New York Medical College

Problem:

The US Virgin Islands, a mainly African-American community in the Eastern Caribbean, ranks substantially lower than the rest of the United States on numerous MCH care measures. Rigorous studies and the opinion of local health care leaders agree that the lack of educational opportunities in general and continuing education in particular is a significant cause.

Goals and Objectives:

Goal 1: To provide a dynamic learning experience for trainees that makes effective use of distance learning principles and practices. Objectives: a. Create a detailed curriculum for both first and second year of the training program that applies generally accepted principles of adult learning to meeting the stated goals of this program b. Create courseware, including both text and non-text artifacts, that can be re-used with minor modifications for continuing education to health professionals Goal 2: To prepare health professionals who understand the knowledge and practice base of MCH health issues of minority populations (i.e. health disparities) served by all health professionals. Objectives: a. All core trainees and non-core trainees will participate in an extended weekend session that will include discussions of health disparities between the USVI and the mainland and within the USVI (according to sex, ethnicity, location and socio-economic status) b. All core trainees will participate in one synchronous online session devoted to health discrepancies within the USVI Goal 3: To prepare health professionals who have the leadership skills necessary to improve and enhance systems of care for children with disabilities and their families. Objectives: a. Meet 2-3 times per month with their mentor b. Compile a portfolio that includes products of the training activities and documents the trainee’s skills and knowledge and will serve as the basis of trainee evaluation. Goal 4: To prepare health professionals who have the knowledge, skills, and values to work in partnership with families. Objectives: a. Each core trainee will include family centeredness as one of their target competencies in their Individualized Training Plan and will, with faculty advisement, work toward the next level of skill in attaining this competency. b. Each core trainee will complete and report back to the group on two required Leadership Projects: a Family Centered Care Project and a Family Resource Development Project. Goal 5: To prepare professionals who have the knowledge, skills, and values to provide culturally competent health care to children with disabilities and their families. Objectives: a. Each core trainee will include cultural competence as one of their target competencies in their Individualized Training Plan and will, with faculty advisement, work toward the next level of skill in attaining this competency. b. Receive training in cultural competence knowledge and skills included in the core curriculum as part of both extended weekends and conference sessions, and throughout the online curriculum (for instance, in sessions with mentors and asynchronous discussion boards).

Methodology:

We are proposing a three-year project to develop a model distance-learning based continuing education program for MCH professionals in the US Virgin Islands. The first six months will be devoted primarily to preparing a detailed curriculum, obtaining and developing program documents and materials and ensuring an adequate technological infrastructure. The training program itself will last the next 24 months. We will devote the final six months to evaluation, dissemination of results, developing sustainability plans and seeking uses of our model, methods and materials to serve other similar communities. We will include a core group of 12 trainees, 6 for the island of St. Thomas and 6 from St. Croix, who will participate in the entire program as well as approximately 40 non-core trainees who will participate in selected events. All trainees will be licensed health care professionals currently practicing in the USVI. The main instructional components of the program will be (1) Regular online instructional modules We will offer these through a combination of real time sessions offered via a live elearning platform (such as WebEx) and asynchronous self-study and discuss offered via a course management system (Blackboard.) (2) Regular meetings with mentors on the US mainland (via telephone, net meeting software, VoIP system such as Skype or video-conferencing) (3) “Extended Weekend” Sessions These are 15 hour workshops lasting one evening and two days, and focusing on a specific theme such as “cultural competence” or a “family-centered perspective” to be offered face to face. HP 2010 Objectives: The primary Healthy People 2010 goal(s) that the project addresses. 1). Related to Objective 16.23. Increase the proportion of Territories and States that have service systems for Children with Special Health Care Needs to 100 percent. (2). Related to Objective 1.7: (Developmental) Increase the proportion of schools of medicine, schools of nursing, and other health professional training schools whose basic curriculum for health care providers includes the core competencies in health promotion and disease prevention. (3). Related to Objective 23.8: (Developmental) Increase the proportion of Federal, Tribal, State, and local agencies that incorporate specific competencies in the essential public health services into personnel systems. (4). Related to Objective 1.8: In the health professions, allied and associated health professions, and the nursing field, increase the proportion of all degrees awarded to members of underrepresented racial and ethnic groups. (5). Related to Objective 23.9: (Developmental) Increase the proportion of schools for public health workers that integrate into their curricula specific content to develop competency in the essential public health services.

Coordination:

We have worked and will continue to work with the following institutions and agencies in the preparation and development of the proposed project. (See letters of support) University of the Virgin Islands Virgin Islands University Center for Excellence in Developmental Disabilities Department of Health, the US Virgin Islands

Evaluation:

Primary evaluation of the program will consist of two main components: (1) Kirkpatrick’s four-level model of assessing trainee competencies (trainee reaction, content mastery, transfer to work process and results/benefits to larger organization or community) and (2) point by point evaluation of all objectives related to each of the ten stated program goals. We will also create and apply the following measure of success: • An evaluation rubric to measure the curriculum and program learning outcomes with respect to documented continuing education needs of MCH professionals in the USVI • Individual training plans for each core trainee • Use of the distance learning model, of the curriculum and of materials developed for this program for similar distance learning programs in other locations