Biomedical subjects
Wanessa Risko
Publications and source records attributed to Wanessa Risko.
Integration of complementary and alternative medicine in a major pediatric teaching hospital: an initial overview.
OBJECTIVE: To describe the establishment of a multidisciplinary team of complementary and alternative medicine (CAM) providers and educators in an urban pediatric hospital and affiliated medical school. BACKGROUND: Pediatric CAM use is increasing. Physicians are interested in CAM-related education but few programs had been developed in pediatrics. In 1998, Children's Hospital Boston established the Center for Holistic Pediatric Education and Research (CHPER), a CAM multidisciplinary team providing clinical services, education, and research. METHOD: A retrospective review describing data from patient consultation notes, CAM lectures, clinical practice guidelines, curriculum materials, team meeting minutes, and team member manuscripts and publications. RESULTS: Over 5.5 years, CHPER staff provided over 2100 consults: acupuncture, massage, holistic pediatrician, relaxation therapies, biofeedback, hypnosis, and bio-pharmaceutics. Acupuncture and massage therapies were incorporated into a Clinical Practice Guideline. Formal education was delivered through didactic sessions, workshops, self-learning modules, clinical observation, and clinical practice. CHPER faculty published 1 book and 64 articles on CAM-related topics. CONCLUSION: An interdisciplinary team of CAM clinicians and educators can be integrated into an urban pediatric teaching hospital to provide CAM medical education and clinical services.
Achieving consensus on competency in community pediatrics.
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Competency in community pediatrics: consensus statement of the Dyson Initiative Curriculum Committee.
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Integrating complementary and alternative medicine into pediatric training.
The Center for Pediatric Integrative Medical Education and Boston Healing Landscape Project represent diverse approaches to integrative medicine and its practice. The relationship and collegial collaboration between the two programs illustrates the extent to which they complement one another. Both recognize the importance of curriculum geared to different levels of learners and of interventions introduced across the full curriculum. Both use case-based learning, although each focuses on different kinds of CAM and different case models. The Center for Pediatric Integrative Medical Education promotes interactive didactics with hands-on, direct experiential learning. The BHLP applies active-learning pedagogy, through experiential learning and its teaching case model. Both programs understand that, given the ongoing interaction among medical students, residents, fellows, and faculty, each group's training in CAM must reinforce the others for a larger system to change.
A new, experiential curriculum in child advocacy for pediatric residents.
OBJECTIVE: To design, implement, and evaluate an experiential child advocacy curriculum for pediatric residents. DESIGN: Pilot study including before-after 2-group trial of an educational intervention and a qualitative component. SETTING: A large, hospital-based, urban resident continuity clinic. PARTICIPANTS: General pediatrics residents (N = 29 [PGY: 1-4]). INTERVENTION: Residents and faculty designed a longitudinal curriculum in child advocacy for the continuity clinic, which included community-based and legislative experiences for individual residents as well as clinic-based group activities. Residents reported their experiences to their clinic group at weekly preclinic conferences. In addition, residents presented posters at their year-end residency retreat and wrote grants to fund community projects based on their original findings. EVALUATION: We used a quantitative assessment of child advocacy knowledge, attitudes, skills, and self-reported practices, which residents completed pre- and postintervention (2 clinics) or, for comparison residents, at the beginning and end of the academic year (3 clinics). In addition, we conducted focus-group discussions with residents in the 2 intervention groups to explore unanticipated responses to the new curriculum. RESULTS: Residents who received the intervention (n = 13) had a greater increase in advocacy knowledge (2.62 vs 0.19, P =.005), ability to identify community resources (0.62 vs 0.16, P =.03), self-reported advocacy skills (2.0 vs -0.21, P =.002), and perceived value of advocacy training (0.31 vs -0.19, P =.03) compared with residents who did not (n = 16). In focus groups, intervention residents (n = 17) reported being surprised by community groups' and legislators' responsiveness to resident inquiries, and they expressed enhanced confidence in engaging these groups in dialogue about child policy issues. CONCLUSIONS: A longitudinal continuity clinic-based curriculum in child advocacy had significant positive impact on pediatric residents.