Caring for children who have special health-care needs: a practical guide for the primary care practitioner

Children who have special health-care needs (CSHCN) require more time, coordination, and resources. Caring for CSHCN can be challenging, but it also is very rewarding. By making small changes in a practice and getting to know the resources in the community, the primary care physician can build a medical home for all patients

Identifying what pediatric residents are taught about children and youth with special health care needs and the medical home

OBJECTIVE: To describe what and how pediatric residents in Massachusetts are taught about children and youth with special health care needs (CYSHCN) and the medical home. PARTICIPANTS AND METHODS: Faculty members and residents at Massachusetts\u27 5 pediatric residency programs were interviewed to identify current curricula and teaching methods related to care of CYSHCN. In addition, residents were surveyed to quantify these concepts. RESULTS: Thirty-one faculty members and 25 residents were interviewed. Most exposure to CYSHCN was reported to occur in inpatient settings. However, most formal teaching about CYSHCN was described as occurring in the ambulatory setting. Promising educational strategies included home and community visits, inclusion of CYSHCN in resident continuity panels, and simulation and role-playing. Overall, the programs had little training emphasis on the lives and needs of CYSHCN and their families outside the hospital setting. Twenty (80%) of the residents interviewed completed the written survey instrument. They noted a high degree of comfort in caring for CYSHCN in various settings and involving families in decision-making about their child\u27s care but expressed less comfort in identifying community resources and collaborating with community agencies and schools. CONCLUSIONS: Programs offer a variety of successful educational and clinical experiences related to the medical home and CYSHCN. The results of our study indicate that residents and faculty members believe that residents would benefit from more formal training opportunities to learn directly from families and community representatives about caring for CYSHCN