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Implementation Science: What Does it Mean to Educators?. Presenters : Patricia O’Sullivan, EdD , UC San Francisco Summers Kalishman , PhD, University of New Mexico SOM. What we will do today. Objectives for today’s session Overview and background Small group work and discussion
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Implementation Science: What Does it Mean to Educators? Presenters: Patricia O’Sullivan, EdD, UC San Francisco Summers Kalishman, PhD, University of New Mexico SOM
What we will do today • Objectives for today’s session • Overview and background • Small group work and discussion • vignette transformation
Objectives for today’s session • Describe the intersection between implementation science and medical education. • Apply the principles of implementation science to medical education to advance the way educators engage in medical education that addresses patient-centered care.
Background/History • Implementation science is considered key to developing optimal healthcare delivery and is often unclear to educators outside of continuing education • AAMC’s Group on Educational Affairs convened a writing group in 2012 to develop manuscripts and provide guidance on Implementation Science in Medical Education.
What is Implementation Science? • Implementation science involves the scientific study of methods to promote the systematic uptake of research findings and other evidence-based practices into routine practice to improve the quality and effectiveness of health services
Assumption • Hard-working, intelligent health care workers and/or medical educators will intuitively implement the best evidence into practice without any need of a skill set for implementation True or False?
Principles of IS • collaboration, • improved capacity, • rigor and relevance, • efficiency and speed, and • cumulative knowledge Glasgow RE, Vinson C, Chambers D, Khoury MJ, Kaplan RM, Hunter C. National institutes of health approaches to dissemination and implementation science: Current and future directions. Am J Public Health. 2012;102(7):1274-1281
Advantages of IS • Systematically-integrated approach to outcomes achievement • Comprehensive understanding of the complexities of health care • Streamlined access to patient data to enhance the meaningfulness of clinical, educational and research initiatives • Eliminating waste and redundancies = cost effectiveness • Improved individual and population health outcomes
Tools in Implementation Science • Individual change behavior models—yes • Implementation and Quality Improvement models--yes • Plan-Do-Study-Act • Six Sigma • Diffusion of Innovation • Root cause analysis • Interprofessional teams—yes • Patient medical centered homes--yes
IS Constructs Applicable to MedEd • Planned behavior/reasoned action • Trans-theoretical model • PRECEED/PROCEED model • Pathman model • Learning transfer model • Force field analysis These models must compliment and work with educational models
Need for evidence is changing • Accreditation requirements focus on implementation of evidence-based approaches • UGME, GME, CPD/CME, MOC • CLER “clinical learning environment review” • sponsoring institutions need to demonstrate leadership in quality improvement, patient safety and reduction of health care disparities
Focus: Desirable Patient Outcomes • reconsider educational activities when performance gaps exist at • individual, • community or • patient population levels
Vision • Medical education is the bridge between research and practice • Inter-professional collaboration is a must • Environments need be conducive to continued learning • Value-added by medical education need to be proven via alternative research designs • Medical education needs to re-imagine new possibilities for engaging medical professionals in learning
Critical Success Factor 2: Culture of Learning & Development Critical Success Factor 1: Collaboration & Integration Critical Success Factor 3: Alternative Research Designs Medical Research Implementation Science Principles (collaboration, improved capacity, rigor & relevance, efficiency & speed, cumulative knowledge) Medical Practice Medical Education as a Bridge between Medical Research and Practice Medical Education
Educational research characteristics align with IS • Conducted in social context (classroom, healthcare office) • Low to no control over multiple variables • Need for progressive refinement of the study design with each iteration • Large amounts of data about climate, learning and system variables • Large undertakings in need of excellent coordination • Results reporting must include: rich descriptions (environments, participants and variables) study design and refinement lessons learned
Potential for the future: IS integration with education • Strengthen interprofessional collaboration and systems-level integration, • Foster an environment conducive to on-going learning and build educator capacity, • Identify and apply alternative research designs to demonstrate the value added by medical education.
