Academic Administration Units in Primary Care

Arizona

D54HP05445
Tamsen Bassford, MD
University of Arizona
Department of Family and Community Medicine
1450 N. Cherry Avenue
Tucson, AZ 85719
Tel: 520-262-0266
Email: bassford@u.arizona.edu

In order to improve patients’ access to quality health care, Title VII of the Public Health Service Act focuses on the distribution, diversity, and quality of the health professions workforce. One component of this act targets the establishment and expansion of family medicine departments, and in the years since 1963 the number of medical schools with a family medicine department has increased to 113 out of 124 United States medical schools. The University of Arizona College of Medicine has had a Department of Family and Community Medicine since 1970; the Department now has the unique opportunity to expand its activities substantially to a new Phoenix campus, which will begin training a first-year class in 2006 and over five years increase the entering class size to double its current number. This growth will require expanding the Department’s role and strengthening relationships with community physicians throughout the state. The first objective of this proposal describes the activities that the Department will undertake in response to the University’s plan to establish a new four-year Phoenix campus, which will help improve access to quality medical care for the 16% of the Phoenix population who live below the poverty line. The second objective also responds to the need to improve access to quality health care. With the 2004 publication of the Institute of Medicine’s report Health Literacy, there is increasing recognition of the problem of limited health literacy in the United States. It is estimated that 50% of United States adults have limited literacy and health literacy, preventing them from receiving the same quality of care as those who have good literacy skills. The activities of the second objective will create a new web-based health literacy continuing medical education (CME) program which will first be offered to Department volunteer faculty statewide, and by the third year of the project made accessible to physicians nationwide through a link on the AMA website.

In order to accomplish this overall goal, two objectives are proposed:

To expand the Department by supporting three Phoenix faculties to plan, develop and implement Department activities for all four years of training to be offered at the new Phoenix campus increasing the total number of College of medicine trainees to 250 per year; and
To develop and implement a web-based curriculum for 203 practicing physician on how to address the needs of patients with limited health literacy.

District of Columbia

D54HP05262
Charles P. Mouton, MD, MS
Howard University College of Medicine
Department of Family Medicine
520 W Street, NW, Room 2400
Washington, DC 20059
Tel: 202-806-6300
Email: cmouton@howard.edu

We propose to reorganize and expand the research faculty of the Department of Community Health and Family Practice by developing a Research Core. This new Research Core will focus on (1) developing a chronic disease and epidemiology unit for creative, cross-disciplinary research on health disparities; (2) develop a practice-based research network focused on practices serving a predominantly urban African American population; and (3) developing a biometry unit for statistical support. Cultural competency research training of research personnel, using a Train-the-trainer approach will be integrated throughout the development of this research core. The Department of Community Health and Family Practice (CHFP) at the Howard University College of Medicine (HUCM) has begun a re-organization. The reorganization has resulted in the identification of three departmental operational cores (1) Clinical, (2) Education and (3) Research. The unit, a practice based research network focused on urban, predominantly African American practices, and a biometry unit. This integration will maximize the efficiency of limited Departmental resources through the operation of an integrated unit that can address health disparities research in a meaningful way.

Goal: The objective of this proposal is to integrate the research operations of two previously exiting divisions (Family Practice and Community Health) into a single operational academic Research unit, the Research Core (RC).

Objectives: Train family medicine researchers with the knowledge and skills to:

Achieve a statistically significant increase in the quantity and quality of family medicine research in the Community Health and Family Practice Department;
Achieve a significant increase in the number of research projects funded by the National Institutes of Health (NIH), the Agency for Health Care Quality (AHRQ) and similar Federal agencies; and
Develop an increased number of family physician researchers who can investigate the issues of health disparities of importance to family physicians who deliver care to urban underserved population.

Florida

D54HP05464
Robert Schwartz, MD
University of Miami SOM
Department of Family Medicine
PO Box 016700 (R-700)
Miami, FL 33101-6700
Tel: 305-243-2766
Email: rschwartz@miami.edu

This project will support the Department of Family Medicine & Community Health to impact the quality of care available to minority populations in South Florida who present to community-based primary care practices and community health centers and school-based health centers. We build upon our practice-based research methodology to accomplish specific aims, each of which will contribute to improving the effectiveness of healthcare for a population that is at high-risk for poor healthcare outcomes. The causes of excessive rates of disease in minority populations are multi-factorial and include such systemic problems as lack of health insurance, cultural attitudes and discrimination in the United States. These societal problems have deep historical roots requiring system-wide interventions; however, there are other factors that are more readily impacted at a local level of intervention. These include increasing efficacy for preventing chronic disease among minority adolescents; improving home-based support systems for people with chronic disease to participate in self-care; improving opportunities for community-based minority physicians to benefit from established and high-quality referral systems; helping minority physicians to improve the economic viability of their practices; and supporting quality assessment and improvement activities within systems that are designed to deliver healthcare to low-income patients. In the proposed project, we will pursue these activities within the context of three distinct primary care research platforms, each of which is designed to allow academic investigators to access targeted components of the healthcare system: high-risk adolescents and their families, minority physicians and publicly-financed primary care centers. We propose to restructure our South Florida Primary Care Practice-Based Research Network (SoFla-PBRN) and expand membership in a manner that will stimulate participating physicians to be more attuned to minority healthcare problems. We will increase the responsibilities of the SoFla-PBRN to include practice management support for minority physicians as well as minority healthcare research. We will move beyond the preliminary stage of a network of school health centers by implementing evidence-based school-based disease prevention interventions. Finally, we will test the feasibility of coordinating an on-going, collaborative quality assessment and improvement activity with four of the 12 community-based primary are centers managed by Jackson Memorial Hospital, which are supported by federal funds to provide primary care to medically underserved populations in Miami-Dade County. The effectiveness of each activity will be examined using rigorous research deigns that will afford opportunities to craft compelling cases for on-going institutional support from our partners. Results of all research will be disseminated through manuscript publication and presentation to different professional audiences including primary care researchers, school health officials and public health professionals.

Objectives:

Increase capacity for minority health research within the South Florida Primary Care PBRN;
Expand and evaluate the effectiveness of the Miami-Dade School-Based Disease Prevention and Research Network; and
Test the feasibility of a Community Health Center quality of Care Practice-Based Research Network.

Illinois

D54HP05466
Donald J. Sefcik, DO, MBA
Midwestern University/Chicago College of Osteopathic Medicine
Department of Family Medicine
555 31^st Street
Downers Grove, IL 60515
Tel: 630-515-6045
Email: dsefci@midwestern.edu

The goal of this proposal is to establish essential new resources within the Midwestern University/Chicago College of Osteopathic Medicine’s Department of Family Medicine to create innovative programs including a new curriculum in service learning emphasizing health literacy, health disparities, health promotion/disease prevention, and “Kids into Healthcare Careers,” and will encourage our students to practice in medically underserved areas.

Objectives: We proposed to substantially expand the resources and infrastructure in the Department of Family Medicine, beginning with the development of an Office for Service Learning (OSL) and an Instruction/Assessment Center that will provide resources for curriculum development in service learning and new methods of instruction and assessment for this innovative curriculum. Our objectives are to:

Expand the Community Health Resource Center (CHRC) to include a new Office for Service Learning (OSL) that will support the development of a service-learning curriculum focusing on health care disparities, health literacy, health promotion, and disease prevention, emphasizing minority underserved and other vulnerable populations, and serve as an infrastructure for the development of campus-community partnerships;
Develop an Instruction/Assessment Center within the OSL to assist course directors in developing valid instruction and testing instruments for the new curriculum, focusing on communication skills and other areas not usually assessed by traditional instruments; and
Integrate the new resources of the OSL into all areas of Department of Family Medicine programming, with emphasis on predoctoral students in Introduction to Clinical Medicine (ICM), Practice of Medicine (POM), the Early Clinical Contact Program (ECCP), the service learning elective, and the Spanish Language and Cultural Immersion program, using traditional and web-based methodologies.

Kansas

D54HP05260
Rick D. Kellerman, MD
Kansas University School of Medicine
Department of Family & Community Medicine (DFCM)
1010 North Kansas Street
Wichita, KS 67214-3199
Tel: 316-293-2607
Email: rkellerm@kumc.edu

This project substantially expands the Department’s young, but active Practice-Based Research Network (PBRN) through two strategies by developing it into a major information-exchange and learning tool for medical students, family medicine residents, and community FM volunteer practices through a monthly subscription e-mail survey system and discussion group. This system will regularly sample and discuss the opinions, experiences and concerns of our large community FM faculty group, and then disseminate findings. The second strategy, giving special attention to our frail elderly, is expansion of the PBRN to long-term-care facilities (LTC) and continuing-care retirement communities (CCRC). Recently completed pilot projects in both areas provide sound evidence of need, feasibility, and strong interest from potential participants.

Objectives:

This project establishes a Kansas “Family Medicine Research and Data Information Office” (Kansas FM Radio) to connect over 200 community family physicians with the DFCM through regular web-based surveys and discussions. The office will elicit survey topics and questions relevant to member physicians, design the short and succinct questionnaires (three to five questions-less than five minutes effort by respondents), and send out surveys by e-mail once a month. The projective is to achieve surveys, which though necessarily short, will achieve the quality and relevance through appropriate topics, content, and response rate that merit publication and wide discussion. The findings of the Future of Family Medicine report will be prominent among survey themes.
This project establishes a “Network for Advancing the Care of the Frail Aged”, a research consortium of the DFCM and Larskfield Place Retirement Community as primary providers of project-development resources, and equal numbers (6 to 10 each) of: 1) well-resourced continuing care retirement communities (CCRCs); 2) rural nursing homes (NHs), often isolated and under-resourced; 3) urban NHs with high Medicaid populations and major resource problems. Network members will share resources to identify and prioritize important researchable concerns that have major impact on the quality of life and quality of care of their frail aged residents. They will work closely with their academic partners to design studies that are practical, meaningful, and doable in their facilities. Projects will typically have one of three themes: 1) assessment and enhancement of resident health, function, and quality of life; 2) training of health care providers in the attitudes, knowledge, and skills conducive to excellent care of the frail aged; and 3) optimal administration of programs and institutions for the best care of frail aged residents. FM students, residents, and community faculty will be recruited to take a significant role in each Network project.

Massachusetts

D54HP05467
Larry Culpepper, MD, MPH
Trustees of Boston University
Department of Family Medicine
715 Albany Street-560
Boston, MA 02118-2304
Tel: 617-414-4465
Email: Larry.culpepper@bmc.org

The purpose of this grant is to become a more complex organization with a GOAL to manage a sustainable critical mass of research activity that works in synergy with our clinical and educational activities to develop generalizable knowledge regarding improvements in primary care and family practice, with special emphasis on the needs of underserved and disenfranchised populations.

We will accomplish this goal through the implementation and evaluation of Community Research Partnerships from which we expect to gain research expertise from Community Health Center collaboration and from our School of Public Health and other medical departments. We will implement a model Research Management System to create a critical mass of research activity that works in concert with our clinical and education activities, provides efficient, effective and non-duplicative management of research objectives across grants, and continues to enhance the ability of well-trained, highly motivated family medicine faculty to conduct original research and secure independent funding. Both endeavors will support the development of novel, innovative methods in primary care research, broaden the department’s based of primary care research critical to our minority underserved populations, and support faculty to engage in original research and obtain independent funding.

In responding to the challenge of establishing family medicine departmental structures that support researchers capable of high quality and meaningful research, especially research that responds to the workforce needs and health concerns expressed in Healthy People 2010, it will be critical for departments of family medicine to partner their research faculty with clinical and research colleagues both within and outside the academic community. With increasing success of department of family medicine research endeavors, it will also be critical to establish research management mechanisms that support faculty to maximally focus their efforts on the achievement of research program outcomes and advancement of their research toward the next questions designed to eliminate health care barriers and health disparities and promote the careers of their junior faculty toward independent academic investigators. The overall purpose of this project is to meet these two critical initiatives through the completion of 2 objectives:

Objective 1: To build, implement and evaluate Community Research Partnerships with the HealthNet CHCs, the Boston University School of Public Health, other Boston University School of Medicine Department and the Veterans Administration that will support the development of novel, innovative methods in primary care research, broaden the department’s base of primary care research critical to our minority underserved populations, and support faculty to engage in original research and obtain independent funding; and

Objective 2: To implement a Research Management System to create a critical mass of research activity that works in concert with our clinical and educational activities, provides efficient, effective and non-duplicative management of research objectives across grants, and continues to enhance the ability of well-trained, highly motivated family medicine faculty to conduct original research and secure independent funding.

Michigan

D54HP05264
Gary L. Freed, MD, MPH
The Regents of the University of Michigan
Department of General Pediatrics
3003 South State St.
Ann Arbor, MI 48109-1274
Tel: 734-615-0616
Email: gfreed@umich.edu

The need for more and better trained researchers to address the array of problems in pediatric health services could not be greater. The University of Michigan has a history of encouraging and cultivating independent researchers in the field of health services research. However, it lacks a strong and well-established presence in health services research specifically focused on children. This void reflects the larger health services research environment in which, nationally, the tremendous methodologic advances seen over the past decades disproportionately address issues that affect adult, rather than pediatric, populations.

A critical element in setting the stage for future advances in pediatric health services research is to create “working laboratories” in which to study child health. The proposed expansion of the research infrastructure and faculty of the Division of General Pediatrics is a three-year plan to develop a critical mass of pediatric investigators and create a supportive environment which will facilitate primary care research focused on children. We will accomplish this by providing the research environment required to address a broad range of health services research issues through collaboration among organizational and administrative resources at the University of Michigan, based primarily in the six schools in health sciences (Medicine, Public Health, Social Work, Nursing, Dentistry and Pharmacy). To achieve its goals, the program aims to: (a) recruit and support scholars with a strong commitment to pediatric health services research; (b) stimulate new faculty with mentorship and technical infrastructure to accomplish their work; and (c) create opportunities for socialization in health services and health services research for new faculty.

There are three specific goals of the proposal:

Goal 1: Recruitment of four fellowship-trained, high quality, highly motivated pediatric health services research faculty members over the next three years;

Goal 2: development of a research infrastructure to support multidisciplinary, child-focused health services research; and

Goal 3: The development of clinical components of research infrastructure which are focused on care of medically underserved communities.

D54HP05461
Maryjean Schenk, MD, MS, MPH
Wayne State University
Department of Family Medicine
540 E. Canfield, Room #1102
Detroit, MI 48201
Tel: 313-577-0884
Email: mschenk@med.wayne.edu

The Wayne State University (WSU) Department of Family Medicine (DFM) requests continued funding in order to expand our research infrastructure by developing a focused area of inquiry in Clinical Encounter Communications to Reduce Health Disparities. We are previously funded by HRSA in 1999 and 2002. With the first HRSA grant, we created the Division of Practice Based Research with the DFM. In that grant cycle, we met all our objectives and completed five funded studies. In 2002, we received HRSA funding to build our practice-based research network, MetroNet, a metropolitan Detroit PBRN. We now seek to develop a research focus to further address health disparities, which, due to the large disadvantaged and minority populations in the Detroit area, is a growing problem. African Americans represent over 80% of the Detroit population. As a group, African Americans have higher incidence and mortality rates of many the nation’s top causes of morbidity and mortality, as detailed in the Healthy People 2010.

With this award, we will develop a research focus on the role of clinical encounter communication in health disparities. In the Institute of Medicine’s Unequal Treatment Confronting Racial and Ethnic Disparities in Healthcare, factors at the patient-level, system-level, and clinical encounter-level were identified as contributing to racial and ethnic health disparities. We propose to create a Section of Clinical Encounter Communication Research that will be a collaborative endeavor of researchers from the DFM’s Division of Practice-based Research and the Karmanos Cancer Institute’s Communication and Behavioral Oncology Program.

We propose the following objectives: 1) build a Clinical Encounter Communications Research Section within the Division of Practice-based Research; 2) develop a model for primary care clinical encounter communications research methodology; 3) seek external funding to rigorously test clinical encounter communications research methodology and/or test an intervention for a specific disease; and 4) strengthen and build MetroNet as a resource for testing interventions to improve clinical encounter communication. All objectives relate to expanding the research infrastructure of the DFM and conducting health disparities research in primary care offices in an ethnically diverse metropolitan area.

Minnesota

D54HP05468
Ruth Westra, DO, MPH
University of Minnesota Medical School - Duluth
Department of Family Medicine
1035 University Drive
Duluth, MN 55812-2487
Tel: 218-726-8393
Email: rwestra@d.umn.edu

The University of Minnesota Medical School Duluth provides education and clinical training for medical students who will practice family medicine and other primary specialties in rural Minnesota and American Indian communities. The Department of Family Medicine objectives are designed to strengthen medical student knowledge and skills in the following areas: the culture of rural medicine, leadership and community service, and interprofessional education. The Culture of Rural Medicine Curriculum will increase student knowledge of opportunities and challenges in rural health care delivery by examining the culture of self, others, and community. The curriculum will stress cultural competency skills necessary for effective delivery of patient care to special populations. Business aspects of medicine will be examined to give students the necessary skills to enter a changing rural health care environment. The creation of a RURAL Program (Reaching Out for the Underserved and Special Populations in Rural Communities through a Rural Academy of Leadership), will give students the skills and community service experiences necessary to improve outcomes in community health efforts. The expansion of the Interprofessional Program will provide medical students with the knowledge and skills necessary to effectively work in teams with other health care professionals. Medical, nursing, pharmacy and social work students will collaborate on at risk patient cases to strengthen clinical, quality, and safety knowledge. The objectives will be evaluated by Observed Structured Clinical Exam (OSCE) stations, course evaluations, and community score card.

Objective One: Develop a Culture of Rural Medicine Curriculum to educate medical students on the impact of culture and economics on rural medicine;

Objective Two: Create a Curriculum for the Reaching Out for the Underserved and Special Population in Rural Communities through a Rural Academy of Leadership (RURAL) Program for medical students; and

Objective Three: Expand and enrich the Interprofessional Activities of the medical students.

Missouri

D54HP05442
Margaret A. Wilson, DO
A.T. Still University of Health Sciences (ATSU)
Kirksville College of Osteopathic Medicine (KCOM)
Department of Family Medicine
800 W Jefferson St.
Kirksville, MO 63501-1443
Tel: 660-626-2813
Email: mwilson@atsu.edu

KCOM’s commitment to training generalist physicians is evidenced by the fact that from 1998-2002, 58 percent of its graduates entered into primary care practice. However, in order to prepare family practice physicians to better reduce current barriers to care and eliminate health disparities, the College seeks to significantly enhance the KCOM Department of Family Medicine (FM) by strengthening the knowledge, understanding, and teaching of evidence-based medicine (EBM) as it applies to family medicine clinical practice as well as family medicine research and scholarly activities. Over the three-year grant period, it is anticipated that 7 core family medicine faculty, 60 family medicine regional/precepting faculty, and 540 medical students will be trained in EBM. In addition, 120 interns and family medicine residents in five OPTIK training sites in Missouri and Arizona will be surveyed and trained in EBM principles and concepts. The learner centered activities will combine traditional instructional strategies, including course lectures, labs, small-group discussions, and research projects; with live and technologically innovative asynchronous EBM Best Practice workshops, case studies, and electives as well as on-line teaching aids. Training facilities will include classrooms, labs, and conference rooms on the main campus in Kirksville, as well as five designated clinical training sites in Missouri and Arizona. A system of continuous quality improvement will be employed; and a rigorous three-year evaluation plan, featuring pre-, formative-, and post-test of knowledge, skills, and attitudes will be used to assess programmatic processes and learning outcomes, to quantifiably/qualitatively measure the educational value added through this project.

Objective 1: To train 7 of KCOM’s core Department of Family Medicine faculty plus 60 FM regional/precepting faculty to model evidence-based medicine (EBM) best practices in primary care medical education/research in an effort to advance the teaching of scientific knowledge and practices;

Objective 2: To revise two components within the existing family medicine compete Doctor course and infuse the family medicine clerkships with the basic principles and concepts of EBM, thus impacting 540 first-through fourth-year KCOM students;

Objective 3: To infuse EBM principles and concepts into the clinical training and practice of 120 family medicine interns and residents at the Missouri and Arizona training sites of KCOM’s Osteopathic Postgraduate Training Institute of Kirskville (OPTIK) graduate medical education program; and

Objective 4: To conduct a formative and summative evaluation of the project, including the numbers impacted as well as the level of educational achievement gained under each objective, and widely disseminates the results in national publications/meetings.

New Jersey

D54HP05265
David E. Swee, MD
UMDNJ-Robert Wood Johnson Medical School
Department of Family Medicine
One Robert Wood Johnson Place
New Brunswick, NJ 08903-0019
Tel: 732-235-7655
Email: swee@umdnj.edu

The UMDNJ-Robert Wood Johnson Medical School (UMDNJ-RWJMS) Department of Family Medicine is committed to enhancing the quality of primary care in practices throughout New Jersey. To do this, the department seeks to take its successful track record in cultural diversity and practice improvement research directly to New Jersey primary care practices.

This project will focus on developing and supporting the necessary start-up capacity to design and conduct essential and sustainable quality of care practice based improvement research and training in a network of primary care practices distributed throughout the state of New Jersey. We believe these efforts are essential to respond to New Jersey’s documented existing poor quality of healthcare and will help to facilitate implementation of Healthy People 2010 goals at the local level in communities throughout the state. This proposal builds on previous successful Title VII funding to enhance the research capacity of the department. By undertaking primary care practice improvement research and interventions designed to share the expertise of the Research Division and its collaborators with practicing clinicians, the Division’s quality focused research activities will be leveraged to translate into better patient care for tens of thousand of patients and families cared for by the participating practices and clinicians. In order to accomplish this, a statewide multifaceted quality of care capacity building strategy will be implemented to:

Develop a statewide practice-based quality of care focused research network the New Jersey Primary Care Quality Institute, in support of primary care practices linked to the research division;
Support a critical mass of family medicine researchers focused on the measurement and enhancement of primary care practice quality that includes organized practitioner training and support through learning collaboratives; and
Build the infrastructure necessary to support and sustain network-based quality of care interdisciplinary family medicine and primary care practice improvement research productivity.

New York

D54HP05446
Marc Gourevitch, MD, MPH
New York University School of Medicine
Department of Internal Medicine and General Pediatrics
Bellevue Hospital Center
462 First Ave
New York, NY 10016
Tel: 212-263-8553
Email: marc.gourevitch@med.nyu.edu

Through a collaboration of the Divisions of Primary Care Internal Medicine (PCIM) and General Pediatrics (GP) at NYU School of Medicine (NYU SOM), we propose the creation of a new Academic Administrative Unit (AAU) to study the effects of medical school curricula of primary care competencies on patient outcomes in medically underserved populations. The process will involve: 1) the creation of the Primary Care Medical Education and Outcomes Research (PCMEOR) Unit; 2) improving PC competency of our residency and fellows by initiating new GME curriculum in three subject areas—obesity, substance abuse, and professionalism; and 3) designing and piloting controlled trials of the impact of these educational interventions on patient outcomes using validated instruments. The PCMEOR group will submit for publication to peer reviewed journals findings of our study.

Objectives:

Objective 1: Establishing a Primary Care Medical Education and Outcomes Research (PCMEOR) Unit;

Objective 2: Designing and implementing new PCMEOR GME curricula to the PC trainees; and

Objective 3: Studying the connection between the new curricula and patient outcomes through pilot studies, thereby creating the Database for Research in Education in Academic Medicine (DREAM), the requisite infrastructure needed to house the information linking the two.

D54HP05462
John J. Smucny, MD
State University of New York, Upstate Medical University
Research Foundation of New York
Department of Family Medicine
P.O. Box 9
Albany, NY 12201-0009
Tel: 315-464-7010
Email: Smucnyj@upstate.edu

This project focuses on our efforts to develop the infrastructure as well as the internal resources that will allow the Department of Family Medicine to exist as a competitive research enterprise within the SUNY Upstate Medical University. The development of the research capacity to proactively meet the research component of the institution’s priorities is the focus of this proposal. This proposal outlines our efforts to: 1. increase the research capacity of our department; 2. provide a critical mass of trained and effective researchers; 3. increase the level of external funding that will support research efforts; and 4. develop a sustainable research endeavor building on our demonstrated experience. Through a cooperative effort with the academic departments of psychiatry and surgery and with the support of the Center for Outcomes Research and Evaluation, we will provide support and protected time for up to four (4) family physician faculty to gain the knowledge and skills necessary to become self-sufficient externally funded researchers. The Dean has pledged, as noted in his support letter, an additional 1.0 FTE family physician salary and benefits for the duration of the project.

Objective 1: Establish a cooperative research endeavor with the academic department of Psychiatry in the area of mental health

Objective 1.1: Identify faculty members to participate

Objective 1.2: Establish base core of knowledge and skills

Objective 1.3: Establish cooperative agreement between each faculty and participating department.

Objective 2: Establish a cooperative research endeavor with the academic department of Surgery in the area of bariatrics and related health conditions.

Objective 2.1: Identify faculty members to participate

Objective 2.2: Establish base core of knowledge and skills

Objective 2.3: Establish cooperative agreement between each faculty and participating department.

Objective 3: Establish project specific supportive relationship with the Center for Outcomes Research and Evaluation (CORE)

Objective 4: To implement tracking system to assure efforts remain on track.

D54HP05263
Peter Setwyn, MD, MPH
Albert Einstein College of Medicine
Department of Family and Social Medicine
1300 Morris Park Avenue
Bronx, NY 10461
Tel: 718-920-4678
Email: Selwyn@aecom.yu.edu

This grant’s primary goal is to promote scholarship, aimed at reducing health disparities, by residents and faculty of the Department of Family and Social Medicine (DFSM) at the Albert Einstein College of Medicine (AECOM)/Montefiore Medical Center (MMC). This will be accomplished through two objectives:

Objective 1: Develop an infrastructure to support resident community based research and education projects (Social Medicine Projects), which address racial and ethnic health disparities. This objective will train 30 family practice residents through a structured curriculum and project mentorship, at least 5-10 medical students who will participate in projects and 12 family practice faculty who will be trained as project mentors.

Objective 2: Develop a structured program to support clinician educator faculty in conducting educational scholarship related to health disparities. This initiative will train 20 faculty members in the DFSM in educational and disparities scholarship through faculty development seminars, Medical Education Grand Rounds and a yearly visiting Professorship. Three cohorts of 4 clinician-educator faculty will participate in a intensive Faculty Health Disparities Scholars which will involve an intensive curriculum, bi-monthly seminar and mentorship by senior faculty.

Ohio

D54HP05444
George E. Kikano, MD
Case Western Reserve University School of Medicine
Department of Family Medicine
10900 Euclid Avenue
Cleveland, OH 44106
Tel: 216-844-3791
Email: gek@cwru.edu

The purpose of this project is to expand the research infrastructure of the Department of Family Medicine to include residency-based research, and to provide modes for research development that will benefit other residency programs. Funds are requested to expand our research infrastructure to provide research training and experience for residency faculty and residents. Residency faculty facilitators will be trained to support the development and implementation of residency-based research projects. This proposal includes three objectives. The first is to develop an infrastructure for the purpose of enhancing capacity to conduct research in the residency practice setting. The second is to utilize this infrastructure to design and implement a series of research projects at three residency program. The third is to provide all faculty, residents and selected medical students with enhanced knowledge and skills in clinical research. The first objective will be met by creation of committee of experienced researchers to monitor, troubleshoot, and facilitate resident participation in clinical research plus oversee the training of faculty and research facilitators at each residency program. The facilitators will work with faculty, residents, and students at 3 residency sites to develop research ideas and projects. To meet the second objective, each residency will design and implement two research projects each year and the results and limitations of each study will be shared with the programs. The third objective will be met by utilizing the research projects as opportunities for faculty, residents and students to learn basic research methods, concepts, and analyses. Residents, medical students and residency faculty will learn by participating in research training and by conducting their own research projects. The number of projects, presentations and publications will be reported annually. Together, these objectives will advance the residency setting as a laboratory and infrastructure for expanding primary care research in our department.

This project is designed to provide an infrastructure that will enhance and expand the department’s research and scholarly capabilities. The goals and objectives are as follows:

Objective 1: Establish a Residency-Based Research Network

Goal: To develop an infrastructure for building research capacity within each of three residency programs affiliated with CWRU by developing residency faculty as resources for teaching research to residents and medical students.

Obj 1.1: To establish an experienced Research Facilitation Committee to monitor, troubleshoot and facilitate participation in clinical research at each residency program;

Obj 1.2: To assign one member of the Department’s Division of Research to each residency program for the purpose of training residency faculty and residents in research methods;

Obj 1.3: To train 3 residency faculty members at each residency program to serve as research facilitators for faculty, residents, and medical students clinical research projects; and

Obj. 1.4: To facilitate replication of this approach to building sustainable research capacity at other residency programs by dissemination commonalties observed among the programs.

Objective 2: Implementation of Research Infrastructure.

Goal: To engage the residency-based research infrastructure in the design, conduct, analysis and dissemination of residency-specific research projects.

Obj. 2.1: To solicit ideas and refine research projects within each residency program. Special emphasis will be given to projects that examine relevant cultural diversity issues for that setting;

Obj. 2.2: To use the expertise of the Research Facilitation Committee and the residency research facilitator to design and implement two residency-based research projects per year;

Obj. 2.3: To have the Division of Research analyze the data from all research projects and provide quick feedback of results to each residency program; and

Obj 2.4: To evaluate and share with each residency program the strengths, weaknesses and limitation of the research studies performed.

Objective 3: Enhance Faculty, Resident and Student Research Knowledge and Skills.

Goal: To view research projects as opportunities for faculty, residents, and medical students to learn basic research methods, concepts, analyses and dissemination.

Obj. 3.1: To provide training in concepts and methods important to the research process;

Obj. 3.2: To provide graded research methods workshops each year that are tailored to each residency faculty and geared to the type of clinical research proposed for study;

Obj. 3.3: To involve residents in the research process through participation in the conduct of the research and through participation in monthly meetings involving all citywide projects;

Obj. 3.4: To provide mentoring for medical students conducting primary care research projects as part of the new research requirement of the School of Medicine; and

Obj. 3.5: To gain experience with presenting the results of research projects at national meetings and with writing for publication.

D54HP05447
Vance M. Brown, MD
Cleveland Clinic Lerner College of Medicine
Department of Family Medicine
c/o CCF Strongsville
16761 SouthPark Center
Strongsville, OH 44136-9302
Tel: 440-878-2585
Email: browny@ccf.org

The Cleveland Clinic Foundation (CCF) is an academically oriented non-profit group practice that is now in the process of starting a brand new medical school for 32 students a year, the Cleveland Clinic Lerner College of Medicine. The medical school features a unique curriculum of five years aimed at producing clinician-researchers. Although, many academic departments at the CCF have well established research infrastructures the Dept. of Family Medicine is a young department without a well developed research capacity. The lack of research in Family Medicine at the CCF is a pressing issue with the advent of the Lerner College of Medicine. Grooming new students to become successful clinician-researchers in Family Medicine and Health Services Research is crucial to HRSA’s goal of elimination health care disparities. The Department of Family Medicine at the CCF requests funding for initial establishment of an Academic Administrative Unit. The focus of this project is to develop a research infrastructure which will provide the opportunity to develop research training and experience for faculty research facilitators to help prepare them for the role of managing student research projects. We have identified a research director who will collaborate closely with established research faculty members of the geographically proximal Case Western Reserve University School of Medicine/University Hospitals Department of Family Medicine to provide local support in mentoring for our community based faculty. The project will also feature pioneering efforts to effectively utilize a large database of electronic medical record data for research and utilize a Community Advisory Board and Minority Health Research Nurse to facilitate research initiatives and trainee experiences in our surrounding medically underserved community.

The experience that we gain in these research activities should help us to not only more effectively serve our surrounding community with its high prevalence of individuals who are at substantial risk for negative health outcomes, but also allow us to experience to build a self sustaining infrastructure to train the next generation of clinician researchers. In brief, this is outlined in the following goals and objectives:

Component 1: Developing our Research Infrastructure to meet our needs for student education and community based research.

Goal: To develop a realistic and sustainable research infrastructure which will meet the emergent and unique needs of the CCF Department of Family Medicine as a new academic department of Family Medicine while building the potential of the Department for community based research and collaboration with other investigators.

Objective 1. To develop a Network of Research Facilitators at Family Health Centers who will work with clinical preceptor and medical students to help incubate research ideas and develop these into potential research proposals;

Objective 2: To hire a Research director and research assistant and to train them to work collaboratively with colleagues in General Internal Medicine and our Chief Information Officer to utilize the power of the electronic medical record as a research tool;

Objective 3: To develop a Community Advisory Board (CAB) and Minority Health Research Nurse that interacts with the minority community to help overcome barriers which these communities face to participation in clinical research projects; and

Objective 4: To link the new departmental infrastructure with the established senior researchers and infrastructure of the CWRU/University Hospitals Department of Family Medicine Research Division through a Research Liaison.

Component 2: Utilization of the Research Infrastructure to Develop Research Initiatives in Primary Care and Public Health.

Goal: To utilize the developed research infrastructure to foster and develop research projects in Primary Care and Public Health which are incubated and initiated by students and junior faculty members of the Cleveland Clinic Lerner College of Medicine and mentored by experienced research faculty.

Objective 1: To develop student and junior faculty driven research initiatives in arenas of public health, health utilization patterns, and health risk and behaviors; and

Objective 2: To utilize the emerging infrastructure to carry out research projects which experienced research faculty members have initiated which center on areas of public health, health care utilization, mental health issues in primary care, and health risk behavior, and efficacy of new models of primary care in underserved communities.

D54HP05463
Raymond C. Baker, MD, MEd
Cincinnati Children’s Hospital Medical Center
General Pediatrics
ML 2011, 3333 Burnet Avenue
Cincinnati, OH 45229-3039
Email: Ray.Baker@cchmc.org

The Division of General and Community Pediatrics at the Cincinnati Children’s Hospital Medical Center has a long and exemplary history of training medical students and pediatric residents in the area of pediatric primary care. As an advanced derivative of the faculty development program, clinician educations in the division have developed in collaboration with the University of Cincinnati College of Education an Online Masters Degree in Education for Healthcare Professionals designed to provide the education pedagogy needed to develop careers in medical education and educational research. The purpose of this grant proposal is to develop within the division a Medical Education Research Section (MERS) to advance educational research in the institution, evaluate and validate the educational efforts of the division, and develop innovative educational programs focusing on general pediatrics education to prepare residents for pediatric primary care in the 21^st century. The division has two well established Sections, the Clinical Research Section and the Clinical Services Section, with outstanding histories of funded research and patient care. The MERS will represent a parallel Section that completes the three-part mandate of pediatric medicine: clinical care, research, and education. The division is ideally positioned to develop such a Section due to the availability of a large base of patients from MUCs, a comprehensive faculty development program and masters degree program to develop educators and educational researchers, and existing clinical Research Section with which to share resources and expertise, and a physician and educator with formal training and experience in educational research. The proposal will permit the hiring of three additional faculties to form the core medical education faculty who will have protected time to pursue educational research designed to evaluate and validate innovative educational programs in important areas of public health, pediatric primary care, and cultural competence to eliminate health care disparities. Educational research will focus on changing physician behavior to improve healthcare outcomes by means of educational programs.

This proposal seeks funds for development of the Section, after which it will become self sufficient through other educational funding sources.

Objectives: The primary objectives of this grant application are to 1) substantially expand the CCHMC Division of General and Community Pediatrics by developing a Medical Education Research Section (MERS) as a third academic administrative unit of the division; 2) build a core group of educators with specific training in educational pedagogy and research to more effectively evaluate resident and student education in important public health areas such as environmental health, school health, obesity and asthma; and 3) develop the infrastructure manpower, and educational focus to create a medical education research program which will collaborate with the other two Sections and study teaching effectiveness and strategies in pediatrics which influence physician trainee behaviors in order to produce more culturally sensitive and effective health care delivery to medically underserved and disadvantaged populations and address health care goals of the Healthy People 2010 initiative that affect these populations.

D54HP05465
John M. Pascoe, MD, MPH
Wright State University
School of Medicine
One Children’s Plaza
Dayton, OH 45404
(937) 641-3277
Email: john.pascoe@wright.edu

This project aims to create a new Division of General and Community Pediatrics within the Department of Pediatrics at Wright State University (WSU) with a significant research infrastructure focus to help increase the nation’s primary care research capacity. This will help enable local division faculty clinical investigators make significant contributions to the national primary care research agenda. It also will increase the quantity and quality of division research that addresses Health People 2010, such as health disparities, health literacy, and cultural competence.

Goal One: Strengthen Division of General and Community Pediatrics Research Infrastructure:

Objective A: Increase division faculty and staff with time solely devoted to research. Methodology: The division leaders will further develop the Dayton Primary Care Practice-Based Research Network (DPCPBRN) with the addition of two new faculty: Co-Director for R & D (.3 FTE) and a Division Research Coordinator (.51 FTE).

Objective B: Improve General and Community Pediatrics faculty research skills. Methodology: This objective seeks to increase faculty research skills via two specific activities: 1) mentor individual division faculty; and 2) present two research skills faculty development workshops during each project year.

Objective C: Increase Division of General and Community Pediatrics research productivity. Methodology: As a direct result of increased numbers of faculty/staff with research skills, Division faculty will increase the number of peer-reviewed journal/articles as well as research-oriented presentations.

Goal Two: Strengthen the Dayton Primary Care Practiced-Based Research Network (DPCPBRN):

Objective A: Facilitate Dayton Primary Care PBRN’s growth and development: Methodology: This objective will require two major activities: 1) recruiting new practitioners to the network, which will be conducted by one of the founding members of the DPCPBRN; and 2) increasing contributions made by the DPCPBRN to the Ohio Pediatric Research Consortium (OPRC), which is committed to collaborative research to improve the health of Ohio’s children.

Objective B: Create a new website for the Dayton Primary Care PBRN. Methodology: Efforts will be made to collaborate both network information and project date entry capabilities on a DPCPBRN website.

Goal Three: Develop a Division Program in Childhood Health Disparities Research - Healthy People 2010 (Goal 2 – Eliminate Health Disparities).

Objective A: Enhance division research activities in childhood chronic disease management with a major focus on childhood asthma. Methodology: The Departments of Pediatrics and Family Medicine will collaborate to evaluate pilot data from their current state funded school pilot program in asthma care coordination. These data will be used to further refine this model.

Objective B: Increase division research activities in health literacy – Healthy People 2010 (Focus Area 11 – Health Communication). Methodology: Initial projects will utilize national datasets for analyses of the associations between literacy and health and identify putative mediators of the relationship. A communication workshop for clinicians also will be developed to enhance effective communication during health-related interactions.

Oklahoma

D54HP05259
R. Michael Morse, MD
University of Oklahoma College of Medicine, Tulsa
Department of Family Medicine
9924 E. 21^st Street
Tulsa, OK 74129
Tel: 918-663-6885
Email: Michael-Morse@ouhsc.edu

The Department of Family Medicine at the University of Oklahoma College of Medicine, Tulsa proposes to facilitate the improvement of evidence-based quality care to disadvantaged and at risk groups such as the homeless, uninsured, and low income minority populations as described in Healthy People 2010 via or through the creation of an expanded research infrastructure. This will take the form of a Division of Research within the department which will act as the catalyst for increasing research capacity in the department, supporting new investigators, and improving quality patient care and safety. The department is major a provider of health care to under-served and minority populations in Tulsa County, and has developed special programs to facilitate the care of uninsured patients. The department hopes to better understand how to meet the needs of these groups by developing research programs which focus on issues of health services delivery, access to care, mental health and cultural competency, as products of expanding scholarship in the department. These goals will be facilitated by an existing program for quality assurance and clinical investigation in the department called the Patient Care Project, or PCP. This process uses the electronic medical record system in the department to provide data for required resident projects on which faculty work with resident teams on quality patient care issues designed as research questions. The outcomes from these projects provide feedback to the physicians and can be used to improve care and patient safety as the information from the studies is implemented. This innovative program educates residents and faculty in critical review and understanding of the research process and how it can assist them in providing evidence based, culturally competent care to various populations. This on-going program is one way to ensure the continuation of the research process. The new Division of Research will provide the structure to both support required resident research, as well as expand investigator initiated departmental and collaborative scholarship. In doing so, it provides for an expanded view of professionalism, and will become the engine for student, resident and new investigator training needed to meet the goals of increasing scholarly activity and creating an environment that exemplifies the department’s motto of “Driven by Education, Centered on Patient Care, and Validated by Research”.

Objectives: The department proposes to accomplish this by: 1) creating the Division of Research which will provide the structure needed to increase research capacity and enhance research expertise; 2) emphasis on projects addressing BHPr and HRSA areas of interest, as well as collaboration with other departments; 3) enhancing research education programs for novice faculty investigators which will train them in evaluating the literature and conducting relevant clinical investigations that will lead to cultural competency and improved health care; and 4) establishing a solid framework for future scholarship and evidence based practice by enhancing the research curriculum and program of clinical investigation within the family medicine residency program which will produce a new generation of clinician scholars.

South Carolina

D54HP05448
J. Routt Reigart, MD, FAAP
University of South Carolina
Department of Pediatrics
135 Rutledge Avenue 2^nd floor
P.O. Box 250561
Charleston, SC 29425
Email: Reigartj@cchmc.org

The Division of General Pediatrics, Medical University of South Carolina proposes to substantially expand as an Academic Administrative Unit in order to improve its research and educational activities with the goal of reducing health disparities among the children of South Carolina. It will hire three new faculty members who will devote 50% or more of their time on research dedicated to reducing health disparities among children in South Carolina. This will increase the proportion of General Pediatric Faculty dedication greater than 50% of their time to research by 300%. It will also increase its educational activities in this area by 1.5 FTE faculty members dedicating at least 50% of their time to curricular development and innovation. The Division will develop a Practice Based Research Network (PBRN) carefully preselected to provide the opportunity to conduct highly targeted and carefully selected projects in the area of health disparities and access to care. It will develop replicable methods of improving the care of children suffering from disparities in the availability and provision of health promotion and health care. It will create a rotation for trainees, especially residents and fellows, allowing the opportunity to work in rural communities. During these rotations, trainees will be required to develop research projects or interventions designed to reduce health care disparities. As an intrinsic element of this project, it will increase the knowledge by trainees at all levels of the issues in health are disparities and methods to study and ameliorate these disparities. This project deserves special consideration, as it will prepare researchers and practitioners to provide improved care to underserved children (a vulnerable population) in our state and reduce our enormous health disparities. Perhaps as importantly, it will train our trainees to critically assess the elements that lead to health care disparities and to learn to develop methods to improve the situation. We will endeavor to make a significant impact upon the unacceptable status quo of health care in our state.

Objectives: We have developed carefully selected process and outcome objectives, all designed to help us understand and decrease health care disparities in the children of South Carolina. We propose to expand the research capacity of the division and implement a PBRN with early implementation and conduct of research designed to reduce health disparities. We will endeavor to implement electronic medical records (EMR’s) throughout this network and use these EMR’s as tools to study disparities using common data elements, collection, and processing. We will develop an educational curriculum in health disparities and involve students, residents, and fellows in the educational process. Residents and fellows will be involved in elective activities, research, and interventions in this program to provide them tools that they can utilize in their later careers in Pediatrics to decrease health disparities and improve the care of their patients. In addition to these process-oriented objectives, we believe this project will allow us to demonstrate improved practice methods to reduce disparities, which could be replicated throughout the state of South Carolina and throughout the USA. Carefully designed projects should provide us with strong data to show that we have methods that will make a difference and should be widely adopted by others to reduce disparities. In addition, we believe that these activities can result in overall improvement in the health of children in South Carolina, potentially lifting it out of the bottom of health rankings.

Tennessee

D54HP05443
Jim L. Wilson, MD
Quillen College of Medicine
East Tennessee State University
Department of Family Medicine, Internal Medicine, and Pediatrics
P.O. Box 70621
Johnson City, TN 37614
Tel: 423-439-4683
Email: Wilsonj@etsu.edu

This is a proposal for collaborative development of the primary care research infrastructure in the Departments of Family Medicine, Internal Medicine, and Pediatrics in the James H. Quillen College of Medicine, East Tennessee State University (ETSU). By expanding the research infrastructure currently in a promising infancy in the Department of Family Medicine, we will extend this infrastructure to the other two primary care departments. A multidisciplinary Appalachian Primary Care Research Advisory Committee will oversee the establishment of research interest groups; and develop and implement a research mentoring program, a primary care research seminar series, and research skills building workshops. Protected research time will be provided for junior faculty interested in conducting primary care research. A Primary Care Research core will provide support for research design, data collection and analysis, writing, and seeking funding for research.

In order to meet the College of Medicine’s progressive primary care research agenda, it is now essential to expand a departmental primary care research initiative to the Departments of Internal Medicine and Pediatrics. These two primary care departments currently have inadequate infrastructure to support primary care research, and very little scholarly productivity in that area. The proposed project, developed collaboratively by the three department chairmen and the primary care research director, will provide resources identified in the literature as necessary for conducting primary care research. These resources were also internally validated in interviews with potential primary care researchers in these departments as currently lacking in the institution. We anticipate that 40 junior faculty members and experienced primary care researchers will participate in one or more project-related activities. In addition, 30 summer research medical students and 13 students or fellows will conduct primary care projects in collaboration with participating faculty.

Under the direction of the primary care research director, the Family Medicine Research Division will become the Primary Care Research core that will provide support for all phases of the project and individual faculty research. These groups will promote primary care research through the accomplishment of two objectives:

Objective 1: To strengthen the primary care research skills and productivity of generalist faculty members from the Departments of Family Medicine, Internal Medicine, and Pediatrics by providing a more focused, collaborative research environment comprised of an interdisciplinary mentoring, training, and skills building program in primary care research; and

Objective 2: To provide three junior faculty members, one each in Family Medicine Internal Medicine, and Pediatrics, with skills and resources to enable them to build a dynamic primary care research program in Appalachia, leading to publication in peer reviewed journals and successful competition for extramural funding.

D54HP05469
Roger Zoorob, MD, MPH
Meharry Medical College
Department of Family and Community Medicine
1005 Dr. D.B. Todd Boulevard
Nashville, TN 37208-3599
Tel: 615-327-6438
Email: rzoorob@mmc.edu

Meharry Medical College (MMC) is the largest private, comprehensive, historically black college for educating health care professionals and scientist in the U.S.

The overall purpose of the project is to implement a substantial expansion the department of family and community medicine. This will include clerkship expansion, increase faculty numbers, and enhance community based research and practice.

The aim of this proposal is responsive to the second goal of Health People 2010: to eliminate health disparities among segments of the population, including differences that occur by gender, race or ethnicity, education or income, disability, geographic location, or sexual orientation. The communities served by the department clinics and its affiliates experience some of the most disparate health outcomes found locally, statewide, and nationally. The state of Tennessee was recently ranked 48^th among states on an overall measure of health status. Within Tennessee, the most disparate health outcomes are experienced by low income, minority populations in large urban areas. The focus of this project also supports the following priorities of the TN Office of Minority Health including: to facilitate coalitions directed toward healthy communities, support recruitment of minority health professionals, and to emphasize improvement and focus of minority health research data.

Objectives:

Increase the third year family medicine clerkship from 4 weeks to 6 weeks, add new preceptor sites, enhance faculty development for preceptors and increase the number of faculty;
Develop a community based departmental research infrastructure with a focus on health care disparities and behavioral change; and
Create a clinical unit that focuses on family and community based care, wellness, health promotion and collaborative team care.

Utah

D54HP05258
Michael K. Magill, MD
University of Utah School of Medicine
Department of Family and Preventive Medicine
Department of Pediatrics
50 North Medical Drive
Salt Lake City, UT 84132
Tel: 801-585-6940
Email: Michael.Magill@hsc.utah.edu

The need for more research devoted to primary care practice and conducted by primary care researchers has been long known and well documented in the literature. The obstacles to primary care research are also well known to the field. It is however, critical that primary care academicians overcome these obstacles and conduct research focused on improving our Nation’s primary care. Some of the known obstacles to primary care research at the University of Utah and elsewhere are:

Little available funding for primary care research infrastructure;
Lack of a critical mass of colleagues with similar interests;
Few experienced primary care research mentors; and
Difficulties in developing a research culture among busy clinician faculty.

Our collective experience has shown that primary care researchers can be successful if these problems are addressed, and the faculty member has the necessary infrastructure support, the advice and support of research colleagues and mentors, and the encouragement of their academic culture to pursue their research goals.

The research infrastructure needs of family medicine and general pediatrics are similar and there are several ingredients present to suggest a collaborative approach to our research development efforts will be successful. These include the 1) amicability of the two disciplines at the Health Sciences Center; 2) similar interests in the further development of research; and 3) successful collaboration in medical student education and in joint research efforts.

Project Goal: Expand primary care research, especially research related to BHPr and Health People 2010 priority areas and objectives, through the creation of a collaborative, multidisciplinary, Primary Care Research Center.

Project Objectives:

Through a combination of grant and institutional support, establish a Primary Care Research Center (PCRC) at the University of Utah Health Sciences Center;
Provide the necessary research infrastructure, promote cross-disciplinary collaboration, and develop a PCRC-based primary care research culture; and
Support the development and submission of research grants, and especially those related to BHPr and Health People 2010 priority areas and objectives, to sustain and expand PCRC activities over time.

Virginia

D54HP00040
John B. Shorling, MD, MPH
University of Virginia
Department of General Internal Medicine
UVA Health System Box 800744
Charlottesville, VA 22908
Tel: 434-982-3458
Email: Jbs7f@virginia.edu

This grant proposal plan to implement a Web-based information system, Systems and Practice Analysis for Resident Competencies (SPARC), will use data from internal medicine residents’ own patient panels to facilitate practice-based improvement, self-assessment, and faculty evaluation of resident performance. Residents will be able to view the utilization data, and preventive medicine information on their patient panel. Many of the necessary building blocks for such a system are already in place, including a comprehensive enterprise-wide data warehouse, prior experience in prototyping an information system to support resident learning, and an existing curriculum in which to optimally structure use of the proposed tool. They will evaluate this system’s utility as both a teaching tool and a tool for faculty assessment of resident performance. This project will be a supplemental award to our current AAU grant and will support our efforts to establish a model ambulatory curriculum to address the new ACGME competencies of Practice-Based Learning and Improvement (PBLI) and Systems-Based Practice (SBP). This curriculum uses chronic illness care for medically underserved populations and patient safety and improvement methods as the content areas. The need for an outstanding residency training curriculum that addresses these topics has become even more urgent, both locally and nationally, since we submitted our original proposal. In addition to the information system, they are requesting additional support for pilot research projects in medical education related to these competencies.

Objectives:

Create SPARC, an easy-to-use, clinically relevant information system that allows residents to achieve competence in Practice-Based Learning and Improvement (PBLI) and Systems-Based Practice (SBP) activities and that allows faculty to better assess resident competence in these areas;
Integrate SPARC into the 2^nd and 3^rd years of our existing internal medicine residency curriculum, allowing learners to effectively and efficiently (a) identify areas for improvement within their own practice; (b) create and implement an action plan to modify their practice; and (c) reassess their practice to examine the impact of their plans; and
Fund pilot educational research projects related to these new ACGME competencies which have a high likelihood of attracting extramural funding.

Washington

D54HP05261
Alfred O. Berg, MD, MPH
University of Washington
Department of Family Medicine
1959 NE Pacific Street
Seattle, WA 98195-6390
Tel: 206-543-3101
Email: aberg@u.washington.edu

The goal of this project is to develop an Underserved Pathway within the University of Washington School of Medicine, administered by the Department of Family Medicine, supporting medical student and resident experiences in underserved communities and with underserved populations. The pathway will match interested trainees with mentors, organize exiting programs, and develop new programs, courses, and rotations to provide access, support, and academic rigor to a focus on the underserved. The Department will establish a mentor recruitment and training process for physicians working with underserved communities and populations. Interested trainees will be matched with suitable mentors for counseling over the course of their training. Two medical student courses will be developed: a sub-internship focused on working in underserved community clinical settings, and a course focused on experiences with community-based organizations working with underserved groups. These will be combined with existing non-credit experiences to provide an array of available options for the students. The required scholarly activity (Independent Investigative Inquiry) in the School will be adaptable so that interested students will be able to complete a project focusing on underserved issues. Residency experiences will be developed so that residents in the WWAMI (Washington, Wyoming, Alaska, Montana, Idaho) network can complete rotations in underserved clinical and community-based organization setting. Trainees will be able to complete the Underserved Pathway by establishing a mentor relationship, completing one of the pathway courses, and completing a research project focusing on underserved issues. All of the training, courses, available experiences, and evaluation will be integrated with a Web tool that will make the information accessible and facilitate enrollment and evaluation.

The proposal has three objectives:

Creating an Underserved Pathway within the structure of the University of Washington School of Medicine;
Establishing a web-based infrastructure to publicize, coordinate and evaluate this pathway; and
Developing mentorship training and support.