Socio-Medical Sciences and Public Health


SOCIO-MEDICAL SCIENCES AND PUBLIC HEALTH

16

703.0
Tutorials in Socio-Medical Sciences, Public Health and Community Medicine

Instructor: Michael A. Grodin, M.D., Department of Socio-Medical Sciences and Community Medicine

Location: BUMC Talbot 3 West
Telephone: 638-4626
Fax:414-1464
Website: www.glphr.org

Number of Students: (To be arranged)
Period to be Offered:(To be arranged)

Description of Elective:

Upon request, individual tutorials may be arranged with any member of the Department of Socio-Medical Sciences and Community Medicine, to pursue in depth a topic of interest to the individual student. Examples of tutorial topics introduced in the first year curriculum include: the doctor/patient relationship, health beliefs and attitudes, care-seeking decisions, health promotion, law-medicine issues, ethical issues, human rights and health regulation and planning.

704.0

Health Law, Bioethics and Human Rights

Instructors: George J. Annas, J.D., M.P.H. and Michael Grodin, M.D.

Location: BUMC Talbot 3W
Telephone: 638-4626

Number of Students: One per month
Period to be Offered: One to two months

Description of Elective:

This course is designed to build on the Health Law, Bioethics and Human Rights material covered in the first year “Essentials of Public Health” course by giving the student an opportunity to become more familiar with a specific area of health law, bioethics, and/or human rights that has a direct impact on medical practice and/or health care policy, on the state, federal, or international level. The course consists primarily of directed readings, meetings with the instructor(s), participation in formal classes that are on-going, and participation in relevant activities of the Department of Health Law, Bioethics, and Human Rights, including working with the Department’s nongovernmental organization, Global Lawyers and Physicians (www.glphr.org)

Topics appropriate for study include defining and implementing the human “right to health”; improving patient safety through regulation; protecting patient rights, including the right to make reproductive decisions; the role of physicians in preventing torture and other human rights abuses; and other specific topics that are proposed by the student. It is expected that at least one of the products that the student will produce during this elective is a comprehensive written paper on the problem the student has choosen to study.

Programs can be tailored to specific interests, and students interested in this elective are advised to contact one of the instructors at least 3 months in advance of the anticipated starting date. A written plan for the elective must be developed and approved prior to beginning the elective.


705.0 International Health Elective

Instructor: Suzanne Sarfaty, M.D., Director, International Health Program, BUSM
Contact: Ana Bediako
Location: A-3
Telephone: 638-4167
Website: International Health Program (provides expanded details in relation to information below)

Description of Elective:

This is a clinical clerkship or research opportunity for medical students interested in the field of International Health (IH). BUSM has a few established affiliations with hospitals and medical schools overseas, but students may seek alternative sites for their electives. They must be conversant with the language spoken in the host country for maximal learning benefit unless there is a provision for translators as part of the elective.

Any student wishing to undertake an IH elective must complete a formal application and submit it for approval to Dr. Sarfaty or the designated faculty contact (e.g. Warren Hershman, M.D. for the Israel elective and Vassilis Zannis, M.D. for the Greece elective). A letter of acceptance from the preceptor under which the student will work is also required.

It is strongly recommended that the student initiate plans for the IH elective six months in advance, as logistics for arranging overseas electives can be difficult. Evacuation/travel insurance will be provided to medical students if deemed necessary after discussion with Dr. Sarfaty or faculty contact.

Stipend:
All students are eligible to apply for a stipend to support the cost of the IH elective. Applications are accepted twice a year (July 15 and October 15) and are funded through a competitive process. Awards typically range from $400 to $1500, although awards of less or more are given. Funding is by reimbursement and is intended to help cover airfare and other expenses related to the elective. A completed post-elective report and original receipts must be submitted in order for reimbursement to be granted. In addition, students should consult the website for other potential sources of funding.

Duration of elective: one to three months

Prerequisite: Student must be in good standing, confirmed by the Office of the Registrar


707.0 Health Care Entrepreneurship Program

Instructor: Peter Russo

Location: School of Management-595 Commonwealth Ave., Boston, MA  02215

Telephone: (617) 353-6164     E-Mail: prrusso@bu.edu

Number of Students:1
Period to be Offered: 4 weeks

Description of Elective:

The elective at the Health Care Entrepreneurship Program (HCEP) exposes the medical student to the health care system from the perspective of the Clinician Entrepreneur. It provides insight into the world of business focusing on the start-up phase of health care companies. It offers exposure to the process of building a company from the moment of idea inception; through the stage of business plan writing, to the point of financing and initiation of operations. While at HCEP the student will join the team and contribute in one of three ways:
§ Critically evaluate new business opportunities presented to HCEP,
§ Actively assist HCEP ventures by conducting clinical and market research necessary to advance the project, or
§ Develop the student’s own ideas for a business opportunity
In addition to the tasks above, the elective will challenge and enhance the student’s analytic abilities, written and verbal communication skills, and his/her ability to function in a professional business environment. HCEP’s current areas of business interests include information technologies, health data and informatics, quality of care, clinical guidelines, cost containment, and delivery system efficiency.

Responsibilities will include:
1) Written report to senior staff members regarding analysis of business plans, research results, and/or a business proposal outline of their own specific health care business idea
2) Interviews with HCEP staff concerning their business experiences as needed
3) Weekly meetings with  to discuss ideas, insights, and progress

Participation in this elective requires:
1) A letter of intent written by the student and submitted  along with a current resume
2) An interview

The above requirements should be met at least 8 weeks prior to beginning the elective.

708.0 Leading Community Health Initiatives: Medicine and Public Health as Partners

4 SPH credits / 2 MED credits

Instructors:

Richard Kalish, MD, MPH Assistant Professor of Medicine Boston University School of Medicine

Lois McCloskey, MPH, DrPH Chair ad Interim and Associate Professor Department Maternal and Child Health, Boston University School of Public Health

Christopher Shanahan, MD, MPH Director, Community Medicine Unit Assistant Professor Boston University School of Medicine

James Wolff, MD, MPH, MAT Associate Professor Department of
International Health Boston University School of Public Health

Location: BUMC/Community-Based Practicums
Telephone: 207 730-2088 Contact: Rebecca Condon
Email: rebeccacondon@gmail.com

Students must submit drop/add forms for signature to:  Chris Shanahan, Crosstown Building, 801 Massachusetts Avenue, 2nd Floor)

Number of Students per Block: 14 students from the school of public health and 14 students from the school of medicine for a total of 28 students

Period to be offered: Fall Semester (Thursdays 6:00 p.m.-8:45 p.m., Sept. 3rd-Dec. 17th, 2009

Housing: Not Available

Rationale:
This course is designed for medical and public health students who seek to gain the leadership skills needed to develop and implement community health initiatives. Students will work in theory and practice to address the question, “ How can we as young physicians and public health professionals work with community partners to lead change for better health?” By the end of the course students will demonstrate the ability to work in teams to apply the Challenge Model to develop and implement a community-based health initiative in the context of and in partnership with a community health center or organization.

Course Goals and Teaching Methods:
The goals of this course are to increase collaboration between students at the School of Medicine and the School of Public Health, build partnerships between the two schools and the surrounding communities, provide students with the skills needed to identify, develop and implement successful community-based health initiatives, and encourage them to work together on these projects in a cross-disciplinary way which promotes community involvement. The teaching methods employed by this course include experiential learning, group exercises, simulations and discussions. Students working in teams will use the Challenge Model developed by Management Sciences for Health to identify and address an important leadership challenge with their community partner. The Challenge Model provides a systematic way for teams to experience the direct impact of applying management and leadership practices to achieve results. It will provide the structure for teams to create a shared vision and define a measurable result, assess the current situation and identify opportunities and obstacles, define a challenge and select priority actions, and implement, monitor, and evaluate progress toward achieving the desired result.

Learning Objectives

After completing this course students will be able to:
• Experience the direct impact of applying leadership and management practices to successfully identify, develop and implement actions that result in better health in the community.
• Utilize the challenge model to identify one challenge at a time and achieve results.
• Lead, support and inspire a team of diverse individuals working together to achieve a common goal.
• Reflect on and develop the one’s own individual leadership and management skills.

Learning Experiences, Course Requirements and Evaluation:
Class Participation 5%
Journal 15%
Group Challenge Model Presentation 15%
3 Short Writing Assignments (10% each) 30%
Final Group Project Presentation 35%

Class Participation:
Students are expected to attend all sessions, participate in class discussions, and contribute to group activities and projects. The class participation portion of the grade will be assessed at the end of the course by the partner institution mentor based on attendance and contribution to in the health center team.

Journal:
Students will keep a journal that will allow them to reflect on different aspects of the course and their own progress toward reaching the course objectives. There will be a total of nine journal entries assigned throughout the course. Journals will be graded upon completion, and grades will be based on quality of self-reflection and thoughtfulness of entries.

Group Challenge Model Presentation:
Students will work in teams, made up of a mix of public health and medical students and community organization representatives. Guided by the Challenge Model, each team of 6-8 will identify a leadership challenge in the context of one of the collaborating community health centers or organization, and work together to develop and implement an initiative to meet the challenge and achieve a specified result.. Each team will present their challenge and plan of action and each student will be given a group grade for the presentation.

Short Writing Assignments:
Students will complete a total of 3 short writing assignments (1-2 pages each) throughout the course of the semester. These writing assignments examine the successes and difficulties that the team encounters as it develops and applies the Challenge Model. The first writing assignment will require students to analyze the team challenge model and the obstacles they anticipate as they implement their actions to achieve their desired results. The second writing assignment will require students to apply the ORID method (stands for be Objective, Reflective, Interpretative, and Decisional) to a negative encounter to determine what they may have done differently to turn this experience into a positive one. The third writing assignment will require students to analyze the performance of their group, identify areas of team strengths and weaknesses, and make recommendations to strengthen the performance of the group.

Final Group Project Presentation:
The final group project presentation is an opportunity to showcase the team projects and accomplishments during the course. Each presentation of 20-25 minutes will include an overview of the group’s challenge model, actions the group took to achieve their desired result, how the group’s project progressed, lessons learned throughout the process, and future plans for their community partner after the course has finished. Other components of the presentation may include obstacles faced, how these obstacles were overcome, breakdowns that occurred, how the team responded to these breakdowns, what went well in implementing the project, what didn’t go well, and what they would do differently next time. Members of the group will all receive the same grade for the presentation.

Class Sessions

1. Introduction to Leadership and Management (school)

2. Challenge Model, Mission and Vision (on-site)

3. Walking tour and current situation (on-site)

4. Measurable Result and Smart criteria (on-site)

5. Leadership Skills Workshop 1: Team work and listening Leading Change Coaching your team through breakdowns/Giving Feedback, Requests and complaints (School)

6. School presentations with community and students on Mission, Vision and Current situation (School)

7. Obstacles and Root Causes (on-site)

8. Stakeholder analysis, Priorities, and Action Plan (on-site)

9. Presentations on Priorities and Action Plan (School)

10. Project implementation

11. Leadership Skills Workshop 2: (Inspire through building trust and gaining commitment/Advocacy and Inquiry/ (School)

12. Project Implementation

13. Presentation Preparation

14. Presentation

15. Debriefing/After Action Review


709.0    Critical Reading and Analyses of the Medical Literature

Department of Urology & Division of Graduate Medical Sciences

Boston University School of Medicine

Instructor: Abdulmaged Traish, Ph.D., MBA

Contact Information: 617-638-4578,  Fax 617-638-5412;  email:  atraish@bu.edu

Location: Students are expected to report to Dr. Traish’s office A building (A502) on the first day at 9 am, to discuss the overall elective requirements and to receive the first assignment.

Number of Students: 4-6 students (This block is designed as an elective for 4th year medical students. )

Period to be Offered: Blocks 18 and 19 (This elective is offered in the spring semester and is organized to accommodate the medical school schedule of electives. )

Length of Elective: 4 weeks

SHORT SUMMARY OF ELECTIVE

The goal of this educational elective is to provide medical students with a unique opportunity to develop critical thinking skills in reading and evaluating basic and clinical research literature.   This elective will provide students with an historical perspective in the art of reasoning and critical thinking in the pursuit of answers to biomedical questions.  Students will be given the opportunity to develop and understand the process of reasoning and refinement of research evidence leading to acceptance or rejection of formulated hypotheses.  Advancements in hypothesis development, methodological and technological approaches, and how such advances are used to solve fundamental questions in basic and medical research will be discussed.

DESCRIPTION OF ELECTIVE

The elective will be comprised of a series of assignments and presentations on selected contemporary basic and clinical science literature articles.  Dr. Traish will meet with students twice a week. The first meeting will be devoted to giving the students an overview of the elective and what is expected from them.  On this first meeting, Dr. Traish will hand the students their first assignment to discuss some key questions that need be addressed in formulating their presentation and summary for the assignment.  In general, at the beginning of the week, each student will meet with Dr. Traish to receive an assigned clinical research article and discuss a set of questions that need be addressed. The students will have several days to read and critically analyze and appraise the research question, methods, results and evaluate the findings and conclusions presented in the assigned article.  The students are expected to formulate a brief oral presentation (15 minutes) and a written summary of their conclusions on the assigned research article.  During the second meeting of the week, the student will orally present the summary of their analysis and findings and this becomes the basis for the discussion (45 minutes).  At the end of this discussion, Dr. Traish will meet with the student one-on-one to provide feedback on the presentation and discussion of the article and review the conclusions made and evaluate the progress made by the student.  A grade will be assigned to the performance on each presentation and discussion and will be used to account for the summative grade.  The summative grade is comprised of the grades for each of the 4 assignments.

GOAL: The goal of the Critical Reading and Analyses of the Medical Literature elective is to provide medical students with a unique opportunity to develop critical thinking skills in reading and evaluating basic science and clinical research literature. Further, we hope to engage students in meaningful discussions on how to identify potential sources of bias, relevant to the study design (prospective cohort vs. retro cohort vs. case-control vs. randomized clinical trials.

OBJECTIVES

By the end of the Critical Reading and Analyses of the Medical Literature , the BUSM IV student will be able to:

  • Develop a proactive approach to seeking newly emerging evidence in the medical and research literature (U)
  • Demonstrate critical reading and thinking skills in order to stay abreast of current findings in the medical and research literature (R, U)
  • Assess the rationale for undertaking a research study, relevance of the question under investigation, quality of study design, validity of results and applicability of outcome to the practice of medicine (U).
  • Acquire, assimilate, and interpret basic and clinical research data via a clear summary through oral presentation of key findings (U).
  • Present effectively research analysis and findings (C)
  • Develop and refine their research literature skills to participate in small group discussions and evaluate the quality and accuracy of clinical and basic research data (U, C, R, S).

Apply current medical literature to improve methods of diagnosis and management of patients (R, U).

CURRICULUM

The curriculum includes reading of assigned clinical research articles, summarizing the key findings of the article in a presentation and discussing the findings.

The first meeting will set the stage for the rotation, to determine in small group interaction, the experience of the students with concepts in analyzing medical literature.   This includes providing articles for background reading on discussion of critical thinking and analyses of the data in the medical literature. The elective will use small group feedback from the students to determine areas of medicine of interest to the students and use this information to compile a set of articles in the literature to evaluate in discussions and presentations as part of this course.

The choice of the clinical research articles that will be used for discussion and presentation will be based on a set of criteria, such as: importance of the study, impact of the study on practice of medicine, the journal in which it is published, the significance of the conclusions of the studies and how will they impact medical practice, commentaries, and letters to the editors that followed publication of the study, the impact of the study/trial on the direction of research, and others as indicated by the papers themselves.

EVALUATION

The individual learner will be evaluated based on fulfilling the elective learning objectives and specifically on his/her ability to:

  • Present clearly the summaries and key findings of the research articles
  • Appraise critically the data of research articles.  The following questions are used in the process of appraisal and comprise student evaluation assignments.  They must be answered appropriately in the written assignment and discussion sessions in order to achieve a passing grade for each assignment:
    • What type of study is this, and discuss the Evidence Based Medicine level
    • Was the research question to be investigated well defined and stated accurately?
    • Were the primary and secondary outcome measures defined and discussed?
    • Were the confounding factors taken in the consideration in the analyses?
    • Were missing and relevant information addressed?
    • Were the data explained in a clear manner? Was the authors’ analysis discussed?
    • Are there errors of fact and interpretation? Is discussion of the data relevant? Are there ambiguous statements?
    • Was the outcome of this study contrasted with data from other trials?
    • Is the pertinent literature cited?
    • Were the authors’ objectives in their discussion of the topic and the related data?
    • Do you agree or disagree with the final conclusions?
  • Participating actively in the discussion of the research articles is required in order to pass each assignment and to achieve a passing grade in this course.  Immediate feedback will be given to the student during discussion sessions, and if any of the above elements are not answered satisfactorily, then this will be communicated to the student along with a plan on how to improve and achieve a passing performance.
  • Depending on the article being reviewed for a particular assignment, other review questions may be developed which are tailored to that article, and will be shared in advance with the student along with expectations for correctly addressing those questions.

Each presentation discussion will constitute 25% of the total grade and must receive a passing grade in at least three out of four assignments over the course of the block. The student will receive an evaluation of their performance by the participating faculty (elective director) halfway through the elective and at the end of the elective.  Any assignment not receiving a passing grade will be reviewed with the student in order to help them improve their performance and knowledge base.  The student will be given the opportunity to update their assignment and engage in a new discussion in order to gauge their improvement and provide remediation if necessary.  This may require extra tutorial sessions.