1. Collaborative Training In Community, Leadership and Advocacy: Reflections After Year Three Vancouver, British Columbia April 2010

2. Presenters Steve Wrightson, MD Andrea Pfeifle, Ed, PT Maria Boosalis, PhD, MPH, RD, LD

3. GPR Training in Pediatric Advocacy and Care Disparities Ted Raybould, DDS Maria Boosalis, PhD, MPH, RD, LD Baretta Casey, MD, MPH Kathryn Haynes, DMD Andrea Pfeifle, EdD, PT Judy Skelton, PhD Tim Smith, PhD Christi Sporl, MA Nikki Stone, DMD Steve Wrightson, MD

4. Objectives Participants will: –Discuss how health conditions, such as poor oral health and pediatric obesity, are community health issues as well as individual health problems –Understand the importance of providing leadership and advocacy training, especially in terms of community medicine instruction. –Assess and provide feedback on the tools used to teach and assess residents leadership and advocacy knowledge, skills and attitudes.

5. Rationale and Background Poor oral health

6. Rationale and Background Pediatric obesity

7. Interprofessional Education Occasions when two or more students learn with, from and about each other to improve collaboration and the quality of care. - Centre for the Advancement of Interprofessional Education, 2002

8. Principles of IPE Works to improve the quality of care Focuses on the needs of service users and caregivers Involves service users and caregivers Encourages professions to learn with, from, and about each other Respects the integrity and contribution of each profession Enhances practice within professions Increases personal satisfaction - CAIPE, 2000

9. IPE Includes Collaboration Respectful communication Reflection Application of knowledge and skills Experience in interprofessional teams

10. Why IPE? Safety and Quality – All health professionals should be educated to deliver patient-centered care as members of an interdisciplinary team, emphasizing evidence-based practice, quality improvement approaches and informatics. - Quality Chasm. Institute of Medicine, 2001

11. The Evidence for IPE Well received by participants Has the potential to enable learning skills for collaboration Has the potential to enhance practice, improve the delivery of services, and make a positive impact on care Supported by QI through enhanced practice, delivery of services, and pt care Can be effective in a variety of settings. -Reeves et al, 2008 (CIHC)

12. Contributing Theoretical Perspectives Social Learning Theory (Bandura et al.) –People learn from observing others – observation in social settings –Observational learning is influenced by processes of: attention, retention, behavioral, rehearsal, and motivation

13. IPE: Contributing Theoretical Perspectives John Dewey (1939) “All genuine education comes about through experience”. However, this “does not mean that all experiences are genuinely or equally educative”. In fact, some experiences “miss- educate,” in that they actually “distort growth…narrow the field of further experiences…(and place people) in a groove or rut.”

14. Leadership Construct The Five Practices –Model the way –Inspire a shared vision –Challenge the process –Enable others to act –Encourage the heart - Kouzes JM, Posner BZ, Exemplary Leadership, Jossey-Bass Publishing, San Francisco, 2003.

15. Curriculum Components Methods –Lecture/workshop –Leadership inventory –Leadership interview –Advocacy assignment

16. Leadership Interview Current Situation –What are the basic facts about the person’s realm of responsibility and authority? –What opportunities and challenges are facing him or her at present? –How did he or she become a manager/leader? –How much authority does he/she have in the leadership role? –Other questions that defines your leader’s situation. Management Perspectives –What does he/she view as the key traits and behaviors of effective leaders? –What is his/her leadership philosophy? –How does he/she differentiate between a manager and a leader? –Is the leadership role satisfying? Explain. –What is the most difficult leadership decision he or she ever made? –If he or she could revisit a past decision or action, what would he/she do differently?

17. Leadership Interview Leadership Development –What has he/she done to prepare themselves for the leadership role? –What readings have been most influential in his or her development? –What experiences have been most influential? –What does he/she do to maintain their physical and emotional well being? –What recommendations does the interviewee have to a student to develop his or her leadership skills and abilities? –What does he or she see as his/her next leadership challenge? Advocacy –Ask her/him to describe her/his role and responsibilities as an advocate for patients, communities, or other stakeholders.

18. Artifacts from Residents Leadership Interview –Good listener –Does what is asked of her –Role models –Seek and develop skills, not necessarily a natural gift –Learn to work as a team –Physician leader advocates for patients

19. Artifacts from Residents Advocacy Assignments –Identification and communication with state or national legislator –Identification of current bills being discussed Dental screening for preschoolers Physical activity in schools Breast feeding support H1N1 vaccine administration

20. Conclusions

21. Barriers Didactics deemed not “relevant” by some residents

22. Final Thoughts Thank-You