Innovative Training for Occupational Medicine Residents in Non-Urban and Agricultural Settings

Details

• Personal Author:
  Levin, Jeffrey L.
• Description:
  Despite centuries of recognition of the contribution of workplace factors to human health, disease, injury, disability, and death, occupational medicine remains an obscure specialty within the health care community. Little emphasis is given to educating physicians at both the undergraduate and post-graduate levels concerning occupational history-taking and little focus is placed in clinical encounters on discerning and reducing work-related risk factors. Following passage of the Occupational Safety and Health Act of 1970, there was a rise in the number of accredited residency training programs in occupational medicine, reaching a peak in the mid-90s. Since then, the number of such programs has declined dramatically in spite of a recognized shortfall of physicians with formalized training in this area. Remaining programs struggle for funding to sustain their educational efforts. In many specialty areas of medical practice, there is also little attention given to the special needs of non-urban environments. Small employers (e.g., those with fewer than 100 employees) are not unique to rural communities. However, rural communities often lack the infrastructure for developing and sustaining a preventive approach to occupational disease and injury particularly for specific work sectors such as agriculture and construction where the hired and/or migrant workforce may constitute the majority of employees. This project has provided innovative training opportunities for occupational medicine residents in rural/non-urban areas (Texas and Kentucky), incorporated distance learning methods, provided for practicum experiences among special populations, identified program specific competencies aligned with the ACGME core or general competencies, and engaged a team of stakeholders to improve educational delivery. Components of this project included: 1) assembly of a team of collaborating stakeholders; 2) a series of web-based interactive didactic presentations originating from NIOSH-supported Agricultural Centers, focusing on niche agricultural health issues and research activities; 3) orchestration of practicum rotations in "same state" MCHCs; and 4) development of competency-based resident evaluation for these practicum experiences. Special emphasis was given to competencies needed to address occupational health concerns in non-urban areas including cultural considerations. Three occupational medicine residency programs were engaged in the project. By their very nature, these residency programs are small (1-4 residents), but opportunities created through a project such as this one help to sustain formalized residency training while providing residents with experience(s) in special work populations such as agriculture and in rural environments. This project is significant in that it demonstrates a team approach to resident education which spans three accredited residency programs in two states, takes advantage of multiple available resources, adopts a competency-based approach, and meets the need of increased accessibility to occupational medicine training with a focus on rural/agricultural occupational health concerns. The project was expected to continue to offer its trainees information regarding current research activities in agricultural occupational health as well as result in transfer of knowledge and experience between prevention/public health professionals and primary providers. Educational outcomes have been qualitatively assessed through feedback from preceptors, stakeholders, and residents along with collection of resident work products. These have been used to guide programmatic and educational improvement. [Description provided by NIOSH]
• Subjects:
  Agriculture Community Health Services Education Farmers Occupational Health Safety Staff Development
• Keywords:
  Agricultural Industry Community Health Farm Workers Medical Services Occupational Medicine Programs Training Grants
• Series:
  Grant Final Reports
• Publisher:
  National Institute for Occupational Safety and Health
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Final Grant Report
• Place as Subject:
  Kentucky ; OSHA Region 4 ; OSHA Region 6 ; Texas
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  OEP - Office of Extramural Programs
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-17
• NIOSHTIC Number:
  nn:20057573
• NTIS Accession Number:
  PB2020-100148
• Citation:
  Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, T01-OH-009221, 2010 Sep; :1-17
• Contact Point Address:
  Jeffrey L. Levin, M.D., M.S.P.H., Occupational Health Sciences, Occupational Medicine Residency Program, The University of Texas Health Science Center at Tyler, 11937 U.S. Hwy 271, North Tyler, TX 75708
• Email:
  jeffrey.levin@uthct.edu
• Federal Fiscal Year:
  2010
• NORA Priority Area:
  Agriculture, Forestry and Fishing
• Performing Organization:
  University of Texas Health Center - Tyler
• Peer Reviewed:
  False
• Start Date:
  20070701
• Source Full Name:
  National Institute for Occupational Safety and Health
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:034d77a7f28245fb90199a3fb3976cbfa2acf0277a048003fac237dbe77d4abff21a3887ee2d68aea502c7f8e97c3da0c0413aa6db272ac33c51a4730da30684
• Download URL:
  https://stacks.cdc.gov/view/cdc/218936/cdc_218936_DS1.pdf
• File Type:
  [PDF - 397.83 KB ]