1. Expands or adapts skills and methods to meet community health and health care needs Didactics and Modules
Online modules on community assessment:
Population Health Assessment Engine (PHATE) Curriculum
Links to an external site.
ECHO/CME on various topics (procedures, family centered maternity care, MAT, Hep C, Behavioral Health, Hospital Med, Peds, etc.)
Presenting Your Case: Making Use of Telehealth in Rural Practice
Links to an external site.
Ethics and scope of practice: Rural Primary Care: Working Outside the Comfort Zone
Links to an external site.
Workshops
Procedural workshops
Enhanced skills training – RuralPREP teaching toolkits
Community Projects and Clinic/Health Systems Projects
Completion of a community and population needs and capabilities assessment (this could be reading an already available CHNA rather than completing their own)
The Community Tool Box: Assessing Community Needs and Resources
Links to an external site.
Analyze referral patterns and access needs
Practice and panel review
Reflection and Coaching
Individual education plan for the resident to address and include skills needed for future practice
ITE review - ABFM MOC/KSA reflection and coaching
Procedure documentation review/portfolio review
Reflection and Coaching: Individual education plan for the resident.
Biosketch, 1:1 meetings with advisor and mentor
Coaching during precepting or rounding to reflect on personal skills and community needs.
Academic Coaching for Learners in Medical Education: Twelve Tips for the Learning Specialist
Download Twelve Tips for the Learning Specialist
2. Partners with the community to address challenges and barriers to health
Didactics (synchronous/asynchronous)
Active learning modules regarding community organizing in rural or tribal settings.
Population Health Assessment Engine (PHATE) Curriculum
Links to an external site.
Principles of community engagement
Didactics on community based participatory research/community engaged scholarship
Community-Based Participatory Research (CBPR)
Links to an external site.
Didactics/modules: social determinants, implicit bias, power/privilege, health literacy, historical trauma
Workshops
Health Equity Rural Workshop
Team based care workshops
Workshops/small groups: Implicit bias, power/privilege, health literacy, historical trauma
Structural Competence Workshops
Community Health Projects and Clinic/Health Systems Projects
Community projects and clinic/health system projects:
Community based projects with documented community engagement strategy
Participating in/Reflecting on community structures (school board, town council, etc.) that influence health
Making a community relational mapping/org chart
Community Windshield Tour/Asset Mapping
Links to an external site. Health policy debates/debriefs
Clinic access analysis (from multiple lenses - language, gender, ability, parents, breastfeeding moms, etc.)
Community organizing listening assemblies/meetings, research actions, 1:1’s with community members
Reflection and Coaching
Reflection/journaling on community participation activities
Community coach
3. Collaborates across the health care system to improve health for all
Didactics
Online modules on community assessment
Professional ethics and responsibilities
Understanding budgets and informatics
Simulated Health System Science Curriculum
Links to an external site.
Integrating Public Health and Primary Care
Links to an external site.
Workshops
Role playing negotiation skills
Crucial Conversations and Conflict Resolution Interprofessional Simulation
Relational Leadership Skills
Equity Lens
Meeting Management
Leading through Change
Conflict Management
QI
Presentation skills
Community Projects and Clinic/Health Systems Projects
Interprofessional/System wide QI projects
Community project with local public health authorities: The Practical Playbook
Links to an external site.
Develop a list of all community health system resources and the relationships between them (Org Chart)
Membership on committees
Participation in ORPRN projects to further research in rural communities
Reflection and Coaching
Reflection on balance between community needs, professional responsibilities and personal needs.
Reflection on importance of being at the table
Request feedback from three different members of teams that you are on and reflect on this with a coach
4. Mentor and invest in future rural/tribal/underserved health care professionals
Didactics
Didactics on instructional techniques (see below)
Meaning in medicine
Reflective practice
Workshops
Clinical teaching strategies (Chalktalks, Teaching on rounds, etc.)
Optimizing the learning environment
Stereotype threat, Imposter Syndrome, and Growth Mindset
Giving feedback
Didactics on mentorship in the health professions: a review (Burgess, 2018)
RuralPREP: Why Do I Teach in Rural Practice? A Day in the Life of a Rural Preceptor
Links to an external site.
Life- long learning strategies
Career anchors
Coaching
Antidotes to burnout
Beloved Communities
Storytelling/narrative medicine
Healer’s Art
Community Projects and Clinic/Health Systems Projects
Engagement with learners at other levels or professions i.e. high school, college, elementary
Participation in rural provider networks
Reflection and Coaching
Development of a personal learning plan
Reflection on what meaning underserved practice has for the resident
Hidden Curricula, Ethics, and Professionalism: Optimizing Clinical Learning Environments in Becoming and Being a Physician: A Position Paper of the American College of Physicians
Download Hidden Curricula, Ethics, and Professionalism: Optimizing Clinical Learning Environments in Becoming and Being a Physician: A Position Paper of the American College of Physicians
Creating their own mentoring network
Establishing Effective Mentoring Networks: Rationale and Strategies
Download Establishing Effective Mentoring Networks: Rationale and Strategies
5. Balances personal and community needs in a defined community context that demands accountability and transparency.
Didactics
Active learning modules regarding professionalism in medicine
Ethics curriculum
Why work-life balance isn’t the right frame:
“The fallacy of chasing after work-life balance”
Download “The fallacy of chasing after work-life balance”
Workshops
Small group discussion of dilemmas that emerge in practice (clinical jazz)
RuralPREP Toolkit: Live where you work
Links to an external site.
Leading Near peer facilitated professionalism workshops for junior residents/med students
Professional Competencies Toolkit: Using Flash Cards to Teach Reflective Practice to Medical Students in Clinical Clerkship
Download Professional Competencies Toolkit: Using Flash Cards to Teach Reflective Practice to Medical Students in Clinical Clerkship
Time management, prioritization, and boundary setting
Community Projects and Clinic/Health Systems Projects
Interviews with community preceptors on finding balance and meaning and what accountability/transparency means to them
Reflection and Coaching
Reflection on Justice, Courage, and Truthfulness: Virtues That Medical Trainees Can and Must Learn
Download Justice, Courage, and Truthfulness: Virtues That Medical Trainees Can and Must Learn
Twelve tips for teaching reflection at all levels of medical education
Download Twelve tips for teaching reflection at all levels of medical education
Book club
Database of Popular literature on Medical Ethics
Links to an external site.
Medical Ethics and Living a Life
6. Negotiates dual relationships with integrity and role fidelity
Didactics
Ethics and Professionalism of Role fidelity for physicians in defined communities:
A proposed rural healthcare agenda
Download A proposed rural healthcare agenda
An Office on Main Street: Health Care Dilemmas in Small Communities
Download An Office on Main Street: Health Care Dilemmas in Small Communities
Setting the Agenda for Urban Bioethics
Download Setting the Agenda for Urban Bioethics
Recognizing and Resolving Ethical Dilemmas in Rural Medicine
Download Recognizing and Resolving Ethical Dilemmas in Rural Medicine
Workshops
Small group discussion of the cases in:
RuralPREP toolkit: Good Fences
Links to an external site.
Role play scenarios utilizing difficult/crucial conversation skills
Community Projects and Clinic/Health Systems Projects
Engage community members to understand their expectations when physician participate as members of the community.
Engage local health system ethics committee in dialogue or event on ethical dilemmas of small communities
Reflection and Coaching
Reflection on professionalism in non-clinical settings.
Reflective writing on expected dual roles and how a professional would act in those situations.
Book club/journal club on above articles
7. Demonstrates the ability to face adversity and use difficult situations to grow personally and professionally and sustain wellness in concert with the community
Didactics
Wellness team developed modules – Moffit slides on importance of stories
Improving Emotional Intelligence (EQ)
Links to an external site.
Strengths Finders/5 Dynamics
Imposter Syndrome/Growth Mindset
Links to an external site.
Stereotype threat
Beloved Communities: The King Philosophy
Links to an external site.
Workshops
Serial iterative scenario role-play assessment and peer feedback
Debriefing workshops following critical incidents: Empowering Residents to Process Distressing Events: A Debriefing Workshop
Download Empowering Residents to Process Distressing Events: A Debriefing Workshop
Resilience training: Everyday Resilience: Equipping Faculty with Practical Exercises to Promote Resilience Among Medical Students
Download Everyday Resilience: Equipping Faculty with Practical Exercises to Promote Resilience Among Medical Students
Role-playing with an emphasis on creative problem solving.
Improvisation practices/ theater as a tool: Active Learning on Center Stage: Theater as a Tool for Medical Education
Download Active Learning on Center Stage: Theater as a Tool for Medical Education
Relational 1:1’s meetings
Peer Mentoring
Establishing Effective Mentoring Networks: Rationale and Strategies
Download Establishing Effective Mentoring Networks: Rationale and Strategies
Community Projects and Clinic/Health Systems Projects
Engage community to identify facilitators and impediments to resilience in previous crises or challenges.
Involvement in rural medicine networks to increase resiliency
Reflection and Coaching
Reflective writing
Coaching in authentic settings
Mentor/coach meetings: Optimizing Your Mentoring Relationship: A Toolkit for Mentors and Mentees
Download Optimizing Your Mentoring Relationship: A Toolkit for Mentors and Mentees
8. Recognizes knowledge, power, and wisdom from people in the community.
Didactics
Concepts on colonizing and decolonizing
History of colonization/oppression of Indigenous people
Intergenerational trauma
General curriculum resources and readings:
Trauma Informed Care
Trauma informed care
Community engagement and organizing: The Community Tool Box
Links to an external site.
Implicit bias: Racism, Sexism, and Unconscious Bias
Download Racism, Sexism, and Unconscious Bias
Power/privilege/intersectionality and identity: Intersectionality—The Interconnectedness of Class, Gender, Race and other Types of Vulnerability
Download Intersectionality—The Interconnectedness of Class, Gender, Race and other Types of Vulnerability
Community Projects and Clinic/Health Systems Projects
Relational meetings with community members
Community feedback/advisory panel/etc. (for programmatic EPAs)
Service learning
Reflection and Coaching
Empathy experiences – AA/NA meetings, police ride-alongs, shelter sign ups, transportation activity
Book/media club – Braiding Sweet Grass
Patient as teacher, Community as teacher
Dialogues: How do different ways of knowing, being, doing show up here?
9. Incorporates ways of inhabiting a place into identity and health of self, patients, and communities.
Didactics
The pedagogy of place-based medical education using The Emergence of Place in Medical Education
Download The pedagogy of place-based medical education using The Emergence of Place in Medical Education
Health equity toolkit: Why Rural Matters
Download Why Rural Matters
End of life care – how to respect patient values around place in end-of-life care planning, how to attend to structurally vulnerable populations at the end of life
Examples of place-based health initiatives: Moving to Action on Place-Based Health
Download Moving to Action on Place-Based Health
Addressing Health Disparities Is a Place-Based Issue
Download Addressing Health Disparities Is a Place-Based Issue
Workshops
NCES curriculum resource: Social and Structural Determinants of Urban American Indian and Alaska Native Health: A Case Study in Los Angeles
Download Social and Structural Determinants of Urban American Indian and Alaska Native Health: A Case Study in Los Angeles
Place-based Med Ed article reading/discussion and workshop PGY level place-based goals for their residency
Place contextualized case based small group sessions (source: place-based med ed)
Community Projects and Clinic/Health Systems Projects
Relational meetings with community members
Community feedback/advisory panel/etc.
Incorporating place-based history into social history: Modeling Clinical Context: Rediscovering the Social History and Evaluating Language from the Clinic to the Wards
Download Modeling Clinical Context: Rediscovering the Social History and Evaluating Language from the Clinic to the Wards
Discharge planning with importance of place in mind
Outdoor/community/cultural immersion retreats:
Identify/visit a significant place in the community and reflect on who has been in that place over time.
Invite speakers from the community to discuss places in the community and what it means to them
Listen to stories of people who lived somewhere a really long time; what are the strengths of this approach to a place, what are the alternatives, what
Reflection and Coaching
Book club and reflective writing using Braiding Sweet Grass by Robin Wall Kimmerer
Discussion prompt: How has place influenced your sense of professional and personal identity?
Photo essay of important places to the resident, to a patient, to the clinic, to the community
Reflect on what it means to be in respect to a significant place and to the people inhabiting it since time immemorial.
Twelve Tips for Teaching Reflection at All Levels of Medical Education
Download Twelve Tips for Teaching Reflection at All Levels of Medical Education
10. Engages with community in anti-racist ways
Didactics
Health equity modules: Structural Competency, Structural Racism, Intergenerational Trauma, Community-Specific and Health System History, Food Insecurity, Housing, Education, Transportation, Corrections, Built Environment, Poverty
Great resources:
Workshops
Identity/Intersectionality /Power/Privilege (activities privilege pie, cross the line, etc.)
Implicit Bias workshop (resource AAFP/OAFP curriculum)
Implicit bias M/M
Cases Conference
Looking inward: building a beloved community
Framework for addressing microaggressions
Structural Competency: Curriculum for Medical Students, Residents, and Interprofessional Teams on the Structural Factors That Produce Health Disparities
Download Structural Competency: Curriculum for Medical Students, Residents, and Interprofessional Teams on the Structural Factors That Produce Health Disparities
Samuel Merritt University Modules
Sakai OHSU
Links to an external site.
Community Projects and Clinic/Health Systems Projects
The Community Tool Box: Windshield and Relationship Building
Links to an external site.
o Food, education, transportation, housing, corrections, etc.
Examining residency program policies, rotations, educational goals/objectives using equity lens: What Is The Equity and Empowerment Lens?
Links to an external site.
Systematic project to include topics intergenerational trauma, racism, and other forms of oppression in history taking and electronic health record
Incorporating Structural Vulnerability Checklist
Presenting/attending the National Center for Education to Address the Social Determinants of Health
Links to an external site. annual conference
Links to an external site.
A Multielement Community Medicine Curriculum for the Family Medicine Clerkship
Download A Multielement Community Medicine Curriculum for the Family Medicine Clerkship
Reflection and Coaching
Empathy experience/writing
Book/media club (how to be an antiracist, medical apartheid, etc.)
Interdisciplinary meetings with community partner/behavioral
Infusing into clinical rotations, committees, and the day to day…
“How is racism showing up….” Reflection over the last 24 hours of inpatient or clinic week, working it into the sign-out or the wrap-up
“Confessions of the oppressor” writing
Racial caucusing
