National Academies Press: OpenBook
Suggested Citation:"Front Matter." Institute of Medicine. 2015. Building Health Workforce Capacity Through Community-Based Health Professional Education: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18973.
×

BUILDING HEALTH WORKFORCE CAPACITY
THROUGH COMMUNITY-BASED
HEALTH PROFESSIONAL EDUCATION

WORKSHOP SUMMARY

Patricia A. Cuff, Rapporteur

Global Forum on Innovation in Health Professional Education

Board on Global Health

INSTITUTE OF MEDICINE
              OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS

Washington, D.C.

www.nap.edu

Suggested Citation:"Front Matter." Institute of Medicine. 2015. Building Health Workforce Capacity Through Community-Based Health Professional Education: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18973.
×

THE NATIONAL ACADEMIES PRESS     500 Fifth Street, NW     Washington, DC 20001

NOTICE: The workshop that is the subject of this workshop summary was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

This activity was supported by contracts between the Academic Consortium for Complementary and Alternative Health Care, the Academy of Nutrition and Dietetics, the Accreditation Council for Graduate Medical Education, the Aetna Foundation, the Alliance for Continuing Education in the Health Professions, the American Academy of Family Physicians, the American Academy of Nursing, the American Association of Colleges of Nursing, the American Association of Colleges of Osteopathic Medicine, the American Association of Colleges of Pharmacy, the American Association of Nurse Anesthetists, the American Association of Nurse Practitioners, the American Board of Family Medicine, the American Board of Internal Medicine, the American College of Nurse-Midwives, the American Congress of Obstetricians and Gynecologists/American Board of Obstetrics and Gynecology, the American Council of Academic Physical Therapy, the American Dental Education Association, the American Medical Association, the American Occupational Therapy Association, the American Psychological Association, the American Society for Nutrition, the American Speech-Language-Hearing Association, the Association of American Medical Colleges, the Association of American Veterinary Medical Colleges, the Association of Schools and Colleges of Optometry, the Association of Schools and Programs of Public Health, the Association of Schools of the Allied Health Professions, the Atlantic Philanthropies, the China Medical Board, the Council of Academic Programs in Communication Sciences and Disorders, the Council on Social Work Education, Ghent University, the Josiah Macy Jr. Foundation, Kaiser Permanente, the National Academies of Practice, the National Association of Social Workers, the National Board for Certified Counselors, Inc. and Affiliates, the National League for Nursing, the National Organization of Associate Degree Nursing, the Physician Assistant Education Association, the Robert Wood Johnson Foundation, the Society for Simulation in Healthcare, the Uniformed Services University of the Health Sciences, the University of Toronto, and the Veterans Health Administration. The views presented in this publication do not necessarily reflect the views of the organizations or agencies that provided support for the activity.

International Standard Book Number-13: 978-0-309-31387-2
International Standard Book Number-10: 0-309-31387-2

Additional copies of this workshop summary are available for sale from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.

For more information about the Institute of Medicine, visit the IOM home page at: www.iom.edu.

Copyright 2015 by the National Academy of Sciences. All rights reserved.

Printed in the United States of America

The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.

Cover photo © 2014 Maria Revlon De Los Reyes, courtesy of Photoshare. Two children in the Aeta communities in Subic, Zambales, Philippines, travel to collect clean water with a 5-gallon water jug because the water from their area is polluted.

Suggested citation: IOM (Institute of Medicine). 2015. Building health workforce capacity through community-based health professional education: Workshop summary. Washington, DC: The National Academies Press.

Suggested Citation:"Front Matter." Institute of Medicine. 2015. Building Health Workforce Capacity Through Community-Based Health Professional Education: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18973.
×

Knowing is not enough; we must apply.
Willing is not enough; we must do.
”      

                                                —Goethe

image

INSTITUTE OF MEDICINE
              OF THE NATIONAL ACADEMIES

Advising the Nation. Improving Health.

Suggested Citation:"Front Matter." Institute of Medicine. 2015. Building Health Workforce Capacity Through Community-Based Health Professional Education: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18973.
×

THE NATIONAL ACADEMIES

Advisers to the Nation on Science, Engineering, and Medicine

The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.

The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. C. D. Mote, Jr., is president of the National Academy of Engineering.

The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Victor J. Dzau is president of the Institute of Medicine.

The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. C. D. Mote, Jr., are chair and vice chair, respectively, of the National Research Council.

www.national-academies.org

Suggested Citation:"Front Matter." Institute of Medicine. 2015. Building Health Workforce Capacity Through Community-Based Health Professional Education: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18973.
×

PLANNING COMMITTEE FOR SCALING UP BEST PRACTICES IN
COMMUNITY-BASED HEALTH PROFESSIONAL EDUCATION1

WARREN NEWTON (Co-Chair), American Board of Family Medicine

SUSAN SCRIMSHAW (Co-Chair), The Sage Colleges

VIRGINIA ADAMS, National League for Nursing

GILLIAN BARCLAY, Aetna Foundation

KATHRYN KOLASA, Academy of Nutrition and Dietetics

DONNA MEYER, National Organization for Associate Degree Nursing

STEPHEN C. SHANNON, American Association of Colleges of Osteopathic Medicine

Consultant

MARIETJIE DE VILLIERS, Stellenbosch University

_____________

1 Institute of Medicine planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteur and the institution.

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GLOBAL FORUM ON INNOVATION IN HEALTH
PROFESSIONAL EDUCATION1,2

JORDAN COHEN (Co-Chair), George Washington University

AFAF MELEIS (Co-Chair), University of Pennsylvania

KENN APEL, Council of Academic Programs in Communication Sciences and Disorders

CAROL ASCHENBRENER, Association of American Medical Colleges

GILLIAN BARCLAY, Aetna Foundation

MARY BARGER, American College of Nurse-Midwives

TIMI AGAR BARWICK, Physician Assistant Education Association

GERALDINE BEDNASH, American Association of Colleges of Nursing

CYNTHIA BELAR, American Psychological Association

JOANNA CAIN, The American Board of Obstetrics and Gynecology/The American College of Obstetricians and Gynecologists

LINDA CASSER, Association of Schools and Colleges of Optometry

LINCOLN CHEN, China Medical Board

MARILYN CHOW, Kaiser Permanente

ELIZABETH CLARK, National Association of Social Workers

THOMAS CLAWSON, National Board for Certified Counselors, Inc. and Affiliates

DARLA SPENCE COFFEY, Council on Social Work Education

JAN DE MAESENEER, Ghent University

MARIETJIE DE VILLIERS, Stellenbosch University

JAMES G. Fox, Association of American Veterinary Medical Colleges

ROGER GLASS, John E. Fogarty International Center

ELIZABETH (LIZA) GOLDBLATT, Academic Consortium for Complementary and Alternative Health Care

YUANZHI GUAN, Peking Union Medical College

NEIL HARVISON, American Occupational Therapy Association, Inc.

DOUGLAS HEIMBURGER, American Society for Nutrition

JOHN HERBOLD, National Academies of Practice

ERIC HOLMBOE, Accreditation Council for Graduate Medical Education

PAMELA JEFFRIES, Johns Hopkins University School of Nursing

RICK KELLERMAN, American Academy of Family Physicians

KATHRYN KOLASA, Academy of Nutrition and Dietetics

JOHN (JACK) KUES, Alliance for Continuing Education in the Health Professions

_____________

1 Institute of Medicine forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published workshop summary rests with the workshop rapporteur and the institution.

2 This is the list of Forum members as of May 2, 2014.

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MARYJOAN LADDEN, Robert Wood Johnson Foundation

LUCINDA MAINE, American Association of Colleges of Pharmacy

BEVERLY MALONE, National League for Nursing

MARY E. (BETH) MANCINI, Society for Simulation in Healthcare

LEMMIETTA G. MCNEILLY, American Speech-Language-Hearing Association

DONNA MEYER, National Organization of Associate Degree Nursing

FITZHUGH MULLAN, George Washington University

WARREN NEWTON, American Board of Family Medicine

LIANA ORSOLINI, Bon Secours Health System, Inc.

BJORG PALSDOTTIR, Training for Health Equity Network

RAJATA RAJATANAVIN, Mahidol University

SCOTT REEVES, University of California, San Francisco

ELENA RIOS, National Hispanic Medical Association

KAREN SANDERS, Veterans Health Administration

MADELINE SCHMITT, American Academy of Nursing

NELSON SEWANKAMBO, Makerere University College of Health Sciences

STEPHEN SHANNON, American Association of Colleges of Osteopathic Medicine

SUSAN SKOCHELAK, American Medical Association

HARRISON SPENCER, Association of Schools and Programs of Public Health

RICHARD (RICK) TALBOTT, Association of Schools of the Allied Health Professions

GEORGE THIBAULT, Josiah Macy Jr. Foundation

JAN TOWERS, American Academy of Nurse Practitioners

RICHARD (RICK) W. VALACHOVIC, American Dental Education Association

SARITA VERMA, University of Toronto

PATRICIA HINTON WALKER, Uniformed Services University of the Health Sciences

SHANITA WILLIAMS, Health Resources and Services Administration, U.S. Department of Health and Human Services

KELLY WILTSE NICELY, American Association of Nurse Anesthetists

HOLLY WISE, American Council of Academic Physical Therapy

XUEJUN ZENG, Peking Union Medical College

BRENDA ZIERLER, University of Washington

SANJAY ZODPEY, Public Health Foundation of India

Suggested Citation:"Front Matter." Institute of Medicine. 2015. Building Health Workforce Capacity Through Community-Based Health Professional Education: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18973.
×

IOM Staff

PATRICIA A. CUFF, Senior Program Officer

MEGAN M. PEREZ, Research Associate

SAMANTHA D. BROWN, Senior Program Assistant

HANNAH PRESS, Intern

CHRISTINE CLARK, National Academies Christine Mirzayan Science Technology Policy 2014 Fellow

JULIE WILTSHIRE, Financial Officer

ROSALIND GOMES, Financial Associate

PATRICK W. KELLEY, Senior Board Director, Board on Global Health

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Reviewers

This workshop summary has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published workshop summary as sound as possible and to ensure that the summary meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this workshop summary:

TARA CORTES, New York University

ZOHRAY MOOLANI TALIB, George Washington University

BETH VELDE, East Carolina University

PAUL WORLEY, Flinders University School of Medicine

Although the reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the workshop summary before its release. The review of this workshop summary was overseen by BOBBIE BERKOWITZ, Columbia University School of Nursing. Appointed by the Institute of Medicine, she was responsible for making certain that an independent examination of this summary was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this workshop summary rests entirely with the rapporteur and the institution.

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Acknowledgments

Two landmark reports set in motion the idea for establishing a global forum to provide a neutral platform for ongoing dialogue among health professionals that could be the catalyst for needed reforms in health and educational systems around the world. Both of these reports—Health Professionals for a New Century (Frenk et al., 2010) and The Future of Nursing (IOM, 2011)—emphasized the importance of community-based health professional education. The Lancet Commission report described curricular innovations from the 1960s, 1970s, and 1980s that broadened “the continuum from classroom to clinical training through earlier student exposure to patients and an expansion of training sites from hospitals to communities” (p. 20). Likewise, the Institute of Medicine (IOM) Committee on the Future of Nursing explained that “an improved education system is necessary to ensure that the current and future generations of nurses can deliver safe, quality, patient-centered care across all settings, especially in such areas as primary care and community and public health” (p. 6).

These reports laid the foundation for the establishment of our IOM Global Forum and further confirmed for us the immense importance of learning from and with communities. It was therefore our great delight when the members of our Global Forum voted to host a workshop on this topic of community-based health professional education. Through the keen insight of the workshop planning committee, a robust agenda was developed and carried out. We thank the workshop planning committee co-chairs, Warren Newton and Susan Scrimshaw, for their leadership in this endeavor, and we thank the planning committee members, Virginia Adams, Gillian Barclay, Kathryn Kolasa, Donna Meyer, and Stephen Shannon, for

Suggested Citation:"Front Matter." Institute of Medicine. 2015. Building Health Workforce Capacity Through Community-Based Health Professional Education: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18973.
×

their support throughout the workshop. We also thank the consultant to the committee, Marietjie de Villiers. Such a wonderful event could not have happened without the keen dedication of the IOM staff of the Global Forum, including Patricia Cuff, forum director; Megan Perez, research associate; and Samantha Brown, senior program assistant. A special thank you goes to Patrick Kelley for envisioning and establishing the Global Forum. And most important, we must acknowledge our deep appreciation to the 45 sponsors and 61 members of the Global Forum on Innovation in Health Professional Education that make it possible for us to host events like the workshop described in this report.

Jordan Cohen, Forum Co-Chair Afaf Meleis, Forum Co-Chair

REFERENCES

Frenk, J., L. Chen, Z. A. Bhutta, J. Cohen, N. Crisp, T. Evans, H. Fineberg, P. Garcia, Y. Ke, P. Kelley, B. Kistnasamy, A. Meleis, D. Naylor, A. Pablos-Mendez, S. Reddy, S. Scrimshaw, J. Sepulveda, D. Serwadda, and H. Zurayk. 2010. Health professionals for a new century: Transforming education to strengthen health systems in an interdependent world. Lancet 376(9756):1923-1958.

IOM (Institute of Medicine). 2011. The future of nursing: Leading change, advancing health. Washington, DC: The National Academies Press.

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Acronyms and Abbreviations

AACN American Association of Colleges of Nursing
AAMC Association of American Medical Colleges
ACCAHC Academic Consortium for Complementary and Alternative Health Care
ACGME Accreditation Council of Graduate Medical Education
ADEA American Dental Educational Association
AFHCAN Alaska Federal Health Care Access Network
AIDS acquired immunodeficiency syndrome
AMA American Medical Association
ANMC Alaska Native Medical Center
ASCO Association of Schools and Colleges of Optometry
ASPPH Association of Schools and Programs of Public Health
ATSU A.T. Still University
BCH Brampton Civic Hospital
BNTC Brampton Naturopathic Teaching Clinic
CAHPS Consumer Assessment of Healthcare Providers and Systems
CARES Community Aid, Relief, Education, and Support Clinic
CBE community-based education
CCL Collaborative Change Leadership Program
CDC Centers for Disease Control and Prevention
CHANNELS Community, Health, Access, Network, Navigate, Education, Leadership, Service
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CHAP community health aide/practitioner
CHC community health center
CHOW community health outreach worker
CHW community health worker
CIHLC Canadian Interprofessional Health Leadership Collaborative
CIO critical incident officer
COPC community-oriented primary care
ECU East Carolina University
FQHC Federally Qualified Health Center
GLLU Gay and Lesbian Liaison Unit
GW George Washington University
HELP Health Education Leadership Program
HIE health information exchange
HIV human immunodeficiency virus
HPE health professional education
HRSA Health Resources and Services Administration
IDC Interprofessional Diabetes Clinic
IHI Institute for Healthcare Improvement
IHPE Innovation in Health Professional Education (the Forum)
IIPHD Indian Institute of Public Health Delhi
IMAGINE Interprofessional Medical and Allied Groups for Improving Neighborhood Environments
IOM Institute of Medicine
IPCP interprofessional collaborative practice
IPE interprofessional education
JDOH Junior Doctors of Health
LGBT lesbian, gay, bisexual, and transgender
LPN licensed practical nurse
MA medical assistant
MCA Maternity Center Association
MEPI Medical Education Partnership Initiative
MHDP Municipal Health Development Plan
MHF mental health facilitator
MOOC massive open online course
Suggested Citation:"Front Matter." Institute of Medicine. 2015. Building Health Workforce Capacity Through Community-Based Health Professional Education: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18973.
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NACHC National Association of Community Health Centers
NBCC National Board for Certified Counselors
NGO nongovernmental organization
NHLBI National Heart, Lung, and Blood Institute
NIH National Institutes of Health
NOSM Northern Ontario School of Medicine
OB/GYN obstetrics and gynecology
OT occupational therapy
PA physician assistant
PACE Program of All-Inclusive Care for the Elderly
PHFI Public Health Foundation of India
PT physical therapy
RCS Rural Clinical School
RN registered nurse
SIHA Study of Immigrant Health and Adjustment
SIU Southern Illinois University
SOMA School of Osteopathic Medicine in Arizona (at A.T. Still University)
SURMEPI Stellenbosch University Rural Medical Education Partnership Initiative
TAG Technical Advisory Group
TeamSTEPPS Team Strategies and Tools to Enhance Performance and Patient Safety
THEnet Training for Health Equity Network
UBC University of British Columbia
UCSF University of California, San Francisco
UHN University Health Network
UofT University of Toronto
UP-SHS University of the Philippines, Manila, School of Health Sciences
USUHS Uniformed Services University of the Health Sciences
WHO World Health Organization
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There is growing evidence from developed and developing countries that community-based approaches are effective in improving the health of individuals and populations. This is especially true when the social determinants of health are considered in the design of the community-based approach. With an aging population and an emphasis on health promotion, the United States is increasingly focusing on community-based health and health care. Preventing disease and promoting health calls for a holistic approach to health interventions that rely more heavily upon interprofessional collaborations. However, the financial and structural design of health professional education remains siloed and largely focused on academic health centers for training. Despite these challenges, there are good examples of interprofessional, community-based programs and curricula for educating health professionals.

In May 2014, members of the Institute of Medicine's Global Forum on Innovation in Health Professional Education came together to substantively delve into issues affecting the scale-up and spread of health professional education in communities. Participants heard a wide variety of individual accounts from innovators about work they are undertaking and opportunities for education with communities. In presenting a variety of examples that range from student community service to computer modeling, the workshop aimed to stimulate discussions about how educators might better integrate education with practice in communities. Building Health Workforce Capacity Through Community-Based Health Professional Education summarizes the presentations and discussion of this event.

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