Community Experience: Interprofessional Education Bridging Health Professions Students, High School Students, and the Community

March 14, 2016

Amy Lee, MD, MPH, MBA

Gina Weisblat, PhD

DISCLOSURE

The presenters have no relevant financial relationships with any commercial interests to disclose.

OBJECTIVES

• Describe a course for small teams of first year medical and pharmacy students who perform community projects, many in collaboration with high school student teams.

• List at least three considerations in implementing an interprofessional course linking students to the community.

HISTORY

• Northeast Ohio Medical University longitudinal community-oriented curriculum

• Pre-medical school (summer practicum)

• Medical school—M1, M2, M3, M4

• College of Pharmacy started 2005

• Inter-professional community experience courses• Inter-professional Medicine and Pharmacy students Addressing

Community Health through Service (IMPACTS)

• Community Experience

Association of Teachers of Preventive Medicine Award1998 Outstanding Program

ASSUMPTIONS 2010

• Faculty—few

• Funding—scarce

• Students--Millennials

FACULTY/ADMINISTRATIVE CONSIDERATIONS

• Incorporate experiential components

• Organize as interprofessional course

• Create transparent overall structure

• Develop modular organization so longitudinal components can fit into grading periods

• Incorporate concepts of teams, leadership, and providing feedback

STUDENT CONSIDERATIONS

• Likes contributing to the community (sense of accomplishment)

• Desires fairness

• Does not like peer evaluations

• Wants to see “big picture”

• Prefers clear instructions (structured curriculum)

• Millennials—short attention span, cooperative team players, frequent positive feedback

COMMUNITY EXPERIENCE 2011-2012

• One year pilot

• 13 sessions (irregularly timed and irregular hours) over fall and spring; “leftover” slots (27.5 hours total over the year)

• 28 groups of 5 students; 11 groups of 6 students (39 groups of 206 students)

• 1 faculty; 3 supporting faculty; academic services support; others contribute

COURSE DESCRIPTION

• Over an academic year, inter-professional groups of students plan, implement, evaluate and share community experience projects

• About $50 per team to use for projects

• Teams submits team project plan and team feedback form at the end of each session

• Final proposal and budget scored

EDUCATIONAL LEARNING OBJECTIVES

• Identify ways that health professionals interact with the communities in which they practice.

• Describe how priorities are determined with regard to community health.

• Describe the strategies of working in teams.

• Perform a basic community assessment.

• Describe how programs are evaluated.

• Implement a feasible project geared toward improving the health of a community.

• Evaluate a community health intervention project.

• Communicate the results of their project.

• Demonstrate the basic dynamics of working in a team.

• Identify elements of successful leadership.

• Describe challenges of leadership in the context of team dynamics.

COMPETENCIES*

1. Assess the health status of populations using available data (e.g., public health surveillance data, vital statistics, registries, surveys, electronic health records and health plan claims data).

2. Discuss the role of socioeconomic, environmental, cultural, and other population-level determinants of health on the health status and health care of individuals and populations.

3. Appraise the quality of the evidence of peer reviewed medical and public health literature and its implications at patient- and population- levels.

4. Apply primary and secondary prevention strategies that improve the health of individuals and populations.

COMPETENCIES (CONT’D)

5. Identify community assets and resources to improve the health of individuals and populations.

6. Explain how community-engagement strategies may be used to improve the health of communities and to contribute to the reduction of health disparities.

7. Participate in population health improvement strategies (e.g., systems and policy advocacy, program or policy development, or other community-based interventions).

*Competenices from: Maeshiro R, Johnson I, Koo D, Parboosingh J, Carney JK, Gesundheit N, Ho ET, Butler-Jones D, Donovan D, Finkelstein JA, Bennett NM, Shore B, McCurdy SA, Novick LE, Velarde LD, Dent MM, Banchoff A, Cohen L. Medical Education for a Healthier Population: Reflections on the Flexner Report From a Public Health Perspective. Acad Med. 2010; 85(2): p. 215.

INCORPORATING HPACS, 2013

• HPACS=Health Professions Affinity Community (pipeline program)

• In Ohio and other states

• Goals for students (mostly high school)• Promote community health

• Address health disparities and challenges

• Enact health projects in their communities

• Learn about health professions

LOGISTICS

• This year, 23 of 47 teams working with HPACs

• Projects• Face-to-face meetings

• E-mentoring

• Brain Bee

• Other/pre-set projects

• Work through AmeriCorps members

COURSE DESCRIPTION--CURRENT

• Over an academic year, inter-professional groups of students plan, implement, evaluate and share community experience projects; uses independent study and active learning

• $42 per team (47 teams)

• Dedicated project time (at least two spring sessions)

• Fall and spring semester, five 4-hour sessions (Thursdays in the fall, Fridays in the spring)

• Two faculty, two guest faculty, AmeriCorps members

• Option of working with the HPACs

• Fall--team project plan and team feedback form at the end of each session; proposal and budget scored

• Spring--project implementation and sharing

COURSE DESCRIPTION--ACTIVITIES

• Lectures on research vs. evaluation and health literacy (and DVD)

• Program plan (4 parts)

• Team assessments with reflection questions

• Proposal

• Abstract

• Poster

• Round table presentation

• Project debrief

NEOMED ’ S BL IZZARD BL ITZ !

PROMOT ING A HEALTHY L I F E STYLE

Chan, Paulo; Coffey, Cory; Dhamija, Yashu; Dhingra, Amitha; Nallapuram, Divya; Gupta, Divya; Dahmen, Natalie; Thomas, Lidia; Tran, Helen; Hussain, Mir; Carter, Beth; Shields, Ryan; Schneider, Brad; Lababidi, Suzanne; Rayl, Joel; Bechtold, William; Kandel, Thad

BACKGROUND

Rootstown High School in Portage County has a childhood obesity rate of 14% and an overweight rate of 30%. The combined rate for children who are obese and overweight is 44%, which is well above the national average of 27.4%. For adults in Portage County, the rate of obesity is 29% and the rate of those who are overweight is 33% ,which is at the level of the national average. Cardiovascular health in Portage county is below the national average in every category measured by the US health department; there is an average of 217 per 100,000 deaths due to heart disease compared to the national average of 211. The percent of adults with hypertension is 39% compared to a national average of approximately 30%. Myocardial infarctions are also increased; 6% of the population will experience one compared to the national average of 3.9%.

REFERENCES

http://www.co.portage.oh.us/healthdept_pages/pdfs/Community%20Health%20Snapshot%202010.pdf

OBJECTIVE

On January 28, 2012 we will hold a one mile race for members of the Rootstown area to evaluate the local physical health interest by attendance; donations will benefit the Rootstown track and field program.

METHODS

To promote physical fitness the team decided to host a one-mile footrace on NEOMED’s campus. This will give the community members an opportunity to compete with friends and family members in a safe fun environment. To promote participation to community members and NEOMED students, all proceeds will be donated to Rootstown High School Track and Cross Country sports booster. Also, seven community businesses have donated gift cards and other perishables to be used as prizes and post-race refreshments.

RESULTS

51 participants from the surrounding community, including Rootstown High School and NEOMED. All proceeds from the race will be donated to the Track, Field, and Cross Country Team at Rootstown High School. By getting people engaged in the race, we hope that running will continue to be a part of their everyday lives as away to improve cardiovascular health and decrease obesity rates within the area.

CONCLUSIONS

Medical and pharmacy students were able to successfully conduct a footrace in which the Rootstown community participated to raise awareness of healthy living and take part in a competitive event. Winners were awarded a choice of prizes and participants were entered in a drawing for remaining prizes (e.g. water bottles, gift cards, and apparel).

FIGURE 1: The registration table

FIGURE 2: The finish line

FIGURE 3: The starting line

FIGURE 4: Individuals of all ages running during the race

DISCUSSION

Overall there was a strong community involvement and there were runners of all age groups. The race required a low budget, which allowed us to donate money to the Rootstown track and cross country teams. On the other hand, the project did present with challenges in an extensive preparation time as well as stimulating interest within the community. To improve the results, advertising of the race could have been made more in advance and we could have provided educational pamphlets about cardiovascular health.

COURSE EVALUATIONS

• Most responses in strongly agree/agree columns

• Comments (negative)• Disorganized

• Why is this necessary?

OTHER COMMENTS

• I earned an MBA a quarter century ago and ran a $125,000,000 consulting company, so I'm familiar with many of the concepts presented in the course. I really wish that I had the opportunity years ago to study project management in a course like this. I do hope that the younger students appreciate this class, as it has the potential to be very helpful if they have taken note of the basic precepts presented here, I know I have learned things that will be helpful to me going forward.

• It was actually nice to get practice putting together a proposal that would bring about some sort of measurable change in the community. I'd always wondered how people came up with programs or events in the community to address a problem, and this class gave me a glimpse into how to do that.

DO YOU WANT TO DO THIS?

• Administrative considerations—mandates, support, funding, scheduling, competing interests

• Faculty considerations

• Student considerations

• Resources—funding, staff, facilities

• Assets—community or other networks (e.g. HPACs)

SUMMARY

• Health professions students and a community experience is possible on scarce resources

• Analyze your assumptions and resources first

• Gain administrative buy-in

• Create a positive experience

CONTACT INFORMATION

Northeast Ohio Medical University

Amy Lee, MD, MPH, MBA

afl@neomed.edu

Gina Weisblat, PhD

gweisblat@neomed.edu