The Expanding Footprint of Innovation in Family Medicine GME

1. The Expanding Footprint of Innovation in Family Medicine GME March 30, 2009

2. Stan Kozakowski, MD • RPS Consultant and P4 Steering Committee Member Sam Jones, MD • P4 Steering Committee Co-Chair

3. Objectives By the end of this presentation the audience participants will be able to: • Discuss the scope of innovations found within the P4 project • Describe at least one ongoing residency innovation project outside of P4 • List 3 areas that any program wishing to undertake innovation should consider

4. Program Format • Introduction to the P4 Project • Update from several P4 programs • Colorado Family Medicine residency consortium – PCMH project • Discussion with panelists and audience of ideas for nurturing innovation in GME

5. The P4 Project: A status report

6. Preparing the Personal Physician for Practice • Also known as P to the fourth power, • P4 is a six-year residency demonstration initiative examining • Innovation at 14 family medicine residencies.

7. P4 - Goals • Inspire innovation in family medicine residency education • Evaluate innovations • Study what changes are needed to prepare graduates to succeed in new practice models • Share learnings that inspire change in training and certification

8. Individualized Curriculum “Intentional Diversification” Longitudinal Curriculum 4 year Curriculum Use of Educational Learner Portfolios in Competency Assessments Decreased Inpatient Time & Increased Continuity Clinic Time (esp. PGY1) Small Group Learning Labs PCMH Practice Re-design Patient-Centered Care Team-based Care & Training in Teams Chronic Disease Management Community Practices as Training Sites Community/Population Health Focus Current Categories of Innovations in P4 Programs

9. Baylor Four-year curriculum with MPH and 4th year emphasis on either international health or inpatient and maternity care. Cedar Rapids Non-rotational format for R-2 and R-3 years with more time in continuity of care setting. P4 Innovators

10. P4 Innovators • Christiana Care Health System Residents will be teamed with faculty “mentors” in an ambulatory focused curriculum with areas of emphasis. • Hendersonville FMC replaced with a network of rural family medicine practices.

11. P4 Innovators • John Peter Smith Hospital Four-year curriculum with integrated fellowship training. • Lehigh Valley Move residents and continuity populations into active community practices. No more “Traditional” Family Medicine Center.

12. P4 Innovators • Loma Linda University Four-year curriculum with integrated MPH and emphasis on care of the under-served. • Middlesex Hospital Four-year curriculum with emphasis on prevention and chronic disease management.

13. P4 Innovators • Rochester University “Ideal Micro Practice” within the FMC. Faculty partnering with residents to provide New Model in a focused experiment. • Tufts University Competency-based, longitudinal curriculum with information mastery and organizational effectiveness training.

14. P4 Innovators • University of Colorado Curriculum extends back into MS-4 year, and continuity of care for only R-2 and R-3 years. • University of Missouri-Columbia Four-year curriculum beginning with MS-4 year of medical school for a select population of learners.

15. P4 Innovators • Waukesha “Majors and Masteries” model of 4-year curriculum with areas of emphasis. • West Virginia University Rural MS-4 Rural Scholars Program with early start of R-1 role and longitudinal curriculum in chronic disease management.

16. Our Participating Panelists • Christiana FMRP • John Peter Smith FMRP • Middlesex FMRP • Waukesha FMRP • Colorado Network of FMRPs

17. Questions for Panelists and Audience

18. If you could start your project over again tomorrow, what would you do differently?

19. If you had a magic wand and could make any change in your residency practice and/or in your educational program, what would it be?