Partnerships between Academic Health Centers and Area Health Education Centers in developing community-based ambulatory education networks in North Carolina and Texas

Context: Community-based ambulatory education is a key component of curricula in many medical schools in the USA. Challenges to implementation include recruitment of sufficient sites, competition among health professions schools for sites, geographical barriers, and availability of adequate funds. Purpose: In this paper we discuss partnerships developed by East Carolina University School of Medicine and the University of Texas Medical Branch at Galveston with their respective North Carolina and East Texas Area Health Education Center systems. We explain how we addressed the challenges mentioned above. Method: We developed community-based ambulatory education networks in both states by establishing formal offices to coordinate site identification and student placement, and to facilitate communication between health professions schools, course directors, and preceptors. Results: We attribute the positive outcomes of the alliances to enrolling sufficient sites, developing a mechanism for providing preceptor and student support services, implementing community faculty development programs, and developing model interdisciplinary teaching sites. Discussion: Several lessons have been learned. First, community sites with unstable financial and personnel situations are generally unsuitable for educational program development. Second, collaboration is an ongoing task requiring repeated reaffirmation of the shared mission. Finally, collaboration strengthens political representation that may be important to garnering financial support for community-based ambulatory education. Conclusion: The model of collaboration described in this paper may be valuable to other schools that plan to expand community-based education.