Pediatric Environmental Health Center | SKILLS, CURRICULAR EXPERIENCES, AND PLANNED EVALUATIONS
Region 1 PEHSU Pediatric Environmental Health Fellowship Training Program
Training Program Director: Alan Woolf, MD, MPH, FAACT, FAAP, FACMT
Copyright 2019, All Rights Preserved
Primary Site: Boston Children’s Hospital
Secondary Sites: Boston Medical Center
Harvard Medical School
Harvard School of Public Health
Massachusetts/Rhode Island Poison Control Center
The Cambridge Hospital
Slone Epidemiology Unit, Boston University
Massachusetts College of Pharmacy & Applied Health Sciences
Massachusetts Department of Public Health
ATSDR & EPA – Region 1
| SKILLS | EXPERIENCES | EVALUATION |
| Academic Perspective | ||
| Writing a grant proposal | -Grant-writing workshop -HSPH methods, biostatistics, epidemiology curriculum -Active Research Mentoring | -Product |
| Submit an IRB application | -IRB-sponsored workshop -CITI training -HSPH methodology curriculum -BCH research course -Active Research Mentoring | -Product |
| Critically evaluate literature | -Journal club -Toxicology seminar series -BCH research course -Active Research Mentoring -SEU meetings | -Attendance |
| Using major national data bases to access information about exposures/outcomes | -PEHSU collaborative data -Other National Data Bases -Active Research Mentoring -SEU/PEHC meetings | -Product |
| Designing a survey or epidemiological study or clinical trial | -HSPH curriculum -Faculty mentoring -TCH research course -SEU/PEHC meetings | -Product |
| Present results at a meeting | -PEH annual meeting -Faculty mentoring | -Product |
| Publish results in peer- reviewed journals | -Faculty mentoring | -Product |
| Interpret legal & regulatory authority | -HSPH course curriculum | -Graded |
| Appreciate policy implications of research findings | -HSPH course curriculum -SEU/PRHC meetings | -Graded |
| Prepare & present testimony before legislative bodies | -BCH Child Advocacy Center -BMC ‘healthy homes’ initiative | -Experiential logs |
| Write a case report or series | -Write a case report or series | -Product |
| Present a pediatric patient at Grand Rounds or like venue | -PEHC patient -Faculty mentoring -Firm rounds or grand rounds as the venue -Presentation at postgraduate local or regional courses | -Meeting participant evaluations |
| Understand impact of environment on child’s development; translate that into research and teaching | -Teaching HMSII course -Conduct BCH fellow’s rounds -Active Research Mentoring | -Participant evaluations |
| Patient Perspective | ||
| Take an environmental history | -PCC clinical work -PEHC clinical work -OEM clinical work -PEHC Case Conference | -Faculty written evaluation -Routine clinic supervision -Conference attendance -Quality of dictations |
| Evaluate health conditions related to environment | -PCC clinical work -PEHC & OEM work -PEHC case conference | -Faculty written evaluation -Routine clinic supervision -Conference attendance |
| Utilize environmental health laboratory; interpret results | -PEHC -Written PEH materials -PEHC Case Conference -HSPH curriculum | -Faculty written evaluation -Routine clinic supervision -Conference attendance -Quality of dictations |
| Report appropriate health condition to health department | -PEHC -OEM -PEHC case conference | -Case log -Faculty written evaluation -Conference attendance |
| Develop plan to reduce patient’s exposure to environmental contaminants | -PEHC -OEM -PEHC Case Conference | -Faculty written evaluation -Conference attendance -Quality of dictations |
| Communicate risks to patients and families | PEHC -OEM -HSPH environmental health curriculum -Written PEH materials -PEHC Case Conference | -Faculty written evaluation -Conference attendance -Routine clinic supervision |
| Evaluate the effectiveness of therapeutic strategies | -PEHC -OEM -PEHC case conference -HSPH curriculum | -Routine clinic supervision -Conference attendance -Conference evaluations -Quality of dictations |
| Identify and coordinate community resources | -PEHC -PEHC Case Conference | -Routine clinic supervision -Conference attendance -Conference evaluations -Quality of dictations |
| Identify and coordinate community resources | -PEHC -PEHC Case Conference | -Routine clinic supervision -Conference attendance -Conference evaluations -Quality of dictations |
| Communicate child’s interaction with the environment to parents | -PCC -PEHC -PEHC Case Conference | -Routine clinic supervision -Faculty written evaluation |
| Respond to questions from parents taken at a poison control center | -Poison Center referrals -Poison Center case rounds | -Patient log book |
| Community Perspective | ||
| Assess health problem in a community | -BMC healthy homes -PEHCATSDR/EPA blocks -HSPH curriculum | -Written evaluation -Product -Attendance |
| Assess environmental exposures in a community | -BMC healthy homes -PEHC -ATSDR/EPA blocks -HSPH curriculum | -Written evaluation -Product -Attendance |
| Design and use survey to describe community’s health | -BMC healthy homes -PEHCATSDR/EPA blocks -HSPH curriculum | -Written evaluation -Product -Attendance |
| Presenting results of a study at a community meeting | -BMC healthy homes -PEHC -ATSDR/EPA blocks | -Written evaluation -Product -Attendance |
| Communicate about environmental risks to community groups | -BMC healthy homes -PEHC -ATSDR/EPA blocks -HSPH curriculum | -Written evaluation -Product -Attendance |
| Evaluate the effectiveness of a community intervention | -BMC healthy homes -PEHC -ATSDR/EPA blocks -HSPH curriculum | -Written evaluation -Product -Attendance |
| Evaluate strategies for community risk reduction | -BMC healthy homes -PEHC -OEM -ATSDR/EPA blocks -HSPH curriculum | -Written evaluation -Product -Attendance |
| Demonstrate leadership in the community for pediatric environmental health | -BMC healthy homes -PEHC -OEM -TCH Child Advocacy Center | -Written evaluation -Attendance |
| Advocate before legislative and executive branch agencies | -BMC healthy homes -TCH Child Advocacy Center | -Written evaluation -Attendance |
| Working as a member of a multi-disciplinary team | -TCH Child Advocacy Center -PEHC -OEM -BMC healthy homes -ATSDR/EPA blocksPEHC | -Written evaluation -Attendance |
| Learn the techniques of conflict resolution | Faculty development workshop | -Written evaluation -Attendance |
| Using media education as an advocacy tool | -TCH Child Advocacy Center -TCH Public Affairs | -Written evaluation -Attendance |
| Communicate about root causes of health disparities and work for environmental justice concerns | -HMSIII course -TCH Firm Rounds -TCH resident/fellow teaching -HSPH curriculum | -Participant evaluations |
Key to Abbreviations
ATSDR – Agency for Toxic Substances & Disease Registry
BMC – Boston Medical Center (formerly Boston City Hospital)
EPA – Environmental Protection Agency
HMS – Harvard Medical School
HSPH – Harvard School of Public Health
PEH – Pediatric Environmental Health
PEHC – Pediatric Environmental Health Center @ Children’s Hospital, Boston
SEU – Slone Epidemiology Unit, Boston University
TCH – The Children’s Hospital, Boston
EVALUATION
Fellows meet regularly with Dr. Woolf or Dr. Goldman to receive individual feedback and to self-reflect on their strengths and areas for improvement. At these meetings fellows are encouraged to set learning goals. Specifically, fellows are asked to review the ACGME competencies 1-2 times per year and reflect on whether or not they believe that they are competent in these areas and in which areas they need additional exposure/experience.
The CHB Office of Faculty Development has published guidelines for Mentoring and Developmental Networks (www.childrenshospital.org/research/ofd) and runs an annual HMS course on Mentoring.
Fellows complete the 8 modules in the on-line Institute for Healthcare Improvement (IHI) Open School for Health Professions. These modules were selected jointly by the Program for Patient Safety and Quality’s Education Committee and the GME Committee. The themes of the modules are human factors in complex systems, medical errors, and patient harm, communication among individuals and teams and adverse event reporting and systems improvement. Complete of the modules over the resident’s course of training is monitored by the Office of GME and reported back to the program.
As part of a hospital-wide initiative to implement a standardized approach to communication, Children’s Hospital Boston has launched the Clarity in Communication program. This workshop provides training to clinicians, including faculty and house staff, in three methods of communication that were identified by hospital leadership as most appropriate for our environment.
Every [patient interaction is an exercise in carrying out professional responsibilities and adhering to ethical principles. Faculty and clinical support staff make sure that residents are successful in feeling supported to achieve these standards. It is expected that faculty and fellows demonstrate and promote professional behavior. The hospital has a policy entitled: “Expectations of
Attending Physicians.” This policy is given to all trainees and attending physicians as part of their credentialing and details expectations of professional behavior for physicians at Children’s Hospital Boston. Such professional behavior is modeled every day by its fellows and faculty, nursing and clinical administrative leadership.
Daily Conferences & Seminars – Pediatric Environmental Health
| Monday | Tuesday | Wednesday | Thursday | Friday |
| Poison Center 8-9 | Toxicology 11-12 | Poison Center 8-9 | Cambridge OEM 3-4 | Poison Center 9-10 |
| PEHC Clinic 8:30-12:30 | Faculty Development Series 12-1 | Pediatric Grand Rounds 12-1 | PEHC Case Conference / Journal Club 10-12 | |
| HSPH Metals Core Conference 12:30-2 | Chief’s Conference 12-1 | |||
| HSPH Neurotoxicology Journal Club 3-4 | HSPH OEM Grand Rounds 12:30-1:30 |
Fellows’ development seminar series schedule:
www.childrenshospital.org/cfapps/research/data_admin/Site1002/mainpageS1002P0.html