Family Medicine for America's Health

Workforce Education & Development Tactic Team

Workforce Education & Development Tactic Team

Workforce Education & Development Tactic Team

The Workforce Education & Development Tactic Team’s has been charged with increasing medical student choice of family medicine. The team is doing this by working to:

  • Improve the evaluation of the full continuum of family medicine education to include and meet the standards of the Entrustable Professional Activities (EPAs).
  • Increase medical students’ choice of family medicine, including through enhanced resident and faculty mentoring, with a specific emphasis on building a diverse workforce that addresses health disparities.
  • Increase the strength, impact and prosperity of Family Medicine departments and residency programs through recruitment, development, and retention of faculty and preceptors, and provide support to enhance their value in their communities and their institutions.

The Workforce Team has been working on a number of projects and initiatives, four of which are featured in the Projects tab below:

  • Entrustable Professional Activities for Family Medicine End of Residency Training
  • Precepting Expansion Initiative
  • Workforce Diversity Resource
  • Student & Resident Led Projects

Several additional projects are scheduled to be completed in late 2017 / early 2018, including:

  • Shared Aim for Percentage of Medical Students Choosing Family Medicine: Representatives from the multiple Family Medicine organizations are working together along with the FMAHealth Workforce Team to develop a shared aim for student choice of Family Medicine. The objective of this collaboration is for the leading family medicine organizations to agree on one goal for student choice of family medicine and work together to develop an action plan to achieve that goal.
  • Department Chair Playbook as Part of a Learning & Action Community: In collaboration with the AAFP, the Workforce Team is developing a playbook for Department Chairs that advises them on how to develop or refine a strategic plan to increase student choice of family medicine at their institution, based upon the following two ideas: 1) How to capitalize on top 10 schools best practices, working with middle of the list and bottom of the list schools on strategy development; 2) How to support Family Medicine Departments in making the necessary changes to increase student choice of family medicine.
  • Primary Care Leadership Collaborative: The FMAHealth Workforce Tactic Team is excited to partner with the AAFP and Primary Care Progress (PCP) in the Primary Care Leadership Collaborative, a year-long national leadership program for AAFP Family Medicine Interest Groups (FMIGs) that is focused on advancing primary care in local communities and preparing the next generation to lead the transformation of primary care. Building on the unique strengths of each of the partner organizations, the year-long learning collaborative will provide structured teaching, coaching and support to enable FMIG teams to have significant impact on the state of primary care delivery and education at their local institutions and in their communities.
Core Team

Christina Kelly, MD, FAAFP – Team Leader; Faculty, Savannah Family Medicine Residency and Director, Mercer University School of Medicine Primary Care Accelerated Track

Anastasia Coutinho, MD, MHS

Jay Fetter, MSHA; Operations Manager, Division of Medical Education, AAFP

Constance Goldgar, PA-C; Associate Professor, Univeresity of Utah PA Program, Department of Family & Preventive Medicine

Wanda Gonsalves, MD; Professor & Vice Chair, Department of Family Medicine at University of Kentucky

Cal Gutkin, MD, CCFP, FCFP; Former ED & CEO of CFPC & Advisor to the Michaelle Foundation

Rick Kellerman, MD, FAAFP; Chair & Professor, Family and Community Medicine at KUSM – Wichita

Mike Tuggy, MD, FAAFP; Rural family medicine physician in Winthrop, Washington and clinical professor at the University of Washington School of Medicine

Additional Workforce Project Team Leaders/Advisors

Sarah Hemeida, MD

KrisEmily McCrory, MD, FAAFP

Michelle Roett, MD, MPH, FAAFP

John Snellings, MD

Kim Yu, MD, FAAFP

Entrustable Professional Activities (EPAs) for Family Medicine End of Residency Training

As part of the strategic planning process of Family Medicine for America’s Health, entrustable professional activities (EPAs) were developed for the discipline of family medicine relating to residency completion. Evidence for improved health outcomes, healthcare system efficiency, and equity in care were used to develop these EPAs. The Association for the Departments of Family Medicine (ADFM) has stepped forward to lead the evaluation of the EPAs as they are implemented by family medicine departments across the country.

EPAs are broad categories of activities that define the essential professional work of a discipline. With regard to residency training, EPAs define the expectations for the education of family physicians. EPAs integrate all of the core competencies, subcompetencies, and their specific milestones.

EPAs define the knowledge, skills, attitudes and behaviors that each family medicine resident physician must master. Each resident physician must be able to perform each activity without supervision before graduation from a family medicine residency training program. Family Medicine educators must ensure that systems of assessment align with the expectations of the future activities of the trainees.

For Family Medicine, the EPAs collectively define a type of care that the residency graduate can be trusted to deliver to the public. It is understood that some graduates of family medicine residency programs will not practice the breadth described in these EPAs. Through such comprehensive training, the goal for the discipline is for more family physicians, rather than fewer, and for the majority of family physicians, rather than some, to practice this breadth.

See the Full Set of EPAs Here

Find the Entrustable Professional Activities Q&A here

References:

Role & Definition of the Family Physician

Patient Centered Medical Home Educational Agenda

Benefits of the Patient Centered Medical Home

Outcomes of the Patient Centered Medical Home

Precepting Expansion Initiative

Primary care clerkships are struggling to obtain and retain quality clinical training sites. The Workforce Team launched a project to address this challenge, and the Society of Teachers of Family Medicine (STFM) stepped forward to take the lead on implementing it. STFM and other primary care stakeholders are now in the midst of a multi-year initiative to address this threat to the sustainability of America’s medical education system. Goals of the initiative are to:

  • Decrease the percentage of primary care clerkship directors who report difficulty finding clinical preceptor sites.
  • Increase the percentage of students completing clerkships at high-functioning sites.
  • How to have a discussion at your institution on workforce diversity
  • How institutions can recruit from their community into medical school and residency
  • How to develop a strategic plan to increase diversity
  • How to develop a teaching plan to teach diversity of thought, culture and ethnicity
  • How to care for a diverse community

In August 2016, the Society of Teachers of Family Medicine conducted a Summit to identify the most significant reasons for the shortage of community preceptors and shape the priorities, leadership, and investments needed to ensure the ongoing education of the primary care workforce. The Summit was supported, in part, by a grant from the American Board of Family Medicine Foundation.

At the Summit, an interprofessional group of primary care stakeholders produced an Action Plan with the following tactics:

  • Work with CMS to revise student documentation guidelines
  • Integrate interprofessional/interdisciplinary education into ambulatory primary care settings through integrated clinical clerkships
  • Develop standardized onboarding process for students and preceptors
  • Integrate students into the work of ambulatory primary care settings (clinical clerkship sites) in useful and authentic ways
  • Develop educational collaboratives across departments, specialties, professions, and institutions to improve administrative efficiencies
  • Promote productivity incentive plans that include teaching

Learn more here.

Family Medicine for America’s Health Workforce Diversity Resource

In order to eliminate health inequities and appropriately care for all patients in the United States, we need a diverse health professional workforce. Currently, we lack the level of diversity we need in medical schools and residencies, both among learners and faculty. Medical students and residents are not graduating with the cultural competency and unconscious bias training needed to care for a diverse community. A more diverse workforce will benefit our patients, ourselves, and everyone around us. As a specialty, we need to take the lead in addressing this important issue.

The FMAHealth Workforce Team has compiled resources from a variety of sources that can help institutions determine the needs of their communities, develop a plan to improve diversity, and effectively educate all learners on cultural competency and unconscious bias.  See our diversity resource here.

Student & Resident Led Projects

The Workforce Student & Resident Advisory Group Leader, Natasha Bhuyan, MD, meets monthly with the Workforce Student & Resident Advisory Group to review the leadership and development curriculum she created and to provide guidance to the following project teams:

Diversity Team: Led by Carlos Cunha, MD; Alice Esame, MD; Jean Shiraki, DO; Christopher Watson, MD

  • Developing and analyzing metrics for social accountability of medical schools for diversity
  • Creating a coalition of partners invested in building a diverse healthcare workforce

Curriculum Development and Education Team: Led by Cecilia Jojola, MD; Jason Woloski, MD

  • Aiming to increase quality family medicine preceptors by demonstrating the values of medical students as part of team-based care
  • Leading a research study on the needs assessment and gap analysis for preceptors of family medicine

Student and Resident Wellness: Led by Kristina Dakis, MD; Joseph Brodine

  • Identifying best practices from institutions with wellness programs and evidence to support components of a wellness curriculum to prevent burnout
  • Gathering student and resident feedback on what is needed for burnout prevention and promotion of wellness through presentations at the AAFP National Conference
  • Initiating and facilitating discussions at FMIG, state, and national meetings regarding burnout prevention – creating a forum for the exchange of ideas and practices among students and residents, as well as among faculty, program directors, and program administrators
  • Learn more about the medical student wellness program at UIC College of Medicine co-founded by Student & Resident Advisory Group member, Kristina Dakis, MD in her interview with AAFP News
  • A letter to the editor entitled “Incorporating Advocacy Training to Decrease Burnout” written by Kristina Dakis, MD and Anastasia Coutinho, MD was recently published in the Journal of the Association of Medical Colleges

Health Policy, Research, Education and Advancement: Led by Anastasia Coutinho, MD, MHS; Alexandra Gits, MD

  • They are aiming to increase advocacy in family medicine through several initiatives:
  • Primary Care Leadership Collaborative
  • CERA study on advocacy education
  • Advocacy trainee survey
  • Advocacy definition Delphi study
  • Creating advocacy curriculum toolkit & core competencies
  • Advocacy curricula literature review

Increasing Student Choice of Family Medicine: Led by Mustafa Alavi, MD; Tiffany Ho, MD; Logan Mims, MD; Chandler Stisher

  • The team has conducted focus group with medical students who entered family medicine vs. other specialties – specifically, they are looking at the top 10 schools that produce family medicine residents vs. those that don’t
  • Findings will be included in the playbook for family medicine department chairs to help increase students’ choice in family medicine

Results from these student & resident led projects will be posted as they become available in late 2017 and early 2018!

FMAHealth would like to sincerely thank the many students and residents who have been involved with this important work.