Investing in the mission - part 2

Another area of campus where WVSOM’s leadership team invested in upgrades and expansions in the past few years is the Clinical Evaluation Center (CEC). More than just a building, the CEC provides an environment for students to learn how to interact with future patients in order to promote patient-centered, evidence-based medicine.

Standardized patients, or individuals from the community who have been trained to accurately portray the role of a patient with a specific medical condition, and human-patient simulators, which  are computer-driven mannequins that talk and breathe, have pulses and pupils that constrict and dilate, help provide students with clinical exposure in a safe and controlled teaching environment.  

“We are providing students the opportunity to learn the skills, practice the skills and be able to assess skills that are important to patient-centered care,” said Gail Swarm, D.O., the CEC’s director. 

Those skills include interviewing, history taking and performing physical exams. Additionally, working with simulation gives students the chance to work in teams, which is also important to patient-centered care, she said.

“The opportunity to practice, make mistakes in a safe environment and debrief, which is a big part of earning, helps make the learning process easier and more natural for the student and ultimately better for the patient,” Swarm said. “For instance, giving bad news is an uncomfortable thing for physicians to do. Practicing before you have to do it in real life is a valuable experience for students. They can observe the things that could be better and hopefully  internalize that and become involved in the systems to make health care better for patients. And that’s what patient-centered medical care is.

The “medical home” does not represent a building, house or hospital, but rather a team approach to providing health care.

The primary care physician organizations state that a medical home originates in a primary health care setting that is family-centered and where a partnership develops between the family and the primary health care practitioner in order to access all medical and non-medical services needed to achieve maximum potential. The medical home maintains a centralized, comprehensive record of all health-related services to promote continuity of care. [See the six aspects of a Patient-Centered Medical Home in the breakout box.] In 2018, the Robert C. Byrd Clinic received National Committee for Quality Assurance (NCQA) Patient-Centered Medical Home recognition for using evidence-based, patient-centered processes that focus on highly coordinated care and longterm, participative relationships. The recognition is valid for three years.

Moving forward, Swarm said, patient centered care will involve better understanding of a physician’s patient population. The Electronic Health Records (EHR) will be a useful tool in obtaining data on a population.

“When we brought in the EHRs, we were trying to teach students that it’s not just about a doctor or nurse using the computer. Physicians can query how many of their diabetics have HbA1c over 8 percent. Where do these patients live by zip code? If they all live in one area, what opportunities exist to assist these patients with self management? This potentially teaches students to get more data from the use of EHRs,” Swarm explained.

The patient-centered teaching methods will be valuable to students like Tito, who already tries to consider a patient’s social, economic and cultural factors to determine how that affects their health.

“Learning about people is important because in the future, when I see patients, drawing from all of my learning experiences, I can look at the things that could impact patients and bring them to my clinic. And learning that is very valuable,” Tito said.

Investing in citizens

Expanding beyond WVSOM’s classrooms and the campus, the medical school strives to serve, first and foremost, the state of West Virginia and the health care needs of its residents, emphasizing primary care in rural areas.

WVSOM programs such as the Center for Rural and Community Health (CRCH) help serve the needs of West Virginians in conjunction with assisting and working with community based organizations. The CRCH is a resource center designed to help improve the health and well being of West Virginians and recognizes the importance of professionals and community members working together to improve the state’s health profile through research, education and outreach opportunities.

Drema Mace, Ph.D., the executive director of the CRCH, said having strong community partnerships ties into WVSOM’s mission of serving the health care needs of its residents.

“Having successful community partnerships is important because there is more strength in numbers and by collaborating we can build an infrastructure in the community that benefits the overall health of our community,” she said.

The role of the CRCH is a varied one. The program has garnered community participatory research for students and faculty; sponsors the Greenbrier County Health Alliance and works closely with the alliance in order to provide farmers markets, work to create a child development center in Rupert and a project where senior centers can have access to fresh fruits and vegetables; and offers statewide training through the Community Health Education Resource Persons (CHERP) program, designed as a community health worker training program. WVSOM has the license for providing evidence based Stanford University programs to educate people about chronic disease self management, chronic pain self management and diabetes. The center also works with the Substance Abuse and Mental Health Services Administration (SAMHSA), a federal funding agency for substance abuse.

“One of the goals of the center is to expand our services statewide in the coming years and part of that process is reaching out to local nonprofits and providing assistance to build a better infrastructure in our state,” she added. “Developing programs within our local nonprofits will impact the health of West Virginians through the programs that are being built.”

Another educational effort by the CRCH was the creation of an opioid toolkit, designed to bring awareness to the rising epidemic in the state and offer resources for those trying to recover. The original idea for a drug awareness toolkit in our area came from a recommendation from the local United Way in February 2016.

The template, which was given by Washington County, Wis., was further developed with feedback from different relevant organizations in the area, according to Haylee Heinsberg, a CRCH health education coordinator who helped oversee the creation of the toolkit.

After months of discussion to create a useful resource, the “Prescription Opioid and Heroin Awareness Toolkit” came to be, in collaboration with the Community Addressing Prescription Drug Epidemic (CARxE) Coalition. Last June, a kick-off event took place on WVSOM’s campus to introduce the prevention guide to the community and begin distribution.

“We are trying to make people more aware of this disease, community resources and the places to get help and to at least start a conversation about how to impact this epidemic,” Heinsberg said of the resource tool.

The toolkit was presented at the West Virginia Rural Health Conference in October. As a result, neighboring counties started expressing an interest in the toolkit. During that time, the Substance Abuse and Mental Health Services Administration also started using it as a model for other areas of the state — hoping to replicate the toolkit in all 55 counties.

“If our toolkit can be a guide to open conversation of coming together as a community in order to make a positive change — and provide support to a caregiver, loved one and family members, to reinforce that people are trying to get clean and sober — then we can start to make a dent in the problem,” she said. “Ninety-one people a day die from opioids. If there was an easy solution it would’ve been fixed a long time ago.”

The toolkit will be gaining national exposure as well. Mace and Heinsberg will present “An Opioid Toolkit: A Rural Community Education Project” at the National Rural Health Association’s annual conference on May 11 in New Orleans, La. The toolkit, along with a provider packet and a series of public service announcements, all come together as one synergistic effort for people to see there are others dealing with the same situation, Heinsberg said.

WVSOM’s mission to serve the needs of West Virginians isn’t just one sided — there are also meaningful benefits for students and alumni who serve the health care needs of residents in rural areas.

Dimitri Tito may only be just over halfway through his second year of medical school, but he has already committed so much of his time and efforts to helping his community through volunteer efforts.

“My background, coming from an underserved area, I kind of know what it’s like to be in a community and being in need. That’s why when I came to medical school I wasn’t just thinking about studying all the time. I was thinking about what I can do for others,” he shared.

Even before Tito officially started medical school he jumped in to volunteer for a community in need. Tito arrived to Lewisburg in Summer 2016, the same time much of southern West Virginia was impacted by heavy flooding.

A group of second-year students organized a Facebook group seeking volunteers to work to cleanup houses in nearby towns. Tito didn’t hesitate to help — even going as far as to crawl in spaces underneath houses to ensure a clean foundation.

“It was an opportunity to start helping and I just got to West Virginia,” he recalled. “We organized many different trips to houses. Right away, I felt the involvement that WVSOM had in the community, and for me, it was very important.”

In addition to flood recovery efforts, Tito has volunteered for WVSOM Cares, has taken blood pressure readings at the state fair and is a member of the Cultural Integrity Committee, which is in the process of organizing culturally diverse standardized patient encounters as a learning opportunity for students. Tito, who is heavily involved in the community as a student, hopes to eventually enter a family medicine or internal medicine residency.

Tito may be headed down a similar path as another former student who was heavily involved — Christopher Donovan “Dino” Beckett, D.O. In the last WVSOM magazine, the Class of 2000 graduate was featured for being awarded the 2017 Rural Health Practitioner of the Year during the National Rural Health Association conference.

Beckett returned to his home of Williamson, W.Va., in 2003 and since then has made great strides in improving the community and the health needs of its residents. He created the Williamson Health and Wellness Center, a free clinic designated as a Federally Qualified Health Center in the Fall 2013. The clinic serves residents of Mingo County in West Virginia and Pike County in Kentucky. Since its opening, the wellness center went from seeing nearly 7,500 patients a year to more than 20,000.

Beckett is an active member of the Mingo County Diabetes Coalition, which focuses on access to healthy eating, physical activity and active living, as well as enhancing access to care through the use of community health workers. He has also helped establish a community garden and a local farmers market.

There are many alumni, like Beckett and Snuffer, who attended WVSOM and decided to practice in West Virginia after they graduated to serve the needs of their community and state. It all goes back to continuous, quality training by people who are completely invested in WVSOM’s mission.

“It’s all about training people to become doctors and training them the right way. I’m actually still learning, because I learn a lot of things from students I precept. They just went through all this training and it’s refreshing for me as well. It keeps me going and up-to-date on what’s happening,” Snuffer said, proving that learning is lifelong.

Date Added: 
Tuesday, July 10, 2018