The Project continues to have as its focus a set of educational programs sponsored by five primary care departments – Geriatrics, Pediatrics, Obstetrics/Gynecology, Family Medicine, and Internal Medicine. The Project Core is made up of leadership from each department as well as the assistant dean for graduate medical education and a representative from M-Care, the Project’s managed care partner. The Core provides direction and coordination for the Project’s curriculum development, its implementation, and its evaluation.

The most involving activity of the Project Core during the period February 1 through March 31, 1998 has been the production of videotape "Caring in the Community." This videotape presents the a variety of examples in which the Project has created meaningful community-based experiences for graduate learners working with vulnerable populations in the areas of Geriatrics, Pediatrics, and Family Medicine. Showing doctor-patient interactions in homes and clinics around the Ann Arbor/Ypsilanti area, the tape demonstrates the lessons our graduate physicians receive as they practice medicine in real world situations. The major activities of the production during this period consisted of taping interviews on-location with patients and the project’s resident physicians and then editing four hours of tape into a fifteen minute presentation. Physicians and staff from Geriatrics, Pediatrics, Obstetrics & Gynecology, and Family Medicine, in addition to Core leadership, have been involved with the planning and production of the videotape. Personnel from M-Care, our managed care partner, and affiliated clinics also took part. [the video is currently being shown on a daily basis over the patient education channel of the UM Hospital’s cable TV system]

The most debilitating activity for the Project during this time period was the resignation of the Project Administrator Janet Heindel on March 5. (see Barriers, below) Another personnel change involved Dr. Caroline Blaum, who ended her employment with M-Care, although, in connection with her appointment in the Internal Medicine Department, she has continued to assist with curriculum development work for the Project.

During March, Dr. Brent Williams of the Internal Medicine department prepared a document, "Resource Guide to Managed Care Curriculum Development," which is included as Appendix A. This guide was developed for presentation in a workshop on teaching managed care for program directors at the Spring APDIM meeting in New Orleans.

Geriatrics: Geriatrics has been continuing its managed care curricula rotations, administering the Attitude Survey pre & post each rotation to 11 residents in Feb & March as well as giving the Program Evaluation Survey after the completion of each rotation.

Pediatrics: Pediatrics continues with its on-going 4 rotations with managed care curricula. The department has begun planning and preparation for the creation and delivery of a knowledge evaluation test of all outgoing seniors in June and all incoming interns in July.

Family Medicine: Family Medicine has begun its managed care rotation at The Corner Clinic in Ypsilanti, including implementation of newly developed Adolescent Health Curriculum.

Obstetrics/Gynecology: OB/Gyne continued planning for rotation-identified curricular materials, Core reading list, and community resources for home visits.

Internal Medicine: Internal Medicine began delivery of the newly developed Core Lectures began to its rotation’s residents during this time period: the first two lectures were given in March. The audience consisted of approximately 30 graduate resident physicians and an equal number of undergraduate medical students at the University of Michigan Hospital. These lectures were also cablecast to U of M residents working at the Veterans Administration Hospital here in Ann Arbor. Also, Internal Medicine began preparation for administering the Managed Care Knowledge Evaluation (to be given in June to all outgoing seniors and to all incoming Interns in July).

Each of the departments individually handled the administration of the Attitude Survey to its own residents. During this time period, Internal Medicine administered 6 Attitude surveys and Geriatrics gave the Attitude Survey pre & post each rotation to 11 residents and administered the Program Evaluation Survey at the completion of each rotation.

The resignation of the Project Administrator has caused a significant slow down in the activities related to this grant. With no one available to coordinate meetings, assist with planning, collect Project-related data, or prepare reports, there has been a break down in the forward motion of curriculum development and rotation planning on an inter-departmental basis. Considerable time has had to be expended in conducting a search for and hiring of a replacement, further slowing the Project’s progress.

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