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1. Lead for Health
Lead For Health is our community medicine track. It is a formal elective for 2nd and 3rd year residents, dedicated to increased community health training and community engagement. This program trains residents to be physician leaders not just in their clinics but in the community at large, translating population and community needs expressed by our patients and witnessed by our providers into community and practice change. Interested residents apply during the spring of their intern year, but are encouraged to start discussions early with faculty and peers if interested. This longitudinal elective program follows a required community medicine month for all interns. Residents select, design, and implement community engagement projects throughout their PGY2 and PGY3 years of residency. Residents receive two half days per non-call month protected for their community work.
Many Lead for Health projects incorporate TRIUMPH (TRaining in Urban Medicine and Public Health) students from the University of Wisconsin School of Medicine and Public Health and/or are run by faculty and resident graduates or leaders of the TRIUMPH program.
Ongoing Lead For Health Projects:
Community Asset Mapping
This project consists of identifying and sharing the community organizations, programs, and places that help keep our patients healthy. We have created a community asset map and directory as a place where providers and our patients can go to find resources that go beyond what we can offer in our clinic.
Working with partners we have identified (and continue to search out) community assets. Some examples include:
- Parks, gyms, and sports leagues to help keep children and adults active.
- Farmers' markets, food pantries, and stores with robust produce offerings to facilitate an adequate and healthy diet.
- AA meetings, support groups, and mental health providers to help with substance abuse.
Group Diabetes Visits
This project consists of a designing and implementing group diabetes visits within the resident clinics. The curriculum consists of cohorts of 8-10 patients who participate together in three visits scheduled at one month intervals. The focus of each group visit is peer mentorship with physician guidance to help patients answer questions and understand diabetes. Topics include what is diabetes and what are the associated complications, medications, diet, and nutrition options. We track self-efficacy scales, HgbA1c, and BMI before, during, and after group visits to measure our progress. We are so excited to see our results as feedback from patients has been excellent so far. This project has been a poster presentation at the Family Medicine FMX conference in 2015 where it won honorable mention. The project was also presented in a round table discussion at Family Medicine Midwest Conference in 2015. Both of these venues were excellent ways to brainstorm and learn from others leading group visits around the country.
Obesity High Five!
Leaders: Alonzo Jalan, and Kjersti Knox, MD
This project strives to address the epidemic of obesity in a culturally competent and creative manner utilizing tools from integrative medicine. We created the Obesity High Five! curriculum and associated community engagement programming to address obesity by focusing on five fundamental areas: 1) Physical Activity, 2) Nutrition, 3) Stress, 4) Sleep, and 5) Pediatric Prevention. The curriculum provides a roadmap to guide clinical caregivers and patients in addressing obesity longitudinally by harnessing patients' individual efficacy and motivation in these five core areas. This project has expanded to include a Walk With Your Doc! series that assembles patients, residents, faculty, and clinical staff monthly to walk together and explore the neighborhood around our clinic. We have also developed a Welcome Home Milwaukee! series that assembles patients, residents, faculty, and clinical staff to field trip together to explore and learn about the Milwaukee community resources available to our patients outside the clinic to help them sustain healthy living. Follow us soon on Twitter!
Sustaining Family Physicians in Urban Underserved Settings
Leaders: Anne Getzin, MD and Bonnie Bobot, MD
This project strives to understand what variables motivate and sustain family physicians working as primary care providers in high need urban settings in Milwaukee. The tremendous need for primary care physicians in underserved areas is well established. Communities in urban areas bear the burden of this need particularly acutely. Assessment of health outcomes and determinants in Wisconsin indicate a high risk population concentrated in its most urban region - Milwaukee. The UW Population Health Institute's assessment in 2013 demonstrated serious health disparities comparing Milwaukee to the rest of the state, finding that Milwaukee County ranked 71st of 72 counties in Wisconsin in both health outcomes and health determinants.* Given the challenges for primary care in Milwaukee, we are interviewing several key family physicians in Milwaukee and using a qualitative analysis approach to learn from their energy, experience, and wisdom and implement successful practices into our programs.
Reach Out and Read Milwaukee!
Leaders: Dan Ziebell and Kjersti Knox, MD
This project is designed to create a culture of reading and early literacy in our residency clinics and patient population. We are using the basic structure of the Reach Out and Read* program, a nationally recognized early literacy program, and local community resources, like the tremendous Milwaukee Public Library system,** to promote excitement around reading. The Reach Out and Read program prepares Milwaukee's youngest children to succeed by partnering with clinicians to prescribe books and encourage family bonding through reading. These early foundational language skills help start children on a path of success in school as well as in life; research shows that, children served by Reach Out and Read score three to six months ahead of their non-Reach Out and Read peers on vocabulary tests. Our goal is to expand the program to all of our residency clinics and make it an integral part of our clinic culture and eventually reach all Aurora clinics that serve children in Milwaukee. Follow us soon on Twitter!
Chronic Illness Management in Teams of Urban Multidisciplinary Scholars (CIMTUMS)
Leader: John Brill, MD/MPH
This project is a collaborative, inter-professional approach to diabetes group visits. It combines medical students, nurse practitioners, physicians, pharmacists, undergraduate students, athletic training students, and dieticians from Aurora, the University of Wisconsin School of Medicine and Public Health, Concordia University of Wisconsin, and Mount Mary University. Five weekly meetings teach patients diabetes self-management, education, and SMART goals and are followed by additional weekly phone coaching. Each group includes 6-21 patients.
2. Integrative Medicine
Leaders: Kristen Reynolds, MD & Becky Shultz, NP
Integrative Medicine (IM) is the thoughtful, evidenced-based combination of conventional medicine and holistic medicine to help people on their journey to health and wellness. The Aurora Family Medicine Residency offers four distinct IM learning opportunities.
Integrative Medicine in Residency (IMR)
The IMR is a 200-hour online curriculum in IM, designed for incorporation into primary care residency education. First launched at Aurora Family Medicine residency in 2010 it serves as the national model for addressing topics currently not included in conventional medical education. The IMR is a required component of residency training at Aurora Family Medicine Residency. Features include:
- Online, interactive curriculum accessible 24 hours per day
- ACGME competency-based learning objectives
- Case-based, interactive learning and video streaming
- Experiential exercises and process-oriented group activities
- Resources for point-of-care clinical applications
The Integrative Medicine Track
The second opportunity for IM training is the integrative medicine track longitudinal IM experience. In this program, residents are selected through a competitive application process to spend one half day per week (on average) during PGY-2 and PGY-3 years at Aurora Wiselives IM clinic. Residents are assigned continuity patients and also see patients for IM-focused consults under the supervision of a fellowship-trained IM faculty. This experience gives residents a more in-depth opportunity to apply concepts and explore health and healing through integrative approaches.
The Integrative Medicine Elective
The third opportunity for IM training is the Integrative Medicine elective, a one-month optional rotation. Residents work more closely with IM providers, including fellowship-trained physicians and nurse practitioners and can spend time shadowing chiropractic, massage therapy, Reiki, acupuncture, Ayurveda, nutrition/health coaching and other integrative specialty services.
Nutrition Part IV MOC
Finally, the faculty of Aurora Family Medicine Residency have developed an online training tool to meet the ABFM Part IV Maintenance of Certification requirements. Nutrition: An Evidence-Based Approach for the Care and Management of Chronic Diseases is free and available online to all Aurora physicians.
Aurora IM Resources
In addition, Aurora Health Care's Department of Integrative Medicine offers several resources for learning, patient care, and self-care.
3. Osteopathic Manipulative Treatment Training
Resident physicians in the Aurora Family Medicine Residency program receive outstanding training in Osteopathic Manipulative Treatment (OMT). The longitudinal curriculum involves hands on experience through multiple weekly OMT specialty clinics, structured monthly didactics for all family medicine residents, and 4 statewide daylong workshops through the University of Wisconsin statewide Osteopathic Family Medicine Residency Program. This training is led by Mark Robinson, DO who serves as full-time faculty within the Aurora Family Medicine Residency, and Program Director of Osteopathic medical education for the University of Wisconsin Osteopathic Family Medicine Statewide Residency Program and Vice Chairperson of the Heartland/DMU Osteopathic Postdoctoral Training Institute (OPTI). We are proud to be one of the largest dually accredited programs in the country.
4. Global Health Leadership Pathway
The Global Health Leadership Pathway mission is to develop globally educated and socially responsible healthcare professionals. This pathway includes online and live training, journal clubs, scholarly projects and international experience. We offer mentorship in the broad discipline of global health for second and third year residents to develop a focus project associated with their international elective. This longitudinal curriculum gives residents the opportunity to improve the health of disadvantaged populations both domestically and internationally.