1. PSSST! A Pipeline, Shadowing, Simulation and Students as Teachers program: Doc4aDay Vicki Hayes, MD Caitlin Willard, MD Maine Medical Center

2. Goals Pipeline across the country/evidence Details about Doc4aDay Discussion of implementing this and other programming

3. Three Things Pipeline program involving simulation Pipeline program involving students as teachers Help with organization/challenges

4. Overview of Pipeline Programs AAMC website https://www.aamc.org/students/aspiring/exp erience/301974/pipeline.html#.UsWTtRyzCE M

5. Key Components Goals of program Target audience Selection criteria Format Effectiveness

6. Target Audience Grade level Minority/underserved Rural AP students Families (especially mom’s—NM) 1 st generation to attend college

7. Features How to ID/screen applicants (counselor/teacher recommendation, essay, academic requirement, extracurricular activity) System to review/select Whether to charge ($550 HS Mini Med MO) Length (K through med school, one-day to 4 years, summer) Housing

8. Format Research project Lectures Labs Shadowing/”day in the life of” Career counseling/professional development MCAT prep College credit (anatomy, physiology)

9. Format Volunteer opportunities Mentors Tutoring Tours Visiting scientists Career fairs/science fairs

10. Format Recreational and cultural events/field trips 3-D demos After-school programs Teaching in schools Financial aid Simulation (computer)

11. Effectiveness Pipeline Programs 2009 US Dept. Health & Human Services critical lit review: 24 studies met inclusion criteria (6 HS, 14 college, 5 post- baccalaureate level health professions schools) Outcomes: admission rates, graduation rates, test scores (SAT, MCAT, math & science), GPA, employment All + except study looking at interview scores http://bhpr.hrsa.gov/healthworkforce/reports/pipelineprog diversity.pdf

12. Doc4aDay Target: underrepresented high school students (Secondary target: candidates for admission to Maine Track program) ID through HS counselors (meeting) One school, multiple schools?

13. Format Sample agenda—length of shortened school day Ice-breaker Pathway to Physician/Health Career Power Point High-fidelity patient scenarios Hands-on skills lab Lunch with med students/residents

14. Format 8:00 – 9:00 Welcome, Ice-breaker, Pathway to Health Career 9:00 – 9:30 Tour Simulation Center 9:30 – 10:30 Group A: Skills Lab, Group B: HiFi Lab 10:30- 11:30 Group A: HiFi Lab, Group B: Skills Lab 11:30–12:30 Lunch with Residents/Medical Students

15. Patient Scenarios Paired with health care professional Shadowing and participating Team approach Students as teachers De-brief

16. Hands-on Suture pigs’ feet Heart sounds Vital signs

17. Other Considerations Welcome letter/email Professional dress White coats Stethoscope

18. Forms Parental consent (email addresses, demographics) Media release Counselor recommendation Follow-up survey (Survey Monkey, paper)

19. Cost Med Ed Dept. (pipeline mission) AHEC (Area Health Education Center) grant Sim Center staff Medical students, residents One faculty Admin—folders, communication, collecting forms Food/supplies (suture material) Travel

20. Benefits to med stud/residents Teaching role Develop, participate in and debrief scenarios Hands-on skills lab Lunch panel Serve as an ambassador

21. Positives Half day Team approach Avoid HIPAA, immunization, safety Accommodate larger numbers Real scenarios (but comfort in pairing) Interact with one another (not present in one-on-one shadowing) Minimal faculty

22. Negatives/Challenges Not a “real” shadowing experience Organization/time—paperwork/connections Challenge meeting deadlines Some expense Cultural concerns Intrusive adult participants Publicity without permission Fairness/access from schools Reaching right students

23. Doc4aDay On the Road Making Connections Facilities Using local students (on rotations, early assurance) Collecting paperwork Reach different target populations Transport high-fidelity or use local simulators (college campus)

24. Feedback “I understood how much a doctor has to go through throughout the day and week.” “The most valuable part of the day for me was getting to talk to all the medical students and doctors and learn about what it takes to become a doctor and what I need to do if I want to become one.” “To actually go through scenarios as a medical student is a lot different than watching the shows.” “This made me want to start now!”

25. Goals Increase number sessions Students as Teachers requirement Tracking

26. Discussion Questions? How could you apply this at your institution?

27. Acknowledgements Maine Medical Center Dept. of Medical Education Maine Area Health Education Centers (AHEC) University of Maine, Orono, and Franklin Memorial Hospital Maine Medical Center Dept. of Family Medicine Participating residents, medical students Participating high school counselors Student attendees Family Medicine Chief Resident, Caitlin Willard, MD

28. Permissions Verbal or written permission/release obtained for all illustrations