670F THE USE OF COMMUNITY LABORATORIES IN PRIMARY CARE PEDIATRIC RESIDENCY TRAINING

Abstract

“Community Laboratories”, a longitudinal three year outreach rotation for Pediatric Residents was instituted in 1978 to broaden the Resident's primary care training. Rural Pediatric practices within a 30 mile radius of the Medical Center were selected on the basis of community interest and teaching potential. Residents,for three years, spend part of each week in the same community. The Resident develops a panel of families that (s)he follows for the three years, and becomes actively involved in the community's health services, including school health,child abuse,public health and health planning. Medical Center faculty are responsible for developing curricula in each area of community health and aid in their local adaptation. The Pediatric practices are members of a Cooperative Data Project, and data on diagnosis frequency and patient management are fed back to the Residents for self-evaluation. The community Pediatricians attend group sessions to share experiences, critique the program, and receive instruction in teaching techniques, evaluation and medicine updates. Community health personnel also meet with the Residency Faculty to review the program and take part in inservice training. In the first year of the community rotation, 40% of all Resident outpatient encounters - 1700 visits - occurred at the community sites. The community laboratories offer a dynamic method for Residents to develop the skills necessary to manage the “new morbidities” of Pediatric practice in a setting that closely simulates the realities of rural Primary Pediatric Care.