Competencies and Objectives

Competencies and Objectives

6.97  Goal: Pediatric Competencies (Child Advocacy)

Demonstrate high standards of professional competence, knowledge, skill, and involvement in activities necessary to effectively advocate for the health and well-being of children.

6.97.1  Competency 1: Patient Care

Provide family-centered patient care that addresses the health and development of the child within the context of the family and available resources (including educational, other health professional, state/federal programs, available community resources, etc.) necessary for the effective promotion of health.  Demonstrate a commitment to acting in the overall best interest of the whole patient and his/her optimal functional status, despite competing time, fiscal, or service constraints.  Demonstrate a willingness to advocate for children and their families.

6.97.2  Competency 2: Medical Knowledge

Understand the scope of established and evolving policies, systems, and resources that can be used by the pediatrician to advocate for the health and well-being of children on an individual, community, state, and national level and apply this knowledge.  Demonstrate a commitment to acquiring the knowledge needed to advocate for the health and well-being of children.  Explain why children need child advocates (e.g. children cannot vote, lobby, or speak for themselves).  Define the role of a child advocate and describe ways in which a pediatrician can advocate for children.  Discuss how the American Academy of Pediatrics advocates for children (e.g., the AAP's federal and state legislative activities and CATCH program). Identify other regional, national, and international child advocacy organizations (e.g., Children's Defense Fund, Mothers Against Drunk Driving, Alliance for Child Survival) and describe how to obtain more information from them.  Describe several major public health issues affecting children that are being considered by the local, state, or federal government (e.g., hand gun control, children's health insurance, smoking cessation, helmet use, abduction surveillance systems). Identify the key elements of the position of for and against each issue and the proponents and opponents, and discuss how the pediatrician might become involved.  Discuss barriers to health and health care for children in one's own community and some strategies to overcome these, including action the pediatrician can take, what the role of local and national government agencies should be, and community resources that are available to lessen or overcome the barriers.  Demonstrate a working knowledge of non-medical systems that influence and direct care for children, including the criminal justice, child protection, and educational systems.  Know and/or access community resources efficiently and appropriately to the care of patients.  Advocate with other medical, social or community services to address the patient's and family's problems and needs.  Understand Special Education systems and the basis for those systems.

  1. Describe the legal basis for adaptations in schools for children with special health care needs, including the Americans with Disabilities Acts (ADA) and the Individuals with Disabilities Education Act (IDEA).
  2. Give examples of classroom modifications that can be extended to children under Section 504 of the Rehabilitation Act.
  3. Assist families of children with special health care needs in accessing services through their schools, including physical, speech and occupational therapies.
  4. Assist families of children with suspected or known developmental needs in accessing evaluation and special education services from their schools.
  5. Understand the process by which schools determine appropriate services for children, including development of an Individualized Education Plan (IEP 3-22 yr), an Individualized Family Service Plan (IFSP birth-3 yr), and a 504 plan.  List local resources and support groups for children and families with social, legal, educational, or special health care needs.  Describe the policy and advocacy efforts of the AAP, the APA, and other groups that speak on behalf of children with special health care needs (e.g., the medical home model).  Understand the history and the tradition of advocacy that has shaped  the role of the pediatrician within our system.

6.97.3  Competency 3: Interpersonal Skills and Communication

Demonstrate interpersonal and communication skills that result in information exchange and partnering with patients, their families and professional associates.  Communicate effectively with community agencies, school personnel, community groups, other health professionals, and child advocates to create and sustain information exchange and teamwork.  Incorporate into routine practice the ability to:

  1. Gather important data on the psychosocial, environmental, economic, and medical issues that relate to a child's health (e.g., does the family have health insurance, enough food, a place to live, adequate resources for basic needs, etc.).
  2. Question caregivers about whether the patient has a medical home.
  3. Explain in terminology the caregiver can comprehend the importance of a medical home to the child's health.
  4. Facilitate the family's access to regular continuity of care.
  5. Discuss and explore problems with various culturally diverse populations.
  6. Explain how to access appropriate resources using language that is both culturally appropriate and on the appropriate literacy level of the caretaker and/or patient.  Collaborate with community based organizations, schools, and/or legislators to address important health problems affecting children.  Identify and communicate (through personal email, fax, phone call, or visit) with a state or federal legislator on an issue affecting children's health.  Speak effectively about child health matters to families and community groups and participate in local child advocacy activities.

6.97.4  Competency 4: Practice-Based Learning and Improvement

Demonstrate knowledge, skills and attitudes needed for continuous self-assessment to investigate, evaluate, and improve one's child advocacy skills.  Establish an individual learning plan, systematically organize relevant information resources for future reference, and plan for continuing acquisition of knowledge and skills.

6.97.5  Competency 5: Professionalism

Demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles and sensitivity to diversity.  Demonstrate a commitment to professional behavior in interactions with community agencies and groups, other child advocates, school personnel, and other health professionls.

6.97.6  Competency 6: Systems-Based Practice

Understand how to practice high-quality health care and advocate for patients within the context of the health care system.  Identify key aspects of health care systems and resources (e.g., public and private insurance, state and federal agencies) as they apply to patients, such as the role of the primary care provider and consultant in advocating for the health and well-being of children.  Recognize and advocate for families who need assistance to deal with system complexities, such as lack of insurance, multiple medication refills, multiple appointments with long transport times, or inconvenient hours of service.  Identify specific ways in which physicians can participate in the legislative process to create or improve public programs for children.  Collaborate with families and communities to provide care coordination in a medical home for children where the family is recognized as the principal caregiver and center of strength and support for the child; the family is also recognized as the expert in their child's care and youth as experts in their own care.  Value the roles of community resources in providing services for children and families.  Identify agencies that provide health-related services to children in their homes or schools, including early intervention programs, hospice, and home health aides.  Identify agencies and resources that provide mental health services to children.  Identify resources available to children and families with special needs (e.g., case management services, social work services, services for homeless, migrant, pregnant, or disabled children).  Identify and work collaboratively with a variety of community resources when providing care to families in need.  For at least one patient, coordinate care among several different local community agencies.  Outline the history of health care in the U.S., including the development of Medicare, Medicaid, and managed care.  Summarize the main functions of the major federal health programs that affect children (e.g., ESPDT, WIC, VFC, VAERS).  Identify a child who is currently uninsured and assist his or her family/caregiver with accessing appropriate resources for insurance enrollment.  Identify a family with social/legal needs and make the appropriate social work or legal aid referral.  Discuss financial needs and limitations with patients in a respectful, sensitive, and confidential manner.  Discuss, in general terms, the services of the state and local health department, e.g., family planning, newborn screening, lead screening and abatement, oral health promotion. Describe services available to patients and families, how to access services, and collaborate with these agencies as opportunities arise in practice.  Discuss, in general terms, the advocacy role and resources of the American Academy of Pediatrics at the state and federal level.  Discuss the role of the Child Health Advocacy Program and describe the types of problems that they can assist families with in our health system.