Concurrent Session A01 Engaging Nontraditional …beyondflexner.org/wp-content/uploads/2-A01-Presentations.pdfCommunity, Diversity, & Equity Concurrent Session A01 Engaging Nontraditional

Community, Diversity, & Equity

Concurrent Session A01

Engaging Nontraditional Partners to Shape Primary

Care Training and Education

Presented at the Beyond Flexner Conference | April 9-11, 2018 | Atlanta, GA USA

All Rights Reserved, no forms of dupblication nor distribution allowed without author's consent.

DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

Community, Diversity, & Equity

The Morehouse School of Medicine Adheres to ACCME Essential Areas, Standards, and Policies regarding industry support of continuing medical education. Disclosure of the planning committee and faculty’s commercial relationships will be made known at the activity. Speakers are required to openly disclose of any limitations of data and/or any discussion of any off-label, experimental, or investigational uses of drugs or devices in their presentations.



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

BUILDING PRIMARY CARE EDUCATIONCOMMUNITIES OF PRACTICE:

Engaging Non-Traditional PartnersMonday, April 9th, 2018

Beyond Flexner Alliance Annual Conference

Robin Harvan, EdDCenter for Integration of Primary Care and Oral Health

Katherine Y. Brown, EdD Meharry Medical College

Karen Sheehan, MD, MPH Northwestern University

Randall Longenecker, MD Rural PREP

Julie Sochalski, PhD, FAAN, RN University of Pennsylvania

Efrain Talamantes, MD, MBA, MSHPM University of California at Davis



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

HRSA Primary Care Training Enhancement:

Purpose:• Conduct systems-level research to inform primary care training• Disseminate best practices and resources• Develop a community of practice to promote the enhancement of

primary care training to produce a diverse, high quality primary careworkforce, in order to help all training programs enhance thetraining in primary care and in order to promote and disseminateresearch and best practices that result in providing higher qualityand access of care to underserved communities.



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

AU-PCTE Partners and Focus Areas

• Harvard University-National Center for Integration of Primary Care and OralHealth (focus: integrating oral health and primary care)

• Meharry Medical College-National Center on Medical Education, Development,and Research (focus: training for needs of vulnerable populations)

• Northwestern University-Program in Primary Care, Health, and Society (focus:addressing the social determinants of health)

• University of Washington-Rural : The Collaborative for Rural Primary CareResearch (focus: training for rural practice)

• University of Pennsylvania-National Center for Integrated Behavioral Health inPrimary Care (focus: integrating behavioral health and primary care)

• University of California at Davis-Center for a Diverse Healthcare Workforce(focus: increasing workforce diversity)



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

Workshop Overview

One of the unifying goals of this AU-PCTE cooperative is for each AU to create a Community of Practice (CoP), through which they engage partners, connect with patients and other stakeholders, share resources, and share and implement best practices related to their work.

Using a variety of platforms and methodologies, AUs are exploring the most effective ways to launch and develop these communities and tap into existing communities, with a strong focus on connecting to and engaging non-traditional and non-health sector partners that can add unique value to the CoPs.



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

Workshop Overview

Panel Presentation: • Each AU will share an example of non-traditional stakeholder

engagement, detailing catalyst for connecting, originalaspirations for relationship, and how relationship has evolved;

• Each AU will share why this stakeholder is considered non-traditional in relation to the AU’s work (e.g. connectingcommunities to researchers when those communities are nottypically involved in research); detail what special effort it maytake to engage these partners; describe successes and lessonslearned; and highlight the impact of each partnership to theadvancement of the CoP.

Workshop Goals



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

Non-Traditional Stakeholder Engagement

National Center for Integration of Primary Care and Oral Health (CIPCOH)

MissionCIPCOH serves as a national resource to consolidate the evidence base for systems-level oral health integration into primary care training.

VisionCIPCOH envisions the role of integrative training and practice leading to cost-effective, patient-centered, and improved patient outcomes within the delivery of primary care.

National CIPCOH - Harvard and Academic Partners



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED


With the establishment of the national center, a growing network of CIPCOH Community of Practice and education collaborations is forming to:• Foster stakeholder engagement, connections and collaborations in

primary care and oral health integration and training enhancements• Share knowledge and best practices for systems-based

improvements• Conduct research and contribute to primary care and oral health

education, practice, scholarship, and policy development




DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED


Community of Practice examples:

• National Interprofessional Initiative on Oral Health• Harvard School of Dental Medicine Initiative to Integrate Oral

Health and Medicine

Through these partnerships, we engage with academics and corporate leaders within the health care community including health insurance companies, community health centers, and consumer advocacy organizations.




DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

https://www.niioh.org/

http://oralhealth.hsdm.harvard.edu/


Catalyst for Connecting and Original Aspirations for Relationship

• Shared vision, mission and values• Recognition of linking education and practice to improved

health outcomes• Provided endorsement and/or letter of support for CIPCOH

funding proposal




DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED


How Relationship Has Evolved

• Ongoing communication and collaboration regarding mutualinterests and activities

• Collaboration with NIIOH on research and dissemination• Collaboration with HSDM Initiative on dissemination and

connections with leadership and healthcare systemsimprovement




DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED


Why “non-traditional”? • Connecting primary care academics and clinicians representing

multiple specialties and disciplines to our researchers whenthose communities are not typically involved in our researcharea of focus

• Connecting corporate leaders and employers representing thehealthcare industry and also representing other industriesconcerned with the economic imperative of healthcaresystems improvement




DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED


Engagement Activities: Push-Pull strategies and methods to facilitate and ensure ongoing engagement

NIIOH • Collaborating on research, publications and presentations• Sharing and linking social media• Collaborating on strategic initiatives policy development

HSDM Initiative• Invitational luncheon to launch CIPCOH• Regular reporting and communication with the Board• Contributing to the newsletter• Participating in annual corporate leadership forums




DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

National Center for Medical Education Development andResearch at Meharry Medical CollegeTransforming Medical Education and Clinical Practices to meet the needs of Vulnerable Populations

Katherine Y. Brown, EdD, Director, Communities of PracticePat Matthews-Juarez, PhD, Project Director, Professor

Paul D. Juarez, PhD, Director, ProfessorNational Center for Medical Education Development & Research(NCMEDR)

Department of Family and Community Medicine



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

National Center for Medical Education Development andResearch at Meharry Medical CollegeTransforming Medical Education and Clinical Practices to meet the needs of Vulnerable Populations

Project Overview:

Goal: Examine evidence-based studies for gaps in primary care training, preventive and clinical interventions in primary care training, access to health services, and treatment of lesbian, gay, bisexual and transgender (LGBT)persons; homeless persons, and migrant farm workers.

Objectives:1) Examine effective models for training primary care residents and medical students in addressing the unique

needs of vulnerable populations (lesbian, gay, bisexual and transgender (LGBT) populations; migrant workers;and homeless persons) within a patient-centered medical home model;

2) Conduct a separate systematic review of the literature of prevention and primary care interventions thathave been identified as effective in meeting the needs of vulnerable populations;

3) Implement (3) communities of practice (CoP) to identify how evidence-based prevention and interventionstrategies can be integrated into primary care practice and training to improve health services to lesbian, gay,bisexual and transgender (LGBT)persons; homeless persons, and migrant farm workers; and

4) Disseminate findings to academic medicine, clinical, and professional organization partners on how tointegrate evidence-based research findings into primary care practice and training within a PCMH model.



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

National Center for Medical Education Development andResearch at Meharry Medical CollegeEngaging Non-traditional Partners as Members of CoP for Maximum Impact

Engaging Non-traditional Partners:• Develop a list of thought leaders, experts, and

stakeholders in areas) of inquiry• Establish communities of practices with internal and

external consistency• Level the playing field: Orientation of Purpose• Establish and implement common goals, objectives,

expectations, and outcomes• Develop pathways for communication across

communities of practice, e.g. teleconferences, webinars, face to face meetings, newsletters, social media (Twitter, Facebook, Instagram, YouTube etc..)

• Arrange face to face meetings• Encourage non-traditional partners to tell their

stories through narratives• Assess/evaluate processes• Dissemination of Information to all audiences• Engaging Non-traditional Partners as Members of

CoP for Maximum Impact

CoP Member Categories:System:

• Medical Schools• Academic Institutions• Health Serving Organizations• Primary Care Facilities inc. Federal Qualified

Health Centers, Private & Group Practices• Faith Based Organizations• National Related Health Services Organizations• Advocacy Organizations• Legislature

Individual:• Community Lay Persons• LGBTQ Persons• Homeless Persons• Migrant Farm Workers• Community Advocates• Stakeholders (Patients & Caregivers)• Policy Makers



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

National Center for Medical Education Development andResearch at Meharry Medical College

Elements of Communities of Practice: Implementation Process• Recruit and sustain a diverse team

of academic, clinical, professional, policy, and lay audiences.

• Conduct regular forums to identify, translate, and disseminate evidence based best practices.

• Identify best strategies and venues for reaching different populations.

• Evaluate effectiveness of strategies in reaching targeted audiences.

Transforming Medical Education and Clinical Practice: Dissemination of Research Findings

Elements of Communities of Practice developed by Matthews-Juarez & Brown, National Center for Medical Education Development and Research, HRSA, Rockville, Maryland, September 9, 2017



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

National Center for Medical Education Development andResearch at Meharry Medical CollegeImpact: The CoP for the NCMEDR at Meharry

Project Outcomes• Seventy-five members the CoP• Held 1 face to face conference with 76 members, 2 seminars

(105 participants), 2 webinars (70 logged on members); and Second CoP conference scheduled for May 31, 2018

• Disseminated results of studies (16 abstracts submitted, 9 accepted abstracts; 2 policy briefs developed; 2 completed manuscripts on findings from studies; 15 presentations at local and national meetings; 2 newspaper articles; 3 radio programs)

• Social Media (SM)Strategic Plan for dissemination of studies and activities: Participation in the Mayo Conference on SM

• Implemented Twitter, FaceBook, Instagram, YouTube, etc. over 300 followers

• Active website with 107,403 visits with 12,968 visits in February

• Monthly online newsletter highlighting CoP members along with a calendar showing national events

• Developing a certificate program the National Health Care for the Homeless Council (NHHC) for health care professionals

• Developing a clinical rotation for medical students and residents in partnership with NHHC on content/cultural competency and interpersonal violence over the lifespan

Actions of the CoP• Relevant and timely feedback on studies,

surveys, academic papers, tool kits for the Center

• Identification organizations and key groups not participating in the CoP using an key informant process

• Identification of additional national, state, and local community processes and practices to expand the inquiry

• Application of rapid cycle quality improvement processes for assessing and evaluation the results of the products for modification and change

• Address national, state, and local trends in addressing gaps/health disparities for vulnerable populations under inquiry

• Expansion and enhancement of community resources for transformation

• Dissemination channels for findings and results of studies



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

Project Overview

• Addressing the Social Determinants of Health is a primary strategy to promote equity.

• Our research focusses on both undergraduate and graduate medical education in order to understand how to best teach medical students and primary care trainees

1) to care for diverse populations2) promote equity in healthcare and3) learn the skills necessary to become outstanding primary care clinicians in

the 21st century health system

Northwestern University



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

Research Highlights and Accomplishments

1. Measure the impact of a longitudinal, team-based primary care clerkship on medical student attitudes, knowledge, and skills as well as likelihood to choose a primary care career path

2. Performed a scoping review of best practices to teach about the SDH at a GME level

3. Performed a scoping review of best practices to teach about the SDH at a UME level

4. Engaged a diverse expert panel including students, faculty and community members to develop a consensus framework for teaching students about the SDH

5. Create a community of practice of academic faculty and community partners who have a shared interest in teaching about the SDH




DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

Non-traditional Partners

1. Not surprising, it is impossible to teach learners about the SDH bystaying within the walls of the academic medical center

2. Developed relationships with many community partners includingthe Chicago Park District, Chicago Public Library, FQHCs, communitydevelopment organizations, and community based organizationsincluding the Chicago Youth Programs




DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

Chicago Youth Programs

• Founded in 1984 by Northwestern University Medical & Law Students

• Goal: to improve the health and life opportunities of at risk youth

• A once a year well child care visit was not enough to improve the health of children

• To improve the health of children, it was essential to get them out of poverty. For most, education was the surest route

• Programs designed to address the health, educational, recreational needs of youth

• Medical students are required to participate in one of the other non- clinical activities to be able to volunteer in clinic

• SDH Exposure




DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

Challenges, Rewards, and Lessons Learned

1. Medical students end their engagement in CYP after about 18 months as they begin to study for boards

2. Mentoring relationships less than 2 years can be detrimental to the program mentees

3. CYP staff provide continuity to CYP participants along with volunteers from the professional sector

4. CYP staff are committed to medical school teaching because it is a core mission of the organization and provides positive role models for the CYP participants

5. Open, honest dialogue critical to success




DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

Rural PREPCollaborative for Rural Primary care Research, Education and Practice – UW, OU, UND

...to improve and sustain rural health through community engagement and research in rural primary care health professions education.



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

Rural PREPCollaborative for Rural Primary care Research,

Education, and Practice2016-2021

Bureau of Health Workforce

“an expanding community of practice in rural health professions education and research"The RTT Collaborative



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

Strategy: Design and Dissemination StudioCollaborative for Rural Primary care Research, Education and Practice

Objectives of the Studio:• Strengthen research proposals,• Increase the relevance of the research to a community of practice,• Improve recruitment and retention of research participants, and • Build a cadre of research-engaged stakeholders• Make research more community centered, culturally relevant, and

accessible to potential research participants

Modeled after the Community Engagement Studio process and Toolkithttps://victr.vanderbilt.edu/pub/resources/upload/files/CES Toolkit.pdf

https://ruralprep.org/researchscholarship/research-design-dissemination-studios/



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

https://victr.vanderbilt.edu/pub/resources/upload/files/CES%20Toolkit.pdf

https://ruralprep.org/research-scholarship/research-design-dissemination-studios/

• Plan a 2.5 hour in-person session as a pre-conference to a stakeholder meeting

• Identify a research project that is proposed, in progress, or published

• Extend an invitation to members of the stakeholder organization to participate

• A pre-reading assignment and preparatory materials

• Rural PREP and community facilitators

• Introduction• Research presentation with a

question for the group (10 min)• Clarifying questions from the

group (10 min)• Group discussion (while the

researcher listens)• The researcher feeds back to the

group what they’ve heard (5-10 min)

• Evaluation

Collaborative for Rural Primary care Research, Education and Practice

Strategy: Design and Dissemination StudioPresented at the Beyond Flexner Conference | April 9-11, 2018 | Atlanta, GA USA


DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

• Catalyst for connecting – multiple perspectives• Original aspirations – Community Health Workers

are an important part of the primary care team, but function differently in rural settings

• How the relationship has evolved• CHWs are not generally considered stakeholders in

primary care education• Impact – Stay tuned!

Collaborative for Rural Primary care Research, Education and Practice

Strategy: Non-traditional stakeholder

“Community Health Workers: Strengthening the Care of Rural Populations” (Research as education)



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

National Center for Integrated Behavioral Health, Penn

… an innovation hub for testing and disseminating best practices for treating behavioral health and substance use

disorders in primary care, and preparing primary care clinicians with the expertise and leadership for integrated

behavioral health care.



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED


A learning network for those who are engaged or need to engagein IBH training, practice, or promotion in primary care

Serve as a convener or hub for curating and sharing ideas andstrategies among members

The goals are to:

◦ Close the gap between knowledge and practice.

◦ Foster professional connections and grow an inventory of IBHtraining models and norms

NCIBH Community of Practice



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED





DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED


NCIBH Community of PracticeCurrent State

Disparate stakeholder groups lacking a common platform of learning systems

Evidence-base for training in IBHPC is limited & siloed

Non-iterative generation of educational models

Future State

NCIBH engages, convenes, and promotes collaboration

NCIBH serves as a resource

Robust evidence-base in IBHPC training and practice

Bi-directional learning across many disciplines to advance IBH science and practice

Realize the value of IBH for patients and families



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED



• Use the CoP to identify:• Practitioners, policy makers, advocates, consumers

• Sites along spectrum of adoption of IBH training and practice

• Core set of resources curated and make available to the community: Trainingmodels, curricula and competencies, and evaluation tools

• Foster iterative learning to enable implementation• Identify critical questions for advancing training for IBH in primary care

• Identify barriers and facilitators of IBH training

• Inform accreditation standards or principles of care standards.



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

Catalyst for the COPNational Center for a Diverse Healthcare Workforce, UC Davis



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

Partners

Statewide Advocacy Organization• California Primary Care Association:

Val Sheehan, Director of Development and External Relations

Health System• Dignity Health: Kristie Griffin, Director of Talent Acquisition

& Liza Kirkland, Manager of Community Health and Outreach

Physician Organization• Sierra Sacramento Valley Medical Society:

Myel Jenkins, Program Director

Student Organizations• MiMentor: Aileen Castillo, President• Latino Medical Student Association

National Center for a Diverse Healthcare Workforce, UC Davis



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

Partnership ObjectivesNational Center for a Diverse Healthcare Workforce, UC Davis

1. Increase and sustain collaborations among high schools, community colleges, universities, health professions/graduate/medical education programs and community health centers in Northern California

2. Increase knowledge about northern California based health career enrichment programs for pre-health students

3. Increase knowledge about the variety of paths to primary care and other health careers



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

Sacramento City College Health Careers Conference




DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

Community College Conference Participants

High School Students: 43Community College Students: 31Post Baccalaureate or Graduate Students: 47Parents: 22Health Professional Mentors: 29Speakers: 48Community-based organizations: 23




DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

Community College Conference Demographics

Students75% female, 53% Latino, 26% more than one race, 81%

percent of students are the first in their family to attend college

Health Professional Mentors75% female, 29% Asian, 21% White, 21% Latino, 15% Black

or African American, 16% more than one race




DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

Lessons learned

1. Recognizing that all partners are working towards same vision

2. Recognizing and discussing who is not in the room, and who needs to be in the room

3. Bi-directional understanding of programs concept, design, goals and objectives to increase student success

4. Realizing programming that is comprehensive and includes smoother transitions for students and their families




DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

Recommendations

1. Develop mentoring ‘best practices’ guides for mentors, faculty, and staff

2. Facilitate partnerships to support outreach to parents and students

3. Facilitate partnerships to engage parents and students in understanding health careers (e.g., primary care)

4. Offer pre-conference and post-conference opportunities to improve mentoring for UIM students




DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

Discussion:



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

Discussion

Small Group Discussion: • Discuss advancing non-traditional stakeholder engagement in

advancing primary care training and education.

Guiding questions1. Identify a non-traditional stakeholder not previously discussed (“Who

else should be at the table?”), 2. Explore appropriate goals of engagement with this stakeholder (“How

might our program and the stakeholder both benefit from this engagement?”), and

3. Determine a strategy for engagement (“What methods and/or platform will best ensure this stakeholder’s ongoing participation?”).

Workshop Participants



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

Workshop Wrap-Up

•Small Group Reports

•Next Steps in Engagement



DUPLICATIO

N

AND

DISTRIB

UTION

PROHIBIT

ED

Documents

Concurrent Session A01 Engaging Nontraditional …beyondflexner.org/wp-content/uploads/2-A01-Presentations.pdfCommunity, Diversity, & Equity Concurrent Session A01 Engaging Nontraditional