Miriam Schechter, MD; Rahil Briggs, PsyD; Laura . Krug, LCSW; Anjali Roye, PsyD, Division of General Pediatrics, Children's Hospital at Montefiore / Albert Einstein College of Medicine, Bronx, NY
Background: Medical students may be unfamiliar with normal infant/toddler developmental and behavioral patterns. Therefore, they may feel ill equipped to assess children for problems in these areas or to properly advise parents. Goals: We sought to teach medical students about infant/toddler development and behavior through a Healthy Steps program, a national initiative which places early childhood specialists into a pediatric primary care setting to help first time parents address the physical, emotional, and intellectual growth of children up to age 3. Methods: During their Pediatric Ambulatory Care Rotation, fourth year medical students were assigned to 4 weekly half-day sessions with a Healthy Steps Specialist (HSS) at a large community based health center in the Bronx, NY. After a small group didactic session, students worked one on one with an HSS. They participated in home visits, office-based primary care Healthy Steps visits, and individual counseling sessions, and also administered ASQ:SE questionnaires. The students were given a brief pre- and post-test to assess knowledge of milestones and comfort level with advising parents on common infant and toddler behavioral and developmental concerns. In addition, they submitted a general program evaluation at the end of the month. Results: Of the 31 students who completed this rotation over the first 2-year period, 25 completed the pretest, 19, the posttest, and 31, the program evaluation. At the start of the month, an average of 55% of students correctly answered questions on developmental milestones and common behaviors, while at the end of the month 61% did so. Initially, an average of 70% of students felt at least somewhat comfortable counseling parents on common behavioral/developmental issues, while after the intervention 93% were at least somewhat comfortable. Student ratings of the program’s quality, structure, and professional relevance were 4.77, 4.58, and 4.55 respectively on a 5-point Likert scale. Conclusions: Integration of fourth year medical students into a Healthy Steps program increased students’ comfort level in advising caregivers about commonly encountered infant/toddler behavior and development issues, more so than their knowledge in this area. The program was well received by the students.