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Socially Accountable Medical Education: An Innovative Approach at Florida International University Herbert Wertheim College of Medicine

Greer, Pedro J. Jr MD; Brown, David R. MD; Brewster, Luther G. PhD; Lage, Onelia G. MD; Esposito, Karin F. MD, PhD; Whisenant, Ebony B. MD; Anderson, Frederick W. MD; Castellanos, Natalie K. JD; Stefano, Troy A. PhD; Rock, John A. MD, MSPH
doi: 10.1097/ACM.0000000000001811
Innovation Report: PDF Only

ProblemDespite medical advances, health disparities persist, resulting in medicine’s renewed emphasis on the social determinants of health and calls for reform in medical education.

ApproachThe Green Family Foundation Neighborhood Health Education Learning Program (NeighborhoodHELP) at Herbert Wertheim College of Medicine provides a platform for the school’s community-focused mission. NeighborhoodHELP emphasizes social accountability and interprofessional education while providing evidence-based, patient- and household-centered care. NeighborhoodHELP is a required, longitudinal service–learning outreach program in which each medical student is assigned a household in a medically underserved community. Students, teamed with learners from other professional schools, provide social and clinical services to their household for three years. Here the authors describe the program’s engagement approach, logistics, and educational goals and structure.

OutcomesDuring the first six years of NeighborhoodHELP (September 2010–August 2016), 1,470 interprofessional students conducted 7,452 visits to 848 households with, collectively, 2,252 members. From August 2012, when mobile health centers were added to the program, through August 2016, students saw a total of 1,021 household members through 7,207 mobile health center visits. Throughout this time, households received a variety of free health and social services (e.g., legal aid, tutoring). Compared with peers from other schools, graduating medical students reported more experience with clinical interprofessional education and health disparities. Surveyed residency program directors rated graduates highly for their cultural sensitivity, teamwork, and accountability.

Next StepsFaculty and administrators are focusing on social accountability curriculum integration, systems for assessing and tracking relevant educational and household outcomes, and policy analysis.

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Funding/Support: In 2009, the Green Family Foundation and Batchelor Foundation created an endowment to support the initiatives of the Green Family Foundation Neighborhood Health Education Learning Program (NeighborhoodHELP). Since 2014, additional funding has been raised for the program through the generous support of various benefactors including the following: Health Foundation of South Florida, Susan G. Komen Foundation, Florida Blue Foundation, the Miami Foundation, Braman Family Foundation, Batchelor Foundation, Baptist Health of South Florida, American Medical Association Accelerating Change in Medical Education Initiative, Aetna Foundation, Peacock Foundation, and the Florida Association of Free and Charitable Clinics.

Other disclosures: None reported.

Ethical approval: The household survey was approved by the Florida International University Institutional Review Board; educational program evaluation data were considered exempt.

Previous presentations: Members of the Herbert Wertheim College of Medicine faculty, staff, and administration have given presentations of the different aspects of the curriculum in a variety of venues, including the following: “Inter professional Teams: Neighborhood-HELP” (Rock J, Allen S) Liaison Committee on Medical Education Webinar, June 23, 2016; “Addressing Disparities in the Provision of Medical Care: A Multisectoral Model for Marrying Medical Education and Household Health in Miami” (Ryan G, Brewster L, Brown D) Roundtable presentation at the 37th Annual Fall Research Conference of the Association for Public Policy Analysis and Management, November 12, 2015, in Miami, Florida; “Innovations in Healthcare Delivery Systems” (Greer PJ) Presentation at the 9th Annual Future of Medicine Summit, September 18, 2015, in West Palm Beach, Florida; “Learning by Example” (Greer P, Brown D, Lage O) Invited presentation for an Institute of Medicine Consensus Study on Educating Health Professionals to Address the Social Determinants of Health, September 15, 2015, at the Institute of Medicine in Washington, DC; “Innovations in Caring for Underserved Communities” (Greer PJ) Plenary speech at the 11th Annual Association of American Medical Colleges (AAMC) Health Workforce Research Conference, April 29–May 1, 2015 in Alexandria, Virginia; “Evaluation framework for a new model of integrated sociomedical outreach at Florida International University” (Brown D, Brewster L, Greer PJ, et al) Poster presented at the 45th Annual Urban Affairs Association Conference, April 10, 2015 in Miami, Florida; Improving Quality and Health Outcomes for All: The Family Physician and the Social Determinants of Health (Brown D, Pollack K, Suarez G, Wright D) Presentation at the American Academy of Family Physicians Scientific Assembly, October 25, 2014 in Washington, DC; “Building Interprofessional Healthcare Teams, One Household at a Time” (Lage O, Delzell J, Brown D, et al) Presentation at the 2014 American Academy on Communication in Healthcare Research & Teaching Forum, October 17, 2014 in Orlando, Florida; Training a Community-Oriented Primary Care Workforce—A Curricular Experience (Greer P) Presentation at the AAMC Annual Learn Serve Lead Meeting, November 3, 2012 in San Francisco, California; and “A New Model of Interprofessional Medical Education” (Brown D, Greer P, Brewster L, et al.) Poster presentation at the American Board of Internal Medicine Foundation Forum, August 2010 in Vancouver, British Columbia, Canada.

Correspondence should be addressed to David R. Brown, Herbert Wertheim College of Medicine, 11200 SW 8th St., AHC2 593, Miami, FL 33199; telephone: (305) 348-8388; e-mail: drbrown@fiu.edu; Twitter: @FIUMedicine.

© 2017 by the Association of American Medical Colleges