Ellen Beck, MD University of California, San Diego Addressing the Health Needs of the Underserved Outcomes of a National Faculty Development Program 1999-2009 Ellen Beck, MD University of California, San Diego

GOALS Program Description Participant Demographics Outcomes Future Plans Questions and Answers

The program: Need Need in the nation for underserved health care Need for leadership in underserved health care (Markuns and Culpepper: Academic Medicine, 10/09: A Need for Leadership in Primary Health Care for the Underserved: A Call to Action)

The Program 3 one week blocks over a week with opportunities for followup and continuity Create a national community of leaders in underserved health care

Program Goals Skill Development in: Core faculty development skills Community Partnership and project development skills Professional renewal and rejuvenation

Teaching Strategies included: Presentations from community leaders and health profession leaders Present a model, then practice using the model towards a goal of the group and individuals Site Visits Opportunities for community building and reflection Addressing specific challenges, case-based model Relaxed setting Skills in Personal and Professional Renewal

Core Philosophy Empowerment Humanistic approaches Transdisciplinary Experiential Community as Teacher Adult Learning Model

Needs, Assets, and Solutions Assessment

Participant Demographics Geography Ethnicity Gender Age

Participants Geographic Distribution 32 states including Puerto Rico and Hawaii

Ethnicity of Participants 27% participants-Underrepresented Minorities in the Health Professions

Gender of Participants

Age Range of Participants

Outcomes: Pre-post Change in overall confidence in being able to demonstrate your proficiency in the following skills… Overall change 48.36% 2.62 3.73

Defining Promotora 118% Designing a Promotora Program 123%

Designing a Research Proposal 60% pre-post change Designing a Program Evaluation or Course Evaluation 50% pre-post change

Designing student curricula related to underserved communities

Designing a student or resident-run free clinic project

Outcomes: Programs and Projects

Designing an Occupational and Environmental Health Experience for students or residents 1.44 3.02 109 Developing occupational health/environmental medicine curricula 1.58 2.98 89 Designing a COPC project or educational experience 1.96 3.66 87 Defining COPC 2.09 3.87 85 Designing a Community Medicine Rotation 2.13 3.68 73 Designing a Needs Assessment 2.27 3.73 64 Grant-writing 2.01 3.22 60 Developing community-oriented curricula or programs 2.58 3.83 48 Developing an educational component or experience addressing issues of culture and race 2.52

2003: Outcomes after first 53 participants 7 new or improved student-run free clinic projects 19 new student curricula 30 new resident curricula 21 PI or co-investigator for a grant 35 new leadership roles

National Community: Examples Second generation participant-former student leader now faculty, generations of change agents Fellowships in Underserved Health Care Institute for Street Medicine National Meeting Student-Run Free Clinic Projects Letters for Academic Promotion Networking for Program Development First readers for grant ideas Policy collaboration: HRSA, transdisciplinary models, liability coverage for volunteer health professionals Friendships, colleagueships, mentoring, trusted relationships

Next Steps: Long-term outcomes Advanced Skills Workshops National meeting: on-site and virtual Your thoughts

Learnings and implications of the data Degree of change reflects a need for skill-building in these areas Strategies used: Individually relevant, national in scope Opportunities for reflection and renewal built into the program A trusted group, a safe environment to take risks Problem-solving: cases

Let the community be your teacher.

Thank you! Colleagues, Participants, Community, Staff, particularly, Carol Whitener, Anne Crane, and Kristin Deveraux and students for continuing to inspire us.