Multiple Perspectives on Designing Longitudinal Behavioral Science Curricula Emilee Delbridge, PhD, LMFT Stephanie Nader, MSW, LCSW, Laura Schaecher, LCSW & Tanya Wilson, MD

No Financial Disclosures to Report

Goals and Objectives Participants will: Identify ways in which Behavioral Science curriculum can be taught across the three years of residency. Gain an understanding of two residencies’ models of longitudinal training. Contribute in small groups in order to create examples of best teaching practices to share with colleagues.

Longitudinal Curriculum: Repeated exposure over time to training that addresses knowledge, skills, & attitudes. No great definition. Vitamin vs immunization shot

Full Longitudinal to Thinking/Wondering about Longitudinal Continuum Exercise Image of line of people

What Behavioral Topic/Training would you like to implement in a longitudinal format? Write down your ideas on Post-Its. 1 idea per post it please Place on larger post it Laura and Stephanie can organize the post – its into 3-5 categories while Emilee and Tanya discuss their curriculum

ACGME & Milestones Interpersonal & Communication Skills Professionalism Patient Care Nothing explicitly required re. longitudinal structure of Bx Sc training. But expectations with specific Milestones expanding on skills, bxs. Ltd research particular to Fam Med (tho psychiatry & IM)

2 Longitudinal Examples Behavioral Science Taught Across Three Years of Residency

Community Health Network 10 – 10 – 10 Community Based Program Fully Longitudinal Curriculum Team Based Structure Behavioral Team Behavioral Faculty Social Workers

Formal Behavioral Education Behavioral Weeks a week each half of every year = 8 half days each year devoted solely to behavioral education (12 whole days through residency) Residents are in teams (residents from each class) Each intern has half day of introduction to behavioral education Behavioral Education also occurs during Didactics Intern Only Time Focus Groups Team Time Intersession Direct Observation in Clinic Review of CGCAPS

Behavioral Activities Behavioral OSCEs (every fall semester) Suicide Assessment, DV, Obesity, Breaking Bad News, Professionalism, Cultural Competency, POST, Agenda Setting Community Outreach Activity Interactive Simulations Domestic Violence, Poverty Live Observation / Videotaping

Behavioral Topics Taught Motivational Interviewing Conflict Management Self Care / Wellness Domestic Violence (adult and teen) Advance Directives/POST Forms/Elder Care Breaking Bad News Management of Outpatient Crisis's Suicidality, Child Abuse, Adult Abuse, Impaired Patients Agenda Setting &Visit Management Common Therapeutic Interventions Management of Difficult Conversations and Sensitive Topics Relationship Effectiveness DiSC Assessment Management of Personality Disorders Feedback

Interdisciplinary Education Warm Hand offs, Crisis management , Management of Difficult Patients Transitions of Care Education Home Visits Team Staffings (interdisciplinary team meetings to manage high need patients)

IU Family Medicine Residency 13-13-13 Academic-based Program Longitudinal Curriculum Core (OP-based Rotations) IP teaching, rounding Explicit/Implicit; Planned/Unplanned

Core Rotations 2 in PGY1; 3 in PGY2; 4 in PGY3 OP Clinics; Bx Sc, Addictions Med, ECG, Opthomology, Practice Mgmt, Public Health, Urology Admin Resident of the Day (ARD) Clinic, Telemedicine Clinic

Core Bx Sc Content PGY1-Core 1 (Orientation/Intro) Psychosocial Assessment Risk Behavior Assessment Mental Health Referrals Handout the Curriculum Overview for Sample Resident & Overview of Bx Sc Content

Core Bx Sc Content PGY1-Core 2 Interpersonal Communication Skills/Motivational Interviewing Human Behavior Change & Stages of Change Handout

Based on Topic of Interest for Development Groups of 3-4 people Group Activity Based on Topic of Interest for Development Groups of 3-4 people

What are the steps of learning & practicing ___? What resources do you have that help residents learn ___? What topic areas can be built on over a year or three years? How can you teach ___ across 3 years? What do 1st years need to know? What should a 2nd year know? What skills should a graduate demonstrate?

Large Group Debrief Each group will share an idea they had for implementing their topic in a longitudinal format?

Emilee Delbridge, PhD, LMFT edelbrid@iupui Emilee Delbridge, PhD, LMFT edelbrid@iupui.edu Stephanie Nader, LCSW snader@ecommunity.com Laura Schaecher, LCSW Lschaecher@ecommunity.com Tanya Wilson, MD wilsotan@iupui.edu