From Physician-Centered to Community-Oriented Perspectives on Health Care: Assessing the Efficacy of Community-Based Training
Abstract
PURPOSE: To understand the influence of a community-based child advocacy block rotation on the perspectives of first-year pediatric residents and whether this influence persists. METHOD: The authors conducted semistructured interviews to assess the impact of the training program on pediatrics residents' perspectives regarding child advocacy and their understanding of the role of the community members and community-based assets in child advocacy. Three cohorts of first-year residents at the University of California, Davis, participated in the two-week community collaborative rotation from 2000 03. Two cohorts of 23 first-year residents were interviewed. In 2003, the first cohort of nine third-year residents was re-interviewed to assess long-term impact. Interviews were conducted before and after residents' experiences with community collaboratives. Transcripts of interviews were reviewed using an iterative process, and a coding system was applied using a qualitative software program. RESULTS: Comparison of pre- and postrotation interview data showed that residents' conceptions of advocacy shifted from ideas about being a pediatrician for the community to being a pediatrician in the community. This change in definition reflected a view of the pediatrician as facilitator, a community asset, rather than as a central administrator of child health affairs. This shift persisted through the completion of residency. CONCLUSIONS: These findings suggest that substantive interaction in a community collaborative can provide a starting point for residents to reconceptualize their role as pediatrician, for understanding the diverse contexts characteristic of children's circumstances, and for identifying and using community-based assets for improving child health. Definition changes persisted through residency and may influence residents' future behavior in clinical practice.
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From A Systematic Review of Advocacy Curricula in Graduate Medical Education (2019) · cites this paper as [48]
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- Authors
- Paterniti, D. A., Pan, R. J., Smith, L. F., Horan, N. M., & West, D. C.
- Affiliations
- University of California, Davis (US)
- Corresponding author
- Paterniti, Debora A.
- Venue
- Academic Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2006-04
- Volume
- 81
- Issue
- 4
- Pages
- 347-353
- ISSN
- 1040-2446 (ISSN-L)
- OpenAlex
- W2148289291
- Cited by
- 29
- References
- 21
- Citations by year
- 2026: 1 · 2024: 1 · 2022: 1 · 2020: 1 · 2019: 3 · 2016: 3 · 2015: 1 · 2014: 1 · 2012: 6
- FWCI
- 2.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Academic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Sierra Health Foundation
- Dyson Foundation
- University of California, Davis
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Health Sciences › Health Professions › General Health Professions › Child and Adolescent Health
- Health Sciences › Health Professions › General Health Professions › Health and Medical Education
- Keywords
- community-based training, child advocacy, pediatric residency, pediatrician role, child health, resident perspectives
- MeSH terms
- Adult, Attitude of Health Personnel, Child, Child Advocacy, Community Health Services, Delivery of Health Care, Female, Humans, Internship and Residency, Male, Pediatrics, Physician's Role, Cohort Studies
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