Question 2 : what knowledge , attitudes , and skills do residents need to improve the health of children at the community level ?

To improve child health at a community level, pediatricians require knowledge and skills that have not been traditionally included in residency training. Recent policy statements from the American Academy of Pediatrics and requirements from Accreditation Council for Graduate Medical Education Residency Review committees emphasizing the importance of community pediatrics training have provided additional incentive for pediatric residency programs to actively explore methods of teaching the principles and promoting the practice of community pediatrics to resident trainees. With a growing number of diverse educational models in various stages of practice or development, common themes and approaches to promote successful teaching of community health and child advocacy can be described. This article defines strategies for 2 critical elements of community pediatrics training, engaging residents and building strong community partnerships, then highlights a number of educational models that illustrate key curricular components and methods. Published results from evaluations of some programs suggest that community pediatrics training of this caliber will cultivate a cadre of pediatricians (academic and community based, generalists and subspecialists, researchers and practitioners) who understand child health in the context of community and have the leadership and collaborative skills to improve the health of children in their communities. Pediatrics 2005;115:1150–1157; community pediatrics, child advocacy, pediatric residency education, competency project. ABBREVIATIONS. AAP, American Academy of Pediatrics; CATCH, Community Access to Child Health; CBO, communitybased organization; CBA, community-based association; PLC, Pediatric Links With the Community; CAI, community action initiative; COPC, community-oriented primary care; OHSU, Oregon Health and Science University; WIC, Special Supplemental Nutrition Program for Women, Infants, and Children. Residency training provides a unique opportunity for teaching the principles and establishing the practice of community pediatrics as integral to the professional role of all pediatricians.1 Residents who are able to recognize social factors that influence health, consider primary prevention strategies, and partner with communities in improving and advocating for child health are more likely to continue these behaviors once in practice.2 Because community pediatrics teaching is relatively new, the challenge has been to define priority competencies in community pediatrics and child advocacy and develop rigorous training initiatives that teach the knowledge, attitudes, and skills to achieve these competencies.3 This article addresses the practical aspects of teaching community pediatrics to pediatric residents and highlights examples of successful educational models. Although each residency program needs to consider which models of community pediatrics training fit best within its own institution and surrounding community, there are common elements to the planning and implementation of educational programs that, when followed, promote success. The framework for our discussion takes the form of 7 questions that are critical to consider when planning and implementing a community pediatrics curriculum. QUESTION 1: WHAT IS THE RATIONALE FOR INCORPORATING COMMUNITY PEDIATRICS TRAINING INTO PEDIATRIC RESIDENCIES? In 1999, the American Academy of Pediatrics (AAP) issued its first policy statement on community pediatrics, labeling it as integral to the role of all pediatricians.1 This idea is now further defined in the revised policy statement.4 David Satcher, MD, PhD, in another article in this supplement,5 has a powerful statement on the importance of this training for the future of child health. Within residency training, there is growing recognition of the need for education that extends beyond the hospital and clinical practice settings and an increasing demand for community pediatrics training from resident trainees and graduates.6–11 From the *Department of Pediatrics, University of Rochester, Rochester, New York; ‡Panorama Pediatric Group, Rochester, New York; §Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana; Department of Pediatrics, University of Florida, Jacksonville, Florida; ¶Department of Pediatrics, Oregon Health and Science University, Portland, Oregon; #Julian Center, Indianapolis, Indiana; and **Carepoint PC, Denver,