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Scholarly Activity

NHDFMR excels in a three-pronged framework for teaching excellent primary care and personal development. These are:

  • expanding the model of patient care,
  • expanding the model of team membership,
  • expanding the model of change management through a systems approach.

The [Systems] curriculum teaches skill development in these three areas throughout residency, while the clinic provides a learning laboratory to experientially trial these skills aimed at enhancing the patient-centered medical home, functioning in an interdisciplinary team, and improving quality gaps in care delivery and patient-team and inter-team relationships. At NHDFMR, we encourage engaging in scholarly activity to connect these three areas: how we teach, how we deliver care, and how we continue to strive for excellence. Engaging in scholarly activity forces us to reflect on what we are doing, analyze our models of teaching and clinical care, and engage in a dialogue with each other and with a broader community for the purpose of constant improvement.  

NHDFMR residents meet the ACGME requirement of participating in the production of at least two scholarly activities with the comprehensive support of a faculty member specifically appointed to the development of scholarly activity.

NHDFMR has a long tradition of scholarly activity production in these four areas of focus:

Expanding the Model of Patient Care

Incorporating the patient’s experience with illness in relation to one’s dimensions of personhood (according to Eric Cassell: personality, past, experiences, culture, roles, politics, ability to do things, body, secret life, transcendence). Prolonged illness threatens aspects of personhood and leads to suffering. Learning is one way to emerge from suffering, and can happen through the process of identifying and understanding a person’s illness experience.

Publications

  • Talen, M. & Valeras, A. (2013). Integrating Primary Care and Behavioral Health: Evaluating the Evidence, Identifying the Essentials. NY, NY: Springer.

  • Council, L., Geffken, D., Valeras, A.B, Orzano, J., Rechisky, A., Anderson, S. (2012). A medical home: Changing the way patients and teams relate through Patient Centered Care Plans. Families, Systems & Health, 30, 190-198.

  • Zubialde, J.P., Mold, J., & Eubank, D. (2009). Outcomes that matter in chronic illness: A taxonomy informed by self-determination and adult-learning theory. Families, Systems & Health, 27, 193-200.

Presentations

  • Valeras, A.B. (2013). Using narrative techniques for empowerment: Working with Domestic Violence. Paper presentation at A Narrative Future for Health Care Launch of the International Network for Narrative Medicine. London, U.K.

  • Devito, G.A., Manning, L., McLean, P. & Valeras, A.B. (2012). Implementing developmental screening recommendations in a Family Medicine Residency Training Program: Barriers, solutions, and recommendations for practice. Paper presentation at the 4th Congress of the European Academy of Paediatric Societies. Istanbul, Turkey.

  • Allen, C., Geffken, D., & Valeras, A. (2011). Chronic disease management: Diabetes group visits for improving patient self-efficacy and quality of life. Paper presentation at Society for Teachers of Family Medicine Conference on Practice Improvement, Newport Beach, CA.

  • Allen, C., Geffken, D., & Valeras, A. (2011). Chronic disease management: Diabetes group visits for improving patient self-efficacy and quality of life. Paper presentation at Family Medicine Education Consortium, Northeast Region meeting, Danvers, MA.

  • Sommers, L., Duir, K., Kenyon, T., Potter, M., Morioka-Douglas, N., & Allen, C. (2010). Decision-making for complex patients in the Patient-Centered Medical Home: A Clinician Collaborative Model. Presentation at Society for Teachers of Family Medicine, Vancouver, Canada.

  • Valeras, A.B., Manning, L., Devito, G., McLean, P. & Hendricks, J. (2010). What about development and behavior? Using child development screening tools to enhance the Medical Home. Paper presentation at the National Research Forum on Children & Families Programs & Policy, Bridgewater, MA.

  • Eubank, D., Gunn, W. & Council, L.S. (2008). Patient-Centered Care Plans: How reframing the complicated to the complex creates a key patient-centered tool. Paper presentation at Society of Teachers of Family Medicine. Baltimore, MD.

  • Shulman, E., Geffken, D., Rechisky, A., Entwisle, B.J. & Tucker, M. (2008). Improving care at the end of life: Creating patient-centered advance directives. Poster presentation at Society of Teachers of Family Medicine Conference on Practice Improvement, Savannah, GA.

  • Geffken, D., Twyon, D., Moore, J., Taylor, D., Rechisky, A., Anderson, S. & Council, L. (2008). Care plans with patients with mental health diagnoses at the Concord Hospital Family Health Center. Poster presentation at Society of Teachers of Family Medicine Conference on Practice Improvement, Savannah, GA.

Expanding the Model of Team Membership

Embracing the need to reframe all team members’ roles away from a hierarchal model towards an interdisciplinary and interdependent model, allowing for all members to be continual learners, to provide care for patients to the best of their skill set, and to embody the patient-centered medical home.

Publications

  • Talen, M. & Valeras, A. (2013). Integrating Primary Care and Behavioral Health: Evaluating the Evidence, Identifying the Essentials. NY, NY: Springer.

  • Hern, T., Valeras, A.B., Banker, J., & Riebe, G. (2013). Collaborative partnerships within integrated behavioral health and primary care. In M. Talen & A.B. Valeras (Eds.), Integrating Primary Care and Behavioral Health: Evaluating the Evidence, Identifying the Essentials. NY, NY: Springer.

  • Baird, M., Peek, C.J., Gunn, W., & Valeras, A.S. (2013). Working with complexity in integrated health settings. In M. Talen & A.B. Valeras (Eds.), Integrating Primary Care and Behavioral Health: Evaluating the Evidence, Identifying the Essentials. NY, NY: Springer.

  • Talen, M., Valeras, A.B., & Cesare, L. (2013). Integrated behavioral health in primary care: Summarizing the lay of the land, marking the best practices, identifying barriers and mapping new territory. In M. Talen & A. Valeras (Eds.), Integrated Behavioral Health in Primary Care: Evaluating the Evidence, Identifying the Essentials. NY, NY: Springer.

  • Ruddy, N., Borresen, D., & Gunn, W. (2008). The Collaborative Psychotherapist: Creating Reciprocal Partnerships with Medical Professionals. Washington DC: APA Press.

  • Gunn, W. & Blount, A. (2008). Primary care mental health: The new frontier. Journal of Clinical Psychology, 65(3), 235-252.

Presentations

  • Ballard, J.B., Valeras, A.B., Geffken, D., & DeCook, A. (2013). Team-based patient-centered care to improve cardiovascular disease outcomes at a safety-net PCMH. STFM Conference on Practice Improvement, San Diego, CA.

  • Thesing, G., Finn, P., Haley, J. (2013). A multi-disciplinary approach to clinical leadership in a family medicine residency in a community health center. Seminar at Family Medicine Education Consortium, Inc, Philadelphia, PA.

  • McLeod, A.Y. (2013). By baby steps: An initiative to improve the interdisciplinary dynamic in hospital maternity care. Presentation at Society for Teachers of Family Medicine Annual Conference, Baltimore, MD.

  • Ballard, J., Valeras, A.B., DeCook, A. & Geffken, D. (2013). Team-based patient-centered care to improve cardiovascular diseasae outcomes at a safety-net PCMH. American Academy of Family Medicine Scientific Assembly, San Diego, CA.

  • Haley, J., Valeras, A.B., & Gunn, W. (2013). Quantifying and tracking productivity for behavioral health clinicians in a primary care practice. Presentation at Collaborative Family Healthcare Association Conference, Denver, CO.

  • Talen, M.R., Valeras, A.B., Peek, C.J., Valeras, A.S., Kwam, B., & Reitz, R. (2012). The good, bad and surprising: Organizing the landscape of collaborative care initiatives. Panel presentation at Collaborative Family Healthcare Association, Austin, Texas.

  • Morse, J., Holmes, A., Valeras, A.B, Geffken, D., & Eubank, D. (2012). Improving the discharge process from Concord Hospital to home. Poster presentation at American College of Preventive Medicine. Orlando, FL.

  • Valeras, A.B. & Raycraft, D. (2011). Holding the door: Collaboration between a community health center and a domestic violence crisis center. Paper presentation at Ending Domestic and Sexual Violence: Innovations in Practice & Research Conference, Portsmouth, NH.

  • Council, L., Anderson, S., Valeras, A.B., & Geffken, D. (2010). Patient-centered care plans: Enhancing the medical home and improving the patient-team relationship. Paper presentation at STFM Conference on Practice Improvement, San Antonio, TX.

  • Valeras, A.B., Levesque, M.C., Gunn, W. & Haley, J. (2009). The Integrated Care Assessment: Implementing and evaluating a model for integrating primary care and behavioral health services in a rural health clinic. Paper presentation at the Collaborative Family Health Association, San Diego, CA.

  • Council, L. & Anderson, S. (2008). Developing care plans to enhance patient-centered team care. Paper presentation at Society of Teachers of Family Medicine Conference on Families and Health, New Orleans, LA.

  • Valeras, A.B., Haley, J.S. & Phillips, A.F. (2008). “Putting out brush fires before they become infernos”: Integrated Care Managers as an integral part of the primary care team. Presentation at the Bi-State Annual Primary Care Conference, Fairlee, VT.

  • Shulman, E., Valeras, A.B. & Gunn, W. (2008). Partners in the exam room: A model of interdisciplinary care coordination. Paper presentation at the Collaborative Family Healthcare Association, Denver, CO.

Expanding the Model of Change Management through a Systems Approach

Using a systems approach takes complex adaptive system theory, which incorporates an emphasis on relationships, communication patterns, emotions, and culture, and applies it to the process of creating change in individuals, teams and systems.

Publications

  • Valeras, A.S., Gunn, W. & Valeras, A.B. (2013). An innovative model for systems-based curriculum: The Complex Continuity Clinic. International Journal of Psychiatry in Medicine, 45(4), 377-387.

  • Devito, G., Manning, L., McLean, P. & Valeras, A.B. (2012). Implementing developmental screening in a family medicine residency program: Barriers, solutions, and recommendations for practice. Archives of Disease in Childhood, 97, A95.

Presentations

  • Blount, A., Mauksch, L. & Valeras, A.B. (2013). The power of the patient-centered care plan to transform primary care practice. STFM Conference on Practice Improvement, San Diego, CA.

  • Valeras, A.S., Morse, J., Valeras, A.B., Eubank, D., Geffken, D.G., & DeCook, A. (2013). Addressing avoidable ED utilization and rehospitalization as symptoms of complexity through a quality improvement methodology. STFM Conference on Practice Improvement, San Diego, CA.

  • Blount, A., Mauksch, L., & Valeras, A.B. (2013). The power of the patient-centered care plan to transform primary care practice. Collaborative Family Healthcare Association 2013 Conference, Denver, CO.

  • Valeras, A.S., Harker, P.T., Geffken, D., Eubank, D. & Valeras, A.B. (2013). Addressing ED over-utilization as a symptom of complexity. Family Medicine Education Consortium, Philadelphia, PA.

  • Devito, G.A., Manning, L., McLean, P. & Valeras, A.B. (2012). Implementing developmental screening recommendations in a Family Medicine Residency Training Program: Barriers, solutions, and recommendations for practice. Paper presentation at the 4th Congress of the European Academy of Paediatric Societies, Istanbul, Turkey.

  • Geffken, D & Harker, P.T. (2011). Quality Improvement training: The new form of health care. AMSA National Conference, Washington DC.

  • Devito, G.A., Manning, L., McLean, P., & Valeras, A.B. (2011). Increasing the use of standardized child development screening tools in a Family Medicine Residency. Poster presentation at Family Medicine Education Consortium, Northeast Region meeting, Danvers, MA.

  • Rixey, S., Alexander, M. & Geffken, D. (2011). Exploring the potential collaboration between family medicine and preventive medicine. Family Medicine Education Consortium, Danvers, MA.

  • Fayre, G. & Eubank, D. (2010). Teaching the process skills of Patient Centered Medical Home: Developing faculty as transformative coaches. Presentation at Society Teachers of Family Medicine, Vancouver, Canada.

  • Shulman, E., Entwisle, B.J., Holmes, A., Rechisky, A., Tucker, M., & Geffken, D. (2009). Meaningful advance directives: Improved communication about end of life care. Poster presentation at American College of Preventive Medicine, Los Angeles, CA.

  • Ward, S., Manning, L., Rechisky, A., Holmes, A. & Geffken, D. (2008). Improving immunization rates of 2 year-olds in a community health center-based residency program. Paper presentation at Society of Teachers of Family Medicine Conference on Practice Improvement, Savannah, GA.

  • Council, L., Geffken, D., Anderson, S., & Gunn, W. (2008). On the same page: How a quality improvement initiative created and implemented patient-centered care plans. Paper presentation at Society of Teachers of Family Medicine Conference on Practice Improvement, Savannah, GA.

Expanding the Model of Resident Education

Incorporating concepts from adult learning theory and change management theory into experiential learning opportunities to learners to generate adaptive learning in family medicine residents.

Publications

  • Kenyon, T., Allen, C. & Siegel, A. (2013). Using practice inquiry to engage uncertainty in residency education. In L. Sommers & J. Launer (Eds.), Clinical Uncertainty in Primary Care: The Challenge of Collaborative Engagement. NY, NY: Springer.

  • Eubank, D., Geffken, D., Orzano, J. & Ricci, R. (2012). Teaching adaptive leadership to family medicine residents: What? Why? How? Families, Systems, and Health, 30(3), 241-252.

  • Holmes, A.V., McLeod, A.Y., Thesing, C., Kramer, S., & Howard, C. (2012). Physician breastfeeding education leads to practice changes and improved clinical outcomes. Breastfeeding Medicine, 7(6), 403-408.

  • Eubank, D., Orzano, A.J., Geffken, D., & Ricci, R. (2011). Teaching team membership to Family Medicine Residents: What does it take? Family, Systems, and Health, 29, 29-43.

  • Dysinger, W.S., King, V., Foster, T.S. & Geffken, D.F. (2011). Incorporating population medicine into primary care residency training. Family Medicine, 43, 480-486.

  • McLeod, A.Y., LaClair, C. & Kenyon T. (2011). Interdisciplinary prenatal group visits as a significant learning experience. Journal of Graduate Medical Education, 3(3), 372-375.

  • Aguilar, A. & Kenyon, T. (2010). Valuable wisdom. Family Medicine, 42(3), 166-167.

Presentations

  • Dreffer, D. (2013). Understanding the value of baseline assessment of incoming residents. Presentation at Program Directors Workshop, Kansas City, KS.

  • Brehio, T. & Kenyon, T. (2013) “Where’s the Balance Between Service and Education? Survey Says…” Society of Teachers of Family Medicine, Baltmore, MD.

  • Rixey, S., Geffken, D., Fagan, H.B. & Hogan, E. (2013). Implementing resident curriculum and service-learning experiences which lead to integration of primary care and public health. Moderated discussion at Family Medicine Education Consortium, Inc, Philadelphia, PA.

  • Entwisle, B.J. & Valeras, A.B. (2013). Home-based Frail Elder Program: Teaching geriatrics in a Family Medicine Residency and teaching them to love it. Paper presentation at Society for Teachers of Family Medicine Annual Conference, Baltimore, MD.

  • Valeras, A.B., Gunn, W. & Mauksch, L. (2013). Relationship Centered Observation Form: Evaluating how residents interface with interdisciplinary teams. Paper presentation at Society for Teachers of Family Medicine Annual Conference, Baltimore, MD.

  • Kenyon, T. (2012). Everything CLICKS: A patient-based population medicine project. Small group session at Society for Teachers of Family Medicine, Seattle, WA.

  • Geffken, D. & Harker, P.T. (2011). Quality Improvement training: The new form of health care. AMSA National Conference, Washington DC.

  • McLeod, A.Y. & Rechisky, A. (2011). A multi-faceted educational intervention to improve appropriate inter-pregnancy intervals: A pre-post study. Poster presentation at Family Medicine Education Consortium Northeast Region Meeting, Danvers, MA.

  • Gunn, W. (2011). CCC: An innovative project to help resident physicians recognize their personal biases. Presentation at Collaborative Family Healthcare Association, Philadelphia, PA.

  • Brehio, T., Bannister, J.B. & Allen, C. (2010). Finding time: Incorporating the EMR effectively into the visit. Presentation at Northeast Regional Electronic Medical Record Conference, Bedford, NH.

  • Devito, G.A. (2010). The developmentally focused well-child visit: A paradigm for teaching patient-centered care. Lecture presentation at Society for Teachers of Family Medicine, Vancouver, Canada.

  • Kenyon, T. (2010). Teaching a person-centered approach to physicians-in-training. Presentation at Contemporary Ethnography Across the Disciplines Annual International Conference, New Zealand.

  • Gunn, W. (2009). Working with complexity: Co-teaching for success. Presentation at Society of Teachers of Family Medicine, Denver, CO.

  • Kenyon, T., Sommers, L., Allen, C., Potter, M., Moriokia-Douglas, N. & Siegel, A. (2009). Learning from clinical uncertainty: Resident and faculty experience with “Practice Inquiry”. Poster presentation at Society for Teachers of Family Medicine, Denver, CO.

  • Devito, G.A., Manning, L. & McLean, P. (2008). Developing medical home skills: Resident participation in a complex child interdisciplinary care team. Lecture presentation at Society of Teachers of Family Medicine, Baltimore, MD.

  • Sommers, L., Kenyon, T., & Potter, M. (2008). We’re in this together: Management of clinical uncertainty through small group learning. Workshop at Society for Teachers of Family Medicine Conference on Practice Improvement, Savannah, GA.

  • Schifferdecker, K. & Kenyon, T. (2008). Evaluating a new residency medical home curriculum: A mixed methods approach. Poster presentation at Society for Teachers of Family Medicine Conference on Practice Improvement, Savannah, GA.