Susan E. Cochella
· Professor (Clinical)University of Utah · Family & Preventive Medicine
Active 2003–2025
About
Susan E. Cochella, MD, MPH, is a board-certified family medicine physician specializing in full spectrum care for patients of all ages. She received her medical degree from the University of Nevada and completed her residency at the University of Utah. Additionally, she completed a faculty development fellowship and earned a master’s in public health. Her professional interests include the care of children, adolescents, and young families, with a focus on patient-centered care that prioritizes mental and emotional health. She is also interested in health and workforce policy, leadership skills, and education. Dr. Cochella is recognized for her compassionate, thorough, and patient-focused approach, emphasizing holistic wellness, effective communication, and shared decision-making. Her extensive experience and dedication have earned her high patient satisfaction ratings, and she is known for her ability to build trusting relationships with her patients.
Research topics
- Computer Science
- Psychology
- Medical education
- Medicine
- Artificial Intelligence
- Family medicine
- Pediatrics
- Medical physics
- Physical therapy
- Pedagogy
- Engineering
Selected publications
2025-09-01
articleOpen accessSenior author<h3>Context</h3> Patients increasingly seek mental and behavioral healthcare services in primary care. As such, the ACGME requires integrated mental and behavioral health (MBH) training for family medicine residents. Given limited time and training resources, integrating MBH across the curriculum requires prioritization through identifying the most relevant knowledge and skills to cover. Residency alumni have unique and relevant insight into skill gaps in their own practice and in the workforce that may be addressed through enhanced residency training. <h3>Objective</h3> As part of a HRSA-funded project to enhance MBH training for family medicine residents, we surveyed program alumni about their learning experiences and confidence managing MBH conditions. This study describes the results and application of findings from the alumni survey. <h3>Population studied</h3> Family medicine physicians who graduated from one residency program in the United States. <h3>Study design/analysis</h3> Annual cross-sectional electronic surveys. In the first year (April – July 2024), we surveyed a sample of all program alumni up to the class of 2023. <h3>Results</h3> We delivered surveys via email to 124 alumni and 39 responded (31% response). Alumni were most confident managing MBH concerns commonly seen in primary care (e.g., 80% confident managing mood disorders). Alumni were least confident managing schizophrenia and psychotic disorders (8% confident), using non-medication management techniques like brief counseling on relationships (36% confident), and with crisis intervention for psychiatric emergencies (47% confident). For all areas of lower confidence, participants stated that additional training during residency would have helped their confidence. <h3>Conclusions</h3> Family medicine graduates are confident providing a variety of MBH treatments and services, especially for areas already covered during residency training and for common conditions frequently managed in primary care (e.g., mood disorders). Areas where confidence was lower (e.g., schizophrenia, psychosis) are not as common but have serious impacts. Therefore, residency training on these less common yet critical conditions is important in promoting future physician confidence. These areas represent targets for future training and are being implemented into our residency program’s didactic schedule.
Family Medicine · 2024 · 1 citations
- Computer Science
- Artificial Intelligence
- Medical education
BACKGROUND AND OBJECTIVES: A recognized gap exists between primary care physicians' training in musculoskeletal (MSK) medicine and the burden of MSK complaints in primary care. Family medicine interns often lack adequate baseline MSK physical exam skills, which prompted a proposal to introduce a fourth-year preceptorship to reinforce MSK education. The aim of this study was to prioritize the most important elements to include in this new clinical rotation. METHODS: We employed a three-round, modified Delphi method to derive consensus. Eleven panelists with experience and expertise in MSK training, medical education, or both generated a list of 118 elements. Each panelist then ranked each element by level of importance, and we reviewed the results. The ranking process was repeated two more times with a goal of achieving consensus. RESULTS: Seventy-seven curricular elements (topics, skills, experiences) achieved consensus recommendation by being ranked either "fairly important" or "very important" for inclusion in the curriculum. Twenty-eight items were unanimously ranked "very important," 42 received a mix of "very important" and "fairly important" rankings, and seven received unanimous ranking of "fairly important." Three items were unanimously ranked "neither important nor unimportant." CONCLUSIONS: Longitudinal repetition of physical exam skills, reinforcement of relevant anatomy, and incorporation of specific frameworks for approaching MSK care are important components. Physical examination of the shoulder, knee, back, and hip are especially meaningful clinically.
Family Medicine · 2024-04-30 · 6 citations
articleOpen accessSenior authorBACKGROUND AND OBJECTIVES: Graduate medical education programs need leadership assessments and curricula to engage residents and advance their leadership skills. The Foundational Healthcare Leadership Self-assessment (FHLS) is a validated 21-item self-assessment of leadership skills residents need to be effective team leaders in health care settings. It generates a composite score along five foundational leadership domains: accountability, collaboration, communication, team management, and self-management. Our objective was to determine whether a leadership curriculum, using the FHLS as an educational tool to support self-assessment, self-directed learning, and reflective practice, promotes self-awareness and engagement in leadership development. METHODS: We conducted a qualitative pilot study in the University of Utah Family Medicine Residency Program, integrating the FHLS into our residency's longitudinal leadership curriculum using coaching, self-directed learning, and reflective practice. Family medicine residents completed the FHLS prior to their leadership rotation. Faculty met with each resident during their rotation using a coaching paradigm based on data from the FHLS to inform leadership self-awareness. Residents identified a leadership domain for self-improvement, selected resources for self-study, and submitted a written reflection. We conducted qualitative content analysis on the reflections for evidence of self-awareness and engagement in leadership development. RESULTS: Residents completed 27 leadership rotations between May 2019 and April 2020, generating 21 reflections. Qualitative content analysis of resident reflections grouped by FHLS leadership domains identified evidence of impact on the residents' leadership development. CONCLUSIONS: This qualitative pilot study supports the usefulness of the FHLS within a residency leadership curriculum to promote self-awareness and engagement in leadership development.
BMC Primary Care · 2024-12-21 · 2 citations
articleOpen accessSenior authorBACKGROUND: The treatment gap for mental and behavioral health (MBH) in the United States (US) remains a major public health concern. Given the growing need for a robust MBH workforce, particularly for underserved populations, calls for integrated MBH in primary care have been mounting. Family medicine providers, who know and can treat all members of a family within the same setting, are uniquely positioned to manage MBH conditions. OBJECTIVES: With HRSA funding, the University of Utah Family Medicine Residency (UUFMR) seeks to address gaps in mental health services by enhancing or developing MBH training and partnerships. This protocol describes the project's evaluation. The evaluation aims to identify areas to improve training content, describe training capacity, and assess intermediate outcomes of improved trainings. METHODS: The evaluation consists of three components: analyzing current curriculum and best practices, developing or enhancing trainings with partners, and assessing residents' and graduates' confidence in providing MBH care. RESULTS: The results from this protocol fill gaps in the current literature regarding evaluation methods for provider- and organizational-level outcomes of increased quality and capacity of residency training in MBH. Further, the results provide practical guidance for other residencies seeking to integrate MBH training into their curriculum. CONCLUSION: Considering the resources committed to the ongoing enhancement of resident education, it is crucial to evaluate the implementation and outcomes of improvements to ensure that limited resources are well-utilized. Assessing the training capacity developed through collaboration supports progress toward creating a high-quality, accessible, and integrated mental and behavioral healthcare system in primary care.
Critical Evaluation of Behavioral Health Curriculum in a Family Medicine Residency Program
2023-11-01
articleOpen accessSenior author<h3>Context:</h3> Family Medicine physicians play a crucial role in providing mental health treatment. Given that individuals with mental and behavioral health diagnoses access both primary care and hospital-based services at greater rates than individuals without these diagnoses, it is critical that family medicine residents complete their training fully prepared to treat the mental healthcare needs of underserved populations. <h3>Objective:</h3> This study aims to analyze curriculum to better understand the integration of behavioral health training during the family medicine residency. <h3>Study design and analysis:</h3> To evaluate the existing curriculum, researchers conducted a formative assessment. Using a Delphi technique, we created a 3-point Likert scale that defined inclusion and exclusion criteria for the curriculum to be assessed. Didactics and rotations that were identified as relating to behavioral health were expertly reviewed, focusing on trainings that do not adequately address existing guidelines for behavioral health training in family medicine. <h3>Setting:</h3> A family medicine residency program at a large academic medical institution in the Mountain West. <h3>Outcome measures:</h3> The robust integration of behavioral health training during family medicine residency. <h3>Results:</h3> Behavioral health training exists in the family medicine residency but is scattered across the curriculum (e.g., didactics and rotations). Existing behavioral health curriculum is largely focused on psychiatry and not family medicine. Additionally, the current version of the curriculum focuses on single adult mental health, with gaps in focus on children’s mental health and the role of families. Trainings on critical topics such as suicide prevention and trauma-informed care are present but are not integrated throughout the curriculum. Further, while residents treat vulnerable and underserved groups, the focus has been on medical care without integration of mental and behavioral health. Finally, there are not strong relationships with multiple community partners to tailor trainings to specific patient groups. <h3>Conclusions:</h3> Our findings highlight the need for an integrated and longitudinal behavioral health curriculum with a strong emphasis on community involvement so residents are well prepared to meet the mental and behavioral healthcare needs of their patients.
PRiMER · 2023 · 7 citations
- Medical education
- Family medicine
- Psychology
Background: Virtual recruitment for all residency programs was endorsed by the Accreditation Council for Graduate Medical Education (ACGME) for the 2021 and 2022 recruitment seasons. This study assesses the impact of virtual recruitment on cost and outcome in a family medicine residency program. Methods: We assessed program recruitment costs and interview-day time with applicants in one program for the 2019 to 2022 recruitment seasons, and we sent an anonymous survey to interviewed applicants (n=98) for the 2022 match year. In-person interviews were conducted in 2019 and 2020. Virtual interviews were conducted in 2021 and 2022. Results: Program recruitment costs decreased from over $70,000 annually for in-person interview seasons to between $10,000 and $20,000 annually for the virtual interview years. Applicant time with the program on interview days decreased from 515 minutes when held in-person, to 345 minutes when virtual. Applicants expressed that they were generally satisfied with the virtual interview format though their preference for the virtual format was only slightly greater than for in-person interviews (38.6% and 35.1%, respectively); 26.3% of the responding applicants had no preference for either format. During virtual interview years, applicants interviewed at an average of 16.6 programs with 80% indicating that virtual interviews allowed for consideration of more programs. Conclusion: The virtual interview format was associated with decreased interview-day costs for programs and interviewees, and decreased time on interview days for both groups. It allowed applicants to consider more programs.
Teaching Self-directed Learning Skills Through a Resident-Led Milestones Process
PRiMER · 2022 · 1 citations
- Computer Science
- Medical education
- Psychology
Introduction: The Accreditation Council for Graduate Medical Education allows flexibility for resident roles in the Milestone assessment process. The University of Utah Family Medicine Residency implemented a resident-led Milestones process to cultivate the skill of self-assessment and promote resident ownership of their learning. Methods: Residents were provided comprehensive evaluation data and asked to self-assess their competency on each Milestone, with input from their advisor. Residents presented their self-assessment to the Clinical Competency Committee, who then determined the final score for each Milestone. A 10-question survey examined perceptions of the resident-led Milestones process by residents and faculty. We calculated means and standard deviations (SD). Results: A total of 16 of 24 residents (67% response rate) and 12 of 14 faculty (86% response rate) completed the survey. Residents agreed most highly with the following statements: "I have good support from my advisor in being prepared to lead my Milestones meeting," "I am actively engaged in guiding the development of my own Milestones ratings," and "Leading my Milestones meeting assists me in accurately self-assessing my progress." Residents showed high agreement that "My final Milestones scores accurately reflect my behavior and level of knowledge." Residents rated the stress as low, in response to the statement, "My Milestones meeting is stressful for me." Faculty responses were similar but tended toward lower scores than residents. Conclusion: The resident-led Milestones process engages residents actively in self-assessment. Residents and faculty believe the process provides accurate assessment results without undue stress; this process potentially increases residents' ability to understand their own learning needs and direct their own learning process.
Pediatrics: A Case-Based Review
Family Medicine · 2020-06-05
reviewOpen access1st authorCorrespondingDevelopment and Validation of the Foundational Healthcare Leadership Self-assessment
Family Medicine · 2018-04-06 · 12 citations
articleOpen accessBACKGROUND AND OBJECTIVES: We sought to develop and validate a self-assessment of foundational leadership skills for early-career physicians. METHODS: We developed a leadership self-assessment from a compilation of materials on health care leadership skills. A sequential exploratory study was conducted using qualitative and quantitative analysis for face, content, and construct validity of the self-assessment. First, two focus groups were conducted with leaders in medicine and family medicine residents, to refine the pilot self-assessment. The self-assessment pilot was then tested with family medicine residents across the country, and the results were quantitatively evaluated with principal component analysis. This data was used to reduce and group the statements into leadership domains for the final self-assessment. RESULTS: Twenty-two invited family medicine residency programs agreed to distribute the survey. A total of 163 family medicine residents completed the survey, representing 16 to 20 residency programs from 12 states (response rate 28.9% to 34.8%). Analysis showed important differences by residency year, with more advanced residents scoring higher. The analysis reduced the number of items from 33 on the pilot assessment to 21 on the final assessment, which the authors titled the Foundational Healthcare Leadership Self-assessment (FHLS). The 21 items were grouped into five leadership domains: accountability, collaboration, communication, team management, and self-management. CONCLUSIONS: The FHLS is a validated 21-item self-assessment of foundational leadership skills for early career physicians. It takes less than 5 minutes to complete, and quantifies skill within five domains of foundational leadership. The FHLS is a first step in developing educational and evaluative assessments for training medical residents as clinician leaders.
Collaborative Skills Essential to Leadership
Family Medicine · 2018-10-02 · 1 citations
letterOpen access
Frequent coauthors
- 7 shared
Sonja Van Hala
University of Utah
- 5 shared
Katherine T. Fortenberry
- 4 shared
Roberto Avant‐Mier
- 4 shared
Sarah E. Croskell
University of Utah
- 4 shared
Joseph B. Stanford
Utah Department of Health
- 4 shared
Dominik Ose
- 4 shared
Stephen C. Alder
University of Utah
- 3 shared
Dan Sepdeham
The University of Texas Health Science Center at Houston
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