About the LEAP Fellowship
Local Implementation of the LEAP Program
LEAP program components
A LEAP fellow participates in four distinct activities during the year-long program: a longitudinal project, a directed set of experiences (subsequently termed “the experiential curriculum”), an intensive mentorship and a supplementary didactic curriculum. The following sections describe what each component entails, its purpose in terms of fellow development and implementation commentary for potential modifications and nuances.
• Experiential curriculum: All LEAP fellows are instructed to engage in what is termed the “LEAP experiential curriculum” throughout the fellowship year, using their contacts at the health department, hospital medical leadership, hospital epidemiology and hospital antimicrobial stewardship programs to participate in a number of activities unique to those fields. A listing of activities is provided (see the experiential curriculum document below) to the fellows to provide a baseline foundation of exposure to each field, though fellows are encouraged to explore activities outside of the list as well. The curriculum document is broken down into core and supplemental experiences, to help fellows prioritize which activities to get involved in. Fellows are not expected to have continuous involvement in all activities (unless they desire to do so) but are instructed to be involved for long enough to understand the activity, its role and function, the underlying principles, and how they relate to other associated activities.
• Longitudinal project: Fellows are required to have at least one personal project (where they are acting as the primary driving force for completion) that spans most of their LEAP year. It does not specifically need to be research focused, as quality improvement projects are also accepted. What is required is that they focus on at least one of the three major LEAP areas of focus (epidemiology, antimicrobial stewardship or public health). The national LEAP fellowship requires that a proposed project be submitted alongside the fellowship application.
○ Purpose – The longitudinal project is not intended to lead to a research product or publication. Instead, it is used as a learning experience to teach the fellow the planning, troubleshooting and leadership skills required to carry larger and more complex projects to completion. It is common that the fellow’s project will encounter roadblocks and other difficulties, requiring the fellow to troubleshoot, replan, reschedule, redesign and potentially revisit whether a project is feasible at all. It is for this reason that the national LEAP program does not place any expectations of abstract submission or publication of the project on the fellows.
○ Initial proposal – Applicants to the national LEAP program are expected to provide a proposal for their longitudinal project alongside their other application documents. These proposals are evaluated alongside the other documents; they must target at least one of the three major LEAP areas of focus (epidemiology, antimicrobial stewardship or public health). They must also be feasible during the one-year fellowship timeframe. Proposals that are innovative or that address timely public health concerns are scored higher on applications, and in general preference is given to projects that involve the public health department in one fashion or another (such as utilizing data from the public health department or focusing on a notable department priority).
○ Project modifications – Given the expectation that longitudinal projects will encounter unexpected issues, the national LEAP program advises fellows to frequently discuss their projects with their mentors and frequently assess and revise their projects. It is requested that for major revisions to their project (such as fully changing aims, or major changes to scope), the fellow submit a quick notification and rationale to LEAP program leadership in order to make them aware of the change. If major issues are encountered that may require abandonment of the original project, fellows are requested to submit an alternative project proposal that they plan to engage in for the remainder of the fellowship year.
○ Project monitoring – Multiple mechanisms are used by LEAP to ensure that issues with fellow projects are detected and addressed as early as possible. The primary mechanism is through the fellow/mentor relationships. Fellows and their mentors are instructed to discuss the longitudinal project at each mentoring session, specifically focusing on any current or potential barriers. Fellows and mentors are instructed to brainstorm possible solutions and, if additional assistance is needed, to notify the LEAP program leadership as soon as possible if higher level troubleshooting is necessary. Additional monitoring is performed through the “mid-point report” (see form here) that fellows are requested to complete approximately six months into the fellowship year. This mid-point report is intended to identify if any major changes have been made to the fellow project that the LEAP program leadership is unaware of and specifically requests that fellows identify barriers that they have encountered. Program leadership is then able to follow up with the fellow if there are any concerning statements.
○ Final presentation – The national LEAP program instructs fellows that there will be a post-fellowship presentation of their LEAP experiences at a national ID conference. Presentations are not expected to focus solely on the longitudinal project, though many fellows choose to do so. To highlight the educational intent of the longitudinal project, fellows are instructed to attempt to discuss barriers encountered and discuss ways they were (or were not) able to overcome them.
○ Implementation comment: It may be useful to have the health department partner identify achievable or priority projects for applicants to select for their longitudinal project, rather than require applicants to submit a de novo project proposal.
○ Purpose – The core principle behind the LEAP fellowship is that career development and preparation is done best through direct experience, and this is seen nowhere more than the experiential curriculum. While academic literature exists on public health, antimicrobial stewardship and health care epidemiology, very little of that goes into significant depths on the day-to-day activities or organizational structures and nuances that are part of being an effective part of those organizations. Direct involvement allows the fellow to learn unwritten details about how these activities are performed, get local expertise in terms of who is involved and ask them questions in the moment, as well as provide their own manpower and expertise to these activities. This also has the side benefit of potentially growing the trust and relationships between health department personnel and ID physicians and the academic ID program.
○ Core experiences – These experiences are vital for the fellow’s training during the LEAP year. They are either extremely common or extremely important activities in each domain.
○ Supplemental experiences – These are experiences that fellows should be on the lookout for and that may be extremely helpful to participate in. Supplemental experiences may not always be available at every single training site and are thus not considered mandatory; however, fellows with greater interest in a domain may want to try and seek out these supplemental experiences to gain a greater understanding of the topic.
○ Supporting literature – Each domain of activity includes references that are either foundational texts on the topic or provide significant theory or practical information. These are tailored to preference freely available resources where possible.
○ Curriculum monitoring – Fellows are largely expected to self-monitor their level of engagement with the experiential curriculum and any specific activities therein. It is expected and desired that each fellow will want more relatively shallow exposure to some activities, while they will want to delve deeper into those closer to their areas of interest. The national LEAP program does not track fellows’ progress through the experiential curriculum in detail, as that was considered likely to cause a burdensome documentation requirement on the fellows. To identify and troubleshoot problems, fellows and their mentors are instructed to discuss their experiential curriculum activities during their mentoring sessions, with particular attention to any difficulties a fellow is having in accessing specific activities of interest so that these can be escalated to the LEAP program leadership for higher level management.
○ Experiential curriculum document
○ Implementation comment
■ Constructive fellow engagement with their experiential curriculum activities is encouraged in part through monthly teleconferencing meetings between fellows where they are instructed to present on one interesting or unique element drawn from one of their curriculum activities.
■ The experiential curriculum is intended to evolve alongside the LEAP fellowship. At the end of each fellowship year, fellows are given the opportunity to provide feedback regarding which curriculum activities were useful to them, and those that were not, as well as new activities they suggest should be in the curriculum document (often unexpected experiences and activities, based on the current public health priorities).
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