Foster Tina, Regan-Smith Martha, Murray Carolyn, Dysinger Wayne, Homa Karen, Johnson Lisa M, Batalden Paul B
Dartmouth-Hitchcock Medical Center (DHMC), Dartmouth-Hitchcock Leadership Preventive Medicine Residency (DHLPMR) Program, Lebanon, NH, USA.
Acad Med. 2008 Apr;83(4):390-8. doi: 10.1097/ACM.0b013e3181667da9.
In 2003, Dartmouth-Hitchcock Medical Center (DHMC) inaugurated its Leadership Preventive Medicine residency (DHLPMR), which combines two years of leadership preventive medicine (LPM) training with another DHMC residency. The aim of DHLPMR is to attract and develop physicians who seek to become capable of leading change and improvement of the systems where people and health care meet. The capabilities learned by residents are (1) leadership -- including design and redesign -- of small systems in health care, (2) measurement of illness burden in individuals and populations, (3) measurement of the outcomes of health service interventions, (4) leadership of change for improvement of quality, value, and safety of health care of individuals and populations, and (5) reflection on personal professional practice enabling personal and professional development. The DHLPMR program includes completion of an MPH degree at The Dartmouth Institute for Health Policy and Clinical Practice (formerly the Center for Evaluative Clinical Sciences) and a practicum during which the resident leads change to improve health care for a defined population of patients. Residents also complete a longitudinal public health experience in a governmental public health agency. A coach in the resident's home clinical department helps the resident develop his or her practicum proposal, which must then be approved by a practicum review board (PRB). Twelve residents have graduated as of July 2007. Residents have combined anesthesia, family medicine, internal medicine, infectious disease, pain medicine, pathology, psychiatry, pulmonary and critical care medicine, surgery, gastroenterology, geriatric psychiatry, obstetrics-gynecology, and pediatrics with preventive medicine.
2003年，达特茅斯-希区柯克医疗中心（DHMC）开办了其领导力预防医学住院医师培训项目（DHLPMR），该项目将两年的领导力预防医学（LPM）培训与DHMC的另一项住院医师培训相结合。DHLPMR的目标是吸引和培养那些寻求有能力引领人们与医疗保健交汇系统的变革与改进的医生。住院医师所学的能力包括：（1）医疗保健小系统的领导力——包括设计与重新设计；（2）个体和人群疾病负担的衡量；（3）医疗服务干预结果的衡量；（4）引领变革以提高个体和人群医疗保健的质量、价值和安全性；（5）反思个人专业实践以促进个人和职业发展。DHLPMR项目包括在达特茅斯健康政策与临床实践研究所（原评估临床科学中心）完成公共卫生硕士学位，以及一段实习经历，在此期间住院医师引领变革以改善特定患者群体的医疗保健。住院医师还需在政府公共卫生机构完成一段纵向公共卫生体验。住院医师所在临床科室的一名导师帮助住院医师制定其实习方案，该方案随后必须经实习审查委员会（PRB）批准。截至2007年7月，已有12名住院医师毕业。住院医师们将麻醉学、家庭医学、内科、传染病学、疼痛医学、病理学、精神病学、肺科与重症医学、外科、胃肠病学、老年精神病学、妇产科和儿科学与预防医学相结合。
