Scholarly Activity

NHDFMR excels in a three-pronged framework for teaching excellent primary care and 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.

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

  • Bannister JB. (2017). Poisoning. In P. Paulman, R.B. Taylor & A.A. Nasir (Eds.), Family Medicine: Principles and Practice, 7th edition (pp. 615-632). NY, NY: Springer International Publishing.

  • Scarry, A., Collins, B., Haque, I., Joshi, M., Eamranond, P., Geary, S. (2017). A system-wide movement to improve patient care and reduce unnecessary laboratory testing. Medical Laboratory Observer

  • 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.

Presentations

  • Entwisle, BJ, Dreffer, D.; Valeras AB.; Fields, C.; Riely, J. (2018). Village at Home: Home-based care for highly complex patients. Presentation at VillageMD National Physician Leadership Forum. 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.

  • 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.

  • 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.

  • Richardson, R., Davis-Thomspson, T. & Song, J. (February 2017). Health care for patients who are refugees. NH NASW: Concord, NH

  • 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.

  • 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.

  • 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.

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

  • 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

  • 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

  • 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.

  • 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, 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.

  • 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.

  • Valeras, AS. & Jacobs, B. 2018. Taking the red pill: Transforming collaborative team training for complex care. Presentation at Collaborative Family Healthcare Association. Rochester, NY.

  • Council, LS & Valeras AB (September 2017). Getting on the same page: The Shared Care Plan as a collaborative tool. Presentation at Citizens Health Initiative Annual Symposium. Concord, 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.

  • Haley, J. (March 2017). Operationalizing integration in practice. Presentation at NH Behavioral Health Learning Collaborative: Concord, NH.

  • 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.

  • Horn A., Geffken D., Decker-Gendron K., Ouellette J., Valeras AB. (2016) It takes a village to battle opiate addiction: Medication-assisted treatment (MAT) for opioid addiction through a team-based patient-centered approach. 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.

  • 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.

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

  • Danca, M. (2017). How to transition from Teflon to Velcro: On Mindfulness. NH Medical Society Newsletter.

  • Zanetti, C. (2016). Value co-creation in healthcare through positive deviance. Healthcare: The Journal of Delivery Science and Innovation.

  • 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

  • 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.

  • 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. (pending 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).

  • Dunn, M.; Cioffi, M.; Valeras, AB. (September 2017). Making Scholarly Activity Accessible to All: Developing Scholarly Activity skills and involvement in a community hospital. Presentation at North American Health Science Library Conference. Waltham, MA.

  • 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.

  • 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.

  • 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. (March 2017). Expanding the model of primary care to include complexity. Webinar for Collaborative Family Healthcare Association (CFHA).

  • 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

  • Singer, A & Valeras, AS. (2016). Revitalizing Primary Care in the Age of Complexity. Expanding the Model of Primary Care to Include Complexity. DHMC Primary Care Grand Rounds. Concord, NH.

  • Finn P., Hill JE., Tanski S., Delworth S. (2016). Stories from early adopters: On the ground perspectives of SBIRT in Primary Care. Panel presentation at New Hampshire SBIRT Summit. Manchester, NH.

  • 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. 

  • 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.

  • 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.

  • Dreffer, D. & Woolever, R. (2016). Creating shared vision: A necessary tool for effective leadership. PDW. Kansas City, KS.

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. (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.

  • White-Davis, T. & Valeras AB. Implicit bias, Race and Health: Cultivating a socio-cultural perspective in Famliy Medidcine Residency. Workshop for Greater Lawrence Family Medicine Residency Faculty Retreat. Lawrence, MA.

  • 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.

  • Entwisle BJ, Valeras AB, Lewin B. & Hong, H. (2016). Frail Elder Home-Visiting Program: Providing patient-centered cost-effective care while teaching geriatric medicine. Poster presentation at the Dartmouth Research Co-op Annual Meeting. North Conway, NH.