Our Priorities New Models for Clinical Education

Typically, many health professions students experience clinical education as a series of brief exposures to patients in hospital settings, where care is more urgent, episodic, and acute. The practice of health care, however, is moving rapidly in a different direction. An increasingly diverse patient population lives longer with chronic disease and the majority of patients are cared for in community clinics, neighborhood health centers, and even the home. While we will always need acute, hospital-based care, we must also prepare physicians, nurses, and other health professionals for team-based, patient-centered, community-oriented health care.

Changing the Status Quo

We support projects to devise, test, and implement new models of clinical education. These initiatives are providing health professions students and residents with more training in outpatient and community settings—places where the majority of health care occurs today.

Building New Skills and Expertise

Medical, nursing, pharmacy, and other health professions schools are developing more clinical training experiences outside of the hospital in order to:

  • Allow learners to develop deeper relationships with patients and their families, their co-workers, and faculty.
  • Help learners develop expertise in caring for patients over extended periods of time—for example, working with patients to manage chronic conditions.  
  • Teach trainees effective communication, collaboration, and relationship-building skills, which are necessary to function successfully as part of the healthcare team and in new settings like patient-centered medical homes.
  • Help students and residents build a richer understanding of the social factors influencing their patients’ health.
  • Expose students to different career paths in healthcare.
  • Better prepare students for careers in primary care or for working collaboratively with persons in primary care.

Overcoming Hurdles to Implementation

Logistical and philosophical challenges involved in integrating new clinical education models include:

  • Identifying new clinical training sites and establishing new institutional partnerships.
  • Influencing accrediting and regulatory standards.
  • Developing faculty skills and experience teaching in non-hospital settings. 

Learn about promising models we’ve funded

Transforming Pediatric Residency Training to Improve Care for Underserved Children

In January 2010, the Josiah Macy Jr. Foundation awarded $500,311 to the American Academy of Pediatrics (AAP) to train pediatricians to care for the unique needs of underserved children and their families.

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Internal-Medicine-Pediatrics Urban Leadership Training Program

The Johns Hopkins Internal-Medicine-Pediatrics Urban Leadership Training Program is a two-phase multi-institutional program that creates a novel residency combining internal medicine and pediatrics to prepare physicians to become leaders in urban primary care in Baltimore and in other cities across the nation.

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Passing the Torch Fostering Medical Humanism Through Faculty Role-Models

In clinical settings, medical students and residents observe and learn from the behaviors and attitudes of more senior residents and attending physicians. To ensure this “hidden curriculum” of medical education is positive, Emory University created and tested a 12-month faculty development program that will help physician-teachers improve their humanistic skills and become better role models for the residents they supervise.

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Education in Pediatrics Across the Continuum – A Competency-based Medical Education Pilot

Since 2010, medical education organizations have been collaborating to carve a new pathway for students interested in pediatrics.

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Increasing Resident Autonomy in the Operating Room

An educational intervention is showing what it takes to help surgical residents practice independently.

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Consortium of Medical Schools with Accelerated Pathway Programs

With support from the Josiah Macy Jr. Foundation, New York University is currently leading a consortium of 12 medical schools (11 US, 1 Canadian) that have established or begun piloting accelerated pathway curricula in order to share best practices.

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Assessing and Improving Medical School Curriculum

Reimagining the third-year clerkship to better prepare the doctors of the future.

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Ensuring Better Training for Physicians and Nurses

In 2009, a program to increase the number of doctors entering rural practice launched in New Roads, Louisiana A town where physicians are in short supply, it is ideal for exposing students to the rigors of practice in an underserved area.

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Building Nurse Leaders to Improve Community Health

A national leadership program is supporting nurses to work with other health professions in the community.

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News and Commentary


2020: A New Decade with New Opportunities

This past year held both triumphant, joyful moments as well as troubling events. Holly Humphrey looks forward into the new decade at how health professionals and the institutions who train them have the...

A Physician Assistant Spearheads an Interprofessional Education Program Spanning the Country

As I became more involved with Yale PA Online, I was struck by the question of: How do you create an environment where students from different professions can learn from each other?

Simulation in PhD Programs (SiPP) to Prepare Nurse Scientists as Social Justice Advocates

Macy Faculty Scholar Coretta Jenerette, PhD, RN, AOCN, CNE, FAAN on preparing nurses to be effective advocates for their patients.

Leveraging Simulation and Telehealth Technology to Empower Family Caregivers of Children with Asthma

Macy Faculty Scholar Cynthia Foronda, PhD, RN, CNE, CHSE, ANEF on closing the critical gap in family caregiver education.


Read Improving Environments for Learning in the Health Professions

David M. Irby, PhD, chaired the April 2018 Macy Conference whose proceedings are recorded in this report, Improving Environments for Learning in the Health Professions.

Read Conference Summary: Improving Environments for Learning in the Health Professions

In April 2018, the Macy Foundation hosted a conference to identify the elements of optimal health professions learning environments and recommend actions needed to better align them with patient needs and societal...

Read Special Report of the President

In a new special report Macy looks back at ten years of progress and accomplishments, and spotlights the people and ideas that will continue to bring about change in health professions education reform.

Read Achieving Competency-Based, Time-Variable Health Professions Education

Catherine R. Lucey, MD, chaired the June 2017 Macy Conference whose proceedings are recorded in this report, Achieving Competency-Based, Time-Variable Health Professions Education.