Joe Florence, M.D. Jim Shine, M.D. Bruce Bennard, Ph.D. Providing Comprehensive Faculty Development to Community-based Faculty Using Continuous Quality Improvement Joe Florence, M.D. Jim Shine, M.D. Bruce Bennard, Ph.D. Department of Family Medicine Quillen College of Medicine East Tennessee State University

Lecture-Discussion Presentation for: 33rd Annual Predoctoral STFM Education Conference January 27, 2007 Memphis, TN

Session Objectives: Describe Community Preceptor Advisory Group and faculty development program. Describe Rural Primary Track Program taught by community faculty Explain QI process as related to our faculty development program. Provide first hand account of community physician “development” as faculty Answer questions and solicit audience input

Faculty Development and the Community Preceptor Advisory Group Community faculty play significant role in our Department Role has increased over 10 years due to curricular change/expansion (RPCT) Community-based faculty and preceptor involvement in programs increasingly varied

~ 15 Exemplars Volunteer Faculty The “Pyramid” ~ 15 Exemplars Volunteer Faculty 4 RPCT Faculty > 100 Volunteer Preceptors

RPCT Faculty - 2 each in Rogersville and Mountain City EXEMPLARS - mostly rural based – they go beyond precepting – i.e. host health fairs, travel to campus for panels, special programs PRECEPTORS – Tri-cities based, some rural, take students one week or less

Community Preceptor Advisory Group RPCT and Exemplars Meet with faculty-health professions leaders once a year (5 meetings to date) Advise Department /COM on community-based education Raise and respond to issues “What’s new in medical school curriculum” Involved in planning Sessions deliberately informal/ under planned

Dr. Bruce Bennard – established Advisory Group Dr. Jim Shine – member of Advisory Group Dr. Joe Florence – regular attendee of Advisory Group

ETSU Mission/ Institutional Purpose University pursues partnerships… … with emphasis on community-based and interdisciplinary education …special emphasis on addressing the needs of Southern Appalachia in the area of rural health care

The Quality Improvement Process The model has two parts: Three fundamental questions, which can be addressed in any order The Plan-Do-Study-Act (PDSA) cycle to test and implement changes in real work settings. The PDSA cycle guides the test of a change to determine if the change is an improvement Institute for Healthcare Improvement

Model for Improvement Institute for Healthcare Improvement

Goals of Rural Primary Care Track at ETSU since 1992 Characteristics A curricular experience that is efficient, consistent and adds value for health professions students Oriented first to student learning Continuously improving with new ideas, people and health issues Key elements Community-based learning Experiential learning Interdisciplinary Community partnerships

ETSU Quillen College of Medicine Rural Primary Care Track 2006 - 2007

Give – Get of Faculty Development Rural Faculty Time Experience Mentorship for students Relationships with faculty Understanding of community needs and resources New Knowledge New Skills Relationships Identity with the university University Faculty Consultants Dollars (Grants) “All purpose” community faculty Community faculty buy in Representation in community

Typical Faculty Development Issues from the University’s Viewpoint Pedagogy: Case Oriented Learning (COL) OSCE Blackboard Content Community Diagnosis/ Assessment Community Based Participatory Research Evidence Based Medicine Medical Literature Data Bases and search techniques Care Model/ Quality Improvement IRB

Typical Faculty Development Issues from the Rural Faculty Viewpoint Course Curriculum – What do you want me to teach? Best Pedagogy for teaching What are the Resources from campus How do I get the university to address what is really needed? Personal agenda – I want to know more about????

Role of the Rural Community-based Faculty Crucial to success Must establish a learning environment where students take more responsibility for their own learning and the learning of others Ideally, the faculty uses facilitation skills as a coach

Attributes of Competent Faculty Competence is a habit Health care is a cooperative art; performance occurs in relationships; competence in relationships Competence is developed along a continuum Knowing the rules is not enough; values are important Adapted from “Residency Training and Systems Based Practice” (2004) David C. Leach, MD, Exec Director ACGME

PDSA = People Doing Something Awesome! Quality Improvement PDSA = People Doing Something Awesome!

Dr. Jim Shine’s Story How I got to Mountain City What am I doing there What keeps me going

Remember Our Mission