UNE’s Center for Health Innovation Forms a Pipeline to Midcoast Maine to Address Healthcare Shortages

UNE students and faculty attend a weeklong rural health immersion in Midcoast Maine (L-R, Row 1 Nancy Simpson, Purvi Patel, Molly Callnan, Emma Mason, Brandi Sargent, Cassidy Carpenter, Row 2 Jennifer Gunderman, Jason Greenbaum, Matthew Fiorilo, Sara Stafford, Kurdistan Pishdary, Heather Curran, Abby Golash, Neva Gross, Katelyn Van Leir , Ian Imbert)

UNE students and faculty attend a weeklong rural health immersion in Midcoast Maine (L-R, Row 1 Nancy Simpson, Purvi Patel, Molly Callnan, Emma Mason, Brandi Sargent, Cassidy Carpenter, Row 2 Jennifer Gunderman, Jason Greenbaum, Matthew Fiorilo, Sara Stafford, Kurdistan Pishdary, Heather Curran, Abby Golash, Neva Gross, Katelyn Van Leir , Ian Imbert)

Fifteen healthcare students from UNE’s College of Osteopathic Medicine, College of Pharmacy, College of Dental Medicine, and Westbrook College of Health Professions Bachelor of Science in Nursing (ABSN) program recently attended a weeklong rural health immersion in Knox and Waldo Counties of Maine’s Midcoast Region. The experience, which is coordinated and funded by UNE’s Center for Excellence in Health Innovation and the Maine Area Health Education Center (AHEC), is a pipeline activity created to reduce healthcare provider shortages in rural Maine and to strengthen UNE’s relationships with healthcare centers around Maine. The weeklong Midcoast Maine rural health immersion experience was the third time that it has been offered to UNE students; last March a weeklong immersion was held in Franklin County and in May of 2016 a weeklong immersion was held in Maine’s northern most county, Aroostook County. The enormous amount of positive feedback from students and community members of the previous two years immersions spurred a third one to be scheduled for 2017.

Attracting healthcare professionals to rural and underserved communities has been a national priority for several years and a particular issue for Maine partly due to the fact that, according to the 2010 Census Data, Maine was the most rural state in the United States. Rural terrain can lead to long commutes for patients seeking basic healthcare services and can exacerbate provider shortages, leading to poorer health outcomes. The locations for the immersion experiences are chosen based on the three AHEC centers strategically located around Maine in Aroostook, Franklin, and Penobscot counties, three of Maine’s most rural counties.

Knox and Waldo Counties provide a contrasting picture of health and well being in Maine, according to the Robert Wood Johnson Foundation’s 2016 county health rankings. For example, Knox county ranked 3rd in health factors and 2nd in health outcomes, while Waldo County did not fair as well, finishing 8th and 10th, respectively. Nancy Simpson, MSN, RN-BC, CNE, associate clinical professor in UNE’s Westerbook College of Health Professions, provided faculty support during the trip and said “The Midcoast Maine immersion encouraged students to look at the everyday world around them through the lens of population health.  This experience provided them with a priceless opportunity for sharing, learning and working with students in other disciplines.”

It’s predicted that some of the health challenges that Maine’s more disparate Counties face would be improved if there were more providers in that area. According to the Robert Graham Center and the Nursing Workforce Forecast, Maine will need an additional 120 primary care physicians and 3,200 nurses in the next decade in order to maintain current rates of healthcare utilization. Moverover, the Maine Department of Labor projects a shortage of 170 dentists. Research shows that students are more likely to practice rural medicine if they have a personal connection to a rural area, so, the rural health immersions aim to provide opportunities for students to connect to rural Maine and hopefully alleviate healthcare provider shortages.

Students meet with the practice manager at Stockton Springs Health Center a FQHC in Stockton Springs, ME.

Students talk about rural medicine at Stockton Springs Health Center a FQHC in Stockton Springs, ME.

The students who participated in the Midcoast Maine rural health immersion came from a broad array of backgrounds, some growing up throughout the country in areas like Michigan and California while about a third of the students had grown up in New England or had spent time previously in rural Maine. Most students had some experience working with underserved populations in the past but, for some it was their first opportunity to experience rural underserved healthcare. One student from UNE’s College of Pharmacy, Sara Stafford, reflected after the final day of the immersion “Not only today, but throughout the entire immersion, I was so thankful to be able to work with students from other professional programs; it was amazing to hear their different perspectives and get to know such great people that I would have otherwise not known. Whether it was their respective discipline or just the people that I was able to share this experience with, I have never been so passionate about doing more interdisciplinary outreach and will definitely continue to seek out the opportunities to do so.”

The students experienced a variety of activities in underserved areas in Knox and Waldo Counties, such as meeting with providers of Waldo County General and Pen Bay Hospitals for a tour of the hospital facilities; a tour and discussion with providers at Stockton Spring’s Federally Qualified Health Center; a meeting with providers at Knox Free Clinic where the students provided health bags consisting of dental hygiene and other relevant health supplies; a trip to Mount Pleasant Dental Care in Rockport to talk about dentition in rural communities; and a meeting with the owner of Jensen’s pharmacy in Rockland. There was also an overarching behavioral health theme during the trip and all of the students were exposed to topics within that field on multiple occasions, such as a Medication Assisted Treatment (MAT) training with David Loxterkamp, MD, and Mary Beth Leone, LCSW, who head Penobscot Community Health Care’s Substance Misuse program. Second year medical student, Matthew Fiorillo, reflected upon the MAT training “I learned that some people are–through no fault of their own–more predisposed to addiction. As healthcare providers, we need to be mindful of this concept, and make sure that we afford each of our patients the time and respect that they deserve.”

Students meet with area providers to talk about substance misuse and effective treatment techniques

Students meet with area providers to talk about substance misuse and effective treatment techniques

The students also enjoyed having time to take in the natural beauty of the area, such as when they met with Mary Ashmore, DO, a local osteopathic physician, at the Camden amphitheater; during nightly walks around Point Lookout, where they stayed in authentic Maine cabins for the week; and during a hike to the top of Mt. Battie in Camden, ME. They students got a taste of the local culture when they had lunch with Maine State Representative Anne Beebee-Center and talked about economics and health policy in rural Maine over dinner. The group also had breakfast one day with Mike Hurley, a previous Belfast town mayor, and talked about his experience governing a rural community in Maine.

Third year pharmacy student Neva Gross gets ready to take a group selfie at the top of Mt. Battie in Camden, ME

Third year pharmacy student Neva Gross gets ready to take a group selfie at the top of Mt. Battie in Camden, ME

There were a variety of clinical skills activities that the students participated in such as visiting two local elementary schools, Walker and Troy, where the UNE students provided health education to the elementary students on the brain, oral health, and tick prevention. Katelyn Van Leir, a second year dental student, had this to say about the early school experience “We all had a lot of fun working with children and we were all very shocked by how much they already knew.” Later in the week the students visited two local YMCA’s, PenBay and Harborside, where they met with clients to provide basic health education and screenings such as blood pressures, filling out File of Life forms, and providing oral health education and overall wellness tips.

UNE students visit local elementary schools in Waldo County and provide education on the brain, oral health, and tick prevention.

UNE students visit local elementary schools in Waldo County and provide education on the brain, oral health, and tick prevention.

Jen Gunderman, MPH, assistant lecturer in UNE’s Westbrook College of Health Professions helped lead the immersion and had this to say of the students experiences “The Midcoast Maine Immersion is a unique opportunity for students to observe, learn, and experience the necessity of an interdisciplinary approach to addressing the needs and identifying the strengths of rural areas.” Another UNE faculty member who participated in the immersion, Rachel King Assistant Clinical Professor in UNE’s College of Dental Medicine, reflects upon the interprofessional experience “The opportunities for student experiences provided by the Rural Health Immersion align well with the vision of the UNE College of Dental Medicine to educate ‘dental professionals who will fulfill their obligations to improve the oral health, overall health and quality of life of people in their communities with integrity, compassion and respect.’ It was very rewarding as a faculty member to witness the ways in which the students’ worldviews changed with each activity, helping define the sense of social responsibility that will ultimately carry into their professional practices”, says King.

UNE medical, pharmacy, nursing, and dental students pose for a picture at the amphitheatre in downtown Camden, ME.

UNE medical, pharmacy, nursing, and dental students pose for a picture at the amphitheatre in downtown Camden, ME.

The full team of students who attended the Midcoast Maine immersion included four medical students from UNE’s College of Ostepathic Medicine Emma Mason, Brandi Sargent, Cassidy Carpenter, Matthew Fiorillo; four pharmacy students from UNE’s College of Pharmacy Purvi Patel, Sara Stafford, Abby Golash, and Neva Gross; three students from UNE’s Nursing Department Heather Curran, Kurdistan Pishdary, and Molly Callanan; and two students from UNE’s College of Dental Medicine Jason Greenbaum and Katelyn Van Leir. You can read more on each students experience here.

The majority of the planning and coordination for the trip was provided by Jen Gunderman, MPH, assistant lecturer in UNE’s Westbrook College of Health Professions, and Ian Imbert, MPH, project coordinator of a four year Josiah Macy Jr. Foundation grant and staff member in UNE’s Center for Excellence in Health Innovation. Jen Van Deusen, M.Ed., Director of Curriculum for UNE’s College of Osteopathic Medicine, Stacey Thieme, DO, Director of UNE’s Preceptor Programs and faculty in UNECOM’s Department of Primary Care, Rachel King, DDS, MPH, Assistant Clinical Professor in UNE’s College of Dental Medicine, and Nancy Simpson, MSN, RN-BC, CNE, associate clinical professor in UNE’s Westerbook College of Health Professions, all attended and provided expertise and mentorship during the trip. Dora Anne Mills, MD, MPH, FAAP, Vice President of Clinical Affairs at UNE and director of UNE’s Center for Health Innovation helped develop the immersion.

The trip was graciously supported by Maine’s Area Health Education Center (AHEC) and the Josiah Macy Jr. Foundation. The Maine AHEC has continued to prioritize experiential learning in rural communities for graduate healthcare students and their commitment to the rural health immersion proved to be invaluable for the success of the trip. The Josiah Macy Jr. Foundation grant that also helped fund the experience is a four-year grant awarded to UNE in 2015 from the Josiah Macy Jr. Foundation and aims to improve health care and education in rural areas.

FMI: Contact Ian Imbert, MPH, (207-221-4625 or iimbert@une.edu)

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