Program:

On-Site Clinical Education & Consultation Program for Ryan White funded clinics & clinics serving minority clients

Description:

The USC site has developed an intensive consultation program with the primary objective of improving the standard of care and improving the quality of HIV/AIDS care throughout clinics in Southern California. During this consultative training program, an AETC faculty contracts to spend a period of six weeks at an individual Ryan White and or other clinic serving minority patients. Special emphasis is given to selection of clinics for consultation training which serve the targeted populations as well as those which have not been able to regularly participate in HIV/AIDS continuing medical education or which have not had access to HIV/AIDS training opportunities.

During the consultation training held at the clinic site, the faculty/clinician completes HIV/AIDS educational needs assessment, conducts thorough patient chart review. In addition, the faculty/clinician sees patients at the clinic with practitioners and provides patient-specific HIV/AIDS training. A special feature of this training program also includes follow-up visits to clinics by the faculty/clinician six months after the initial consultation training for another defined time period. During this follow-up consultation, the faculty/clinician assesses the effectiveness of the consultation training and provide additional training to practitioners as needed.

Program:

Evidenced Based Clinical Training for Primary Care Providers

Description:

This intensive clinical training is designed to help primary care providers develop skills which will allow them to care for their patients who are HIV seropositive or who have AIDS.

This one-week mini-residency is designed for physicians, physician assistants, nurse practitioners, with emphasis on clinical instruction the context of direct patient care at 5P21, L.A. County and USC Medical Center Outpatient HIV Clinic. Throughout the clinical rotation, training is one-on-one with a faculty preceptor, including ongoing trainee presentations with faculty review. Faculty are primary care physicians and specialists who concentrate in HIV disease.

In addition to the teaching in conjunction with patient care, knowledge and skill building is addressed through a day-long HIV/AIDS Complete Overview seminar, a course syllabus and resource guide, a mental health seminar, and an standardized patient interaction.

During the 2002-03 year, clinical training participants will include practitioners from Ryan White funded clinics, comprehensive community clinics, the Correctional System, as well as other referred practitioners from sites and clinics which serve minority and disadvantaged patients.

Program:

Early Intervention and Prevention Workshops (Standardized Patients in Simulated Clinical Encounter)

Description:

This training program includes practical skill development workshops for physicians, nurses, nurse practitioners, and teach healthcare professionals from a variety of clinics and programs which serve minority and disadvantaged patients. Chief objectives of these workshops include building skills which enable practitioners to incorporate HIV prevention and risk assessment counseling with all patients or clients seen, regardless of perceived that patients’ perceived risk.

During training workshops, participants practice introducing the topic of HIV with patients, learn to ask patients about risk factors for HIV, and talk with patients about ways of reducing risk of transmission. In addition, participants have an opportunity to providing pre- and post-HIV test counseling. In these interactive small group sessions, trainees practice skill building with standardized patients, actors who are carefully trained to portray real patient cases. At the conclusion of the sessions, the standardized patients give feedback to the participants, providing the patient’s perspective on the interview and provider/patient interaction

Skills taught and practiced with the standardized patients include

1. introducing the topic of HIV
2. assessing the patient's risk for HIV infection, including taking a sexual history
3. providing information to the patient on risk reduction & "safer" sex
4. recommending HIV testing to the patient
5. providing pre-test counseling to the patient
6. informing the patient of the results of the test
7. providing post-test counseling

Community & Migrant Health Center Training Program

Description:

This program includes a series of education and training programs and workshops designed for staff at federally funded Community and Migrant Health Clinics. A needs assessment will be conducted at each Community and Migrant Health Center site, and the resulting training interventions will be designed to be site specific and will address educational needs identified. Trainings will include up-dates on HIV/AIDS care and prevention, skill-building workshops, clinical case presentations, and in-depth knowledge building on specific topics. Examples of educational program topics include:

1. HIV Prevention Counseling and antibody testing,
2. Identification of acute primary HIV infections,
3. Study results of ACTG 076 protocol and implications for care,
4. Care and treatment of HIV infected persons: Opportunistic infections,
5. Care and Treatment of HIV infected persons: Combination drug therapies,
6. Primary care of HIV infected persons who are receiving HIV care elsewhere,
7. Care and treatment of HIV infected pregnant women,
8. HIV risk reduction education,
9. Legal issues: informed consent, confidentiality, etc.
10. Care and treatment of newborn of HIV infected women,
11. Ongoing pediatric care of HIV infected newborn
12. Community resources for the HIV positive person,
13. Developing service delivery systems for HIV positive women.

Workshops for Los Angeles County Jail System

Description:

This training is targeted for the 500 nurses working with the incarcerated population at the L.A. County Jail. The training is the AETC response to a needs assessment conducted at the L.A. County Jail in conjunction with the L.A. County Incarcerated HIV/AIDS Task Force and the Pacific AETC at USC. L.A. County Jail is one of the largest jails in the world, with an incarcerated population of 21,000 and an average of 700 new inmate admissions daily. (Note: other training for medical providers will also be provided by the AETC at USC, with jail physicians participating in the clinical training program, as well as with on-site education and training programs.)

The training for nurses will consist of bi-monthly training programs conducted on site at the jail. Faculty for this program will be registered nurses or nurse practitioners who serve as faculty for the AETC at USC and who are actively providing care to HIV/AIDS patients at clinics serving large numbers of HIV infected patients. Training focuses on knowledge building on the following topics:

1. HIV/AIDS Overview/Definition of terms,
2. Epidemiology
3. Incarcerated Prevalence/statistics and challenges
4. Medications: Classes, dosing, combinations, side effects,
5. Opportunistic Infections: PCP, Toxoplasmosis, Histoplasmosis, CMV, Cryptoplasmosis,
6. Nutrition

Description:

This training program is a weekly rounds presentation directed toward providers of HIV infected patients throughout the Los Angeles city region. This program has been developed in a collaborative effort with the AETC at USC and two of the primary Ryan White funded clinics in central Los Angeles. The primary objective is to provide the highest caliber of HIV rounds in a central location in Los Angeles to enable active providers to build and maintain "state-recognized" known experts in HIV/AIDS research and care. With a core of providers participating from the largest Ryan White funded clinics, the goal is to broaden this trainee audience to reach providers who are more isolated in their practice and who may not have regular opportunities for ongoing HIV/AIDS educational programs.