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Opportunities


Part-time Gold Professorship Project Internship

The position is non-paid, part-time and will require approximately 10 hours of work per week with a commitment of approximately a year. Responsibilities are variable and we can include this project as a masters’ thesis, practicum, or internship.

The Disparities Solutions Center (www.mghdisparitiessolutions.org) within the Mongan Institute for Health Policy at Massachusetts General Hospital, is seeking an individual to help us with a project on interprofessional education in the health professions entitled Through the Veil of Language: Addressing the Hidden Curriculum to Promote Quality, Safety and Humanism in the Care of Patients with Limited English Proficiency.

The research is supported by the Gold Foundation’s Humanism in Medicine Professorship Award and the Principle Investigator is Alexander Green, MD, MPH – Associate Professor of Medicine at Harvard Medical School and Associate Director of the Disparities Solutions Center at MGH. The project will present an opportunity for the individual involved to carry out original research in interprofessional education focused particularly on how medical and nursing students learn to care for patients with limited English proficiency and cross-cultural barriers to care in the clinical setting. In the first two years of the project we did a qualitative study to explore the “hidden curriculum” – the way students are taught (often in a negative way) by role modeling, subtle messages, and the organizational culture in which they are immersed. In the second year we developed a quantitative instrument to measure this and are currently analyzing data to validate this tool. For the third (current) year the project coordinator will work to measure this hidden curriculum for specific medical school rotations and then work with clerkship leadership and the hospitals to design and implement an educational and systems intervention to address the underlying issues (e.g. resident and faculty lack of knowledge, skills, empathy with LEP patients, ineffective or non-standardized systems for identifying LEP patients and accessing interpreter services). The ultimate goal will be to change the organizational culture (and the hidden curriculum) to promote humanism and professionalism in the care of patients with LEP.

Background

Communication barriers faced by people with limited English proficiency (LEP), lead to frequent misunderstanding of diagnosis, treatment, and follow up plans, inappropriate use of medications, lack of informed consent for surgical procedures; high rates of serious adverse events, and a lower quality health care experience compared to patients who speak English. This is not a small problem. Ten percent of the US population is LEP (up from 7% in 1990) many of whom will become newly insured under health reform. Unfortunately, health professions students are not well trained to care for patients with LEP. At Harvard Medical School (HMS) 70% of fourth-year students we surveyed felt inadequately prepared to care for patients with LEP, and one third of residents nationally admitted to having used a child under the age of twelve as an interpreter.   Anecdotal evidence suggests nursing students are similarly unprepared. Providing high quality care to patients with LEP will require new educational approaches and a reinvigorated commitment to humanism medical education. This goes beyond simply teaching students how to work with an interpreter. It involves raising expectations for the level of care that is possible, seeing beyond the veil of language to understand the individual in the context of their culture, and speaking up when others accept (and even contribute to) suboptimal care.

This 3 year project has the following goals:

Goal 1: Explore how medical and nursing students experience and respond to the hidden curriculum in various clinical settings for the care of patients with LEP.
Goal 2:  Develop a tool to assess the hidden curriculum of a clinical setting as it relates to the care of patients with LEP.
Goal 3: Design and pilot a set of system-based interventions to change organizational culture (and the hidden curriculum) to promote humanism and professionalism in the care of patients with LEP.

Responsibilities
The individual will help to oversee management and implementation of a wide variety of components of the project including:

  • Literature reviews as needed
  • Quantitative analysis of survey data and validation of a survey instrument
  • Advocacy for health systems change
  • Surveying medical students
  • Implementing a quality improvement intervention including both systems and educational components
  • Assist PI with manuscript development and submission.

Requirements

  • Student must be in a master's degree program (or doctorate) in public health or education, or in medical or nursing school or a similar educational track.
  • Knowledge of and interest in racial/ethnic disparities in health care, and previous work experience with health care research and/or health care disparities preferre
  • The ideal candidate for this project is someone with a high degree of professionalism, who is highly organized, detail oriented and creative, and who has the ability to complete tasks on-time.
  • Must have strong project management and implementation skills, including the ability to keep a project on track to achieve goals
  • Preferred candidates will have skills in evaluation and data collection and quantitative data analysis.
  • Ability to work with a broad range of people to collaboratively complete projects
  • Must be able to multitask, pro-actively take initiative and be a team player, as well as work independently under the supervision of the PI.
  • Must demonstrate strong communication skills, both oral and written.
  • Must demonstrate an understanding of and commitment to the mission of the Disparities Solutions Center.

Under-represented minorities encouraged to apply.

If interested, please send a cover letter and resume to

Alexander Green, MD, MPH
Associate Director
The Disparities Solutions Center at the Mongan Institute for Health Policy
Massachusetts General Hospital
50 Staniford Street, Suite 901
Boston, MA 02114
argreen@partners.org