Engaging UCSF and Community Partners in

Effective Workplace Learning

Christy Boscardin, PhD Naomi Wortis, MD

Bridget O’Brien, PhD

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Workshop Objectives• Describe key principles of community

engaged workplace learning• Discuss the benefits of conducting needs and

resource assessments of both learners and sites

• Develop a plan for placement of learners at a site

• Devise a placement guideline template that can be used for a range of placements

• Identify existing resources to help prepare learners and sites

Workshop Agenda• Introductions• Presentations• Introduction of template examples• Small group work on template/checklist

development• Report back to large group and refine

template• Future plans and evaluation

Classroom and Workplace Learning

Classroom Workplace

Learner Identity Student Novice professional

Knowledge is • Situated in more controlled environments and activities – e.g. planned activities, individual or group assignments

• Decomposed

• Situated in more routine practice, authentic problems, and co-participants – e.g. discussions on rounds, charts, development of plans

• Integrated

Performance is Demonstrated on exams, behavior in simulated situations

Demonstrated through completion of tasks & Participation in real work

Valued Outcomes include

Mastery of facts, conceptual understanding, critical thinking

Finding solutions to unanticipated problems, Efficiency, Effectiveness (meeting quality standards)

Communities of Practice

• Learning occurs through social interaction and participation

• Learners begin as peripheral participants, gradually gain legitimacy and move from the periphery to more central roleso Student run clinicso Health coaching programso Action Research Program: Cardiology clinic

• Teachers are just one of many resources for learning

Conceptual Framework for Workplace Learning

Affordances and Engagement

Learningthrough

participation

Selection of tasks and activities

Responsibility

Sequencing

Continuity

Relationships within the practice community

Invitational Quality

Supported participation

Personal engagement

Nature of Work Practices

Time pressure/workload

Organization of work

Technology & Resources

Adaptation and expansion of Billett (2001) three factors of workplace curriculum - Learning in the Workplace: Strategies for effective practice. Crows Nest, Australia: Allen & Unwing. P180-186

Community Engagement

• “The process of working collaboratively with and through groups of people affiliated by geographic proximity, special interest, or similar situations to address issues affecting the well-being of those people”

• Goals are to: o build trusto enlist new resources and allieso create better communicationo improve overall health outcomes

CDC, 1997

Service Learning“…a structured learning experience that combines community service with explicit learning objectives, preparation, and reflection.”  

From: Seifer et al, Creating Community-Responsive Physicians: Concepts and Models for Service-Learning in Medical Education, 2000.

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Service Learning…• Developed, implemented, and evaluated in

collaboration with the community• Responds to community-identified concerns• Attempts to balance the service that is provided

and the learning that takes place• Enhances the curriculum by extending learning

beyond the lecture hall and allowing students to apply what they are learning to real-world situations

• Provides opportunities for critical reflection

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Service Learning v. Traditional Clinical

Education

• Balance between service and learning objectives

• Emphasis on reciprocal learning• Emphasis on more than individual

interactions• Emphasis on reflective practice• Integral role of community partners

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Service Learning Opportunities

• Community Partnerso Service, economic, and social benefitso Opportunity to teach next generation of health professionalso Increased awareness of institutional assets/limitations

• Studentso Transformational learning experienceso Awareness of determinants of healtho Become more community-responsive, culturally competent health

professionals

• Facultyo Increased understanding of community issueso New scholarship directions

• Allo Wonderful relationships—linking complementary skills and

resourceso New/better ways to solve problemso Capacity building 12

Example

Tips for Successful Service Learning Partnerships

• Point people for communication continuity• Shared understanding and expectations from

outset• Community guides project design &

implementation• Clear plan for tangible product of use to

community• Be flexible and open• Mutual respect• Cultural humility

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Principles of PartnershipUCSF’s University Community Partnership Office encourages all partners to adhere to the

following principles of partnership, adapted from Community Campus Partnerships for Health:• Partners have agreed upon mission, values, goals and measurable outcomes for the partnership.• The relationship between partners is characterized by mutual trust, respect, genuineness and

commitment.• The partnership builds upon identified strengths and assets, but also addresses areas that need

improvement.• The partnership balances power among partners and enables resources among partners to be

shared.• There is clear, open and accessible communication between partners, making it an ongoing priority

to listen to each need, develop a common language and validate/clarify the meaning of terms.• Roles, norms, and processes for the partnership are established with the input and agreement of all

partners.• There is feedback to, among, and from all stakeholders in the partnership, with the goal of

continuously improving the partnership and its outcomes.• Partners share the credit for the partnership's accomplishments.• Partnerships take time to develop and evolve over time.• Partners embrace the art of evaluation, documenting whenever possible their process and measuring

their interventions to create transparency, accountability and replicability.• Partners plan together the dissemination of research findings into translatable and practical

applications with the community.

Sources: Community-Campus Partnerships for Health, Community Partnership Resource Center and University Community Partnerships at UCSFCCPH: https://ccph.memberclicks.net/principles-of-partnership

• Yours and theirs• Benefits

o Address need prioritized by the siteo Understand contexto Build on existing resources; don’t reinvent

themo Increase chance of sustainable change

Assessment of Needs and Resources

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Partnership Clarity• Who are we separately?

o What are our missions/goals?o What are our needs?o What are our resources?

• Who are we together? Do we have a shared mission/goal?

• How will we agree to proceed?o What will we do together?o What are our respective roles?o How will we keep communication open?

• What will we both get out of this partnership?• How will we share power and/or redress power

imbalances?

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MOU: Support for Role Clarity

Memorandum of Understanding (MOU):• Who are the partners?• What are they going to do together?• What are their respective responsibilities?• Timeframe• Signed by responsible parties

Then do it!

Existing UCSF Resources

• UCSF Office of University Community Partnerships (UCP)o http://partnerships.ucsf.edu/

• UCP Community Engagement online moduleso https://courses.ucsf.edu/course/view.php?id=42o http://partnerships.ucsf.edu/cemodules (for those outside UCSF)

• UCSF CTSI Community Engagement & Health Policy Programo http://ctsi.ucsf.edu/about-us/programs/community-engagement-health-

policy

University Community Partnerships Office

• Our VisionTo actively improve the quality of life and promote health equity throughout our communities by cultivating, sustaining and advancing strong collaborative partnerships that model excellence in University and community engagement.

• Our MissionTo build collaborative relationships between UCSF and the community, promoting civic engagement, fostering community health and well-being, and enhancing the environment for education, patient care, research, and employment at UCSF. The Office serves as a bridge between UCSF and local communities, emphasizing partnerships that value and respect the assets and diversity of both.

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UCP CE Modules

• Modules include:1. Introduction to Community Engagement2. Introduction to San Francisco’s Diverse Communities3. Health Communication4. Community Assessment5. Partnering with UCSF (for community partners)

• Each module runs approximately 20-30 minutes

Action Research Program

• Implementation Science courses within Training in Clinical Research Program

• Increase experiential learning component to focus on the unique culture/context that define specific settings

• Partnering with the health care setting to improve their own practices/environment

• Designed for MS1s and MS2s

Community-Based Participatory Research (CBPR)

• Contexts: Clinical context, Capacity and Readiness, Importance of the problem identified.

• Group Dynamics: Incorporate equitable partnerships, decision-making, problem identification, and reciprocal learning

• Intervention: Fits local and cultural beliefs, norms, and practice

• Outcomes: System and capacity changes, sustainability, community empowerment

Action Research Program in Cardiology

• Cardiology leadership and staff identified clinic improvement areas: patient satisfaction, provider satisfaction, staff recognition

• Conducted clinic observations• Co-designed a pilot intervention• Co-developed intervention protocols: List of

training components for the Clinic vs. ARP team• Co-developed logic model to identify appropriate

outcomes

Training Component• Pre-requisite Trainings

o Historyo Vitals

• APEX Trainingo APEX training for 1st, and 3rd year students through SOMo Perform Abstract encountero Medication Reconciliation

• Update medications• Update/revise Pharmacy for e-prescribing

• Patient Interviewing (SOM)• Health Coaching (SOM)• Cardiology Specifics

o If questions arise: Chief of Cardiology (Dr. Jeffrey Olgin), Administrative Director (Brenda Mar), Practice Manager (Brenda Mar)

o Shadow session with current students and MAs within 4 weeks of starting rotation.

Service Learning Resources

• Community-Campus Partnerships for Health (CCPH) https://ccph.memberclicks.net/service-learning (resources on service learning with a health focus)

• California Campus Compact (CACC) http://www.cacampuscompact.org/ (resources on community engagement for California higher education institutions)

• National Service-Learning Clearinghouse http://www.servicelearning.org/ (extensive resources on variety of topics)

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References• CDC/ATSDR Committee for Community Engagement

Accessed 2/19/14 at: http://www.atsdr.cdc.gov/communityengagement/pdf/PCE_Report_Chapter_1_SHEF.pdf

• Community Campus Partnerships for Health (CCPH) https://ccph.memberclicks.net/principles-of-partnership

• UCSF’s Office of University Community Partnerships http://partnerships.ucsf.edu/about-us/general-principles

Introduce Templates