A New Model of Community Engaged Interdisciplinary Medical Education
ABSTRACT
TITLE:A New Model of Community Engaged Medical & Interdisciplinary Education
BACKGROUND:
Coinciding with the 100th anniversary of the Flexner Report and sweeping health care reform legislation, the Florida International University (FIU) Herbert Wertheim College of Medicine (HWCOM) is the first medical school to open in a major metropolitan area in 25 years. This occurs at a time of an increased understanding of how the social determinants of health and illness are at the root of unprecedented health inequities
OBJECTIVE:
To transform medical education to meet the needs of patients, medically underserved communities, and society based on the ACGME general competencies and an additional competency, social accountability.
METHODS:
The curriculum includes an enhanced emphasis on primary care, behavioral and social sciences, and public health; incorporating early community and clinical experiences integrated longitudinally over the four years. The signature community component, NeighborhoodHELPTM (Health Education Learning Program), is integrated with a four year family medicine clerkship. Medical, nursing, social work, and other students form inter-professional teams assigned longitudinally to neighborhoods and households in medically underserved communities. NeighborhoodHELPTM has adopted a community-based participatory approach that stresses mutual learning, capacity building and trust.
RESULTS:
The college of medicine has developed multiple partnerships including coursework integrating medical, nursing, and social work students. Twenty five affiliation agreements have been executed with local community based organizations who are referring households. Baseline community data has been collected for the outcome evaluation. Recruitment of households is underway.
CONCLUSIONS:
To fulfill the implicit social contract of medicine, the NeighborhoodHELPTM curriculum is designed to integrate students into medically underserved communities. It incorporates elements of participatory research, asset based community development, community oriented primary care, and service learning. The goal is to educate students to form inter-professional, inter-cultural, collaborative partnerships to improve the health of patients, households and communities.
NEXT STEPS:
Household visits begin in September.
BACKGROUND
•South Florida’s First Public Medical School
•Miami is one of the poorest big cities in the country
•NeighbhorhoodHELPTM is the school’s signature program
•Primary care is the vehicle for integration of curriculum across 4 years
•10:1 ratio of students to full-time NeighborhoodHELP primary care teaching faculty
David Brown, MD; Pedro “Joe” Greer, MD; Luther Brewster, PhD; Iveris Martinez, PhD; Juan Acuna, MD, MPH; Alina Perez-Stable, MSW; Virginia Harvin, RN; Joe Leigh Simpson, MD; and John Rock, MD, MPH Florida International University Herbert Wertheim College of Medicine
OBJECTIVE
To educate students to form inter-professional, inter-cultural, collaborative partnerships to
improve the health of patients, households and communities. The curriculum is
intended to transform medical education to meet the needs of patients, medically
underserved communities, and society based on the ACGME general competencies and
an additional competency, social accountability. To fulfill the implicit social contract
of medicine, the curriculum is designed to integrate students into medically
underserved communities and to develop social accountability in students and social
capital in communities.
METHODS
What is NeighborhoodHELPTM?
Health Education Learning Program
Educating future physicians and providing service to our communities through community engagement
Experiential learning opportunities that expose students to the social, psychological, and economic conditions that influence health outcomes.
Community Experiences
Community Advisory Team
Community Classrooms
Service-Learning Projects
Household Visits
Health Professions Pipeline Activities
Household Visits (Begin September 2010)
Medical students along with students from nursing, social work, law education, and other professions, are assigned to a community and a household. Medical students make monthly visits to the same household, continued longitudinally throughout their training. Students engage with household members and community organizations in health promotion service learning activities supervised by family medicine faculty (ten students per full-time faculty member).
Four Distinct Global Tasks:
1. Build a rapport with communities & households
2. Assess health, educational, social service and advocacy needs and available resources
3. Develop and help implement an action plan with the including methods for measuring success
4. Comprehensive intervention & outcome reporting
METHODS
Community Engagement Model
CONCLUSIONS
NeighborhoodHELPTM is designed to integrate students longitudinally into medically underserved communities. It incorporates elements of participatory research, asset based community development, community oriented primary care, and service learning. The goal is to educate students to form partnerships to improve the health of patients, households and communities. A door-to-door community survey will serve as a benchmark for program evaluation. Outcomes to be evaluated include costs, neighborhood indicators, as well as household assessments of health literacy, health behaviors, health care access and utilization, and other health outcomes. Student outcomes will be evaluated by a variety of tools to assess knowledge and skills and attitudes relating to cultural competency, social accountability, and inter-professional team work.
RESULTS
For additional information please contact:
David BrownDepartment of Humanities, Health & SocietyFlorida International University Herbert Wertheim College of Medicine [email protected]
Community Engagement
Community Organizations
Affiliation agreements with 25 organizations
Engagement activities include meeting, presentations, health fairs
Household Recruitment
Households referred by community partners
121 of targeted enrollment of 168 households completed
Academic Partner Development
Development of Household Protocols
Inter-Professional Supervision
Health Professions Core with Multiple Inter-Professional Partners
Curriculum, Medical Records Policies, HIPAA, Evaluation
Joint Curriculum Development
Inter-professional Workshop Held with Seven Disciplines
Shared Classroom Curriculum (Medicine, Nursing, & Social Work)
Benchmark Survey Preliminary Results (Data still being entered)
Multi-method Evaluation
Benchmark Survey
Process Evaluation
Household Outcomes
Student Learning Outcomes
Economic Analysis
Population Based Benchmark Survey
Household Problems
% of Households
Hypertension 80
Diabetes 41
Asthma 28
Obesity 27
Anxiety or Depression
25
Heart Disease 20
Cancer 10
Main Source of Insurance
%
Employer 44
Medicare 25
Medicaid 21
None 10
Other 11