2011 - UCSF School of Medicine - University of California, San ...

UCSF Education Day 2011Reflective critique: This program may serve as a modelthat informs broader integration of multidisciplinaryclinical experience at UCSF.Diabetes, Hypertension andAsthma…Oh My! Can a ChronicIllness Cohort Help Improve Studentand Patient Outcomes?Margo Vener, MD, MPH, UCSF, mvener@fcm.ucsf.edu;Ben Howell, MS 3, UCSF, ben.howell@ucsf.edu; NicoleGomez, MS 3, UCSF, nicole.gomez@ucsf.edu; KateChomsky-Higgins, MS 3, UCSF,Kate.chomskyhiggins@ucsf.edu; Nili Sommavilla, MS 3,UCSF, nili.sommavilla@ucsf.edu; Margaret Wheeler,MD, UCSF, mwheeler@medsfgh.ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Communication, LongitudinalEducational Activities, Patient Care, Primary CarePurpose: To evaluate whether our 3rd-year chronicillness curriculum improved: 1) students’ understandingof chronic illness and management and/or 2) clinicaloutcomes for chronically ill patientsBackground: To care for an aging population, futurephysicians need skills to optimize chronic illnessmanagement (1,2). We designed an innovativecurriculum to improve 3rd-year students’ ability toprovide chronic illness care. Students developed theirown panel of chronically ill patients. They performedstructured visits emphasizing understanding the patient’sgoals, self-management, education, and prevention.Methods: Twenty-five students each followed at leastpatients for six months. Using student reports, wetracked patient metrics (blood pressure, glucose, etc)and behavior changes (starting exercise, etc). We alsofollowed patient educational outcomes. We assessed theeducational impact to medical students through Likkertsurveys and focus groups.Results: While the average patient did not showsignificant change in blood pressure, etc, selectedpatients demonstrated very impressive changes (eg: 20lb intentional weight loss). Both students and patientsfound these changes highly inspirational. Students alsoreported greater appreciation of: 1) the ups and downsof chronic illness management; 2) the importance ofcontinuity: 3) the value and challenge of patienteducation and prevention 4) the need not to stereotypepatients 5) the importance of follow up outside officevisits 6) the importance of hope.Discussion: Although chronic care was not optimizedfor all participating patients, helping even one patient intheir panel make substantial health gains had markedimpact on students’ understanding of chronic illness andtheir belief that they could improve health outcomes theirpatients.Reflective critique: We plan to present this at WGEAfor feedback. Future efforts will focus on how to extendthis curriculum to third-year students in other longitudinaland block rotations.References:1. Pols, Chronic Illness, 2009.2. Holman, JAMA, 2004.Dissemination and Implementation ofan Evidence-Based, Tobacco-Treatment CurriculumAlan K. Louie, MD, UCSF, alanlouie@lppi.ucsf.edu;Sebastien C. Fromont, MD, UCSF,SCFromont@hotmail.com; Karen Suchanek Hudmon,DrPH, RPH, UCSF, hudmonk@pharmacy.ucsf.edu;Sharon M. Hall, PhD, UCSF, Sharon.Hall@ucsf.edu;Judith Prochaska, PhD, MPH, UCSF,JProchaska@ucsf.eduAreas abstract covers: UME, GMEDomain(s) addressed: Evaluation of Programs andCurricula, Faculty Development, InterprofessionalEducation, ResidencyPurpose: The goal of the current study was to improvecompetency in tobacco-treatment by psychiatrictrainees. The objective was to evaluate thedissemination and implementation phase of PsychiatryRx for Change, a 4-hour, tobacco-treatment curriculumfor psychiatric residencies and graduate psychiatricnursing programs.Background: Nearly half of cigarettes sold in the U.S.are smoked by people with mental illness and substanceuse disorders. Yet, surveys suggest psychiatrists rarelytreat tobacco use and only half of psychiatric residencyprograms provide didactics on such treatment, with amedian length of 1 hour (Prochaska et al., 2006). Wedeveloped the Psychiatry Rx for Change curriculum toaddress this gap and demonstrated positive educationaloutcomes sustained at 3-months follow-up with 55psychiatric residents (Prochaska et al, 2008). Diffusionof Innovations theory (Roger 1995) and the RE-AIMframework (Glasgow & Emmons, 2007) guideddissemination and implementation.Methods: Faculty from psychiatric residencies (n=28)and graduate psychiatric nursing programs (n=15) fromthe Western U.S. attended a one-day Psychiatry Rx for28 The Haile T. Debas Academy of Medical Educators