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Suggested Citation:"2 Scenario Planning." National Academies of Sciences, Engineering, and Medicine. 2022. Lessons Learned in Health Professions Education During the COVID-19 Pandemic, Part 2: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26484.
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2

Scenario Planning

On April 7, 2021, the forum held an abbreviated scenario planning activity, led by Charles Thomas, Accreditation Council for Graduate Medical Education (ACGME). In this activity, interprofessional groups of 10 to 12 participants were given mini scenarios taking place 5 years in the future, and a set of assumptions that must be accepted as fact. The goal of the exercise, said Thomas, was to “get creative juices going” and to think strategically about the issues health professions education (HPE) will have to contend with in the future. While the scenarios were fictional, the participants were asked to consider real-life events that happened during COVID-19, and how the lessons learned during the pandemic could inform the future of HPE. Thomas noted the year 2020 was a good example of a real-life scenario in which people had to quickly adapt and respond creatively to a situation that was unexpected and unprecedented.

Highlights from Scenario Planning Breakout Group Discussions1

Participants were divided into breakout groups to discuss the scenario and create an “HPE organization” using the opportunities and constraints of their scenario. Groups were tasked with determining the name of the organization; its mission, functions, and processes; how it would be funded;

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1 Thomas’ introduction slides can be accessed at https://www.nationalacademies.org/event/04-07-2021/lessons-learned-in-health-professions-education-from-the-covid-19-pandemic-part-2-of-a-workshop-series-scenario-planning-session#sectionEventMaterials (accessed February 11, 2022).

Suggested Citation:"2 Scenario Planning." National Academies of Sciences, Engineering, and Medicine. 2022. Lessons Learned in Health Professions Education During the COVID-19 Pandemic, Part 2: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26484.
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and where it sits (e.g., government, academia, etc.). While each group was given a different scenario, for all scenarios, the set up was similar: the economy is good, but geographic and socioeconomic spots of high unemployment and societal disaffection persist, and politics are highly divisive. The COVID-19 pandemic is in a state of “active management;” vaccines work well but require boosters, and control of the pandemic requires individuals to take personal precautions (see Box 2-1). As a result of the pandemic and ongoing challenges within HPE, health professions educators realize there is a need for a national coordinating body. Additionally, each group had a set of radically different assumptions added to the setup. So, each breakout had some similarities and some significantly different assumptions. These assumptions included trends in health and health care, social and economic circumstances, and characteristics of the HPE system. (The specific assumptions for each group are in Box 2-2.) Participants are tasked with designing the optimum organization to fulfill the following two missions:

  1. Function as a networking organization that can be mobilized during times of need and crisis for sharing information/solutions and broadcasting messages relevant to all within HPE.
  2. During non-crisis times, the organization can be used to deal with ongoing challenges faced in education by all health professions.

The challenge facing each breakout group was to invent an “organizational/business model” that achieves the two missions, but also conforms to the constraints or opportunities defined by its four assumptions mini scenario. Thus, each group had distinctly different operating conditions within which to develop their organization. Groups were asked to consider how the assumptions would impact, enhance, or constrain the organization being built, and to consider the interaction and synergy between the assumptions.

With the help of an assigned lead, the groups were tasked with determining the name of the organization; its mission, functions, and processes; how it would be funded; and where it sits (e.g., government, academia, etc.). Each group was given an identical scenario, in which the participants were asked to imagine they were living in 2026. The economy is good, the participants were told, but geographic and socioeconomic spots of high unemployment and societal disaffection persist, and politics are highly divisive. The COVID-19 pandemic is in a state of “active management;” vaccines work well but require boosters, and control of the pandemic requires individuals to take personal precautions. As a result of the pandemic and ongoing challenges within HPE, health professions educators realize there is a need for a national coordinating body. Participants are tasked with designing the optimum organization to fulfill the following two missions:

Suggested Citation:"2 Scenario Planning." National Academies of Sciences, Engineering, and Medicine. 2022. Lessons Learned in Health Professions Education During the COVID-19 Pandemic, Part 2: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26484.
×
  1. Function as a networking organization that can be mobilized during times of need and crisis for sharing information/solutions and broadcasting messages relevant to all within HPE.
  2. During non-crisis times, the organization can be used to deal with ongoing challenges faced in education by all the health professions.
Suggested Citation:"2 Scenario Planning." National Academies of Sciences, Engineering, and Medicine. 2022. Lessons Learned in Health Professions Education During the COVID-19 Pandemic, Part 2: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26484.
×
Suggested Citation:"2 Scenario Planning." National Academies of Sciences, Engineering, and Medicine. 2022. Lessons Learned in Health Professions Education During the COVID-19 Pandemic, Part 2: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26484.
×
Suggested Citation:"2 Scenario Planning." National Academies of Sciences, Engineering, and Medicine. 2022. Lessons Learned in Health Professions Education During the COVID-19 Pandemic, Part 2: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26484.
×

Although all four groups had the same scenario, each group was given a unique set of four non-negotiable assumptions that shaped the future world in which participants were working. These assumptions included trends in health and health care, social and economic circumstances, and characteristics of the HPE system. (The specific assumptions for each group are in Box 2-2.) The challenge facing each breakout group was to invent an “organizational/business model” that achieves the two missions, but also conforms to the constraints or opportunities defined by its four assumptions. Thus, each group had distinctly different operating conditions within which to develop their organization. Groups were asked to consider how the assumptions would impact, enhance, or constrain the organization being built, and to consider the interaction and synergy between the assumptions.

After the breakout sessions, the groups reconvened and a member from each group shared “sales pitches” about their organizations, including concrete steps for getting the organizations up and running within a year. Although the groups started with different assumptions, Richard Berman, University of South Florida, observed, there was “a lot of overlap” among the discussions. He particularly called out how all the breakout groups considered ways to change the HPE system to line up more directly with the new ways of delivering care. Zohray Talib, California University of Science and Medicine, agreed, saying although everyone was thinking outside the box, “we all landed in a similar box.”

Health Professions Education Corps

Group 1 created an organization called the Health Professions Education Corps, said Dawn Mancuso, Association of Schools and Colleges of Optometry. The key mission of this organization would be to coordinate education by remaining in constant bi-directional communication with communities. Mancuso said the organization would be “like an Alexa” in that it is “always listening and always monitoring what is going on.” During crisis times, the organization’s main function would be to mobilize an interprofessional emergency health professions education corps. During non-crisis times, it would conduct and coordinate research activities, provide services to the community, and serve as a pipeline/pathway into HPE. An annual meeting would be held, said Mancuso, to bring together all stakeholders and to promote communication and build relationships. The organization would be a public–private partnership with low overhead and interprofessional leadership. It would be funded through a variety of sources, including foundations, tax breaks on the investments of large corporations, and insurers.

Suggested Citation:"2 Scenario Planning." National Academies of Sciences, Engineering, and Medicine. 2022. Lessons Learned in Health Professions Education During the COVID-19 Pandemic, Part 2: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26484.
×

National Health Professions Preparedness Coalition

Jody Frost, National Academies of Practice, reported on the discussion held by Group 2. The organization created by the group, titled National Health Professions Preparedness Coalition, is a public–private partnership designed to serve as a source of credible, trustworthy information for the public and to inform policy. It would be structured as a national, non-hierarchical coalition representing all of health care, including patient and community voices, said Frost. The coalition would bring together all HPE from all levels, and would seek to be representative and inclusive of the diverse communities served across the nation. The organization would be funded through public money, foundations, health care, and educational institutions; Frost stressed the importance of money “from both sides of the political aisle.” The three strategies for implementing this plan, said Frost: first, engage health professions and large foundations; second, build connections with a diverse set of key players; and third, emphasize the importance of an organization that supports truth and science.

A Bridge to Better Health

Group 3, reported Rick Weisbarth, National Academies of Practice, created a nonprofit called A Bridge to Better Health, with a focus on HPE, and a structure explicitly designed to “remove the silos currently in place between the different professions.” The organization would work to coalesce and catalyze essential functions and serve as a clearinghouse for best practices, particularly during crisis times. There will be a diversity of thought and diversity of stakeholders represented in the organization, he said, and it will seek to “challenge everything about the current system” to change the status quo of health education and health care. The organization will engage in policy, advocacy, and data collection activities, and the guiding principles will be efficiency, cost-effectiveness, and addressing the quadruple aim. One focus of the organization will be to expand the definition of the health care team to include families and communities, said Weisbarth. The organization will be structured as a public–private partnership, and will be funded through a variety of sources, to ensure nimbleness and flexibility. Weisbarth described the group’s three strategies for getting the organization up and running: first, to create an advisory committee to develop a business plan; second, to secure funding; and third, to create a public–private partnership with a coalition of stakeholders that includes different health professionals, educators, students, employers, and patients and their families.

Suggested Citation:"2 Scenario Planning." National Academies of Sciences, Engineering, and Medicine. 2022. Lessons Learned in Health Professions Education During the COVID-19 Pandemic, Part 2: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26484.
×

Health Innovation Incubator

The organization created by Group 4, said Talib, and would function as an incubator to prepare the health workforce for the future. The “Health Innovation Incubator” would be oriented around patient health outcomes, and would re-envision education around a core set of principles of efficiency, effectiveness, safety, and accountability. It will recruit a diverse group of stakeholders, including patients, learners, payers, educators, administrators, and health service delivery organizations. The “brightest minds” will be selected to be educated together, the organization will use inclusive processes of designing, teaching, and assessing centered around a common curriculum of patient safety, quality improvement, and social determinants of health. The organization is to be a global forum, funded through stakeholder support. To get the organization off the ground, stakeholder institutions will be brought together to develop a sustainability plan, an innovative learning model will be created, and funding will be secured.

Suggested Citation:"2 Scenario Planning." National Academies of Sciences, Engineering, and Medicine. 2022. Lessons Learned in Health Professions Education During the COVID-19 Pandemic, Part 2: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26484.
×
Page 5
Suggested Citation:"2 Scenario Planning." National Academies of Sciences, Engineering, and Medicine. 2022. Lessons Learned in Health Professions Education During the COVID-19 Pandemic, Part 2: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26484.
×
Page 6
Suggested Citation:"2 Scenario Planning." National Academies of Sciences, Engineering, and Medicine. 2022. Lessons Learned in Health Professions Education During the COVID-19 Pandemic, Part 2: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26484.
×
Page 7
Suggested Citation:"2 Scenario Planning." National Academies of Sciences, Engineering, and Medicine. 2022. Lessons Learned in Health Professions Education During the COVID-19 Pandemic, Part 2: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26484.
×
Page 8
Suggested Citation:"2 Scenario Planning." National Academies of Sciences, Engineering, and Medicine. 2022. Lessons Learned in Health Professions Education During the COVID-19 Pandemic, Part 2: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26484.
×
Page 9
Suggested Citation:"2 Scenario Planning." National Academies of Sciences, Engineering, and Medicine. 2022. Lessons Learned in Health Professions Education During the COVID-19 Pandemic, Part 2: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26484.
×
Page 10
Suggested Citation:"2 Scenario Planning." National Academies of Sciences, Engineering, and Medicine. 2022. Lessons Learned in Health Professions Education During the COVID-19 Pandemic, Part 2: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26484.
×
Page 11
Suggested Citation:"2 Scenario Planning." National Academies of Sciences, Engineering, and Medicine. 2022. Lessons Learned in Health Professions Education During the COVID-19 Pandemic, Part 2: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26484.
×
Page 12
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The COVID-19 pandemic was arguably the greatest disrupter health professional education (HPE) has ever experienced. To explore how lessons learned from this unprecedented event could inform the future of HPE, the Global Forum on Innovation in Health Professional Education of the National Academies of Sciences, Engineering, and Medicine convened a virtual workshop series in 2020 and 2021. The first workshop focused on identifying challenges faced by educators, administrators, and students amidst the pandemic and how the different stakeholder groups shifted and adapted in response. The second workshop explored how experts from various health professions might respond to hypothetical—but realistic—future world situations impacting HPE. The final two workshops contemplated the future of HPE post-COVID and explored next steps for applying lessons learned from the workshop series to allow educators to test and evaluate educational innovations in real time. This Proceedings of a Workshop summarizes discussions from the second, third, and fourth workshops in this series.

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