Envisioning the Future of Health Professional Education Workshop Summary (2016) / Chapter Skim
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3 A Changing Health Workforce
3 A Changing Health Workforce
Pages 43-68
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( albott and Valachovic) T • Task shifting/sharing or task-specific role training represents a departure from traditional delivery models that depend on spe cialist workers.
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The health professions, as with others in higher education, are committed to creating an academic environment that is conducive to learning and attractive to students who will become the backbone of a future health workforce. Because of certain generalized personality traits exhibited in employees, employers and educational institutions that offer greater work–life balance may be particularly luring to the younger generation, known as millennials.
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2. Examples of health professional students' stresses and impacts • ocial work: A survey of 68 undergraduate and graduate social work stu S dents showed that about 34 percent of students indicated high levels of depressive symptoms and were at high risk of clinical depression, 6 percent met criteria for posttraumatic stress disorder, and 3 percent were highly likely to have a dissociative disorder (Horton et al., 2009)
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o Being trained in a balanced environment will provide a positive intro duction to the health professions.
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Previous generations of health professionals were able to develop a command of knowledge about their field during their entry-level education and postgraduate training and continuing education that served them and their patients well over their ca reers. The current explosion of knowledge means that this will no longer be the case.
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One cross-cultural challenge Iwu has observed is the pressure of an overburdened curriculum. Perspective of a Chinese Physician and Educator Xuejun Zeng, a medical doctor and educator at Peking Union Medical College, provided her views of the work–life balance in China from a provider's and educator's perspective.
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The Second Debate Holly Wise from the American Council of Academic Physical Therapy moderated the second debate that addressed whether or not new task-specific roles should be the strategy for health professionals to meet individual and community health needs. Wise explained the debate issue in terms of tasks.
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There have been other instances where people with chronic conditions such as asthma or diabetes have been trained to manage their own care; then, with additional training, the same people become peer navigators offering valuable services to health teams. In essence, task shifting or task-specific role training represents a departure from traditional delivery models that depend on specialist workers.
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2. Better use of health workers with defined skills will maximize the limited time of health professionals and improve the financial resource allocation so expen sive professionals perform interventions they are uniquely qualified to do, as well as being part of a health care team approach.
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• A t a time when the world is facing a shortage of health workers, the focus needs to be on policy and programs to bolster the global health work force. Think globally and act locally to build clinical practice that retrains and re-delegates functions within the system.
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Lack of commensurate compensation for new roles, nonabsorption of the nontraditional, and new cadres of service providers often complicate implementation of task sharing if not tackled proactively. Unrealistic professional restrictions that limit the scope of practice and training for some health workers prevents maximum participation in patient care.
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Pleasant framed his remarks around health literacy as the "currency of a globalized health professional education." In his introductory remarks, Pleasant began by describing how health and literacy come together to create health literacy. He described health as not just the absence of disease but as a resource for life.
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Chronic disease prevention and treatment are other areas where people could grasp concepts and use information to make informed choices more easily if instructions were expressed in terms that are more readily understood. Pleasant noted the link between low health literacy and poorer health outcomes, and said that the cause for this is not necessarily the fault of the individuals but rather a result of complex systems and judgments made in those systems about people with low health literacy.
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Integrating Health Literacy into Health Professional Education Clifford Coleman, M.D., M.P.H. Oregon Health & Science University Cliff Coleman works at a Federally Qualified Health Center (FQHC)
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To respond to the need, Coleman, Hudson, and Maine (2013) published a consensus report that looked across all health professions and identified 62 health literacy competencies trainees should have before graduation.
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It led him to radically transform their medical school curriculum that was based on five guiding principles as follows: • Moving from systems-based to case-based curriculum • Organized in seven blocks of related systems • Clinical and science "threads" run longitudinally • Compressing preclinical curriculum to 18 months • Competency driven The main change was to thread health communications longitudinally throughout the curriculum so important issues like health literacy are continuously reinforced. For health literacy, Coleman and his colleagues drew ideas from Kaiser Permanente in developing their own "habits model." The model tracks four domains during multiple simulated patient encounters taking place during the preclinical curriculum.
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The first is the new Bachelor of Science in Health and Wellness Innovation degree at Ohio State; the second is the CRI Life Enhancement Program (CRI LEP) ; and the third is the CRI Theater for Health program.
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Cabe believes that part of the popularity of the program is due to students seeing career opportunities in wellness, thanks in part to requirements under the Patient Protection and Affordable Care Act mandating a focus on wellness for large employers and some government entities. This program will build a workforce so organizations can improve their employees' health outcomes and productivity through wellness activities.4 4 For more information on the CRI partnership with Ohio State, visit http://www.
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Spirituality 7. Social support and follow-up One week of training takes place in Arizona at Canyon Ranch Health Resort then the CRI LEP Core Team (the Core team)
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The established partnership continues through CRI coaching the core team members via in-person and virtual connections as long as the partner offers the CRI LEP.5 CRI Theater for Health Program The CRI Theater for Health program started in 2010 as a partnership between CRI and The Clorox Company to advance health literacy and improve household hygiene through the arts in two impoverished communities on the outskirts of Lima, Peru (CRI, 2011; Pleasant et al., 2014)
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The research findings were included in an intensive 2-week workshop held in Lima that involved the interdisciplinary team of local actors, directors, and stage personnel; scientific experts from Peru and the United States; and team members from both countries with academic and professional backgrounds in arts, public health, health literacy, and communication. This process educated the artists about the science of household hygiene, and educated the scientists about the process of using the arts in an interactive manner to address health issues.
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Michelle Troseth from Elsevier and also representing the National Academies of Practice commented on the importance of cultural competence in preparing health professionals to work in a globalized community that brings the focus back to the individual and the patient. But with the advent of new technologies like the electronic health record, the focus on the person risks being lost.
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Improving Communication in a Globalized World The next question was addressed using a rapid-fire presentation technique where participants succinctly share ideas in a short amount of time. Table 3-2 is a compilation of the responses generated from the question: How might health literacy be globally integrated into health professional education to improve communication in a globalized world?
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Emilia Iwu Jonas Nursing Scholar Use real patients who understand their disease process to provide feedback to prelicensure health professional learners about their ability to communicate effectively. REFERENCES AAMC (Association of American Medical Colleges)
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2015. A health literacy training intervention for physicians and other health professionals.
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2013. Newborn mortality and fresh stillbirth rates in Tanzania after Helping Babies Breathe training.
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