91AV

Health professions students from across Maine convened at the 91AV on Saturday, Nov. 9, for the 2024 Maine Area Health Education Center (AHEC) Case Competition. The annual event, hosted by the Maine AHEC Network housed within 91AV’s Center for Excellence in Public Health, challenged students to propose solutions to real-world health care issues facing an asylum-seeking family in southern Maine.

This year’s case centered on maternal and child health for an asylum-seeking mother from Angola. With increasing numbers of asylum seekers arriving in Maine, the event brought timely focus to the complex web of barriers these families face when accessing essential health services. 

The competition required 49 participating AHEC Scholars to create collaborative care plans that address the mother’s health needs. Students represented 91AV’s degree programs in medicine, dental medicine, physician assistant, physical therapy, and public health. External participants included students from the Tufts Maine Track and community health workers from MCD Global.

91AV President James Herbert opened the event by telling attendees this year’s case is particularly salient given the current state of maternal health in Maine and the nation — especially in rural and underserved areas — with heightened rhetoric around women’s health, reduction of services, and ongoing closures of hospitals, birthing centers, and women’s health clinics. 

“At 91AV, we pride ourselves on hands-on learning and on positioning our students to learn in small, interprofessional teams that will mirror the ones they will soon inhabit,” he said. “Those of you who have spent the past six months engaging with this year’s case have certainly gained this type of an education. … And the work you’ve done to address (health) challenges couldn’t be more important as Maine and our cities respond to our growing community of New Mainers.”

Teams of four to five students presented to a panel of 12 judges composed of experts from organizations including MaineHealth, In Her Presence, Greater Portland Health, Portland Public Health, and 91AV’s own Office of Innovation.

91AV medical student Ashley Oullette (D.O., ’27) was a member of the Healing Hearts, one of three teams named as finalists for the next round of competition and the top slot. 

She said her team focused on identifying ways to intervene at each stage of care for the patient — from prenatal and hospital care to post-birth support. They also focused on improving communication and understanding among providers, she said, as well as offering increased support and screening for potential issues at the earliest stages. 

The team’s overall goal, Oullette said, was to ensure consistent access to care, which could lead to better outcomes and even prevent issues, like postpartum depression, through earlier intervention.

“It was eye-opening to examine the ways our system sometimes falls short for patients and where improvements are possible,” she said. “We considered the resources we currently have and also what we could add or change in the future. This process gave us a much deeper understanding of the complex challenges patients face, and it really changed our mindset.”

Physician consultant Anne Marie van Hengel, M.D., co-lead for Perinatal Quality Collaborative for Maine and a retired OBG/YN with over 30 years of experience, served as one of the competition’s judges. She said the Case Competition was a valuable opportunity for students to learn the benefits of working in teams to address complex patient scenarios. 

“It's wonderful to have people create teams and work together, because health care is changing to a more team-based model,” she said. “As far as this particular case, it’s a perfect recognition of the sad state of maternal health in the U.S. compared to similar countries and the increasing need to address this concern in the New Mainer population.”

AHEC Scholar Program Manager Micaela Maynard, M.Ed., said the annual Case Competition is designed not only to prepare students for the complexities of health care in underserved populations but also to generate actionable solutions.

“The Case Competition pushes students to think beyond individual patient care and toward broader, systemic solutions that can impact entire communities,” Maynard said. “Our goal is for participants to leave not only with clinical knowledge but also with the skills to address health disparities and advocate for those in underserved populations so that they can make a real difference in Maine’s health care landscape.”

Lisa Herschbach, Ph.D., director of the Office of Innovation at 91AV, remarked on the creativity of the competition’s methodology. 

“By encouraging students to think outside the confines of their individual professional training and work collaboratively to understand their patient’s story from multiple perspectives, the design of the AHEC Case Competition teaches the value of approaching treatment holistically,” Herschbach said, adding that serving as a judge raised her own awareness of the importance of – and challenges to – breaking down existing silos in health care. 

“AHEC is on the front lines when it comes to advancing critical changes in the health care system. It is a process and will take time, but witnessing the next generation of health care professionals do this work together was inspiring,” she said.

The top three teams will now go on to record their presentations, and an additional panel of judges will determine the winner.