The Rights of Children for Optimal Development and Nurturing Care.

Millions of children are subjected to abuse, neglect, and displacement, and millions more are at risk for not achieving their developmental potential. Although there is a global movement to change this, driven by children's rights, progress is slow and impeded by political considerations. The United Nations Convention on the Rights of the Child, a global comprehensive commitment to children's rights ratified by all countries in the world except the United States (because of concerns about impingement on sovereignty and parental authority), has a special General Comment on "Implementing Child Rights in Early Childhood." More recently, the World Health Organization and United Nations Children's Fund have launched the Nurturing Care Framework for Early Childhood Development (ECD), which calls for public policies that promote nurturing care interventions and addresses 5 interrelated components that are necessary for optimal ECD. This move is also complemented by the Human Capital Project of the World Bank, providing a focus on the need for investments in child health and nutrition and their long-term benefits. In this article, we outline children's rights under international law, the underlying scientific evidence supporting attention to ECD, and the philosophy of nurturing care that ensures that children's rights are respected, protected, and fulfilled. We also provide pediatricians anywhere with the policy and rights-based frameworks that are essential for them to care for and advocate for children and families to ensure optimal developmental, health, and socioemotional outcomes. These recommendations do not necessarily reflect American Academy of Pediatrics policy.

Addressing pediatric medical training needs in noncommunicable diseases.

The importance of addressing non-communicable diseases (NCDs) has been identified by health care leaders in India and around the world. Calls to action have been made to address this issue, including the creation of effective surveillance and research systems across South Asia. These efforts include collaboration within India at the local, regional, and national levels to support these initiatives. In addition to these efforts, it is critical to assess and strengthen medical training in NCDs. This can be done by providing clinicians with curriculum development tools to augment their clinical skills, as well as enabling them to advocate and role model as educators. The authors provide recommendations on how clinicians can address the threat of NCDs as educators, role models and advocates for improved pediatric NCD training.

An innovative process for faculty development in residency training.

BACKGROUND: For programs to accomplish the goals of the Accreditation Council of Graduate Medical Education (ACGME) Outcome Project, faculty must be trained to deliver and assess education that is level-specific, competency-based, standardized, integrated, and easily accessible. DESCRIPTION: An innovative faculty development model that accomplishes these goals is described. This model trained faculty to analyze curricular needs and then to design, disseminate, and evaluate their curricula. This model utilized guided experiential learning that promoted the creation of residency program curricula and faculty buy-in. EVALUATION: Key outcomes included high levels of resident satisfaction and use of the curricula, improved tracking of rotation progress, improved faculty satisfaction with their role as educators, perceived improvement in resident evaluations, and increased involvement of faculty in creating and teaching to the curriculum. CONCLUSION: This process may be adapted by other programs based on their available resources to address faculty development needs. The process serves as a model for meeting ACGME requirements.

Pediatric residency training in child abuse and neglect in the United States.

BACKGROUND: Child abuse and neglect are leading public health problems with significant morbidity and mortality. Previous studies indicate that physicians often lack knowledge and confidence in addressing child abuse and neglect. OBJECTIVES: Our goal was to assess the child abuse and neglect curricula in pediatric residency programs as reported by chief residents and to identify levels of preparedness of residents to address child abuse and neglect on graduation. We analyzed variables related to preparedness. METHODS: A 28-item survey was sent to chief residents of all 203 Accreditation Council for Graduate Medical Education-accredited pediatric residency programs in the United States from 2004-2005. We performed descriptive, bivariable, and multivariable analyses. RESULTS: The response rate was 71%. Most programs taught didactics on physical and sexual abuse, but only 54% included domestic violence. Ninety-three percent of respondents rated their didactics as useful or very useful. Forty-one percent of programs required mandatory clinical rotations in child abuse and neglect, 57% offered elective rotations, and 25% offered no rotations at all. Respondents rated the levels of preparedness of graduating residents to address child abuse and neglect as: very well (12%), well (54%), somewhat well (28%), or not well (6%). Preparedness was significantly associated with didactic usefulness, number of hours of didactics, total number of inpatient cases of child abuse and neglect seen, percent of residents completing mandatory rotations, number of sexual abuse cases during mandatory rotation, number of physical abuse cases during mandatory rotation, and length of mandatory rotation. CONCLUSIONS: Mandatory clinical experiences in child abuse and neglect improve the preparedness of graduating residents to identify and evaluate patients for child abuse and neglect. Perhaps residency training in child abuse and neglect should be a required subspecialty rotation with more explicit curricular content than in the current mandates.