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Learning Experiences & Rotations

Current practicum offerings through the Atlanta Veterans’ Affairs Medical Center:

 (1) Health Promotion and Disease Prevention

Overview  This rotation provides the opportunity to be involved in institutional prevention efforts as part of the recent health initiatives created within the VA healthcare system. This includes involvement in the Prevention Committee, Employee Wellness initiatives, general health promotion/disease prevention initiatives and efforts to more effectively integrate preventive service in clinical primary care. Residents have access to the entire roster of patient education classes offered within the Veterans Learning Center and may instruct existing classes or create new classes based on patient needs and interests.

Goals To gain knowledge and skills in the creation and evaluation of educational programs and social and physical conditions within the institution that promote health, well-being, and self-management among VA staff and patients. 

Objectives: (1) perform needs assessments to identify areas of need among staff, providers, and patients; (2) design, implement, and evaluate content and mechanism of delivery of prevention programs for staff, providers, and/or patients according to the quality improvement model. 

Example Projects:  (1) Implementation of a quality improvement project to improve administration of influenza vaccination to high-risk veterans in the primary care clinic setting; (2) Develop and evaluate group visits for diabetic (or other chronic disease) patients to promote healthful eating and activity behaviors and self-management in accordance with current clinical recommendations.

 Competencies Addressed

Medical Knowledge (MA 2, BE 2, BE 4; Acquire knowledge related to risk and protective factors and behaviors for specific diseases; Acquire knowledge related to established recommendations for management, including self-management and monitoring) of chronic health conditions.

Patient Care (BE 1, BE 3, BE 5, MA 2, CPM 1, CPM 2, CPM 3)

Interpersonal & Communication Skills (G 1, G2, G3, G5)

Practice-based Learning & Improvement (MA3, BE5, G3, MA1, G2)

Systems-based Practice (G7, CPM3, G5, G3, G6, MA4, MA2, G1, G2, MA1, MA3)

Professionalism (G 4, G 5, MA 4)

Assessment Methods: Faculty observation, Resident evaluations by site supervisor, Resident self-evaluations

 (2) Women’s Wellness Clinical Experience

Site supervisor:  Drs. Cedrella Jones-Taylor and Brenda Melton

Overview  This rotation provides clinical preventive medicine exposure via the Women’s Wellness Clinic in the form of prevention visits, follow-up in conjunction with the Women’s Prevention Letters program, and conducting women’s health education and prevention-based classes.

Goals To gain knowledge and skills in the care of individual patients and the delivery of preventive medicine services in the clinical setting, to include knowledge and skills related to the clinical content of care as well as behavioral aspects of engaging and motivating patients in health-promoting habits and behaviors.

Objectives: (1) deliver primary and secondary preventive health care services in the clinical setting; (2) communicate with patients regarding recommended preventive behaviors and care practices; (3) develop and deliver the content of educational classes to promote healthful behaviors among women attending the Women’s Wellness clinics. 

Competencies Addressed

Medical Knowledge (MA 2, CPM 4; Acquire knowledge related to age- and gender-specific recommended prevention and preventive care practices per the U.S. Preventive Services Task Force; Acquire knowledge related to established recommendations for management including self-management and monitoring of chronic health conditions).

Patient Care (MA 2, CPM 1, CPM 2, CPM 4)

Interpersonal & Communication Skills (G 1, G 3)

Practice-based Learning & Improvement (G 3)

Systems-based Practice (MA 2, G 1)

Professionalism (G 5)

3. Occupational Health and Employee Wellness.

Site supervisor:  Dr. Michael Miller

Overview  This rotation provides clinical occupational medicine experience via pre-employment physicals, sick call, hazard/toxin exposure work-ups and seasonal influenza mass campaign efforts. Additional experience in legal medicine/worker’s compensation including trial exposure, fit for duty exams, and reasonable accommodations boards.

Goals To gain knowledge and skills in the care of individual patients and the delivery of preventive medicine and occupational health services in the clinical setting, to include knowledge and skills related to the clinical content of care, appropriate occupational assessments, as well as behavioral aspects of engaging and motivating patients in health-promoting habits and behaviors.

Objectives: (1) perform pre-employment physicals, exposure evaluations, and workers’ compensation assessments; (2) deliver primary and secondary preventive health care services in the clinical setting; (3) communicate with patients regarding recommended preventive behaviors and care practices; (4) develop and deliver the content of educational classes to promote healthful behaviors among patients. 

Competencies Addressed

Medical Knowledge (CPM 4, OE 1, OE 2, BE 6, MA 2)

Patient Care (G7, BE 1, MA 2, CPM 1, CPM 2, CPM 3, CPM 4, OE 1, OE 2, BE 6)

Interpersonal & Communication Skills (G1, G3, G5, G2)

Practice-based Learning & Improvement (G3, MA 1, G 2)

Systems-based Practice (G7, CPM 3, G 4, G 3, G 6, MA 2, G 1, G 2,

Professionalism (G 4, G 5)

 

4.  System-based Approaches to Patient Safety

Site supervisor:  Karen Sutton, Jean Rogers, and Tousha West

Overview  This rotation provides an opportunity to teach medical students and residents the Patient Safety Curriculum regarding a systems-based approach to medical errors and close calls, the opportunity to be involved in Root Cause Analysis (RCA) teams and cold reads resulting from facility reported adverse events, and the opportunity to be involved in Healthcare Failure Mode and Effect Analysis teams and processes.  Additional opportunities to be involved in patient safety initiatives such as the Home Safe, Drive Safe, Stay Safe campaign, quality improvement efforts and suicide prevention are also available. 

Goals To gain knowledge and skills in system-based approaches and specific models to prevent and reduce health care errors and adverse events and improve patient safety. 

Objectives: (1) teach the Patient Safety Curriculum to learners; (2) participate in Root Cause Analyses of facility-reported adverse events; (3) participate in the design and implementation of institution-wide patient safety initiatives.

Competencies Addressed

Medical Knowledge (BE 4)

Patient Care (MA 2, CPM 3, BE 6)

Interpersonal & Communication Skills (G 1, G 3, G 5, G 2)

Practice-based Learning & Improvement (MA 1, G 2)

Systems-based Practice ( G 7, G 4, G 3, G 6, G 1, G 2, MA 1)

Professionalism (G 4, G 5)

5. Health Care Administration

Site supervisor:  Dr. Norberto Fas, Dr. David Bower

Overview  This rotation provides the opportunity for participation and engagement in higher level management meetings: Fee Improvement Committee, Executive Committee, Clinical Service Line Staff Meeting, Compliance and Business Integrity Committee, Affiliations Sub-counsel Meeting, and Information Management Committee.

Additional involvement in morning huddle, department personnel management, and problem solving/conflict resolution is also available. 

Goals to develop competency in health care management and administration. 

Objectives: (1) to be exposed to human and financial resource management systems for the operation of the quality improvement and management information systems; (2) develop skill sin communications, team building, leadership, innovation, and continuous learning. 

Core Competencies Addressed:

Interpersonal & Communication Skills (G1, G 3, G 5, G 2)

Practice-based Learning & Improvement (G 3, MA 1, G 2)

Systems-based Practice (G 7, G 4, G 3, G 6, G 1, G 2, MA 1)

Professionalism (G 4, G 5)

Assessment Methods: Faculty observation, Resident evaluations by site supervisor, Resident self-evaluations

6. Health Media

Site supervisor:  Robin Brown

Overview  This rotation provides the opportunity to be involved in print, audio and visual media health efforts tailored to the needs and educational level of the target population (patients, staff or both). Depending on interest and educational needs, this may include experience with text editing, photo editing, videography, website creation and/or revision, and mass media campaigns.

Goals To acquire knowledge and skills in the creation of media to promote healthy behaviors and self-care practices among patients and/or evidence-based prevention practices among providers. 

Objectives: (1) to participate in the development of media and messages to promote healthy behaviors among patients and/or evidence-based practices among providers; (2) to participate in the evaluation of media abd messages. 

Core Competencies Addressed:

Medical Knowledge (MA 2)

Patient Care (MA 2, CPM 3, BE 5)

Interpersonal & Communication Skills (G 1, G 3, G 5, G 2)

Practice-based Learning & Improvement (BE 5, G 3, G 2)

Systems-based Practice (G 4, G 3, G 6, MA 4, G 1, G 2)

Professionalism (G 4, G 5, MA 4)

Assessment Methods: Faculty observation, Resident evaluations by site supervisor, Resident self-evaluations

Additional elective practicum offerings available through the training program:

Public Health Agency Rotations.  The residency program maintains practice agreements with the Centers for Disease Control and Prevention and the Georgia Department of Community Health, and these experiences may serve to fulfill the ‘public health agency’ rotation (as does the Atlanta Veterans’ Affairs Medical Center).  In a given academic year, these public health agencies may have sufficient funding to offer specific practica to Emory’s Preventive Medicine residents. 

Elective Experiences and Additional Rotations.   Residencies may further develop his or her competencies in specific areas of general preventive medicine and public health through participation in additional activities that may include working with faculty in academic preventive medicine and public health settings, county or state public health officials on community- or state-based projects and initiatives, and other governmental and non-governmental organizations that have a role in shaping or implementing health policy and community-based interventions.  Prior to embarking on such rotations, the Program Director works with the resident and the agency site supervisor to develop an educational plan that specifies the rotation goals, competency-based learning objectives, and methods of assessment.   General goals and objectives for these public health agency and elective rotations are found below.  Prior to embarking on such rotations, the Program Director works with the resident and the agency site supervisor to develop an educational plan that specifies resident-specific rotation goals, competency-based learning objectives, and methods of assessment.  

Goal:  To achieve competencies and substantive knowledge and skills in areas of public health and preventive medicine highly relevant to the future career of the resident. 

Objectives:  The resident will:

a. Deepen his/her understanding and skills in areas of applied public health/preventive medicine highly relevant to their planned future career;

b. Function as a member of a team to perform health services, community-based, preventive or    epidemiologic research; perform surveillance and monitoring; administer or evaluate health programs or systems; or formulate and advocate for clinical practices or policies. 

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[1] Code to competencies:

General

G1 – Communicate to target groups, including health professionals, the public, and the media, in a clear and effective manner, both orally and in writing, the levels of risk from real or potential hazards, and the rationale for selected interventions.

G2 – Communicate to target groups, including health professionals, the public, and the media, in a clear and effective manner, both orally and in writing, the levels of risk from real or potential hazards, and the rationale for selected interventions.

G3 – Use information technology for specific applications relevant to preventive medicine and public health.

G4 – Interpret relevant laws and regulations relating to protection and promotion of the public’s health.

G5 – Identify ethical, social, and cultural issues relating to policies, risks, research, and interventions in public health and preventive medicine contexts.

G6 – Identify the processes by which decisions are made within an organization or agency and their points of influence.

G7 – Identify and coordinate the integrated use of available resources to improve the community’s health.

Biostatistics and Epidemiology

BE1 – Characterize the health of a community.

BE 2 – Design and conduct an epidemiologic study.

BE 3 – Design and operate a surveillance system.

BE 4 – Select and describe limitations of appropriate statistical analyses as applied to a particular data set.

BE5 – Translate epidemiologic findings into a recommendation for a specific intervention to control a public health problem.

BE6 – Design and/or conduct an outbreak and/or cluster investigation.

Management and Administration

MA1 – Assess data and formulate policy for a given health issue.

MA2 – Develop and implement a plan to address a specific health issue or problem.

MA3 – Conduct an evaluation or quality assessment based on process and outcome performance measures.

MA4 – Manage the operation of a program or project, including human and fiscal resources.

Clinical Preventive Medicine

CPM1 – Develop, implement, and refine screening programs for groups to identify risks for disease or injury, and opportunities to promote wellness.

CPM2 – Design and implement clinical preventive services for individuals.

CPM3 – Implement community-based interventions to modify/eliminate identified risks for disease and to promote wellness.

CPM4 - Diagnose and manage diseases/injuries/conditions in which prevention plays a key role.

Occupational and Environmental Health

OE1 – Assess individual risk for occupational/environmental disorders using an occupational and environmental history.

OE2 – Identify occupational and environmental hazards, illness, and injuries in defined populations, and assess and respond to identified risks.