OREGON HEALTH & SCIENCE UNIVERSITY A Creative Approach to Teaching Health Policy: Involving Students in Curriculum Development OREGON HEALTH & SCIENCE UNIVERSITY John Santa MD MPH Evelyn Ford MPH Kathryn Chappelle MA Shawn Blanchard MD William Toffler MD Santa introduces; Evelyn introduces herself and says a few words about OHSU in general

Student-Planned HP Sessions Today’s Outline: Context (Social, Political, School) Initial efforts teaching Health Policy Current approaches—role of students NIH behavioral & social sciences grant Results Current objectives Santa runs through outline

Oregon Context Climate of citizen participation Process oriented state Volunteerism Evelyn does this slide—she is a native Oregonian—emphasizes commitment to process, volunteerism.

Political Context Past Governor: John Kitzhaber, MD Oregon Health Plan/Evidence Multiple public health policy discussions Variation / Wennberg Santa does this slide—builds on Evelyn’s comments

OHSU Context Only medical school in the state Commitment to rural medicine Oregon Evidence-based Practice Center Two-Year Principles of Clinical Medicine curriculum & teaching format Santa does this---as only AMC OHSU has an obligation to provide all sides with a voice in any debate

PCM/Family Medicine Creation of a policy culture Multiple policy leaders, role models in PCM & Department of Family Medicine Department of Human Services Office of Oregon Health Policy and Research Health Services Commission Health Resources Commission Medicaid HMOs Advocacy groups Santa starts this—diverse department—includes public health, preventive medicine, many diverse elements. Evelyn provides a student perspective. Kathy, Bill, Shawn add anything we forget.

Initial Efforts Informal / Ad hoc approach variable number and timing of sessions Student Role primarily passive little involvement or perceived stake Curriculum Presenter-Dependent redundancy, contradictory information, outdated materials Santa does this

Student-Planned Health Policy Sequence 5 sessions, second year, winter term Consistent syllabus development Current readings and web references Consistent student roles and process Consistent approach to speakers Santa does this

Student Process Recruited early in fall term All students in class invited, no favorites 1 student/session ideal (5 total) Identifying topic—most important task Review/develop readings and syllabus Evelyn does this—identifying topic is most important

Facilitator Process Set topic boundaries Suggest: Retain 2-3 best previous sessions based on evaluations Create 2-3 new Suggest: Topic options Presenter options Reading options Confirm speakers. Get commitments. Reassure. Don’t interfere. Santa does this

Student Process (cont) Formal invitations Greet speaker(s) Introduce session and speakers Moderate Q & A Wrap up Critique/Evaluate Evelyn does this

Topics Health Systems Rationing Future of Primary Care Should Oregon Have a Public Hospital Redesigning Practice Quality Improvement---Measurement Obesity Epidemic Santa does this

Examples Kitzhaber session Controversies session Topic Balance Questions—keep faculty quiet (especially me) Santa intros , Evelyn comments

NIH Behavioral & Social Sciences Grant Project Overall PCM “system” approach Improve consistency Integration with other sessions Potential for future Basic Sciences, Clerkship involvement Santa does with Toffler commenting

Challenges Weather Faculty development for small groups Faculty dominating Q & A sessions Integrating health economics Test Questions Santa starts; Evelyn makes comments especially on the test issues

Results Strong evaluations from students and faculty Student appreciation / respect for involvement of their peers Improved “buy-in” by students to relevance of health policy to practice of medicine Good performance on subsequent standardized tests Santa gets discussion going, Evelyn joins in as do others

Current Objectives for Improvement Move from description to analysis Move from anecdote to big picture Integrate economic issues Provide more role models Improve test questions Santa does this with comments from others.