Scholarly Activity

NH Dartmouth Family Medicine Residency Program (NHDFMR) utilizes a three-pronged approach to teaching excellence in primary care and supporting personal development. 

  1. Expanding the model of patient care.
  2. Expanding the model of team membership.
  3. Expanding the model of change management through a systems approach.
Dr. McKenna presenting to residents

Dr. Brian McKenna, NHDFMR Class of 2019

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 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

  • Hemingway S., Chassie TG., Kelly B., DeVito GA., Boulter S., Freeman JJ., Valeras AB. (2016). The ABCs of a school-based health center: PATCH, the Pre-Adolescent to Teen Center for Health. NH Journal of Education. http://nhje.plymouth.edu/?article=the-abcs-of-a-school-based-health-center-patch-the-pre-adolescent-to-teen-center-for-health
  • Brunette, MF., Gunn, W., Alvarez, H., Finn, PC., Geiger, P., Ferron, JC., McHugo, GJ. (2015). A pre-post pilot study of a brief, web-based intervention to engage disadvantaged smokers into cessation treatment. Addiction Science & Clinical Practice, a10:3.

Presentations

  • Tan, M.; Millette, D.; Tumminkatti, R.; Valeras, AB.; Haley, J.; Whitney-Gill, G.; Hemingway, S.; Geffken, D. (2019). Prevalence of social vulnerability in a community health center: Works-in-progress. Poster presentation at Family Medicine Forum: Vancouver.
  • Curt, H. & Valeras AB. (2019). Addressing memory concerns in older adults through an integrated care approach. Presentation at Collaborative Family Healthcare Assocation. Denver, CO.
  • Haley, J., Hogan, C., Hemingway, S., Allosso, L., Cobb, E., & Valeras AB. (2019). Trauma-informed primary care from the patient’s point of view. Workshop presentation at NASW-NH Annual Conference. Whitefield, NH.
  • Kazanczuk, M. (2019). Emergency contraception: Not just about the “morning after”. Lecture presentation at NHAFP Annual Conference. Whitefield, NH.
  • Marolda, M. (2019). The heart and gut of the matter: Aspirin use in primary prevention of cardiovascular disease and colorectal cancer. Lecture presentation at NHAFP Annual Conference. Whitefield, NH.
  • Dickson, A., Lopez, A., Morse, J., Valeras, AB. (2019). A process for deprescribing with elderly patients. Poster presentation at Society for Teachers of Family Medicine (STFM). Toronto, Canada.
  • Prodger, M. Valeras, AB (2018). Addressing the adult with Adverse Childhood Experiences (ACEs) in primary care requires a team. Presentation at Forum for Behavioral Sciences in Family Medicine. Chicago, IL.
  • Mesick, N. (2018). Hepatitis C screening for Baby Boomers in primary care. Lecture at NH Association of Family Physicians. Whitefield, NH.
  • Hesselson, L. (2018). Health care disparity among the LGBTQ community: Recommendations on creating an inclusive environment. Lecture at NH Association of Family Physicians. Whitefield, NH.
  • Haley, J.,Morse, J., Phillips, A., Twyon, D., Pelletier, L., Brown, A., Hemingway, S., Valeras AB. (2018). Partners in the Exam Room: A model of Integrated Behavioral Health in Primary Care. Workshop at NH-NASW Annual Conference, Whitefield, NH.
  • Council, LS & Valeras AB (September 2017). Getting on the same page: Care plans as a tool for patient-centered care collaboration. Presentation at Citizens Health Initiative Annual Symposium. Concord, NH.
  • Kuftinec, A. (April, 2017). Mood disorders in primary care: Beyond depression. NH Academy of Family Physicians Annual Meeting: Whitefield, NH.
  • Yerdon McLeod, A. (April 2017). Neonatal Abstinence Syndrome: Our youngest patients affected by the opioid epidemic. NH Academy of Family Physicians Annual Meeting: Whitefield, NH.
  • Song, J.; Haley, J.; Valeras AB. (June 2017). Cultural identity and acculturation for New Americans. Presentation at the Groves Conference on Marriage and Family. Charleston, SC.
    *** Won the Goebel-Macklin Student Award.
  • Kelly, B., Allen, C. Geffken D., Valeras AB. (2017) You are the connection to HPV series completion: The importance of the HPV Vaccine. Presentation at the NH Vaccine Conference.
    *** Won the Adolescent Vaccine Award.
  • Yerdon, AY. & Radwan, S. (2017). Breastfeeding basics for mothers in recovery. Presentation at VNA Health System of Northern New England. Concord, NH.
  • Kelly, B., Allen, C. Geffken D., Valeras AB. (2016). Improving HPV Vaccination Coverage with clinic-based and community-based interventions at the AAFP FMX. Orlando, FL
  • Muench, J., Valeras, AS., Kallenberg, G., Reiter, J. (2015). Introduction to Integrated Behavioral Healthcare (IBH): Help for you and your patients. Preconference Workshop at Collaborative Family Healthcare Association (CFHA). Portland, OR.

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

  • Valeras, A.B., Cobb, E., Prodger, M., Hochberg, E., Allosso, L., VandenHazel, H. (2019). Addressing adults with adverse childhood experiences requires a team approach. The International Journal of Psychiatry in Medicine, 54(4-5).
  • Morse, J., Valeras, AS., Geffken D., Eubank D., Orzano AJ., Dreffer D., DeCook A., Valeras AB. (2016).Using a team approach to address avoidable emergency department utilization and rehospitalizations as symptoms of complexity through Quality Improvement methodology. Proceedings: 1st International Conference on Systems and Complexity for Health. NY, NY: Springer

Presentations

  • Periera, A.; Valeras, A.B.; Cobb, E. (2020). “I’ve got a team behind me here”: Integrated Behavioral Health in Primary Care from the patient’s point of view. Presentation at Collaborative Family Healthcare Association: virtual.
  • Valeras, A.S. & Valeras A.B. (2020). Partners in the exam room: A model of integrated behavioral health in primary care. Presentation at STFM Conference on Practice Improvement and Quality Improvement. Kansas City, KS.
  • Valeras AS & Valeras AB (2018). Effective and engaging team development: Giving primary care teams the tools to succeed. Presentation at NH Association of Family Medicine. NH.
  • Brown, A., Coco, M., Meyer, D., Roll, D. (2017). The challenges of creating and joining a care team. Panel discussion at Harvard Medical School Cambridge Health Alliance Symposium on Working Together: Integrating Mental Health and Medical Care. Boston, MA.
  • Conway, D., Doubleday, P. & Montague, S. (April 2017). Walking the walk: Incorporating team training for safety improvement. Presentation at 18th Annual National Conference on Fetal Monitoring: Las Vegas, NV.
  • Hyun, H., Morse, J., Entwisle, BJ., Valeras AB. Geffken, D. (2017). Cultivating Dynamic Primary care Teams to Improve Advance Directive Quality Measures: A Microsystem Approach. Presentation at American College of Medical Quality.
    *** Won the National Quality Scholar Award.
  • Allis P., Richardson R., Gunn W., Valeras AB., Geffken D. (2016). The Downtown Clinic: Creating a residency-run clinic for homeless persons. Presentation at Family Medicine Education Consortium. Pittsburgh, PA.
  • Horn A., Geffken D., Decker-Gendron K., Ouellette J., Valeras AB. (2016) It takes a village to battle opiate addiction: Medication-assisted treatement (MAT) for opoid addiction through a team-based patient-centered approach. Presentation at Collaborative Family Health Care Association. Charlotte, NC.
  • Gunn W., Kuftinec A., Valeras AB (2016). A multidisciplinary approach to teaching integrated behavioral health in a family medicine residency. Presentation at Society of Teachers of Family Medicine (STFM). Minneapolis, MN.
  • Morse, J.; Hong, H.; Geffken, D. (Feb 2016). Quality Improvement is a team sport: Understanding complexity in Quality Improvement Projects. Presentation at Preventive Medicine Annual Meeting (ACPM). Washington DC.
  • Yerdon AM & Kenyon T. (2015). Communication strategies to address inter-team tension for family medicine residency on the maternity unit. Presentation at Family Medicine Education Consortium (FMEC). Danvers, MA.

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. (2020). Healthcare provider burn-out: A war with uncertainty. Families, Systems, & Health, 38(1), 96-98.
  • Valeras, A.S. (2019). Caring is complex: And it always has been. Families, Systems, & Health, 37(1), 98-100.
  • Valeras, A.S. (2019). Healthcare’s wicked questions: A complexity approach. Families, Systems, & Health, 37(2), 187-189.
  • Valeras, A.S. (2019). Relationships matter in population health. Families, Systems, & Health, 37(3), 274-276.
  • Valeras, A.S. (2019). Quality improvement in a complex world. Families, Systems, & Health, 37(4), 352-353.
  • Kwan, B., Valeras AB, Brown-Levy S., Nease D., Talen M. (2015). Roadmap to Integrated Behavioral Health in Primary Care. AIMS Public Health. http://www.aimspress.com/article/10.3934/publichealth.2015.4.691/fulltext.html

Presentations

  • Morse, J.; Valeras, AB.; Geffken, D.; Seery, M. (2019). Approaching relocation of a residency-based clinic using Quality Improvement tools. Poster presentation at Institute for Healthcare Improvement. Orlando, FL.
  • Geffken, D.; Smith, P.; Dahal, B.; Sikyala, MD; Green, J.; Breault, A.; McCracken, K.; Carbonneau, A.; Tellez, T.; Thomas, A.; Denoncour, S.; Jennison, T. (2019). Promoting equity through authentic partnerships to improve community health. Panel presentation at Team Up, Take Action: Lebanon, NH.
  • Valeras, AS. (2019). Complexity registries as a tool in population health. Poster presentation at ACPM. Pittsburgh, PA.
  • White-Davis, T., Valeras AB., Burnside, M., El-Amin, W. (2019). Breaking the silence: Dismantling racism in graduate medical education. Seminar at Society for Teachers of Family Medicine. Toronto, ON.
  • Valeras, AS. & Jacobs, B. 2018. Taking the red pill: Transforming collaborative team training for complex care. Presentation at Collaborative Family Healthcare Association. Rochester, NY.
  • Khatri P., Gunn W., Talen M., Valeras AS. (2018). Beyond hotspotting: Identifying complexity and solutions at the micro, meso, and macro levels. Presentation at Collaborative Family Healthcare Association. Rochester, NY.
  • Valeras, AS & Jacobs, B. (October 2017. Addressing complexity through cross-setting, integrated primary care and intensive care management: How to reduce Emergency Department utilization. CFHA. Houston, TX.
  • Valeras AS. (March 2017). Expanding the model of primary care to include complexity. Webinar for Collaborative Family Healthcare Association (CFHA).
  • Valeras, AS,; Morse, J.; Geffken D.; & Valeras AB. (2017). Working with complexity: Applying the right intervention to address avoidable utilization in primary care. The Lown Institute Conference, Boston, MA.
  • Valeras AS., Talen M., Aramburu M., Valeras AB. (2016). Identifying and addressing complexity in integrated behavioral health in primary care. Presentation at Collaborative Family Health Care Association. Charlotte, NC.
  • Valeras, AB, Talen M., Ring, J. (2016). Letting Art Transform: Self-awareness, Team Conversations, and Systemic Challenges. Workshop at the Behavioral Science in Family Medicine Forum. Chicago, IL.
  • Dreffer, D. & Woolever, R. (2016). Creating shared vision: A necessary tool for effective leadership. PDW. Kansas City, KS.
  • Geffken D. & Millette, D. (Feb 2016). Becoming LEAN: Basic Concepts in Quality Improvement. Presentation at Preventive Medicine Annual Meeting (ACPM). Washington DC.
  • Geffken, D. & Shah, N.R. (Feb 2016). Using Information Technology, analytics and Quality Improvement to improve population health. Presentation at Preventive Medicine Annual Meeting (ACPM). Washington DC.
  • Geffken D.; Susco, J.; Bamberger, J.D.; Oldham, R. (Feb 2016). A hot spotter / Super utilizer identification and delivery of care. Presentation at Preventive Medicine Annual Meeting (ACPM). Washington DC.
  • Valeras, AS. (Feb 2016). Using innovative approaches to address complexity in primary care. Presentation at the Dartmouth Research Co-op Annual Meeting. North Conway, NH.
  • Morse J., Geffken D., Ricci R., Valeras A., Harker PT., Kelly R., Valeras AB. (2015). Leadership, complexity and teams, oh my! How the Quality Improvement process can improve resident education and health center culture. Workshop at Family Medicine Education Consortium (FMEC). Danvers, MA.
  • Valeras, AS., Geffken, DG., Morse, J., Gunn, W., Valeras, AB. (2015). Innovative approaches to address complexity in primary care. Poster presentation at North American Primary Care Research Group (NAPCRG). Cancun, Mexico.
  • Geffken D, Eubank D & Ricci R. (2015). Coaching: Adapting organizational development concepts to teach practice. Plenary at Association for Prevention Teaching and Research (APTR). Charleston, SC.

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.

Presentations

  • Kenyon, T. & Heatherton C. (2020). Ready for Rural (R4R): An innovative approach to the transition from medical student to competent and confident rural practitioner. Virtual presentation at Rural Training Track Collaborative.
  • Kenyon, T. et al. (2020). Not what we planned: Strategies for converting unexpected project outcomes (“failures”) into lessons learned. Presentation at Society for Teachers of Family Medicine: Virtual.
  • Geffken, D., Valeras, A.B., Brown, P.A. (2019). Process groups as a wellness initiative to decrease physician burnout. Poster presentation at Institute for Healthcare Improvement. Orlando, FL.
  • Chahine, L.; Brown, PA; Nino, JR; Gildenblatt, L; Hagar, M.; Valeras AB. (2019). Resident wellness: Understanding it and applying the evidence. Presentation at Forum for Behavioral Science in Family Medicine. Chicago, IL.
  • Talen, M. & Valeras AB. (2019). Integrating the arts into the science: Teaching strategies and resources. Workshop at Forum for Behavioral Science in Family Medicine. Chicago, IL.
  • Valeras, AB., Morse, J., Coombs, R., Hesselson, L., Mesick, N., & Grigoryan-Koster, J. (2019). EmpowHER: ‘Women in Medicine support group to mentor female resident physicians. Lecture presentation at Society for Teachers of Family Medicine. Toronto, ON.
  • Morse, J., Richardson, R. (2019). Supporting Community Preceptors through Effective Onboarding at a Family Medicine Residency. Scholarly Roundtable at Society for Teachers of Family Medicine (STFM). Toronto, Canada.
  • Morse, J., Richardson, R. Thesing, G., Orzano, AJ, & Kenyon, T. (2019). Co-advising: Blending contributions of academic and clinical advisors. Lecture at Society for Teachers of Family Medicine (STFM). Toronto, Canada.

    Gopal B., Kenyon, T., & Johnson, B. (2019). Update on Faculty Competencies Project. Scholarly Roundtable at Society for Teachers of Family Medicine (STFM). Toronto, Canada.
  • Kenyon, T. Brehio, T., Sanborn, J., Morse, J., Brown, A. (2019). Running lapse: Interactive modules for measuring specific patient safety and professional conduct milestones that can be elusive. Seminar at Society for Teachers of Family Medicine (STFM). Toronto, Canada.
  • Panchal A., Forest, C., Kenyon, T., Allen C., Sommers L. (2019). Hidden in plain sight: The Family Medicine physician and uncertainty work. Society for Teachers of Family Medicine (STFM). Toronto, Canada.
  • White-Davis, T., Valeras, AB., Burnside, M., Do Ponte, L. (2018). “Of course, that doesn’t happen here”: Exploring experiences of racism in medical education. Poster presentation at NYC Research and Improvement Networking Group (NYC RING). NY, NY.
  • Brown, PA., Gisonno, H., Cobb, E., Haley, J. (2018). Integrating Behavioral Health into Inpatient Medicine as a model for Interprofessional education. Presentation at Forum for Behavioral Sciences in Family Medicine. Chicago, IL.
  • Gopal,B., Clark,J., Johnson,B. & Kenyon,T. (2018). Developing Faculty Milestones: A Collaborative Path to Greater Transparency in Faculty Competency. Program Director’s Workshop, Kansas City, MO
  • Valeras, AS., Geffken, D., Ricci, R., Valeras AB. (2018). [Systems]: A Family Medicine curriculum to teach the role of complexity science in healthcare. Seminar presentation at Society for Teachers of Family Medicine. Washington DC.
  • Kenyon,T.,Johnson,B.,Boltri,J. (2018). Bridging the gap: Examining the implications of implementing universal developmental milestones for faculty. Seminar presented at STFM. Washington DC.
  • Brown, A. & Hewitt, A. (2017). Teaching harm reduction: A critical skill in treating Substance Use Disorders. Presentation at Forum for Behavioral Sciences in Family Medicine. Chicago, IL.
  • Kenyon, T., Trelease-Bell, A., Taylor, D. & Schirmer, J. (May 2017). Advancing in a retreat: Lessons learned from an annual regional residency collaboration day. Presentation at STFM: San Diego, CA.
  • Kenyon, T. (May 2017). Catching the pass: Helping learners identify and address challenges with standardized examinations. Presentation at STFM: San Diego, CA.
  • Kenyon, T. & Matthew L. (April 2017). Learning together: Effective feedback strategies for the educator. NH Academy of Family Physicians Annual Meeting: Whitefield, NH.
  • Kenyon, T., Panchal, A., Allen, C., Forest, C., Sommers, L. (2019). In uncertain terms: Using small group learning to teach residents how to effectively engage clinical uncertainty. Society for Teachers of Family Medicine (STFM). Toronto, Canada.
  • Richardson, R., Geffken, D. & Kennedy, M. (2015). Trials and tribulations of establishing a homeless clinic within a family medicine residency program. Presentation at Family Medicine Education Consortium (FMEC). Danvers, MA.
  • Finn P., Carr M. (2015). Improving family medicine residents’ outpatient educational experience with a walk-in model of patient access. Presentation at Family Medicine Education Consortium (FMEC). Danvers, MA.
  • Valeras, AS., Geffken, DG., Ricci, R., Eubank, D., Eubank D., Gunn, W., Valeras, AB. (2015). [Systems]: A Family Medicine Curriculum Focused on Working in Interdisciplinary Teams and Embracing Complexity in Healthcare. Presentation at Collaborative Family Healthcare Association (CFHA). Portland, OR.
  • Boylan M., Valeras AS. & Valeras AB. (2015). Evaluating and enhancing the osteopathic education of DO residents in a Family Medicine Residency. Poster Presentation at Society for Teachers of Family Medicine (STFM). Orlando, FL.
  • Gunn, W., Dreffer, D,. Valeras, AS., Geffken, D., Eubank, D., Ricci, R., Valeras, AB. (2015). Teaching residents to embrace complexity in health care today: The [Systems] Curriculum. Seminar at Society for Teachers of Family Medicine (STFM). Orlando, FL.
  • Sommers, L., Somerville, N., Mawji, E., Young, E., Kenyon, T., Allen, C. & Seigel, A. (2015). A mist opportunity: Walking through the fog of clinical uncertainty in residency. Presentation at Society of Teachers of Family Medicine (STFM). Orlando, FL.
  • Quaresima J., Valeras AS., Meek J., Dekker K. & Dreffer D. (2015). Elevating the Chief Resident role: A mutually beneficial initiative. Poster presentation at Family Medicine Education Consortium (FMEC). Danvers, MA.
  • Entwisle BJ, Valeras AB, & Lewin B. (2015). Frail Elder Home-Visiting Program: Providing patient-centered cost-effective care while teaching geriatric medicine. Poster presentation at North American Primary Care Research Group (NAPCRG). Cancun, Mexico.