Teaching and Training for Tomorrow’s Health Care
We must prepare tomorrow’s clinicians for an environment that demands and rewards cost-efficiency, positive outcomes and high patient satisfaction. This health care future also means greater demand for primary/preventive care and inter-professional and intra-professional teamwork.
Medical school debt reliefAs health care reform extends access to more patients, the need for more primary care physicians will increase. Yet medical students continue to gravitate toward higher paying specialty fields to repay heavy educational debt. In 2011, URMC joined with other Rochester area health systems, the areaâ€™s largest health plan, and an employer group to create a fund that will provide about $600,000 a year in debt relief for the next four years. In return for the debt relief, physicians pledge a minimum of four years of service in primary care in the greater Rochester area.
Choosing a career in primary care
To enhance the primary care practice experience for residents, we redesigned the residentsâ€™ outpatient practice as a patient-centered medical home. The medical home uses data-driven, population-based medicine to manage care. In the Internal Medicine residency, we also launched a pilot program that gives residents longer blocks of time in primary care practices, allowing a resident to see a patient multiple times and creating a better, more meaningful learning experience. Each of these efforts is aimed at encouraging more physicians to choose primary care.
Patient-centered medical homes
School of Nursing faculty members serve as consultants to the care managers of the more than 22 newly-created patient-centered medical homes within the Center for Primary Care, providing evidence-based instruction and insight to support care managers in their effort to motivate patients toward sustainable lifestyle changes in the areas of tobacco use, diabetes prevention, nutrition, exercise, and stress-reduction. Itâ€™s a prime example of URMC educators helping our delivery system develop new practice models.
Quality and safety curriculum
We created a new module in the curriculum for second-year medical students on quality, safety, and information management. The two-day module introduces the core concepts of safety science and quality measures in both ambulatory and inpatient medical practice. It also reviews resources students can use to provide efficient, high-quality care to patients. The module includes workshops and lectures on disclosing medical errors, high-efficiency literature searching, electronic medical records, and quality care in surgery, inpatient and ambulatory practice.
URMC has taken a practical step by creating a new service organization that will support all Medical Center educational activities and learning needsâ€”from standardized patients to simulation. To address important elements of health care reformâ€”the widespread application of information technology to health care and the adoption of electronic health records, for exampleâ€”we established a masterâ€™s degree in medical informatics. And in several areas, we used grants to improve access to education and to cross-disciplinary training.
Physicians and nurses increasingly must work together as a team. We are planning to expand inter-professional simulation education to several areas of the curricula. Students from the School of Medicine and Dentistry and the School of Nursingâ€™s Nurse Practitioner programs have been participating in inter-professional simulation educational experiences for the past four years. High-fidelity simulators generate remarkably realistic clinical situations where students can practice safely and receive feedback about their performance before they enter high stakes clinical practice. The goals are to promote teamwork, enhance communication and collaboration, augment an understanding of specific roles, and develop critical thinking skills. Formal evaluations indicate that students not only enjoy the experience, but gain an appreciation of the importance of communication and collaboration in providing quality care to patients.
Integrating research and clinical practice
The Eastman Institute for Oral Health (EIOH) received $3.8 million from the National Institute of Dental and Craniofacial Research to continue helping prepare oral biologists and dentists-scientists for careers within academia, government and industry. Integrating basic science research and clinical practice, this training program involves collaboration among several Medical Center departments, including EIOHâ€™s Center for Oral Biology, Pharmacology and Physiology, Microbiology and Immunology, Biomedical Genetics, Medicine and Dermatology.
Dentistry training in China
EIOH also began its first ever faculty/resident exchange program with Chinaâ€™s Peking University School of Stomatology, a large academic dental institution that treats 3,000 patients a day. Because there are no formal post-graduate residency training programs in China, a Peking University faculty member has formally joined the Advanced Education in General Dentistry program at EIOH, with the goal of starting a similar program in China. The two institutions are exploring collaboration opportunities within research and other clinical areas, as well.