Pediatric Academic Societies and American Academy of Pediatrics Joint Meeting May 12-16, 2000 Hynes Convention Center, Boston

Expanded Schedules for: Friday Saturday Monday Tuesday Schedule-at-a-Glance Affiliate Societies & Clubs SUNDAY, MAY 14

PUBLIC POLICY LEGISLATIVE BREAKFAST SYMPOSIUM

¨Medical Science and the Brave New World of Electronic Publishing
Moderator: James Perrin, Editor, Journal of the Ambulatory Pediatric Association

Speakers: Jerold Lucey, Editor-in-Chief, Pediatrics and Alvin Zipursky, Editor, Pediatric Research

APA PAST OFFICERS' BREAKFAST

TOPIC SYMPOSIA

¨Advances in Imaging: Following Cells and Molecules
Chair: Christopher H. Contag, Stanford University School of Medicine, Stanford

Recent advances in imaging technologies have enabled in vivo molecular and cellular analyses at near micron resolution. These advances permit the evaluation of biological events in the context of intact living systems such that the interactive processes of normal physiology and pathophysiologic conditions can be revealed at the level of cells and molecules. This symposium will highlight new imaging strategies and demonstrate how these approaches can be used to answer questions that were previously inaccessible to biological investigation.

Imaging the Wiring and Re-wiring of the Developing Brain
Scott Fraser, California Institute of Technology, Pasadena

Imaging Gene Expression Patterns
Christopher H. Contag, Stanford University School of Medicine, Stanford

New Developments in Functional and Molecular Imaging
Ralph Weissleder, Massachusetts General Hospital, Boston

¨The Neurobiologic Basis of Behavior and Development
Chair: James M. Perrin, Mass General Hospital for Children, Boston

This session will describe recent work linking developmental aspects of brain function and structures with understanding of child development, developmental disabilities, and child and adolescent behavior. Expanding knowledge in areas of brain development, anatomic structures, and molecular biology of the central nervous system broaden the base for understanding clinical phenomena. New work has helped to characterize environmental and central nervous system influences on child and adolescent behavior. Recent long-term follow-up data from the Infant Health and Development Program inform regarding the predictors of outcomes for children at developmental risk.

Brain Development and Developmental Disabilities
Mark L. Batshaw, Children’s National Medical Center, George Washington University School of Medicine, Washington

Neurobiologic Representations fo the Social World: Developmental Considerations
Felton Earls, Harvard Medical School, Boston

The Infant Health and Development Project: Implications for Neurobiologic Basis of Development
Marie McCormick, Harvard School of Public Health, Boston

SUBSPECIALTIES/THEMES
(Original Science Abstract Programs)

• Asthma: Health Services Research
• Critical Care
• Endocrinology and Metabolism II
• Gastroenterology
• Genetic Mechanisms of Disease and Aberrant Development
• Health Care Delivery in Underserved Populations
• Hematology and Oncology
• Infectious Diseases III: Bacterial Diseases
• Neonatology: Disease-Oriented Research I
• Neonatal Pulmonology I
• Pediatric Nutrition and Metabolism I
• Sudden Infant Death Syndrome

WORKSHOPS

TICKETS NECESSARY FOR THIS EVENT. NO FEE IS REQUIRED BUT PRE-ENROLLMENT IS ESSENTIAL TO ATTEND.

WS19 Children’s Health 2000 Won’t Happen Without Reimbursement/Financing
One can teach and preach combined inissions of clinical care, research, education and advocacy issues, but it cannot be achieved without adequate financing and reimbursement for professional and hospital services. The formal educational preparation and in- training experience of most doctors is usually deficient and poorly coordinated.

This workshop will present an overview of reimbursement and financing principles for the pediatric generalist and medical and surgical subspecialist, whether engaged in private solo, multispecialty, HMO or academic practices in the following areas:
1. The medical encounter - an overview from patient care through reimbursement.
2. Understanding medical finance - the basics.
3.Application of medical finance - understanding the business of practice revenue.
4. Needs for medical finance - different settings, yet similar needs. How do different practice settings impact reimbursement? facility vs. non-facility fees.
5. Sources of reimbursement / finance and different payment arrangements.
6. Who controls / does what related to coding and RVU’S.
In conclusion, the attendee will be given direction for future study and sources of information.

S. Berman, The Children’s Hospital, Denver; R.A. Molteni, Children’s Hospital, Seattle; C.M. Vanchiere, Children’s Clinic of SW La., Lake Charles

WS20 Community Based Teaching: Creative Solutions For The New Age
The community setting has become a critical arena for diverse and challenging patient care. As such, effective and focused teaching strategies are essential tools for preceptors. This workshop reviews several problems frequently encountered in community teaching settings, such as limited teaching time, limited continuity with the learner, limited space, expansive patient load, and expansive clinical information to discuss. Participants will explore and practice strategies to avoid such problems, tackle such problems, or work around them.

Despite a great deal of recent attention to strategies such as the one minute preceptor, problem-based learning, and the use of teaching scripts, the challenges to effective teaching and efficient learning persist. This workshop will cover a spectrum of teaching strategies from the perspective of learning success. Implications for effectiveness of learning, learning in the managed care environment, and learner styles will be addressed. The challenges of teaching in the community setting can be transformed into opportunities for a stimulating and highly satisfying teacher-learner interaction. In this workshop, participation, rehearsal, audiovisuals and "hands-on" techniques will help attendees to develop or expand their teaching repertoire for community based clinical training.

L. Chandran and J. E. Fischel, Department of Pediatrics, State University of New York at Stony Brook, Stony Brook

WS21 Designing Low Cost Objective Structured Clinical Evaluations (OSCES) For Pediatric Clerkships: Not An Oxymoron!
An OSCE is a clinical performance evaluation tool designed to appraise student behaviors or skills in a variety of areas. OSCEs are frequently used in pediatric clerkships to provide formative and summative feedback to students and to assess the clerkship curriculum. Good OSCEs must have realistic objectives, multiple stations, evaluate specific tasks, have generally agreed upon evaluation criteria. Unfortunately, an OSCE can be quite labor intensive and expensive to set up and operate.

The objective of this workshop will be to design OSCE stations that minimize the use of scarce labor and financial resources yet still effectively measure student performance. Participants will review different methodologies, costs associated with each, and the National Core Curriculum in Pediatrics. Using a combination of inexpensive "low tech" and "high tech" props, participants will design OSCE stations to measure specified student skills and competencies outlined in the National Core Curriculum in Pediatrics. By the conclusion of the workshop, the participant should be familiar with how to design and implement a low-cost 10-15 station OSCE.

W.V. Raszka, Department of Pediatrics, University of Vermont College of Medicine, Burlington and P. B. Patterson, The Barbara Bush Children’s Hospital at Maine Medical Center, Portland

WS22 Evidence-Based Pediatrics And The Cochrane Collaboration
An interactive classroom session with several facilitators and demonstrations of new resources in pediatric medicine. This session will provide attendees with an increased awareness of the scientific foundation of evidence-based pediatric practice and will demonstrate the Cochrane Library and other evidence-based resources which can assist the pediatrician in providing optimal care.

V. Moyer, University of Texas – Houston Medical School, Department of Pediatrics, Houston; A. Ohlsson, Mount Sinai Hospital, Toronto, T. Klassen, University of Alberta, Edmonton

WS23 From Jonesboro To Melrose Place: Media Violence, Sexual Violence And The Internet
Hollywood claims that the media merely reflect a more violent society. Some public health activists claim that the media actually cause violence among teenagers. The literature is complex, but the answers are extremely important, given the events of the past two years. Where does the truth lie?

This workshop will explore the current state-of-the-art knowledge regarding media violence and sexual violence in movies, on television and in music videos, and the impact of the Internet. Participants will learn how to counsel teens and their parents and what solutions are practical demonstrations, and hand-outs will be provided.

Dr. Strasburger is a pediatrician and adolescent medicine specialist who has authored or co-authored most of the AAP’s statements on media for the past decade. Dr. Donnerstein is one of the primary authors of the National Television Violence Study.

V. C. Strasburger, University of New Mexico School of Medicine, Albuquerque; E. Donnerstein, University of California, Santa Barbara

WS24 Malpractice And Communication Skills For Difficult Situations
Medical students have not always had access to information and behavior skills training related to malpractice, and communication skills for difficult situations. Perhaps, as a result, some pediatricians become involved in lawsuits that might have been avoided by using interpersonal skills to enhance the physician-patient relationship. Research suggests that many families file malpractice suits when adverse outcomes are associated with poor physician-patient relationships, physicians’ criticism of one another, and unclear communications. This research has led multidisciplinary faculty and risk management staff to develop a 6 hour, small group course for practicing physicians, residents and 4th year medical students taking their 4 week ambulatory pediatrics rotation. The proposed workshop presents a mini version of the course and suggests how it may be adopted elsewhere.

Participants are challenged to: identify patient dissatisfactions that increase risk of suits, communicate effectively in adverse circumstances, relate physician’s interpersonal behaviors to patients’ perception of quality care and understand risk management’s issues and roles. Participants practice with surrogate patients who present 10 cases based on research and actual lawsuits. Scenarios range from a diagnosis of cerebral palsy in which a mother wants to blame her obstetrician to a case of iatrogenic death. The workshop will include a brief lecture, role plays and discussions that focus on: structuring difficult interactions, dealing with patients varied responses to bad news, what to do when you or another physician has erred and principles of risk reduction.

J. Gigante, G.B. Hickson, T. Trotter, J. W. Pichert, Vanderbilt Children’s Hospital, Nashville

WS25 Methods To Establish Productivity-Based Compensation Programs For Academic General Pediatric Practices That Promote Effective Teaching
Most academic health centers are actively building or consolidating practice networks and employ more physicians engaged predominantly in primary care practice. As a result, academic health centers require new methods to develop physician compensation packages that encourage physicians to be accountable for their individual clinical productivity as well as contribute to the academic success of the institution. Often, educational responsibilities - teaching of residents and students - are not addressed in compensation programs, resulting in diminished physician effort in this area and a perception that teaching is not valued.

This workshop will focus on the formulation and initial implementation of a productivity-based primary care compensation program in an academic health center. The workshop will provide an understanding and comparison of measures of physician productivity, including gross charges, collections, visit numbers, and relative value units (RVUs).

At the conclusion of the workshop, participants will be able to: 1) define performance responsibilities and expectations for faculty, 2) establish a market-based productivity benchmark using national norms, 3) define educational efforts in terms of work RVUs, 4) link salary to performance, 5) implement work RVU as measure of productivity, 6) use market-based dollar conversion per unit of productivity per work RVU, and 7) establish a regular checks and balance system for accurate recording of performance activity.

M. Andreae, G. Freed, University of Michigan, Ann Arbor

WS26 Qualitative Research In Pediatrics
Qualitative research has steadily acquired greater popularity and respect in medical and health services research over the past two decades. Increasingly, this set of methods is viewed as complementary to traditional quantitative research approaches. Qualitative research techniques represent a diverse set of research methods featuring the collection and analysis of narrative data to capture a subject’s unfiltered view of a situation or topic. Qualitative methods hold particular promise in certain research activities such as medical education, ethics, quality of care, cultural perspectives, survey research and patient-doctor communication.

This workshop will introduce participants to qualitative methodology and its application to research questions in pediatrics by addressing two of the most commonly employed methods: focus groups and ethnographic interviewing. Participants learn to: (1) identify research topics appropriate for the use of qualitative methods; (2) design a qualitative study using the two highlighted methods; (3) organize a paper for publication; (4) determine research opportunities to blend qualitative and quantitative methods in a single multi-method study design. Methodological issues such as sampling, data collection, coding, data analysis, and validity and reliability will be reviewed using examples from published literature and from participants’ own research questions.

D.C. Grossman, C. Feudtner, J.I. Takayama, Department of Pediatrics and Robert Wood Johnson Clinical Scholars Program, University of Washington, Seattle and Department of Pediatrics, UCSF, San Francisco

WS27 Searching For The Evidence – Use Of Electronic Databases & Internet In Research & Clinical Decision Making
Evidence-based Medicine requires new skills in identifying and retrieving information for both the researcher and clinician, yet many of us have received little training in how to acquire this expertise. Computers can provide easily accessible tools to meet this challenge. In this workshop, we will (1) explore available sources of information focusing on MEDLINE searches of the primary literature, as well as identification of internet based sites for secondary sources, guidelines, & more; (2) create well-formulated researchable questions using the PICO method; (3) find on-line resources to address practical clinical scenarios; and (4) use directed computer exercises to demonstrate how participants can improve the efficiency and comprehensiveness of their primary literature searches. The workshop will enhance participants’ skills in searching for evidence both for research purposes and to provide support for clinical decision making. Materials will be distributed to aid teaching medical students and residents this topic. It features hands-on, real-time computer exercises under expert guidance. Participants should have at least an introductory level of understanding about MEDLINE searches and the Internet; Workshop limited to 20 participants.

The goal of the workshop is to provide faculty and primary care clinicians with the skills necessary to integrate Evidence-based medicine in their practice and in teaching medical students & residents.

This workshop will be held in the Boston University Computer Lab. Transportation will be provided.

L.N. Werk, C. Shubkin, J. Kasper, S. Chapman, B. Siegel, H. Bauchner, Department of Medical Education, Arnold Palmer Hospital for Children & Women, Orlando, Division of General Pediatrics, Boston University School of Medicine, Boston, and Greater Lawrence Family Health Center, Lawrence

WS28 Teaching The Pediatric Sexual Abuse Examination
For a number of reasons, many practitioners of pediatric medicine are uncomfortable with the presenting complaint of possible sexual abuse. Several pediatric sexual abuse centers have been established across the United States to address this issue and also to attempt to improve the quality and consistency of care delivered. Unfortunately, however, such a center is often not readily accessible to practitioners and their patients. It is therefore imperative that pediatric training centers become adept in teaching their residents and students how to most effectively manage the alleged sexual abuse victim.

At the UT – Houston pediatric sexual abuse center, we have developed a teaching module that we are currently implementing with faculty, residents and students. It includes a pre and post module questionnaire, audiovisual material, and interactive teaching with pediatric sexual abuse experts. The course content is easily modifiable according to the level of experience of the learner and the amount of time available. Using primarily a hands-on format, we will present our module to workshop participants and explore with them ways in which it may be implemented in various teaching situations.

R. Girardet, S. Lahoti and N. McClain, Department of Pediatrics,University of Texas – Houston Medical School, Houston

WS29 Ten Common Sports Injuries In Adolescents
Pediatricians are caring for an increasing number of children and adolescents who are injured from sports participation. This session will review the diagnosis and management of the ten most common injuries in children and adolescents that develop during sports activities. Emphasis will be on when to manage and when to refer. Questions from the audience will be welcome.

M. Goldberg, New England Medical Center, Boston; L. Micheli, Children’s Orthopaedic Surgery Foundation, Children’s Hospital, Boston

WS30 The Medical Home And Measures Of Success
This session will address the meaning of the medical home concept, how to operationalize it, and how to measure its impact. Faculty will discuss the challenges of coordinating care among a variety of community and hospital settings, and offer strategies for overcoming hurdles. To address the growing need for evidence-based outcomes as a justification for service provision, the program will provide participants with knowledge and tools that can help them: (1) define the population of children with special needs; (2) develop mutually beneficial partnerships with families; and (3) ensure that children in their practice have access to all needed medical and non-medical services as a part of a medical home.

J. Palfrey, Children’s Hospital, Division of General Pediatrics, Boston; W. C. Cooley, Crotched Mountain Rehab Center, Greenfield, A. Sandler, The Olson Huff Center for Child Development, Thomas Rehabilitation Hospital, Asheville

WS31 Turning The Pediatric Resident On To Adolescent Health Care; Are You Up To The Challenge?
Most pediatric residents cringe at the thought of seeing adolescents at the health maintenance visit. Violence, sex, drugs, depression, abuse, and school failure are some of the critical issues to explore in providing optimal adolescent health care. A thorough physical assessment, including breast, testicular and gynecologic examination, is an integral part of the visit. The pediatric resident is often not prepared to explore the adolescent psychosocial risk profile or to thoroughly examine the adolescent patient. Dealing with the parents of adolescent patients is also a source of stress for residents. Providing anticipatory guidance to parents, as well as addressing parental concerns, is rarely discussed in the curriculum of pediatric residency.

Workshop faculty will present contrasting experiences teaching pediatric housestaff adolescent health care from two distinct clinical settings; one a General Pediatric Group Practice and the other, an established Division of Adolescent Medicine. The purpose of this workshop is to share skills and approaches in educating and inspiring pediatric residents to provide care to adolescent patients. We will review standard assessment tools such as GAPS and Bright Futures and use role-plays to teach participants how to respond to common scenarios involving the triad of parent, teen and medical provider.

K. Soren, B. Pfeffer, and E. Alderman. Division of General Pediatrics, Columbia University and Division of Adolescent Medicine, Albert Einstein College of Medicine

WS32 You Can Do It, Too! Successful Models Of Program Change Using The APA Educational Guidelines
The APA’s Education Committee published a major revision of the APA Educational Guidelines for Residency Training in General Pediatrics in 1996, and conducted two previous APA workshops on strategies for implementing the Guidelines. This workshop will discuss survey results on use of the Guidelines since that date and highlight successful models of implementation from residency programs nationwide. The models will be competitively selected by the workshop leaders after review of invited submissions, and will be shared in the workshop in brief oral or poster presentations. Presentations will cover implementation issues such as pre-accreditation program review, development of new or modified rotations, design of new curricular materials, and improvement of evaluation methods. Models will be analyzed and discussed interactively in relation to demonstrated outcomes, resources required, and implementation barriers. The group will discuss how the Guidelines can be used to implement change in pediatric residency programs, and how approaches to implementation may be adapted to the special needs and environments of different training programs. Posters and interactive discussions will allow participants to pool ideas about creative uses of the Guidelines. The workshop will also include displays of newly published curricular materials and contact lists to facilitate networking among programs undertaking similar initiatives.

D. Kittredge, C. D. Baldwin, M. E. Bar-on, R. F. Trimm, III (Members of the APA Education Committee) and invited presenters from programs nationwide

SPECIAL INTEREST GROUPS

TICKETS NECESSARY FOR THIS EVENT. NO FEE IS REQUIRED BUT PRE-ENROLLMENT IS ESSENTIAL TO ATTEND.

SG14 Emergency Medicine
Chair: Mark Douglas Baker

Information on this SIG will be posted on our website in early 2000.

SG15 Faculty Development
Chairs: Michelle S. Barratt, Charlene Gaebler-Uhing, Ronald V. Marino

This SIG is a forum for ongoing exchange in the area of medical education and faculty development.  The SIG is open to anyone that has an interest in Medical Education and Faculty Development.  Some members of the SIG participated in the APA Faculty Development  Scholars Program. The first cohort of 50 received training in one of three tracks:  Community Based Clinical Teaching, Educational Scholarship or Executive Leadership. The SIG will provide discussion and leadership in all three areas. Come help us brainstorm, problem-solve and share experiences.  Ideas for discussion can be emailed to jennifer@ambpeds.org and your message will be forwarded to the co-chairs.

SG16 International Health
Chairs: David Shay and Anna Mandalakas

This SIG has combined forces with the International Health Section of the AAP to offer a program directed to those interested in or curious about international aspects of child health. This year’s program is specifically designed to help prepare pediatricians or other child health care workers who may be interested some day in volunteering in the developing world. All are welcome.

Subjects to be discussed will include:
1. preparing for international volunteerism
2. advances and challenges in pediatric tropical medicine
3. the state of the world’s children – where are we? (a presentation by Dr. Robert J. Haggerty)
4. dealing with complex humanitarian emergencies.

SG17 Literacy Promotion in Primary Care
Chairs: Robert Needleman and Perri Klass

This SIG will provide a forum for directors of primary care literacy programs modeled after Reach Out and Read to discuss program innovations, successes, and ongoing challenges. As in previous years, topics will include clinician and volunteer training, recruitment, fund-raising, publicity, books, and other program logistics. Participants are encouraged to bring examples of recently-developed educational materials, photos, and vignettes. We will also review current research in the field, including a discussion of current studies by SIG participants. A special session will be set aside for work on the collaborative Before-and-After-Books-and-Reading (BABAR) study, which now has more than 20 sites, and more than 900 completed interviews. Another special session will serve as an introduction to ROR for physicians and others interested in beginning a clinic-based literacy program. Teaching modes will include videotape and live demonstration, role-play, discussion, and small-group problem solving. Those interested are encouraged to contact ROR at www.reachoutandread.org.

SG18 Medical Informatics
Chair: Kevin B. Johnson

Now in its second year, the Medical Informatics Special Interest Group will devote this meeting to improving our understanding of "pediatric Informatics." In particular, we will informally discuss research projects underway by our members. We will spend the bulk of the meeting definng the role of Medical Informatics in the field of Pediatrics. What work should we as pediatricians be doing to enhance the lives of children, and to improve the ability for other pediatric clinicans to care for them?

SG19 Practice-Based Research Network
Chair: Mary Ottolini

Information on this SIG will be posted on our website in early 2000.

SPR PRESIDENTIAL PLENARY & AWARDS AND E. MEAD JOHNSON AWARD LECTURES

Presidential Address: Thomas Hazinski,Vanderbilt University Medical Center

Student Awards: Kyle Cowan, Aaron M. Milstone, Christine Siambani

House Officer Awards: Douglas D. Fraser, Paul J. Galardy, Matthew A. Saxonhouse

Fellow Basic Awards: Christopher E. Belcher, Elif Erkan, Syed Zaidi

Fellow Clinical Awards: Michael J. Ackerman, Okan Elidemir, Mika Ramet

David Nathan Award: Lisa Wang

Young Investigator Award Lecture:
Brendan Lee - Identification of Molecular Genetic Defect for Cleidocranial Dysplasia & Nail-patella Syndrome

E. Mead Johnson Award Lectures:
Mark Kay - Seminal Scientific Contributions to the Field of Hepatic Gene Therapy
Gregg Semenza - Molecular Response to Hypoxia

APS BUSINESS MEETING
Members Only

LUNCH BREAK

APA BUSINESS MEETING & AWARDS

Health Care Delivery Award
Public Policy Award
Research Award
Teaching Award
Ray E. Helfer Award for
Innovation in Pediatric Education
International Health Research Award
Ludwig-Seidel Award

MARCH OF DIMES PRIZE IN DEVELOPMENTAL BIOLOGY (Fifth Annual Lecture)
Presented by the March of Dimes

Genetic Control of Programmed Cell Death in C.elegans
H. Robert Horvitz, Professor of Biology, Howard Hughes Medical Institute Investigator, Massachusetts Institute of Technology, Cambridge, MA

AAP PRESIDENTIAL PLENARY & JACOBI AWARD
Presidential Address: Donald E. Cook, American Academy of Pediatrics, Elk Grove Village
Jacobi Award: Catherine DeAngelis

WORKSHOPS

TICKETS NECESSARY FOR THIS EVENT. NO FEE IS REQUIRED BUT PRE-ENROLLMENT IS ESSENTIAL TO ATTEND.

WS33 Advocacy Training For Pediatric Residents: The Role Of The Community Pediatrician.
Child advocacy is central to the practice of pediatrics. Pediatricians have been exemplary child advocates at the local, state and national level. Paradoxically, only recently has training in advocacy been a requirement of residency training. There is no national consensus regarding a child advocacy curricula or how to teach it. As training programs develop their advocacy training programs, one potentially effective and rewarding model includes cooperative efforts with the AAP’s CATCH program.
Specific objectives include:
•Defining the role of CATCH and the AAP in resident advocacy training
•Learning about different models of curricula for advocacy training
•How to build institutional support for community based advocacy training
•How to incorporate community pediatricians into resident advocacy training

The workshop will use brief presentations about model programs from different training programs and interactive breakout groups. Reference material and resources will be distributed to attendees.

S.D. Blatt, J. Brown, A.S. Botash, J. Harisiades, D. Haut, D. Keller, T Tonniges. SUNY Health Science Center @ Syracuse, U of Colorado, Denver, Children’s Memorial Hospital, Chicago, AAP, Elk Grove Village, U of Massachusetts, Worcester

WS34 Community Pediatrics: The APA/AAP Interface
Community Pediatrics has matured into a well recognized discipline and the general pediatrics professional societies (APA and AAP) have had many projects and initiatives in this area. Several APA Special Interest Groups (SIG) focus on Community Pediatrics issues and the AAP Committee on Community Health Services recently released a policy statement with an expanded Community Pediatrics definition. One of the core content areas of Community Pediatrics is the commitment to service, research and teaching regarding underserved pediatric/adolescent communities and populations. In this workshop, during the first concurrent meeting of the APA and AAP, leadership in the area of Community Pediatrics will present information on their activities, specifically focusing on underserved populations and communities. A town hall meeting format will be used. APA SIG Chairs, AAP Section and Committee Chairs, AAP CATCH leadership and others involved in Community Pediatrics will make brief presentations. The discussants at the workshop will be the Presidents-elect of the two organizations (APA - Ken Roberts and AAP - Steve Berman) and there will be audience participation. The expected workshop outcome is an enhanced understanding of the Community Pediatrics interface between the two organizations with a specific focus on services for underserved pediatric/adolescent populations.

J. Brown, S. Berman and K. Roberts, Department of Pediatrics, Colorado School of Medicine, Denver; Moses Cone Memorial Hospital, Greensboro

WS35 Dermatologic Manifestations Of Systemic Disease
This session will concentrate on the recognition of the cutaneous manifestations of a variety of systemic disorders. These will include collagen vascular diseases, vasculitic disorders, hypersensitivity syndromes, neurocutaneous disorders, and disorders of pigmentation. In addition the systemic implications of vascular lesions and infiltrative lesions will be reviewed.

S. E. Gellis, Children’s Hosptial, Boston, M. Liang, Children’s Hosptial, Boston, Richard Antaya,Yale, New Haven

WS36 Evaluation Of Research Methodologies In Medical Education
In education, research is often focused on the determination of progress that students have made toward educational goals. These studies use methodologies which not only determine outcomes but also analyze the process with which these outcomes are derived. Researchers in medical education are often faced with the difficulty of defending their methodologies to "peer-reviewers" who are accustomed to the more rigorous quantitative analysis of traditional scientific papers. Because human nature is so complex, it is much more difficult to develop sound theories of human behavior than to predict occurrences in the physical world.

The methodologies in educational research may be classified into two broad categories: quantitative and qualitative studies. For medical education research, quantitative studies are limited because quantified results focus on the outcomes of the study. Qualitative studies are more complex and as such, are able to utilize different methodologies to explore the process of the study. Both types of studies are necessary to understand the intricate interaction between education and human nature.

This workshop will address the use of varying methodologies in medical education research by reviewing four recently-published papers. By comparing and contrasting the methodologies employed in each of the papers, participants will be able to appreciate that quantitative and qualitative studies have different standards for validity and reliability which are equally valuable to the field of medical education.

A. A. Kuo, Cedars-Sinai Medical Center, Los Angeles; G. S. Blaschke, Naval Medical Center, San Diego; B. S. Siegel, Boston Medical Center, Boston; J. P. Hafler, Harvard Medical School, Boston, and A.M. Katz, Harvard Medical School, Boston

WS37 Evidence Based Pediatrics: What Works Best And The Challenges For The Future
The potential for the EBM movement to positively influence care of children is increasingly recognized, but its real use and effect continues to be minimal. Using the combined experience from our institutions we will cover two topics with the goals of increasing the use of EBM. The first part of the workshop will address and review the requisite tools necessary for the practice of EBM; we will address the skills necessary for EBM users to understand papers on prognosis, screen, diagnostic testing and treatment, including a discussion of odds, risks, ROC curves, and kappas. The second half of the workshop will concentrate on the common barriers that most ‘EBM users’ are likely to face eventually. This will include a discussion of difficulties at each step in the practice of EBM, including (a) using the evidence (especially when it is scant or poor), (b) summarizing the evidence (and why there is a need for a common EBM language and format), (c) problems in disseminating the products of EBM in the midst of a busy clinic, and finally (d) problems in implementing evidence in real-time, using computers. We will use our own examples to encourage audience participation.

R.L. Davis, D.A. Christakis, T. Newman, University of Washington, Seattle, and University of California, San Francisco, San Francisco

WS38 Performing Secondary Data Analyses: How, When, Where & Why
A variety of large data sets are increasingly becoming available for research purposes, namely secondary analyses. A secondary analysis is a fundamental tool in health services research allowing a re-analysis of previously collected data in an effort to address questions which may not have been considered in the original study. One of the values to such work is that the data are often nationally or regionally representative samples which may permit easier generalization of study findings beyond small clinic or hospital samples.

This workshop is geared towards faculty and fellows at the initial planning stages of a secondary data analysis project. The workshop will use several examples of completed secondary analyses using data from state, federal and industry sources as "cases" from which the participants may: 1) review the approach to a secondary analysis, 2) identify strategies to discover and acquire data sets, 3) highlight challenges and opportunities inherent in such work and 4) discuss the resources necessary to pursue a secondary analysis project including staff expertise, statistical modeling and information systems requirements.

At the conclusion of the workshop the participants will have had the opportunity to review the pros and cons of pursuing a secondary analysis project and have a frame of reference from which to consider any additional training or resources needed to complete such a project.

A. P. Giardino, D. R. Durbin, The Children’s Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia

WS39 Resuscitation And Stabilization Of The Pediatric Transport Patient In "Virtual Reality"
When confronted with complications which arise during the interhospital transport of pediatric patients, health care providers must take into account the unique characteristics of critically ill children and the transport environment. This workshop is intended to introduce a hands-on, teaching tool which develops skills including: identification, management, and prevention of problems commonly encountered in critically ill pediatric transport patients. Participants join in a scenario where instructors pose as health care professionals treating a critically ill child (actually a resuscitation mannequin) at a referral facility." A variety of inappropriate and potentially dangerous interventions (ie. improperly stabilized endotracheal tube) have been performed. While resuscitating, stabilizing, and preparing the "patient" for transport, the participants try to identify and correct these inappropriate interventions using equipment provided for their use. The participants then place the "patient" into an actual ambulance. While the ambulance is in motion, the participants try to solve problems which are unique to the moving ambulance environment. For the purposes of this workshop, participants will view a video of pediatric residents participating in this teaching exercise. Workshop participants may then participate in similar scenarios where they will try to identify potential problems, resuscitate, stabilize and prepare a mannequin for transport.

G. Zuckerman, M. Pante, B. Fischberg, W. Goerlich. Departments of Pediatrics and EMS Education, Robert Wood Johnson Medical School, New Brunswick

WS40 Teenage Psychosocial And Interactive Problems: Family Systems Approaches For Primary Care
Psychosocial-behavioral problems often accompany teenagers’ entry into adolescence (e.g., separation, individuation, and independence). Problems include teen-parent conflict, noncompliance with medical regimes, somatic complaints, sexual promiscuity, substance abuse, affective disorders, and emotional-behavioral complications of ADHD and school learning problems.

Furthermore, the family is in a new family development cycle and parents are facing their own challenges with mid-life, mid-career changes.

Most psychosocial problems and transitions benefit from a family-centered approach. Detecting, treating, and referring constitute comprehensive primary care for teenagers. Participants will learn 1) family systems concepts; 2) clinical application for evaluation and management; 3) solution-oriented interviewing techniques; 4) techniques for referral; and 5) further training opportunities.

Teaching methods will include brief formal talks, interactive discussions, case studies, videos of family interviews, and extensive handouts.

W.L. Coleman,University of North Carolina, Chapel Hill

WS41 The Ethics Of Research In Infants, Children And Adolescents
While the NIH and the FDA have both called for greater inclusion of children in research, the ethical barriers have not changed. These barriers frequently strike the clinical pediatrician as unnecessary, if not incomprehensible. The workshop leader participated in the review of the ethical inclusion of children in research at the Mayo Clinic for 10 years and has chaired the review group for 5 years. In this workshop, the participant will gain an understanding of and learn how to apply the rules regarding the ethical inclusion of children as promulgated by the U.S. Department of Health and Human Services. Through the establishment of minimal risk, parental permission, subject assent, and a balance between benefits and risks, these rules apply the spirit of the Declaration of Helsinki to children and can be understood through the principles of beneficence, justice, and self-determination. In this workshop, the leader will present didactic material on the history and current status of the ethical rules as they apply to infants, children, and adolescents. The participants will then break into small groups and apply these rules to several cases drawn from research applications made to the leader’s institution. The participants will reconvene as a large group to discuss the small-group analyses and conclusions.

R. M. Jacobson, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester

WS42 What’s Style Got To Do With It? Using Diverse Teaching Methods And Teaching Styles To Enhance Teaching And Learning In The Busy Clinical Setting
Effective teaching in the office setting requires flexibility, energy, and commitment amidst a busy background of clinical care. Effective teaching also requires that teachers are able to address learners’ needs and understand the variations in learners’ styles and approaches. Teachers can accomplish these requirements while creating an optimal teaching-learning environment by utilizing a variety of teaching methods and teaching styles. If teachers use a variety of teaching methods and styles, learners are exposed to both familiar and unfamiliar ways of learning which provides both tension and comfort during the process and which gives learners multiple ways to excel. This ultimately may encourage adaptability and lifelong learning in the teaching-learning process.

This interactive faculty development workshop will provide participants a framework of teaching methodologies and teaching styles for the busy clinical setting. Participants will examine and reflect on their own dominant teaching style and learning style preferences and how these affect their choice of teaching methodology and style. Participants will also have the opportunity to practice various traditionally non-medical teaching methodologies in small groups (e.g., contract teaching, role plays, helping trios, modular instruction, electronic lectures, fishbowl discussion, student journals, jigsaw groups, think-pair-share, student-preceptor of the day, and two-minute papers) and learn how to apply them to the medical education setting. They will also learn about and practice brief teaching techniques which have been shown to be effective in the medical setting (one-minute preceptor, Aunt Minnie method, Socratic method). Participants will obtain written materials describing the various teaching methodologies and styles which will facilitate their adoption in participant’s office settings.

L. Vaughn, J. Gonzalez, and R. Baker. Children’s Hospital Medical Center, Cincinnati

WS43 Working in International Child Health
Part 1: Children of the World 2000: An Overview
Ninety percent of children in 2000 will be born into the not-yet-industrialized parts of the world. This session will help child health professionals become aware of the difference in lifestyles and issues facing these children compared to those of children living in the western world. Participants will also gain awareness of how the health of all children impacts on all of the world’s people both now and into the 21st century.

Part 2: How to Help Children in Disasters
More than half of all people affected by disasters are children. Many will have long-term physical and mental health consequences. Their special needs and interests are often overlooked. This session will help child health professionals to understand the magnitude of the problem, to recognize the special needs of children in disaster situations, and to know how to help these children.

Part 3: Recommendations for Pediatricians Who Want to Work in International Health
Child health professionals with both short and long term experience in working internationally will compare their learning and provide recommendations for colleagues interested in becoming similarly involved.

K. Olness, Rainbow Babies and Children’s Hospital, Cleveland; B. Duncan, University of Arizona, Department of Pediatrics, Tucson; R. Haggerty, University of Rochester, Department of Pediatrics, Rochester; J. Kennell, Rainbow Babies and Children’s Hospital, Cleveland; R. Meier, Shriners Hospital for Children, Lexington

SPECIAL INTEREST GROUPS

TICKETS NECESSARY FOR THIS EVENT. NO FEE IS REQUIRED BUT PRE-ENROLLMENT IS ESSENTIAL TO ATTEND.

SG20 Adolescent Medicine
Chairs: Paula Braverman and Martin Fisher
Co-leaders: Robert Sege, Shari Barkin, and Carole Sousa.

Practical Approaches to Violence Prevention
This session is co-sponsored by the Special Interest Group in Adolescent Medicine of the Ambulatory Pediatric Association and the Section on Adolescent Health of the American Academy of Pediatrics. Both the Special Interest Group and the Section on Adolescent Health focus on the provision of care to teenagers in the community, private practice, and teaching hospital setting with emphasis on the practical issues in delivering this care. The session is open to anyone interested in adolescent health and will focus on interpersonal and dating violence. Practical approaches to screening and suggestions for prevention on the individual and community level will be addressed.

SG21 Child Abuse
Chair: John Leventhal

SG22 Health Services Research
Chair: Lawrence Kleinman

Information on this SIG will be posted on our website in early 2000.

SG23 Medical Student Education
Chair: Helen Loeser

The Medical Student Education SIG will focus on "Partnerships in curricular development."

The Session will start with poster displays on medical student education, with time to view and discuss. We will also present updates on the work of the Council on Medical Student Education in Pediatrics (COMSEP), which includes faculty development, a nationally developed curriuculum, technology applications, and a new video to introduce students to the approach and exam of infants and young children.

We will then turn to our major new work, identifying existing models that work in several aspects of curriculum development, and then, in small groups, working to develop and adapt these programs to specific schools’ and communities’ resources and needs.

The areas we have identified for development will consider, in particular, what is working, and how to enhance opportunities, in practice and ambulatory settings. The aspects we will focus on for curricular development include:
1. Outcomes of medical student education, especially as they affect career counseling and career choice; and
2. Service learning, especially as a model for providing "added value" in community clinical settings, in learning about chronic illness and in serving the underserved.

This meeting is open to anyone interested in medical student education, and we encourage new attendees and particularly invite AAP members to join our discussion! We always invite medical students to join our working sessions, which ensures that they are fun, productive and stay on target.

SG24 Nutrition
Chair: Robert Karp

Micronutrient supplementation: Why, when and for whom. 

These presentations were developed so as to familiarize pediatricians with contemporary uses of micronutients in clinical  practice with both well and sick children.  

1. A historical perspective of micronutrient supplementation  - Robert Karp
•recognizing the historical deficiency disease
•chemical isolation of micronutrients and the use of nutrients in prevention of ancient scourges
•the reappearance of concern for deficiency in families of poorer children — classic diseases and increased risk for modern ones.

2.  The Infant and Child — Mike Farrell
•breast and bottle feeding
•the prevention of iron deficiency
•concerns for degenerative diseases of contemporary society.

3.  The Adolescent Infancy and Early Childhood  - Sandy Hassink
•the nutrient needs of the adolescent
•preventing osteoporosis
•the dieting obese child as a special concern

4.   Medical Therapy and Micronutrients - Liz Sheppard
•medically necessary micronutrient supplementation
•examples: in type II diabetes, cystic fibrosis, and treatment with INH or Dilantin
•use of micronutrients in ‘alternative therapy’

A panel discussion with participants.

COMMERCIAL EXHIBITS OPEN AND POSTERS AVAILABLE FOR VIEWING
Available for Viewing - 2:00 pm - 6:45 pm
Author Attendance - 4:45 pm - 6:45 pm

TOPIC SYMPOSIA

¨Advances and Application of Psychopharmacology in Pediatrics
Chair: Donald E. Greydanus, Michigan State University, Kalamazoo and East Lansing

The field of psychopharmacology has expanded rapidly over the past few decades. Research into psychopharmacologic management of mental disorders in children and adolescents has also expanded over the past decade. This sessions will review current research and its application to the treatment of attention deficit / hyperactivity disorder, depression in youth and juvenile bipolar disorder. The three presenting faculty are actively involved in this exciting research. In addition to a lecture format, questions from the audience will be invited.

Attention Deficit / Hyperactivity Disorder
Jefferson B. Prince, Northshore Children's Hospital, Massachusetts General Hospital, Harvard Medical School, Boston

Juvenile Bipolar Disorder
Joseph Biederman, Harvard Medical School, Boston

Depression in Youth
Thomas J. Spencer, Harvard Medical School, Boston

¨The Biology and Disorders of Sleep
Chairs: David Gozal, Kosair Children’s Research Institute, University of Louisville School of Medicine, Louisville and Jean Paul Praud, University of Sherbrooke, Québec, Canada

This symposium aims to introduce the audience to novel and exciting concepts regarding the ontogeny of chronobiological rhythms, the genes that regulate such rhythms, and the potential implications they may have for development. In addition, the effect of sleep states on upper airway muscle function in the immature mammal will be presented as well as the implications of sleep-disordered breathing for neurocognitive function.

Timekeeping by Genes of the Circadian Clock
Amita Sehgal, Howard Hughes Medical Institute, University of Pennsylvania Medical School, Philadelphia

The Development of Circadian Rhythmicity
Scott A. Rivkees, Yale University School of Medicine, New Haven

Ontogeny of Upper Airway Muscle Function During Sleep
Jean Paul Praud, University of Sherbrooke, Québec, Canada

Neurocognitive Sequelae of Obstructive Sleep Apnea in Children
David Gozal, University of Louisville, Louisville

Supported by an educational grant from Boehringer-Ingelheim/Roxane Laboratories

¨Research in Office and Community Settings: Studying Pediatric Care in the Real World
Chair: Peter G. Szilagyi, University of Rochester School of Medicine, Rochester

Research performed in pediatric offices and community settings has contributed substantially to improving the health of children. Office-based research can provide useful descriptive information about health conditions of children, improve the quality of care delivered by practitioners, and promote new innovations in health care delivery. Research in community settings such as schools and daycare sites and in children’s homes can focus on high-risk populations and on the "new morbidity" such as developmental and behavioral problems, social concerns, and mental health issues. Many future health problems will be prevented by targeting entire communities, rather than patients, for interventions, and employing public health and systems approaches focusing on community-level targets, measures, and outcomes. Research in office and community settings represents an overlapping domain of academic pediatrics, private pediatrics, and public health. This panel will (a) review the history and the future of office-based research (b) summarize critical practical issues regarding research in office and community settings, (c) discuss local research networks and the national PROS research network, (d) present specific examples of types of research that would most benefit from collaborations between academic pediatricians, private pediatricians, and public health and community-based child health experts.

Research in Office and Community Settings: The Past and the Future
Evan Charney, University of Massachusetts Medical School, Shrewsbury, MA

Doing Research in a Busy Private Primary Care Pediatric Office
Gordon B. Glade, Chairman PROS Steering Committee, American Fork, UT

Office-Based Research: A Community Pediatric Agenda
Thomas McInerny, University of Rochester School of Medicine and Dentistry, Rochester

Pediatric Research in Office Settings (PROS): A National Approach to Office-Based Research
Richard "Mort" Wasserman, University of Vermont/PROS Network, Burlington

Community Pediatrics Research and Vulnerable Populations: The Role of the New AAP Center for Child Health Research
Michael Weitzman, The Center for Child Health Research and the University of Rochester School of Medicine & Dentistry, Rochester

Collaborations Between Primary Care Pediatricians and Academic Departments
Elizabeth McAnarney, Children’s Hospital at Strong, University of Rochester Medical Center, Rochester

SUBSPECIALTIES/THEMES
(Original Science Abstract Programs)

• Emergency Medicine: General
• Endocrinology III: Insulin Deficiency/Insulin Resistance/Obesity
• Gene Regulation I
• General Pediatrics II
• Immunizations in Underserved Populations
• Neonatal Epidemiology
• Neonatal Immunology and Hematology I
• Neonatal Patient Oriented Research II
• Oxidants/Antioxidants: Brain, Lung and Basic Mechanisms
• Pediatric Nutrition and Metabolism II

POSTER SESSION III

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Last Modified: April 13, 2000