Population Health Clerkship: Caring for Populations Within Their Communities
1. Course goals
This is a two-week immersion course (with several preparatory meetings) required of all second year medical and first year graduate nursing students. Its aim is to introduce students to public health concepts and to communities as a unit of care. Community engagement in this course allows students to develop and nurture relationships with community organizations for the mutually beneficial exchange of knowledge and resources, in a context of equitable partnership and reciprocity.
As a result of this Population Health Clerkship experience, students from the medical school and graduate school of nursing will:
• Gain experience in working collaboratively
• Appreciate the value of looking at populations and communities as units of care rather than just individual patients
• Become aware of available and needed resources for the population
• Become aware of the need to work in teams and collaborate with different professions and disciplines providing care and services and value the role of provider as population advocate
*Students: Please note that the Population Health Clerkship is an important experiential part of your core coursework for medical and graduate nursing school and your participation is required. There is flexibility in the scheduling in order for preceptors to maximize the benefit of the experience; however, this flexibility is not meant for you to schedule dentist visits, court dates, moving days, etc. There are now many courses that are recorded and available for you to access via technology - we suggest that you schedule outside appointments on days when you would miss content that is available through such other means.
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The Population Health Clerkship strives to achieve objectives related to student learning, community service and service-learning.
Student learning objectives
1. Describe how socio-economic, cultural, policy, behavioral, environmental and biological factors contribute to specific individual and population health outcomes.
2. Collect and review existing data, identify gaps in data, and explain how data can be used to improve the health status of the population of focus (and, as relevant, the mission of an organization that works with the population).
3. Identify the common public health and advocacy strategies and programs for preventing and addressing a health issue in a population.
4. Work collaboratively with other health professional students, health care providers, and community agencies to develop strategies to advocate for a vulnerable population. This is achieved through the development of clerkship products including a service project that is negotiated with the team’s primary agency to meet a need.
5. Demonstrate an ability to be aware of, and reflect on, personal reactions to people with the particular health issues of focus. This is achieved through guided reflection.
Community service objective
Develop a data-driven product that will help a population meet a goal of improved health and/or a product or activity that the organization working with the population identifies as a need to improve health. This is achieved through development of a project, product or proposal.
Articulate specific health professionals' social responsibility related to serving the health needs of a population.
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3. Educational methodology
This course component employs a variety of educational methodologies including small group sessions, a field experience, reflective practice activities, a population health assessment, dissemination of findings (poster presentation) and continuous self-learning activities. This course fosters community engagement, the process by which organizations and individuals develop and nurture relationships for the mutually beneficial exchange of knowledge and resources in a context of equitable partnership and reciprocity.
Small group teams (September – November)
Students rank their top five choices for a clerkship team and are assigned by faculty to enable maximizing the mix of medical and advanced practice nursing students. Students meet for the first small group introduction with academic and community faculty in late September and then convene again in mid-October. Preparatory readings are assigned for all students (located at end of this document) in addition to population-specific readings and resources identified by team leaders.
Field experience (October)
The core field experience occurs over two weeks in October. The field experience is structured to provide the students with ten full days of learning, i.e. 6 hours of active learning, plus 2 hours of additional study per day. There is some flexibility due to travel and scheduling with community agencies.
Early in the field experience, working with the community preceptor and academic faculty team leader, students confirm the focus to develop and implement a service activity. As part of their field experience, students should collect data pertaining to a health related issue faced by the population of focus, and learn about the array of available services and ongoing advocacy initiatives. An optional Population Health Framework worksheet is available to guide teams through this process. Through reflective exercises, students will demonstrate awareness of background material and ability to reflect on its application in the context of their team-based experiences. Students are expected to participate actively in the clerkship experience and collaborate on a service project, and to create and present a poster to the UMMS community in November, as detailed in the assessment section.
Academic faculty team leaders and community preceptors should help students identify the necessary sources of data, including contacts with other agencies and providers. As relevant, students may spend time at agencies to develop an understanding of the service network. These agencies include those providing direct patient care, and regulatory and other agencies that have an impact on direct service delivery.
When possible, it is expected that community preceptors will provide students with an opportunity to observe the impact of a population health problem at the individual level. Scheduling for this type of opportunity should begin early in the clerkship so that students will be able to interview a patient and perhaps his/her family to understand the impact of the health problem on a patient and understand a patient's experience of receiving care. An understanding of a patient's pathway through the health care system will likely prove invaluable to understanding some of the services provided for a particular problem/issue.
Dissemination to community (November)
A poster session at the end of the immersion experience provides each group an opportunity to synthesize their experiences and findings. It also serves as a means to exchange information among groups. Through the posters, students present an analysis of data gathered within the Framework, as well as a summary of their field experience and service project to fellow students, faculty, and community members. The most recent batch of posters is available from the left navigation menu on this page.
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4. Assignments, evaluation and assessment
Students are evaluated on a credit/no credit basis. All students are expected to attend all planned meetings, complete the clerkship requirements, and be active contributors to group activities. Each student team will conduct a service project or activity as assigned by the team leader(s) and create an academic poster. Each individual student will complete reflective writing assignments and will receive a professionalism grade determined by the site preceptor based on factors such as attendance, engagement and teamwork. Students' final grades will be determined using each of these criteria to calculate the final grade.
1. Scholarly poster (35 points): this poster will facilitate sharing of knowledge with colleagues, fellow classmates, academic and community faculty and school administration. Each team will be expected to present their poster orally to attendees at the poster session in November. Instruction on how to prepare academic posters for the Population Health Clerkship are available online here. If students plan to use images from their experiences in the community, they are urged to get permission of all people included in the photos. A permission slip can be downloaded here [link]. There is an optional peer review session scheduled for students to work together on finalizing their posters. During this hour, students will be encouraged to share feedback and make final changes before submitting files for printing.
1. Reflective writing (30 points): As a part of the Population Health Clerkship, you are required to show written evidence that you have reflected on the experience. The requirement is to write a reflective paper of at least 5 (double-spaced) pages. Your initial submission should be a page or two of initial reflections, and must be received by team leader(s) on Wednesday evening of the first week to allow for early feedback. The second and final submission should include evidence of ongoing reflection during the two week period. Creativity is allowed for this assignment; for example, your submission might include art/photographs with text explaining what these images evoke in you, based on your experiences. The final assignment is due to your team leader(s) by 5pm on the last day of the clerkship.
To help you guide your thinking as you continue your reflections, we are providing a reflection guide with several questions to get you started. We strongly recommend that you answer the included questions as indicated for the first and final reflection entries. The other questions are included as a guide and as a way to help prompt your thinking and move beyond description for the rest of your writing during the ten days. Note that some team leaders have developed their own guidelines for reflective assignments, so be sure to attend all meetings and listen carefully to community preceptors.
2. Performing to standards of professionalism (35 points): You represent UMass Worcester during this experience, and are expected to perform up to the standards held in the community for professionalism. You are expected to dress appropriately, attend all sessions, arrive on time and stay until the end of each day's activities. Preceptors will be looking for full participation and thoughtful interaction, both within your team and with the full range of proessionals and others with whom you come into contact. They will be asked to provide a professionalism score for each student based on your work during the immersion period.
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Below you’ll find a timeline for PHC activities in 2016:
8/8/16: Students receive team catalog and are asked to rank preferences
8/15/16: Student preference rankings due
8/24/16: Student placements announced
9/6/16: 3-4pm Introduction to PHC and 4-5pm small group orientation: Population Health Clerkship Teams meet with academic faculty and/or community preceptors for introductions and discussion of students’ specific interests, unless otherwise arranged by team leaders.
10/17-28/15: Population Health Clerkship Team Field Experience
10/19/16: First reflection due to team leaders
10/28/16: All reflections and poster drafts due to team leaders
10/31/16: Final poster PPT or PPTX files submission deadline (to Heather-Lyn.Haley@umassmed.edu )
11/07/16: Poster session 3-5pm in Sherman Center, 2nd and 3rd floor Learning Community Suites
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6. Reading List
These readings are provided for all students; others will be identified by small group team leaders. We recommend reading a few selections from this list prior to beginning the immersion experience in October.
Betancourt, J.R., Quinlan, J. 2007. Personal Responsibility Versus Responsible Options: Health Care, Community Health Promotion, and and Battle Against Chronic Disease. Prev Chronic Dis 4(3). http://www.cdc.gov/pcd/issues/2007/jul/07_0017.htm. Accessed September 2011.
Fielding, J.E., Teutsch, S.M. 2009. Integrating Clinical Care and Community Health. JAMA 302(3): 317-319.
Gadon, M. 2007. Revisiting the Social Contract: Physicians as Community Health Promoters. Prev Chronic Dis 4(3). http://www.cdc.gov/pcd/issues/2007/jul/06_0195.htm. Accessed September 2011.
Gruen, R. L., Campbell, E.G., Blumenthal, D. 2006. Public Roles of US Physicians: Community Participation, Political Involvement, and Collective Advocacy. JAMA 296(20): 2467-2475.
Hale, Janet. 2011. The Value and Imperative for Health Professions Engaging in Interprofessional Learning. Click here for pdf.
Halfon, Neal, Larson, Kandyce and Shirley Russ. 2010. Theories And Consequences: Why Social Determinants? Healthcare Quarterly, 14(Sp) 2010: 8-20. Available at http://www.longwoods.com/content/21979
Interprofessional Education Collaborative. 2016. Core competencies for interprofessional collaborative practice: 2016 update. Washington DC: Interprofessional education Collaborative. http://www.aacn.nche.edu/education-resources/IPEC-2016-Updated-Core-Competencies-Report.pdf
Krisberg, Kim. 2013. Medical Schools Integrate Health Disparity Education Across Curriculum. AAMC Reporter, June 2013. https://www.aamc.org/newsroom/reporter/june2013/346366/health-disparity.html
Marmot, M. 2007. Achieving Health Equity: From Root Causes to Fair Outcomes. Lancet 370: 1153-1162.
McGinnis, J.M. 2010. Observations on Incentives to Improve Population Health. Prev Chronic Dis 7(5). http://www.cdc.gov/pcd/issues/2010/sep/10_0078.htm. Accessed August 2011.
Parrish, R.G. 2010. Measuring Population Health Outcomes. Prev Chronic Dis 7(4). http://www.cdc.gov/pcd/issues/2010/jul/10_0005.htm. Accessed August 2011.
Radzyminski, S. 2007. The Concept of Population Health within the Nursing Profession. J Professional Nursing 23(1): 37-46.
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7. Useful links
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8. Team listing
The 2016 listing of students placements will be made available here on 8/24/16.
Information describing each of the teams is compiled into a Team Catalog to help you as you consider your preferences for team placement. Hard copies of the catalog will be available in the Learning Community Suites beginning on August 9, and you can download the Team Catalog as a pdf here. This document provides descriptions of the teams, their leaders, planned activities and resources to learn more.
Students are asked to rank their top five choices . Students should keep in mind that there is no reimbursement for travel or meals. Housing is provided for the team on Martha's Vineyard, as described in the catalog.
The direct link for ranking of teams is: https://www.surveymonkey.com/r/PHC2016_rankings