Heather-Lyn Haley

Purpose of program/study/research: To accelerate the advancement of women professionals at an academic medical center through creative collaboration. Methodology (including study design, analysis, and evaluation): The UMass Medical School Women's Faculty Committee (WFC) initiated a partnership with the medical library to compete successfully to host the traveling exhibition "Changing the Face of Medicine: Celebrating America's Women Physicians." Concurrent with the 6-week exhibition, fifteen events brought local and nationally prominent women together for mentoring activities, an original dramatic production, and an awards luncheon for women faculty. Women featured in the exhibit as well as its Visiting Curator spoke at UMMS about their research and career challenges, read from their published works, and were featured at graduation and a regional medical society event. Results: Application-writing and event planning sessions forged robust working relationships amon...

As part of the mini-symposium entitled "Utilizing Community Voices to Translate Research into Communities: Results from Three Pilot Studies Conducted by Academic and Community Partnerships," this presentation discusses a study that focuses on understanding the barriers refugees face when obtaining critical support services, benefits and housing. The aim is to improve individual and systemic level advocacy and training strategies designed to reduce the barriers impeding access to public benefits and housing for Worcester's growing and diverse refugee population.

Background: Refugees resettling in the US historically follow a trajectory of declining health as they adopt American diet and physical activity. Methods: This participatory research study explored health beliefs and behaviors of refugees from Burma currently resettling in New England. Community members and researchers adapted a healthy living bilingual educational flipchart, which was piloted in two workshops with a total of 20 adult men and women. An interpreter translated the audio taped discussions which were transcribed and analyzed using standard qualitative methods. Conclusions/ Discussion: Refugee camps constrain food and physical activity related health behaviors. Refugees rely on traditional healing practices but are familiar with western public health care and preventive education. In camps, close living quarters encouraged social interaction and group play. Physical activity was built into daily life as transportation, occupation and food gathering method. Exercise was a...

BACKGROUND Many reports, including the Future of Family Medicine, have called for change in primary care, but few have defined, implemented, and evaluated mechanisms to address such change. The regional, interdisciplinary Primary Care Renewal Project was designed to address problems in primary care practice and teaching related to practice management, compensation, increasing responsibility for teaching, and faculty development. METHODS Twelve northeastern US medical schools assembled a conference attended by teams of key stakeholders representing both clinical and educational missions. Teams developed and implemented an institutional plan to address identified needs. Outcome data was collected during, and for 1 year after, the conference. RESULTS Findings demonstrate novel ways of improving learning experiences, coordinating and centralizing planning efforts, and addressing faculty needs. The magnitude of organizational change ranged from establishing new administrative units with ...

Community partnerships Eat Walk Sleep Discuss: Building a Multi-Dimensional Participatory Relationship Heather-Lyn Haley1, Suzanne Cashman1, Mick Godkin1, Meredith Walsh2,3, Nang Maung2,4, Toy Lim3, Sarah Tracy5, Clara Savage6, James Madson II6 1 UMass Medical School Dept of Family Medicine and Community Health, 2 Worcester Refugee Assistance Project, 3 UMass Graduate School of Nursing, 4 UMass Graduate School of Biomedical Sciences, 5 UMass Medical School Class of 2014, 6 Common Pathways

Background/significance: Relationships between community and university partners need to be responsive to opportunities for addressing emerging community needs as well as for identifying research resources. Building a long term partnership from a series of initiatives is challenging but achievable. Objective/Purpose: Guided by the Healthy Communities paradigm, a multi-faceted relationship developed between UMass Medical School, the MA Department of Public Health Community Health Network Area (CHNA) Common Pathways Coalition and the Worcester Refugee Assistance Project (WRAP). Methods: Student-engaged community work at WRAP was originally supported by an external foundation fellowship. Existing partnerships between the university and the local CHNA were leveraged to expand the relationship with WRAP. Portions of an ongoing CHNA-led summer conversation series were utilized for refugee community identification, needs assessment, and neighborhood asset mapping exercises. Prevention Rese...

Refugees resettling in the US historically follow a trajectory of declining health as they adopt American habits of poor diet and low levels of physical activity and sleep. This participatory research study explored health beliefs and behaviors of the new community of refugees from Burma currently resettling in New England from refugee camps. Community members and researchers worked together to adapt a healthy living curriculum entitled Eat Walk Sleep for Health (EWS), creating a bilingual educational flipchart. The flipchart was piloted in two workshops with a total of 20 adult men and women. Workshop discussion focused on participants' prior and current health behaviors as well as their current health challenges. An interpreter translated during the discussions which were audio taped, then transcribed and analyzed using standard qualitative methods. Refugee camps constrain food and physical activity related health behaviors. Refugees rely on traditional healing practices but a...

Many reports, including the Future of Family Medicine, have called for change in primary care, but few have defined, implemented, and evaluated mechanisms to address such change. The regional, interdisciplinary Primary Care Renewal Project was designed to address problems in primary care practice and teaching related to practice management, compensation, increasing responsibility for teaching, and faculty development. Twelve northeastern US medical schools assembled a conference attended by teams of key stakeholders representing both clinical and educational missions. Teams developed and implemented an institutional plan to address identified needs. Outcome data was collected during, and for 1 year after, the conference. Findings demonstrate novel ways of improving learning experiences, coordinating and centralizing planning efforts, and addressing faculty needs. The magnitude of organizational change ranged from establishing new administrative units with significant institutional a...

Providing health care in corrections is challenging. Attracting clinicians can be equally challenging. The future holds a shortage of nurses and primary care physicians. We have a unique opportunity, now, to develop and stabilize our workforce, create a positive image, and enhance quality before the health care landscape changes even more dramatically. Focus groups were conducted with 22 correctional health care professionals divided into three groups: physicians (6), nurses (4), and nurse practitioners/physician assistants (12). Content focused on curricular themes, but additional themes emerged related to recruitment and retention. This article describes recruitment challenges, strategic themes identified, and the proposed initiatives to support a stable, high-quality correctional health workforce.

Little has been published describing curricular experiences in correctional health (CH). Our goal is to articulate a curriculum cognizant of the special needs of the correctional health care worker. We conducted focus groups with nurses, nurse practitioners, physician assistants, and physicians focused on content crucial to prepare competent medical professionals committed to careers in correctional health. Six main themes emerged from the data, which were used to confirm and add to the growing curriculum on correctional health used in our university's correctional health electives. The themes are (a) characteristics of the population being served; (b) prevalent conditions requiring clinical expertise; (c) public health opportunities in correctional facilities; (d) ethical considerations; (e) medical-legal issues; and (d) the CH system, structure, and administration. The successful provision of health care in correctional settings requires specialized knowledge, skills, and awareness not typically available in other health care training settings.

The importance of assessing physician-patient communication skills is widely recognized, but assessment methods are limited. Objective structured clinical examinations are time-consuming and resource intensive. For practicing physicians, patient surveys may be useful, but these also require substantial resources. Clearly, it would be advantageous to develop alternative or supplemental methods for assessing communication skills of medical students, residents, and physicians. The Video-based Test of Communication Skills (VTCS) is an innovative, computer-administered test, consisting of 20 very short video vignettes. In each vignette, a patient makes a statement or asks a question. The examinee responds verbally, as if it was a real encounter and he or she were the physician. Responses are recorded for later scoring. Test administration takes approximately 1 h. Generalizability studies were conducted, and scores for two groups of physicians predicted to differ in their communication skills were compared. Preliminary results are encouraging; the estimated g coefficient for the communication score for 20-vignette test (scored by five raters) is 0.79; g for the personal/affective score under the same conditions is 0.62. Differences between physicians were in the predicted direction, with physicians considered "at risk" for communication difficulties scoring lower than those not so identified. The VTCS is a short, portable test of communication skills. Results reported here suggest that scores reflect differences in skill levels and are generalizable. However, these findings are based on very small sample sizes and must be considered preliminary. Additional work is required before it will be possible to argue confidently that this test in particular, and this approach to testing communication skills in general, is valuable and likely to make a substantial contribution to assessment in medical education.

Objective structured teaching exercises (OSTEs) are relatively new in medical education, with few studies that have reported reliability and validity. To systematically examine the impact of OSTE design decisions, including number of cases, choice of raters, and type of scoring systems used. We examined the impact of number of cases and raters using generalizability theory. We also compared scores from standardized students (SS), faculty raters (FR) and trained graduate student raters (TR), and examined the relation between behavior checklist ratings and global perception scores. Generalizability (g) coefficients for checklist scores were higher for SSs than TRs. The g estimates based on SSs' global scores were higher than g estimates for FRs. SSs' checklist scores were higher than TRs' checklist scores, and SSs' global evaluations were higher than FRs' and TRs' global scores. TRs' relative to SSs' global perceptions correlated more highly with checklist scores. SSs provide more generalizable checklist scores than TRs. Generalizability estimates for global scores from SSs and FRs were comparable. SSs are lenient raters compared to TRs and FRs.

Community health center (CHC) clinicians describe significant challenges in delivering care for populations with complex health needs. A three-workshop series was presented to 102 providers working in CHCs. Training focused on four areas identified through online needs assessment: challenging interactions; patient perspective; health literacy; and motivational interviewing. A retrospective pre-post evaluation measured self-perceived change in content knowledge in all four areas. Participants documented commitments to change behaviors across workshops, which were analyzed for recurring themes. Paired t-tests documented improvement in all four content areas. Content analysis of commitments yielded four themes: empowering patients, structuring care, understanding patients, and reflecting purposefully. Of the sixty-eight percent of participants responding to post-workshop queries about their commitments (n=70), 94% report having fully implemented changes in practice behavior or planning to do so. Providers at CHCs benefit from opportunities to learn and reflect together about communication challenges in practice.

The purpose of this study was to compare the continuous method of scoring a performance test composed of standardized patients with a derivative method that assigned each examinee a dichotomous score and to explore the use of Ang off 's method at the case level with these ...

The Liaison Committee on Medical Education recently set standards for cultural diversity training as part of the medical school curriculum. To the authors' knowledge, this is the first description of a faculty-development program designed to develop the capacity of the clinical faculty to integrate culture and advocacy education into clinical training. The paper describes the first two years of the development of an ongoing cultural competence curriculum that has been integrated into the training of community preceptors from 13 medical schools in New England and New York. The training, entitled"Teaching the Culture of the Community," consists of four 2.5-hour modules that include interactive lectures and small-group role-play exercises on cultural needs assessment, patient-centered interviewing, feedback on cultural issues and use of the community to enhance cultural understanding. The 137 participants in the first two years of the program (1999-00 and 2000-01) reported a high level of acceptance of the curriculum. In the second year, the program began to document participants' self-reported"intention to change" in relation to the cultural competence curriculum. Many participants reported plans to change aspects of their clinical care and their teaching practices. Intentions to change were most frequently expressed in the context of content on effective communication skills. In summary, cultural competency training has been successfully integrated into an existing faculty-development program for community-based preceptors.

In 1989, a survey was sent to each U.S. and Canadian medical school requesting information about how standardized patients are used for teaching and evaluating clinical skills, and 95% of the schools responded. Although there was widespread use of standardized patients throughout the curricula, the role and training of these patients varied markedly within a given school as well as across schools. One outcome of this survey is the development of a network to share resources, protocols, and training material to enhance the development of this educational strategy.

Method Subjects. In 1990-1991, 624 first-year residents from 37 training programs participated in an evaluation pilot study conducted by the ECFMG. Test centers were located in Worcester, Massachusetts, Chicago, Illinois, Brooklyn, New York, and Newark, New ...

Since 1986, there has been a clinical performance assessment program for fourth-year students at the University of Massachusetts Medical School. Students interact with several standardized patients (SPs) and complete other tasks such as interpretation of electrocardiograms and interpretation of X-rays. Scores are generated both by checklists and rating forms completed by the SPs and by paperwork completed by the students at the end of each encounter. Since 1986, students have been asked how frequently they have been observed by faculty and residents as they interacted with actual patients; the students report that such observations have markedly increased. Since 1989, there has been increased feedback to students by the attending faculty during and following clinical rotations. Although it is difficult to claim cause and effect, it is clear that since the inception of this exercise, the faculty have made a conscious effort to improve students' clinical skills by providing increased observation and feedback.

Repository Citation Levin, Len L.; Nordberg, Judith M.; and Haley, Heather-Lyn, "Being there, there and there: using research methodology to evaluate the effectiveness of librarians embedded in chart rounds within a multi-center Family Medicine residency program" (2011). University of Massachusetts Medical School. Library Publications and Presentations. Paper 131. https://doi.org/10.13028/fkb6-jj14. Retrieved from https://escholarship.umassmed.edu/lib_articles/131