Faculty Development Program for Professionalism in Contemporary Practice

In an earlier project supported by the Macy Foundation, Kelley Skeff, MD, PhD designed and perfected a “train-the-trainers” model that brought medical school faculty members from other institutions to Stanford for intensive training to improve their teaching effectiveness. Over a five-year period, 265 faculty members participated. This core faculty then trained more than 15,000 faculty and residents in new educational methods at their home institutions. For this work Dr. Skeff received the 2002 Abraham Flexner Award for Distinguished Service to Medical Education from The Association of American Medical Colleges.

This grant enables Dr. Skeff to use his train-the-trainer approach to address the issue of quality in health care by involving health professionals in quality improvement programs. Month long training sessions for 18 health professionals are planned. These professionals then will train an additional 360 physicians and other health care professionals at home institutions, creating 36 continuous quality improvement projects.

Dr. Skeff’s approach was tested in a pilot project at the Palo Alto VA Health Care System where interdisciplinary practice teams designed their own continuous quality improvement projects in the General Internal Medicine Clinic and Intermediate Intensive Care Unit. Teams focused on improving patient understanding and implementation of discharge care plans and follow-up, and on ensuring that physicians adequately communicated to nurses both the short-and long-term follow up plans for each patient.

The pilot’s success prompted the application for this grant. In the pilot study, trained facilitators taught the knowledge, skills and attitudes needed to improve the health care system to both physicians and other health care team members.

The curriculum for this new project includes evidence-based care, patient safety, quality improvement, shared decision-making, and methods for facilitating change. This curriculum encourages multi-disciplinary teamwork and emphasizes to participating physicians the need to appreciate the roles played by other members of the health care team as well as the key role of the physician in enabling patients to participate in “shared decision making.” One of Dr. Skeff’s broader goals is to use the reputation, experience and methods of the Stanford Faculty Development Center to disseminate the curriculum nationally. This project is one of the few significant efforts aimed at changing health professional education by placing improved quality of patient care and safety at the top of the agenda. If results continue to be positive, this project will have impact on many institutions and will be picked up by larger funding agencies when Macy support ends.