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University of Colorado Primary Care and Health Services Research Fellowship


 

Program Description

The University of Colorado Primary Care and Health Services Research Fellowship (PCHSRF) trains clinicians in Health Services Research (HSR) to ensure high quality, low cost, equitable health care delivery to populations, communities and individuals. Program graduates acquire the skills to identify and address gaps in health care quality and safety, assess the efficiency and effectiveness of care delivery, inform high value care in a range of delivery systems or academic settings, and be successful in obtaining extramural funding.  The fellowship includes a faculty development curriculum and offers candidates the opportunity to obtain advanced degrees through the Graduate School and the Colorado School of Public Health.

Candidates and Program Graduates

Most PCHSRF scholars have been general pediatricians, general internists, and family physicians, but the program is open to hospitalists and non-physician primary care clinicians committed to a career in HSR (e.g., physician assistants, nurse practitioners and clinical pharmacists). Applicants have a record of academic excellence and often plan to apply HSR skills to research priorities in their home institutions.  Most PCHSRF scholars have limited previous research experience and use their training to acquire and apply foundational skills in HSR.

PCHSRF program graduates go on to leadership roles in academia, health care delivery, and community engagement--influencing health care quality improvement and innovation locally and nationally.  Of 40 program graduates from the past 15 years, 32 (80%) are in academic positions and 25 (63%) are full-time faculty.  Example areas of research interest include: quality improvement, substance abuse, chronic disease care, childhood and adult obesity, school and community-based interventions for mental health, vaccine preventable diseases and immunizations, provider communication, newborn hearing screening, and healthcare policy. 

Program History and Funding

The PCHSRF was founded in 1993 at the University of Colorado (CU) and has provided the cornerstone of HSR training at CU for over 25 years.  Federal fudning support for the Program has come from HRSA, NRSA, and AHRQ, the latter of which allowed for its expansion beyond the university to train clinicians at the Denver Health safety net integrated delivery system.  Currently, PCHSRF trainees receive support from their departmets and divisions at their home institutions for a minimum of 40% protected time for the fellowship's research and education requirements.

Faculty and Mentorship

Program faculty have appointments in the Division of General Internal Medicine in the Department of Medicine, the Department of Family Medicine, and the Section of General Academic Pediatrics in the Department of Pediatrics at CU, the CU School of Public Health, Denver Health, and the Kaiser Permanente Colorado Institute for Health Research.  Core faculty serve as primary mentors for trainees, attend weekly work in progress session and create a learning community for all program participants.
Our core faculty members include:
  • Elizabeth Bayliss, MD, MSPH (Program Director; Senior Investigator in the Institute for Health Research at Kaiser Permanente Colorado; Professor of Family Medicine at the University of Colorado, Anschutz Medical Campus)
  • Mandy Allison, MEd, MD, MSPH (Program Co-Director; Assistant Professor in the General Academic Pediatrics Section in the Department of Pediatrics at the University of Colorado, School of Medicine)
  • Lori A. Crane, PhD, MPH​ (Associate Program Director; Professor and Chair of Community and Behavioral Health at the Colorado School of Public Health)
  • Arthur Davidson, MD, MSPH (Associate Program Director; Associate Professor in the School of Public Health [Biostatistics and Informatics] and Medicine [Family Medicine]; former [retired] Director of Epidemiology, Preparedness, Informatics and Surveillence at Denver Public Health Department)
  • Amy Huebschmann, MD, MS, FACP (Associate Program Director; Professor and Clinician-Investigator in the Division of General Medicine; Chair of the Society of Behavioral Medicine Education, Training and Career Development Council)
Additional program faculty include:
  • Suzanne Dircksen, MBA (Research Training Program Manager at Denver Health)
  • Michael Fisher, PhD, MS (ACCORDS Qualitative Research Core; Assistant Reserach Professor, School of Medicine)
  • Anna Furniss, MS (ACCORDS Analytic Core, Analyst Co-Lead)
  • Rebecca Speer, MA (Research Training Program Manager at ACCORDS, University of Colorado, Anschutz Medical Campus)
  • John Rice, PhD (Assistant Professor in the School of Public Health [Biostatistics and Informatics]; Biostatistician)

Program Setting

The Program is located at The Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), an actual and virtual consortium of health services researchers at the University of Colorado, Anschutz Medical Campus.  Trainees typically conduct research projects in primary care departments and divisions at CU and in many areas within the Denver Health integrated delivery system.  However, recent trainees have also conducted projects in a range of Denver and Colorado communities and with multiple community collaborators.  These have included the Denver criminal justice system, a shelter for homeless youth, with community partners in Grand Junction, CO, and through the Kaiser Permanente Institute for Health Research.

Curriculum  

Trainees devote between 40% and 60% of a full time equilvalent position to curricular activities.  At the beginning of the first year, each trainee is assigned one of the fellowship's core faculty as a primary mentor to help identify areas of research interest, set learning objectives and create a personalized plan for formal coursework.  Trainees meet individually with their primary mentor at least every two weeks and with additional mentors monthly throughout the fellowship's duration.  Over the two year program, fellows have access to biostatisticians and qualitative research experts to guide the design and analysis of their research projects.  The standard training curriculum has four primary components, all of which are individualized to meet trainees' educational and research needs:
  1. Complete one or more independent HSR projects under longitudinal one-on-one mentoring from two or more faculty mentors.  Disseminate results to local stakeholders and submit manuscript(s) for peer-reviewed publication.
  2. Engage in weekly, interactive "work-in-progress" (WIP) sessions to conceptualize and address research questions in an interprofessional scientific community of peers and experienced core faculty researchers.  Weekly WIP sessions alllow each fellow to develop researchable questions, discuss methods, review data collection instruments, discuss actual output from statistical analyses, practice presentation of abstracts and posters in preparation for scientific meetings, and comment on sections of manuscripts in preparation.
  3. Complete a program of relevant didactic coursework (usually through the CU School of Public Health) tailored to the needs and goals of the trainee.  Core coursework includes epidemiology, biostatistics, qualitative methods and survey development as well as individual electives.  PCHSRF trainees are expected to complete a Certificate in Public Health, and depending on time and available support, may pursue either an MSCS or MPH.  Tuition support is arranged through the scholars' sponsoring departments.  Scholars may qualify for their home organization's tuition reimbersement program.
  4. Complete a 2-year core curriculum of mini-courses addressing multiple HSR and career development topics including literature searching, obtaining human subjects board approvals, managing data, designing research questions, developing secondary database analyses, and writing for peer-reviewed publication, among other topics.  In the second year of the fellowship, fellows also participate in an intensive grant writing course. 

Clinical Opportunities

Trainees who have established clinical roles at CU, Denver Health, or other healthcare delivery systems maintain clinical practices with 40% to 60% of their time; trainees negotiate clinical commitments with their department or division heads. ​​​​