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Scholarly Activity

NH Dartmouth Family Medicine Residency Program (NHDFMR) utilizes a three-pronged approach to teaching excellence in primary care and supporting personal development.

Expanding the model of patient care.
Expanding the model of team membership.
Expanding the model of change management through a systems approach.

Dr. Brian McKenna, NHDFMR Class of 2019

The [Systems] curriculum teaches skill development in these three areas throughout residency, while the clinic provides a learning laboratory to experientially trial these skills aimed at enhancing the patient-centered medical home, functioning in an interdisciplinary team and improving quality gaps in care delivery and patient-team and inter-team relationships. At NHDFMR, we encourage engaging in scholarly activity to connect these three areas: how we teach; how we deliver care; and how we continue to strive for excellence. Engaging in scholarly activity forces us to reflect on what we are doing, analyze our models of teaching and clinical care, and engage in a dialogue with each other and with a broader community for the purpose of constant improvement.

NHDFMR residents meet the ACGME requirement of participating in the production of at least two scholarly activities with the comprehensive support of a faculty member specifically appointed to the development of scholarly activity.

NHDFMR has a long tradition of scholarly activity production in four areas of focus.

Expanding the Model of Patient Care

Incorporating the patient’s experience with illness in relation to one’s dimensions of personhood (according to Eric Cassell: personality, past, experiences, culture, roles, politics, ability to do things, body, secret life, transcendence). Prolonged illness threatens aspects of personhood and leads to suffering. Learning is one way to emerge from suffering and can happen through the process of identifying and understanding a person’s illness experience.

Presentations

Rice K. (2023). Trauma-informed care for the opiod-exposed mother. Presentation at NH Academy of Family Physicians: Whitefield, NH.
Gupta S., Bartlett J., Rice K. (2023). Speaking the same language: Improving colon cancer screening rates in non-English speaking patients. Poster presented at NH Academy of Family Physicians: Whitefield, NH.
Wang L. (2023). PrEP-ing primary care: Expanding access to HIV pre-exposure prophylaxis. Oral presentation at NH Academy of Family Physicians: Whitefield, NH.
Kuftinec A & Brown PA (2023). ADHD in the time of COVID. NH Academy of Family Physicians: Whitefield, NH.
Gurung A.; Dahal S.; Haller LE; O’Leary S; Valeras AB; Valeras AS. (2023). Culturally sensitive mental health care: Learning from a Nepalese-speaking community in NH. Poster presented at NH Academy of Family Physicians: Whitefield, NH.
Chekuri, B, Haller L, Reddy S. (2023). Managing heat-related illness in clinical care. Seminar presentation at Society for Teachers of Family Medicine (STFM) Annual Conference: Tampa, FL.
Valeras, A. B. & Hogan, C. (2022). "Alone Together": Telemedicine group therapy to address social isolation. Presentation at Collaborative Family Health Care Association. Boise, ID.
Wright, M. (2022). Treating the person and not the parts: Education in trauma informed care. Presentation at NH Academy of Family Physicians. Whitefield, NH.
Haller, L. E., Valeras A. B., & Valeras, A. S. (2022). Barriers to primary care from the perspective of patients with Limited English Proficiency. Poster presentation at NH Academy of Family Physicians. Whitefield, NH.
Rice, K., Yerdon, A. M., Collins, E., Valeras, A. B., Roy, A., & Tumminkatti, R. (2022). Mothers' experience of Eat, Sleep, Console (ESC) approach to Neonatal Abstinence Syndrome. Poster presentation at NH Academy of Family Physicians. Whitefield, NH.
Milligan, M. (2021). Calling for contraception: Utilization of telemedicine to improve access to family planning. Presentation at NH Academy of Family Physicians. Virtual.
Yerdon, A. M., Collins, E., & Valeras A. B. (2021). Teaching the care of infants with Neonatal Abstinence Syndrome (NAS) through East, Sleep, Console (ESC) approach. Presentation at Society for Teachers of Family Medicine. Virtual.
Tan, M., Millette, D., Tumminkatti, R., Valeras, A. B., Haley, J., Whitney-Gill, G., Hemingway, S., & Geffken, D. (2019). Prevalence of social vulnerability in a community health center: Works-in-progress. Poster presentation at Family Medicine Forum. Vancouver, BC, Canada.
Curt, H. & Valeras A. B. (2019). Addressing memory concerns in older adults through an integrated care approach. Presentation at Collaborative Family Healthcare Association. Denver, CO.
Haley, J., Hogan, C., Hemingway, S., Allosso, L., Cobb, E., & Valeras A. B. (2019). Trauma-informed primary care from the patient’s point of view. Workshop presentation at National Association of Social Workers-NH Annual Conference. Whitefield, NH.
Kazanczuk, M. (2019). Emergency contraception: Not just about the “morning after”. Lecture presentation at NH Academy of Family Physicians Annual Conference. Whitefield, NH.
Marolda, M. (2019). The heart and gut of the matter: Aspirin use in primary prevention of cardiovascular disease and colorectal cancer. Lecture presentation at NH Academy of Family Physicians Annual Conference. Whitefield, NH.
Dickson, A., Lopez, A., Morse, J., Valeras, A. B. (2019). A process for deprescribing with elderly patients. Poster presentation at Society for Teachers of Family Medicine. Toronto, ON, Canada.

Expanding the Model of Team Membership

Embracing the need to reframe all team members’ roles away from a hierarchal model towards an interdisciplinary and interdependent model, allowing for all members to be continual learners, to provide care for patients to the best of their skill set, and to embody the patient-centered medical home.

Publications

Valeras, A. B., Cobb, E., Prodger, M., Hochberg, E., Allosso, L., & VandenHazel, H. (2019). Addressing adults with adverse childhood experiences requires a team approach. The International Journal of Psychiatry in Medicine, 54(4-5).

Presentations

Drost S., O’Grady C., McCleery S. (2023). Increasing PHQ-2 screening rates through EMR optimization and an interdisciplinary approach. Poster presented at NH Academy of Family Physicians: Whitefield, NH.
Valeras AS. (2022). Building and Leading the Integrated Care Team. Webinar for AAFP’s Behavioral Health Integration Learning Series.
Valeras, A. B. & Valeras, A. S. (2022). A match made in heaven: Examining the marriage between medicine and behavioral health in integrated settings. Presentation at Collaborative Family Health Care Association. Boise, ID.
Valeras A. S. (2021). The essence of team. Presentation for New Hampshire State Society of Medical Assistants.
Periera, A., Valeras, A. B., & Cobb, E. (2020). “I’ve got a team behind me here”: Integrated behavioral health in primary care from the patient’s point of view. Presentation at Collaborative Family Healthcare Association. Virtual.
Valeras, A. S. & Valeras A. B. (2020). Partners in the exam room: A model of integrated behavioral health in primary care. Presentation at STFM Conference on Practice Improvement and Quality Improvement. Kansas City, KS.

Expanding the Model of Change Management through a Systems Approach

Using a systems approach takes complex adaptive system theory, which incorporates an emphasis on relationships, communication patterns, emotions, and culture, and applies it to the process of creating change in individuals, teams and systems.

Publications

Milligan M. (2023). What if Medicaid expansion isn’t reauthorized? Ask your doctor – they’ll tell you. Union Leader, January 30
Demasi, M., Chekuri, B., Paladine, H., & Kenyon, T. (2022). Climate change: A crisis for family medicine educators. Family Medicine, 54(9):683-685.
Chekuri, B. & Milligan, M. (April, 2022). Calling for care: Telehealth benefits women and the planet. As We See It: Voices From the AAFP. https://www.aafp.org/news/opinion/guest-editorial-telehealth-expansion.html
Valeras, A. S. & Cordes, C. (2020). Adaptive leadership: Becoming the change. Family, Systems, & Health, 38(4), 495-497.
Valeras, A. S. (2020). Finding purpose. Families, Systems, & Health, 38(3), 338-340.
Valeras, A. S. (2020). COVID-19: Complexity and the black swan. Families, Systems, & Health, 38(2), 221-223.
Valeras, A. S. (2020). Healthcare provider burn-out: A war with uncertainty. Families, Systems, & Health, 38(1), 96-98.
Valeras, A. S. (2019). Caring is complex: And it always has been. Families, Systems, & Health, 37(1), 98-100.
Valeras, A. S. (2019). Healthcare’s wicked questions: A complexity approach. Families, Systems, & Health, 37(2), 187-189.
Valeras, A. S. (2019). Relationships matter in population health. Families, Systems, & Health, 37(3), 274-276.
Valeras, A. S. (2019). Quality improvement in a complex world. Families, Systems, & Health, 37(4), 352-353.

Presentations

Valeras AS. (2022). PCBH Model Case Studies. Webinar for AAFP’s Behavioral Health Integration Learning Series.
Valeras AS. (2022). Making the Case for Change. Webinar for AAFP’s Behavioral Health Integration Learning Series.
Valeras AS. (2022). Don’t Go It Alone – Success Requires Community-Based Solutions. Webinar for AAFP’s Behavioral Health Integration Learning Series.
Reitz, R; Ogbeide, S; Pratt, G; Penwell-Waines L.; Myerholtz, L; Brown, A. (2023). Behavioral Medicine’s leaders and role breakers – A Pecha Kucha experience. Panel discussion at Society for Teachers of Family Medicine (STFM) Annual Conference: Tampa, FL.
Haller L., Valeras AB, Bogle E. (2023). Beyond the walls: Going into the community to understand barriers to health care for patients with LEP. Lecture at Society for Teachers of Family Medicine (STFM) Annual Conference: Tampa, FL.
Brown, P. A., Edberg, D., Pratt, G., Rickert, J., Talen, M., Reitz, R., & Wall, T. (2022). Even one voice: Teaching advocacy as a core competency in family medicine. Presentation at the Forum for Behavioral Science in Family Medicine. Chicago, IL.
Matzka, L. (2022). When silence does not equal acceptance: Actively creating a safe health care environment for LGBTQ+ patients. Presentation at NH Academy of Family Physicians. Whitefield, NH.
Valeras, A. S. (2022). A model for the integrated care of patients with complex health needs national. Center for Integrated Behavioral Health (NCIBH) at Mayo Clinic. https://www.youtube.com/watch?v=Hm38FE_ZFis
Valeras, A. S. (2022). Leadership and the soft skills of integrated behavioral health. National Register of Health Service Psychologists. Webinar at https://www.nationalregister.org/education-training/webinars/national-register-associate-certificate-program-integrated-care/
Brown, P. A. & Chekuri, B. (2021). Speak up: Or how one program stopped worrying and learned to love advocacy. Presentation at Society for Teachers of Family Medicine. Virtual.
George, D., Harrison, M., Ring, J., Valeras, A. S., & Winford, E. (2020). Our community at the intersection of COVID-19 & Black Lives Matter. Workshop at Collaborative Family Healthcare Association. Virtual.
Baily, S., Daub, S., Fisher, J., Jacobs, B., & Valeras, A. S. (2020). Clinician rising: Transforming from front line warrior to large system change leader. Workshop at Collaborative Family Healthcare Association Conference. Virtual.
Morse, J., Valeras, A. B., Geffken, D., & Seery, M. (2019). Approaching relocation of a residency-based clinic using quality improvement tools. Poster presentation at Institute for Healthcare Improvement. Orlando, FL.
Geffken, D., Smith, P., Dahal, B., Sikyala, M. D., Green, J., Breault, A., McCracken, K., Carbonneau, A., Tellez, T., Thomas, A., Denoncour, S., & Jennison, T. (2019). Promoting equity through authentic partnerships to improve community health. Panel presentation at Team Up, Take Action. Lebanon, NH.
Valeras, A. S. (2019). Complexity registries as a tool in population health. Poster presentation at American College of Preventive Medicine. Pittsburgh, PA.
White-Davis, T., Valeras, A. B., Burnside, M., & El-Amin, W. (2019). Breaking the silence: Dismantling racism in graduate medical education. Seminar at Society for Teachers of Family Medicine. Toronto, ON, Canada.

Expanding the Model of Resident Education

Incorporating concepts from adult learning theory and change management theory into experiential learning opportunities for learners to generate adaptive learning in family medicine residents.

Publications

Demasi, M., Chekuri, B., Paladine, H., Kenyon, T. (2022). Climate change: A crisis for family medicine educators. Family Medicine, 54(9):683-685.
Chekuri B, Milligan M. Calling for Care: Telehealth Benefits Women and the Planet. As We See It: Voices From the AAFP. Published April 27, 2022. https://www.aafp.org/news/opinion/guest-editorial-telehealth-expansion.html
Culmer, N., Johnson, B., Kenyon, T. et al. (2021). Competencies outside the clinic: A systematic review of necessary, non-clinical competencies in medical faculty. PROSPERO 2020 CRD42020213519 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020213519

Presentations

Valeras AS. (2022). Teaching and preparing residents for Integrated Care. Webinar for AAFP’s Behavioral Health Integration Learning Series.
Davis-Thompson T, Hedberg V, Scarponi K, Valeras AB. (2023). Understanding primary care practice around adolescent confidentiality. Poster presented at NH Academy of Family Physicians: Whitefield, NH.
Geffken, D. (2023). Using the Just Culture framework to guide a residency progressive assistance and disciplinary action policy. Innovation Showcase at AAFP Residency Leadership Summit: Kansas City, MO.
O’Grady, C & Brown A. (2023). Integration of a longitudinal curriculum in community advocacy: Perspectives from family medicine residents. Poster presented at Society for Teachers of Family Medicine (STFM) Annual Conference: Tampa, FL.
Myerholtz, L.; Brown, A.; Nikel, C.; Wall, T. (2023). Taking action: Addressing stigma for healthcare professionals seeking mental health support. Seminar presentation at Society for Teachers of Family Medicine (STFM) Annual Conference: Tampa, FL.
Shilling T, Betchart C, Haller L, Thesing G, Brehio T, Valeras AB. (2023). Closing the gap: Improving colorectal cancer screening rates in a family medicine residency practice. Poster presentation at Society for Teachers of Family Medicine (STFM) Annual Conference: Tampa, FL.
Shilling T., Betchart C., Brehio, T., Valeras AB. (2023). “I want to see MY doctor”: Improving continuity of care in a family medicine residency practice. Poster presentation at Society for Teachers of Family Medicine (STFM) Annual Conference: Tampa, FL.
Castallanos Mendez, A. & O’Grady, C. (2022). Our role in helping elders age in place. Presentation at the NH Medical Society. Newcastle, NH.
Reitz, R., Sudano, L., Lenherr, E., Obstfeld, M., Valeras, A. S., & Lebensohn-Chialvo, F. (2022). Narrative medicine and mindful gratitude in mentorship and work-force development. Presentation at Collaborative Family Health Care Association. Boise, ID.
Valeras, A. B. (2022). Art & antidote: A treatment for COVID sequelae. Presentation at Collaborative Family Health Care Association. Boise, ID.
Brown, P. A. (2022). Using simulation to teach shared decision-making to primary care providers. Presentation at the Forum for Behavioral Science in Family Medicine. Chicago, IL.
Yerdon, A. M. (2022). Wellness: Strategies to promote professional re-engagement for you, for us, for our patients. Presentation at NH Academy of Family Physicians. Whitefield, NH.
Kenyon, T., Servey, J., Gopal, B., Johnson, B., Culmer, N., Tulshian, P., Hartmark-Hill, J., Tattleman, E., & DeMasi, M. (2022). The next chapter: Sharing a universal set of competencies for interdisciplinary faculty development. Presentation at Society of Teachers of Family Medicine. Indianapolis, IN.
Chekuri, B. (2021). Changing seasons: Health impacts of climate change in NH. Presentation at NH Academy of Family Physicians. Virtual.
Mikail, S. (2021). Listen to your mother (nature): The impact of the outdoors on health and healing. Presentation at NH Academy of Family Physicians. Virtual.
White-Davis, T., Smyre, C., El-Amin, W., & Valeras, A. B. (2021). Interrupting and addressing racism in medical education. Workshop at Beyond Flexner Alliance: Social Mission in Health Professions Education. Virtual.
Kenyon, T. et al. (2021). Exploring implementation of teaching competencies for faculty in all specialties. Presentation at Accreditation Council for Graduate Medical Education (ACGME) Annual Conference. Virtual.
Kenyon, T. et al. (2021). Exploring implementation strategies for a new set of interdisciplinary faculty competencies. Presentation at Society for Teachers of Family Medicine. Virtual.
Tulshian, P, Gopal, B., & Kenyon, T. (2021). Faculty competencies: An exploration of feasibility and utility. Presentation at Society for Teachers of Family Medicine. Virtual.
Kenyon, T. (2021). Engaging clinical uncertainty. Presentation at Southern NH Area Health Education Center Nurse Practitioner Fellowship.
Kenyon, T. (2021). Introduction to practice inquiry: Method for engaging uncertainty. Presentation at Southern NH Area Health Education Center Nurse Practitioner Fellowship.
Kenyon, T. & Heatherton, C. (2020). Ready for Rural (R4R): An innovative approach to the transition from medical student to competent and confident rural practitioner. Presentation at Rural Training Track Collaborative. Virtual.
Kenyon, T. et al. (2020). Not what we planned: Strategies for converting unexpected project outcomes (“failures”) into lessons learned. Presentation at Society for Teachers of Family Medicine. Virtual.
Geffken, D., Valeras, A. B., & Brown, P. A. (2019). Process groups as a wellness initiative to decrease physician burnout. Poster presentation at Institute for Healthcare Improvement. Orlando, FL.
Chahine, L., Brown, P. A., Nino, J. R., Gildenblatt, L., Hagar, M., & Valeras, A. B. (2019). Resident wellness: Understanding it and applying the evidence. Presentation at Forum for Behavioral Science in Family Medicine. Chicago, IL.
Talen, M. & Valeras, A. B. (2019). Integrating the arts into the science: Teaching strategies and resources. Workshop at Forum for Behavioral Science in Family Medicine. Chicago, IL.
Valeras, A. B., Morse, J., Coombs, R., Hesselson, L., Mesick, N., & Grigoryan-Koster, J. (2019). EmpowHER: ‘Women in Medicine support group to mentor female resident physicians. Lecture presentation at Society for Teachers of Family Medicine. Toronto, ON, Canada.
Morse, J. & Richardson, R. (2019). Supporting community preceptors through effective onboarding at a family medicine residency. Scholarly Roundtable at Society for Teachers of Family Medicine. Toronto, ON, Canada.
Morse, J., Richardson, R., Thesing, G., Orzano, A. J., & Kenyon, T. (2019). Co-advising: Blending contributions of academic and clinical advisors. Lecture at Society for Teachers of Family Medicine. Toronto, ON, Canada.
Gopal B., Kenyon, T., & Johnson, B. (2019). Update on faculty competencies project. Scholarly Roundtable at Society for Teachers of Family Medicine. Toronto, ON, Canada.
Kenyon, T., Brehio, T., Sanborn, J., Morse, J., & Brown, A. (2019). Running lapse: Interactive modules for measuring specific patient safety and professional conduct milestones that can be elusive. Seminar at Society for Teachers of Family Medicine. Toronto, ON, Canada.
Panchal, A., Forest, C., Kenyon, T., Allen, C., & Sommers, L. (2019). Hidden in plain sight: The family medicine physician and uncertainty work. Society for Teachers of Family Medicine. Toronto, ON, Canada.
Kenyon, T., Panchal, A., Allen, C., Forest, C., & Sommers, L. (2019). In uncertain terms: Using small group learning to teach residents how to effectively engage clinical uncertainty. Society for Teachers of Family Medicine. Toronto, ON, Canada.