You are on page 1of 5

1

Transformative Student Initiated Innovations & Developments


in Medical Education
2:00 - 3:30 PM Sunday November 3, 2013 Philadelphia, PA


Project Name: The Mental Health Clinic at the East Harlem Health Outreach Partnership
Medical School: Icahn School of Medicine at Mount Sinai
Student Contact Information:
Name: Jessica Fields
Email: jessica.fields@mssm.edu
OSR Representative Contact Information:
Name: Adam Fields
Email: adam.fields@mssm.edu
Program Director/Faculty Sponsor Contact Information:
Name: Dr. Craig Katz
Email: craig.katz@mountsinai.org


The Mental Health Clinic at the East Harlem Health Outreach Partnership was started 5 years ago as an ancillary clinic to
the main medical clinic because of the overwhelming need to provide mental health care to the uninsured. In East Harlem,
about 27% of residents are uninsured and the rate of hospitalization for mental health is twice as high in East Harlem than
in all of Manhattan. Thus, we have sought to bridge this knowledge to develop a well-organized and professional clinic run
by students to bring quality, compassionate care to the community while simultaneously fostering collaboration among
students, residents, and attendings.

Our clinic is held two Saturdays each month and is staffed by students under the supervision of psychiatry residents and
attendings. Two 2nd year students serve as the clinic managers; these students are in charge of scheduling
appointments, checking-in/out patients during clinic, and following up with patient prescriptions/questions throughout the
week. Three 4th year medical students serve as the providers; these students provide talk therapy and medication
management and conference with a resident at the end of the visit to ensure the highest quality care as well as to provide
a learning opportunity for these students. We have devised a system to ensure that an attending is always on-call, and
this attending also serves to provide feedback on student notes. We also work closely with a social worker to provide
resources in the community for the specific needs of each patient. In addition, we have set up a student-resident co-led
group psychotherapy program for patients each week focused on life skills training and dialectical behavioral therapy; this
is a unique session for patients to work on themselves and meet others in similar circumstances who they can relate to.
Currently, we have 45 patients who are seen regularly. Longitudinal care is a critical goal, and we implement schedules in
which clinicians see the same patients. At the clinic, we often address patient diagnoses and medication adherence.

Overall, we believe it is imperative to spread word of the mental health clinic created at Mount Sinai so that it may serve
as an example for other students to set up similarly modeled clinics in their respective communities. Our goal to provide
mental health care in a caring, confidential, and respectful environment has thus far been achieved, and we hope to
expand the program to include more patients and student providers in the future. Moreover, the clinic has definitely proven
to be an excellent teaching tool for all involved, in which students learn about the intricacies of outpatient care and the
field of psychiatry while residents learn how to effectively mentor students and act as supervisors on route to their next
step as attendings.








Home
Print
Close
2
Project Name: Operation Mend Medical Student Buddy Program: Learning to heal the wounds of war
Medical School: University of California, Los Angeles David Geffen School of Medicine
Student Contact Information:
Name: Gil Weintraub & Kristofer Roberts
Email: gweintraub@mednet.ucla.edu & Kwroberts@mednet.ucla.edu
OSR Representative Contact Information:
Name: Yas Sanaiha
Email: YSanaiha@mednet.ucla.edu
Program Director/Faculty Sponsor Contact Information:
Name: Christopher Crisera, MD, Faculty Sponsor for Operation Mend Medical School Organization
Email: ccrisera@mednet.ucla.edu


Operation Mend is a unique partnership between UCLA Health, Brooke Army Medical Center, and the Veteran Affairs
Healthcare System. It was established in 2007 to help treat U.S. military personnel wounded during service in Iraq and
Afghanistan. Utilizing the expertise of both the public and private sectors, and the most advanced medical technologies
available, Operation Mend delivers the highest quality patient care to our servicemen and women who have made
incredible sacrifices for our country. The programs services range from reconstructive plastic surgery and upper
extremity transplants to addiction intervention and social work, in an effort to heal the wounds war.

Operation Mend Medical Student Organization (OMMSO) was founded in 2011 to allow medical students the opportunity
to contribute to the recovery of our wounded veterans. This unique patient population allows medical students to
experience the multidisciplinary approach needed to tackle the complicated medical problems commonly seen with
wounds of war. More importantly, the support structure within Operation Mend introduces medical students to the very
human aspect of caring for the person beneath the injuries.

One of the organizations biggest contributions has been through the Buddy Program. Within Operation Mend, servicemen
and women travel from across the country for evaluations, surgeries, and lengthy follow-up care. The stress of medical
care is often compounded by the unknown environment of Los Angeles and the challenges faced by many veterans
working to re-acclimate to life outside of the warzone. To help in the healing process, service members are paired with
Buddy Families who volunteer to provide strong social support and continuity of care for each man or woman in Operation
Mend.

To improve the Buddy Family system and advance innovation in medical education, OMMSO established the option for
longitudinal Buddy Families composed of UCLA medical students. Through this alternative, medical students serve as the
patients support system across multiple medical visits. Buddies are some of the first faces the patient sees upon arrival,
and they help foster a warm, supportive, and welcoming environment. Although students accompany patients to clinic
visits and shadow surgical procedures, much of the experience is spent away from the medical setting: sightseeing,
eating, or just sharing stories. Bringing together similar age students and veterans makes it easy to relatemedical
students are able to learn about the military experience and culture while veterans can put a face on what at times can
feel like an impersonal medical system. The program provides veterans with continuity of care and companionship while
simultaneously allowing students to experience both the medical and human aspects of healing. Through Operation
Mend, UCLA medical students have the privilege to give back to wounded veterans who have made incredible sacrifices
for our nation. UCLAs greater motto is, Healing Humankind one patient at a time. Similarly, OMMSO allows UCLA
medical students the humbling opportunity to help heal our nations warriors, one veteran at a time.


3
Project Name: Simulated Chaos: Adding Interactive Education to UCF COMs Annual Global Health Conference
Medical School: University of Central Florida College of Medicine
Student Contact Information:
Name: Erin Kane
Email: ekane@knights.ucf.edu
OSR Representative Contact Information:
Name: Erin Kane
Email: ekane@knights.ucf.edu
Program Director/Faculty Sponsor Contact Information:
Name: Dr. Judith Simms-Cendan
Email: Judith.Simms-Cendan@ucf.edu


Purpose:
The second annual Global Health Conference sponsored by MedPACT (Medical Students Providing Across Continents)
focused on disaster preparedness and emergency medicine, highlighted by a half day of interactive simulations.
Participants engaged in six different simulations designed with specific learning objectives in mind to further the
participants knowledge of various maladies and situational decision-making skills. Following each set of learning
objectives, individual simulations were designed to include a short briefing by student and physician instructors, a 15-20
minute simulated experience, and a debrief including instructor feedback and participant Q&A.

Simulations included a mass casualty scenario with rapid triage, life-saving intervention with limited supplies (featuring
interactive mannequins), grief counseling, burn treatment, and patient stabilization and evacuation both with and without
standard medical supplies. Three of the scenarios followed a longitudinal story of one patient from the mass casualty
scene through life-saving treatment and culminating with counseling. Though the simulations were themed to immediately
follow a hurricane, the skills and objectives taken away from each scenario could be applied more broadly to the field of
disaster response and emergency medicine.

Players:
Participation included UCF faculty, community physicians, local EMS crews, and students from universities and medical
schools across Florida. As with every element of the annual conference, the simulations were designed and implemented
by medical students. Two Directors of Simulations designed and implemented the scenarios, including creation of learning
objectives, community contact, and participant training. Participation from the student body included Student Instructors
who were paired with physicians to lead simulations, voice actors to give life to the SimMann 3G computerized
mannequins, and modulated triage and burn victims who brought varying degrees of life and theatrical presence to their
simulations.

UCF COM faculty and community physicians led and participated in five of the simulations and represented the different
physician roles integral to emergency response including emergency physicians, surgeons, internists, psychiatrists, and a
pathologist with several years of naval medical training. The Clinical Simulations Department provided training,
supervision, and use of the computerized mannequins. Professional make-up artists brought movie magic to the triage
scenario. Two community members accustomed to working with our Clinical Skills Department volunteered their services
as standardized patients for grief counseling, bringing their theatrical skills and tears. Orange County Fire Rescue
provided a six person educational team to help students walk in the shoes of rescue personnel. When not sounding the
sirens to start the mass casualty scenario, the ALS team gave tours of the ambulance during breaks. Last, but not least,
the American Red Cross donated one of their refrigerated trucks to help keep cold water and snacks readily available due
to the hot Florida sun.

Program Impact:
Ultimately, the coordination of the Central Florida medical community with student leadership provided a unique,
interactive learning experience for students from five Florida universities, including students from medical, nursing,
undergraduate, and graduate schools. The simulation format was developed to be sustainable for future annual
conferences and long-lasting community relationships.


4
Project Name: Homerun Project
Medical School: University of Mississippi School of Medicine
Student Contact Information:
Name: Kevin Battle
Email: kbatte@umc.edu
OSR Representative Contact Information:
Name: Kevin Battle
Email: kbatte@umc.edu
Program Director/Faculty Sponsor Contact Information:
Name: Dr. Richard deShazo
Email: rdeshazo@umc.edu


The Mississippi Healthy Students Act, enacted by the state legislature in 2007, is one of the most progressive programs
for school health in the United States. It requires school health councils for each school, as well as healthy lunches and
an organized exercise period. Unfortunately, the Mississippi Healthy Students Act was enacted without funding.
Numerous approaches have been used to support implementation of the legislation, including the Homerun Project. In
addition, the University of Mississippi Medical Center has a number of pipeline programs that are attempting to identify
students in the public schools with an interest in medicine or other health professions by role modeling.

Homerun Project was started after discussions between the leadership of the UMMC Health Innovations Lab and the
Department of Healthy Schools in the Mississippi State Department of Education. In 2011, the pilot program was initiated
and is now being expanded to the public schools in the Jackson area with the hopes of taking the program statewide in
the future. In this program, medical students and other health professionals work with classroom teachers to improve
students understanding of the science curriculum and promote a discussion of healthy choices (low-calorie, low-fat diet),
exercise, and tobacco and substance abuse avoidance as part of their presentations.

The program was initiated in one pilot high school in the Jackson Public School system. Science teachers would identify
various topics with which they did not feel they possessed a full understanding or which would be better taught by
students from the University of Mississippi School of Medicine, and the list of classes submitted would be passed along to
the student body. Classes were taken on a first come, first serve basis, and students would then prepare a lesson plan
and go to the school to present the lesson. The ultimate objectives were to incorporate in teaching an emphasis on
healthy living, offer a fresh approach to the teaching of science, and to generate an interest in the sciences among the
students. These goals were achieved with success and the feedback generated prompted the Mississippi Department of
Education to allow the Homerun program to expand into two more elementary schools in 2012. The goal was to reach
children at a younger age and instill healthy living habits early on. Classes were not as complex and allowed time for
incorporation of special healthy choice, exercise, and tobacco and substance avoidance lectures at the end of the class.

The program has continued to receive positive feedback from both students and teachers alike. Teachers often talk about
how excited their students are to have visitors from the medical center, and how their attention spans seem to increase
when new teachers enter the classroom. The primary goal of Homerun Project was and continues to be the vision that
children learn to make healthy choices early and that ultimately these choices can be carried on throughout life.


5
Project Name: SELECT Superutilizer Project
Medical School: University of South Florida Health Morsani College of Medicine, SELECT Program
Student Contact Information:
Name: Alexandra Printz
Email: aprintz@health.usf.edu
OSR Representative Contact Information:
Name: Alexandra Printz
Email: aprintz@health.usf.edu
Program Director/Faculty Sponsor Contact Information:
Name: Dr. Abby Letcher
Email: Abby_s.letcher@lvhn.org


As healthcare changes, and medicine challenges itself to manage the health of populations, medical students are in a
unique position to help facilitate change. In his article The Hot Spotters Dr. Atul Gawande highlights the Camden Project
which found superutilizers of healthcare and provided them with additional resources. The efforts of the Camden Project
resulted in better coordinated care, improved health outcomes, and reduced costs. The Neighborhood Health Centers of
the Lehigh Valley (NHCLV), in partnership with the Lehigh Valley Health Network (LVHN), joined the Camden Coalition to
recreate their successful Hot Spotters model in the Lehigh Valley. As medical students we wanted to be a part of the
change.

Our objective was to create a role for medical students that would allow us to explore systems based healthcare and
population health, as well as the complexity of the chronic care model, but most importantly help us understand medicine
from the point of view of our superutilizer patients.

Working with administration, several students advocated to have a Superutilizer Project added to the 3rd year
Longitudinal Primary Care Clerkship curriculum. The objective of this project was for each of the 18 USF MCOM SELECT
students at LVHN to identify a superutilizer at their family practice. Patients were identified based on the Camden
Coalition criteria, which include multiple chronic conditions and more than 3 ER visits or inpatient admissions in the past 6
months.

Students then perform a home visit, working with nurses and social workers of the NHCLV team to assess the patients
needs and limitations in accessing care. If the patient is interested, the team enrolls them in the Camden Coalition project
and begins to provide them with the resources they need. In addition to encouraging students to practice patient-centered
care, the program allows students to serve as ambassadors in their various clinic sites throughout the community, starting
the conversation of hot spotting and population management.

For students who are interested in being more involved, an option was created to have students spend 50% of their
Longitudinal Family Practice experience with the Superutilizer Project. This allows those students to work more closely
with the projects interdisciplinary team, and serve as a health coach for patients. In this role students perform weekly
home visits, accompany patients to appointments, and help them navigate their health.

The program is creating a ripple throughout our community. Healthcare workers are talking about population management
and how to identify patients in their practice who could benefit from additional resources, students are entering the homes
of patients and learning what it is like to live with multiple chronic conditions, and patients are being given the support they
need to be successful.

As the Superutilizer Project moves forward we will continue to try and maximize the impact both for the student and
patient. By the end of the year we will have brought the Hot Spotter model to over a dozen providers in the community,
and had students work one on one with over 20 patients living with chronic disease. Meanwhile, student leaders work to
collect data to measure the impact of the project on the healthcare utilization of our superutilizers.