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Health Resources and Services Administration
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Academic Year: 2023-2024
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Bureau of Health Workforce
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OMB Number: 0906-0086
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Annual Performance Report
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OMB Expiration Date: 03/31/2027
EXP-2: Experiential Characteristics - Trainees by Profession/Discipline
EXP-2 - Selecting Training Program and Site NameWarning Multiple steps are required to complete this portion of the subform. Please read instructions carefully. Figure 1. EXP-2 - Selecting Training Program and Site Name
Type of Training Program: Select a training program by clicking on the drop-down menu in Column 1 and choosing one of the available residency program options (marked on the Training Program Setup Form as “active” in the annual reporting period).Site Name: Pair the selected training program with a site name by clicking on the drop-down menu in Column 2 (Block 1) and choosing one of the available options (sites that were marked in EXP-1 as “used” in the annual reporting period). Repeat this process until all used Training Program/Site combinations used in EXP-2 are present. Note The EXP-2 form will initially appear blank. |
EXP-2 - Selecting Profession and Discipline/Specialty of Individuals Trained Figure 2. EXP-2 - Selecting Profession and Discipline/Specialty of Individuals Trained
Select Profession of Individuals Trained: Select the individual’s profession by clicking on the drop-down menu in Column 3 and selecting one of the available options. - Allied Health
- Allied Health - Student
- Behavioral Health
- Behavioral Health - Student
- Dentistry
- Dentistry - Student
- Medicine
- Medicine - Student
- Nursing
- Nursing - Student
- Other
- Other - Student
- Paraprofessional
- Paraprofessional - Student
- Physician Assistant
- Physician Assistant - Student
- Public Health
- Public Health - Student
Select Discipline/Specialty of Individuals Trained: Select the individual’s discipline/specialty by clicking on the drop-down menu in Column 3a and choosing from one of the available options. Please note that you must select a discipline/specialty that is associated with the profession you selected in Column 26c. The disciplines/specialties are organized by profession in the drop-down; please scroll to find the correct option. Example: If you are reporting on an individual who is a Plastic Surgeon, the Individual’s Profession would be “Medicine” and the Individual’s Discipline/Specialty would be “Plastic Surgery”.
Example: If you are reporting on an individual who is studying to be an Occupational Therapist, the Individual’s Profession would be “Allied Health – Student” and the Individual’s Discipline/Specialty would be “Occupational Therapy”. Example: If you are reporting on an individual who is a Clinical Social Worker, the Individual’s Profession would be “Behavioral Health” and the Individual’s Discipline/Specialty would be “Clinical Social Work”. |
EXP-2 - Entering # Trained in the Profession and Discipline Figure 3. EXP-2 - Entering # Trained in the Profession and Discipline
Enter # Trained in this Profession and Discipline: For each row, enter the number of "Principal" trainees, your residents, in the profession and discipline listed. Note Principal residents are those who were directly or indirectly supported through your grant. For your grant program, these are the individuals reported on the INDGEN form. |
EXP-2 - Entering # of Other Interprofessional trainees who participated in team-based care Figure 4. EXP-2 - Entering # of Other Interprofessional trainees who participated in team-based care
Enter # of Other Trainees in this Profession and Discipline Who Participated in Interprofessional Team-based care: For each row, enter the number of all "Other Interprofessional" trainees in each profession and discipline listed. Warning Do not count faculty or non-trainees. Note “Other Interprofessional” trainees are those individuals who trained at the same site on an interdisciplinary team with your principal trainees, but who did not received support from or have an association with your HRSA grant |
EXP-2 - Adding Individuals Trained Example 1Principal Residents ONLY (no interprofessional trainees) In this example, the medical residents from the Family Medicine residency program do not have interprofessional experiences. The medical residents trained at 3 different clinical training sites. At the first site, there were 24 Family Medicine residents and no interprofessional trainees at North Regional Hospital. At the second site, there were 10 Family Medicine residents and no interprofessional trainees at Community Physicians. At the third site, there were 4 Family Medicine residents and no interprofessional trainees at the Doctor’s Clinic. Figure 5. EXP-2 - Adding Individuals Trained Example 1
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EXP-2 - Adding Individuals Trained Example 2 Principal AND Interprofessional Trainees In the example on this page, the Residency in Family Medicine program trained 24 of its family medicine residents at North Regional Hospital. As part of Interprofessional team-based care, the Family Medicine residency program also trained 2 Internal Medicine residents and 3 graduate students in psychology. At a second site, the Family Medicine residency trained 14 of its medical residents alongside 4 pharmacy students who were part of interprofessional team-based care.
Figure 6. EXP-2 - Adding Individuals Trained Example 2
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EXP-2 - Adding Individuals Trained Example 3Principal AND Interprofessional Trainees In the example on this page, the Family Medicine residency program trained 24 of its own medical residents at North Regional Hospital. As part of Interprofessional team-based care, the Family Medicine residency also trained 10 Family Medicine residents from non-HRSA funded residency programs, 2 Internal Medicine residents and 5 pharmacy students. At a second site, the Family Medicine residency trained 10 of its own medical residents alongside 8 additional Family Medicine residents from different Family Medicine residency programs as well as 4 physical therapy students who were part of interprofessional team-based care.
Figure 7. EXP-2 - Adding Individuals Trained Example 3
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EXP-2 - Selecting Type of Site Used Figure 8. EXP-2 - Selecting Type of Site Used
Select Type of Site Used: Following the selection of a training site in EXP-1, the associated type of site will be automatically populated when the save and validate button is selected. - Academic institution
- Acute Care for the Elderly (ACE) Units
- Acute care services
- Aerospace operations setting
- Ambulatory practice sites
- Assisted Living Community
- Community Behavioral Health Center
- Certified Community Behavioral Health Clinic (CCBHC)
- Community Health Center (CHC)
- Community Care Programs for Elderly Mentally Challenged Individuals
- Community-based Organization
- Critical Access Hospital
- Day and Home Care Programs (e.g. Home Health)
- Dentist Office
- Emergency Room
- Federal and State Bureau of Prisons
- Federal Government - Other
- FQHC or look-alike
- Hospice
- Hospital
- National health association
- Independent Living Facility
- Indian Health Service (IHS) Site
- International Nonprofit/Nongovernmental Organization
- Local Government Office or Agency
- Local Health Department
- Long-Term Care Facility
- Mobile Clinic/Site
- Nurse Managed Health Clinics
- Nursing Home
- Other
- Other Community Health Center (e.g. free clinic)
- Other Oral Health Facility
- Physician Office
- Surgery Clinic
- Program of All Inclusive Care for the Elderly
- Veterans Affairs Healthcare (e.g. VA Hospital or clinic)
- Residential Living Facility
- Rural Health Clinic
- School-based Clinic
- Senior Centers
- Specialty Clinics (e.g. mental health practice/rehabilitation/substance abuse clinic)
- State Government Office or Agency
- State Health Department
- Tribal Government
- Tribal Health Department
- Tribal Organization
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EXP-2 - Selecting Type of Setting Where the Site was Located Figure 9. EXP-2 - Selecting Type of Setting Where the Site was Located
Select Type of Setting Where the Site was Located: Following the selection of a training site in EXP-1, the associated settings will be automatically populated when the save and validate button is selected. - Medically underserved community
- Primary Care Setting
- Rural area
- None of the above
To Complete the Form: Click on the “Save and Validate” button located on the bottom right corner of your screen. If no errors are found, the BPMH system will automatically route you to the next required subform. |
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