Community-Academic Community-Academic Partnerships: Partnerships: Teaching Medical Teaching Medical Students Public HealthStudents Public Health

American Public Health Association, American Public Health Association, November 2004November 2004Jan K Carney MD MPH Jan K Carney MD MPH University of Vermont College of University of Vermont College of MedicineMedicine

Why Public Health Why Public Health Projects? Projects? All physicians will face public All physicians will face public

health issueshealth issues Multiple determinants of healthMultiple determinants of health Population/community context of Population/community context of

individual patientsindividual patients Increasing need for disease Increasing need for disease

preventionprevention Partnerships essentialPartnerships essential

Multiple Determinants Multiple Determinants of Healthof Health

health care

behaviors

biology

environment

social/econ

Why public health Why public health projects?projects? Physicians face a growing list of public health Physicians face a growing list of public health

issues in clinical practice today: examples:issues in clinical practice today: examples:– Preventing childhood obesityPreventing childhood obesity– Emerging infectious diseasesEmerging infectious diseases– Preventing and caring for chronic conditions in an Preventing and caring for chronic conditions in an

aging populationaging population

IOM recommends that “all medical students IOM recommends that “all medical students receive basic public health training in the receive basic public health training in the population-based prevention approaches to population-based prevention approaches to health.”health.”

Vermont Integrated Vermont Integrated Curriculum (VIC)Curriculum (VIC)

Implemented at the UVM College of Implemented at the UVM College of Medicine fall 2003Medicine fall 2003

Integrates sciences and clinical Integrates sciences and clinical medicinemedicine

Develops skills for life-long Develops skills for life-long learninglearning

Public health competencies Public health competencies

Public Health ProjectsPublic Health Projectsin the Vermont in the Vermont Integrated CurriculumIntegrated Curriculum MSLG I = first yearMSLG I = first year

– Student groups of 8Student groups of 8– May 2004 = project rankingMay 2004 = project ranking

MSLG II = Public Health ProjectsMSLG II = Public Health Projects September through December September through December

– Second year studentsSecond year students– Begin September 2004Begin September 2004– 13 projects per year13 projects per year

Themes and Themes and Competencies Competencies Professional developmentProfessional development LearningLearning Leadership and CollaborationLeadership and Collaboration Research and DiscoveryResearch and Discovery

Goals and ObjectivesGoals and Objectives

Public Health Projects:Public Health Projects:Educational GoalsEducational Goals

Understand the breadth and scope Understand the breadth and scope of public healthof public health

Understand current and emerging Understand current and emerging public health issuespublic health issues

Understand how public health Understand how public health interfaces with clinical medicineinterfaces with clinical medicine

Understand and apply public Understand and apply public health research methodshealth research methods

Public Health ProjectsPublic Health ProjectsEducational GoalsEducational Goals

Understand the role of the Understand the role of the community in improving community in improving individuals’ healthindividuals’ health

Learn practical ways to improve Learn practical ways to improve the health of both individuals and the health of both individuals and populationspopulations

Be creative and have fun!Be creative and have fun!

For each Public Health For each Public Health Project:Project:

1. must address a public health 1. must address a public health issueissue

2. must ask and answer a 2. must ask and answer a scientific scientific questionquestion

3. must show a public health 3. must show a public health benefitbenefit

Public Health Public Health FrameworkFramework

Healthy People 2010Healthy People 2010Overarching goalsOverarching goals

1. increase quality and years of 1. increase quality and years of healthy lifehealthy life

2. eliminate health disparities2. eliminate health disparities

Healthy People 2010Healthy People 2010Focus AreasFocus Areas Access to quality health Access to quality health

servicesservices ArthritisArthritis CancerCancer Chronic Kidney DiseaseChronic Kidney Disease DiabetesDiabetes Disability Disability Educational programsEducational programs Environmental healthEnvironmental health Family planningFamily planning Food SafetyFood Safety Health CommunicationHealth Communication Heart Disease and StrokeHeart Disease and Stroke HIVHIV Immunization and Infectious Immunization and Infectious

DiseasesDiseases

Injury and violence preventionInjury and violence prevention Maternal, infant and child Maternal, infant and child

health health Medical Product SafetyMedical Product Safety Mental healthMental health Nutrition and overweightNutrition and overweight Occupational healthOccupational health Oral healthOral health Physical activityPhysical activity Public Health InfrastructurePublic Health Infrastructure Respiratory DiseasesRespiratory Diseases Substance abuseSubstance abuse TobaccoTobacco Vision and HearingVision and Hearing

Community-Academic Community-Academic PartnershipsPartnerships Students asked for better way to Students asked for better way to

make a differencemake a difference Previous project design reversed:Previous project design reversed: “ “Community First”! Community First”! Community agencies asked to Community agencies asked to

identify public health needsidentify public health needs Projects designed to meet Projects designed to meet

community-identified needscommunity-identified needs

Community-Academic Community-Academic Partnerships Partnerships Link with community agenciesLink with community agencies United Way of Chittenden CountyUnited Way of Chittenden County Invited proposals – January 2004Invited proposals – January 2004 Protocols developed to match Protocols developed to match

HP2010 focus areas and educational HP2010 focus areas and educational goals goals

May 2004 – student rank and matchMay 2004 – student rank and match IRB process/IRB tutorial IRB process/IRB tutorial

EvaluationEvaluation

Field notes – for peers (COMET)Field notes – for peers (COMET) Written report – Written report –

– About 10 pagesAbout 10 pages– Background, Methods, Results, ConclusionsBackground, Methods, Results, Conclusions– For mentors and agenciesFor mentors and agencies

Poster presentation – Poster presentation – – Visually appealing summaryVisually appealing summary– Professional qualityProfessional quality– Suitable for submission to national meetingSuitable for submission to national meeting– January poster presentation at COMJanuary poster presentation at COM

Evaluation (cont’)Evaluation (cont’)

Grading = Pass/FailGrading = Pass/Fail Student self-assessmentStudent self-assessment Agency assessmentAgency assessment Faculty mentor assessmentFaculty mentor assessment Midpoint and finalMidpoint and final

– Individual contribution and group Individual contribution and group workwork

– Competency basedCompetency based

Project Examples: Project Examples: 20042004

Public Health ProjectPublic Health ProjectTitles: 2004Titles: 2004

1. Navigating a 15 minute doctor visit: 1. Navigating a 15 minute doctor visit: Helping patients communicate with Helping patients communicate with their physicianstheir physicians

2. Public Health for Refugees in 2. Public Health for Refugees in Vermont: Public Health in the HomeVermont: Public Health in the Home

3. Healthy Choice for Teens: the path 3. Healthy Choice for Teens: the path to well-being through diet and exercise to well-being through diet and exercise (Woodside)(Woodside)

4. The Built Environment and Health: 4. The Built Environment and Health: Promoting healthy and active Vermont Promoting healthy and active Vermont communities (VDH)communities (VDH)

Projects – 2004 (cont’)Projects – 2004 (cont’)

5. Helping patients to help themselves: 5. Helping patients to help themselves: educational methods to improve access to educational methods to improve access to health care – Lund family centerhealth care – Lund family center

6. Teaching young children about 6. Teaching young children about nutrition and physical activity: Improving nutrition and physical activity: Improving nutrition and physical fitness in YMCA nutrition and physical fitness in YMCA familiesfamilies

7. Improving health care quality and 7. Improving health care quality and reducing errors (VNA)reducing errors (VNA)

8. Assessing psychiatry needs at a 8. Assessing psychiatry needs at a community mental health center community mental health center (Howard)(Howard)

Projects 2004- (cont’)Projects 2004- (cont’)

9. Immunizations are for adults, too: 9. Immunizations are for adults, too: reducing the risk of influenza and reducing the risk of influenza and pneumococcal disease in a nursing homepneumococcal disease in a nursing home

10. Diabetic-friendly food donations: 10. Diabetic-friendly food donations: nutritional options for the homebound nutritional options for the homebound senior (CCEFS)senior (CCEFS)

11. Improving the health of the 11. Improving the health of the community: educational strategies at the community: educational strategies at the Community Health Center Community Health Center

Projects – 2004 (cont’)Projects – 2004 (cont’)

12. Improving the health of 12. Improving the health of Puerto Cabezas, Nicaragua, Puerto Cabezas, Nicaragua, Burlington’s Sister CityBurlington’s Sister City

13. Complementary and 13. Complementary and Alternative Medicine: Physician Alternative Medicine: Physician beliefs and patient/doctor beliefs and patient/doctor communicationcommunication

Public Health Projects – Public Health Projects – Healthy People 2010 Healthy People 2010 areas areas Access to Quality Health ServicesAccess to Quality Health Services Health CommunicationHealth Communication Environmental HealthEnvironmental Health DiabetesDiabetes Immunizations and infectious Immunizations and infectious

diseasedisease Nutrition/Physical ActivityNutrition/Physical Activity Mental HealthMental Health

Jan K Carney, MD MPH,Jan K Carney, MD MPH,Associate Dean for Public Associate Dean for Public Health, Health, University of Vermont University of Vermont College of MedicineCollege of Medicine

371 Pearl St, Burlington VT 371 Pearl St, Burlington VT 0540105401

(802) 847-8268(802) 847-8268

Jan.Carney@uvm.eduJan.Carney@uvm.edu