The document provides an agenda and instructions for a learning collaborative session on developing a post-graduate residency program curriculum. It includes details on turning on webcams, muting during presentations, and sending attendance via chat. The agenda covers program curriculum, curriculum development, schedules and resources, marketing, recruitment, applications, a presentation from Western North Carolina Community Health Services, and a QI theory burst on process mapping. Attendees are asked to continue working on their communications and marketing plans, map out a schedule skeleton, develop a list of key clinical topics, and post successes or challenges to the discussion forum before the next session.

1. We will begin shortly…
Welcome
1

2. Using Zoom
 Turn your webcam on!
 Please remember to
mute yourself during the
presentations.
 Please send in your
attendance via the CHAT
box

3. Organizational Overview

4. Shout out to the Coaches!
HEALTH CENTER COACH
Avenal Community Health Center Veronica Vo Lumley
Central City Concern- Lauren Land
CHAS Health Marcus Riccelli
Lamprey Health Care Evalie Crosby
Lyon Martin Health Services Nina Soares
Menominee Tribal Clinic Diane Hietpas
Montbello Health Center Lisa Wanger
Johnson City Community Health Center- Betsu Kappes
Rutgers Community Health Center Mary DiGuilio
The Children’s Clinic Jack Tsai

5. AGENDA- Learning Collaborative Session 3
November 9 3:00-4:30pm (EST)
 Welcome- Review Agenda and Assignments
 Program Curriculum
 Curriculum Development
 Schedules and Resources
 Marketing, Recruitment, Applications
 Western North Carolina Community Health Services
 QI Theory Burst- Process Mapping
 Action Period Items (Assignments)
Ask Questions!

6. 96
94
100
94
91
92
93
94
95
96
97
98
99
100
Gathering and
Using Data Skills
Using Effective
Meeting Skills
Using Improvement
Skills
Applying Teamwork
Skills
%StronglyAgreeorAgree
Team Skills Self-Assessment (N=39)
Percentage Strongly Agree or Agree

7. 90
90
90
90
90
80
80
80
80
70
70
60
0 20 40 60 80 100
feel confident that the organization can support people as they adjust.
will do whatever it takes.
want to implement.
feel confident that they can handle the challenges that might arise.
feel confident that they can keep the momentum going.
are motivated.
are determined.
are committed.
feel confident that they can coordinate tasks so that implementation goes smoothly.
feel confident that they can manage the politics.
feel confident that they can keep track of progress.
feel confident that the organization can get people invested.
% of Teams Agree or Somewhat Agree
How the People Who Work at Your Organization Feel About
Implementing a Post-Graduate Residency Program (N=10)

8. Using the Progress Checklist
Purpose
1. To help you track your progress on the items
you have selected to work on
2. To help us identify where you need more
help
3. To help your coaches identify areas in which
you need more encouragement and
reminders

10. What to do….
• Can be completed during a team meeting or
the coach can complete it separately based on
conversations with team members
• Just check the box or color it in
• Display it as you work
• You will do this again midway through and at
the very end of the Learning Collaborative
• Complete both tabs

11. Curriculum Development
Part 2
Elements of your curriculum
11

12. Plan going forward
• Session 3: Elements of
your curriculum
• Session 4: Mapping
content
• Session 5: Organizing
the curriculum into a
cohesive whole
• Session 6: Evaluation of
the learner
• Session 7: Evaluation of
the program
• Session 8: Crosswalking
the curriculum and
evaluation
• Session 9: Feedback
loops and QI for revising
the curriculum and
evaluation

13. Your outcome for this session
 Describe the key elements of a curriculum
– Topics (example): domain: Patient-centered Care (NP)
– Topics (example): Theories of assessment, diagnosis,
intervention (Psych)
– Clinical v. didactic activities and topics
– KSAs
– Resources
– Schedule

14. NP Standard 2: Curriculum
5 Required Elements and 8 Competencies
Elements
• 1. clinical-based care and
patient care experiences;
• 2. regularly scheduled didactic
sessions;
• 3. systems based learning and
quality improvement;
• 4. population-based health
focus;
• 5. leadership and professional
development, especially in
inter-professional practice.
Competencies
• 1. patient-centered care;
• 2. knowledge for practice;
• 3. practice-based learning
and improvement;
• 4. interpersonal and
communication skills;
• 5. professionalism;
• 6. systems-based practice;
• 7. interprofessional
collaboration;
• 8. personal and professional
development.

16. What we have covered so far…..
Mission
Goals
Objectives

17. Mission Goals Objectives
Broad statement of
purpose and reason
Long term target,
what you want to
accomplish
Presents the overall
program domains,
i.e., the outline of
what content will be
offered
Gives rise to the
goals
Gives rise to the
objectives
Gives rise to learner
outcomes
Should remain
consistent over time
Should remain
consistent with
minor modifications
Can be modified as
needed, measured
at a program level
Definitions

18. Curriculum Objectives vs.
Learner Outcomes
• Curriculum objectives are general and measured at a program
level. They present the overall outline of what the program
will offer. The objectives introduce the curricular domains, of
the program, eg: Patient-Centered Care, Professionalism,
Clinical Practice
• Learner outcomes are a measurable benchmark, the intended
results within each curricular domain. They demonstrate
what the learner will actually do, and often use Bloom’s
taxonomy of action verbs. How you measure their
achievement of outcomes is your evidence that your residents
are learning and doing what you said they would learn and
do. These are sub-domains in the guidelines.

19. DRIVERS LEADERSHIP/BOARD/FINANCES
MARKETING, RECRUITMENT
CURRICULUM
Domains/subdomains
Space/equipment Space/equipment
Policies
Patients DIDACTIC
Preceptors Faculty
EVALUATION OF LEARNER SCHEDULE EVALUATION OF LEARNER
REMEDIATION OF LEARNER REMEDIATION OF LEARNER
ACCCREDITATION GRADUATES WHO FULFILL YOUR MISSION
CLINICAL
TOPICS
/KSAs
MISSION
Program goals/objectives
Learner
outcomes/competencies

20. Some definitions
• Curriculum: All activities—didactic, clinical, learner evaluation—
that provide the structure, content, and processes to ensure
that your residents achieve learner outcomes and fulfill your
mission
• Domains/subdomains (competencies): from your accreditation
standards; these help to identify topics in clinical practice that
will be incorporated into didactic and clinical activities, e.g.,
Patient-Centered Care: “treatment of health problems”
• Topics: What do your residents need to know? What do they
need to know how to do? What values do they need to
embrace and demonstrate?
– KSA: Knowledge, Skills, Attitude

21. Definitions cont.
• Clinical: Any activity that involves direct
patient care by the resident
– Providing care in clinic with and without a
preceptor (NP)
– Treatment sessions with patients/Supervision with
senior psychologist (Psych)
– Documentation of care
– Ordering tests, referrals, etc.
– Consultation with care team/peer about a patient

22. Definitions cont.
• Didactic: Any activity outside of direct care in
which preceptors and “faculty” formally
engage in teaching, training, or informing
residents about topics in clinical practice,
policies and procedures in your setting; can
include orientation
• Evaluation of the Learner: a formal process in
which learners evaluate their own learning and
practice, and faculty/preceptors evaluate the
residents; this can include reflective journaling

23. Definitions cont.
• Schedule: A planned outline of the timing and
topics of didactic, clinical and evaluation activities
over the course of the residency
– Use hours, not “days” or “sessions” to quantify time
spent on learner activities
– A full-time job (40hrs/wk/50 wks) is 2000 hours
– Accreditation standards do not set a minimum or
maximum amount of time
– For NP programs, 1500-1600 structured hours is
typical
– For PhD programs, minimum 1500 hours

24. Resources
• Space/equipment: office, exam room, computers,
etc.
• Patients: do you have enough of the type you
need?
• Faculty: anyone involved in didactic activities
• Preceptor/supervisor: professional peer
responsible for oversight of resident’s practice
• Financial resources
• Policies: any policies/procedures that may need
to be revised to accommodate resident practice

25. Questions to ask yourself:
1. How/why did you decide on “primary care clinic?”
2. What happens in primary care clinic?
3. What does your resident need to know to care for
these patients?
4. What does your resident need to know how to do
to care for these patients?
5. What values, attitudes, behaviors do you want your
resident to demonstrate?
Knowledge (know), Skills (do), Attitude
(behave)

26. You have a pile of pieces. Start separating them into groups.
Have a small team start to put them together.
Build
from the
outside
in, or the
inside
out.

27. Every site will have a
different looking
puzzle because every
site has different
resources and patient
populations.
Later, we will show
you how to crosswalk
your curriculum with
accreditation
standards.

28. CHCI’s Program Schedule - Month

29. Needed Resources
• Preceptors and Mentors - staff
• Didactic Presenters – staff and external
• Specialty Rotations – what does your program
want to include? What is your patient population?
– CHC’s Specialty Rotations – pediatrics, geriatrics,
newborn nursery, women’s health, HIV/Hep C,
orthopedics, dermatology, adult psychiatry, child
psychiatry, healthcare for the homeless

30. CHCI’s Program Schedule - Week
Program
Resources

31. Yakima Valley Farm Workers Clinic

32. Post Doc Psychology Program
• Weekly schedule

33. Example: Start with a domain:
Patient-centered care
1. Patient-centered care
2. Knowledge for practice
3. Practice Based
Learning and
Improvement
4. Interpersonal and
Communication Skills
5. Professionalism
6. Systems-based
Practice
7. Inter-professional
Collaboration
8. Personal and
Professional
Development

34. Competency/Domain: Patient Care
• Patient Care: Provide patient-centered care that is
compassionate, valued, appropriate and effective for the
treatment of health problems and the promotion of health.
• What health problems are most prominent in YOUR
population of patients?

35. Sub-domains: outcomes/competencies
1.1 Perform all screening, diagnostic assessments and procedures for
patients with _________.
1.2 Gather essential and accurate information about patients with
_________ through review of records, history-taking, physical exam
and assessment, and review of data derived from laboratory and
imaging testing.
1.3 Organize and prioritize responsibilities to provide care to patients
with _________ that is safe, effective and efficient.
1.4 Interpret laboratory data, imaging studies, other tests required for
the care of patients with _________.
1.5 Make informed decisions about diagnostic and therapeutic
interventions based on patient information and preferences, evidence
based information and clinical judgment
1.6 Develop and carry out management plans for patients with
_________.

36. Care of the patient with _______
• Learner outcome: Provide appropriate and effective care for
adult patients with _______ that is compassionate and
consistent with patient preferences.
• Topics in subdomain: diagnostics, procedures, clinical
decision-making, history and physical, management of
treatment plan
• What is didactic, what is clinical? Other?

37. Start a list of topics
Knowledge
Describe, explain,
apply…..
• Diagnostics: which
tests for which
conditions?
Skills
Demonstrate….
• History and
physical
Attitudes
Demonstrate…
• Compassion

38. You should not be re-teaching content/topics
that the residents learned in graduate school.
But you can remind them as you focus on the
application of these topics in your clinical
setting with your unique patient population.

39. You will notice:
! There is a lot of overlap in topics, e.g., between
diagnostics and procedures
! There is a lot of overlap as you decide which
topics to put under which domain, e.g., Patient
care and Knowledge for practice
! You can use some of the same language again
and again-- Patient Care, e.g., change “patients
with _____” to “patients with HTN,” or “patients
with complex needs”
!This is how you start to organize your
curriculum!

40. Takeaways….
 Start with whatever piece of the curriculum seems easiest to start
with for you:
 Schedule
 List of the subdomains/topics
 What does the resident need to KNOW?
 What does the resident need to KNOW HOW TO DO?
 What behaviors do you want the resident to DEMONSTRATE?
 What belongs in didactic? In clinical? Other?
 There will be overlap—don’t worry for now
 JUST START
Patient
centered
care
Knowledge
for
practice

41. Marketing and Recruitment Strategy
Who?
• Who will you be recruiting (local vs. national applicants)?
• What are you looking for in a candidate?
Where?
• Where will you recruit and advertise? (local schools, partnering graduate
programs, current NP students, career fairs, conferences)?
When?
• When will you recruit ? – recruitment timeline
*Postdoc programs follow APPIC guidelines

42. Communications and Marketing Plan
Create
Webpage
Program email
address
NPResidency@
Press
Release
Residency
Application
Advertisement

43. Communications and Marketing Plan
Grid

44. Developing Application Process
• Recruitment timeline
*Post Doc programs have shorter timeline for
Feb. 27th 2017 match date
• Create an Application
– What kind of information do you
want to capture in your application?
– What is your organizations current
process?
• Post application and instructions
• Process for reviewing applications

45. Interviewing and Selection
• Focus next session:
– Interviewing Process and Timeline
• Set your interview dates
• Who will be involved in your interviews?
• How will you choose who to interview?
– Selection Process and Timeline
• Selection Criteria - What kinds of characteristics are you looking
for in your candidates?
• Who will be involved in selecting your residents?

46. WNCCHS MARKETING
&
RECRUITMENT
PROCESS
Sara Mertz, A/GNP, Residency Director
Scott Parker, Director of Collaboration and
Development

47. Brief History
• April 2014 CEO sent staff up to CHC, Inc. to take a look at their
Residency Program;
• Integrated core pillars of CHC, Inc. program and customized it to
our patient population/regional needs as well as our FQHC
structure;
• CEO and Board committed to funding the residency program via
agency budget, not relying on grant/foundation funds;
• Built off our strong social media presence with currently 11,000 FB
followers and over 40,000 hits per year to our agency website to
promote the residency;
• Created our own APSNR website and FB page and began
promoting to regional/state NP/PA schools

50. Marketing
• 2015 BCBS Foundation $27,000 to brand, promote, market
program; as well as develop “white paper” on how to
replicate a residency program in FQHC setting in NC;
included professional video’s for marketing and imbedding in
online PDF for email campaigns;
• Target social media ads to regional PA/NP schools e.g. Duke,
UNC, Wake Forest, ETSU,WCU, etc.
• Contact staff at programs at each school via email bi-
annually to remind them of program
• Attend many of the schools’ job fairs

51. Recruiting
• New graduates from NP or PA schools
• NPs and PAs who wish to transition to practice in safety net
primary care from other specialties
• Start application process in early Spring
• End application process usually before most have completed
their education;
• Interview ALL applicants (web-based or in person);
• Select residents for start in September to overlap training
with current residency “class”
• Offer good benefits package and salary

52. Recruiting Road Bumps
• On-call requirement
• Due to regulations as an FQHC, ALL of our residents must be
fully credentialed before stepping in our building to start the
residency (this may take month(s)
• PA schools in our region usually don’t graduate until August
or December so we have had reduced numbers of PA
applicants
• We did not overlap residency classes between the first and
second years and had a month long “gap” in care so had to
hire locums tenens for that gap ($$$$$) and providers had to
orient the locums tenens creating significant additional
workload

54. Questions?

55. Action Period Items
1. Continue to work on Communications
and Marketing template
2. Map out skeleton of schedule
3. Develop list of key clinical topics that
they want to cover in their curriculum
4. Post on Discussion forum (new topic or
reply) Share successes/challenges
Next Session
December 7th