JeffSTARS: One Student, One Resident, One Step Toward Change Columbia Physician Advocacy Fellows Meeting November 18-19, 2010 Esther K. Chung, MD, MPH Associate Professor of Pediatrics Jefferson Medical College, Thomas Jefferson University A.I. DuPont Hosp for Children/Nemours JeffSTARS Overview Req. Outpt Rotation (Year-Round) • Journal Club (monthly) • Advocacy Café (weekly) • Reflective writings • Community Site visits and reports • Pre- and postassessments Continuity Clinics (Yearly) • JeffSTARS paper/talk Intensive Elective (1-3x/Year) • Seminar series • 50% time with a community partner • Mutually agreeable project • Legislative Advocacy Day • Presentation • Paper • Cafés and Journal Club Year 1 Progress: July ’09 – Sept ‘10 IMPACT • 3rd year students: 138 • 4th year students: 15 • Pediatric residents: 52 • Family and community medicine residents: 18 • Cafés: 58 • Community site visits: approx. 90 • Community partners • Advocacy opportunities for faculty • Expansion to Wilmington Clinic • Website completion • Community partners • Campus partners Community Site Visit - Examples • WIC orientation and visit to neighborhood offices • Home visits with the MOMobile • Trips to Harrisburg – Child Death Review • EPA Hearing • PSR Peaceful Posse groups • PA AAP Advocacy Initiatives • Child with Special Health Care Needs workgroup Mike Campbell, Esq., with two 3rd-year medical students in front of Kendra Klein, MD’s poster on child abuse prevention at the Community Partner’s Appreciation Lunch Advocacy Cafés & Reflective Writings Topics – examples • • • • • • • • • Childhood obesity Media violence Child abuse Teen pregnancy Infant mortality Access to care Access to dental care Car safety Breastfeeding Qualitative analysis of writings • Tone (detached, engaged, passionate) • Broadening perspective (barriers, personal experience, selfreflection) • Empowerment (passive/active; generating ideas/actions, attitudes) Advocacy Café, Fridays, 1230 – 2 pm Kurt Yusi, MS III, “Why don’t all clinical rotations have small group discussions where we talk about advocacy?” Language Barriers in Clinical Care: Reflections from A.M., 3rd-Yr Pediatrics Resident • “Advocating for ways to provide medical care in a language the patient can understand is important for all…involved: patients, families, and physicians.” • “The inefficiency that comes from everyone hoping the patient speaks English could be avoided. This is a problem that needs to be dealt with headon, not when it’s just too obvious to ignore.” Refugee Clinic (Clinical Care) at Jeff. Peds – Reflections from A.B., 3rd Yr Pediatrics Resident • “The refugee clinic is…amazing…, and I’m so proud that our residents will be a part of it.” • “I don’t know that I would have ever come home from a regular clinic day and read multiple articles about refugee camps and international policy; the experience undoubtedly leads to reflection.” Community Site Visit to Harrisburg with PA AAP – Resident Reflections “This experience was significant in unveiling the mystery of the legislative process.” “I now realize how achievable it is to identify a problem you feel passionate about, and work towards a solution with the help of your state legislators.” “As a young resident, I feel energized and empowered to work towards change for the members of my community.” Pre- and Post-Assessments • Rise in subjective and mean objective knowledge scores (17 vs. 23, p < 0.0001) for residents and medical students, independent of anticipated specialty • Rise in self-reported, comfort and ability to advocate for children (mean score 24 vs. 28, p < 0.0001) • Residents when compared to medical students were more likely to vote in the past year (97% vs. 81%, p < 0.01) • Higher advocacy activity scores were associated with higher baseline mean objective knowledge scores (0-3: 15; 4-6: 17; 7+: 19, p < 0.01) Elective Projects • Launching a Refugee Clinic at Jeff Peds • Developing a Toolkit for Teachers for Prevent Child Abuse PA • Developing Guidelines for the Transition of Medically Complex Foster Care Children • Developing Web Resources for Health Professionals for Planned Parenthood • Contributing to Reproductive Health Guidelines with the Women’s Law Project • JeffREP: Jefferson Refugee Education Partners Recent meeting with Cheryl Bullock, Senior Advisor and Southeast Regional Director for U.S. Senator Bob Casey (Risa Yavorsky, MS III; Cheryl Bullock; Vicki Mui, MS III) Goals for Year 2 • Expand community partners • Delaware expansion • Change to the JeffSTARS longitudinal component • Continue to take advantage of community events • Reassess volume of data collected Thank you! Happy Thanksgiving!