Health disparities educational initiative for residents

Abstract

Background: The Wayne State University Graduate Medical Education (GME) Office and Ascension Crittenton Hospital developed an educational initiative to increase resident awareness of health disparities and local community health priorities. The Plan-Do-Study-Act (PDSA) rapid-cycle performance improvement framework was used for implementation and evaluation. Methods: During the first PDSA cycle, residents attended 5 didactic sessions. During the second PDSA cycle, residents participated in a problem-based learning (PBL) case. The following data were collected: evaluations of the didactic sessions and case, the number of appointments for diabetes self-management and education (DSME) referred by faculty and residents, and responses to questions on the annual GME surveys related to resident understanding of health disparities and the hospital’s community health needs assessment (CHNA). Results: Eighty-eight percent of residents defined health disparities at least partially correctly in both project years. The percentage of residents who knew how to access their hospital’s CHNA increased from 25% to 29% year over year. Residents rated PBL more effective in achieving learning objectives than didactics, but the difference was not statistically significant. Six appointments for DSME were referred by program faculty and residents in the 2-month period immediately before the didactic sessions, and 6 referrals were made in a 2-month period between the didactic sessions and the PBL case. In the 2-month period immediately following the PBL case, 9 appointments for DSME were referred by residents and program faculty. Conclusion: Residents have a good understanding of health disparities, although many may not recognize disparities that exist in their local community. PBL was more effective than didactics for resident education about local health disparities, CHNA, and DSME. Aligning GME and hospital leadership in a common vision for disparities education, as well as community engagement, is critical to successful outcomes.