AHRQ ePSS Helps Colorado Medical Students Understand Preventive Care Guidelines
The Colorado Area Health Education Center (AHEC) is participating in the AHRQ Knowledge Transfer project "Outreach to Health Professionals" to improve the implementation of the U.S. Preventive Services Task Force (USPSTF) recommendations and the electronic Preventive Services Selector (ePSS) among preceptors and medical students. The AHEC includes six regional centers serving Colorado.
Emily Burns, MD, MSPH, Executive Director of the Southwestern Colorado AHEC, is leading the project in conjunction with Jack Westfall, MD, AHEC Program Director, and David Gaspar, MD. The six regional AHECs organize community-based clinical rotations for medical students from the University of Colorado School of Medicine. Students are expected to provide appropriate clinical preventive services to patients during their 8-week family medicine rotation.
AHRQ is providing technical assistance to Southwestern Colorado AHEC and the University of Colorado School of Medicine to incorporate USPSTF recommendations in schools offering health professions curriculums. With this technical assistance, Burns is strengthening the students' clinical learning experience by:
- Including a one-page description and summary of the USPSTF recommendations in the students' clerkship orientation.
- Giving students a link and instructions to download the ePSS tool, a free electronic application available online that can be downloaded to a handheld device (e.g., iPhone, BlackBerry). The ePSS information can be used at the point of care and is based on the current recommendations of the USPSTF. The tool can be searched by specific patient characteristics, such as age, sex, and selected behavioral risk factors. Students will be instructed to use the ePSS tool for all patients they see during their 8-week family practice rotations.
- Providing background information on the USPSTF recommendations and several case studies with which the students can practice. The ePSS tool will be explicitly referred to in these studies, which will be culled from the Technical Assistance Guide developed as part of AHRQ's "Outreach to Health Professionals" project.
- Requiring students to keep a log of all patients they see during their clinical training. In addition to information about primary medical issues and basic demographics that students will record in their logs, they will also be asked to record whether they addressed the clinical preventive service(s) identified for that patient by the ePSS tool.
Burns plans to enlist preceptors to teach the USPSTF recommendations to medical students. She will present information about the recommendations to preceptors at their annual Colorado AHEC conference. The presentation will introduce them to the USPSTF recommendations and resources such as ePSS, as well as encourage them to use the tool in practice. It will also prepare them to field potential questions from students about the tools.
Prior to implementation of the ePSS tool in the family medicine rotation, Colorado AHEC plans to conduct a brief phone survey of all family medicine preceptors in Colorado. Burns says, "We will survey preceptors about current prevention practices and use of the USPSTF recommendations and tools. The survey will help guide the development of the educational intervention and will also measure progress after the intervention."
Survey questions will include the following:
- How often are USPSTF recommendations consulted in practice?
- What tools are available at the preceptor's practice for following the USPSTF recommendations?
- What barriers exist to using the USPSTF recommendations and tools?
After their clinical experiences, medical students will complete a brief questionnaire about the number of patients with whom the student used the handheld ePSS tool, how helpful it was, how much it improved their practice skills, and how often the recommendations matched what their preceptors were doing. To the extent possible, the Colorado AHEC will attempt to use responses from the questionnaire to determine how consistently the preceptors implement the USPSTF recommendations. This feedback will allow the group to refine its preceptor training programs for future students.
U.S. Preventive Services Task Force. Guide to Clinical Preventive Services, 2010-2011. Rockville, MD: Agency for Healthcare Research and Quality; September 2010. http://www.ahrq.gov/clinic/pocketgd.htm
Electronic Preventive Services Selector. Rockville, MD: Agency for Healthcare Research and Quality. http://epss.ahrq.gov/PDA/index.jsp