2023 Building Trust Through Diversity, Health Care Equity, Inclusion and Diagnostic Excellence in Internal Medicine Training Grant Program
In July 2023, Alliance for Academic Internal Medicine (AAIM), the American Board of Internal Medicine (ABIM), the ABIM Foundation, the American College of Physicians (ACP), the Gordan and Betty Moore Foundation, and the Josiah Macy Jr. Foundation awarded a total of $470,000, split among 20 projects at medical schools and training programs.
Learn more about the selected projects:
- Duke University School of Medicine ($20,000): This project seeks to increase rates of colorectal cancer (CRC) screening among African Americans age 45+ in the community Duke serves. It includes a number of interventions, including improving education about personal risk for CRC through community health fairs; educating trainees about the disparate burden of CRC in various populations using a health equity framework; creating the framework for a health equity curriculum that would enable the adaptation of the project to address other health disparities; working with community partner the Community Health Coalition to distribute FIT screening tests and follow up with patients to encourage colonoscopies where appropriate. The project is designed to build trust and influence attitudes in the community about the importance of preventative health services and cancer screening.
- Duke University School of Medicine ($40,000): Internal medicine residents will moderate enrichment programs intended to promote careers in HIV care at eight Historically Black College and Universities (HBCU) in North Carolina. The Evidence2Practice program features 3-day workshops that highlight implementation science in the context of HIV prevention; the workshops lead to the development of a student-generated, campus-specific action plan to improve awareness of HIV pre-exposure prophylaxis (PrEP). The grant will enable residents to help address a major public health crisis driven by health inequities, develop skills in health education/promotion, and promote a pathway to medical school and IM residencies for HBCU students.
- Eastern Idaho Regional Medical Center ($10,000): The grantee will establish a mini-curriculum for internal medicine residents to raise awareness of rural-urban health disparities; establish a residency-led mobile health unit that will enable interdisciplinary teams to connect with underserved communities; provide free preventive health screening for hypertension, diabetes and other conditions to build trust with rural and underserved communities in Idaho; and use the mobile health unit initiative to introduce DEI principles into its internal medicine residency training program.
- Emory University School of Medicine ($10,000): Emory will develop a Health Equity Case Competition toolkit and develop best practices for integrating community organizations into case competitions, which bring groups of learners and community members together to develop solutions to address inequities in the community. To toolkit will describe the value of case competitions, a step-by-step guide for creating a competition, and a framework for evaluation.
- Jesse Brown VA Medical Center/Northwestern University ($20,000): This project will use point of care ultrasonography (POCUS) to train high school, college, and post-college students who participate in a Chicago-based program to help under-represented minority students successfully pursue career pathways in health care. The POCUS project is intended to reinforce the anatomical, physiological and clinical concepts the students learn, and to foster confidence and motivation among the group. The grant will support four six-month rotations, with 30 students in each rotation.
- LSU Health Shreveport School of Medicine ($10,000): This grant will support the development of a curriculum to improve residents’ understanding of DEI within their community. The curriculum will include a community tour that will introduce residents to inter-professional colleagues in the community and important community partners. Residents will also receive bias training, including presentations form outside experts and training modules.
- Massachusetts General Hospital/Harvard Medical School ($20,000): This project will expand the Patient Support Corps program, in which pre-medical students prepare patients for medical visits, helping patients prepare a “question list” that they can bring to an appointment. The program is intended to help patients navigate their appointments more effectively, help clinicians have more efficient visits and aid in diagnosis, and providing clinical experiences and communication skills training for future physicians. This grant will enable the extension of the program to Harvard’s Core-I Medicine Clerkship; medical students will be trained in and conduct pre-visit meetings with patients.
- Northwell Health ($10,000): This grant is designed to improve diabetic glycemic control in an underserved population through the use of continuous glucose monitors. Northwell’s Eliminating Barriers Initiative (EBI) is an inter-professional project that works with patients with diabetes and emphasizes the importance of patient self-efficacy. A majority of patients who are part of EBI have improved their A1C scores, but most have not yet met their goals. CGMs would help these patients track and manage their condition, but few EBI participants have insurance coverage that enables them to access CGMs. This grant will enable 50 EBI patients to use CGMs as part of their comprehensive diabetes care.
- Northwestern University ($40,000): This grant will support the development of a protocol to increase residents’ ability to provide trauma informed care (TIC) and enhance patient trust in residents. It will help residents conduct trauma histories with patients and respond appropriately and confidently to disclosures of trauma in the inpatient setting. To develop the protocol, the project team will collect baseline data on patient experience with trauma and levels of patient trust in resident physicians, and host focus groups of patients with recent hospitalizations to learn more about how the hospital setting can better support lived experiences with trauma and how residents can better communicate with patients in a trauma-informed manner. The protocol itself will be developed by an inter-disciplinary committee that includes experts, residents, the internal medicine program director, social workers, nurses, chaplains and security guards. Up to 20 residents will pilot the protocol, and residents and patients exposed to the protocol will be surveyed.
- One Brooklyn Health ($40,000): One Brooklyn Health will build a new inter-professional curriculum to advance health equity, health care quality and collaboration among health professional trainees and the community. The curriculum will train internal medicine and pediatrics residents, nursing colleagues, and front-line staff in pragmatic community organizing and leadership skills. It will also teach participants how to develop community-driven projects to address health equity within the system and in the community.
- Sidney Kimmel Medical College at Thomas Jefferson University ($40,000): Develop an inter-professional ‘Un-Learning Bias’ curriculum informed by the arts and humanities and intended to help learners reflect on issues of race and racism in health care. Students collaboratively explore active efforts to incorporate anti-racist practices into their work with patients, colleagues and communities by deconstructing race as a biological category, confronting structural racism in health care systems, and highlighting narratives and practices of resilience and creative healing. Through this, they develop their understanding of present and historical factors affecting health equity to inform their future as health care professionals committed to socio-political awareness and cultural humility.
- State University of New York at Buffalo ($40,000): Support longitudinal curriculum for internal medicine residents to provide firsthand knowledge of patient experiences through simulation and partnership with community-based organizations and inter-professional collaboration with the health care team. The curriculum will help residents better understand barriers to health equity and reflect on practices that inadvertently create gaps in care. Among other things, residents immerse themselves in activities that simulate the financial, transportation, housing, and other challenges their patients face. They also can take an elective course where they can learn about and experience inter-professional collaboration with individuals from a wide variety of other clinical fields, and witness interactions between patients and these other clinicians. Finally, residents can work with community partners to learn about resources available to the community, barriers to accessing them, and ways to overcome those barriers.
- UAB Heersink School of Medicine ($10,000): This grant will support the development and implementation of an ‘upstander training curriculum’ for residents, fellows and other inter-professional team members at UAB. Participants will learn how to speak or act in support of clinicians and staff who are subjected to micro- and/or macro-aggressions.
- Uniformed Services University of the Health Sciences ($40,000): This project is designed to spread a Health Equity Rounds curriculum developed at Walter Reed Medical Center to the 10 other Military Internal Medicine Training Programs. The project team will host a weeklong Train the Trainer program that representatives of each of the other training programs will attend, followed by quarterly troubleshooting calls for all participants.
- University of California – Los Angeles ($40,000): UCLA will launch a combined ‘street medicine’ clinic/internal medicine health equity training program to provide equitable, high-quality health care to patients experiencing homelessness. The project team will partner with a church and a local neighborhood homeless coalition to meet patient needs such as transportation, food and clothing. Residents who participate will teach other residents about street medicine, and medical students will provide care and participate in quality improvement and research projects.
- University of Iowa ($10,000): The grantee will create a Distinction in Health Equities track for Internal Medicine residents who desire training in health equity that goes beyond the core DEI curriculum, and who envision working toward eliminating health care disparities as part of their careers. The DIHE track will include a formal curriculum, partnership with community organizations, providing clinical care for vulnerable populations, advocacy opportunities and a capstone project.
- University of Texas Health San Antonio ($10,000): This grant will fund a study on patient harassment of learners. The research team will survey residents and nurses at four sites about their experiences of patient-perpetrated harassment and focus on inter-professional communication between residents and nurses. They plan to identify the frequency of harassment, comparing it across study sites; study the presence and awareness among respondents of policies for reporting patient harassment; and explore how resident-nurse communication can improve understanding, collaboration and teamwork in the clinical learning environment.
- University of Utah ($10,000): This grant will fund the development of workshops in which residents improve their ability to provide culturally competent care that address social determinants of health by engaging in case-based learning with community health workers and learning how to collaborate with CHWs as part of a multi-disciplinary team in inpatient and outpatient settings. The project team will create video recordings of the sessions and facilitator guides, to enhance the program’s sustainability and potential spread.
- University of Wisconsin ($10,000): This grant will support the creation of interactive workshops for upper-level residents that will address racial disparities in the grantee’s service area; the history and impact of ‘racialized medicine’ on historically marginalized communities; and race-based diagnostic bias, how it develops and tools to mitigate it. Among other things, residents will learn about race-based clinical algorithms and clinical calculators.
