and practical understanding of systems and the relevance to health and
psychiatric care
knowledge about local/ national organizations involved in advocating and caring for
youth/ families
Expectations
Residents will learn about
the interaction between and reciprocal impact of their own patient care and other
professional practices and those of other professionals, health care organizations,
and society
the different public and private systems involved with children, adolescents, and
families: the services, costs, and access to care
cost effective health care practices and resource allocation while providing quality
patient care
mental health advocacy for children, adolescents, and families in general as well
as for individual patients and families to negotiating systems and obtaining services
collaboration with other professionals to understand and negotiate health care and
other systems to provide and manage quality health care
Suggested topics (not inclusive) include:
Educational systems
Special educational services
Legal mandates
Community programs, agencies, and systems (public and private)
Social Service systems
Public services
Child protective services, welfare, foster care, adoption
Institutional (hospital) services
Private agencies
Mental Health Systems (public and private)
Legal systems
Health Care systems (public and private)
Insurance systems (public and private)
Political systems
Attitudes
Definition
Residents will exhibit interest in and an understanding of health care delivery and
system interactions
Expectations
Residents will participate actively in didactic and clinical situations with an understanding
of
the impact of and interrelationships between patient care practices and other professional
activities
the systems and services available to children, adolescents, and families and their
influence on patient care and clinical practices
Residents will demonstrate the abilities to negotiate and collaborate with
systems to advocate for and provide the best possible care for children, adolescents,
and families
other professionals, patients, and their families to integrate services from multiple
systems
Skills
Definition
Residents will demonstrate an understanding of how
their patient care and other professional practices affect other health care professionals,
the health care organization, and the larger society and how these elements of the
system affect their practice
types of medical practice and delivery systems differ from one another, including
methods of controlling health care costs and allocating resources
to practice cost-effective health care and resource allocation in a manner that does
not compromise quality of care
to advocate for quality patient care and to assist patients in dealing with system
complexities
to partner with health care managers and health care providers to assess, coordinate,
and improve health care and knowing how these activities can affect the system
Expectations
Residents will demonstrate
the ability to provide cost effective quality patient care with appropriate utilization
of resources
an understanding of the advocacy needs of children, adolescents, and families and
the ability to help patients and families negotiate systems and access to resources
the ability to collaborate with other professionals to negotiate systems and provide
patient care
Assessment/Measurement
Objective Measures
Regular documentation by clinical and teaching faculty of participation in didactic
modules, case conferences, and other teaching sessions
Completion of CHILD PRITE annually with review of individual scores with the training
director
Completion of essay exam annually with review with the training director
Supervision
Regular documentation of resident performance in areas relevant to systems based care
by supervising outpatient and on-rotation faculty
Clinical Skill Evaluation
Direct observation of the individual resident's clinical and didactic activities by
identified faculty
Completion and review of 360 input
Observation and evaluation of videotaped patient interactions by supervisors and/
or teaching faculty on a regular basis
Annual clinical examination of “mock board” type
Biannual review of performance with training director
Independent Learning
Demonstration of self-initiated as well as directed study through leadership of discussions
in both didactic and clinical activities and through presentations to the residency
program in various formats (e.g. required papers; seminars; grand rounds; etc)
Deficiency Remediation
Regular review for each individual resident with the training director of the various
measures of performance and competence with the
identification of any specific deficits
documentation of all identified areas requiring remediation or additional concentration
development of specific remediation plans based on the particular deficiencies identified
planning for further assessment with the outcome being determined by a method of assessment
similar to the one used to identify the original deficiency (e.g. relative deficits
identified on the CHILD PRITE might be subsequently reassessed by later performance
on the CHILD PRITE or another written examination; deficits identified through the
supervisory process might be reassessed by subsequent supervisory reports specifically
targeted at assessing and remediating the identified deficits; etc)
