1. 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

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

3. 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

4. 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

5. ~ 15 Exemplars Volunteer Faculty
The “Pyramid”
~ 15 Exemplars Volunteer Faculty
4 RPCT Faculty
> 100 Volunteer Preceptors

6. 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

7. 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

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

10. 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

11. 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

12. Model for Improvement
Institute for Healthcare Improvement

13. 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

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

15. 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

16. 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

17. 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????

18. 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

19. 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

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

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

30. Remember Our Mission