Synergy in Basic and Applied BSSR

"Alternative Futures" Scenario Planning to Prepare BSSR Readiness

Many fields, including medical education, have embraced future scenario planning to prepare for an uncertain future. (Nasca et al, 2015) As the COVID19 pandemic illustrates, the future is highly unpredictable. Scenario planning envisions a series of exaggerated but plausible "alternative futures'' to develop risk management plans. The Accreditation Council for Graduate Medical Education (ACGME) - the accrediting body for all graduate medical education - is undertaking a massive effort to rebuild program training standards that would affect all in-training physicians. ACGME worked with consultants to develop four scenarios about the US health care system around which it will revamp standards starting with internal medicine (Figure 1) . Synergizing basic and applied BSSR could similarly benefit from scenario planning. For example, NIH could sponsor funding for a ten-city study in which a cross-section of public health programs, health departments, community members, accreditors, and other major stakeholders convene to develop future scenarios about regional or US public health in 2040. Once there is general agreement on the scenarios, each coalition would work separately or together in ten cities to develop important BSSR skills and and related behaviors (i.e. academic co-training of health department employees, increased community-based training, more collaboration between communities and academic institutions, more cross-training). Each coalition would also propose systems-based changes to optimize BSSR skills preparedness across the public health workforce and community. This innovation has several advantages: 1) it narrows the yawning gap between academia and the community by creating sustained engagement 2) it positions public health programs to be more adaptive, community-oriented and forward-thinking 3) it allows learners to gain knowledge and experience from sustained engagement and to engage in critical analysis about broad public health challenges 4) it would force all partner organization on the coalition to improve recruitment and continuing education practices 5) it would create a social capital network among community stakeholders that could improve community health in unanticipated ways. Read more: "Optimizing Upstream Health in the Community-Oriented Integrative Domain" - "Three domains define major challenges facing U.S. health care... Equally important is that prioritization of needs and program planning are interwoven with community capacity-building and self-determination. Integrative engagement relies on direct community participation to develop the clinical equivalent of a history and physical, differential diagnosis and treatment plan. Action at this level values principles of reciprocity and ongoing interpersonal communication to advance shared goals of community health." (Williams, 2018) Figure 1 Free Markets Unchained a world dominated by libertarian public policies) Boom Doogle (a world where Baby Boomers are in charge) There's an App for That, Too?(a world where most people's health is tracked via wearable/embeddable sensors) Cloudburst(a world where cyber attacks have disabled the Internet) Nasca, T. J., & Thomas, C. W. (2015). Medicine in 2035: Selected Insights from ACGME's Scenario Planning. Journal of graduate medical education, 7(1), 139–142. doi:10.4300/JGME-D-14-00740.1 Williams CM, El-Bayoumi J. Optimizing Upstream Health in the Community-Oriented Integrative Domain. Health Equity. 2018;2(1):313–315. Published 2018 Oct 24. doi:10.1089/heq.2018.0041

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Idea No. 341