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Department of Family Medicine
Annual Report
2001-2002
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Education

PREDOCTORAL SECTION
INTRODUCTION
SECTION PLANS FOR 02-03
MISSION STATEMENT
THE FAMILY MEDICINE PATHWAY
PREDOCTORAL PROGRAMS

Back to the Top   INTRODUCTION

Medical student education is a core activity for the Department of Family Medicine. Since the Department was founded over a quarter century ago, it has supported required and elective programs and courses to enrich the education of all medical students.

Tom Greer, MD, is faculty director of the predoctoral section. Audrey Lew is program supervisor.

The Department contributed teaching and administrative activities in a number of other departments, schools, and committees, including Admissions, Clinical Curriculum, Academic Affairs Council, and Independent Investigative Inquiry (III). Members of the Department continued to serve on the Advisory Committee for the Student Providers Aspiring to Rural/Urban Underserved EXperiences program (SPARX), an interdisciplinary program for students of the University of Washington Schools of Dentistry, Medicine, Nursing, Pharmacy, Community Medicine, and Public Health. The Department is also active in a University of Washington Initiatives Fund (UIF) project, Health Science Interdisciplinary Partnerships in Clinical Education (HSPICE), a consortium of faculty, students, and health-care professionals in cross-disciplinary teams (Nursing, Dentistry, Medicine, Pharmacy, Public Health, and Social Work) focused on the diverse patient groups served by Harborview.

A long-term planning process to review core curricular offerings and to plan for more financial stability continued during 2001-2002. A new funded federal predoctoral training grant proposal will allow us to continue to build on our past efforts to teach medical students a general patient-centered approach, grounded in evidence-based medicine by teaching how to achieve positive health behavior change. The two interwoven themes in the grant are 1) teaching medical students principles of achieving positive health behavior change through two topics—addressing risky sexual behavior and helping patients make the transition from curative to palliative care at the end of life, and 2) optimizing the use of web-based technologies and CD-ROM materials to deliver curricular content across several diverse programs and courses over a four-year curriculum. A federal Academic Administration Unit In primary Care grant was also funded. This grant will establish a Medical Education Research Group (MERG) that will serve as the focus for educational research activities within the Predoc Section. MERG will identify and integrate essential components for building a research infrastructure. These component include 1) a clearly defined research need in general education with a particular focus in cross-sectional issues in predoctoral and graduate education, 2) motivation and enthusiasm of faculty members for collaboration in educational research activities through MERG, and 3) regular meetings for research agenda setting and progress reports.

A federal faculty development grant proposal continues to create a train-the-trainer program for selected faculty leaders from the 24 Family Medicine Clerkship sites in this region. Training will focus on four key areas: 1) student advising and career choice; 2) evidence- and population-based medicine; 3) patient-centered care; and 4) clinical teaching. Other objectives are to develop courses on such topics as career advising and mentoring of students and residents, including recruitment and retention at the residency programs and working with learners in difficulty. There will be sessions on educational issues, legal issues, the Americans with Disability Act, and impairments. This year two sites, Mount Vernon, Washington (a satellite of the Anacortes, Washington site) and Wrangel, Alaska, were selected to take part in a training program where faculty would be trained at their home sites. A needs assessment to identify training needs were administered and site visits were conducted to the two sites to further identify faculty needs and to do training. We will continue to training at these two sites and select two additional sites in the coming year.

Back to the Top  SECTION PLANS FOR 2002–03 INCLUDE:

1. Build on our accomplishments:

  • 501 Continuity Course is now an option for the new School of Medicine continuity requirement.
  • Eight family physicians are members of the School of Medicine's new colleges.
  • Family Medicine courses and associated programs provide new options for the new III (Independent Investigative Inquiry) program.
  • Planning begins for a new four-week, required chronic care clerkship, with family medicine leading the end-of-life component.
  • The advising program has added a new Dinner with a Doc program.
  • A family physician is part of the ICM I course leadership.
  • We have added new faculty and staff to our section.
2. Manage funding and responsibilities of three federal training grants:
  • Continue the new Predoctoral federal training grant, involving many Predoctoral courses and programs.
  • Continue the New Academic Unit grant establishing a Medical Education Research Group (MERG).
  • Continue the Federal Faculty Development grant that funds train the trainer activities at Family Medicine Clerkship training sites.
3. Manage change.
    New responsibilities, new funding, new faculty and new staff mean change and growth. We will work to manage our change in a productive and positive way despite lack of space and other potential difficulties. To manage the change we will focus on improved communications and ways to enhance our effectiveness in a relatively small working space.
  • We will nurture innovation and support new courses and programs as resources allow.
  • We will continue to nurture students and strive to help more students choose careers in Family Medicine.
  • We will continue to improve the evaluation and dissemination of all our courses and programs with special attention to more efficient evaluation systems and improved web resources.
  • We will continue to share what we do with others at regional and national meetings and through publication.
  • We will continue our searches for more stable funding for Family Medicine medical student education.
Back to the Top   MISSION STATEMENT
Revised June 19, 2002

The Predoctoral Section mission is:

  • To develop and support innovative and high-quality educational experiences in family medicine for all UW medical students.
  • To train medical students who will later serve the evolving needs of the people of Washington, Wyoming, Alaska, Montana, and Idaho.
  • To support the development of careers in rural and urban underserved locations.
We believe in:
  • Nurturing our students, our staff and our faculty in their professional and personal development.
  • Teaching evidence-based, patient-centered, and community-based medicine.
  • Learning that is both service-based and continuous.
  • Advocating for a health system built on the family medicine approach to patient care.
Back to the Top   THE FAMILY MEDICINE PATHWAY

To more sharply focus on the important elements of today’s family medicine curriculum, the section has returned to the notion of a Family Medicine Pathway, first implemented over 25 years ago when students had to choose whether to focus on primary care or on another pathway. The family medicine curriculum is designed to enhance the education of all students with required and elective courses and programs to meet a variety of educational needs. We have identified a core of important courses open to all students; supplemented by selectives and electives.

To supplement basic science/preclinical requirements, a preceptorship elective (501), gives students a chance to work with a family physician in practice and to experience continuity with patients and health care teams over as long as two years. This course will fulfill the School of Medicine's new requirement for a continuity experience. The Rural and Underserved Opportunity Program (RUOP) allows students to integrate what they are taught in the first year of medical school while learning about rural and underserved medical practices. Family physicians and other primary care providers throughout the Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) region teach this School of Medicine program. The Community Health Advancement Program (CHAP) teaches service to the underserved and provides one of the only opportunities for leadership training over four years. The medical student research program allows students to work with family physicians to meet their Independent Investigative Inquiry (III) requirement.

In the clinical years, students participate in the intensive six-week Family Medicine Clerkship offered at 24 sites in the Washington, Wyoming, Alaska, Montana and Idaho (WWAMI) region. The WWAMI Rural Integrated Training Experience (WRITE) program, another School of Medicine initiative designed to promote future practice in rural areas, places students in a rural setting during the second half of their third year. This continuity experience satisfies the family medicine clerkship requirement and may provide students with family medicine elective credit.

The advising program and family medicine student interest groups were recognized again by the American Academy of Family Physicians (AAFP) for having an average of over 20% of students selecting residencies in family medicine for the previous three years.

Family Medicine electives draw attention to curricular innovation that may take years to move into the required curriculum. Courses teaching end-of-life issues; spirituality and medicine; and the skills of patient-centered communication are a part of the Pathway electives. These and other electives offer everything from geriatrics and medical Spanish to suturing workshops and interdisciplinary field trips to learn about rural health.

Back to the Top   PREDOCTORAL PROGRAMS

Back to the Top   Family Medicine 501: Continuity Preceptorship in Family Medicine
The purpose of this course is twofold: to expand the student's understanding of the role of the family physician in patient care and to provide a setting to increase his/her clinical understanding of continuity of care and clinical skills. Students attend weekly one-half day sessions in the offices of their assigned community preceptors and complete a Learning Plan/Mid-Course Progress Form during the fifth week of the quarter. This course offers one of the few continuity experiences available in the medical school curriculum. A second class meeting consists of small group discussions of clinical questions arising from students' work with preceptors using a patient-centered, evidence-based medicine approach.

The course enrolled 87 students: there were 63 individual students of whom 20 enrolled in two consecutive quarters and 2 students enrolled in three consecutive quarters. Enrollment details are as follows:

An Honors option provided students with an in-depth exposure to comprehensive and continuous care of patients and families through clinical experience. Sixteen students successfully completed the Honors Program. An honors grade was awarded to students who met the following criteria:
1. Completion of two or more quarters of preceptorship experience, two quarters of which were taken with the same family physician.
2. Completion of a Family Case Project including a written report, a home visit, and a seminar presentation to faculty and other students, including discussion of a clinical question generated by care of the family.
3. Honors quality work in either the clinical experience or Family Case Project and above average performance in the other.

Kathleen Ellsbury, MD, was the faculty coordinator and Wes Fitch, the program coordinator.

Back to the Top   Rural and Underserved Opportunities Program (RUOP)
The Rural and Underserved Opportunities Program is a School of Medicine program administered by the Department of Family Medicine designed to increase the number of students who consider and ultimately choose careers providing primary care to underserved populations. Students spend four weeks at their RUOP sites in rural and underserved communities throughout the five-state WWAMI region, which includes Washington, Wyoming, Alaska, Montana, and Idaho.

Students received travel and stipends for living expenses. Community physicians volunteer as preceptors and many individual communities provide housing and food, often arranged through local hospitals, for participating students. A total of 86 students participated during the 2001-2002 academic year: 14 from Washington State University, 3 from the University of Alaska, 20 from Montana State University, 10 from the University of Idaho, 9 from the University of Wyoming, and 30 from Seattle-based University of Washington students (see attachment). Major sponsors included the School of Medicine, the Department of Family Medicine, Area Health Education Centers (AHECs), the WWAMI campuses, and the Washington Academy of Family Physicians Foundation (the philanthropic arm of the WAFP). Roger Rosenblatt, MD, MPH, was the faculty advisor, Caroline Lanza, MSW, served as education specialist, and Ian Maki provided program coordination. Forrest Bennett, MD, served as liaison for the Department of Pediatrics and Dawn DeWitt, MD, as liaison for the Department of Medicine.

Caroline Lanza visited four urban clinics, and Ian Maki visited three rural RUOP sites in Western Washington this year. Dr. Rosenblatt visited four rural sites in Eastern Washington, and Peter House visited four sites. Students and preceptors at each of the sites were strongly supportive of RUOP. The remote site preceptors were especially appreciative of Dr. Rosenblatt's visit to their rural communities. Sylvia Moore, Wyoming Clinical Director and Assistant Dean with Colleen Hubbell, the Wyoming placement coordinator, visited seven of ten Wyoming placements, and Janice Troyer, Alaska site coordinator, was able to visit two Alaskan sites, Palmer and Anchorage. Bettie Rundlett, AHEC at Washington State University-Spokane placement coordinator, visited seven sites in Eastern Washington. Brenda Helbling, Idaho placement coordinator, also conducted site visits. Frank Newman and Sharon Kott collectively visited five of the Montana placements and four more preceptors after the students had returned to Seattle.

The RUOP web site continued to be updated as a source of information about the program for both students and community preceptors; the Preceptor Manual and Student Syllabus are on-line. Additional web site resources for preceptor development include links to medical literature through UW Health Sciences Libraries. Ian Maki worked with Ian Simpson of the Department’s Information Technology Systems and Services, to automate the evaluation process for RUOP and make all application, support and evaluation materials available on-line.

Back to the Top   RUOP-Independent Investigative Inquiry Programs
The RUOP program played a special role this year in facilitating opportunities for satisfying the School of Medicine Research Requirement, now known as the Independent Investigative Inquiry (III). The III program is characterized by offering four options to fulfill the requirement. RUOP was responsible for piloting the Experience Driven Inquiry (Option 3), which is characterized by a Community Oriented Primary Care framework. Forty students competed for 20 slots in the program this year. Participants are required to complete a project that responds to the needs of their RUOP community, identified either through their clinical experiences or through discussions with community members. They are then required to contextualize these projects via a community health scan, literature review, and structured personal reflection. Please see the table attached for a list of participating students, their preceptors, locations, and project topics.

Additionally, five students participated in the RUOP/MSRTP program, which fulfilled the III Option 1 - Hypothesis Driven Inquiry program. These projects were designed by faculty who then selected RUOP participants to assist them in data collection and analysis. Please see the attached table for a list of participating students, their advisors, and project topics.

Back to the Top   Family Medicine 640-659, 698: Family Medicine Clerkship
The Family Medicine Clerkship is a required, third-year clerkship taught at 24 sites in the states of Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI). Clerkship efforts focus on these six-week rotations as well as on four quarterly meetings of the clerkship steering committee and four daylong meetings with representatives of each site attending these Seattle meetings. The Family Medicine Clerkship expanded its goals to four for the 2001–02 academic year:

1. The student will learn a primary care approach to the diagnosis and management of common medical problems presenting in the family practice setting.
2. The student will increase his/her understanding of the role of the primary care physician.
3. The student will learn elements of a patient-centered communication (PCC) and evidence-based medicine (EBM) approach to working with patients presenting in a family practice setting.
4. The student will successfully participate in the Virtual Clinic. (Separate learning goals are also in place for the Virtual Clinic, which is discussed below.)

The Clerkship's 24 sites are varied, with urban, rural, suburban, and underserved locations in group practices, health maintenance organizations, community clinics, and residency programs within the five WWAMI states. Sites are listed below. For academic year 2001–02, there were 165 students enrolled in the course.

CLERKSHIP SITES AND COORDINATORS – Family Medicine 640–659, 698

The Clerkship Steering Committee meets on the evening before the daylong quarterly meeting for faculty from each site. The Steering Committee provides guidance to the UW clerkship team and site coordinators regarding curricular development, faculty development, and addressing difficult or complex issues between quarterly meetings. Steering Committee members included: Bill Phillips, MD, UW faculty (appointed by the chair); Dr. Ron Miller, MD, Glacier Medical Associates of Whitefish, Montana; and Gerry Rosellini, MD, Renton Valley Medical Center. Tom Greer, MD, and Stu Farber, MD. were the Co-Faculty Directors; Sara Kim, PhD, played an important clerkship role. Wes Fitch served as program coordinator.

The Steering Committee continued development of a Curriculum Review Committee to review the goals, objectives, and learning strategies of the clerkship and to propose improvements and modifications. The Curriculum Review committee members were Sara Thompson, MD, Group Health Residency, Seattle; Russell Maier, MD, Yakima, Washington; Tom Greer, MD. and Stu Farber, MD, Co-Faculty Directors; and the members of the Steering Committee (Ron Miller, MD. Gerry Rosellini, MD and Bill Phillips, MD) and Sara Kim, PhD. The committee was staffed by Wes Fitch, Program Coordinator.

The clerkship team working with the Steering Committee held four quarterly meetings attended by the faculty site coordinator or another representative from each of the 24 teaching sites. Held in October, January, March, and June, these daylong meetings focused on faculty development in administrative, teaching, technical, and clinical areas.

A major focus of the quarterly meetings has been faculty development around patient-centered communication (PCC) and evidence-based medicine (EBM). Funded by a federal training grant, we have worked with teachers to prepare them to teach these subjects to medical students beginning in academic year 2001–02. With outstanding work by Larry Mauksch, MEd, and Tom Egnew, EdD, coordinators have developed a PCC-EBM curriculum for students. The new curriculum was supported by End-of-Quarter meeting training sessions and site visits by residency network behavioral scientists.

Between quarterly meetings, the Clerkship Team continued to publish Highlights, a newsletter to keep all faculty and university officials up to date on clerkship activities. This newsletter is mailed to over 300 recipients including many site faculty who are unable to attend quarterly meetings.

A continuing major focus has been the streamlining of course administrative operations, including evaluation and enhancing educational materials using the clerkship web site, http://www.fammed.washington.edu/predoctoral/clerkship.

Revisions to the Student Guide, the Virtual Clinic (discussed below), and other clerkship materials were a part of the team's work priority in the last year.

The proprietary FirstClass® e-mail system provides access to vital information including a regularly updated 1) clerkship directory, 2) information about quarterly meetings, 3) site visit planning and scheduling information, and 4) a student roster. During most of the EOQ meetings Clerkship faculty practice using internet technology and view new student programs offered on the web. All clerkship sites have access to the FirstClass system.

An online Virtual Clinic has been in operation since 1999, with initial development funded by a Tools for Transformation Grant from the University of Washington. The clinic is an innovative way for students to learn together over three time zones and with very different and busy schedules using e-mail and the Internet. The Virtual Clinic is designed to be more like real life and less like classroom learning; it is problem-solving based on a real patient case. The aim is for the student to learn factual information in the context of a common patient situation while also learning to work with a team to find resources. Increasingly, references are on the Internet as journal articles or in databases where the articles have already been analyzed by experts. Members of the clerkship team led educational sessions on the Virtual Clinic at the Predoctoral STFM Conference in February and the Annual Spring STFM Conference in April.

Evaluation of the clerkship’s programs includes student evaluation of the course and faculty, peer evaluation through site visits every one to two years, End-Of-Quarter meetings (EOQs), as well as self-evaluation and reflection. The School’s successful Liaison Committee on Medical Education (LCME) accreditation visit took place in March 2002.

Back to the Top   Community Health Advancement Program (CHAP)
The Community Health Advancement Program (CHAP) encourages medical students to consider primary care careers in service to underserved populations. CHAP projects are all volunteer efforts of medical and other health profession students in a variety of community-based settings. In addition, the program has educational and leadership development goals for participating students. CHAP projects include the Dermatology Clinic for the Homeless, the Flu Shot Clinic, the Foot Care Clinic, the Sports Medicine Clinic, the Brown Bag Community Seminars, tutoring at Orion Center, and mentoring at Hamilton Middle School. In the past year 395 students volunteered at least once in a CHAP service activity. Students organize and administer the CHAP programs with the assistance of Sharon Dobie, MD, faculty coordinator; Caroline Lanza, MSW, education coordinator; and Connie Huffine, program coordinator.

The CHAP Dermatology Clinic met on the second and fourth Wednesday of each month at the Downtown Emergency Service Center, a shelter for more than 250 adult men and women. Nine students shared leadership responsibility: scheduling students and attendings, ensuring that supplies were stocked, and supervising each clinic session. A medical student team that consisted of a first- or second-year student (pre-clinical) and a third- or fourth-year student (clinical) delivered care. The teams were precepted by a volunteer attending physician. All students attended an orientation at the Downtown Emergency Service Center. Student coordinators and student care providers attended quarterly seminars on the health concerns of the homeless. Funds from the Friends of the School of Medicine, Turner Foundation, Harborview Medical Center, and Pioneer Square Clinic helped support this program.

The two Saturday Flu Shot Clinics were cancelled at Rainier Park Community Clinic during Autumn Quarter due to the unavailability of the influenza vaccine. We plan to have two flu shot clinics in the fall of 2002. Funds allocated from the University of Washington Medical Alumni Association will be used to support this project.

The Saturday Diabetic Foot Care Clinic at Rainier Park in Seattle continued on a quarterly basis. Each clinic involved a two-hour student training on the diabetic foot exam taught by Sharon Dobie, MD, and a one-hour group educational session facilitated by a nurse diabetic educator at Rainier Park Clinic. Prior to the clinic, students were taught the principles of diabetic pathophysiology and management and health education techniques and strategies for encouraging life-style and behavioral change. Thirty medical students saw 30 patients. Four students served as medical coordinators. The Friends of the School of Medicine helped with the cost of this clinic.

A one-day sports medicine clinic for underserved adolescents at Blaine Elementary School in Seattle provided six teams of first- and second-year medical students the opportunity to provide free examinations to 47 adolescents. Santana Macias, MD, and Sharon Dobie, MD, provided a special three-hour training session to the student providers. The Junior League of Seattle and Friends of the School of Medicine helped fund this project.

There were five CHAP Brown Bag Seminars this year attended by health science students. We co-sponsored these events with the Student Providers Aspiring to Rural and Underserved Experiences (SPARX). We sponsored two seminars on “Domestic Violence.” Sixty-five students attended the first seminar and 90 students attended the second seminar. Twenty-five students attended the panel discussion, “Living on the Streets," by Peace in the Streets by Kids from the Streets. Two Multicultural Competency Workshops were held in conjunction with SPARX and the Office of Multicultural Affairs. Fourteen people attended the first workshop and 17 people attended the second workshop. The Medical Student Association, SPARX and Multicultural Affairs helped sponsor this program.

Health education at Orion Center continued. Orion Center, in association with Seattle Public Schools, aids homeless teens in obtaining a high school diploma or GED. Orion provides meals, educational opportunities, recreational programs, mentoring, and other services. Medical and premedical students gave 15 presentations covering such topics as the brain, the ear, STDs, street drugs and their effect on the body, the immune system, bones, parenting skills, first aid, cops, and docs. Six students tutored reading, writing, and math, one-on-one in the classroom. Student coordinators also attended a half-day training session with the Hamilton Adolescent Mentoring Group. Friends of the School of Medicine, the Medical Student Association, and the University of Washington Medical Alumni Association provided partial funding for this project.

The adolescent health-mentoring program continued at Hamilton Middle School in two classrooms of children with English as a second language, spanning grades six to eight. This program was staffed by an interdisciplinary team of 29 students from medicine, nursing (undergraduate), pharmacy, MEDEX, physical therapy, social work, history (undergraduate), and premed (undergraduate). CHAP worked closely with Seattle Public School personnel. All mentors attended two evening training seminars. Health education presentations and small group discussions emphasized smoking prevention, career decisions, sleep, dental hygiene, anger management, anatomy, mental health, nutrition, viruses, reproduction/contraception, and positive body image. The middle school students participated in a field trip to the University of Washington to see where their mentors went to school. Seattle Public Schools, Friends of Medicine and SPARX provide some support for this program.

CHAP sponsored a very successful health fair for women at Mary’s Place, a drop-in center for homeless women in downtown Seattle. Twenty-five medical students and three dental students served 72 homeless women. CHAP along with community partners provided information on nutrition, birth control, smoking cessation, and alcohol and drug treatment. We provided dental screening exams, blood pressure checks, information and coupons for a free mammogram, foot care and dermatology care.

CHAP participated in the University of Washington’s Community Service day, which took place on Martin Luther King Jr. Day. Eight students, Dr. Dobie, and Connie Huffine spent a day at the Seattle Boat Museum on Lake Union packing up papers, office equipment, and museum items and moving the office to its new location. In addition, an old wooden boat that will be on display was sanded

Back to the Top   Medical Student Research Programs
The Department of Family Medicine medical student research programs provide opportunities for students to work with skilled family medicine investigators to explore topics central to family practice using a spectrum of methods of scientific inquiry. These programs allow students to pursue independent scientific work under the supervision of university- and community-based faculty.

  • HUMAN BIOLOGY 599. MEDICAL STUDENT REQUIRED RESEARCH PROJECTS.
    Many students work through the Department of Family Medicine to complete their School of Medicine research requirements: Independent Investigative Inquiry (III) for E2001 and later entrants or Independent Study in Medical Science (ISMS) for E2000 and earlier entrants.

    Thirty students graduated in 2002, after meeting their research requirement for the MD degree by completing ISMS projects sponsored by the Department of Family Medicine. Forty-nine students are currently working on approved ISMS projects sponsored by the Department. Seven students are currently working on approved Independent Investigative Inquiry (III) projects sponsored by the Department of Family Medicine.

    Dr. Thomas Taylor chaired and Dr. William Phillips served as a member of the School of Medicine ISMS Committee. Both faculty members also served on the ISMS Curriculum Review Subcommittee for the School of Medicine.

    Other medical students are meeting their research requirements by completing projects sponsored by the Department of Family Medicine through the RUOP, CHAP, WRITE and MSRTP programs

  • STUDENT EXTERNSHIP IN FAMILY MEDICINE RESEARCH.
    This intensive summer program provides structured experience for medical students to work with faculty mentors on selected topics relevant to practice or policy. The program includes lectures on family medicine research, seminars in study design, and formal presentations of student projects. Students receive financial support for full-time research work. Most use this opportunity to fulfill their ISMS/III requirements. The program is funded by the Washington Academy of Family Physicians and the American Academy of Family Physicians.

    Five students completed studies through the Research Externship program in Summer 2001, and three presented their work at the Carmel meeting of the Western Student Research Forum in February 2002.

    Three medical students are completing studies in Summer 2002 through the Research Externship program:

    1. Sara Benveniste, Sources of Dissatisfaction among Family Practitioners: Survey of 870 Graduates of the UW Family Practice Residency Network. Sponsors: William R. Phillips, MD, MPH; Sara Kim PhD

    2. Mary Nielson. Maternal Health Benefits of Breast Feeding: Literature Review and Development of a Patient Decision Aid. Sponsor: MaryAnn O'Hara, MD, MPH, MS

    3. Annaliese Floyd. Patient Attitudes toward Direct-to-Patient Advertising of Prescription Drugs. Sponsors: Lynn Oliver, MD; Jeffery Hambleton, MD

  • FAMILY MEDICINE 499: UNDERGRADUATE RESEARCH.
    By special arrangement, undergraduate students can work with Department of Family Medicine faculty members on selected studies

  • THE WESTERN STUDENT MEDICAL RESEARCH FORUM is the premier annual meeting for presentation of research by medical students in all fields. Three students sponsored by the Department of Family Medicine presented their research at the 2001 meeting in Carmel, CA.

  • STUDENT RESEARCH AWARDS
    The Washington Academy of Family Physicians presents an annual Student Research Award at graduation. The award for 2002 went to Elise Leland, “Thinner for Life or For Now: Factors Contributing to the Successful Maintenance of Weight Loss," Jane Huntington, M.D, faculty sponsor. Honorable Mentions were given to Heidi Lowrey, “Factors Influencing Women Family Physicians’ Choice or Rural or Urban Practice," Sponsor: Tom Norris, M.D. and to Lisa Sharon, “Reproductive services in western Washington: Factors influencing behavior of rural and urban family physicians.” Sponsor: Roger Rosenblatt, M.D., MPH

    William Phillips, MD, MPH, directed Student Research Programs, and Connie Huffine served as program coordinator.

Back to the Top   Advising
The Department continued its efforts to educate students about the discipline of family medicine and to assist students and associated residency programs in the mechanics of career choice, including use of the new computerized match system. Student advising is under the direction of Kathleen Ellsbury, MD, and Matthew Thompson, MBChB, faculty coordinators, and Wes Fitch, program coordinator.

Thirty-four individuals (18% percent of the graduating class) selected family practice residencies in March 2002; 20 of these students matched in UW affiliated programs in the WWAMI region. The Department was recognized by the AAFP for its three year average of 22.1% of graduating medical students selecting residencies in family medicine.

In October 2001 the advising team planned and coordinated the Predoctoral Section's third annual Open House. First and second year students were invited to visit the Section's offices to meet staff and faculty representatives of various courses and programs administered out of the office.

The student-organized Family Medicine Interest Group (FMIG) continued with financial aid and staff support from the Washington Academy of Family Physicians (WAFP), the Hoescht Marion Roussel Laboratories and the Department. First- and second-year students served as FMIG coordinators. Fourth-year student, Andrew Gilbert, was student trustee on the WAFP Board. On October 30, 2001, Dr. Bob Crittenden spoke at an evening forum on the "Strength of Family Practice." Approximately 55 medical students attended. On November 27, 2001, Dr. Steve Dresang talked about his experiences working with Doctors with Borders, the Nobel Peace Prize winning organization. Over 100 medical students, PA students, and nursing students attended this event. On December 5, 2001, a panel of four family physicians joined 45-50 medical students to talk about finding a sense of balance in their career and family lives. Participants included Dr. Paul Costello of Lynnwood Community Health Center who shares a practice with his wife; Dr. Jean Marshall of Group Health Factoria who took a year as the ship’s doctor on a Semester at Sea program; Dr. Gerry Rosellini of Valley Medical Center who took paternity leave and also practiced abroad; and Dr. Sara Thompson, part time at Group Health, who has been able to practice medicine and teach residents in her career. Winter quarter events included Valentines for Hospice patients on February 14, 2002, a Sports Medicine Injuries Workshop on February 27, 2002, and an evening forum on subspecialties on February 25, 2002. Participants included Dr. Ed Kay--diving medicine; Dr. Jonathan Sugarman--quality assurance, non-profit CEO, residency teaching, formerly IHS physician; Dr. Linda Gromko--women's health care, transgender medicine, counseling, surgical assisting, formerly ER work; Dr. Chris Behrens--HIV/AIDS; and Dr. Sam Cullison--addiction medicine, geriatrics, administration, leadership. About 40 medical students attended the event. During Spring Quarter students delivered Easter baskets to hospice patients and attended a combined social event with the Holistic Medicine Society and Bastyr students.

A new joint program with the WAFP, Dinner with a Doc, was piloted Winter Quarter. The aims of the program are to 1) increase the interaction of UWSOM students with practicing family physicians, 2) increase student interest in family medicine as a career, 3) provide a relaxed, informal venue for student-physician interaction, and 4) include students' partners/significant others in the career decision process. The program brought together small groups of students and their significant others with two practicing family physicians for an informal dinner. During the dinner the physicians described his/her practice and lifestyle, the challenges and the rewards of the practice, and any other topics the students raised. Drs. Bob Crittenden, Matt Thompson, Al Berg, Tom Greer, Jean Marshall, Kathleen Ellsbury, Chris Gayner, and Shawn West were the faculty hosts.

The Department assisted third- and fourth-year students interested in primary care with the residency application process, including participating in the SOM Annual Career and Residency Process session on May 23, 2002. Jennifer Hoock; a UWMC resident, Wuaca Luna; and Tom Greer conducted the family medicine workshop portion of that meeting. Students met individually and reviewed their personal statements with the education specialist and faculty advisors. The section also co-hosted an evening reception for students to meet with UW Family Practice Residency Network program representatives on May 30, 2002.

Faculty development sessions were conducted on advising topics at required third-year quarterly faculty development meetings (EOQs). The advising web site provided students and faculty off campus with on-line access to career advising information. The advising program completed the final year of its current three-year federal grant, including outreach trips to the WWAMI campuses (Anchorage, Bozeman, Laramie and Moscow/Pullman) to introduce first year students to courses and programs available at the Seattle campus. A new three-year federal Faculty Development grant will enable the advising program to train faculty to better work with students and residents on issues related to career decisions.

Back to the Top   Family Medicine 505: Rural and Urban Preceptorship
Twenty-six students in leadership positions in the various activities of the Community Health Advancement Program (see above) received credit for their work. Sharon Dobie, MD, was the faculty coordinator; Caroline Lanza, MSW, was the education specialist; and Connie Huffine was the program coordinator.

Back to the Top   Family Medicine 545: Preclinical Geriatrics
This course addresses what health and social services professionals need to know about aging and older people. Material covered included the well elderly and normal aging process. Students attended seminars and field trips. Ten students registered for this course Spring Quarter. Richard Baker, MD, and Jeannette Franks, PhD, were the faculty coordinators.

Back to the Top   Family Medicine 546: Hospice Volunteer Training
This course provides interdisciplinary, educational experiences for health sciences professional students in understanding the hospice philosophy of care, understanding a team approach to care delivery, and developing the professional skill of self-reflection in the context of end-of-life care. Course work includes fieldwork, small group participation, group discussion, readings, mentoring, and self-reflective assignments. This course is offered jointly with Medical History and Ethics 517 and is offered Winter Quarter only. A total of 28 students (14 FM; 14 MHE) students registered for the course. Faculty coordinators were Stu Farber, MD; Denise Dudzinski, PhD; and Mark Wicks, MEd, with the assistance of personnel from Hospice of Seattle, Swedish Hospice, and Evergreen Hospice.

Back to the Top   Family Medicine 547: Spirituality and Medicine
Under the direction of Stu Farber, MD; Tom McCormick, DMin; Jan Bridge, MD; and Denise Dudzinski, PhD this course was offered Spring Quarter. In nine two-hour evening sessions, topics addressed included the role of religious traditions, exploration of various spiritual/religious traditions and case presentations; personal faith and prayer in healing and health care; multi-cultural religious sensitivity and physician/chaplain collaboration; spiritual history taking; and balancing personal and professional life. This course is offered jointly with Medical History and Ethics 518. A total of 22 students registered for the course (8 FM; 14 MHE).

Back to the Top   Family Medicine 556: Spanish For Health Professionals
The goals for this course are to teach students to 1) feel more comfortable with patients who speak only Spanish, 2) pronounce words in Spanish correctly, 3) provide vocabulary needed to perform a physical examination, and 4) provide resource materials that would allow for the continuation and improvement of Spanish language skills. The course was not offered Spring 2002. Sam Eggertsen, MD, and Charlie Garcia, director of UWSOM Multicultural Affairs Office, were the designated faculty coordinators.

Back to the Top   Family Medicine 630: WRITE (WWAMI Rural Integrative Training Experience) Clinical Clerkship
This program provides third-year students with 4.5 months (February through mid-June) of extended education in rural community practices with physicians and other health care professionals. This experience comes after completing the first two years of medical school and passing Step 1 of the United States Medical Licensing Exam (USMLE). Students receive credits from several required clinical rotations including Medicine, Pediatrics, Psychiatry, and Family Medicine. Nine students participated at the following sites: Othello, WA; Colfax, WA; Cle Elum/Ellensburg, WA; Sand Point, McCall, Hailey, ID; Kenai/Soldotna, AK; and Libby, MT. Jim Blackman, MD; Phil Cleveland, MD; Tom Nighswander, MD; and Rich Hillman, MD were the faculty coordinators.

Site visits were completed by Family Medicine faculty at the five rural WRITE sites during February, March, April, and May. This rural training experience for third year medical students will continue to train approximately ten students during the coming academic year.

Back to the Top   Family Medicine 670: Advanced Preceptorship in WWAMI Underserved Areas
The purpose of this course was to teach attitudes, knowledge, and skills needed to care for underserved populations in rural primary care offices or in urban community health centers in Washington, Wyoming, Alaska, Montana, and Idaho. Students may elect to return to their Rural and Underserved Opportunities Program sites. Five students were enrolled during this year. The faculty coordinator for this program was Roger Rosenblatt, MD, and the program coordinator was Ian Maki.

Back to the Top   Family Medicine 671: Advanced Preceptorship in the United States
Supplemental experience for late junior or senior medical students in rural or urban practices or other family medicine departments outside the WWAMI region. Two students completed preceptorships: Kathleen Ellsbury, MD, was the faculty coordinator and Wes Fitch was the program coordinator.

Back to the Top   Family Medicine 672: Advanced Preceptorship International
Coordinated by Connie Huffine, program coordinator, with the faculty assistance of Thomas Greer, MD, this course offered students an opportunity to participate in patient care abroad under the supervision of an experienced primary care physician. Knowledge of how social, cultural, political, educational, and economic forces impact health care delivery was emphasized. Fifteen students completed preceptorships in India, Africa, Canada, Guatemala, Haiti, and Ecuador.

Back to the Top   Family Medicine 674: Advanced Interviewing in Primary Care
This elective was offered at the UWMC Family Medical Center and the Harborview Family Medical Center. Two teams of two students spent four weeks focusing on development of physician-patient interaction skills and primary care counseling skills. The strongest part of the design was the interactive peer observation using a structured feedback form. Students also videotaped many hours of patient encounters. As the final product of the course, students present an edited videotape documenting their learning and mastery.

Back to the Top   Family Medicine 680: Traditional Indian Medicine Clerkship
In an urban or Indian reservation primary care setting, the student learns how Western physicians collaborate with traditional Indian healers in the provision of health care to an Indian population. Part of the "Indian Health Pathway," this elective course had three UW students and one visiting student this year. Walt Hollow, MD, was the faculty coordinator; Polly Olsen was the program coordinator.

Back to the Top   Family Medicine 681: Indian Health Clerkship
These individually designed learning experiences place students in training opportunities unique to their goals and needs. Potential Indian health learning experiences include Indian Health Service (IHS) clinics, Tribal Health program, IHS Public Health Program, Urban Indian Health programs, Tribal Council Health activities, and Tribal/IHS alcoholism treatment programs. This course is an elective component of the "Indian Health Pathway." Two UW students and three visiting students were placed. Walt Hollow, MD, was the faculty coordinator; Polly Olsen was the program coordinator.

Together SPARX, CHAP, and OMCA hosted two Multicultural Competency workshops this year. We provided activities and dialog to become better communicators for health care providers in the Health Science disciplines. Polly Olsen from NACOE was a co-facilitator.

Back to the Top   Family Medicine 699: WWAMI Family Medicine Special Electives
By special arrangement for qualified students, clerkships or externships may be available at institutions located within the WWAMI region other than the University of Washington. Seven students registered for the course. Tom Greer, MD, was the faculty coordinator and Wes Fitch was the program coordinator.

Back to the Top   Conjoint 515: Interdisciplinary Health and Human Services Delivery in Rural Communities
This course, coordinated by Family Medicine, Rehabilitation Medicine, MEDEX Program, and the School of Nursing, provided opportunities for students in health care related professions to explore current trends and issues of service delivery in rural communities.

Topics addressed in a lecture-seminar format covered the demographics, economics, and special populations; the historical context of rural health; current issues; rural health providers; rural policy development; multidisciplinary case studies of management of conditions such as fetal alcohol syndrome; and the balancing of personal and career concerns for providers in rural areas. Students participated in a field trip to Leavenworth and Wenatchee, Washington. The course textbook was Textbook of Rural Medicine, by University of Washington faculty, John P. Geyman, MD, Thomas E. Norris, MD, and L. Gary Hart, PhD, Editors, with additional readings provided by guest lecturers.

Enrollment for Winter Quarter 2002 was 35. The student make-up for the course was: Medicine–19; Nursing–6; Public Health (grad.)–3; Pharmacy-2; PT/Rehab Med-2; Undergraduates 2; and Dentistry-1.

The faculty coordinators were Peter J. House, MHA, Clinical Associate Professor in Family Medicine, and Amy Hagopian, MHA, Clinical Assistant Professor in Health Services. The program coordinator was Joyce Kirk.

Back to the Top   Complementary and Alternative Medicine

The UW Department of Family Medicine has received a five-year grant totaling $1.5 million from the National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health (NIH). The UW is one of 15 academic institutions in North America funded by this type of NIH educational grant.

Goals: The CAM Education Grant will be used to:

  • prepare medical students to communicate more effectively with patients about their use of complementary and alternative therapies
  • deepen medical students' knowledge about complementary and alternative medicine, especially herbals and supplements, and to advise patients on safety.
  • provide medical students with the knowledge and attitudes to communicate effectively with complementary and alternative therapy providers.
Specific Objectives:
    1) Promote a climate of cooperation, collegial relationship, and better under- standing between ‘conventional’ and ‘complementary’ medicine faculty.
    2) Foster interdisciplinary student interactions and engage in a respectful exploration of the similarities and differences between conventional and CAM approaches to healing.
    3) Develop and integrate an interdisciplinary evidence-based CAM curriculum in the existing required courses and establish new elective opportunities throughout the four year medical school program at the UW-SOM
    4) Design and implement faculty development in CAM for clinical faculty involved in teaching the required clinical clerkships and elective preceptorships throughout WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho)
    5) Enhance existing information resources so that faculty, student clinicians, and other health-professionals, region-wide will have integrated access to essential CAM databases and education resources at the point of care.
The principal investigator, Ronald Schneeweiss, professor of family medicine, will work closely with Craig Scott, professor of medical education, and Joe Chu, vice president for academics and research at Bastyr University in Kenmore, Wash. Chu is the former assistant dean for curriculum at the UW School of Medicine.

Using an evidence-based approach similar to that used in teaching medical students about conventional therapies, faculty members from the UW departments of family medicine, internal medicine, pediatrics, obstetrics and gynecology, pharmacy, and medical history and ethics are working with their counterparts at Bastyr University.

Together they are developing and integrating complementary and alternative medicine content into selected required courses, electives and preceptorships. This educational effort will be evaluated to measure students' knowledge and attitudes.

Students from the UW medical school and Bastyr University will collaborate on interest group activities and student research projects. A faculty group will bring together researchers from both institutions to present their work and foster research collaborations.

The Complementary and Alternative Medicine Theme Committee includes, in addition to Schneeweiss and Scott, Dedra Buchwald, Erika Goldstein, Barak Gaster, Linda Pinsky and Nassim Assefi, all from the UW Department of Medicine; Susan Reed from the UW Department of Obstetrics; Cora Breuner from the UW Department of Pediatrics, Gary Elmer from the UW School of Pharmacy; James Whorton from the UW Department of Medical History and Ethics; Daniel Cherkin from the UW Department of Family Medicine, and Sylvia Moore, director and assistant dean for the Wyoming WWAMI Program.

Bastyr University faculty, including Chu, Jane Guiltinan, dean of clinical affairs; Robin DiPasquale, chair of botanical medicine; and Terry Courtney, chair of acupuncture and Oriental medicine, will provide the Theme Group with content expertise and will participate in joint activities under the grant.

For information, contact the Program Coordinator Tiffany Lee at 206-543-9425 or tifflee@u.washington.edu.

The UW CAM website can be found at:
http://www.fammed.washington.edu/predoctoral/CAM



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