Building Health Workforce Capacity Through Community Based Health Professional Education

There is growing evidence from developed and developing countries that community-based approaches are effective in improving the health of individuals and populations. This is especially true when the social determinants of health are considered in the design of the community-based approach. With an aging population and an emphasis on health promotion, the United States is increasingly focusing on community-based health and health care. Preventing disease and promoting health calls for a holistic approach to health interventions that rely more heavily upon interprofessional collaborations. However, the financial and structural design of health professional education remains siloed and largely focused on academic health centers for training. Despite these challenges, there are good examples of interprofessional, community-based programs and curricula for educating health professionals. In May 2014, members of the Institute of Medicine's Global Forum on Innovation in Health Professional Education came together to substantively delve into issues affecting the scale-up and spread of health professional education in communities. Participants heard a wide variety of individual accounts from innovators about work they are undertaking and opportunities for education with communities. In presenting a variety of examples that range from student community service to computer modeling, the workshop aimed to stimulate discussions about how educators might better integrate education with practice in communities. Building Health Workforce Capacity Through Community-Based Health Professional Education summarizes the presentations and discussion of this event.

There is growing evidence from developed and developing countries that community-based approaches are effective in improving the health of individuals and populations. This is especially true when the social determinants of health are considered in the design of the community-based approach. With an aging population and an emphasis on health promotion, the United States is increasingly focusing on community-based health and health care. Preventing disease and promoting health calls for a holistic approach to health interventions that rely more heavily upon interprofessional collaborations. However, the financial and structural design of health professional education remains siloed and largely focused on academic health centers for training. Despite these challenges, there are good examples of interprofessional, community-based programs and curricula for educating health professionals. In May 2014, members of the Institute of Medicine's Global Forum on Innovation in Health Professional Education came together to substantively delve into issues affecting the scale-up and spread of health professional education in communities. Participants heard a wide variety of individual accounts from innovators about work they are undertaking and opportunities for education with communities. In presenting a variety of examples that range from student community service to computer modeling, the workshop aimed to stimulate discussions about how educators might better integrate education with practice in communities. Building Health Workforce Capacity Through Community-Based Health Professional Education summarizes the presentations and discussion of this event.

Assessing Health Professional Education is the summary of a workshop hosted by the Institute of Medicine's Global Forum on Innovation in Health Professional Education to explore assessment of health professional education. At the event, Forum members shared personal experiences and learned from patients, students, educators, and practicing health care and prevention professionals about the role each could play in assessing the knowledge, skills, and attitudes of all learners and educators across the education to practice continuum. The workshop focused on assessing both individuals as well as team performance. This report discusses assessment challenges and opportunities for interprofessional education, team-based care, and other forms of health professional collaborations that emphasize the health and social needs of communities.

Since 2004, the U.S. government has supported the global response to HIV/AIDS through the President's Emergency Plan for AIDS Relief (PEPFAR). The Republic of Rwanda, a PEPFAR partner country since the initiative began, has made gains in its HIV response, including increased access to and coverage of antiretroviral therapy and decreased HIV prevalence. However, a persistent shortage in human resources for health (HRH) affects the health of people living with HIV and the entire Rwandan population. Recognizing HRH capabilities as a foundational challenge for the health system and the response to HIV, the Government of Rwanda worked with PEPFAR and other partners to develop a program to strengthen institutional capacity in health professional education and thereby increase the production of high-quality health workers. The Program was fully managed by the Government of Rwanda and was designed to run from 2011 through 2019. PEPFAR initiated funding in 2012. In 2015, PEPFAR adopted a new strategy focused on high-burden geographic areas and key populations, resulting in a reconfiguration of its HIV portfolio in Rwanda and a decision to cease funding the Program, which was determined no longer core to its programming strategy. The last disbursement for the Program from PEPFAR was in 2017. Evaluation of PEPFAR's Contribution (2012-2017) to Rwanda's Human Resources for Health Program describes PEPFAR-supported HRH activities in Rwanda in relation to programmatic priorities, outputs, and outcomes and examines, to the extent feasible, the impact on HRH and HIV-related outcomes. The HRH Program more than tripled the country's physician specialist workforce and produced major increases in the numbers and qualifications of nurses and midwives. Partnerships between U.S. institutions and the University of Rwanda introduced new programs, upgraded curricula, and improved the quality of teaching and training for health professionals. Growing the number, skills, and competencies of health workers contributed to direct and indirect improvements in the quality of HIV care. Based on the successes and challenges of the HRH program, the report recommends that future investments in health professional education be designed within a more comprehensive approach to human resources for health and institutional capacity building, which would strengthen the health system to meet both HIV-specific and more general health needs. The recommendations offer an aspirational framework to reimagine how partnerships are formed, how investments are made, and how the effects of those investments are documented.

A pressing challenge in the modern health care system is the gap between education and clinical practice. Emerging technologies have the potential to bridge this gap by creating the kind of team-based learning environments and clinical approaches that are increasingly necessary in the modern health care system both in the United States and around the world. To explore these technologies and their potential for improving education and practice, the National Academies of Sciences, Engineering, and Medicine hosted a workshop in November 2017. Participants explored effective use of technologies as tools for bridging identified gaps within and between health professions education and practice in order to optimize learning, performance and access in high-, middle-, and low-income areas while ensuring the well-being of the formal and informal health workforce. This publication summarizes the presentations and discussions from the workshop.

On March 21, 2019, the Roundtable on Population Health Improvement of the National Academies of Sciences, Engineering, and Medicine convened a 1-day workshop to explore the broad and multidisciplinary nature of the population health workforce. Workshop participants explored methods for facilitating a population health orientation/perspective among public health and health care leaders and professionals; framing the work of personnel such as community health workers (CHWs), health navigators, and peer-to-peer chronic disease management educators within the context of population health; and leveraging the competencies of public and private sector workforces, such as education, transportation, and planning, that are working to include a "health in all policies," community livability, or well-being orientation in their activities. This publication summarizes the presentations and discussions from the workshop.--Publisher’s website.

An adequate, well-trained, and diverse health care workforce is essential for providing access to quality health care services. However, despite more than a decade of concerted global action to address the health workforce crisis, collective efforts are falling short in scaling up the supply of health workers. The resulting health workforce shortage affects people's access to quality health care around the globe. In October 2016, the National Academies of Sciences, Engineering, and Medicine convened a workshop to explore resources for financing health professional education in high-, middle-, and low-income countries and innovative methods for financially supporting investments in health professional education within and across professions. Participants examined opportunities for matching population health needs with the right number, mix, distribution, and skill set of health workers while considering how supply and demand drive decisions within education and health. This publication summarizes the presentations and discussions from the workshop.

In concept and practice, public health casts a wide net, spanning assessment, intervention, and policy; education, prevention, and protection; public, private, and government entities. But key elements are often missing from the picture, including a clear understanding of public health and its goals by the general public, and specific public health education throughout the workforce. Preparing the Public Health Workforce responds to these and related challenges by elegantly summarizing the state of the field in an era of dwindling budgets, competing and overlapping services, and a shaky professional infrastructure. In keeping with public health goals set out by the CDC and other leading agencies, the author makes a real-world case for standardizing training, establishing best practices in the field, and coordinating public health systems with their healthcare counterparts. Theory, case examples, tools, and callout boxes highlight knowledge, preparation, and skills professionals need in addressing chronic issues and complex emergencies. Throughout, the emphasis is on greater competency and visibility for the profession, resulting in a more informed, healthier public. Featured in the coverage: Issues in defining the public health workforce. The state of public health education. Practicing and teaching public health: local, national, and international cases. Standardizing public health practice: benefits and challenges. Integrating public health and healthcare. The future of public health as seen from academia and the frontlines. Identifying urgent issues and providing cogent answers, Preparing the Public Health Workforce is a call to action for those involved in creating the next level of public health, including professors, practitioners, students, and administrators.