Beyond Co-Location: Development of a School Health Integration Measure.

BACKGROUND: School-based health centers (SBHCs) can integrate health and educational services to achieve common goals of student wellness and success. As no method exists to quantify the degree of integration for clinics and partner schools, this study aimed to design such a measure. METHODS: Measure items were drafted from the literature. Eleven school health experts from Los Angeles, CA, used a modified Delphi method to reach consensus around items for inclusion in a School Health Integration Measure (SHIM), evaluating each on its appropriateness, substantivity, and feasibility. Twenty-eight staff at 17 SBHC campuses pilot tested the SHIM to examine its psychometric properties. RESULTS: From 36 items, the expert panel utilized 4 rounds to reach consensus on 12 items across 5 domains: health authority, integrated programming, marketing and recruitment, shared outcomes, and staff collaboration. In the SHIM pilot, scores ranged from 2.25 to 5 (possible 1-5, mean 3.53). The measure had high internal consistency (alpha = 0.9385) and was associated with participants' general assessment of integration at their sites (p = .001). CONCLUSIONS: The SHIM provides a new tool to quantify health and educational service integration at SBHC sites, drive practice improvement, and test whether integration leads to better student outcomes.

From the Hawaiian classroom to the wards: A model of effective pedagogy for clinicians, trainees, and patients.

Clinical teachers receive little training in the actual practice of teaching, often lacking any pedagogical framework by which to approach learners. The Center for Research in Education, Diversity, and Excellence (CREDE) offers an evidence-based pedagogical framework from our experience in primary and secondary education that can transform the clinician's teaching practice. The CREDE standards of effective pedagogy provide concrete guidance for a clinician's interactions with trainees, peers, and patients. This framework can support clinical teachers to be more effective when working with the diverse set of trainees, peers, and patients that our fields must engage.