IDEAS Award Recipients
Jalil Afnan, MD, MRCS
Designated Institutional Official
Assistant Professor of Radiology, Tufts University School of Medicine
Division of Radiology, Lahey Hospital and Medical Center
Proposal Title: “An Innovative Program to Identify, Address and Challenge Microaggressions experienced in the Clinical Workplace”
Eliza Bullis, MD
Clinical Assistant Professor of Medicine, Tufts University School of Medicine
Maine Medical Center, Portland, ME
Proposal Title: “Navigating Patient-Initiated Microaggressions During Clinical Training: Allyship and Empowerment”
Deborah Erlich MD, MMedEd, FAAFP
Associate Professor of Family Medicine, Tufts University School of Medicine
Clinical Site Development Director, Dean’s Office
Vice Chair for Education, Department of Family Medicine
Proposal Title: “Pursuing a Diverse Standardized Patient Educator Clinical Assessment to Increase Inclusion and Decrease Bias in Grading”
Dr. Anna Marie Vu, PhD
Director, Sam W. Ho Health Justice Scholars Program, Tufts University School of Medicine
Founding Co-Director, Tufts Student Service Scholars Program, Tufts University School of Medicine
Proposal Title: “A Place to Belong: Evaluation and Tailoring of the Sam W. Ho Health Justice Scholars Program for Spread at TUSM”
Clinton Pong, MD
Tufts Medical Center
GEOMAP Elective: Developing Population Health Training in Community Health Settings
Geographic Information Systems (GIS) combined with Social Determinants of Health (SDOH) can geomap patients in their community, their care clinic, and community-based organizations. This is an emerging evidence-based approach to identifying healthcare disparities that PCPs and medical students may find helpful for Population Health management and Quality Improvement work, especially as Massachusetts leads the nation in development of Accountable Care Organizations.
This proposal for a GIS-Education Organizing Med Students & Aligning Population Health (GEOMAP) Project will provide visualization of Population Health Curricular (PHC) content for students and faculty and equip medical students with the knowledge and skills to promote health among diverse populations especially the underserved. We will develop Tufts Population Health Curriculum for a clerkship mini-elective, perform a needs assessment of students/faculty/partners via focus group/interview, create a checklist of useful geomapping tools, and monitor future applications of this elective work towards future QI projects, posters, capstone projects, or community advocacy work.
Karen M. Freund, MD, MPH
Tufts Medical Center
Bias Reduction Training for TUSM Faculty
In order to improve the culture of inclusion for medical and graduate students, there is an urgent need to increase the knowledge, attitudes and skills among our faculty regarding recognizing and counteracting implicit bias in their selection and interaction with trainees, staff, and faculty. Therefore, there is a need to support evidence-based implicit bias training of faculty.
The Department of Medicine has committed to providing evidence-based training to its entire faculty. This proposal seeks to expand this training to all clinical faculty at Tufts Medical Center and all faculty in the basic and population health sciences at TUSM. We will work with departments and divisions to arrange a 2.5 hour in-person training. A set of facilitators within TUSM will receive training on the evidence-based program developed by and for academic biomedical science.1,2 Evaluation of the program will include pre- and post-testing on attitudes and recruitment behaviors. The student-specific evaluation metric will be a pre- and post-assessment of letters of reference for students, using a previously developing method of assessing for bias- based words for women and minority applicants.
The short-term outcomes include changes in faculty attitudes and behaviors; the long term outcomes will be increases in diversity of faculty hiring, changes in bias in written student evaluations, and the training a cadre of local facilitators for future training. These outcomes will meet the long term objectives of the program to provide a more inclusive environment and reduction in bias in evaluation of all trainees.
Anthony Schlaff, MD, MPH
Tufts University School of Medicine
A Four Year Integrated Anti-Racism Curriculum for Tufts School of Medicine MD Students
Physicians in the United States receive little training about structural racism, but need this training to form more trusting relationships, address structural racism in the clinical visit, and advocate for their patients. Public Health & Community Medicine faculty members Anthony Schlaff, Fernando Ona, and Ndidi Amutah-Onukagha propose to develop and pilot a short anti-racism curriculum, integrated across the 4 years of medical education, for Tufts University School of Medicine students. We will use a literature review, results of focus groups with Tufts School of Medicine students, and our faculty’s expertise to develop a course that uses the flipped classroom and active small group sessions. The curriculum will be piloted with current 3rd and 4th year student volunteers in spring 2019. Our final product will be a flexible curriculum, available on Tufts courseware, that we hope to incorporate as a required component of the new Tufts curriculum.
Signe Peterson Flieger, PhD, MSW
Tufts University School of Medicine
Modules on Equity, Social Justice, Racism, and Power for Public Health and Clinical Students
The objectives of this project are: (1) to develop evidence-based, thoughtful, stand-alone modules that will be embedded in the core public health curriculum and address issues of equity, social justice, racism, and power in a multidisciplinary and coordinated way to build on throughout the rest of the public health curriculum; (2) to practice faculty facilitation of difficult discussions about equity, social justice, racism, and power; and (3) to adapt these modules for other educational contexts, with a particular focus on the clinical training programs (e.g., MD and PA) here at Tufts University School of Medicine. These modules will be embedded in our revised two-course Foundations curriculum that will launch in 2019-2020. As part of that curriculum revision, we are working to embed these themes more explicitly in our teaching around how we assess public health problems, and how we intervene to address public health problems. Specifically, as part of this project, we will develop three 90 minute sessions focused on these frameworks in the context of needs assessment to be delivered in Foundations I. We will also develop one 3 hour session focused on intervening to address issues of equity, social justice, racism, and power in Foundations II. These sessions will be developed with robust didactic and active learning materials for each part of the session, so that they could be easily adopted and adapted for other teaching and training contexts throughout the Tufts School of Medicine curriculum. While we in the Department of Public Health and Community Medicine know that these are critical dimensions of public health and health care training, many faculty members feel reluctant and/or ill-prepared to facilitate these difficult discussions with students. The co-creation of these modules through teams of faculty will enable us to enhance our collective depth of knowledge and comfort in these areas, while at the same time creating modules that could be used in a variety of contexts, including in the newly revised MD curriculum, or in other clinical training opportunities at Tufts School of Medicine. Through this project, we will not only develop these modules on paper, but we will also practice delivering them among our peers, to facilitate refinement and improvement.
James Yoo, MD; Dallas Reed, MD
Tufts Medical Center
Pilot Program to Increase the Diversity of the Tufts School of Medicine Applicant Pool
Our pilot program will recruit five Tufts University undergraduate students who are interested in a career in medicine and would like particular exposure to Surgery and Obstetrics/Gynecology. The mini-fellowship will provide mentorship, career guidance, and clinical exposure to surgical specialties at Tufts Medical Center. Our aim is to identify highly competitive candidates for medical school and allow them to develop long lasting professional relationships with faculty at Tufts Medical Center, in addition to learning the ins and outs of the medical school admissions process and test preparation. We are excited to start with our first group of students in January 2019.
Sabrina Kurtz-Rossi, M.Ed.
Tufts University School of Medicine
Teaching Cultural Competency and Humility in E-learning Environments: Opportunities and Limitations of Asynchronous and Synchronous Dialogue
This study aims to further cultural competency teaching at Tufts University School of Medicine by applying a cultural humility framework to promote discussion of topics related to health care equity, implicit bias, and structural racism. Tufts School of Medicine values diversity and inclusion, and students are calling for more training and deeper dialogue. Group discussion and dialogue are commonly used strategies for teaching cultural competence and humility. However, little is known about the benefits and limitations of online discussion tools to promote cultural competence and humility among health professions students. This study will examine dialogue among students in asynchronous and synchronous e-learning environments. The study will take a grounded theory approach to identify types and topics of discussion among students in response to a cultural competency and humility lesson and narrative. Mixed methods will include qualitative analysis of asynchronous discussion board and live online synchronous discussion transcripts, pre- /post-lesson evaluations, and a follow-up survey. Teaching with technology and cultural competency are Tufts School of Medicine priorities. The results of this study will be used to increase our understanding of the opportunities and limitations of asynchronous and synchronous online discussion tools and help inform future cultural competency and humility teaching at Tufts School of Medicine.
Neha Sharma, DO
Tufts Medical Center
Innovations in Cultural Psychiatry Education of Adult Psychiatry Residents
The goals of this project are: to support the educational mission of Tufts School of Medicine by promoting self-awareness and integrity within medical students in order to enable them to recognize the biases that they bring to the clinical encounter; collaborating with other disciplines and providers at all levels in order to provide the most compassionate and culturally-sensitive care; developing medical students as leaders; and creating an environment for the promotion, respect, and care for the quality of diversity as well as for diverse peoples. Recognizing the need for formalized training in cultural competence, particularly at an urban medical center in an increasingly diverse country, a Physician Identity Formation will be initiated for Tufts Third Year Medical Students in 2015. The course includes self-assessment of biases, knowledge based article, and video clips of experts on the topic. Aimed at adult learners, topics are presented not only through lecture, but also through small groups, video clips, vignette discussions, and narrative. Physician Identity Formation will be a required lecture for all 3rd year medical students who are rotating through Psychiatry clerkship starting July 2015. It will run every six weeks until April 2016. The course will be evaluated by changes in Pre- and Post- course surveys. Specifically, we hope to use Clinical Cultural Competency Questionnaire that is modified for medical students. Additionally, the interpersonal and communication skills subset of assessment during standardized patient OSCE will be used to assess the course.
The long-term goal of this project is to produce a course that becomes an integral part of medical students’ curriculum, across medical specialties. The medical students could demonstrate their understanding of working with patients from diverse backgrounds by their interaction with a standardized patient, preferably from a minority group or culture, during OSCE. This would be an opportunity for students to showcase their interpersonal skills. Furthermore, the expected long-term outcome is for the medical students to retain skills and knowledge to better interact with patients in a more humble, sensitive and respectful manner, by encouraging the medical student’s curiosity of their attitudes and belief systems.
JoAnna Leyenaar, MD, MPH and Jessica Bennett, MD, MPH
Tufts Medical Center
Empowering Residents and Medical Students to Lead Cultural Competency Curriculum Development: an Innovative Approach to Cultural Competency Training
Cultural competency is a requirement for medical school and residency accreditation. Despite this, effective methods to teach these skills to senior medical students and residents remain elusive. Our proposal describes an innovative approach to teaching cultural competence, whereby pediatrics residents and medical students provide education to one another about important tenets of culturally competent care. This curriculum applies self-directed learning principals and builds upon technological infrastructure to integrate an innovative evaluation approach. Working in teams of fourth year students and pediatric residents, small groups will draw upon their own personal and patient experiences to develop lesson plans based on knowledge or skills deficits identified in the initial evaluation. Our approach allows participants to be completely engaged with the subject matter being taught while also providing data regarding differences in our three outcomes of interest - cross-culture preparedness, skillfulness and experience - across levels of training. This work will generate essential preliminary data to support subsequent grant proposals to assess the impact of this curriculum on larger groups of medical students and residents in other disciplines.
Laura Liscum, PhD
Tufts University School of Medicine
Pathway to PhD
The Tufts Graduate School of Biomedical Sciences seeks to diversify its student body. We hypothesize that establishing strong ties with undergraduate science majors at a Boston area college or university with a diverse student body will, in the short term, increase the number of diverse applicants to the Tufts Graduate School of Biomedical Sciences undergraduate and post-baccalaureate training programs. In the long term, we predict that this will result in increased numbers of qualified applicants of diverse backgrounds to Tufts Graduate School of Biomedical Sciences PhD programs.
We propose to test this hypothesis by bringing six talented University of Massachusetts Boston undergraduate science majors to the Tufts health sciences campus each January during their winter break. During a 3-week period, Tufts Graduate School of Biomedical Sciences students will lead the undergraduates in laboratory experiments, while faculty members offer career development workshops and introduce them to our undergraduate, post-baccalaureate, and graduate research training opportunities. This will provide the undergraduates with an enriching experience while giving Tufts Graduate School of Biomedical Sciences students teaching opportunities. Success of the program will be measured through pre- and post-experience surveys and tracking student outcomes.
January 2013 was the first offering of such a Tufts School of Medicine - UMass Boston Enrichment Program. We propose to build on the success of this inaugural program with a more vibrant curriculum that will become an established Tufts Graduate School of Biomedical Sciences program and be portable to other graduate schools that wish to partner with their local undergraduate institutions.
Michael Rosenblum, MD; J. Aleah Nesteby, RN, FNP; Lauren Meade, MD; Carolyn Delk, DO; Malina Yotova, MD
Increasing Competency in Transgender Care: A Case-based Curriculum
The goal of our project is to increase the competency of Tufts medical students in working with transgender patients. By improving physician knowledge of the various psycho-social issues impacting the transgender population, they will be able to deliver health care services in a more competent, respectful, and sensitive manner. This project will utilize two multi-media instructional modules over the course of a semester, reaching Tufts medical students as well as interested Baystate faculty and staff. Participant knowledge and comfort level regarding the subject matter will be assessed prior to, immediately following, and within 3 months after completion of the transgender health curriculum. The expectation is that participants will demonstrate increased knowledge, comfort and sensitivity in working with the transgender population.
Gladys Fernandez MD; Mihaela Stefan MD; David Page MD; Kaitlyn Wong MD; Kimberly William; Rebecca Blanchard PhD; Elizabeth D’Amour RN; Andrew Doben MD; Richard Wait MD PhD; Neal Seymour MD
Baystate Medical Center
Implementation of a Dynamic Curriculum for Cultural Competency Training
A multicultural and multidisciplinary group of faculty and educators at Baystate Medical Center is coming together to participate in the development and implementation of a dynamic curriculum for cultural competency training for students and residents. Notable experience has been gained over the past several decades regarding development and delivery of curricula in many of the core competency areas fundamental to patient care. In addition, content delivery methods have expanded from traditional didactics to multi-method innovative techniques. One fundamental educational area that has yet to evolve in the undergraduate, graduate and professional continuing education realm is that of cultural competency training. Healthcare populations and workforce diversity have evolved significantly nationally, yet educational curricula for these have not. Provision of suboptimal healthcare in diverse population groups, language and behavioral gaps, lack of provider knowledge regarding cultural competence, and a growing ethnically and racially diverse nation provide the impetus for curriculum development in areas of diversity education. We propose to utilize a variety of interactive curriculum techniques developed and delivered by a diverse faculty group to all medical students exposed to clinical rotations within our institution for a one year period. Assessment of baseline knowledge, skills and attitudes will be followed by interactive training techniques and subsequent post-intervention re-evaluation of performance. The ultimate aims of this year-long experience are to hone a variety of effective curriculum delivery and assessment methods, develop a distributable educational product for all Tufts students and residents, and foster student-as-teacher dissemination techniques for ongoing practice-based learning and improvement.
Amy Chi, MD, Tufts Medical Center
Elisabeth E. Bennett, PhD, Baystate Medical Center
Cultural Assessment and Online Modules of Diversity in End of Life Care
The goals of this project are to (a) Assess cultural competency and needs in preparation for handling end of life discussions with families of different ethnic background, (b) Build awareness of the issues surrounding end of life care in different ethnic populations, (c) Provide knowledge of the resources available to facilitate end of life discussions with families of different ethnic groups. These objectives will be met through the development of online testing and online curriculum modules during the medical student’s inpatient clinical clerkship. Ultimately, this project will provide the a baseline assessment of cultural competency in end of life care issues among medical students and begin to build awareness of cultural issues through the development of online modules for clerkship students. This is a cross-institutional collaboration with educational faculty from Baystate Medical Center and Tufts Medical Center.
Cambridge Health Alliance
Group Visits in Diverse Populations
Group visits are an innovative and effective approach for handling difficult or routine problems in primary care. The faculty in the Tufts School of Medicine Family Medicine Department based in the Cambridge Health Alliance health centers have been using group visits for a variety of issues including diabetes, obesity, stress reduction, tobacco cessation, pre-natal, parenting and well child care. These group visits occur in our clinics which serve a variety of ethnic populations including immigrants from Haiti, Brazil, Portugal, Cape Verde, Central America, China, and the Asian sub-continent. Our project would involve pairs of Tufts School of Medicine students in our group visits in these diverse clinics and patient populations. Participating faculty members would provide immediate feedback at the end of each session and at the end of the experience. Each student would do a reflective piece and give an oral presentation about the group visit experience to fellow students at the end of the semester.
Flavia C. Perea, PhD, MSEd
Tufts University School of Medicine
An Advanced Course on Health Disparities and the Social Determinants of Health
Increasing provider understands of how socio-environmental factors impact health is crucial for eliminating racial/ethnic health disparities and developing efforts to put people on pathways to health as opposed to disparities. This project entails the development of a course on racial/ethnic health disparities and the social determinants of health. The goals for the course are to: (1) Increase students’ knowledge and understanding of racial/ethnic health disparities and the social determinants of health, (2) foster students’ development of the cultural competency skills and values to work with diverse populations and integrate the social determinants into their clinical practice, and (3) help students’ develop strategies to integrate the SDOH into clinical practice. The course will be initially piloted to third and fourth-year MD/MPH students, and at the culmination will present strategies for disseminating the course content to all Tufts MD students.
Debra Sepulveda, MD; Erin Reardon, MD; Kalli Varaklis, MD
Maine Medical Center
Applying and Integrating Education for Cultural and Linguistic Competence: Utilizing Scripted Counseling Techniques
The goals of this project are to create and implement a culturally aware clinical system as a model for resident and student teaching which will improve trainee understanding and utilization of cultural competency techniques. By integrating and emphasizing ‘linguistic competence’ we aim to improve trainee teaching in cultural competence utilizing the techniques of directed teaching, practice and evaluation innovations and scripted prompts for sustainable integration of competency skills into clinical systems.