A03 – Modifying the One-Minute Preceptor Method in Combating Ethno-Racial Health Disparities in a Family Medicine Residency Clinic

Summary

This quality improvement (QI) project focused on improving faculty confidence in discussing ethno-racial health disparities with their learners during precepting time using the modified OMP Model for Health Equity. Methods: Population and Setting: Physician Faculty and Family Medicine Residents within the Family Medicine Residency (FMR). Implementation of this QI project used a Plan-Do-Study-Act (PDSA) framework. Faculty physicians and residents were administered the AREA survey (faculty), precepting practice survey (residents), and demographic information electronically 1 month prior to the modified OMP for Health Equity intervention (“plan” stage of PDSA). Faculty physicians were introduced to the intervention through a brief (30 minute) didactic during a faculty meeting. Faculty physicians then began use of the intervention for a two-month period. After the intervention (“do” stage of PDSA), faculty were re-administered the AREA survey to assess impact of the modified OMP for Health Equity as well as the brief didactic during the faculty meeting and to determine next steps for ongoing faculty development related to addressing health disparities with learners (“study” and “act” stage of PDSA). Results: The AREA survey was completed by 12 family medicine faculty prior to the intervention and by 8 faculty after the intervention. Prior to the intervention, the majority of faculty demonstrated engagement in the areas of awareness (mean= 4; SD= 1.32) and reflection/empowerment (mean= 4.83; SD= 0.36) while lower engagement levels were seen in action (mean=1.53, SD= 0.49). After the intervention, faculty engagement levels slightly increased in the areas of awareness (mean=4.25; SD= 0.70) and action (mean= 1.58; SD= 0.49) and slightly decreased in reflection/empowerment (mean=4.5; SD= 0.51). A total of 28 family medicine residents completed the pre-survey and a total of 32 completed the post-survey on precepting practices. Using a 1-7 Likert scale, where higher numbers indicate discussions occurring very often and residents being very satisfied, residents reported that discussions of ethno-racial disparities occurred often during precepting in the residency’s outpatient continuity clinic and in its inpatient service both before the intervention (mean=4.07; SD= 1.58) and after (mean 4.06, SD=1.58). Residents reported overall satisfaction with the clinical teaching about ethno-racial health disparities prior to the intervention (mean= 4.04; SD = 1.59) and slightly higher satisfaction after the intervention (mean= 4.66; SD= 1.59). The results show that by using the PDSA cycle framework for QI, faculty engagement in addressing ethno-racial health disparities can improve. The modified OMP for Health Equity intervention can be used as a concrete clinical teaching tool to increase awareness and to promote self-reflection and change on issues of ethno-racial health disparities for not only learners, but for primary care educator engagement as well.