2017 CoP conference program distribution
- 1. Communities of Practice Conference | August 10 – 11, 2017 in Nashville, Tennessee Revised: 8/8/2017 10:31 AM Program Outline Page 1 of 8 COMMUNITIES OF PRACTICE CONFERENCE OVERVIEW Courtyard Marriott – Green Hills Hotel Nashville, TN Meharry Medical College was recently funded by the Health Resources and Services Administration (HRSA) to establish a new academic administrative unit under grant number UH1HP30348. The new center is an academic unit (AU) housed in the Department of Family and Community Medicine at Meharry Medical College through a cooperative agreement with HRSA to evaluate the evidence-base for primary care interventions targeting vulnerable populations to transform primary care training in medical education and clinical practice in Tennessee and within the United States. The goal of the center is to transform primary care training and clinical practice in the United States through curriculum transformation in primary care. For the purpose of this award, HRSA defined vulnerable populations as Lesbian, Gay, Bisexual, Transgender and Questioning (LGBTq), homeless persons, and migrant farm workers. The National Center for Medical Education, Development and Research (NCMEDR) goals are to 1) conduct systems-level research of evidence-based interventions for vulnerable populations to inform primary care training; 2) disseminate best practices and resources to primary care providers and trainees across the mid-South to improve clinical outcomes among vulnerable populations; and 3) establish a community of practice (CoP) that will promote the widespread enhancement and development of a diverse primary care workforce that will produce better health outcomes for LGBT, homeless and migrant worker populations. In addition, this new community of practice will assist the Center in identifying and providing curriculum transformation and innovation. It is anticipated that the CoP will give relevant and timely feedback on the development of toolkits including case studies for simulation, and provide educational models and coaching to primary care faculty to train residents and health professions students to deliver high quality, cost-effective, patient-centered care to vulnerable populations in underserved communities. The Center anticipates by linking clinical knowledge with the expertise of basic, clinical, and social science faculty and community partners in this new Center that we will strengthen capacity for engaging in multi-level, transdisciplinary and inter-professional primary care research and training. It is expected this engagement will assist other medical schools as they develop new curriculum to examine health disparities, health services, health equity, and primary care training from a systems framework using a life course model. Therefore, the charge of the CoP for Vulnerable Populations is to assist us in the development, identification, research, and feedback on the application of new tools in medical education that will enhance teaching and modeling of the provision of health care services to vulnerable populations through feedback and dissemination of ideas on medical education to primary care departments across the United States. The topics for our first year were to: Identify how medical schools are teaching students to address implicit physician bias towards vulnerable populations; and Find out how they are preparing students to introduce preventive measures such as Pre- Exposure Prophylaxis (PrEP) to vulnerable patients in order to prevent HIV. Our second year topics will include how medical schools are teaching students to address: Interpersonal violence across the lifespan; and The effects of adverse childhood experiences in these three vulnerable populations.
- 2. Communities of Practice Conference | August 10 – 11, 2017 in Nashville, Tennessee Revised: 8/8/2017 10:31 AM Program Outline Page 2 of 8 Thursday, August 10, 2017 12:00 PM – 2:00 PM PURPOSE: To acquaint members of the community of practice with the national medical education landscape and to establish common principles and understanding of the current and future work of the Center around medical education development and research and training medical students and residents around ensuring health equity for vulnerable populations. OBJECTIVES: Provide common ground and a starting place for content experts, faculty, and staff of the Center. Introduce a systematic approach to health equity, medical education. Highlight the importance of ethics in developing innovative approaches and tools in primary care training that includes health care delivery and clinical practice. Present current studies and methodologies used for current projects in Years 1 and Year 2. Engage a core of content experts for the National Center over the next four (4) years. 12:00 PM – 12:05 PM Opening & Greetings Veronica Mallett, MD, MMM Meharry Medical College 12:05 PM – 12:10 PM Greetings Millard Collins, MD Meharry Medical College 12:10 PM – 12:15 PM Overview of the National Center for Medical Education, Development and Research & Communities of Practice Patricia Matthews-Juarez, PhD Meharry Medical College 12:15 PM – 12:35 PM Curriculum Transformation and Medical Education in the Age of Teaching Millennials to provide Health Care to Vulnerable Populations Veronica Mallett, MD, MMM Meharry Medical College 12:35 PM – 12:40 PM Overview of Vulnerable Populations & Current Work on Projects including Methodology Paul Juarez, PhD Meharry Medical College 12:40 PM – 12:50 PM The Importance of Training Primary Care Physicians to Provide High Quality Care to Vulnerable Populations :LGBTq, a Community in Search of Health Equity Sharon M. Spencer, PhD University of South Carolina 12:50 PM – 1:00 PM Teaching Ethics as Elements in Medical Education for Vulnerable Populations Rueben Warren, DDS, MPH, DrPH, MDiv Tuskegee University 1:00 PM – 1:10 PM Integrating the Use of PrEP as a Prevention Tool into the Medical Education Curriculum Leandro Mena, MD, MPH University of Mississippi 1:10 PM – 1:20 PM Overview of Current Trends in the Health Care Needs of Homeless Persons: A Need for New Approaches in Medical Education Beth Shinn, PhD (INVITED) Vanderbilt University 1:20 PM – 1:30 PM Examining Current Trends in Providing Health Care for the Migrant Workers: The Importance of Innovation in Clinical Transformation in Medical Education Thomas A. Arcury, PhD Wake Forest School of Medicine 1:30 PM – 2:00 PM Moderated Questions & Answers Rueben Warren, DDS, MPH, DrPH, MDiv Tuskegee University
- 3. Communities of Practice Conference | August 10 – 11, 2017 in Nashville, Tennessee Revised: 8/8/2017 10:31 AM Program Outline Page 3 of 8 2:00 PM – 4:00 PM Content Expert Working Groups on Communities of Practice / Vulnerable Populations SESSION OVERVIEW: This is a hands-on review of the work in Center in Year 1 by the Content Experts. The intent is for the content experts to examine the projects to determine if the work that was done in Year 1 explored and test hypotheses using secondary data to assess the effectiveness of new training curriculum or modalities, clinical interventions, case studies, and health care service delivery models on patient outcomes. OBJECTIVE: To have content experts provide detailed and explicit feedback on the process and outcome to determine the effectiveness of using systems research to promote primary care training for transforming medical education and to predict observable changes in patient outcomes arising from the provision of evidence-based primary care health services. 2:00 PM – 4:00 PM Group 1: LGBTq Group Members (11) Carey Bayer* Joy Hunter Gilbert Nick* Freida Outlaw* Jessica Powell Amandla Ramesh Mindi Spencer* Machell Thompson Steven Wakefield* Rueben Warren* Consuelo H Wilkins Foster Williams Charles Woeppel Robert Lyle Cooper, PhD Meharry Medical College Leandro Mena, MD, MPH University of Mississippi Group 2: Homeless Group Members (12) Tene Franklin Tammy Henderson* Wansoo Im Darlene Jenkins* Janella Melius* Christian Neal Linda Redd Ujjal K Singha Natalie Stevenson Cassandra Ward Suzanne Wenzel* Tiffinie Zellars Matthew Morris, PhD Meharry Medical College Beth Shinn, PhD (INVITED) Vanderbilt University Group 3: Migrant Workers Group Members (12) Stephanie Bailey Katherine Brown Thomas A. Arcury, PhD Wake Forest School of Medicine Paul Juarez, PhD Meharry Medical College
- 4. Communities of Practice Conference | August 10 – 11, 2017 in Nashville, Tennessee Revised: 8/8/2017 10:31 AM Program Outline Page 4 of 8 Elochukwu Ezekakpu Virginia Floyd* Adrienne Hicks Daryl Hood* Oluchukwu Oluoha Michael Paul Mohammad Tabatabai Susanne Tropez-Sims Eszter Volgyi Julia Watson Group 4: Medical Education Group Members (11) Paul Alexander Millard Collins Jacquelyn S Favours Natalie Fleming Digna Forbes Cheryl Holder* Saletta Holloway Cherry Houston Regina Offodile Davis Patterson* Frank A Perry Jr. Armin Weinberg* Zuay Thompson Veronica Mallett, MD, MMM Meharry Medical College Carl G. Streed, Jr., MD Brigham and Women's Hospital 4:00 PM – 6:00 PM Group Interactive Reception by Communities of Practice James E. K. Hildreth, PhD., MD President Meharry Medical College
- 5. Communities of Practice Conference | August 10 – 11, 2017 in Nashville, Tennessee Revised: 8/8/2017 10:31 AM Program Outline Page 5 of 8 Friday, August 11, 2017 7:30 AM – 8:15 AM Breakfast 8:15 AM – 11:30 AM Communities of Practice Working Groups: Review of Year 1 Projects SESSION OVERVIEW: Project 1: Training for Health Care Providers in the Administration of Pre-Exposure Prophylaxis to Men and Transgender Women who have Sex with Men: A Systematic Review This project examined the efficacy of PrEP and Identified best practices in delivery, to MSM and TG persons in the United States. Project 2: Physician Bias Education of Medical Students in providing culturally competent care for Lesbian, Gay, Bisexual and Transgender Patients (LGBT) Populations The research study describes the methodology for establishing an evidence-based curriculum designed to reduce the effects of physician implicit bias among medical students to improve the provision of health care services to LGBT populations. OBJECTIVES: Provide direct feedback and consensus from content experts on the adequateness of the primary care research training process using evidence-based studies and data, methodologies, products and succinct directions on Projects 1 and 2. Determine the effectiveness and efficacy of the studies, results, findings, and products for curricular change in training medical students and residents in treating vulnerable populations using the PCMH model or any other treatment and reimbursement model that focus on continuing quality of care, team building and value-based pricing. 8:15 AM – 11:30 AM Project 1 Robert Lyle Cooper, PhD Meharry Medical College Project 2 Matthew Morris, PhD Meharry Medical College 11:30 AM – 11:45 AM Feedback from the Communities of Practice on the National Survey on Medical Education Curriculum for Teaching Vulnerable Populations SESSION OVERVIEW: Evidence-based studies indicate that there is limited published information about how medical students and residents are taught to provide effective health care services to LGBTq, homeless persons, and migrant workers as vulnerable populations. This survey attempts to query medical schools across the United States about how they are addressing issues of physician bias in training of medical students in the medical education curriculum. OBJECTIVE: To have content experts review the National Survey on Medical Education Curriculum and make recommendations based on evidence-based and experiential information. 11:30 AM – 11:45 AM Facilitator Aramandla Ramesh, PhD Meharry Medical College 11:45 AM – 12:45 PM Communities of Practice Working Lunch: A Marketplace of Ideas SESSION OVERVIEW
- 6. Communities of Practice Conference | August 10 – 11, 2017 in Nashville, Tennessee Revised: 8/8/2017 10:31 AM Program Outline Page 6 of 8 Content experts are encouraged to have lunch while meeting with others to discuss a range of ideas, concepts, and key focus areas for addressing medical education, clinical transformation, and patient- centered care as central building blocks for the National Center. These interactive discussions may suggest strategies that can be applied as a catalyst of curricular changes in medical education and clinical transformation vis a vis vulnerable populations. OBJECTIVES: Explore and share with a lunch partner and/or group 3 ideas, concepts, and/or strategies for changing and implementing curriculum changes, teaching practice and strategies as they apply to high quality of care and health outcomes for vulnerable populations. Share one idea, concept, or strategy with the larger group of Communities of Practice. 11:45 AM – 12:45 PM Facilitator Kermit G. Payne President and CEO 1Joshua Group, LLC 1:00 PM – 2:30 PM NCMEDR Presentation of Year 2 Projects PROJECT 3 Screening and Health Care Services for Vulnerable Populations Exposed to Interpersonal Violence This research project will assess the extent to which medical schools prepare students to address the needs of vulnerable populations exposed to interpersonal violence in primary care settings. It will employ multiple methods to assess current medical school educational practice, identify evidence- based best practices, and develop and recommend curricular modifications, and disseminate information to the broader medical education profession through presentations at professional meetings, policy briefs, and articles in peer reviewed journals. Statement of the problem, gaps in current research. Interpersonal violence (IV) is “the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, that either results in or has a high likelihood of resulting in injury, death, psychological harm, stunted emotional development, or deprivation.1 IV occurs across the life course and threatens the life, health and happiness of thousands of persons each year in the United States. IV encompasses a wide range of incidents from child abuse and neglect by caregivers, youth violence (violence by adolescents and young adults aged 10 to 29 years), intimate partner violence, sexual violence, elder abuse, and gun violence. There is a limited evidence base regarding best strategies in teaching medical students how to screen for and address the needs of vulnerable populations affected by interpersonal violence. It is important that medical students understand and are prepared to take steps to address underlying individual, interpersonal, community and societal-level factors that increase the risk for violence among of vulnerable populations. This research project will assess the extent to which medical students are taught about the needs of vulnerable populations and the skills to screen, care, and refer those exposed to interpersonal violence in primary care. RESEARCH QUESTIONS What is the evidence base regarding education of medical students on screening for interpersonal violence among vulnerable populations for medical students in primary care settings? What are the core elements of the medical educational curriculum that can be revised and adapted to ensure students have the knowledge and skills to provide culturally competent health care for vulnerable populations exposed to interpersonal violence? PROJECT GOALS:
- 7. Communities of Practice Conference | August 10 – 11, 2017 in Nashville, Tennessee Revised: 8/8/2017 10:31 AM Program Outline Page 7 of 8 To identify the extent to which medical students are trained to screen, treat, or refer persons exposed to interpersonal violence across the life course. To develop model curricular elements that can be used by other medical schools to prepare students to effectively address the needs of vulnerable populations exposed to violence. To disseminate research results on how medical schools are addressing ACEs in vulnerable populations to graduate medical education audience. 1:00 PM – 1:15 PM Project 3 Paul Juarez, PhD Meharry Medical College 1:15 PM – 1:45 PM Project 3 Feedback Paul Juarez, PhD PROJECT 4 Screening and Health Care Services for Adverse Childhood Experiences in Vulnerable Populations in Primary Care Settings The aim of this research is to identify and assess the extent to which medical students are taught about adverse childhood experiences (ACEs): screening, treatment, community referrals and their impact on personal health and health disparities in primary care settings. Based on this aim, we pose several research questions to be answered through systematic review of the literature, curricula, and student surveys about how medical schools are preparing students to address the effects of ACEs, with a focus on vulnerable populations. We will disseminate findings through scholarly presentations at graduate medical education conferences and meetings, peer reviewed publications, our community of practice, and a policy brief and provide technical assistance to programs on how to incorporate ACES in their curriculum and respond to the needs of vulnerable populations. Statement of the problem, gaps in current research: Increasingly, studies are showing that adverse childhood experiences (ACEs) influence the health and well-being of a person throughout their lifespan. Yet, there is paucity of information in the literature regarding strategies to teach medical students how to screen for ACEs and be responsive to the needs of vulnerable populations that are impacted by ACEs. While there is a growing body of research that supports a dose-response relationship between number of ACEs experienced during childhood and a range of adverse health outcomes of adulthood, especially among vulnerable populations, relatively little is known about the extent to which medical students are being taught about the effects of ACEs on the health of vulnerable populations, including LGBTQ, homeless persons and, migrant workers, and how to screen for and care for those who have multiple exposures. To date, little systematic attention has been given to ensuring future primary health care providers are trained to screen for ACEs, undertake interventions that can improve long term health outcomes across the life course, or refer patients to community resources that can lead improvements in health and healthcare. RESEARCH QUESTIONS: What evidence exists regarding what and how medical students are being taught about ACEs: what they are, what impact they have across the life course, how they affect vulnerable populations, and what skills they are being taught to help students address them? What are the core elements of the medical educational curriculum that can be revised and adapted to ensure students have the knowledge and skills to provide culturally competent health care for vulnerable populations exposed to ACEs? PROJECT GOALS: To identify the extent to which medical students are trained to screen, treat, or refer persons exposed to ACEs in primary care settings.
- 8. Communities of Practice Conference | August 10 – 11, 2017 in Nashville, Tennessee Revised: 8/8/2017 10:31 AM Program Outline Page 8 of 8 To identify and/or develop model curricular elements that can be used by other medical schools to prepare students to effectively address the needs of vulnerable populations exposed to ACEs. To disseminate research results and curricular modules on how medical schools are addressing ACEs in vulnerable populations to graduate medical education audience. OBJECTIVES: Provide direct feedback and consensus from content experts on the adequateness of the primary care research training process using evidence-based studies and data, and methodologies. Determine the effectiveness and efficacy of the studies, results, findings, and products for curricular change in training medical students and residents in treating vulnerable populations using the PCMH model or any other treatment and reimbursement model that focus on continuing quality of care, team building and value-based pricing 1:45 PM – 2:00 PM Project 4 Robert Lyle Cooper, PhD Meharry Medical College 2:00 PM – 2:30 PM Project 4 Feedback Robert Lyle Cooper, PhD 2:30 PM – 4:00 PM Lessons Learned & Pathway Forward: Communities of Practice Feedback SESSION OVERVIEW: Summative feedback is presented about the direction of the center, the projects, and the products produced to date by the Center. It is anticipated that the Community of Practices will 1) share their opinions, recommendations, and advice; 2) provide guidance; and 3) dissemination findings. OBJECTIVE: Integrate feedback from the Communities of Practice that will improve and enhance Years 1 and 2 projects, products, and infrastructure of the center. Speaker Patricia Matthews-Juarez, PhD Meharry Medical College