Amy Shaheen, School of Medicine
Ambulatory education is fundamental but the availability of ambulatory learning sites has declined. The decline in ambulatory sites is due to competing demands, lack of remuneration, feelings of inadequacy as teachers, and production-based compensation. To improve the numbers of learning sites, we emphasized bidirectional value of population health management to practices and students. We expanded our ambulatory curriculum to include population health management. Students participated in experiential learning doing quality improvement projects to improve the health of a population. Students were encouraged to align with institutional goals and to pair with local quality improvement experts. We also held faculty development sessions on quality improvement and population health management. UNC affiliated practices increased participation by 17 sites. To date, 86 students have participated in the new curriculum. Projects aligned with practice goals and most with metrics followed on practice dashboards. Students documented improvement 78% of the time. There were improvements in diabetes metrics, such as the use of aspirin and statins, eye exams, and foot exams. Improvements in colorectal cancer screening included implementation of FIT testing, improvement in return rate of FIT tests, and improvement in documentation of outside colonoscopies. Mammography rates increased, including those in uninsured patients due to improved processes for scheduling. One student revised the UNC health system dashboard with a “number needed to goal” calculator to make monthly dashboards more understandable. Population health management curriculum improved physician recruitment for ambulatory education. Curricular support for those goals can improve clinical metrics.