UCSF Fresno Pediatrics-Child Psychiatry

Collaborative Office Rounds (COR): A Longitudinal Curriculum for Pediatric Practitioners in the San Joaquin Valley

 

 

 

 

 

 

 

 

 

 

 

 

Trainee Liaison: Soe Maw, MD

 

Program Contact Information:

 

Project Director:

Serena Yang, MD, MPH

University of California, San Francisco – Fresno

Department of Pediatrics

155 N Fresno Street, Suite 219

Fresno, CA 93701

Phone: (559) 499-6556

FAX: (559) 499-6561

Email: syang@fresno.ucsf.edu

 

Websites and Social Media:

http://www.fresno.ucsf.edu/pediatrics/community.htm

https://www.facebook.com/UCSF-Fresno-Pediatrics-982946371731146/

 

Program Profile:

 

Overview

 

The San Joaquin Valley of Central California is rich in cultural and linguistic diversity and agricultural wealth, but fraught with some of the most impoverished and medically underserved areas in the US. UCSF Fresno was created as a regional campus of the University of California, San Francisco in 1975 with the support of the California Legislature and the Veteran’s Administration to address the severe shortage of physicians in the San Joaquin Valley.

 

As the largest medical education training program in the San Joaquin Valley, UCSF Fresno trains medical students, residents, and fellows in 8 medical specialties and 17 sub-specialties, and supports mentored experiences for Fresno County public high school and undergraduate students in health professions pipeline programs. Over 40% of graduates stay to practice in the San Joaquin Valley.

 

UCSF Fresno Pediatric Residency Program trains 36 residents, many of whom are committed to practicing in areas of unmet need. We train pediatric residents in family-centered, culturally-responsive primary care through a high quality medical home for an impoverished, medically underserved, and culturally-diverse pediatric population of Fresno County. Our training emphasizes the importance of building relationships and interprofessional collaboration to deliver high-quality care and optimize systems of care in the context of the family and community. Our residents routinely work with licensed non-physician professionals including CPNP, LCSW, LMFT, RN, psychologists, pharmacists, occupational & speech therapists, and school teachers. We partner with community organizations to provide rich experiential learning opportunities. Residents have experiences in the home, public schools, and low-income neighborhoods to instruct on social determinants of health such as poverty, culture, and language, and the impact of these variables on disparities in health and health care.

 

Purpose

 

UCSF Fresno Pediatrics-Child Psychiatry Collaborative Office Rounds (COR) is an interprofessional effort that aims to enhance primary care providers’ abilities in prevention, early detection, and management of psychosocial, developmental, and mental health concerns of at-risk children in collaboration with developmental-behavioral pediatricians and child psychiatrists. UCSF Fresno COR Program objectives are to (1) enhance primary care provider understanding of psychosocial aspects of child development, disorders, and disability, (2) increase provider ability to help children and families address these issues, (3) expand provider ability to distinguish between transient disturbances and more serious psychiatric disorders requiring referral, (4) promote collaboration among primary care providers, developmental-behavioral pediatricians, and child psychiatrists, and (5) facilitate a comprehensive approach to child health supervision as outlined in the American Academy of Pediatrics Bright Futures guidelines.

 

Training

 

We have a longitudinal monthly curriculum that blends case-oriented small study group team-based learning with web-based exercises, evidence-based resources/tools, and large group activities. We emphasize practical challenges faced by primary care providers when dealing with psychosocial, developmental, behavioral/mental health concerns. Moderators are General Pediatrics, Developmental-Behavioral Pediatrics, and Child Psychiatry faculty. Participants are UCSF Fresno residents, faculty, midlevels, and students from primarily from Pediatrics, but also Family Medicine, Psychiatry, Social Work, and community-based child health organizations.

 

Research

 

COR participants have conducted projects in HRSA priority areas of improving access to primary care and mental health care, cultural/linguistic sensitivity, and ensuring high quality of care for all. Residents have presented oral and poster abstracts at regional and national scientific meetings on COR-related topics including:

 

  • Communication barriers in the pediatric primary care setting for parents with limited English proficiency

  • Utility of the PHQ-9 in screening for adolescent depression in primary care in Fresno

  • Development of a resident peer-mentorship program at UCSF Fresno

  • Residents partnering with at-risk teens at a high school in Fresno

  • Utility of incorporating home visits into pediatric residency training

  • Improving screening for tobacco smoke exposure in a pediatric primary care clinic in Fresno

  • Health literacy disparity between English and Spanish speaking parents in the NICU

  • Integrating global health into pediatric residency training

  • Obesity prevention advocacy in the hospital setting

  • Understanding barriers to exclusive breastfeeding for mothers in Fresno

  • Role-modeling dialogic reading in the waiting room to promote early literacy in a primary care clinic

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