BUILDING HEALTH WORKFORCE CAPACITY
THROUGH COMMUNITY-BASED
HEALTH PROFESSIONAL EDUCATION
WORKSHOP SUMMARY
Patricia A. Cuff, Rapporteur
Global Forum on Innovation in Health Professional Education
Board on Global Health
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
THE NATIONAL ACADEMIES PRESS
Washington, D.C.
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
NOTICE: The workshop that is the subject of this workshop summary was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.
This activity was supported by contracts between the Academic Consortium for Complementary and Alternative Health Care, the Academy of Nutrition and Dietetics, the Accreditation Council for Graduate Medical Education, the Aetna Foundation, the Alliance for Continuing Education in the Health Professions, the American Academy of Family Physicians, the American Academy of Nursing, the American Association of Colleges of Nursing, the American Association of Colleges of Osteopathic Medicine, the American Association of Colleges of Pharmacy, the American Association of Nurse Anesthetists, the American Association of Nurse Practitioners, the American Board of Family Medicine, the American Board of Internal Medicine, the American College of Nurse-Midwives, the American Congress of Obstetricians and Gynecologists/American Board of Obstetrics and Gynecology, the American Council of Academic Physical Therapy, the American Dental Education Association, the American Medical Association, the American Occupational Therapy Association, the American Psychological Association, the American Society for Nutrition, the American Speech-Language-Hearing Association, the Association of American Medical Colleges, the Association of American Veterinary Medical Colleges, the Association of Schools and Colleges of Optometry, the Association of Schools and Programs of Public Health, the Association of Schools of the Allied Health Professions, the Atlantic Philanthropies, the China Medical Board, the Council of Academic Programs in Communication Sciences and Disorders, the Council on Social Work Education, Ghent University, the Josiah Macy Jr. Foundation, Kaiser Permanente, the National Academies of Practice, the National Association of Social Workers, the National Board for Certified Counselors, Inc. and Affiliates, the National League for Nursing, the National Organization of Associate Degree Nursing, the Physician Assistant Education Association, the Robert Wood Johnson Foundation, the Society for Simulation in Healthcare, the Uniformed Services University of the Health Sciences, the University of Toronto, and the Veterans Health Administration. The views presented in this publication do not necessarily reflect the views of the organizations or agencies that provided support for the activity.
International Standard Book Number-13: 978-0-309-31387-2
International Standard Book Number-10: 0-309-31387-2
Additional copies of this workshop summary are available for sale from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.
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Copyright 2015 by the National Academy of Sciences. All rights reserved.
Printed in the United States of America
The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.
Cover photo © 2014 Maria Revlon De Los Reyes, courtesy of Photoshare. Two children in the Aeta communities in Subic, Zambales, Philippines, travel to collect clean water with a 5-gallon water jug because the water from their area is polluted.
Suggested citation: IOM (Institute of Medicine). 2015. Building health workforce capacity through community-based health professional education: Workshop summary. Washington, DC: The National Academies Press.
“Knowing is not enough; we must apply.
Willing is not enough; we must do.”
—Goethe
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
Advising the Nation. Improving Health.
THE NATIONAL ACADEMIES
Advisers to the Nation on Science, Engineering, and Medicine
The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.
The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. C. D. Mote, Jr., is president of the National Academy of Engineering.
The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Victor J. Dzau is president of the Institute of Medicine.
The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. C. D. Mote, Jr., are chair and vice chair, respectively, of the National Research Council.
PLANNING COMMITTEE FOR SCALING UP BEST PRACTICES IN
COMMUNITY-BASED HEALTH PROFESSIONAL EDUCATION1
WARREN NEWTON (Co-Chair), American Board of Family Medicine
SUSAN SCRIMSHAW (Co-Chair), The Sage Colleges
VIRGINIA ADAMS, National League for Nursing
GILLIAN BARCLAY, Aetna Foundation
KATHRYN KOLASA, Academy of Nutrition and Dietetics
DONNA MEYER, National Organization for Associate Degree Nursing
STEPHEN C. SHANNON, American Association of Colleges of Osteopathic Medicine
Consultant
MARIETJIE DE VILLIERS, Stellenbosch University
_____________
1 Institute of Medicine planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteur and the institution.
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GLOBAL FORUM ON INNOVATION IN HEALTH
PROFESSIONAL EDUCATION1,2
JORDAN COHEN (Co-Chair), George Washington University
AFAF MELEIS (Co-Chair), University of Pennsylvania
KENN APEL, Council of Academic Programs in Communication Sciences and Disorders
CAROL ASCHENBRENER, Association of American Medical Colleges
GILLIAN BARCLAY, Aetna Foundation
MARY BARGER, American College of Nurse-Midwives
TIMI AGAR BARWICK, Physician Assistant Education Association
GERALDINE BEDNASH, American Association of Colleges of Nursing
CYNTHIA BELAR, American Psychological Association
JOANNA CAIN, The American Board of Obstetrics and Gynecology/The American College of Obstetricians and Gynecologists
LINDA CASSER, Association of Schools and Colleges of Optometry
LINCOLN CHEN, China Medical Board
MARILYN CHOW, Kaiser Permanente
ELIZABETH CLARK, National Association of Social Workers
THOMAS CLAWSON, National Board for Certified Counselors, Inc. and Affiliates
DARLA SPENCE COFFEY, Council on Social Work Education
JAN DE MAESENEER, Ghent University
MARIETJIE DE VILLIERS, Stellenbosch University
JAMES G. Fox, Association of American Veterinary Medical Colleges
ROGER GLASS, John E. Fogarty International Center
ELIZABETH (LIZA) GOLDBLATT, Academic Consortium for Complementary and Alternative Health Care
YUANZHI GUAN, Peking Union Medical College
NEIL HARVISON, American Occupational Therapy Association, Inc.
DOUGLAS HEIMBURGER, American Society for Nutrition
JOHN HERBOLD, National Academies of Practice
ERIC HOLMBOE, Accreditation Council for Graduate Medical Education
PAMELA JEFFRIES, Johns Hopkins University School of Nursing
RICK KELLERMAN, American Academy of Family Physicians
KATHRYN KOLASA, Academy of Nutrition and Dietetics
JOHN (JACK) KUES, Alliance for Continuing Education in the Health Professions
_____________
1 Institute of Medicine forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published workshop summary rests with the workshop rapporteur and the institution.
2 This is the list of Forum members as of May 2, 2014.
MARYJOAN LADDEN, Robert Wood Johnson Foundation
LUCINDA MAINE, American Association of Colleges of Pharmacy
BEVERLY MALONE, National League for Nursing
MARY E. (BETH) MANCINI, Society for Simulation in Healthcare
LEMMIETTA G. MCNEILLY, American Speech-Language-Hearing Association
DONNA MEYER, National Organization of Associate Degree Nursing
FITZHUGH MULLAN, George Washington University
WARREN NEWTON, American Board of Family Medicine
LIANA ORSOLINI, Bon Secours Health System, Inc.
BJORG PALSDOTTIR, Training for Health Equity Network
RAJATA RAJATANAVIN, Mahidol University
SCOTT REEVES, University of California, San Francisco
ELENA RIOS, National Hispanic Medical Association
KAREN SANDERS, Veterans Health Administration
MADELINE SCHMITT, American Academy of Nursing
NELSON SEWANKAMBO, Makerere University College of Health Sciences
STEPHEN SHANNON, American Association of Colleges of Osteopathic Medicine
SUSAN SKOCHELAK, American Medical Association
HARRISON SPENCER, Association of Schools and Programs of Public Health
RICHARD (RICK) TALBOTT, Association of Schools of the Allied Health Professions
GEORGE THIBAULT, Josiah Macy Jr. Foundation
JAN TOWERS, American Academy of Nurse Practitioners
RICHARD (RICK) W. VALACHOVIC, American Dental Education Association
SARITA VERMA, University of Toronto
PATRICIA HINTON WALKER, Uniformed Services University of the Health Sciences
SHANITA WILLIAMS, Health Resources and Services Administration, U.S. Department of Health and Human Services
KELLY WILTSE NICELY, American Association of Nurse Anesthetists
HOLLY WISE, American Council of Academic Physical Therapy
XUEJUN ZENG, Peking Union Medical College
BRENDA ZIERLER, University of Washington
SANJAY ZODPEY, Public Health Foundation of India
IOM Staff
PATRICIA A. CUFF, Senior Program Officer
MEGAN M. PEREZ, Research Associate
SAMANTHA D. BROWN, Senior Program Assistant
HANNAH PRESS, Intern
CHRISTINE CLARK, National Academies Christine Mirzayan Science Technology Policy 2014 Fellow
JULIE WILTSHIRE, Financial Officer
ROSALIND GOMES, Financial Associate
PATRICK W. KELLEY, Senior Board Director, Board on Global Health
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Reviewers
This workshop summary has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published workshop summary as sound as possible and to ensure that the summary meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this workshop summary:
TARA CORTES, New York University
ZOHRAY MOOLANI TALIB, George Washington University
BETH VELDE, East Carolina University
PAUL WORLEY, Flinders University School of Medicine
Although the reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the workshop summary before its release. The review of this workshop summary was overseen by BOBBIE BERKOWITZ, Columbia University School of Nursing. Appointed by the Institute of Medicine, she was responsible for making certain that an independent examination of this summary was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this workshop summary rests entirely with the rapporteur and the institution.
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Acknowledgments
Two landmark reports set in motion the idea for establishing a global forum to provide a neutral platform for ongoing dialogue among health professionals that could be the catalyst for needed reforms in health and educational systems around the world. Both of these reports—Health Professionals for a New Century (Frenk et al., 2010) and The Future of Nursing (IOM, 2011)—emphasized the importance of community-based health professional education. The Lancet Commission report described curricular innovations from the 1960s, 1970s, and 1980s that broadened “the continuum from classroom to clinical training through earlier student exposure to patients and an expansion of training sites from hospitals to communities” (p. 20). Likewise, the Institute of Medicine (IOM) Committee on the Future of Nursing explained that “an improved education system is necessary to ensure that the current and future generations of nurses can deliver safe, quality, patient-centered care across all settings, especially in such areas as primary care and community and public health” (p. 6).
These reports laid the foundation for the establishment of our IOM Global Forum and further confirmed for us the immense importance of learning from and with communities. It was therefore our great delight when the members of our Global Forum voted to host a workshop on this topic of community-based health professional education. Through the keen insight of the workshop planning committee, a robust agenda was developed and carried out. We thank the workshop planning committee co-chairs, Warren Newton and Susan Scrimshaw, for their leadership in this endeavor, and we thank the planning committee members, Virginia Adams, Gillian Barclay, Kathryn Kolasa, Donna Meyer, and Stephen Shannon, for
their support throughout the workshop. We also thank the consultant to the committee, Marietjie de Villiers. Such a wonderful event could not have happened without the keen dedication of the IOM staff of the Global Forum, including Patricia Cuff, forum director; Megan Perez, research associate; and Samantha Brown, senior program assistant. A special thank you goes to Patrick Kelley for envisioning and establishing the Global Forum. And most important, we must acknowledge our deep appreciation to the 45 sponsors and 61 members of the Global Forum on Innovation in Health Professional Education that make it possible for us to host events like the workshop described in this report.
Jordan Cohen, Forum Co-Chair | Afaf Meleis, Forum Co-Chair |
REFERENCES
Frenk, J., L. Chen, Z. A. Bhutta, J. Cohen, N. Crisp, T. Evans, H. Fineberg, P. Garcia, Y. Ke, P. Kelley, B. Kistnasamy, A. Meleis, D. Naylor, A. Pablos-Mendez, S. Reddy, S. Scrimshaw, J. Sepulveda, D. Serwadda, and H. Zurayk. 2010. Health professionals for a new century: Transforming education to strengthen health systems in an interdependent world. Lancet 376(9756):1923-1958.
IOM (Institute of Medicine). 2011. The future of nursing: Leading change, advancing health. Washington, DC: The National Academies Press.
Contents
Summary: Understanding the Community Context of Health
4 Community-Based, Interprofessional, Educational Innovations
B Abstracts of the May 2, 2014, Webcast Session
C Abstracts of the May 1, 2014, Poster Session
D Summary of Updates from the Innovation Collaboratives
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AACN | American Association of Colleges of Nursing |
AAMC | Association of American Medical Colleges |
ACCAHC | Academic Consortium for Complementary and Alternative Health Care |
ACGME | Accreditation Council of Graduate Medical Education |
ADEA | American Dental Educational Association |
AFHCAN | Alaska Federal Health Care Access Network |
AIDS | acquired immunodeficiency syndrome |
AMA | American Medical Association |
ANMC | Alaska Native Medical Center |
ASCO | Association of Schools and Colleges of Optometry |
ASPPH | Association of Schools and Programs of Public Health |
ATSU | A.T. Still University |
BCH | Brampton Civic Hospital |
BNTC | Brampton Naturopathic Teaching Clinic |
CAHPS | Consumer Assessment of Healthcare Providers and Systems |
CARES | Community Aid, Relief, Education, and Support Clinic |
CBE | community-based education |
CCL | Collaborative Change Leadership Program |
CDC | Centers for Disease Control and Prevention |
CHANNELS | Community, Health, Access, Network, Navigate, Education, Leadership, Service |
CHAP | community health aide/practitioner |
CHC | community health center |
CHOW | community health outreach worker |
CHW | community health worker |
CIHLC | Canadian Interprofessional Health Leadership Collaborative |
CIO | critical incident officer |
COPC | community-oriented primary care |
ECU | East Carolina University |
FQHC | Federally Qualified Health Center |
GLLU | Gay and Lesbian Liaison Unit |
GW | George Washington University |
HELP | Health Education Leadership Program |
HIE | health information exchange |
HIV | human immunodeficiency virus |
HPE | health professional education |
HRSA | Health Resources and Services Administration |
IDC | Interprofessional Diabetes Clinic |
IHI | Institute for Healthcare Improvement |
IHPE | Innovation in Health Professional Education (the Forum) |
IIPHD | Indian Institute of Public Health Delhi |
IMAGINE | Interprofessional Medical and Allied Groups for Improving Neighborhood Environments |
IOM | Institute of Medicine |
IPCP | interprofessional collaborative practice |
IPE | interprofessional education |
JDOH | Junior Doctors of Health |
LGBT | lesbian, gay, bisexual, and transgender |
LPN | licensed practical nurse |
MA | medical assistant |
MCA | Maternity Center Association |
MEPI | Medical Education Partnership Initiative |
MHDP | Municipal Health Development Plan |
MHF | mental health facilitator |
MOOC | massive open online course |
NACHC | National Association of Community Health Centers |
NBCC | National Board for Certified Counselors |
NGO | nongovernmental organization |
NHLBI | National Heart, Lung, and Blood Institute |
NIH | National Institutes of Health |
NOSM | Northern Ontario School of Medicine |
OB/GYN | obstetrics and gynecology |
OT | occupational therapy |
PA | physician assistant |
PACE | Program of All-Inclusive Care for the Elderly |
PHFI | Public Health Foundation of India |
PT | physical therapy |
RCS | Rural Clinical School |
RN | registered nurse |
SIHA | Study of Immigrant Health and Adjustment |
SIU | Southern Illinois University |
SOMA | School of Osteopathic Medicine in Arizona (at A.T. Still University) |
SURMEPI | Stellenbosch University Rural Medical Education Partnership Initiative |
TAG | Technical Advisory Group |
TeamSTEPPS | Team Strategies and Tools to Enhance Performance and Patient Safety |
THEnet | Training for Health Equity Network |
UBC | University of British Columbia |
UCSF | University of California, San Francisco |
UHN | University Health Network |
UofT | University of Toronto |
UP-SHS | University of the Philippines, Manila, School of Health Sciences |
USUHS | Uniformed Services University of the Health Sciences |
WHO | World Health Organization |