Office of Primary Care and Area Health Education Centers (AHEC) Program

Projects and Internships

AHEC Scholars 2023 Summer Projects and Application

Informational session for class of 2026 LCOM students and other health professions students on January 25, 2023 12pm - 1pm, Med Ed 200 Sullivan Classroom.

A common application is used to apply to summer projects hosted by three organizations: UVM AHEC Program, Northern VT AHEC, and Southern VT AHEC. All projects are AHEC Scholars-eligible activities and fall into one of two tracks: research and quality improvement or mentoring and education. Applications will be accepted from first year LCOM students and students in other health profession graduate programs, such as nursing, public health and social work. Projects are typically 100 hours (40 didactic/curriculum-based and 60 hour field-based/project-specific) and pay a $1,500 stipend.

All projects will link to one or more AHEC focus areas:

• Interprofessional Education/Interprofessional Practice
• Behavioral Health Integration
• Connecting Communities and Supporting Health Professionals (CHWs)
• Virtual Learning and Telehealth
• Social Determinants of Health
• Cultural Competency
• Medical Practice Transformation
• Current and Emerging Health Issues

Project dates vary, but most activities are within the summer recess date range of June 19 to August 10, 2023. Some projects may provide for travel, meals, and lodging. Some projects may require a criminal background check. Please read the complete program description prior to completing the application. AHEC Scholars 2023 Summer Projects program description.

Application:  https://redcap.link/med.uvm.edu.2023SummerProjectsApplication

Individuals may participate in more than one project.

This is a competitive process. Decisions will be based on the best match for each program.

Application Deadline is Wednesday, February 22, 2023 at midnight.
Applicants will be notified in early March 2023.

2023 Project Descriptions

Project descriptions serve as a guide for a specific topic area; actual projects evolve once a project team is formed.

Track: Research/Quality Improvement (UVM AHEC)

Food Systems Project
Access to healthy food is a critical social determinant of health. Nationally and in VT, healthcare providers are implementing social determinant screening and making referrals to address food insecurity/healthy eating. Community agencies are implementing innovative strategies and collaborating with health care providers to address common goals.

Specific questions or goals for 2023
Examine a regional initiative - the Champlain Valley Office of Economic Opportunity (CVOEO) Food Access Network - as an example of community agency and healthcare program collaboration to address food security and health.
What lessons can be shared with other VT locations interested in implementing similar programs?
How can CVOEO collect and use data for program improvement and to describe program impact?

Electronic Medical Record Projects
The Epic Electronic Medical Record (EMR), while an essential part of healthcare, can be complex and confusing. The informatics team, which includes physician-informatacists, is continuously engaged in projects to improve daily workflows for safety and efficiency. AHEC Scholars students have completed many successful EMR Projects, messaging projects, standardization of documentation projects, and a recent E-consultation project, which addresses long wait times for specialty consultation. 

Specific questions or goals for 2023 
Based on student interest, there are opportunities to continue previous projects or begin new ones. Overall goal is to expose students to the complexity of medical documentation and the roles of individuals working on quality improvement.
How can the EMR facilitate transparency and communication?
How to improve accuracy, understandability or efficiency of notes?
How do patient perspectives compare with provider perspectives?

Communication Disabilities in Healthcare
Patient-provider communication is a foundational element of healthcare delivery, but may be influenced by communication disabilities. Approaches to improve clinical communication include bringing a “communication companion” along to visits, use of a written after-visit summary, communication via an electronic patient portal, and others. We have developed and pilot-tested the Patient-Companion-Provider Communication Tool that is designed to elicit patient preferences for overcoming communication barriers.

Specific questions or goals for 2023 
Goal is to deploy survey and summarize results to inform clinical systems improvement.
What are patient preferences for improving communication with their health team?
How can we encourage the use of communication companions where appropriate?

Office of the Healthcare Advocate: Medical Debt Project
The Office of the Healthcare Advocate, at Vermont Legal Aid, works to address access to care and health equity across Vermont. The Public Policy and Advocacy team works to identify key topics, provide recommendations, and advocate within statewide forums including the Vermont Statehouse. Medical debt is a current priority for the Office of the Healthcare Advocate, with a current focus on the health needs of low-income older Vermonters. 

Specific questions or goals for 2023 
Project goal is to collect data and information, including patient stories, to inform and support recommended solutions.
How do existing medical debt, insurance coverage, and other financial considerations affect patients’ decisions about accessing care?
Do healthcare providers understand how finances/medical debt may be impacting patient choices? How often do they inquire about or recognize this as a barrier?

Health Equity and Patient Centered Care in the Medical Home: Review and Update to Wellness and Screening Forms
Primary care settings are working on changes to be more inclusive and affirming to patients at risk for health disparities (LGBTQ, racial, ethnic, and socioeconomic groups). Signage and communication in the patient visit can enhance or hinder quality of care. Forms and screening tools can both create an inclusive welcoming environment or further alienate populations.

Specific questions or goals for 2023
What are identified shortcomings of forms, screenings, signage and processes within the medical home? What are the questions or controversies?
What are best practices identified in the literature for screening, questionnaires and signage in medical home?
Which sector is leading the way, providing examples to learn from?

AHEC Interprofessional Challenge Project: Prevention of Firearm Injury
Each day more than 100 Americans die by firearms and nearly 200 are shot and injured. A comprehensive public health approach is needed to address the gun violence epidemic. Vermont specific data is needed - firearm suicide and homicide, domestic violence, police- involved shooting, unintentional shootings, nonfatal firearm injuries.

Specific questions or goals for 2023 
A variety of health professions students to research firearm injury in the state of Vermont and propose targeted interventions for at risk populations.
What age groups are most at risk for firearm injury or death in Vermont? What areas of Vermont are most at risk?
How should health care professionals become involved to reduce firearm injury in Vermont?

Track: Research/Quality Improvement (Southern Vermont AHEC)

Patient Health Education in Rural Communities QI Project
Community Health (formerly Community Health Centers of the Rutland Region) is the largest of the 12 Federally Qualified Health Centers (FQHCs) in Vermont.  Key health topics prevalent in the patient population were identified, including diabetes awareness, signs of depression, alcohol use disorders, oral health, and others. Using a health equity lens, develop handouts or other tools to be shared by providers to patients.

Specific questions or goals for 2023 
Research best practices in patient education on the identified topics.
Identify ways health equity approaches and interventions can be applied in a predominately white, rural population.
Assess factors necessary to make patient information appropriate and accessible to all (e.g. differently abled, culturally and linguistically diverse, etc.)

Track: Education/Mentoring (Northern Vermont AHEC)

The Governor's Institute on Health and Medicine
The Governor's Institute on Health and Medicine is a week-long, health science enrichment and career exploration camp for high school students. Northern Vermont AHEC is seeking residential mentors to support students’ learning and assist in creating a fun and respectful learning community. The Institute on Health and Medicine runs from Sunday, July 9 through Saturday, July 15 on the campus of Northern Vermont University Lyndon Campus. Mentors lead and assist in teaching clinical skills. Content is delivered through hands-on activities, scenario-based learning, and case discussion.

Track: Education/Mentoring (Southern Vermont AHEC)

MedQuest Mentors
MedQuest 2023 is an on-site, 3-day, non-residential program for high school students to explore a variety of health careers in a rich learning environment with engaging content and group discussions, skill-building activities, job shadowing, mentoring, and dialogue with health professionals. Session one is July 24-26, 2023 at Springfield Hospital and North Star Health. Session two is August 2-4, 2023 at Rutland Regional Medical Center. Southern Vermont AHEC is seeking 2-4 mentors to assist in preparing and presenting materials to students and facilitate small group discussions and activities.

Advanced MedQuest Mentors

Advanced MedQuest is an on-site, 5-day, non-residential program for high school students who have previously completed MedQuest. Students participate in an intensive job shadow experience and learn via hands-on experience. Advanced MedQuest runs from June 26-June 30, 2023 at Rutland Regional Medical Center and Vermont State University at Castleton. Mentors assist in preparing and presenting materials to students and facilitate small group discussions and activities.

Pre-medical/Pre-health Enrichment Program for VTSU (PEP)

Modeled after UVM AHEC’s PEP program, PEP-VTSU is an extracurricular enrichment program being developed for Vermont State University students interested in health professions. The program is geared toward professions in high demand in Vermont, with emphasis on meeting the needs of the Vermont health care workforce. Summer project students will support the development of the PEP-VTSU Program by identifying resources for Vermont State University students interested in pursuing a health profession. Potential activities include: Conduct focus groups or qualitative interviews with VTSU students and faculty, review VTSU course offerings and other existing resources, explore the potential for mentoring matches between LCOM Med Mentors SIG and VTSU students.

Past AHEC Scholar Summer Project(s):

2022 Project Descriptions

2021 AHEC Scholars Summer Project: Primary Care Implementation of Continuous Glucose Monitoring and Novel Medications for Type 2 Diabetes in Vermont: A Statewide Survey

Audio presentation

Poster

Public Health Projects with Medical Students

Public Health Projects (PHP), a required course incorporated in the Vermont Integrated Curriculum, teaches second-year medical students to apply the principles and science of public health while working to improve the health of the community.  Public Health Projects respond to health needs identified by local community agencies. 16 projects are completed each fall by medical student groups working in partnership with community agencies, and mentored by both College of Medicine faculty and community agency mentors.

FY21

Project: "Naturopathic Medicine in Vermont's Healthcare System: A Thematic Analysis"

Abstract: Background:--Naturopathy is a practice of medicine that emphasizes natural therapies. In Vermont, Naturopathic doctors (NDs) are eligible for full prescriptive authority and may be designated as primary care providers, however their specific role within the healthcare system is not well understood. The objective of this project was to explore the role of NDs in Vermont’s healthcare system.

Medical Students (class of 2024): Trevor Coles, Tayler Drake, Rosie Eiduson, Dan Fried, Max HoddWells, Simran Kalsi, Mahima Poreddy

UVM Faculty Mentor:  Charles MacLean, MD 

Naturopathic Medicine in Vermont's Healthcare System: A Thematic Analysis Abstract
Naturopathic Medicine in Vermont's Healthcare System: A Thematic Analysis Poster

Past Public Health Projects

FY19

Project:  "Opinion and Attitudes of Vermont School Principals and Nurses on Youth Vaping"

Abstract: Background--A rapidly emerging new trend that is turning into a nationwide epidemic for youth in the United States is the use of electronic vapor products also known as “e-cigs”, “e-hookahs”, “vapes”, “mods”, and “JUULS”. There is little known about the long-term health effects of prolonged use of vapes. The rise in vape products sales and use, poses a public health threat to adolescents. The study’s purpose is to assess the opinions and attitudes of school principals and nurses about youth vaping. The results will identify if any gaps exist in the youth vaping issue and further expand on existing concerns of school issues. Using this information, public health recommendations can be developed.

Student: Vy Cao, MPH (UVM Class of 2019)

UVM Faculty Mentors:  Charles MacLean, MD and Katherine Mariani, MD

Youth Vaping Abstract

Youth Vaping Poster

Project:  "Vermont Legislators' Opinions Regarding the Opioid Epidemic"

One of the Public Health projects presented by the students in the Larner College of Medicine Class of 2021, "Vermont Legislators' Opinions Regarding the Opioid Epidemic" was performed in partnership with the UVM AHEC Program.

Abstract: Background--In response to the opioid crisis, the 2018 Vermont legislative session proposed 22 bills, nine of which passed.  While there is literature that includes various legislators' information source preferences, there is no literature regarding how Vermont State Legislators gather information and formulate public health decisions surrounding opioid policies.  The goals of the study were 1) to identify Vermont legislators' opinions regarding investments in, and effects of, programs to prevent and treat opioid addiction, and 2) to determine sources of information used and valued by legislators.

Pictured from left:  Ryan Harned, Bridget Moore, Casandra Nowicki, Matthew Lebrow, Emily Eichner, Jonathan Gau, and Liam du Preez

Medical Students (class of 2021):  Casandra Nowicki, Emily Eichner, Liam du Preez, Jonathan Gau, Matthew Lebow, Bridget Moore, Ryan Harned

UVM Faculty Mentors: Charles D. MacLean, MD and Jan K. Carney MD, MPH

Community Agency Mentor: Elizabeth Cote

Vermont Legislators' Opinions Regarding the Opioid Epidemic Abstract
Vermont Legislators' Opinions Regarding the Opioid Epidemic Poster

FY18

One of the Public Health projects presented by the students in the Larner College of Medicine Class of 2020, "Prescriber Perspectives of July 1, 2017 Opioid Prescribing Rules" was performed in partnership with the UVM AHEC Program.

Abstract: Introduction--In July 2017, Vermont enacted new rules on acute opioid prescribing to reduce misuse, addiction, and overdose associated with prescription opioids. The new rules include requirements of non-opioid therapy use when possible, querying VPMS, patient education and informed consent, and co-prescription of naloxone. Our study objective was to gain insight into the perspectives of opioid prescribers on the new rules read more.

Medical Students (class of 2020): Zara S. Bowden, Jinal Gandhi, S. Natasha Jost, Hanna Mathers, Chad Serels, Daniel Wigmore, and Timothy Wong

Pictured from left: Timothy Wong, Chad Serels, S. Natasha Jost, Jinal Gandhi, Hannah Mathers, Zara S. Bowden, and Charles MacLean, MD (missing from photo: Daniel Wigmore)

UVM Faculty Mentors: Charles D. MacLean, MD and Jan K. Carney MD, MPH
Community Faculty: Elizabeth Cote

Prescriber Perspectives of July 1, 2017 Opioid Prescribing Rules Abstract
The 2017 Vermont Opioid Prescribing Rules: Prescriber Attitudes Poster

FY17

Students in the Larner College of Medicine Class of 2019 presented posters and explained findings from 16 different Public Health projects at a public reception and celebration on January 18, 2017.

One of the 16 student projects, “Patient Perspectives on Medication Assisted Therapy in Vermont” was performed in partnership with the UVM AHEC Program.

Vermont has the highest per capita buprenorphine use in the U.S. The UVM AHEC Program's PHP cohort aimed to gain a better understanding of patient perspectives on the barriers and enablers of successful Medication-Assisted Therapy (MAT) – buprenorphine treatment for opioid addiction – in order to help inform system refinement. The students developed an interview guide based on established tools, as well as input from program leaders, clinicians and community stakeholders, and conducted interviews with 44 patients at two specialty treatment centers in Burlington, VT in October 2016. The students found that half of the subjects reported a mental health condition and stated that barriers to treatment included transportation (25 percent) and stigma (41 percent), among other factors. The students advised that “a comprehensive system that addresses this wide range of domains is critical to achieving optimal outcomes."

Medical Students (class of 2019): Ashley Adkins, Holly Bachilas, Florence DiBiase, Michael Marallo, John Paul Nsubuga, Lloyd Patashnick, Curran Uppaluri
Pictured (from left): Holly Bachilas, Florence DiBiase, John Paul Nsubuga, Curan Uppaluri, and Michael Marallo

UVM Faculty Mentor:  Charles MacLean, MD and Jan Carney, MD, MPH
Community Faculty: Elizabeth Cote

MAT Patient Perspectives Poster
Patient Perspectives on MAT Abstract

FY16
Students in the Larner College of Medicine Class of 2018 presented posters and explained findings from 16 different Public Health projects at a public reception and celebration on January 20, 2016. One project, “Addressing the Opioid Crisis in Vermont: Lessons Learned from Primary Care Physicians,” was sponsored by the UVM Office of Primary Care and statewide Area Health Education Centers (AHEC) Program. The goal of the project was to identify physician barriers to providing office-based opioid treatment (OBOT) in Chittenden County. The students who conducted the study are Timothy Henderson, Molly Markowitz, Adam Petchers, Brittany Rocque, Andrew Sheridan, Nathaniel Sugiyama, and Lindsey Wyatt. Their UVM faculty mentors are Charles MacLean, MD, and Jan Carney, MD, MPH; community faculty members are Beth Tanzmen, MSW, Assistant Director, Vermont Blueprint for Health, and Elizabeth Cote, director, Office of Primary Care and AHEC.

Of the 25 primary care physicians interviewed, non-office-based opioid treatment providers more frequently reported that OBOT patients were challenging. OBOT providers more frequently acknowledged the stigma associated with OBOT. Both groups of physicians expressed a desire for increased state support for OBOT. The student recommendations are: increased state support/resources for OBOT; mentorship of new OBOT providers by experienced OBOT providers; and generation of OBOT best practice guidelines for primary care providers.

Asked what they were most surprised by in their study, Lindsey Wyatt said it was the fact that almost every provider said OBOT was easier and more rewarding than they thought it would be.

The Class of 2018 medical students working on this project found that "the five most frequently reported barriers were: insufficient state logistical support, challenging patient population, practice infrastructure/capacity, time, and provider fears/concerns. Seventy-nine percent of non-prescriber PCPs said that they would provide OBOT if the identified barriers were removed."

“Addressing the Opioid Crisis in Vermont: Lessons Learned from Primary Care Physicians.” (PDF)

An Inter-Professional Exploration of Cuba’s Primary Healthcare System

This presentation gives an overview of learning from a June 2014 trip to Cuba by faculty in the Larner Colleges of Medicine, Social Work, and College of Nursing and Health Sciences; medical students, a dental student, a dental technician, a social work graduate student, a nurse practitioner student; and members of the Burlington College faculty. The purpose of the course was to gain a better understanding of the Cuban health system, particularly the role of primary care, and the interaction between primary care, public health and the community. Cuba has a well-regarded system of population health and primary care.

Exploring Cuba's Primary Healthcare System (PDF
)