Description

This innovation seeks to strengthen early relational health (ERH) by reshaping how pediatric residents learn to engage and partner with families.

Through experiential, parent-led, and reflective teaching strategies, residents practice skills grounded in mutual respect, empathy, and shared purpose. The goal is to foster a generation of pediatricians who enter clinical practice with a deep appreciation for the power of relationship-centered care. By centering family leadership in the design and delivery of medical education, this initiative aims to shift the power dynamics of pediatric care—creating a culture where partnership and co-learning between families and providers is the norm.

Need / Problem Statement

Traditional medical education often teaches relational health and communication through a top-down model, with curricula designed primarily by medical professionals.

While well intentioned, this approach reinforces hierarchical dynamics and can inadvertently exclude the lived expertise of families.

• Key driver: A need to reimagine pediatric resident education so that families—not just clinicians—define what meaningful partnership looks like in the exam room.
• Impact: Families, especially those navigating complex or teaching hospital systems, often experience miscommunication, mistrust, or “mis-attunement” during visits.
• Access considerations: Centering family voice in training helps address the relational barriers that disproportionately affect families who experience systemic inequities or cultural disconnects in healthcare.

As the team explains, “Building partnerships must be guided by the lived experiences and priorities of families themselves.”

Process

The design process was intentionally family led and included a pediatrician with expertise in medical education, a psychologist specializing in ERH, and a Family Advisory Board (FAB) of parents with experience receiving care in teaching environments as key partners. The process included:

• A deliberate design approach where FAB parents led discussions to identify what families most want residents to learn—they created and refined goals, modeled attuned versus misattuned interactions, and scripted vignettes based on real experiences

• Continued iterative development through feedback from both FAB members and residents incorporated throughout, ensuring that the curriculum evolved dynamically based on participant experiences

The team’s mantra throughout the process was that the curriculum should feel as relational in its creation as it aims to be in practice.

Partnership

A Family Advisory Board (FAB) guided every stage of this innovation’s development.

Their insights shaped the curriculum’s priorities and tone, ensuring authenticity.

Implementation

Implementation unfolded over 12–24 months, guided by iterative family and resident collaboration that included:  

• Curriculum review: Families reviewed existing resident curricula and identified missing relational elements and any gaps in attunement and empathy.

• Focus groups: FAB parents defined the central curriculum question: “How does one learn to be a trusted partner with families while maintaining conscientious professionalism?”

• Curriculum creation: Families identified specific learning goals, wrote scripts, and filmed vignettes illustrating real-life attuned and mis-attuned encounters.

• Feedback integration: Residents and faculty provided structured critiques, which FAB participants discussed and used to refine materials ensuring that diverse family perspectives were integrated into the learning materials.

• Training adoption: The final materials are now being implemented into UCSF’s pediatric residency program.

Skepticism, when it arose, was treated as “a contributing voice in the collaboration.” The team deliberately embraced critique as a tool for building realism and shared ownership.  

Changes & Outcomes

The innovation has already created visible cultural shifts within the clinical education environment, including:  

• Leadership engagement: UCSF clinic leadership has begun integrating family voice into both care programs and educational curricula.

• Curriculum influence: The FAB provided direct input on UCSF’s FAN (Facilitating Attuned Communication) curriculum—a model that trains providers to recognize and respond to emotional cues—and their insights are now reflected in the resident curriculum.

• Program synergy: FAB input helped refine messaging for the HealthySteps program at UCSF, which will soon be introduced in the clinic.

• Ripple effect: Other UCSF projects have now requested FAB collaboration, signaling growing institutional recognition that family input is essential to medical training.

Long term, the initiative aims to evaluate how family-led relational health education impacts provider empathy, patient satisfaction, and clinical outcomes. As one family leader summarized, “Our hope is to make parent voice a required component of medical education everywhere.”  

Measurement for Success

Evaluation integrates quantitative tools and qualitative storytelling:

• Resident feedback: Pre- and post-tests administered before and after each focus group measured shifts in residents’ attitudes and skills.
• FAN training data: Numbers were collected by the Erikson Institute (a research and training center in child development) and shared with the UCSF team.
• Qualitative data: There will be ongoing collection of stories and reflections from FAB members and residents about the impact of the process.
• Future measure: The team plans to include a “connectedness” metric in UCSF’s post-visit patient satisfaction surveys to assess whether the relational principles taught are perceptible to families during real clinical encounters.

Payment & Funding

• Funding type: Philanthropic and braided funding sources support this project, allowing for sustained family participation and compensated parent leadership.
• Anticipated gains:
  

  • Improved provider-family relationships lead to better engagement, reduced disparities, and lower systemic costs associated with breakdowns in communication or mistrust.

  • By embedding parent leadership into medical education, the project not only enhances pediatric care but also cultivates physician well-being and resilience. Two other UCSF initiatives have already chosen to incorporate FAB feedback in their own implementation efforts, demonstrating the scalability and influence of this model.

To learn more about this innovation please email Hope Williams-Burt, Family Relationship Development Consultant ([email protected]) or Diane Halberg, Pediatrician and Director of the Community, Advocacy & Primary Care Rotation at UCSF Benioff Children’s Hospital ([email protected])