Families as Teachers: The Value of Home Visits for Physicians in Training Working with Medically Complex Children

Authors: Martha Hernandez & Lori Ann Dotson

Research has found that few medical programs have home visits to patient homes as part of their training for pediatric residents, despite the benefits to both the patient and the pediatric resident (Steinkuller, 1992). From this study many of the programs that included home visits, were conducted in low-income areas. Home visits provided pediatric residents with a different understanding of the family, such as how little financial resources a family may have, or how able the family was to care for the child. Pediatric residents disclosed feeling more competent to support a family, six-months after the home visit. They expressed being able to address questions regarding medication, feeding, and other practical problems that may arise, more readily, therefore benefiting the care of the child and supporting the family. 86% of the residents of this study believed they gained valuable information that will help in their work with other families in the future. The current study offered an in-vivo training in the home of a family with a child with MIRAGE syndrome, a rare and complex medical condition. Participants included a board certified pulmonologist and two pulmonary fellows. They were all given an introduction to the experiences the family has at home and then they were shown what the equipment and home life is like for this child. The fellows completed a pre-test aimed at assessing their preconceived biases and expectations of what they would see at the home. They were then asked a series of questions regarding their experience, what they learned, and how they are implementing those lessons learned following their visit.