Each year, scholars and their mentors, along with the program’s National Advisory Committee and Macy Staff, convene to discuss their work to reform health professions education, sharing updates and lessons learned.
2017 Macy Faculty Scholars Program Annual Meeting
On June 7th and 8th, 2017 the Macy Foundation held its sixth Annual Meeting of the Macy Faculty Scholars Program. Past and present Macy Faculty Scholars, the mentors of the 2016 Scholars, and the program’s National Advisory Committee gathered to discuss issues they are encountering in their careers, participate in career development breakout sessions, and learn from their shared experiences. This report provides a full summary of the meeting.
As with prior Annual Meetings, the introduction of the latest class of Faculty Scholars was a highlight of this meeting. The 2016 Scholars outlined the purpose, progress, and next steps of their Faculty Scholars projects. In order to receive more focused feedback about the progress they’ve made so far and how to improve the project after their formal award period ends the 2015 Scholars presented their work in breakout group sessions. This year’s meeting featured two insightful sessions led by National Advisory Committee members. The first was a session on coaching and mentoring led by Kelley Skeff, and the second was an inspirational interview with Afaf Meleis about her career. Some highlights from the 2016 Scholars’ presentations are below, and the full meeting report can be found here:
DorAnne Donesky, PhD, RN
Dr. Donesky is developing an interprofessional center for palliative care education for learners from pre-licensure through graduate education. As part of Dr. Donesky’s interprofessional center she wants to develop curriculum and a self-sustaining model funded by tuition, fees, and philanthropic organizations for students and clinicians from medicine, nursing, spiritual care, and social work who desire additional interprofessional training in palliative care. Dr. Donesky then plans to disseminate these palliative care educational programs through educational scholarship and implementation in other university settings.
Christina M. Gonzalez, MD, MEd
Dr. Gonzalez is working to design, implement, and rigorously evaluate a comprehensive, longitudinal, developmentally appropriate curriculum to teach medical students to recognize and manage their racial and ethnic implicit biases in clinical encounters. Dr. Gonzalez believes that increased knowledge and awareness of implicit bias — the unconscious, unintentional assumptions people make — may help ameliorate disparities in clinical practice behaviors of individual physicians. Once students have taken Dr. Gonzalez’s course, she plans to evaluate the impact of the curriculum on students’ knowledge, attitudes and skills regarding implicit bias, including their clinical practice behaviors.
Temple Ratcliffe, MD, FACP
The focus of Dr. Ratcliffe’s project is implementing collaborative care on general medicine teams. His collaborative care initiative offers an authentic interprofessional practice environment that can engage learners from multiple professions. Dr. Ratcliffe aims to improve the orientation process for learners working on collaborative care teams, create learning objectives that align with both principles of interprofessional education and patient-partnered care, and design curricular content and assessment strategies that support these objectives.
Tyler Reimschisel, MD, MHPE
Dr. Reimschisel is instituting a working-learning health system (WLHS) that relies on interprofessional teams to provide personalized, cost-effective, comprehensive health services to a panel of patients. Dr. Reimschisel hypothesizes that this WLHS will improve health outcomes and the quality of care for patients, and that students in this system will glean a robust education in health systems science. In the WLHS pilot, a multigenerational, interprofessional team of health care professionals will include faculty in medicine, advanced practice nursing and social work; as well as students in medicine, advanced practice nursing, pharmacy, physician assistant, and social work. Students will be immersed in the WLHS for an extended period-of-time – daily for one to three months.
Jing Wang, PhD, MPH, MSN, RN
With millions of people in the U.S. using mobile or wearable devices to track health information, Dr. Wang is working to increase students’ competency in using mobile and connected health technologies to facilitate the delivery of patient-centered interprofessional team-based care. To achieve this goal Dr. Wang is designing an interprofessional curriculum guided by the ADDIE (Analyze, Design, Develop, Implement and Evaluate) instructional design model. Before implementing her curriculum Dr. Wang will be collecting stakeholder feedback from patients, industry, and community partners for their insights on her curriculum design.
On June 7th and 8th 2016 the Macy Foundation held its 5th Annual Meeting of the Macy Faculty Scholars Program. Past and present Macy Faculty Scholars, the mentors of the 2015 Scholars, and the program’s National Advisory Committee gathered to meet the latest cohort of Scholars, discuss issues they are encountering in their career, and learn from shared experiences.
As with prior Annual Meetings the introduction of the latest class of Faculty Scholars was a highlight of this meeting. The 2015 Scholars outlined the goals, progress, and next steps of their Faculty Scholars project. The 2014 Scholars presented updates on their ongoing projects, detailed their most recent successes, and discussed how the vision for their project will be achieved now that they are formally becoming Alumni Scholars. For the first time this meeting featured three concurrent breakout sessions. The topics of each breakout session were suggested by Scholars and a pair of alumni Scholars led each session. Some highlights from the 2015 Scholars’ presentations are below, and the full meeting report can be found here:
Lauren Collins, MD
The goal of Dr. Collins’ project is to develop, implement, evaluate and disseminate a new comprehensive, integrated Interprofessional Education/Collaboration curriculum, VERTICAL, across the educational continuum at Thomas Jefferson University. Dr. Collins and her colleagues are working to prepare a new cohort of highly competent VERTICAL students who will represent the new face of healthcare: Value-driven, Ethical, Responsible, Team-based, Interprofessional, Collaborative Aligned Leaders. VERTICAL students will achieve the IPEC Core Competencies and graduate equipped to deliver high quality, person-centered collaborative care.
Cheryl Woods Giscombé, PhD, MSN, RN, PMHNP
Dr. Giscombé is developing the Interprofessional Leadership Institute for Mental Health Equity (ILI-MHE). The ILI-MHE is an academic-community partnership that addresses factors contributing to mental health disparities, including stigma; perceived incongruence of culture, values, and priorities between patients and providers; and access to and use of health care among underrepresented and underserved groups. Through an existing academic-community partnership at Healing With CAARE, Inc. (a community health agency), health professions students enrolled in existing, discipline-specific community health practicum and clinical training courses are completing clinical, research, and transformational leadership development experiences. Participants will be trained to provide culturally sensitive, contextually relevant, team-oriented, evidence-based, holistic care including focus on healthcare systems and policy.
Deepthiman Gowda, MD, MPH
The primary purpose of Dr. Gowda’s project is to introduce narrative medicine into interprofessional team meetings. Narrative medicine is a branch of medical humanities that engages health care teams with literature, art, and reflective writing in order to explore a patient’s experience and the lives of other health professionals on the care team, and reflect on one’s own experience as a provider of health care. Using qualitative approaches Dr. Gowda also wants to explore how the introduction of narrative medicine unfolds in clinical settings.
Lisa Kitko, PhD, RN
The objectives of Dr. Kitko’s project are to increase the number of healthcare professionals able to effectively deliver primary palliative care regardless of practice setting, and develop educational innovations that promote interprofessional collaborative practice. These objectives will be addressed by developing and implementing an online primary palliative care graduate certificate program incorporating an interprofessional internship and joint coursework.
Bridget O’Brien, PhD
Dr. O’Brien’s project aims to improve the visibility of untapped teachable moments and learning opportunities in interprofessional contexts. To realize this aim Dr. O’Brien plans to identify common areas where professional roles, perspectives, and expertise overlap and how professionals negotiate these overlaps. Creating faculty development resources to support coaching around role clarification, information and perspective sharing, and establishment of shared understanding of care plans is another way Dr. O’Brien plans to improve interprofessional collaboration.
The Macy Foundation held its 4th Annual Meeting of the Macy Faculty Scholars Program on June 2nd and 3rd 2015. Convening over two days represented a first for the Faculty Scholars Program. Past and present Macy Faculty Scholars, the mentors for the 2014 Scholars, and the program’s National Advisory Committee convened in New York City to discuss the ever changing landscape of health professions education.
The 2014 Scholars were the highlight of this meeting. They introduced themselves to the rest of the Faculty Scholars and summarized the goals and progress of their current Faculty Scholars Project. After each scholar completed their presentation their Institutional and National Advisory Committee mentors discussed how each project had progressed, highlighting the project’s impact. The 2013 Scholars presented updates on their ongoing projects, detailed their most recent successes, and discussed their plans for dissemination and sustainability. For the first time ever this meeting featured two panel discussions comprised of our Alumni Scholars. The first panel discussed strategies that can be used to overcome institutional barriers when implementing interprofessional education programs at institutions, and the second panel discussion presented ways to navigate, manage and anticipate career transitions. Some highlights from the 2014 Scholars’ presentations are below, and the full meeting report can be found here.
Laura Hanyok, MD
Dr. Hanyok is working to align educational, practice, and health system goals around primary care practice to construct highly functioning interprofessional clinical learning teams for students and trainees working in patient-centered medical homes (PCMHs) within Johns Hopkins. Dr. Hanyok also aims to mentor primary care internal medicine residents to become skilled and effective teachers of interprofessional practice in primary care, and create a working model of an interprofessional clinical learning team that can be adopted in other patient-centered medical homes and outpatient practices.
Douglas Larsen, MD, MEd
One of the principle goals of health professions education is to develop providers who are self-regulated, life-long learners who are driven by learning from and for their patients. In most programs that incorporate learner-generated goals, the time span often covers months. This timescale is unlikely to create the self-monitoring to truly change practice. In Dr. Larsen’s project, entitled Patient-Centered Learning Goals: A Tool for Culture Change, students in clerkships generate learning goals on a weekly basis because it is frequent enough to influence daily activities without creating an unsustainable burden on students and faculty. By incorporating this program across all of the core clerkships, students at Washington University in St. Louis will develop longitudinal habits of monitoring and learning from their practice that will hopefully persist throughout their training and careers.
Sarah Peyre, EdD
The Electronic Medical Record (EMR) is dramatically changing how health care providers communicate and interact with patients and families, as well as with each other. EMR affects every aspect of the clinical encounter, from how eye contact is made and patient histories are collected; to the kinds of information shared, deemed important and actionable; to how provider to provider communications and collaboration are structured, sequenced, and substantively framed. The aim of Dr. Peyre’s project is to identify patient centered needs in regards to the utilization of the EMR in the ambulatory setting including workflow, communication patterns, and provider motivation with the goal of developing an educational intervention that will improve and enhance patient centered care in relation to the use of the EMR.
Deanna Reising, PhD, RN, ACNS-BC, ANEF
The purpose of Dr. Reising’s educational innovation is to develop an Interprofessional Collaborative Practice (IPCP) model that will use interprofessional student teams as patient navigators to facilitate safe and effective transitions across the continuum of care. The aims of this project are to advance the Institute for Healthcare Improvement’s (IHI) Triple Aim while simultaneously preparing health professions students for practice in a complex health care environment.
Charles Vega Jr., MD
The aim of Dr. Vega’s project is to transform the medical school curriculum at University of California, Irvine School of Medicine so that every teaching activity is ultimately focused on the patient. To meet this need Dr. Vega is integrating the Patient-Centered Advanced Clinical Education (PACE) curriculum at UC Irvine. The PACE Curriculum is multifaceted and longitudinal, and it also capitalizes on the potential at UCI for interprofessional education. Components of the PACE Curriculum include the PACE Clerkship, a commitment to active and self-directed learning, and interprofessional and peer-based education.
Meg Zomorodi, PhD, RN CNL
The purpose of Dr. Zomorodi’s project is to develop, implement, and evaluate an interprofessional team-based model that blends students and healthcare professionals in primary care clinics to improve patient care. More specifically Dr. Zomorodi wants to provide an integrated and collaborative learning experience for students and providers, and develop interprofessional partnerships for clinical education and practice. Dr. Zomorodi also wants to develop and deliver contemporary content focused on population health, quality improvement, patient safety, health economics, informatics, and outcomes management.
In June 2014, the Macy Foundation held its 3rd Annual Meeting of the Macy Faculty Scholars Program. In New York City the Macy Faculty Scholars, the mentors of the 2013 Scholars, and the program’s National Advisory Committee convened to discuss the ever changing landscape of health professions education.
For the first time we had an alumni class of scholars present. The 2011 Scholars provided inspiration and perspective for the 2012 and 2013 scholars. The 2012 Scholars presented brief updates on their work to date and discussed where they envision their projects heading in the future. The 2013 Scholars presented their work in detail with commentary by their institutional mentors and their National Advisory Committee mentors. Some highlights from those presentations are below, and the full meeting report can be found here:
Lisa Day, PhD, RN, CNE
In an effort to make professional values more visible in health professions education, Dr. Day is leading a group of Duke School of Medicine and Duke School of Nursing faculty and students to create a new process-based course in values clarification for undergraduate nursing, undergraduate medical, doctor of physical therapy and physician assistant students.
The new interprofessional course will be offered as an elective in the Duke University School of Nursing ABSN program, and in the Duke School of Medicine. The course will assist students in recognizing, articulating, interpreting and reconciling values – their own and those of their colleagues – and in integrating these values into their professional work with individuals, families and communities. The goals of the course are being developed by an interprofessional faculty team and will form the basis for developing the class sessions.
Memoona Hasnain, MD, MHPE, PhD
Dr. Hasnain is working to develop, implement and evaluate an interprofessional team-based training program for medicine, nursing, dentistry, pharmacy, public health and social work students at the University of Illinois at Chicago. The program is designed to equip learners with essential skills to improve health care for underserved populations and transform health disparities through interprofessional education, research and collaborative practice.
Overall, Dr. Hasnain has made significant progress and also discovered new venues for interprofessional collaboration, education, research and service. Based on the progress made, she is very optimistic that her project will lead to meaningful contributions that advance medical education science towards discovering new models for training the future healthcare workforce, addressing the needs of the country’s evolving patient populations and reducing health disparities.
Kelly Karpa, PhD, RPh
Dr. Karpa is developing an interprofessional program that teaches medical and nurse practitioner students safe and effective medication prescribing and effective prescription utilization for patients. The overarching goal of Dr. Karpa’s Interprofessional Pharmacology Clinical Reasoning (i-PCR) Project is to develop and launch an interprofessional clinical pharmacology curriculum at Penn State University’s Hershey Medical Campus. Initially the i-PCR project involved medicine and nurse practitioner learners, but the project has evolved to include pharmacy learners (non Penn State students) as well.
Moving forward Dr. Karpa’s mission is to expand interprofessional education endeavors at Penn State University. Dr. Karpa has made plans to bring new learners, specifically nurse practitioner and pharmacy students, into several medication management related activities that are completed in a patient-centered medical home elective.
Lauren Meade, MD
Dr. Meade focuses her work on ensuring that patients experience a safe and effective discharge from the hospital. Thus far Dr. Meade has implemented a new discharge curriculum in a collaborative of eleven internal medicine training groups. At the end of these courses Dr. Meade surveyed the physicians, nurses, and patients that participated.
In the future, Dr. Meade and the collaborative plan to study the effects of this discharge curriculum on patient and interprofessional practice outcomes. The discharge of a patient from the hospital is an ideal setting for studying interprofessional education and the Triple Aim of improved patient care, population health, and lower cost.
Mayumi Willgerodt, PhD, MPH, RN
Dr. Willgerodt is implementing and evaluating an interprofessional education curriculum for pediatric dental residents, advanced practice nursing students and social work students that focuses on oral health care among underserved children. A pilot project called i-TEETH (interprofessional Teams Engaged in Education and Training for Health) was created to allow trainees to experience the learning continuum together (exposure, immersion, integration); allow trainees to move together along the didactic to practice continuum; and address content and skill gaps in existing advanced practice nursing and dental curricula.
As Dr. Willgerodt moves into her second year as a Macy Faculty Scholar she plans to expand the i-TEETH program to include primary care community partners so teams may gain experience in primary care settings, and also include social work, physician assistant, family nurse practitioner and family medicine trainees.
In June 2013, Macy convened the Macy Faculty Scholars and the program’s National Advisory Committee in New York to discuss the landscape of health professions education reform and the range of new programs and approaches that are being tested in health professions institutions across the country.
2011 Scholars provided an update on their projects, lessons learned and plans for the future, while 2012 Scholars presented progress on their educational change projects. Some highlights from those presentations are below, and the full meeting summary can be found here:
Kenya Beard, EdD, GNP-BC, NP-C, ACNP-BC
Dr. Beard conducted an extensive review of existing multicultural education programs to identify best practices that promote learning for culturally diverse students. Using this research, Beard designed a six hour workshop for nursing educators. In addition to promoting effective teaching practices and learning environments, the workshop will also address the benefits of workforce diversity and invite participants to reflect on personal attitudes toward teaching culturally diverse students. The workshop will be piloted at Hunter College over the summer.
At the same time, Beard helped establish the Center for Multicultural Education and Health Disparities, a hub for research and best practices on multicultural education, to help institutions looking to restructure their curriculums and recruit and retain students from diverse backgrounds.
Ted James, MD, FACS
Dr. James is working on a new patient safety and quality improvement curriculum for medical students at the University of Vermont. To date, he has designed and implemented a course on patient safety and quality improvement for third year medical students that includes an interactive discussion of patient safety, case studies and a team-based simulation that requires students to work together to pinpoint safety errors and risks. Approximately 90 percent of students who have completed the course reported feeling more empowered to act on a safety issue.
James has also developed an interprofessional simulation course for medical and nursing students. The course brings fourth year medical students entering a surgical career and graduating nursing students together in an advanced simulation course that requires them working together over the phone and then at the bedside to care for a patient suffering from atypical chest pain. The students are then provided feedback on their clinical management as well as their communication and teamwork skills. Preliminary feedback from both medical and nursing students has been positive, with students saying they valued the opportunity to practice clinical management in a realistic yet safe environment.
In his second year as a Macy Faculty Scholar, James will develop a course on patient safety for first year medical students and a course on medication safety for second year medical students. He will also begin to design an evaluation strategy to measure the entire four-year program’s long-term impact on the student’s future clinical performance.
Wrenetha A. Julion, PhD, MPH, RN
Dr. Julion is developing a 15-week cultural competency course for interprofessional students at Rush University that incorporates community-based service learning. With the course objectives, content and two training sites in place, she will pilot the program with nursing students starting in January 2014.
In her second year, Dr. Julion will expand the curriculum to students in medicine, health sciences and health systems management, and increase the number of service-learning sites. She designed this initiative to better prepare health professionals to assess, treat, and educate patients who come from culturally diverse communities.
Wendy Madigosky, MD, MSPH
As a Macy Faculty Scholar, Dr. Madigosky is working to design, develop and implement a patient safety and quality improvement curriculum across all the health professions schools at the University of Colorado School of Medicine—dentistry, medicine, nursing, pharmacy, physical therapy, physician assistant.
Madigosky’s first step was to convene an advisory group of faculty and students from each of the health professions schools. This interprofessional group analyzed curriculum content for each school, identifying gaps and areas where curriculums and competencies could be better aligned across the schools. They then developed a framework for a new interprofessional education model and have initiated conversations about adoption across the campus.
As development of the new curriculum continues, Dr. Madigosky will work on creating new tools to measure competency in patient safety and quality improvement and designing an evaluation of the new curriculum.
Sandrijn M. van Schaik, MD, PhD
As a Macy Faculty Scholar, Dr. van Schaik is exploring how learners in interprofessional teams provide and receive feedback, and how that feedback is incorporated into performance changes. Van Schaik has spent her first year as a Scholar collecting and analyzing data on perceptions of feedback.
This research will drive the next phase of her project: examining barriers and success factors for IPE feedback and developing feedback guidelines for use in health professions education and team-based care. These guidelines will help ensure high quality patient care and facilitate teamwork among health professionals.
Leading Innovation in Health Professions Education
The first class of Macy Faculty Scholars held their inaugural annual meeting June 2012 in New York. The intimate group of 5 scholars and their mentors along with the program’s National Advisory Committee and Macy Staff convened to discuss their work to reform health professions education, sharing updates and lessons learned. Here are some highlights from the meeting:
Roberta Waite, EdD, APRN, CNS-BC
Several factors served as motivation for Dr. Roberta Waite to develop The Macy Undergraduate Leadership Fellows Program at Drexel University, including the growing importance of nursing leadership in today’s changing health care system. The program, which consists of six courses, is working to foster leadership competencies and culturally sensitive practices among its participants—a diverse cohort of Bachelor of Science in Nursing (BSN) candidates. Seventeen students have completed the first course, Authentic Leadership, and are currently undertaking their second course Leadership in Action and Community Health.
Self-evaluations show students feel they have a better understanding of leadership values and characteristics, and increased appreciation for diversity and its role in leadership. To track impact beyond the duration of the program, Waite hopes to examine leadership growth and outcomes among these students at one, three and five years post-graduation.
Jennifer S. Myers, MD
Dr. Jennifer S. Myers of the University Of Pennsylvania believes that in order to improve health care quality and safety we need to bridge the divide between education and practice. While teaching hospitals have clear quality and safety goals and activities in place, these are often not reflected in their associated graduate medical education (GME) programs.
To better align the health system and GME programs in achieving related quality and safety goals, Dr. Myers has developed a house staff quality and safety leadership council at the University of Pennsylvania health system. The council has been recognized in its first year as a forum to execute quality improvement initiatives across GME programs, with residents leading the change.
Myers, has also focused on activities designed to build a pipeline of Health Care Improvers—physician leaders in quality and safety who will direct future improvements in systems, education, and research.
This has including introducing patient safety concepts in undergraduate courses at the Perelman School of Medicine and expanding Penn Medicine’s residency track in “Healthcare Leadership in Quality” by recruiting 13 residents from 5 different specialties. Myers will focus next on developing discipline-specific safety curricula in three core clerkships (internal medicine, pediatrics, and ob-gyn) and creating a joint training for residents, faculty and nurse mentors on quality improvement and patient safety.
Alan Dow, MD, MSHA
Dr. Alan Dow is developing an interprofessional curriculum for Virginia Commonwealth University’s nursing and medical students.
Dow began by examining the theoretical basis underlying the function of healthcare teams. This included exploring team and leadership work lead by the field of organizational science; conducting a study comparing team processes between an acute medicine inpatient unit and an acute rehabilitation unit; and assessing the impacts of interprofessional experiences currently being implemented on the Virginia Commonwealth University campus, using a measurement tool based on the Core Competencies for Interprofessional Education.
Key elements of the interprofessional curriculum include a yearlong interprofessional case series where students will follow a patient through several episodes of care over four sessions. Over 700 learners from allied health, medicine, nursing, pharmacy, and social work will participate this upcoming academic year. In addition, trainees with basic clinical skills will participate in an interprofessional senior mentor program. Students will follow a community-based elder for a year in order to learn about gerontology and how each profession engages in the care of ambulatory patients. This program will be piloted with 20 three-person teams of one student each from nursing, pharmacy, and medicine in fall 2012.
Dena Hassouneh, PhD, ANP, PMHNP
Dr. Dena Hassouneh of the Oregon Health & Science University is conducting a study to explore the influence of racism on nursing and medical faculty of color and identify strategies to support the recruitment, retention, and success of medical and nursing faculty of color.
Hassouneh’s work is guided by a theory of change in which an institution’s culture moves through five stages, going from complete exclusion, where there are no faculty of color, to indifferent, and finally to real inclusion where diversity is a genuine priority, aggressive recruitment and retention strategies are in place for faculty of color, and faculty of color hold senior positions. According to Hassouneh, the majority of schools of nursing and medicine are in the indifferent stage—these schools have some diversity among their students but no active, mindful recruitment of faculty of color.
Since September, Hassouneh has been conducting research into the experiences of faculty of color in predominantly white schools of nursing and medicine. Initial results from a small study sample indicate that the broad conceptualization of diversity frequently used by schools of nursing and medicine has the potential to derail efforts to recruit and retain faculty of color. Hassouneh broadened her research to a national sample, and is currently analyzing data from in-depth interviews with 53 nursing and medicine faculty. Concurrently, Hassouneh is conducting a review of successful diversity programs in schools of nursing and medicine to identify common characteristics. She hopes to use her research to develop a pilot program aimed at encouraging diversity in medical and nursing schools.
Eve R. Colson, MD
Dr. Eve Colson of Yale School of Medicine is designing a new curriculum for nursing, physician associate and medical students that includes a longitudinal clinical experience in the outpatient setting which allows students to follow patients over time and work alongside other professions.
Colson began by conducting a literature review to identify the goals and challenges for establishing such a curriculum. Yet she encountered limited literature about what facilitates interprofessional education. In collaboration with Macy Faculty Scholar, Dr. Jennifer Myers, Colson conducted interviews with more than 25 faculty members who are actively involved in teaching and education administration at the Schools of Nursing and Medicine at The University of Pennsylvania and Yale, as well as the Physician Associate Program at Yale. Takeaways from this research was that a willingness to leave one’s comfort zone is key to pushing forth with interprofessional education and the biggest barrier is “a conviction among each profession that their science or service is the only way to think; and an unwillingness to humble oneself enough to participate fully with people from another discipline so that you can get a sense for what their discipline is like.”
Colson has assembled a taskforce to help design the curriculum and work on the curriculum will continue over the next several months. The program will be piloted at Yale beginning September 2013 and will be fully implemented the following year.