NCA Residency LC Session 4_Dec 7

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. AGENDA- Learning Collaborative Session 3
December 7 3:00-4:30pm (EST)
 Welcome- Review Agenda and Action Items
 Health Center Report Outs- 3min each
 Launch Date, Where are you in the process?
 Major success/challenges
 Program Curriculum
-Curriculum Mapping -Academic Affiliations
 Applications and Interviews
 Moodle Discussion Board
 Action Period Items
Next Session:
-Program Staffing-
Roles & Responsibilities
-Program Curriculum

4. ACADEMIC AFFILIATIONS
4

5. Curriculum Development
Session 4:
Mapping content
5

6. 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

7. Your outcome for this session
 Describe how to map a curriculum

8. 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 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.

9. Review…
• Program objectives v. Learner Outcomes
• Curriculum
• Clinical, Didactic, Evaluation of the Learner
• Domains/subdomains (competencies)
• KSAs
• Schedule in hours
• Resources

10. 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

11. 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.

12. Every site will have a
different looking
puzzle because every
site has different
resources and patient
populations.

13. We asked you 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)

14. One way of doing it: Start with the
competencies
Competency/Domain:
• Patient Care: Provide patient-centered care that is compassionate,
valued, appropriate and effective for the treatment of health
problems and the promotion of health.
• Learner outcome: Provide appropriate and effective care for adult
patients with DIABETES 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?

15. Diagnostics Procedures
Knowledge
Attitude Attitude
Clinical Decision-making History and Physical
Knowledge Management of treatment plan Knowledge
Attitude Knowledge Attitude
Attitude
Knowledge
SkillsSkills
Skills
Skills
Skills
HEALTH PROBLEM
DIABETES

16. History and Physical
Knowledge
Attitude
Skills

17. Patient-centered care: Health problem: diabetes
Topic: History and physical
Knowledge
Describe components
of a patient history:
Review of systems
Family history
Screenings
Presenting problems
Etc.
Skills
Perform a head-to-
toe physical exam,
incl. cardiovascular,
pulmonary,
abdominal, mini-
mental status, etc.
Communicate
effectively with
patients…..
Attitudes
Commit to having
respect for patient
dignity, privacy,
confidentiality, and
autonomy

18. A little sidebar before we continue….
• Have you done a needs assessment for your population?
• What is the standard of care for a history and physical in
your setting with your patients?
• For example: Do you always ask sexual history? Drug and
alcohol history? Do you always screen for depression?
Do a mini-mental status? Housing? Access to food?
• Do you have a standard of care for certain populations:
transgender, rural, homeless, HIV, diabetes?
• Use your standard of care when you develop your KSAs.

19. History and Physical
Knowledge
Attitude: Commit to respect….
Skills: Communicate effectively….
Skills: Communicate effectively: That’s from the Competency:
4. Interpersonal and Communication Skills: Communicate
effectively with patients….across a broad range of backgrounds
Attitude: Commit to respect: That’s from the Competency:
4. Professionalism: Demonstrate a commitment to compassion,
integrity, and respect for others

20. One learner outcome has mapped to at least
three domains/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. Inter-professional
Collaboration
8. Personal and
Professional
Development

21. Repeat process with other topics
• Which of the Topics’ KSAs belong in didactic?
Clinical? Other?
• Where are the overlaps with other
domains/competencies?
• You will use the same language over and over again,
which is what you want to do
• Evaluation of the learner will flow from these
• Start with a big whiteboard or sheet of paper and
start mapping

22. Another way of doing it:
Start with the clinical rotations and map outcomes
to competencies
• Provide appropriate and effective care for adult primary care
patients that is compassionate and consistent with patient
preferences.
 Details of what that means and looks like: KSAs
• Communicate effectively with patients…..
 Details of what that means and looks like: KSAs
• Commit to having respect for patient dignity, privacy,
confidentiality, and autonomy
 Details
• Collaborate effectively with peers…..
• Demonstrate professional behavior and values…..
• Contribute to improvement of patient care….

23. One learner outcome has mapped to at least
six domains/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. Inter-professional
Collaboration
8. Personal and
Professional
Development

24. Map it in excel: start filling in the blanks
Adult primary care
Content areas Knowledge Skills Attitude Learner activities
Clinical topics/conditions:
*History/physical
*Diagnostics
*Clinical Decision-making
*Procedures
*Management of treatment plan
Communication skills w/
patients, peers, families
Collaboration with peers
Professionalism
Practice-based learning/QI
No matter where you start, you will cover the same ground.

25. Let’s look at the post-doc psychology
programs…
….The program requires that all residents demonstrate an advanced
level of professional psychological competencies, skills, abilities,
proficiencies, and knowledge in the following content areas:
(a) Theories and effective methods of psychological assessment,
diagnosis, and interventions;
(b) Consultation, program evaluation, supervision, and/or teaching;
(c) Strategies of scholarly inquiry;
(d) Organization, management, and administration issues pertinent
to psychological service delivery and practice, training, and research;
(e) Professional conduct, ethics and law, and other standards for
providers of psychological services; and
(f) Issues of cultural and individual diversity that are relevant to all
of the above.

26. Let’s look at the post-doc psychology
programs…
• Start with a list of topics/diagnoses: depression,
anxiety, personality disorder, etc.
• Or with a list of rotations: individual adult, individual
child/teen, group, family
• Or with a list of treatment modalities: cognitive
behavioral therapy, dialectical behavior therapy
• Learner outcome: the resident will provide care to
adult patients with depression that is evidence-based
and culturally sensitive….

27. Example: diagnosis of major
depressive episode
Theories Assessments
Knowledge
Attitude Attitude
Differential diagnosis Interventions
Knowledge Management of treatment plan Knowledge
Attitude Knowledge Attitude
Attitude
Skills
Skills
Knowledge
Skills Skills
DIAGNOSIS:
DEPRESSION
Skills

28. Example from Avenal
Topic Knowledge Skills Attitudes
Behavioral Health –
Depression/anxiety/
domestic
violence/substance
abuse questionnaire.
Pharmacology H&P/past referrals/
exams/assessments
/manage treatment plan
Compassion
Empathy
Chronic conditions –
Basic 5—DM, HTN,
COPD, CAD, CHF
Pharmacology H&P/past referrals/
exams/assessments
/manage treatment plan
Patience

29. Possible schedule from Central City
Day Monday Tuesday Wednesda
y
Thursday Friday
AM Precepted
Clinic
(Preceptor
#1)
Specialty
Rotation
Meetings/
Didactics
(IM res,
ECHO)
Precepted
Clinic
(Preceptor
#3)
Mentored
vs.
Precepted
Clinic
PM Precepted
Clinic
(Preceptor
#2)
Specialty
Rotation or
Community
Site
Didactics/C
ME/ Admin
Time
Precepted
Clinic
(Preceptor
#4)
Mentored
vs.
Precepted
Clinic

30. Just start somewhere!!
Questions?
Assignments:
1. List of topics: KSAs for selected topics
2. Possible schedule: include hours
3. Write learner outcomes for one clinical rotation;
cover as many competencies as you can
4. Write a learner outcome for one didactic session

31. Application Process
• How will applications be submitted?
 Electronically, hardcopy or both
• Who will applications go to?
• What is the cut off date for accepting applications?
• How will they be reviewed once they come in?
• What is the timeline for review for selection
committee?

32. Process Suggestions
• Keep a record of inquiries – contact to remind to apply
• Create a checklist of application requirements
 Post on website for applicants – keep a listing for program
 Application, CV, essay, letters of recommendation
 Create checklist for each candidate
• Once your process in finalized - post the process to your website
or webpage – clear, transparent process for candidates

33. Selecting Candidates to Interview
• Decision on criteria to assess your candidates
• CHCI Criteria: Quality of education, clinical experience, linguistic skills,
commitment to underserved placement, intangibles
• Further define these criteria for those reviewing and assessing
candidates
• Choose your Selection Committee
• Include a variety of roles in your organization – leadership, clinical and
operational leadership, potential preceptors, HR, etc.
• Develop process for your selection committee to review, score,
and discuss candidates

34. Example Scoring Grid

35. Example Postdoc Psychology Residency
Scoring Grid

36. Other Considerations for Interviews
• How many candidates to invite?
• Invite more than you want to accept
• CHCI invites double the amount of candidates for available slots
• Program with 2 to 3 slots should invite 4 to 6
• Set and post your interview dates on your website
• Decide on how you will hold interviews
• In person, virtually or both

37. Other Considerations for Interviews
• *For Post doc psychology programs-be familiar with APA
requirements
• APPIC resources available: Webinars on Postdoctoral Selection/Application
Education Resources
• Develop Interview schedule- (tour, presentation, HR participation,
Interview agenda)
• Provide detailed interviewing information to applicants
• Provide timeline of next steps to candidates

38. Questions?

39. Action Period Items
1. Curriculum Development
• List of topics: KSAs for selected topics
• Possible schedule: include hours
• Write learner outcomes for one clinical rotation; cover as many
competencies as you can
• Write a learner outcome for one didactic session
2. Post on Discussion forum (new topic or reply) Share
successes/challenges
3. Submit a Draft of an Application
4. Submit Monthly Report
Next Session
January 11th