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Tufts Health Care Institute (THCI) organized the Mini-Rotation on the Health Care System as an interactive seminar: four days at one location, with participants—many of whom traveled from outside of Massachusetts—required to attend all sessions and to be excused from their routine clinical and training responsibilities. We held the course in meeting spaces at our partnering organization, Tufts Health Plan, which offered conference rooms and audio-visual support. To keep the sessions interactive, attendance was limited to 25 residents in a suitable conference room. Small breakout group exercises were conducted in nearby meeting rooms. Depending on the topic, a number of health plan medical directors and executives also participated as seminar faculty, in addition to experts from other organizations.

The course consisted of a series of learning sessions: experts delivering presentations and conducting discussions on key topics. THCI scheduled 60- to 90-minute sessions for each presenter and longer for panels. Alternative approaches may be adopted to organize these topics and sessions. The format, duration, and sequencing of the Mini-Rotation are all flexible.

For instance:

  • The course can be structured as a block rotation, in which the residents devote several consecutive days to the sessions (as in the THCI course). Organizers need to select dates that make sense for the program(s) from which the learners are drawn.
  • An alternative is a longitudinal rotation, in which the sessions are interspersed with the residents’ other activities. Sessions might be scheduled weekly, twice a month, or monthly.
  • Regarding location, all sessions might be held in the offices of a partnering organization if one is engaged; certain sessions can be scheduled in the locations where the presenters work; or sessions can take place in the hospital or clinical site where the residents are practicing.
  • Clearly, the course schedule and location(s) will depend on who is organizing the course and for which residents. Is it for a single training program, multiple programs at the same institution, or residents at multiple institutions?
  • An alternative to live sessions, as a substitute or complement, is online training. Videos of presentations and/or reading materials can be posted online, with follow-up sessions in which faculty discuss the information with residents.
  • Beyond the individual sessions and presentations, it is ideal to frame the entire series or course as an integrated learning experience. This is reinforced by defining goals and objectives for the full course, grouping sessions around overarching themes, and engaging one course director, or two co-directors, to introduce the themes and topics, highlight the issues, and moderate discussions.
  • Finally, programs and course organizers may choose to focus on only one of the thematic systems-based topics that THCI’s Mini-Rotation covered, due to local conditions and/or constraints and needs. Similar issues related to faculty recruitment, materials and course direction would apply.


THCI’s direct expenses for conducting the Mini-Rotation in 2015 were under $2,000 per day. These expenses included food, course materials, and videotaping selected presentations. Meeting space was donated by the partnering organization, Tufts Health Plan. Course directors and faculty members provided their time and expertise free of charge. We found that the physicians and administrative leaders we recruited enjoyed interacting with physicians-in-training, and they were pleased to be able to share their knowledge and experience.