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Academic Internal Medicine Week 2017 Workshop Descriptions

Workshop Session I

Workshop Session II

Workshop Session III

Workshop Session IV

Workshop Session V

Workshop Session VI

All workshops will be filled on a first-come, first-served basis; all rooms will be set for maximum capacity.

Pre-registering for a workshop does not guarantee a reserved seat in that workshop.

Download all workshop descriptions for Academic Internal Medicine Week 2017 (PDF).

Workshop Session I
Monday, March 20, 2017
9:45 a.m. to 11:15 a.m.

AIM Educational Conference—101. Preparing for the Future: Redesigning Your Teaching Service for Value-Based Care
Academic health center leadership views the teaching services as products of ACGME rules and established dogma for the “right way” to teach residents. However, these models have a significant impact in the context of value-based care. The medicine teaching service was not aligned with value-based care. We developed and successfully implemented a new teaching service model which began with engagement from patients and hospital administration. The new model consists of teams of faculty and residents who care for patients across a continuum and work together for the duration of the resident’s training with an empaneled patient population. To improve efficiency and inter-professional communication each care team was “geolocalized” to a designated unit. To reduce handoffs and transitions in care, resident schedules were optimized to allow for admissions to each team, day and night. In the outpatient setting the same team worked together to care for their empaneled patients. Since implementation of our system we have seen improvements in our adjusted length of stay, readmission rates, and patient and staff satisfaction. We have developed strategies that have been effective for undertaking a large transformational change and hope to share them with workshop participants.

Educational Objectives:

  • Outline a patient- and family-centered approach to redesigning the medicine teaching service within your hospital.
  • Illustrate the benefits of redesigning the teaching service around team-based care, value added handoffs, and use of nocturnalists.
  • Learn strategies to engage leadership and successfully complete a transformational change.

Lindsay Sonstein
Leah Low
Erin Hommel
Jay Torres
University of Texas Medical Branch at Galveston

AIM Educational Conference—102. Improving the Patient Experience with Technology
The goal of this presentation is to share with administrators and physicians how the implementation of technologies can transform your clinical practice. We will show the data on our patient experience scores and to see how they were transformed when we implemented JabFab, a web-based patient communication tool.

Educational Objectives:

  • Explain how JabFab works with our clinical mission.
  • Show how JabFab gave us the ability to make real-time decisions regarding patient issues.
  • Show data that supports the transformation in our patient experience score with the implementation of technologies.

Craig DeGarmo
Rashida Toy
Georgetown University School of Medicine

AIM Educational Conference—103.  Present Yourself Powerfully: Create Your Presence
In the session you will learn how to create a powerful presence that builds rapport with your audience.   Learn the difference between insecure versus confident gestures.  Learn a way to communicate complex information to your audience.  Realize that the impact of your message is determined by:
What you say...and how you say it. How you look...and what you do!

Educational Objectives:

  • Words express info – Vocal and non-verbal drive the delivery of message
  • Develop rapport with your audience and increase engagement
  • Learn to speak with your audience not at them
  • Learn how changing your body language can change your delivery

Diane Beliveau
Dale Carnegie Institute

APDIM Spring Meeting—104. Implementing Universal Mental Health Screening into a 360 Degree Wellness Curriculum for Internal Medicine Residents
Resident physician wellness and prevention of burnout has recently become an area of great concern and research.  Up to 90% of residents experience burnout at some point during their training and up to 50% of internal medicine residents experience depression.  In addition, physician burnout has been tied to suicide, substance abuse, and adverse patient outcomes.  ACGME has made burnout and physician wellness one of the main areas of focus and innovation.  We have implemented a wellness curriculum which addresses physical health, emotional health, and social support and engagement.  This workshop will explain our curricular initiatives in detail as well as allow time for sharing of other ideas by audience members.  In particular, we will discuss universal mental health screening for all residents to decrease the stigma and remove barriers to mental health care.  Survey data on resident attitudes toward universal mental health screening will be presented.  We will also describe the formation of a peer discussion group to foster humanism and reflection.  We will examine challenges that we have encountered including administration “buy-in.” There will be time for audience members to share their concerns and difficulties of implementing their own wellness curriculum. 

Educational Objectives:

  • Identify the components of a wellness curriculum and discuss ways to implement each component, including humanism and reflection.
  • Discuss the utility of universal mental health screening for all residents to decrease the stigma and minimize barriers to mental health care.
  • Examine resident attitudes about the effectiveness of wellness initiatives. 

Sarah Sofka, MD
Nathan Lerfald, MD
Laura Davisson, MD
Carl Grey, MD
West Virginia University School of Medicine

APDIM Spring Meeting—105. Extreme Makeover: Journal Club Edition—How to Bring Your Journal Club into the 21st Century
Journal club (JC) is a well-known and nearly universal educational strategy in postgraduate medical education to teach evidence-based medicine (EBM), specifically the skill of critical appraisal and application of the medical literature as highlighted by the ACGME competency of practice-based learning and improvement. Traditional JC formats usually involve expert discussants addressing strengths, weaknesses, and clinical application of selected articles. However, this format may not be the most ideal strategy to engage residents, as selected articles may not be relevant or applicable to resident typical clinical practice and active learner participation may be variable. As a result, JC may suffer from poor attendance and learner dissatisfaction and may have little impact on knowledge or skills in EBM.

From 2015 to 2016, the University of Chicago internal medicine residency program restructured JC to address these deficits. The new format, “Clinical Challenges in Internal Medicine,” focuses on clinical questions that commonly arise in daily clinical practice, fosters resident-driven overview and critical appraisal of two distinct articles addressing a clinical question, and engages residents in active comparison and application of the evidence to the clinical problem at hand. This workshop will review elements of successful JCs as described by the limited available literature on this subject as well as evaluation methods that may be linked to milestones. We will share tips and strategies from our pilot experience to illustrate how to successfully revamp JC and describe a structured JC format that is easily adaptable for use at different programs and with multiple levels of learners.

Educational Objectives:

  • Identify the elements of a successful journal club as described by the literature and reflect on the presence or absence of these elements in their program’s journal club structure.
  • Acquire tools to improve their program’s journal club by adapting a structured journal club format to the needs and practices of their own programs.
  • Describe how to incorporate evaluation methods for journal club at their programs and how to link these methods to ACGME milestones in problem-based learning and improvement.

Shannon K. Martin, MD
Jason Alexander, MD
Shalini T. Reddy, MD
University of Chicago Division of the Biological Sciences Pritzker School of Medicine

Patrick Lyons, MD
Washington University in St. Louis School of Medicine

Charlie Wray, DO
University of California-San Francisco School of Medicine

APDIM Spring Meeting—106. The First Step in Remediating Struggling Learners: Completing an Individual Learing Plans (ILPS) and Coaching Based on Self-Determination Theory
Faculty often struggle with a systematic approach to identify the best course of remediation for learners who may be struggling in a competency-based program of education. Emphasizing a learner-centered approach based on Malcolm Knowles adult learning theory, we describe our process to aid residents and students who have been identified in need of remediation for any of the six general competencies of patient care: medical knowledge, interpersonal communication skills, professionalism, practice-based learning and improvement, and systems-based practice. We begin with learner developed individual learning plans (ILP) and then provide faculty development for assigned mentors using coaching techniques based on self-determination theory and the commitment to change model. We demonstrate how learners are instructed to complete an ILP by developing specific goals and objectives using the ISMART approach: important, specific, measurable, accountable, realistic, and timely. Attendees are also provided instruction in completing a well-designed ILP. Attendees are provided additional coaching techniques using self-determination theory, a comprehensive theory of human behavior that indicates all people have intrinsic tendencies to meet three basic psychological needs: autonomy, competency (or mastery), and relatedness (or a sense of purpose). Finally, faculty are also instructed in using the two-step process of the Commitment to Change model to guide subsequent meetings with learners to assess the effectiveness and revise the original ILPs.

Educational Objectives:

  • Implement an ILP for struggling learners that ensures goals and objectives are constructed using the ISMART approach.
  • Use coaching techniques to motivate learners based on self-determination theory (SDT).
  • Use the two step process of the Commitment to Change (CTC) model to assess the effectiveness of the original ILP and revise if necessary.

Lawrence K. Loo, MD
Sonny Lee, MD
Tamara Shankel, MD
Loma Linda University School of Medicine

APDIM Spring Meeting—107. Engaging Learners and Leadership through an Innovative and Longitudinal QI and PS Curriculum
Through a complementary approach, we prioritize quality improvement (QI) and patient safety (PS) education within the residency program as a whole as well as with facility-specific programs. Inspiring residents to become better leaders in improving health care requires an innovative and multi-pronged approach and ours is adaptable to other internal medicine programs. There are three facility-specific components of this curriculum. Our “Better Week” consists of four one-week blocks throughout the PGY-2 and PGY-3 schedule, each occurring during the five-week months throughout the year. The focus of “Better Week” is interactive teaching of health care QI and PS concepts, training on how to perform a thorough audit of a faulty process or patient safety event, and learning to design, implement, present, and disseminate a project. Our QI and PS faculty champions and engages residents help plan and present quarterly multidisciplinary case-based patient safety conferences as part of their work on the GME QI and PS subcommittee, discussing concepts such as adverse event identification and reporting, team dynamics, and transitions of care. With institutional leadership buy-in, our “High Value Idea Competition” encourages trainees to submit a feasible idea to improve the value of the care they provide. Top ideas are chosen and trainees given the tools needed to follow through and present results at our annual Quality and Safety Day.

Educational Objectives:

  • Utilize the schedule, format, and content of our QI and PS curriculum (“Better Week”) to engage learners in PS work and QI project completion and presentation.
  • Work within a GME QI and PS subcommittee to create a multidisciplinary conference series focused on QI and PS themes common to all training programs.
  • Gain the tools to create meaningful and mutually beneficial connections between institutional leadership and trainee QI projects.

Ruth Franks Snedecor, MD
Emily Mallin, MD
University of Arizona College of Medicine-Phoenix

APDIM Spring Meeting—108. Strategies for Incorporating Training about Social Determinants of Health for Medicine Interns: A Discussion of the “See the City You Serve Fieldtrip” at George Washington University
It is critically important that new internal medicine interns develop an understanding of the patient populations they will serve during residency, particularly the social determinants of health (SDOH) that drive the health outcomes of their patients. Further, developing skills and knowledge about community resources to address SDOH and promote health equity are equally important. Nonetheless, there have been limited evaluation of tools for teaching SDOH to medical trainees. At George Washington University, we piloted a program called “See the City You Serve Fieldtrip,” a one-day bus tour and discussion of medically underserved neighborhoods in Washington, DC, for all incoming interns, led by community leaders with expertise in these neighborhoods, health disparities, and community resources. Evaluation revealed that this simple, inexpensive intervention improved intern-basic knowledge of geographic health disparities, increased comfort level with understanding the neighborhoods from which their patients come, and utilizing community resources to address patient needs. Interns consistently reported that the experience would change the way they practice medicine. These results suggest this project is a feasible and acceptable approach to exposing interns to SDOH and health equity. This is one of many approaches to resident SDOH training. We explore the challenges of resident SDOH training, including financing, authentic community engagement, identifying “space” in the curriculum, and balancing required versus elective opportunities. We discuss potential innovative solutions for further SDOH curriculum, including utilizing community partners for didactic learning, community service learning, and other experiential learning opportunities.

Educational Objectives:

  • Discuss the feasibility and effectiveness of conducting an experiential SDOH learning activity such as the “See the City You Serve Fieldtrip” for incoming medical interns and review a plan for replicating or adapting this project at other institutions.
  • Identify the challenges and potential solutions to implementing SDOH training into medical resident curriculum, including financing, authentic community engagement, identifying “space” in the curriculum, and balancing required versus elective opportunities.
  • Brainstorm innovative strategies to expanding SDOH training for medical residents, such as didactic learning with a community-based experts and community service learning opportunities.

Monique Duwell, MD
George Washington University School of Medicine and Health Sciences

Jehan El-Bayoumi, MD
Tracie Bass-Harrel
Rodham Institute at George Washington University

APDIM Spring Meeting—109. Program Director/Program Administrator Partnership: Strategic Planning for Fellowship Program Improvement
Strategic planning is a tool that every program director/program administrator team can implement to assure success of their program. Strategic planning is an effective method of organizing program improvement initiatives and it provides direction to attain the goals that meet your program mission. By leveraging the strengths within the program director/program administrator partnership, programs can make great strides in program improvement. With a vision of where a program wants to be and an assessment of the available situation and resources, strategic planning provides a map and guidelines to achieve your goals. Workshop presenters will guide attendees through the strategic planning process, beginning with a SWOT analysis (strengths, weaknesses, opportunities, threats) to help define goals and the creation of an action plan to attain strategic initiatives.

Educational Objectives:

  • Understand how to create a strategic plan to make long-and short-term improvements to your residency or fellowship program.
  • Learn how to leverage your program director’s and program administrator’s strengths in the development and implementation of strategic planning and strategic initiatives.
  • Construct the framework of a strategic plan that can be developed and used at their own institution.

Rahul Kuver, MD
Stephanie Schulz
University of Washington School of Medicine

APDIM Spring Meeting—110. Update in Internal Medicine Graduate Medical Education: Systematic Literature Review of High Quality Medical Education Research in 2016
The purpose of the workshop is to provide participants with a concise, objective review of the relevant medical education research in internal medicine graduate medical education published in 2016. Articles selected for discussion are considered innovative, of greatest interest to the APDIM membership, and of highest research quality (based on the medical education research scoring mechanism). Participants will be provided with a brief synopsis of the 10 to 12 selected research articles, focusing on the strengths and limitations of the research as well as the practical implications of the studies for program directors. APDIM members who are authors of selected studies will be invited to attend the workshop in advance of the meeting. Participants will have the opportunity to engage in group discussion and to ask questions of the presenters and authors in attendance.

Educational Objectives:

  • Describe the characteristics of high quality medical education research.
  • Be familiar with the top 10 to 12 key medical education research papers in internal medicine GME.
  • Engage in active discussion with the authors of key graduate medical education publications in internal medicine in 2016.

Stephanie A. Call, MD
Virginia Commonwealth University School of Medicine

Paul R. Chelminski, MD
University of North Carolina School of Medicine

Chris Stephenson, MD
Mayo Clinic College of Medicine

APDIM Spring Meeting—111. Reshaping Clinical Reasoning Conference: Why Residents Love Practicing Metacognition
Cognitive errors constitute a third of all medical errors and are usually associated with higher morbidity. Clinical reasoning is the art of making accurate diagnosis and developing appropriate treatment plans. While extremely important, medical knowledge is not enough. Metacognition is a strategy promoted to improve clinical reasoning and uncover the unconscious cognitive biases that might jeopardize it. In an era of patient safety, trainees need curricula that promote metacognitive skills to improve their clinical reasoning and minimize cognitive errors. Multiple barriers face implementing case-based clinical reasoning conferences including appropriate case selection, effective conference moderation, and maintaining emphasis on thinking processes and cognitive biases. Moreover, ensuring audience interaction in such sensitive conferences can be challenging. This workshop will underscore the value of metacognition and clinical reasoning conferences as a platform to promote patient safety. Via large and small group activities, participants will grapple with challenges and joys of developing such conferences. In a case-based activity, participants will use metacognition to identify cognitive errors and potential cognitive biases involved. Participants will discuss strategies to moderate the case in an interactive way that highlights thought processes and biases identified. The presenters will also share their experience creating a popular clinical reasoning conference at Cleveland Clinic. By the end of the session, attendees will take away materials incorporating practical strategies to implement a highly educational and engaging clinical reasoning conference.

Educational Objectives:

  • Identify the value of metacognition as a strategy to prevent cognitive biases and promote optimal clinical reasoning.
  • Brainstorm strategies to mitigate common challenges inherent in successfully structuring and delivering a clinical reasoning conference.
  • Develop strategies to implement interactive case-based clinical reasoning conferences focusing on thought processes and cognitive biases.

Ali Mehdi, MD
Mohammad Mohmand, MD
Abby L. Spencer, MD
Cleveland Clinic Foundation

James C. Pile, MD
Case Western Reserve University (MetroHealth)

APDIM Spring Meeting—112.  Osteopathic Recognition 101

ACGME-accredited programs with Osteopathic Recognition (OR) provide an osteopathic-focused learning environment that spans the length of the educational program. Each program has varying resources and missions based on geographic location, background of faculty members, and the needs of the patient population it serves. The avenues to create an osteopathic learning environment are equally varying, to allow each individual program to successfully meet the requirements for Osteopathic Recognition. This workshop will introduce participants to the benefits of OR to trainees, institutions, and patients. Participants will also review the process for securing OR with ACGME.

Educational Objectives:

  • Articulate a rationale for ACGME-accredited IM programs to seek OR.
  • Summarize the basics of OR and recent updates.
  • Explain how a program can obtain OR.
  • Discuss the OR application process.

Steven V. Angus, MD
University of Connecticut (New Britain)

Robert Cain, DO
Ohio University, Heritage College of Osteopathic Medicine

Susan M. Enright, DO
Genesys Regional Medical Center

Donald S. Nelinson, PhD
Amercian College of Osteopathic Internists

ASP Annual Meeting—113. Beyond Cultural Competence: Strategies to Foster Diversity and Inclusiveness in GME Programs
Creating an environment that is diverse and inclusive is critical to the success of any residency program. Enhancing diversity and inclusiveness benefits everyone in the program as it ensures a wide variety of perspectives contributing to a rich learning climate. It also creates a more culturally responsive environment where residents feel cherished and supported, thereby minimizing stress and isolation and maximizing academic and clinical excellence. Further, there is evidence that a diverse health care workforce, particularly one that reflects the diversity of the general population in the United States, is key to improving health care access and eliminating health disparities, especially for vulnerable patients. There are numerous threats to achieving and maintaining diversity and inclusiveness in GME.

This workshop will demonstrate how three different GME programs are achieving diversity and creating inclusiveness through strategic efforts with applicant recruitment, providing mentorship and support for IMG residents as they adapt to a US health system, holding events and implementing programs that celebrate diversity among all trainees and faculty, and addressing contemporary matters of social injustice. A series of real cases from these programs will be presented and participants will work in small groups to identify solutions, with the goal of building skills to address challenges to diversity and inclusiveness in their own programs.

Educational Objectives:

  • Explain the importance of fostering diversity and inclusiveness in training programs.
  • Describe strategies for increasing diversity in a residency program through recruitment and celebrating diversity throughout the academic year.
  • Identify ways to eliminate acculturative stress of IMG residents in GME training programs.

Erica Johnson, MD
Johns Hopkins University/Bayview Medical Center

Jennifer Thompson, MD
Orlando Veterans Affairs Medical Center

William Hannah, MD
San Antonio Uniformed Services Health Education Consortium

Abdo Asmar, MD
University of Central Florida College of Medicine

ASP Annual Meeting—114. Remediation of Clinical Fellows and Lessons Learned from Unexpected HR Issues
A panel discussion to review through case examples the potential pitfalls and pearls while managing challenging human resources issues in trainees.  The workshop will include time for audience comment and questions.

Educational Objectives

  • Recognize potential adverse outcomes to the integrity of training for trainees in specific scenarios.
  • Identify approaches to reduce the potential for adverse outcome in specific training scenarios related to professionalism.
  • Explain the process to determine whether accommodation for trainee disability will affect the trainee’s ability to successfully complete training.

Julia L. Close, MD
University of Florida College of Medicine

Scott D. Gitlin, MD
University of Michigan Medical School

Elaine Muchmore, MD
University of California-San Diego School of Medicine

CDIM National Meeting—115. Possibilities of Simulations in Medical Education
The medical education systems are under increasing pressure to meet the demands of society to produce safe, knowledgeable, and professional learning environments while utilizing limited training resources. Faculty teaching time is at a premium due to competition with patient care and administrative duties to name a few. Learners at all levels are expected to meet certain benchmarks to advance to independent unsupervised care of a patient in a preset time frame, regardless of their learning style. The facilitators of this workshop will present strategies for effective use of simulation to advance your medical education curriculum including teaching and assessment in a world that is not one size fits all.

Educational Objectives:

  • Acquire operations skills to put together the right team including standardized patient, teaching associate, IT support, environment, cases, and assessment tools to advance the curriculum from implementation to remediation.
  • Learn effective use of a medical illustrator and hybrid simulation to engage the learner and enhance learning from the 2D through the virtual reality realm for all types of learners.
  • Gain strategies to employ virtual patients to reinforce the curriculum and identify struggling learners.
  • Understand how simulation can be customized to fit your medical program’s goals and objectives.

Kathleen Wortmann
Rita DuBoyce, MD
Elizabeth Weissbrod
Eric Singdahlsen
Uniformed Services University of the Health Sciences F. Edward Hebert School of Medicine

CDIM National Meeting—116.  Integrating Patient Safety into the Undergraduate Medical Education Curriculum Using an Interprofessional Simulation Approach
To change the culture of health care organizations and improve patient safety, health professionals in-training, including medical students, need to be taught about adverse events and how to prevent harm. Although the accrediting bodies for undergraduate and graduate medical education mandate formal education in patient safety, standardized educational practice for conducting patient safety training is lacking. It is often challenging for educators to find the best strategy to effectively teach safety. An even a bigger challenge for educators is to fulfill the requirements outlined in the core entrustable professional activity 13: identifying system failures and contribute to a culture of safety and improvement. In this workshop, we will demonstrate our approach to teaching safety using basic clinical simulation scenarios that incorporate key patient safety concepts. Additionally, we will demonstrate the use of a collaborative, interprofessional model that include medical students and nursing students, working as a team to promote safe patient care. During the workshop we will use clinical simulation cases that we designed and developed for the internal medicine clerkship as a platform to teach fundamentals of patient safety. Clinical cases used are basic; they include simulation application scenarios of chest pain as a result of anterior wall myocardial infarction, chest pain as a result of inferior wall myocardial infarction, and sepsis.

Educational Objectives:

  • Describe the components and steps in the design, development, and implementation of interprofessional patient safety simulation experiences.
  • Describe the challenges, advantages, and disadvantages of utilizing interprofessional simulation in teaching patient safety.
  • Integrate safety concepts outlined in entrustable professional activity 13 into routine clinical scenarios.

Nirvani Goolsarran, MD
Roderick Go, MD
Carine Hamo, MD
Jonathan Barnett
Stony Brook University School of Medicine

CDIM National Meeting—117. Project 6-55 Stories: An Efficient Reflective Writing Workshop for Professional Growth
Our workshop presents an innovative reflective writing process that can be efficiently used in a number of settings for professional development and wellness. Our method incorporates two literary tools that assist learners and clinicians to effectively reflect on experiences pertaining to professional identity development. The six-word story and 55-word story are literary formats popular in short fiction publication venues. The 55-word story was also used in medicine as an independent tool for reflection (Fogarty 2008). The goal of each format is to tell a story in exactly the number of words designated to better understand a patient or other clinical experience. Together, these story formats can be written within 20 minutes and can be very effective in sharply conveying an experience, with the main difference being that the six-word story conveys very quick ideas, while the 55-word story creates more context. The reflective process we demonstrate combines the six-word format to create lists of memories and the 55-word format to process one intense or unresolved experience. We will discuss our own curriculum implementation and evaluation data and aim to recreate the experience for participants to take to their home institutions.

Educational Objectives:

  • Analyze the barriers to the use of reflective writing and describe effective methods of implementing a narrative curriculum that contributes to professional identity development.
  • Experience the narrative process by writing brief stories and reflecting through a guided shared discussion.
  • Utilize this reflective process as a component for an individual or programmatic wellness program.

Kristy Y. Kosub, MD
Krista Bowers, MD
University of Texas School of Medicine at San Antonio

CDIM National Meeting—118. The Core EPAs in Action: Lessons from the Pilot Schools
Over the past 10 years, the momentum to develop and implement competency-based curricula in medical education has reached an important threshold and now theory is rapidly translating to practice. The construct of entrustable professional activities (EPAs) has helped catalyze this transformation because it places trust at the center of the education mission and links what patients should trust their physicians to do with what teachers must entrust their learners to do with less and less supervision over the course of their training. In undergraduate medical education, AAMC has articulated the core EPAs: those activities that all residents should be trusted to perform without direct supervision on their first day. Now that the core EPAs have been published, medical schools are grappling with ways to implement competency-based curricula using the core EPAs. A group of 10 schools, convened by AAMC, is in the midst of piloting the core EPAs and developing best practices for their implementation. The purpose of this workshop is to share early experiences from the implementation of the core EPA curricula, assessment, and entrustment processes at the 10 AAMC core EPA pilot schools and to engage medical educators at schools implementing EPA-based systems and those considering using EPAs in their curricula in a discussion about opportunities and challenges.

Educational Objectives:

  • Describe the ways the Core EPAs inform what each intern should be able to do on day one of residency.
  • Describe the pathway to entrustment for Core EPAs, and the range of supervisory levels.
  • Apply the Core EPA construct to your curricula.

Meenakshy K. Aiyer, MD
University of Illinois College of Medicine at Peoria

Teresa Carter
Virginia Commonwealth University School of Medicine

Janet A. Jokela, MD
University of Illinois College of Medicine at Urbana

Heather Laird-Fick, MD
Michigan State University College of Human Medicine

CDIM National Meeting—119. Why Does Your Learner Score Poorly on Tests? Using Self-Regulated Learning Theory to Diagnose the Problem and Implement Solutions
Test performance is critical to professional success and trainees who underperform on tests require considerable time and effort to remediate. Our session will describe a method for using self-regulated learning theory to identify and remediate the learner’s test-taking problem(s). First, we will explore reasons for poor test performance and introduce self-regulated learning theory as the use of self-generated feedback to optimize the strategic pursuit of goals. We will then introduce the method for diagnosing and remediating struggling test takers, which is a form of self-regulated learning microanalytic assessment and training. This method assesses self-regulatory processes such as strategic planning, self-monitoring, causal attributions, and adaptive inferences during the academic task of answering a test question. Using a think-aloud exercise and question review form, the faculty will be able to classify the learner’s problem as one or more of the following: lack of script recognition, lack of script specificity, premature closure/anchoring bias, underconfidence, causal attribution problems, adaptive interference problems, and isolated learning deficits. Lastly, attendees will view video portrayals of learners, diagnose them using this method, and develop learner-centered remediation plans. Attendees will also have the opportunity to practice the method on each other via roleplay and will leave with a handout describing the method, a step-by-step method of implementation, and suggested courses of action based on specific learner problems.

Educational Objectives:

  • Identify reasons why learners underperform on standardized tests.
  • Understand how self-regulated learning theory and script theory can help in identifying and remediating test-taking deficiencies.
  • Demonstrate a standardized method for assessing and remediating struggling test-takers.

Mary A. Andrews, MD
William F. Kelly, MD
Uniformed Services University of the Health Sciences F. Edward Hebert School of Medicine

CDIM-Clerkship Administrators—120. Illustrating the Importance of Support Staff to and within Medical Education
GME and UME Program Administrators have a unique role when it comes to helping learners transition from student to resident to fellow and/or practice. This workshop will contain 'snap shots' on how our learners transition through the various stages as well as discussion regarding how we as Program Administrators can ease the transitions for our medical learners.

Educational Objectives:

  • Engage expertise from all Program Administrators who come into contact with medical learners in order to generate a discussion surrounding best practices.
  • Highlight the importance of Program Administrators as being key to a successful, smooth transition.
  • Brainstorm best practices that Program Administrators can take back to their respective programs.

Tracy M. Stasinopoulos
Medical College of Wisconsin

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Workshop Session II
Monday, March 20, 2017
11:30 a.m. to 1:00 p.m.

AIM Educational Conference—201. Special Interest Group: Division Administrators
Workshop description and educational objectives TBA

Kristen K. Cole
Ohio State University College of Medicine

AIM Educational Conference—202. Special Interest Group: Chief Administrative Officers
Workshop description and educational objectives TBA

Karen D. Farrell
University of Oklahoma College of Medicine

APDIM Spring Meeting—203. Herding the Cats: Making PSQI Projects Happen in a Busy Residency Program
The ACGME and IOM emphasis on the importance of quality improvement (QI) and patient safety (PS) drive their incorporation into GME curricula. Both residents and faculty are required to actively participate in PSQI projects. However, PSQI skill development is not a standard element of medical training. Therefore, meaningful PSQI instruction needs to be integrated within the existing curriculum to teach both residents and faculty how to conduct effective PSQI projects. Our team implemented a co-learning PSQI curriculum originally described by Wong et al. Two key elements were preserved in our implementation.

  • Residents and faculty participated in the same training, which allowed for both to receive the information simultaneously and for teams to immediately relate discussion points to their shared projects. 
  • PSQI projects were to be aligned with departmental/institutional priorities and/or ongoing initiatives. 

Both residents and faculty responded favorably to the curriculum which resulted in the successful completion of eight unique team PSQI projects. The presenters will first describe the process by which they implemented this curriculum, challenges they faced, and lessons learned from the first full implementation of the curriculum. They will then guide participants through steps and provide them with tools to develop a similar curriculum within their own programs. Objectives will be accomplished via a short lecture, large group discussion, facilitated small group discussion, and individual reflection/template completion and will conclude by returning to the large group for summary and wrap-up with plenty of time for question/answers.

Educational Objectives:

  • Identify and address barriers to implementing a successful QI co-learning curriculum at their own institution. 
  • Follow the timeline by which they should address various elements of a successful QI co-learning curriculum implementation. 
  • Implement a successful QI co-learning curriculum at their own institution.

Claudia A. Kroker-Bode, MD, PhD
Shari Whicker
Chad Demott, MD
Virginia Tech Carilion School of Medicine

APDIM Spring Meeting—204.  Build Your Own Fire Extinguisher – Practical Ways to Reduce Faculty Burnout
Issues of physician burnout and approaches to addressing wellness have become a true “hot button” issue in recent years. Finding solutions to these concerns is at the forefront of many leader minds and on the high priority list for many institutions and programs. Faculty that report higher degrees of burnout are less engaged, have less satisfied learners, and provide less effective patient care. We will begin with an interactive discussion of the best methods for measuring faculty burnout, including the “Mini Z” survey, a popular approach. See how our results stack up against national data and learn how easy it is to assess your own faculty at your home institutions. We will also share our detailed, ready to use model to tackling these complex issues. Of critical importance is our innovative approach that utilizes a very limited amount of time and resources, allowing programs to begin addressing their local concerns quickly and effectively. Participants will leave with a clear roadmap to follow as well as a toolkit that can be used across varied programs and institutions. This workshop is truly suited for any and all faculty, within all levels of leadership, and at programs large and small. Our workshop will allow faculty in leadership positions to plan for programming, while providing individuals with immediately useful personal techniques for addressing issues of burnout. Building resiliency through targeted, effective, and simple programs is the focus of our action-oriented workshop.

Educational Objectives:

  • Utilize appropriate and validated tools to assess faculty burnout within your institution or program.
  • Create and initiate a faculty wellness program.
  • Examine ongoing effects of a faculty wellness program and support its continued evolution.
Shannon Boerner, MD
Jennifer Harsh, PhD
Sarah Richards, MD
University of Nebraska College of Medicine

APDIM Spring Meeting—205. A Blueprint for Teaching Residents to Achieve Milestones in the Provision of Patient-Centered Care
ACGME requires residency programs to evaluate residents on their ability to practice patient-centered care. Resident physicians in a Planetree-designated institution—an international designation given to institutions that demonstrate a robust commitment to patient-centered care—have a unique opportunity to learn in an environment that champions compassion, humanism, and empathy in the provision of care. We convened a multidisciplinary committee charged with creating a curriculum that fosters the development of patient-centered skills together with minimum standards needed for resident progression and graduation. Our goal was to provide educational pathways to nurture empathy, engage patient and family members in the delivery of care, and foster compassionate and collaborative communication with patients. The curriculum wove in components emphasizing patient-physician communication, apology and disclosure, cultural competency, empathy, spirituality in medicine, integrative medicine, and breaking bad news. Acknowledging the profound impact of physician wellness on patient care, we also incorporated elements to promote wellness and mitigate burnout. Baseline measures of empathy and burnout were assessed and tracked to measure the impact of the curriculum. Nursing and peer evaluation surveys were used to assess individual resident patient-centered performance. At the end of the first year of incorporating the curriculum, mean empathy scores increased slightly and only two interns demonstrated burnout at the conclusion of their first year of training. The proposed workshop will discuss the curriculum we developed, explore other innovative approaches to curriculum development in this area, and provide tools for evaluation of patient-centered care behaviors and attitudes.

Educational Objectives:

  • Acquire a mechanism to develop a curriculum on patient-centered care.
  • Learn strategies to assess residents on their ability to practice patient-centered care and receive assessment tools to accomplish relevant milestone reporting.
  • Develop an intervention that may nurture resident empathy and mitigate burn-out.

Maria Maldonado, MD
Icahn School of Medicine at Mount Sinai

Tzivia Moreen, MD
Kirsten Hohmann, MD
Steven Horowitz, MD
Stamford Hospital/Columbia University College of Physicians and Surgeons

APDIM Spring Meeting—206. Online Quality Ratings: Educating Residents about Them and Working to Improvement
Online reporting of hospital’s performance on patient safety and quality metrics are increasingly common. Recently, CMS introduced its online star rating system “Hospital Compare.” Many hospitals have internal dashboards and reporting systems to monitor ongoing performance. At the same time, many supervising physicians are not familiar with their individual hospital’s performance. Similarly, many training programs are not educating residents about the existence of these metrics nor how to improve these outcomes. Often hospitals focus their improvement efforts on individual nursing units and bypass physician engagement. This missed opportunity to educate and partner with physicians can make significant durable change to improve care. During this workshop, participants will learn about online star ratings and how they can improve the knowledge and engagement of their supervising faculty and trainees by creating a provider-centered patient safety and quality scorecard. In group exercises, we will identify meaningful data points that should be included that can be used to track improved performance. Score cards simultaneously serve as educational tools and metrics. Review of individual or aggregate physician data serves as a platform to improve quality. Using examples, participants will develop strategies to involve trainees in real time quality improvement to improve performance. With help of physician specific scorecards, participants will be able to better understand how they can directly influence their hospital’s performance through their individual actions.

Educational Objectives:

  • Increase familiarity with hospital acquired conditions, patient safety indicators, hospital acquired infections, and other indicators which influence online hospital star ratings. 
  • Distinguish which metrics used in online star ratings are meaningful to internal medicine faculty and residents.
  • Identify provider centered patient safety and quality initiatives that can lead to better overall institutional outcomes.

Gregory Bump, MD
Ben Sprague, MD
Franziska Jovin, MD
University of Pittsburgh School of Medicine

Da Jin, MD
David Geffen School of Medicine at the University of California, Los Angeles

APDIM Spring Meeting—207. From Idea to Action Plan: Making an Educator’s Clinical Research a Reality
Medical educators serve many roles including mentor, coach, teacher, assessor, leader, and scholar. While some faculty focus their scholarly role solely in the realm of education, others aspire to move their educational work into the world of clinical research and encounter barriers. Educators may feel unprepared for this leap, causing them to avoid ever attempting clinical research. Based on a successful multi-centered clinical trial run by educators, this workshop will serve as a primer for how educators can use their existing interests and projects to investigate clinical issues and as a launching pad for future collaborations. Workshop facilitators will begin with a brief presentation on steps educators can take to get started in clinical research. Topics include picking the right condition, diagnostic versus treatment studies, walking the line of quality improvement versus research, principles of collaboration, finding grants, writing a protocol, knowing your expertise, support needs, and not being intimidated by the process. We will also elicit research interests from attendees. We will break into small groups (each with a facilitator) based on elicited research interests, and share barriers and solutions to moving ideas into action. Small group members will provide feedback, advice, and ideas to one another and begin to form collaborative relationships. Attendees will be provided with a worksheet to develop an action plan, including a follow-up contact with at least one new collaborator. Small groups will then debrief with the entire workshop group.

Educational Objectives:

  • Develop a realistic, implementable action plan for an educational study with both educational and clinical outcomes.
  • Define and refine your own principles of collaboration to maximize your project’s chances of success.
  • Begin to develop a community of collaborators and schedule follow-up contact with one potential collaborator.

Benjamin Kinnear, MD
University of Cincinnati College of Medicine

Benji Matthews, MD
University of Minnesota Regions Hospital

Ernest Fischer, MD
Georgetown University School of Medicine

APDIM Spring Meeting—208. Survey Says: Opportunities for an Interactive Delivery of Quality Improvement and High Value Care Concepts
Learning should be fun! However, engaging residents and students can be extremely challenging as pressures to compete with current technology exists. The charge for interactive learning and the flipped classroom approach increasingly are expectations instead of outliers. In this workshop, participants will learn how our institution has used the concept of the flipped classroom through enhancing an online-based quality improvement and high value care curriculum with interactive in-class didactics. We will review interactive classroom learning activities used to excite and engage learners while facilitating quality improvement and high value care learning and share the feedback received from our learners regarding the use of these activities. We will begin the session by reviewing the tenets of adult learning theory and the concept of the flipped classroom, illustrating a set of patient scenarios created to enhance curricular points. We will then break into small groups and the facilitators will lead the groups through two interactive activities utilized at our institution, one focusing on quality improvement and another on high value care. At the end of the session, a list of interactive activities with resources will be available to take back to one’s home institution.

Educational Objectives:

  • Describe elements of active learning through adult learning theory and flipped classroom structure.
  • Demonstrate three active learning exercises: one focused on quality improvement methodologies, one focused on high value care components, and a series of patient scenarios that can be used to combine the two.
  • Identify available resources for creative facilitation of quality improvement and high value care learning.

Anne Cioletti, MD
Chavon Onumah, MD
Courtney Paul, MD
George Washington University School of Medicine and Health Sciences

Jessica Logan, MD
Washington DC Veterans Affairs Medical Center

APDIM Spring Meeting—209. If You See Something, Say Something: Encouraging and Assessing Resident Patient Safety Reporting
Voluntary patient safety reporting is a useful but underutilized tool to identify adverse events and errors. Each report is a potential learning experience as well as an opportunity to improve patient care. The recent Clinical Learning Environment Review report suggests that receiving feedback on reports may encourage further reporting behavior. However, there has not been a standardized approach to providing positive reinforcement and formative feedback on resident patient safety reports. Review of patient safety reports by program leadership may provide insight into resident quality and safety concerns, which in turn may serve as a catalyst for program-wide improvement projects. In addition, the program may be aware of trends in patient safety events for particular units and teams that can lead to targeted education and/or interdisciplinary quality improvement projects. This workshop will provide an outline of three university-based program approaches to patient safety reporting, including training, requirements, providing feedback, and linking reporting behavior to milestones. Additionally, many institutions experience similar challenges and barriers to resident patient safety event reporting; we will discuss these challenges and ways to mitigate common barriers.

Educational Objectives:

  • Describe three university-based approaches to training residents in, encouraging, and evaluating patient safety event reporting.
  • Demonstrate use of a feedback tool designed to provide formative feedback on the quality of resident patient safety reports using example reports, and be familiar with how to link this to milestone-based evaluations. 
  • Discuss and mitigate challenges and barriers to resident error reporting, including the impact of requirements for error reporting.

Michelle Brooks, MD
Virginia Commonwealth University School of Medicine

Ashley Duckett, MD
Medical University of South Carolina College of Medicine

Starr Steinhilber, MD
Winter Williams, MD
University of Alabama School of Medicine

APDIM Spring Meeting—210. A Tale of Two AHDs: Developing, Implementing, and Sustaining an Academic Half Day
Residency programs are exploring novel and more effective ways to educate. Many have transitioned from noontime conferences to an academic half day (AHD), in which residents come together weekly for extended timeframes, providing opportunities for deliberate sequenced curricular content, protected learning time, development of community, and reinforcement of resident preparation and accountability. The internal medicine residency programs at University of Cincinnati and Baystate have implemented weekly AHDs into their programs. From their unique experiences, the establishment of an AHD has successfully addressed many of the pitfalls of noontime lectures, including lack of attendance, competing responsibilities, and ineffective passive learning. However, both programs have found that sustaining a robust AHD requires continuous innovation. This highly interactive workshop will explore cultural and structural transformation. Furthermore, we will describe lessons learned through our innovations with an eye toward helping other programs avoid some of our unforeseen challenges. We will describe our diverse, reproducible, and successful models of AHD and the steps we have taken to ensure an active, innovative learning experience for our residents. Attendees will learn how each institution implemented state-of-the art educational strategies, including small group learning, flipped classroom, and learning communities.

Educational Objectives:

  • Discuss benefits and potential untoward effects of instituting an AHD.
  • Compare and contrast the AHD implementation and maintenance strategies of two internal medicine residency programs.
  • Describe various innovative active learning experiences to incorporate into an AHD.

Raquel Belforti, MD
University of Massachusets Medical School-Baystate

Michael Rosenblum, MD
University of Massachusetts Medical School

Lauren Ashbrook, MD
Eric Warm, MD
University of Cincinnati College of Medicine

APDIM Spring Meeting—211. Lapses in Professionalism: A Structured Approach to Unmask and Address the Problems
Professionalism problems are ubiquitous in GME training programs, and yet they are often among the most challenging issues to address. Unlike deficiencies in the other core competencies, often it is not clear if remediation of professionalism is possible or how a remediation plan should be developed and implemented. Since professional conduct encompasses a complex set of attitudes and values, medical educators are often faced with making difficult, value-based decisions regarding the action(s) to take when a trainee demonstrates a lapse in this essential domain of medical practice. In some instances, it is necessary to balance a trainee’s future career potential against the mandate of patient safety and public trust. This workshop will introduce a simple yet structured approach to dissect the professionalism problem into its component parts. The approach, which uses the mnemonic “MASK,” first makes the important distinction between willful misconduct and academic deficiencies. For problems that fall in the latter realm, techniques to identify and differentiate deficiencies in knowledge, skills, and attitudes will be discussed along with specific strategies for addressing each deficient component as it relates to an episode of unprofessional conduct. A series of real-life cases that involve unprofessional conduct will then be presented, and participants will break into small groups to identify the component deficiencies with the goal of generating a comprehensive and individualized plan for addressing the unprofessional episode. Facilitated large group discussion will be used to share strategies and solutions.

Educational Objectives:

  • Recognize unprofessional conduct that results from academic deficiencies that may be amenable to remediation.
  • Utilize a structured approach to identify and address underlying deficiencies that may result in an episode of unprofessional conduct.
  • Devise a strategy to address unprofessional conduct in the cases presented for discussion.

Jennifer Thompson, MD
University of Central Florida College of Medicine

Erica N. Johnson, MD
Johns Hopkins University School of Medicine

William N. Hannah, Jr., MD
San Antonio Uniformed Services Health Education Consortium

Abdo Asmar, MD
University of Central Florida College of Medicine

ASP Annual Meeting—212. Competency Committees in Fellowship Training
This workshop is focused on the creation of and effective implantation of the competency committee including utilizing milestones, committee make up, and effective development of the trainee and the training program.

Educational Objectives:

  • Understand the milestones in context of competency evaluation.
  • Create a competency committee that works.
  • Understand the longitudinal evaluation of fellows and how it impacts individual and program development.

Donna K. Polk, MD
Harvard Medical School Brigham and Women’s Hospital

ASP Annual Meeting—213. Strategic Planning and Developing Financial Proposals

The workshop is intended to be a highly interactive environment focusing on strategic planning and “how to fund success.”  The focus will be on divisional strategic planning but can be “scaled” either up or down the organizational ladder.  The presentation and discussion will involve analysis of culture versus strategy, and the importance of comprehensive development of mission, vision and values.  In addition, assessment tools as well as a template will be presented and discussed.

Educational Objectives:

  • Determine role of Strategic Planning
  • Review selected tools to facilitate strategic planning
  • Review template for a strategic plan model
  • Understand the barriers to implementation and success
  • Understand the development of a financial proposal to fund success

Joe Doty
Baylor College of Medicine

Mark W. Geraci, MD
Indiana University School of Medicine

CDIM National Meeting—214. The Osler Effect: A Stepwise Approach to Implementing a Robust Physical Diagnosis Curriculum for Clerkship Students
High quality physical exam skills are important for clinical diagnosis and skill development. The CDIM/SGIM Core Medicine Clerkship Curriculum Guide lists physical exam as one of the core competencies required to be taught to all trainees during their clerkship. Clerkship directors, faculty members and residents are tasked with cultivating their trainee physical exam skills, yet most physicians have had little training on how to teach physical exam skills. Without a strong framework, faculty and residents are left struggling to effectively teach clerkship students the basics of the physical exam. This workshop is designed to provide participants with a concrete framework and approach, so that they are better equipped to successfully incorporate physical exam skills into the medicine clerkship. First, we will briefly discuss basic principles and review best practices that serve as a foundation for effectively teaching trainees physical exam techniques. We will then elicit information from participants about their practices and discuss barriers to teaching trainees physical exam skills. In addition, we will provide an easy to adapt five-step method that will enable participants to successfully and systematically teach their trainees physical exam techniques. Participants will then gain practical experience applying the physical exam skills framework through role play and case-based vignettes. We will provide participants with the knowledge and tools to immediately apply the framework to teaching trainees at their home institutions.

Educational Objectives:

  • Describe major barriers to teaching physical exam skills to trainees.
  • Develop a concrete framework for teaching physical exam skills to clerkship students.
  • Practice applying the physical exam skills framework to clinical situations through role play and skill building exercises.

Nadia Bennett, MD
Jehan Bahwainwala, MD
Sarah Nagle, MD
Mo Sarhan, MD
Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania

CDIM National Meeting—215. Letters for Academic Promotion: It’s about Evaluation, Not Recommendation

Soliciting and reviewing letters in support of academic promotion is a key responsibility of department chairs. Writing letters in support of academic promotion is an activity often sought from and provided by individuals as their academic rank increases. Such letters provide attestations from the community of practice that substantiate an individual candidate’s progress and readiness for academic promotion, and also uphold the standards of the professional community. Writing such letters can be a challenge, in part because the standards of achievement for academic promotion, particularly for clinician-educators, often have similarities yet key differences across institutions. From a department chair’s perspective, despite guidance provided to letter writers, letters regarding a candidate for academic promotion should be letters of evaluation but are too often letters of recommendation. To some extent, this discrepancy may arise because academic faculty are often also asked to provide letters of recommendation, such as in applications for residency programs. While AAIM has led the way by developing guidelines for departmental letters of recommendation for residency application, there are no similar consensus guidelines for writing letters of evaluation in support of academic promotion. In this workshop, we will review core tenets of academic promotion, discuss the role of letters of evaluation in the promotion process, compare and contrast evaluation and recommendation, and work with participants to develop best practice guidelines for academic promotion letters.

Educational Objectives:

  • Describe the academic promotion process and the role of letters of evaluation.
  • Delineate key differences between evaluation and recommendation.
  • Develop best practice guidelines for writing letters of evaluation for academic promotion.

Paul A. Hemmer, MD
Louis N. Pangaro, MD
Uniformed Services University of the Health Sciences F. Edward Hebert School of Medicine

CDIM National Meeting—216. Transitioning: Using the Internal Medicine Subinternship to Bridge the Gap From UME to GME
This interactive workshop session will feature the results of the 2010 APDIM Survey and how the core skills identified map to the AAMC entrustable professional activities (EPAs). Utilizing both small and large group formats, participants will begin to develop internal medicine subinternship curricula and assessment tools to address acquisition of these core skills.

Educational Objectives:

  • Identify core skills for incoming interns as identified in the 2010 APDIM Survey. 
  • Describe the importance and role of AAMC core EPAs in the fourth year curriculum in general and the internal medicine subinternship in particular.
  • Develop strategies for implementation of curricula to address the four core skills as identified in the 2010 APDIM Survey.

Nadia J. Ismail, MD
Baylor College of Medicine

Jonathan S. Appelbaum, MD
Florida State University College of Medicine

Allison Ferris, MD
Drexel University College of Medicine

Cori Salvit, MD
Weill Cornell Medicine

CDIM-Clerkship Administrators—217. Is This Where It All Ends? Career Progression for the Clerkship Administrator
Career progression for clerkship administrators is often thought of moving into a GME position and that isn’t always the case. We want to move on from that box and to give participants career paths that still involve UME as well as ways to help you advance your own UME career. This workshop will be a round table discussion with current and former clerkship administrators who have progressed in their role either by staying in the same position or moving to another.

Educational Objectives:

  • Start thinking about career progression outside the box of GME.
  • How to navigate HR for classifications and professional development opportunities.
  • How to market your skills into promotion.

Lisa Oliver
State University of New York Upstate Medical University College of Medicine

Julie Randall
Michigan State University College of Human Medicine

Britt Simonson
Harvard Medical School Brigham and Women’s Hospital

Kellie Engle
University of Washington School of Medicine

CDIM National Meeting—218. Nobody Gets between Me and My Attending: Designing a Medicine Clerkship on Direct-Care Hospitalist Services
In this workshop, led by clerkship directors and hospital medicine specialists, participants will discuss the benefits and challenges of medical student education on non-housestaff teams. For participants who are developing a curriculum housed on a hospital medicine service, this workshop guides educators to share their experiences and plan an optimal clerkship rotation for students and direct-care hospitalist faculty.

Educational Objectives:

  • Describe challenges of designing an optimal learning environment for students on direct-care hospitalist services.
  • Discuss specific approaches to support hospitalists in offering a robust educational experience for medical students while also providing effective and efficient direct-patient care.
  • Identify core guiding principles for implementing medical student clinical rotations on direct-care services.

Amulya Nagarur, MD
Katherine T. Johnston, MD
Harvard Medical School Massachusetts General Hospital

Bipin Thapa, MD
Medical College of Wisconsin

Alexander R. Carbo, MD
Harvard Medical School Beth Israel Deaconess Medical Center

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Workshop Session III
Tuesday, March 21, 2017
10:00 a.m. to 11:30 a.m.

AIM Educational Conference—301. Implementing an Educational Relative Value Unit (eRVU) System to Quantify and Compensate Faculty Teaching Effort
This workshop will focus on designing and implementing a quantifiable system to compensate faculty teaching activity. Similar to a work RVU system for clinical care, this education RVU (eRVU) system recognizes a broad spectrum of teaching activities in a department of medicine and weighs their individual value while tracking total activity. Total eRVUs for individual faculty members can be calculated and compensated at rate commensurate with departmental goals and financial abilities. Participants will be shown an active successful model in a large department, review the components of the model, and identify key process steps to successful implementation. Tips for success, lessons learned, and funding strategies will be shared and discussed.

Educational Objectives:

  • Outline components of a functional eRVU system and establish a quantifiable weighting system for various teaching activities based on time and effort, ranging from a shadowing first-year student to oversight of senior fellows in an inpatient setting. 
  • Build a financial eRVU model based on quantifiable educational effort and compare with other quantifiable components of compensation (research funding and clinical productivity). 
  • Utilize detailed data on educational effort to generate relative weightings of clinical, educational, and research compensation for individual faculty members and compare to peers division/department faculty for purposes or annual reviews, and promotion/tenure consideration.
  • Demonstrate quantifiable, educational effort (and faculty development) to your dean's office and regulatory agencies.

John D. Buckley, MD
T. Robert Vu, MD
Deborah Stombaugh
Indiana University School of Medicine

AIM Educational Conference—302. Moving From Quantity to Quality: One Department’s Experience in a Fixed Revenue Reimbursement Model
In 2014, Maryland hospitals, in partnership with the Center for Medicare and Medicaid Innovation, adopted a new health care financing system called the global budget revenue program. The program aims to move hospitals from the traditional fee-for-service model to a pay-for-performance model, adopting a fully capitated payment model with entire operating margins at risk based on quality of care. In addition to improving quality, Maryland hospitals have committed to realizing more than $300 million in Medicare savings over the initial five-year project period. Although hospitals and related outpatient services operate with a set revenue amount each fiscal year, professional revenue still follows the traditional fee-for-service model. Hospitals and physician practices now have financial systems which drive behaviors that are not aligned; hospital leadership is looking for ways to manage patients outside the traditional care environment while physicians are still being incentivized based on traditional measures of productivity. We will provide participants an overview of our experience operating for the past two years in a financing system that forces value-based decisions instead of volume-based decisions. We will display reports created to help manage in this new paradigm and use examples of clinical services and business plans that have been changed as a result of this financing structure. The presenters will present both the hospital and physician practice perspective.

Educational Objectives:

  • Understand the basic structure, operating principles, and goals of the Maryland global budget revenue program.
  • Learn how one department of medicine is adapting management practices to meet the demands of a capitated payment system.
  • Identify challenges and solutions for operating a physician practice and hospital with competing reimbursement methodologies in an integrated delivery system.

Amanda Vanderzyl
Douglas Brooks
Johns Hopkins University School of Medicine

AIM Educational Conference—303. Building a Department of Medicine Leadership Development Program: Blueprints and Early Results
As academic medicine faces an increasing number of complex challenges, there has emerged an urgent need for experienced leaders and thus a growing demand for leadership training. In response to these challenges and the need to develop transformational leaders, the department of internal medicine at the Medical University of South Carolina built and launched a leadership development program in 2014. The leadership in academic medicine, or LEAD program, is now in its third year and has been designed to build a culture of leadership through the development of established and future leaders of high potential. The program focuses on several specific domains including leadership self-discovery and emotional intelligence, individual skills education in communication, conflict resolution, vision setting, team building, and driving change. Attendees of this workshop will review the history of leadership development programs in academic medicine with an emphasis on rising need, learn about the LEAD program, and its implementation, and dive into a strategic framework for creating a program at their own institution. Results from experience will also be discussed. Through small group discussion and interaction, workshop attendees will explore their reasons for creating a leadership development program and problem-solve potential barriers. Workshop attendees will brainstorm objectives for their potential programs and metrics for success. At the conclusion of the workshop, attendees will have an understanding of the LEAD experience and an outline for a leadership development program at their home institution.

Educational Objectives:

  • Explain the rising interest in leadership development programs in academic medicine.
  • Outline a strategic framework for building a leadership development program.
  • Iterate institution-specific objectives for a leadership development program and metrics for success.

Elisha L. Brownfield
John Joseph Gough
Steve Vinciguerra
Medical University of South Carolina College of Medicine

Catherine G. Wood
Duke University College of Medicine

APDIM Spring Meeting—304. Beyond the Wards: Resident Engagement in Scholarship during Training
Scholarship during residency training is a core ACGME requirement for internal medicine residency programs that has tangible benefits for both residents and faculty. From the resident perspective, involvement in scholarship can build a foundation that informs future practice of evidence-based medicine, increase competitiveness for a desired fellowship or faculty position, or even inspire a future research career. From the faculty perspective, engagement of residents in scholarship can provide valuable pilot data for future research grants, result in publications or presentations that contribute to promotion, and increase overall job satisfaction. There are multiple barriers to engagement in research or other scholarship during residency, including lack of time, mentors, and funding. Growing interest in overcoming these barriers has resulted in a variety of interventions nationally, including research electives, didactic curricula, and support for faculty to mentor resident scholarship. We recently evaluated the outcomes of the structured experiential research curriculum that we instituted at our program in 2012 to promote resident engagement in scholarship. In this workshop, we will emphasize why scholarship during residency is important and discuss barriers and strategies to promote resident engagement in scholarship. Workshop participants will share experiences at their own programs, we will review barriers and successes reported in the literature, and we will share our own lessons learned while implementing and evaluating our structured research curriculum. Workshop participants will leave with a toolkit of implementable suggestions for creating an infrastructure for resident scholarship at their own institution.

Educational Objectives:

  • Describe importance of scholarship during residency training.
  • Identify barriers to resident participation in scholarly activities during residency training.
  • Strategize ways to increase resident engagement in scholarship during residency training.

Andrea Carter, MD
Amy Farkas, MD
Alexandra Mieczkowski, MD
Carla Spagnoletti, MD
University of Pittsburgh School of Medicine

APDIM Spring Meeting—305. Primary Care Programs – Creating and Keeping Interest High!
Various features of successful primary care programs—curricula, structural components of continuity clinics and rotations, recruitment strategies, mentorship and career counseling, special pathways and clinic sites and more—will be highlighted in regards to implementation and sustainability. Ample time will be devoted to breakout groups, tailored to level of experience, for those considering starting a PC program as well as to those with existing programs who are looking for innovative and fresh ways to invigorate the enthusiasm for all things primary care. Participants will have the opportunity to connect with other programs through facilitated discussion and collaborative innovation.

Educational Objectives:

  • Discuss key features of several successful primary care programs from various institutions and settings.
  • Recognize opportunities at your home institution and community that may be available to invigorate interest in primary care.
  • Develop strategies to create and sustain interest for primary care.

Karen M. Chacko, MD
University of Colorado School of Medicine

Leonard Feldman, MD
Johns Hopkins University School of Medicine

Rebecca Berman, MD
Harvard Medical School Brigham and Women’s Hospital

Gina Luciano, MD
University of Massachusets Medical School-Baystate

Jason Ojeda, MD
Sidney Kimmell Medical College at Thomas Jeffereson University

APDIM Spring Meeting—306. Training Our Future Doctors to Be Community Change Agents: Addressing the Social Determinants of Health through Active Community Engagement
As defined by the World Health Organization, social determinants of health (SDOH) “are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life.” Socioeconomic forces have a substantial impact on our patient health and well-being, however these factors have traditionally received scant attention in US medical training. To provide holistic care for all patients, physicians-in-training need to develop a basic understanding and appreciation of the SDOH. However, just as knowledge alone is insufficient to achieve excellence in clinical medicine, knowledge of SDOH alone is also insufficient. Trainees must obtain real-world experience advocating and impacting change in their patient communities. Through such experiences in training, future physicians will have the pragmatic skills and knowledge to promote the health of patient communities. In this workshop, we will describe how several different internal medicine residency programs successfully promoted or developed community engagement curricula to reinforce principles of SDOH and inspire future physicians to become change agents in the communities they serve. Through structured reflection and breakout sessions, we will then guide participants to consider ways to augment community engagement in their residency programs.

Educational Objectives:

  • Identify methods and available resources to teach the basic principles and significance of the social determinants of health in your internal medicine residency.
  • Describe multiple approaches to promote community engagement and advocacy.
  • Identify ways to initiate or enhance community engagement in your internal medicine residency.

Paul David O’Rourke, Jr., MD
Sammy Zakaria, MD
Johns Hopkins University/Bayview Medical Center

Brita Roy, MD
Yale University School of Medicine

Erin J. Goss, MD
Albert Einstein College of Medicine

APDIM Spring Meeting—307. Blind Leading the Blind: How to Equip Faculty to be Better Quality Improvement Advisors
ACGME requires that residency programs integrate safety and quality training into their curriculum with all trainees participating on quality improvement (QI) projects. In addition, most medical schools are introducing quality improvement concepts earlier in education, creating another group of learners eager to participate on these projects. However, faculty may not have formal training in QI methodologies despite a growing number of new trainees and students familiar with these concepts, requiring faculty to learn and lead at the same time. In this workshop, participants will learn how to equip faculty to be better quality improvement advisors. They will review barriers and identify opportunities to optimize faculty development when mentoring QI projects, which will include reviewing presenter successes and setbacks during the mentorship experience over the last four years, ranging from making small programmatic changes to gaining departmental and institutional support. Topics will include changing the culture towards QI, working with institutional review boards (IRBs), guiding the QI process, and generating a discussion board to focus projects. We will also review available faculty development resources related to quality improvement and patient safety.

Educational Objectives:

  • Identify resources available to optimize faculty development and mentorship in quality improvement.
  • Recognize opportunities for leveraging stakeholders in GME, UME, and IRB offices.
  • Translate strategies for empowerment of residents and students to make effective changes at one’s own institution.

Anne Cioletti, MD
Chavon Onumah, MD
April Barbour, MD
George Washington University School of Medicine and Health Sciences

Cherinne Arundel, MD
Washington DC Veterans Affairs Medical Center

APDIM Spring Meeting—308. Finding Synergy Between GME and UME: A Novel Residents-as-Educators Curriculum Embedded in an Intern Preparation Course
Many medical schools now offer intern preparation courses to ease the transition to internship. These courses provide an opportunity to foster connections between undergraduate and graduate medical education; however, they are resource intensive, requiring significant faculty time. We have devised and implemented a solution to this barrier: coaching medicine residents through design, delivery, and evaluation of teaching sessions in an intern preparation course. During this process, residents receive individualized professional development as educators and provide an indispensable perspective to medical students about to start internship. We will detail our residents-as-educators curriculum, identify potential barriers and facilitators in implementation, and discuss participating resident views. We will start by outlining our objectives, instructional strategies, and logistics. We will describe our asynchronous coaching activities, designed to accommodate the varied availability of busy medicine residents and faculty, while providing personalized faculty feedback on assigned tasks. Particular focus will be on our novel peer coaching strategy and longitudinal curriculum over three years of residency, both aimed at providing self-sustainability of the curriculum given faculty time constraints, as well as allowing residents to hone their skills in giving effective feedback to peers. Lastly, we will facilitate interactive discussions about barriers to implementing a similar curriculum at participant institutions, possible strategies to overcome these barriers, resident views of the curriculum, and future directions. Attendees will leave with the information, materials, and initial plans necessary to implement a residents-as-educators curriculum at their medical institution.

Educational Objectives:

  • Discuss the positive impact of resident educators in medical student intern preparation courses and be able to implement a toolkit for a residents-as-educators curriculum.
  • Review a scaffolded strategy to coach resident educators in key skills of effective classroom teaching and curriculum design over the course of residency.
  • Discuss strategies, such as peer coaching, to overcome the barrier of limited faculty resources in developing residents as educators and delivering a medical student intern preparation course.

Jessica Tischendorf, MD
Sara Johnson, MD
Amy Zelenski, PhD
University of Wisconsin School of Medicine and Public Health

Melissa MacDonald, MD
University of Wisconsin Hospital and Clinics

APDIM Spring Meeting—309. Mindfulness for Wellness, Resilience, and Burnout Prevention
Physician burnout is increasing with considerable consequences on well-being and patient care. ACGME is prioritizing physician well-being for training programs across the country. Mindfulness has been incorporated as part of physician and physician training well-being programs and has shown to be effective in reducing the risk of burnout. Mindfulness is paying attention, on purpose, in the present moment. Mindfulness can be incorporated in everyday life, at work, and at home with informal and formal practice. Mindfulness can also help build the foundations for resilience and can be cultivated by internal medicine housestaff for optimizing well-being, building resilience, and preventing burnout. The development and incorporation of formal well-being curricula, particularly incorporating mindfulness, remains challenging for many programs. This workshop seeks to immerse participants in an interactive experiential session using several different ways to incorporate mindfulness, both formally and informally. The workshop will also seek to address barriers, challenges, and solutions regarding potential development and integration of mindfulness into well-being curricula. Participants will also receive tangible resources on literature cited on the use of mindfulness in training programs, existing curricula, and web-based mindfulness resources.

Educational Objectives:

  • Gain insights from the literature regarding the use of mindfulness in well-being programs for 
trainees across the country that have successfully 
developed and incorporated mindfulness into well-being curricula. 

  • Experience mindfulness based practices including body scan, mindful movement, and awareness of breath meditations. Engage in appreciative inquiry, a way of mindful listening and mindful interviewing which can be used in day to day communication among colleagues and patients. 

  • Discuss barriers, challenges, and potential solutions, and be provided with ways to address how to incorporate mindfulness into well-being curricula.

Ni-Cheng Liang, MD
Simerjot Jassal, MD
University of California-San Diego School of Medicine 

APDIM Spring Meeting—310.  Put Some Pep in Your PIPs and Swing in Your SWOT
How to organize, strategize, and plan for the future of your program. One of the main components of the 10-year self-study cycle is the review of each programs performance improvement plans (PIPs) and strengths, weaknesses, opportunities, and threats (SWOT) analysis. The goal of each program is to be prepared going into the self study and not have to struggle in the prior year review. This process can be very time consuming and labor intensive. In this workshop we will teach you how to maximize the time spent in your end of year program evaluation committee meeting. The goal is to walk away with your SWOT analysis and PIPs completed for the upcoming year. Your PIPs will be complete with the necessary structure: area of concern, action plan, responsible party, timeline, and measurement of success. Simple pre-work and organizational strategies will allow you to yield tremendous results. In an interactive group session, we will use a mock program database to draw conclusions about a program and plan for its future.

Educational Objectives:

  • Identify strategies to streamline your annual end of year program review.
  • Choose the necessary data to evaluate in your end of year program review.
  • Perform a SWOT analysis and generate a PIP.

Karen Ann Friedman, MD
Kyle Katona, MD
John Raimo, MD
Hofstra Northwell School of Medicine at Hofstra University

APDIM Spring Meeting—311. “I’ve Got Your Back”: Supporting Residents in the Face of Microaggressions or Discrimination
Every day, residents of color may face microaggressions which are dismissals or insults from patients, typically due to their appearance, gender, or other identifying feature. They may come in the form of a request for a physician who looks like them – a white physician, a non-Muslim, a man or woman, or by overt derogatory racial slurs towards the resident. These situations may occur in the presence of the entire medical team and many attendings do not know how to address them, which leads to a missed opportunity to discuss how to handle similar situations in the future or to check in on the emotional wellbeing of the resident. More typically, the team disperses from the bedside to do the day’s work and the resident who was subjected to the microaggression is left feeling isolated, not knowing if the attending and team realized how hurtful it was to him or her. Perhaps the most common form of discrimination for physicians of color (and for female physicians) is being assumed by the patient to be the nurse, food service worker, or housekeeper despite wearing a white coat and stethoscope. Participants will develop skills to support residents experiencing race, religious, or gender discrimination. Through small group case discussion, participants will learn strategies to create a safe environment in clinical educational settings to openly discuss discrimination with the resident team. Participants will leave with a detailed toolkit of strategies to accomplish these goals including articles, case vignettes, a slide set to be used for faculty development around support residents of diverse backgrounds.

Educational Objectives:

  • Recognize microaggressions against residents of diverse backgrounds.
  • Develop three strategies to openly discuss discrimination with the resident team.
  • Develop three strategies to support a resident from a diverse background who has been subjected to a microaggression or overt discrimination.

Alda Maria R. Gonzaga, MD
Eloho Ufomata, MD
Eliana Bonifacino, MD
University of Pittsburgh School of Medicine

Shanta Zimmer, MD
University of Colorado School of Medicine

APDIM Spring Meeting—312. RRC-IM Update
This workshop will provide participants with up-to-date interpretations of the core and subspecialty program requirements from RRC-IM and highlight changes in the accreditation process.

Christian Cable, MD
Residency Review Committee for Internal Medicine

ASP Annual Meeting—313. Incorporating Core Entrustable Professional Activities for Entering Residency in Teaching and Assessment Activities within a Geriatrics Clerkship
In this interactive workshop, participants will create new or refine existing geriatrics learning experiences to integrate performance-based measures for students. The core entrustable professional activities (EPAs) for entering residency define behaviors that medical students should be able to do to ensure readiness for residency. Each is mapped to the physician competency reference set but mapping to the minimum geriatrics competencies (MGC) for graduating medical students has not been reported. Using examples of workshops based on MGC, the audience will engage in a mapping exercise to identify how to address key functions associated with EPAs so that assessment of competencies critical to entrustment of the EPA can occur. Using a learning activity designed to facilitate student ability to “accurately identify clinical situations where…patient preference, or goals of care should override standard recommendations for treatment in older adults,” participants will define the key functions associated with EPA 4, the ability to enter and discuss orders and prescriptions, that can be learned in the session. The group will then brainstorm assessment strategies to document student performance of this task. The participants will then use their own teaching exercise or work to design a new teaching exercise based on MGC to define formal teaching experiences and assessment methods that to enhance learning and document performance of EPA-based tasks. Lastly, in a large group facilitated discussion, participants will discuss how to integrate curricular initiatives in geriatrics teaching within the larger context of a clerkship and the longitudinal clinical curriculum at their home institution.

Educational Objectives:

  • Identify opportunities to teach and assess the core entrustable professional activities for entering residency in geriatrics learning experiences.
  • Align efforts to address minimum geriatrics competencies and key functions associated with the Core EPAs in geriatrics-based teaching.
  • Enhance performance-based assessment to facilitate entrustment and allow students to fully engage in clinical care.

Huai Y. Cheng, MD
Maryellen Gusic, MD
University of Virginia School of Medicine

ASP Annual Meeting—314. Clinical Teaching Tools for the Subspecialty Consultant
It is a common expectation in academic medicine that subspecialty consultants, including fellows, should teach in the clinical environment as a means to transfer knowledge and improve patient care. Clinical teaching by consultants is also a valuable way to provide clinical exposure and mentorship to trainees who may be interested in a particular subspecialty field. Despite this high demand for subspecialty teaching, there is very little in the literature on how to teach in the consultant role, especially in the current era of increasing time constraints due to the demands of patient care activities and duty hours requirements for trainees. In this session, we will provide the busy subspecialist with a toolbox of practical skills for clinical teaching while in the consultant role. We will review the different opportunities that exist for teaching members of the consult team, outline innovative ways to teach members of the primary team, and review the key components of creating a positive learning climate while in the consultant role.

Educational Objectives:

  • Develop a toolbox of practical skills for clinical teaching while in the consultant role.
  • Recognize the different opportunities that exist for teaching members of the primary and consulting teams.
  • Define the key components of creating a positive learning climate as a subspecialty consultant.

Jennifer M. Babik, MD
Bradley Sharpe, MD
University of California-San Francisco School of Medicine

CDIM National Meeting—315. Promoting Resilience in the UME Continuum
Burnout is prevalent among medical students and has been associated with unprofessional conduct, decreased altruism, declining perception of the learning environment, and more stress and fatigue. In contrast, less is known about medical student resilience and few resilience interventions have targeted students. Additionally, most resilience efforts to date have focused on residents while students similarly need these skills and have unique needs. Resilience is the ability to thrive when faced with adversity and fostering resilience is a promising way to mitigate stress and burnout. Our workshop is a novel session to help programs promote resilience in their students across the UME continuum to improve professional development. After discussing how to recognize student burnout, we will briefly define resilience and review the literature pertaining to students. The majority of the session will be spent in groups. First, participants will brainstorm topics for student resilience skill-building. After introducing basic resilience concepts and techniques to enhance resilience, including reflection, mindfulness, skills courses, stress-management, and longitudinal patient experiences, groups will brainstorm ways to teach resilience skills focused on one assigned topic and how to incorporate this teaching in their curriculum. Participants will focus on helping students promote resilience during difficult team interactions on clinical rotations by discussing real student scenarios and approaches to help promote student resilience. Throughout the session, we will share our experiences and highlight techniques to promote resilience training in students. At the end, we will briefly summarize key themes and share toolkits.

Educational Objectives:

  • Identify and understand five resilience building techniques: mindfulness, reflection, skills courses, longitudinal patient experiences/clerkships, and stress-management workshops.
  • Understand basic resilience concepts to address five key resilience topics for students including managing xpectations, coping with difficult team interactions, finding meaning in daily work, dealing with setbacks and failure, and dealing with the unexpected (or lack of control).
  • Identify areas for faculty engagement to help students build resilience skills.

Amber Pincavage, MD
Wei Wei Lee, MD
University of Chicago Division of the Biological Sciences Pritzker School of Medicine

Rachel Halina Kon, MD
Margaret Plews-Ogan, MD
University of Virginia School of Medicine

CDIM National Meeting—316.  Medical Students in Medical Specialties: How to Design an Optimal Medical Student Elective Experience
The core medical school curriculum is remarkably similar between institutions, and each medical student encounters this core curriculum in a similar fashion at their given school. However, each medical student has different needs and interests. The medical school elective fills a key role in medical student education, bridging essential foundational knowledge and clinical skills in the early years of medical school to individualized learning that the learner specifically chooses to enhance their training and possibly bridge to a future specialty. Medical student electives often present unique challenges in regards to structure, student assessment, and faculty involvement. This interactive workshop will highlight the role of the medical school elective in medical education, with a specific emphasis on medical subspecialty electives. Attendees will then be introduced to key goals and challenges of this aspect of the medical school curriculum while outlining a simulated or proposed medical specialty elective for their institution. Challenges and tools related to assessment and faculty oversight will be discussed as well. Attendees will have access to an electronic toolbox including an annotated bibliography, elective outline worksheets, as well as assessment and faculty development tools. Vanderbilt University School of Medicine has undergone recent curricular revisions which emphasize individualized undergraduate medical education and emphasize the role and quality of the elective.

Educational Objectives:

  • Understand the position, purpose, and goals of electives in the arc of medical school education.
  • Outline a proposed medical student elective in a medical specialty.
  • Acquire tools to facilitate and develop novel ways to assess elective students and develop elective faculty participants.

Anna Person, MD
Ed Vasilevskis, MD
Cody Chastain, MD
Patty W. Wright, MD
Vanderbilt University School of Medicine

CDIM National Meeting—317. Interprofessionalism across the Continuum: Incorporating IPE into Your Internal Medicine Clerkship and Residency
In 2011, an expert panel sponsored by the InterProfessional Education Collaborative (IPEC) outlined the need for interprofessional education in health care education. The feeling of the panel was that by having interprofessional training, students would later engage in improved collaborative practice leading to improved patient care and health outcomes. There are a lot of opportunities for interprofessional education in the internal medicine clerkship through interactions with learners and practitioners from all health care professions in both inpatient and outpatient settings. These learning opportunities extend beyond the clerkship and can be incorporated into residency training to provide a more comprehensive education. This interactive workshop will help participants learn about the core competencies of interprofessional education and methods to incorporate it into internal medicine training. We will present results of a survey of clerkship directors of how they use interpersonal education in their curriculum. We will also present how several institutions in particular have built interprofessional educational activities into their clerkships and residencies using diverse modalities emphasizing how interprofessional education can extend along the educational continuum and include both medical students and residents. Participants will be given time to go through a worksheet reflecting on how to incorporate an interprofessional activity into their own clerkship or residency program and then share in small groups. We will end with a presentation on the group’s experiences as far as trials and tribulations learned from incorporation of interprofessional activities, summarize main points, and allow for questions.

Educational Objectives:

  • Explain the core competencies in interprofessional education and how they apply to undergraduate and graduate training in internal medicine.
  • Give examples of current ways in which interprofessional education can be utilized in the internal medicine clerkship and residency program.
  • Generate an idea and plan for an interprofessional education component in their clerkship or residency.

Christopher Bruti, MD
Rush Medical College of Rush University Medical Center

Megan Newman, MD
Michael McNeal, MD
Texas A&M Health Science Center College of Medicine

Diane Levine, MD
Wayne State University School of Medicine

CDIM National Meeting—318. Adding Reflection to the Medical Student Clerkship and Using It in Residency
Among physicians, professional burnout has reached nearly epidemic proportions. Evidence has shown that matriculating medical quality of life and empathy decreases in the clinical years of medical school and continues to decline during their resident training to below their non-medical peers. It would seem plausible to suggest that the seeds of burnout are sowed in the learning environment during medical school. It would follow that medical school is good place to start intervening. It is our belief that skills in self-reflection, the ability to identify stressors in oneself and one’s colleagues, and the ability to effectively communicate will prepare our learners better for their future challenges. The aim of this workshop is to explore curricular methods that have helped our own learners and thus represent models for other programs. This workshop commences with an interactive discussion on how to identify the learner who may be experiencing early signs of burnout. We will then lead participants through curricular innovations in two institutions that focus on cultivating reflective capacity during medical school—including curricula in both pre-clinical and clinical training. We will go over the specific methods and objectives of the sessions. Program evaluations have shown these experiences to be well received by students and provides evidence that objectives are being met. The workshop will conclude with a small group discussion on adding reflection to clerkship of participants or daily rounds. We will discuss the challenges faced in the initiation and give participants tools to help implementation at their institutions.

Educational Objectives:

  • Recognize and understand the consequences of burnout in students during clerkship.
  • Review two institutional experiences of introducing reflection into the medical school curriculum that engages and arms learners with tools to help through the challenges they are facing.
  • Construct a reflection curriculum for participant programs and discuss the challenges in implementation and time with colleagues to brainstorm solutions to incorporating it into the program.

Shaden Eldakar-Hein, MD
Lee Rosen, PhD
Robert Larner, MD, College of Medicine at University of Vermont

Alisa Peet, MD
Hannah Raverby, MD
Lewis Katz School of Medicine at Temple University

CDIM National Meeting—319. Teaching Clinical Reasoning at the Level of the Reasoners
Clinical reasoning is one of the cornerstones of safe, high value medical practice and is the core focus of educational experiences in clinical medicine. There is significant room for improvement in clinical reasoning skills, however, as evidenced by the proportion of diagnostic errors attributable to cognitive errors. Furthermore, as learners enter the clinical realm, they are often still focused on the acquisition of medical knowledge about diseases and conditions and do not have a chance to explicitly focus on the development of their clinical reasoning skills. To improve learner clinical reasoning skills and create a culture of lifelong continuous personal quality improvement with respect to clinical reasoning, three easily implementable approaches will be presented. The first uses online serial-cue based clinical reasoning modules to develop reasoning skills in pre-clinical medical students. The second approach is an intentional progression from online virtual patient cases to the real-time use of published patient cases to actively discuss the reasoning process while working through a case. Lastly, this workshop will describe explicit approaches for learners to reflect on the decision-making in their own clinical cases to continuously and more rapidly improve their diagnostic reasoning abilities.

Attendees will leave with key resources and curricular materials to implement these approaches in their home institutions as well as a more nuanced understanding of the diagnostic reasoning process.

Educational Objectives:

  • Identify evidence-based strategies to teach clinical reasoning at each level of learner development.
  • Discuss the development of clinical reasoning across the continuum of medical education as well as the prevailing theories of how reasoning develops.
  • Identify strategies to implement novel approaches to developing clinical reasoning in students across the four years of medical school, including serial-cue based tools, online virtual patient cases, the use of published cases, and reflection on learner’s own experiences.

Robert L. Trowbridge, MD
Maine Medical Center

Patrick Rendon, MD
University of New Mexico School of Medicine

Rabih Geha, MD
University of California-San Francisco School of Medicine 

Laura Garcia, MD
University of Texas Rio Grande Valley (Valley Baptist Medical Center)

CDIM-Clerkship Administrators—320.  Connecting Passion with Purpose: Creating a Roadmap to Reach Your Full Potential
"Finding ones “purpose” in life can feel like an intimidating task.  The theory of authentic leadership suggests that what you loved to do as a child has everything to do with what you love about your job or personal life now. Purpose shows up in many ways and places and helps you identify your core passion.  Under times of duress, being able to articulate why you are doing what you are doing is a resource. Those who are aware of their purpose, and sense of meaning tend to be more resilient and able to see past current challenges.   Additionally, going from gut purpose to articulated purpose allows one to more accurately assess opportunities for the future as well as tilt their current work toward what energizes them.  

Participants will work in small groups to recognize their passions and create a roadmap to apply their authentic impact statement to their everyday practice. This workshop aims to help participants develop their impact statement with a positive psychology coaching tool designed to help them discover what is already there but is rarely uncovered. The goal for this workshop is for participants to end with an impact statement about themselves…”I am a person who loves X, Y and Z and I am at my best when I am A, B and C.”  Further, work in small groups will develop a specific action plan, including milestone markers to achieve these goals in both their personal and professional lives."

Educational Objectives:
•    Identify the importance of authentic leadership and connecting passion and purpose.
•    Develop their own impact statement incorporating their authentic talents and purpose.
•    Develop short and long term goals and strategies to implement their impact statement.

Crys S. Draconi
Tufts Medical Center
Kerri Palamara, MD
Harvard Medical School Massachusetts General Hospital

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Workshop Session IV
Tuesday, March 21, 2017
11:45 a.m. to 1:15 p.m.

AIM Educational Conference—401. Civic Engagement: Serving the Greater Good
This workshop will speak to the largest organized effort of integration and community involvement in a follow-up response to previous campaigns at Johns Hopkins Hospital (Our Journey in Medicine Continues - 2015) and Johns Hopkins Bayview Medical Center (Medicine for the Greater Good (MGG) – 2013). Alongside MGG’s preexisting structure, the development of two collaborative steering committees in the department of medicine: staff engagement steering committee and community engagement steering committee will meet together to plan activities to enhance diversity and inclusion programs for everyone within the department of medicine—faculty, nursing, and administrative staff—as well as enhance our connection to our surrounding community. This session will provide the past, present and future states of department-wide civic engagement/medicine for the greater good initiatives.

Educational Objectives:

  • Engage and connect clinical and non-clinical members with an understanding of community outreach opportunities to enhance innovative partnerships and trust beyond organizational walls and expand health education for the most vulnerable and disadvantaged populations.
  • Strategize and develop novel approaches to improving our environment, building a stronger culture of respect and helping us to become better change agents to improve our surrounding community.
  • Describe the success within the of the Baltimore community and beyond as well as describe the impact on medical education to community partnerships.

Darren W. Brownlee
Johns Hopkins University/Bayview Medical Center

Panagis Galiatsatos
Kirsten Gercke
Johns Hopkins University School of Medicine

AIM Educational Conference—402. Presenting Quality and Operating Metrics Visually for High Impact
This workshop will present various graphical examples of quality, financial, and operating metrics to help make high-impact presentations geared towards executive leaders.

Educational Objectives:

  • Demonstate ways of presenting operating and financial metrics, such as expense and revenue trending, physician productivity, physician referrals, testing volumes, procedure mix, and occupancy/capture.
  • Demonstrate ways of presenting quality metrics such as satisfaction, engagement, and environment of care.
  • Describe the best types of graphs and charts for various indicators and how to use pivot tables to sort through large data sets.

Jessica L. Schmidt
Georgetown University School of Medicine

AIM Educational Conference—403. Creating a Clinical Administrative Infrastructure and Oversight Model from Division Perspective
This workshop shares a model successful at Duke University for the division of gastroenterology. We have created an administrative infrastructure within the division to support a robust and growing clinical practice. As administrative leaders, we have forged strong partnerships, collaborations, and working relationships that bridge from the faculty/providers and division leaders to the scheduling center, practice locations, hospitals, and other clinical leadership entities. We have seen great success in our clinical practice, increased volumes, work culture improvement, less staff turnover, greater job satisfaction, and patient satisfaction not to mention happy providers.

Educational Objectives:

  • Review the administrative infrastructure organization chart, layer in staff assistant roles, nurse triage support, scheduling center support, and clinical nurse specialist function.
  • Clarify roles and collaborations: partnership with scheduling center and oversight, role of the medical director, standard expectations of templates/faculty productivity. And provider messaging.
  • Manage governance: clinical leadership, monthly “business meeting,” patient satisfaction processes at division and site level, and monthly volume.

Cathy O’Neill
Duke University School of Medicine

APDIM Spring Meeting—404. The Humanism Project – Curricular Innovation to Teach Communication Skills to Residents
All residents benefit from mentoring around communication skills, the patient-physician relationship, and wellness. But how do we formally structure and integrate this curriculum? This workshop will present a longitudinal three year course, “The Humanism Project,” which is nested within the ambulatory week of a 4+1 residency matrix at a large community hospital. Every five weeks, residents rotate through a module learning experience, and over the lifetime of their training, this project ensures a comprehensive exposure to these topics. Each module brings together discussions and exercises on one of numerous diverse topics, including specific communication skills (Ask-Tell-Ask, SPIKES, NURSE), bioethical dilemmas (judging decision-making capacity, discussing non-beneficial care), the culture of medicine (unconscious bias, conflict resolution, shared decision-making, language used to describe death), and methods of self-care. The presenters will review their collection of materials including video clips, bibliography, case scripts, use of standardized patients, group discussion faculty notes, and homework assignments. We will also outline many of the obstacles met while creating this project. During small group work, participants will share their current program approaches to this material. Facilitators will support participants to brainstorm about developing new curricula, which could include materials, formats, and approaches from The Humanism Project.

Educational Objectives:

  • Learn the scope of The Humanism Project’s diverse content, which is designed to improve patient-physician relations, to develop greater resident appreciation for the complex skill set required to communicate well with patients, and to promote resident wellness.
  • Identify new curricular formats (video clips, Polleverywhere, scripted actors, communication drills) which engage residents.
  • Develop an action plan for an improved and expanded curriculum focused on the patient-physician relationship and resident wellness.

Lawrence B. Wolf, MD
Jennifer Breznay, MD
Beth Popp, MD
Melvyn Hecht, MD
Maimonides Medical Center

APDIM Spring Meeting—405. Listening to Reason: Strategies for Instilling a Culture of Clinical Reasoning in Graduate Medical Education
In a recent report, “Improving Diagnosis in Health Care,” IOM identified diagnostic error as an important contributor to adverse patient outcomes and highlighted the urgent need for better training in decision making across all medical disciplines. ACGME and ABIM have similarly identified the development of clinical reasoning skills as a priority for internal medicine residency training. Despite this wide recognition, explicit instruction regarding clinical reasoning principles is often lacking. Additionally, there is equipoise in the literature about how to best establish a curriculum that enhances each resident’s ability to develop and refine their clinical reasoning skills. We have developed a multipronged approach for creation of a culture of clinical reasoning in our internal medicine residency program. Through this workshop, we will describe the teaching and clinical venues that can be used to disseminate the common language that governs clinical reasoning, rolemodel a systematic approach to case solving, create an environment where uncertainty and errors can be freely discussed and learned from, and plan for, address, and discuss bias. Discussion will focus on an interactive case-based conference series that highlights clinical reasoning by master diagnosticians, didactics and interactive online methods for introduction to the principles of clinical reasoning, and a variety of chief resident and faculty development sessions focusing on how to best facilitate clinical reasoning while teaching. This workshop will provide attendees with the knowledge and skills to implement clinical reasoning curricula in a multimodal approach at their own institutions.

Educational Objectives:

  • Identify multiple modalities and techniques with which to teach the complexities of clinical reasoning, and list advantages and disadvantages for each method.
  • Illustrate examples of how implementation of a multimodal approach can make clinical reasoning a focus of graduate medical education.
  • Develop a plan for creation of a multimodal clinical reasoning curriculum at their own institution using the toolkit provided by presenters.

Eliana Bonifacino, MD
Deborah DiNardo, MD
Sarah Tilstra, MD
University of Pittsburgh School of Medicine

APDIM Spring Meeting—406. Optimizing U: A Curriculum Designed to Help Residents Realize Their Potential
What can we learn from Olympians and other high performance athletes? What are the mindsets, mental skills, and strategies that permit them to perform their best on the world’s stage? How might we train our residents differently if we learned from their peak experiences? Optimizing U is our personal development curriculum, designed to allow residents to learn practices and explore mindsets that enable them to reveal and realize their highest potential. Borrowing liberally from the applied science of high performance psychology and taking a “human first” point of view, we explore the conditions and perspectives that permit increasingly higher levels of performance in areas outside of medicine and apply them to the training of our residents with the goal of improving their experience and performance. In this workshop, we will describe how and why we expanded our discussion of burnout, mindfulness, and resilience to include optimizing and fearless learning. We will present an overview of the curriculum with specific examples of content and application. Audience members will experience one of the sessions we conducted within our program intended to connect residents with their optimal inner experience. Finally, we present our initial measures and future direction.

Educational Objectives:

  • Explore how high performance psychology can be applied to the experience and performance of residents.
  • Experience a session intended to connect residents with their inner experience when they are preforming at their best.
  • Review specific measures to assess impact of the Optimizing U curriculum.

Alvin S. Calderon, MD
Joy Bucher, MD
Virginia Mason Medical Center

APDIM Spring Meeting—407. Starting or Improving Your Primary Care Track: What You Need to Know
There is an urgent national need to train future primary care physicians and leaders. It is critical that primary care tracks differentiate themselves from categorical programs and prepare residents for practice in this changing environment. This workshop will review the principles necessary to start and maintain a successful primary care track, including how to obtain institutional support and show the value of a primary care track. Using programs from two universities, we will demonstrate strategies to integrate primary care-focused subspecialty experiences, create innovative continuity clinics, and foster primary care-based scholarly activities. The workshop will also focus on maintaining your mission as a primary care track and graduating residents who will pursue careers in primary care. One of the programs is long-standing, with a separate match, and over 80% of its graduates remain in primary care. The second program was recently developed, is embedded within the categorical residency program, does not have a separate match, and allows transfer into the track during residency. Discussion of the specific design and education components of these programs will serve as a catalyst for discussion about different methods of applying the principles necessary to develop and maintain a successful primary care track. Learning will be facilitated through small group breakout sessions and large group discussion. Participants will develop plans for integrating primary care experiences into their home programs.

Educational Objectives:

  • Describe the principles of developing and maintaining a successful primary care track.
  • Compare and contrast two successful primary care tracks.
  • Develop a plan for integrating new primary care experiences into your program.

Joan Addington-White, MD
Vidthya Abraham, MD
University of Wisconsin School of Medicine and Public Health

Kristin Collier, MD
Jennifer Lukela, MD
University of Michigan Medical School

APDIM Spring Meeting—408. Enhancing Continuity in the Resident Longitudinal Clinic
ACGME expects internal medicine residency programs to provide a longitudinal continuity experience in which residents develop a continuous, long term therapeutic relationship with a panel of general internal medicine patients. Ensuring continuity in the longitudinal clinic is a difficult problem for many programs, and the absence of continuity may steer residents away from careers in primary care internal medicine. The residents are only available for clinic periodically due to other responsibilities, while adult primary care patients have needs and expect service – visits, paperwork, or returned calls/emails on a nearly daily basis. The experience of both the patient and the resident learner is improved if the resident and patient have continuity between visits. The purpose of this workshop is to review the recent literature on best practices in maintaining continuity in the longitudinal resident clinic, to address barriers to continuity, and to develop solutions for patient access. Participants will work together in groups to develop program-specific solutions across differing clinic formats and settings.

Educational Objectives:

  • Appreciate solutions published in the literature on enhancing continuity in the resident longitudinal clinic across differing schedule formats including traditional longitudinal clinics and X+Y formats.
  • Recognize and address barriers to continuity in community and university-affiliated resident longitudinal clinics.
  • Develop solutions to the problem of between-clinic work, i.e., paperwork, referrals, prescriptions, phone calls and emails.

James Bragg, MD
G. Dodd Denton, MD
Caley McIntyre, MD
Do Young Kim, MD
Ochsner Clinic Foundation

APDIM Spring Meeting—409. Flexing Your Leadership Skills
Medical educators often find themselves in new leadership positions without ever having any formal instruction or practice in some of the key competencies critical to effective leadership. We are often placed in the position to advocate for our training programs, negotiate for necessary resources, influence stakeholders, and recover from failure with the resilience and reflection to try again. Most of those skills are not taught in medical school, residency, or even on the job until we are face to face with our first hurdle. Our workshop will provide a taste of executive leadership training to help educators and leaders build competencies in communication, leadership and executive presence, and effective influence. We will teach, discuss, and practice key principles and skills to encourage participants to overcome professional barriers and enhance resilience and job satisfaction. It will be accomplished through large and small group discussions, skills practice, and reflection exercises.

Educational Objectives:

  • Identify the leadership qualities that are critical to achieving success as defined by participants.
  • Learn, practice and apply skills of posture, voice and breathing to help facilitate effective communication and self-empowerment.
  • Help participants to identify two individuals who can help promote career goals and a thoughtful way to approach those individuals.

Debra S. Leizman, MD
Case Western Reserve University School of Medicine

Ronda Mourad, MD
Cleveland Veterans Administration Hospital, Case

Abby L. Spencer, MD
Cleveland Clinic Foundation

Leslie Dickson

APDIM Spring Meeting—410. New Faculty in Your Clerkship or Residency Program? Give Them This Crash Course in Learner Assessment
You are expanding your third year clerkship and relying more on community-based preceptors. Your residents are rotating at a new hospital your health system just acquired. Many new faculty will now be supervising your learners. How can you avoid the halo effect and ensure an accurate assessment of learner performance? This workshop will provide you with a portable “off the shelf” faculty development session you can deliver in under an hour. It includes a practical, jargon-free approach that will provide a shared mental model of learner trajectory. As clinicians, your faculty are familiar with illness scripts, a targeted exam, and pattern recognition. This program builds a parallel process using learner scripts then prime faculty to “examine with intent”—observing for discrete skills or behaviors—that will correlate to your evaluations whether they are rooted in EPAs or milestones. We will provide you with a template to make it easy for the faculty to write high-quality written comments. This workshop is geared for anyone interested in improving student/resident assessment and evaluation or those charged with training new faculty who will be working with a spectrum of learners. You will leave with everything you need to return to your home institution and implement the session—slides, learner scripts, and an easy to use template to adapt to your rotation assessment tools.

Educational Objectives:

  • Deliver efficient faculty development to new faculty working with students and residents.
  • Differentiate learner scripts and target these to developmental trajectories.
  • Improve the assessment skills of faculty.

Kristy Deep, MD
Andrew Hoellein, MD
University of Kentucky College of Medicine

Alexander R. Carbo, MD
Harvard Medical School Beth Israel Deaconess Medical Center

Abdo Asmar, MD
University of Central Florida College of Medicine

APDIM Spring Meeting—411. Miles Ahead: Meeting Your Interprofessional Milestones through Ambulatory Curricular Innovation
Interprofessional education (IPE) is a strategy to train health professionals in effective, collaborative team-based care with the goal of improving health outcomes for patients. Traditionally, residency training has had limited integrated educational curricula with other health professionals. While ACGME has established the importance of IPE by requiring specific interprofessional milestones for internal medicine residents, residency programs are struggling on how to practically implement and measure IPE in their curriculum. Many internal medicine residency clinics are moving towards patient centered medical home certification, the cornerstone of which is interprofessional collaborative care for patients. It endorses the explicit need for IPE in the ambulatory setting; however, many programs have traditional didactics that overlook the opportunity to teach about interdisciplinary team-based care. In this workshop, we will review the importance of interprofessional education in residency training and the milestones that address interprofessional team-based care. We will describe how two different residency programs successfully integrated IPE into ambulatory education through several curricular innovations including: interprofessional team-based learning didactics, interprofessional quality improvement projects, integrated journal club, and interprofessional medical jeopardy competitions. We will guide participants through the development of an implementation IPE curriculum through roleplay. Participants will reflect in small group sessions to address the IPE needs of their unique institutions, brainstorm various strategies for implementing IPE in the ambulatory setting, and assess the interprofessional ACGME milestones through didactics at their residency programs.

Educational Objectives:

  • Define IPE and review the AGCME milestones that address interprofessional team-based care.
  • Be guided through an example of interprofessional curricular design for the ambulatory setting and reflect on the experiences of two university-based residency programs in implementing innovative ambulatory interprofessional curricula for residency education.
  • Examine resources that exist within your own institution and develop strategies for implementing an IPE program in the ambulatory setting for your residency program.

Elizabeth Lee, MD
Lewis Katz School of Medicine at Temple University

Jennifer Verbsky, MD
Jason Ehrlich, MD
Frank Cacace, MD
Hofstra Northwell School of Medicine at Hofstra University

APDIM Spring Meeting—412. Is Our CCC Successful? Creating Resident Competency Reports for More Effective and Transparent Evaluation Process that Engages CCC Members and Residents Advocate Lutheran General Hospital internal medicine residency program recognized the needs for continuous improvement of our CCC evaluation process. Our goal was to design a transparent competency based document which included resident’s metrics and performance. This innovative resident competency report (RCR) improved the effectiveness of our CCC meeting, allowed to recognize areas of impact early in the evaluation process and aided in providing detailed feedback to our residents. After inventorying where our program milestones are taught and assessed, we compiled the data into a two page competency report. Resident can actively provide academic/scholarly updates and self-reflection on the worksheet (which is a part of RCR), this way becoming active agents in the evaluation process. The resident and advisor have a face to face meeting to provide timely feedback. The residents bring with them the completed worksheet and together they complete an action plan. Our development of the RCR improved the quality of the feedback and normalized constructive feedback providing transparency around performance expectations. After our CCC meeting and resident feedback session, we have established a survey for both CCC members and residents to evaluate our CCC process for continuous educational quality improvement. This survey informed us of additional areas where our residents are evaluated in the milestones allowing us to continually improve the RCR and to evaluate the effectiveness and transparency of the feedback residents receive.

Educational Objectives:

  • Establish a quality improvement process for the CCC that engages both the committee and the residents.
  • Design a transparent process to assess resident milestone progress.
  • Develop a structured competency milestone report to improve the quality and normalize constructive feedback between advisor and residents.

Jadwiga Loj, MD
Jill Patton, DO
Danielle Priester
Afshan Woodrich
Advocate Lutheran General Hospital

ASP Annual Meeting—413. How to Manage Failing Faculty

This workshop will review the lessons learned from the Ohio State University Professionalism Consultation Committee regarding remediating faculty who have had lapses of professionalism and are referred to the committee for evaluation/remediation

Educational Objectives:

  • Understand why medical professionalism is important.
  • Review the OSUWMC experience and how remediation is undertaken
  • Review the approach/teaching OSUWMC takes to teaching professionalism
  • Discuss three common traits that successful practitioners have as assessed by the Professionalism Consultation Committee at OSUWMC

Edward Levine, MD
Ohio State University College of Medicine

ASP Annual Meeting—414. ACGME Self-Study: How It’s Good for Fellowship

The ACGME self-study is an opportunity for programs to analyze their training environment to augment their strengths, foster improvement, and anticipate future challenges.  It is also an opportunity for core programs and subspecialty fellowships to ensure they have shared goals, are effectively coordinated, and are meeting the needs of their trainees.  This workshop will explore the ACGME self-study process and how it can foster improved communication and collaboration between the core program and subspecialty fellowships.  We will explore the sequential steps undertaken in our self-study process and detail the data sources utilized in developing a robust program-fellowship self-assessment in advance of the self-study site visit.  Lessons learned from self-study site visits across the country will be shared to help inform best practice.

Educational Objectives:

  • Discuss the timeline for effectively implementing a program self-study with the goal of improving collaboration between the core programs and subspecialty fellowships.
  • Describe the data sources utilized, and the process of undertaking an effective self-study.
  • List common themes in aims, strengths, and perceptions of the environment for internal medicine subspecialty programs.
  • Discuss the value of the self-study for internal medicine subspecialty programs, and describe lessons learned from self-studies across the country and how this process may evolve in the future.

Sanjay V. Desai, MD
C. John Sperati, MD
Johns Hopkins University School of Medicine

Ingrid Philibert, PhD
Accreditation Council for Graduate Medical Education

CDIM National Meeting—415. Teaching the Seven Habits to Medical Students: Empowering Medical Students to Become Effective Self-Leaders in Their Personal and Professional Lives to Increase Resiliency and Decrease Burnout
Why teach fundamentals of leadership to medical students so early in their careers? The two most important reasons are that it prepares them for the challenges in residency and provides them a framework for lifelong improvement and servant leadership. Job burnout, time management problems, inability to maintain currency, lapses in professionalism, unwillingness to put the patient first and work-life imbalance are concerns that all future physicians may face. Using a values-based leadership program can give medical students the tools to combat each of these potential challenges in a very personal way. We have created a voluntary course for students to address these concerns using The Seven Habits of Highly Effective People and the book’s accompanying workbook. The course is conducted over three months. After the first introductory session which is led by a faculty moderator, students become the teachers in our curriculum. The course is limited to seven students so that each participant is equally involved and owns a habit that they must discuss in front of their peers and the faculty in attendance. Each session is conducted in an interactive format to promote discussion and dialogue. Waiting for residency training to develop personal and public success skills while also learning activities that promote self-renewal is too late in the development of today’s physician. Our curriculum provides a road map that will allow participants to effectively navigate through and overcome challenges that they will face in medical school, residency training, and beyond.

Educational Objectives:

  • Discuss and demonstrate techniques at beginning a medical student leadership curriculum at their institution.
  • Discuss and demonstrate how to use small group meetings and learner driven involvement in a longitudinal manner to promote character, leadership, collaboration, and resiliency development in medical school.
  • Discuss and demonstrate how to use The Seven Habits of Highly Effective People and the accompanying workbook to achieve these goals.
  • Discuss and demonstrate the impact of such a curriculum based on involvement by students and faculty who have participated.

Kevin E. O’Brien, MD
Kira Zwygart, MD
Hugo Narvarte, MD
Meg Scott
University of South Florida Health Morsani College of Medicine

CDIM National Meeting—416. Teaching Medical Students Proficient EHR Use: Embracing the Challenge
The pervasive nature of electronic health records (EHRs) in medical environments makes proficient EHR use imperative for practicing physicians. However, debates regarding student EHR use and inconsistencies between medical schools in providing EHR access as well as a lack of specific student education in skills needed for EHR mastery hinder the goal of uniform medical student preparation in its use. This session will generate a toolbox of methods for meeting EHR teaching guidelines.

In 2012, the Alliance for Clinical Education (ACE) released a collaborative statement setting forth recommended guidelines for EHR teaching. Recommendations included requiring students to document in EHR, practice order entry, to be exposed to decision aids accompanying the EHRs, and demonstrate a set of competencies related to EHR use by graduation. This workshop will demonstrate use of tools and lesson plans currently employed by The Ohio State University and by Northwestern University in the preclinical classroom environment to teach students proficient electronic patient encounter documentation, to introduce the use of EHR-linked decision aids, and to bolster EHR information retrieval and order entry skills. Existing practices in order entry teaching will be reviewed from the limited available literature and participants will generate a set of guidelines that may be implemented at home institutions to help fulfill this challenging requirement. These guidelines can be shared by email following the session.

Educational Objectives:

  • Develop a plan to teach proficient patient encounter documentation in the EHR to medical students.
  • Utilize a schematic to teach information retrieval skills in the EHR to clinical learners.
  • Generate an approach to and understand the challenges of teaching electronic order entry to medical students.

Camilla Curren, MD
Kimberly Tartaglia, MD
Ohio State University College of Medicine

Jennifer Bierman, MD
Katie Hufmeyer, MD
Northwestern University Feinberg School of Medicine

CDIM National Meeting—417. Real-Time Approaches for Evaluating a Student’s Mastery of Evidenced-Based Medicine
As medicine and medical technology advance, it has become increasingly challenging for medical school curricula to keep up. A major strategy is to instill students with an understanding of evidence-based medicine (EBM) principles to allow self-directed learning in the face of overwhelming new knowledge. As evidence, AAMC has focused several of its CEPAERs on mastery of EBM principles; CEPAERs 2, 3, and particularly 7 rely on EBM-related critical competencies, with a goal of “[developing] a well-formed, focused, pertinent clinical question based on clinical scenarios or real-time patient care.” There are many possible interventions to help students achieve this goal. Traditional venues, such as didactics and journal club, are often separate from clinical work. As such, students may view these as abstract and less practical. At our institutions, we apply a novel evaluation tool to give immediate feedback on EBM presentations, and also incorporate EBM into real-time H&P case write-ups. In this workshop, we will present a brief history of EBM – how it has been taught, and how EBM learning has been assessed. After reviewing the evidence for successful EBM teaching and assessment strategies, we will describe in detail the EBM-focused CEPAERs. We will then present our tools for incorporating EBM into clerkships, and conclude by suggesting how these tools can be used to assess EBM-focused CEPAER competencies.

Educational Objectives:

  • Review the history of EBM teaching and assessment, and to present data on successful strategies.
  • Describe the CEPAERs that rely most heavily on EBM critical competencies.
  • Present a novel rubric for evaluating student EBM case presentations, as well as a rubric for evaluating incorporation of EBM into student case write-ups.
  • Show how the above tools may assess student mastery of EBM-focused CEPAER competencies.

Mark Goldin, MD
Syed Ejaz Ahmad, MD
Hofstra Northwell School of Medicine at Hofstra University

Amanda Raff, MD
Serena Roth, MD
Albert Einstein College of Medicine

CDIM National Meeting—418. Ambulatory Education: Faculty Recruitment, Curricular Opportunities, and Meaningful Student Learning
This workshop will focus on several areas essential to high quality ambulatory learning. Participants will brainstorm types of meaningful responsibilities for students in the ambulatory setting at different stages of their training. Each potential responsibility will then be discussed with respect to how it may bring value to ambulatory sites and patients. Workshop participants will discuss how to best develop faculty and curricula for these student responsibilities. Participants will discuss barriers and solutions to shortages in sites and teachers for ambulatory education. Workshop faculty will summarize and share solutions from the literature and their own experiences. Finally, participants will consider alternatives for curricular design that optimize learning and teaching in ambulatory settings. Participants will brainstorm curricular structures that optimize continuity of care, site, patient diversity, teachers, or curricular objectives. Workshop leaders will discuss innovative ambulatory models from the literature and personal experience and ask participants to consider priorities, barriers to change, and solutions for enhancing their own curricula.

Educational Objectives:

  • Identify strategies to improve recruitment and retention of ambulatory sites and teachers.
  • Identify alternative ambulatory curricular structures that consider health (or clinic) system, and curricular needs.
  • Identify curricular elements that give students meaningful responsibility while bringing value to practices and patients.

Amy Shaheen, MD
University of North Carolina School of Medicine

Shobhina G. Chheda, MD
University of Wisconsin School of Medicine and Public Health

Jeffrey LaRochelle, MD
Uniformed Services University of the Health Sciences F. Edward Hebert School of Medicine

CDIM National Meeting—419. Preparing Future Resident Teachers While Improving Preclinical Learners Clinical Skills
This interactive workshop provides participants an opportunity to develop a novel near-peer preceptor program, which enhances preclinical clinical skills of learners and prepares senior medical students to be effective resident teachers Workshop faculty will guide participants as they work in small groups to develop their own residents-as-teachers modules and complementary simulation cases for preclinical learners. Each small group will have an opportunity to present their work for feedback and discuss evaluation methods to measure success. By the end of the workshop, participants will have completed a workbook that can facilitate the program’s adoption into their home institution’s curriculum.

Educational Objectives:

  • Discuss the needs, methods, and challenges of implementing a near-peer preceptor program.
  • Outline necessary steps to develop effective teaching modules to facilitate near-peer precepting in the simulated clinical environment including the development of educational objectives, curricular materials, and learning activities.
  • Identify institutional champions, early adopters, and evaluation methods to assure success.

David Ecker, MD
University of Colorado School of Medicine

Vinita Kiluk, MD
Dawn Schocken, PhD
University of South Florida Health Morsani College of Medicine

CDIM-Clerkship Administrators—420. The Art of Clinical Reasoning
How should we teach clinical reasoning to medical students?  That is the million dollar question.  Certainly it seems that the core internal medicine clerkship should be the backdrop for this task. This workshop will take you through the steps that we have created to develop clinical reasoning in the 3rd year medical student program.  This includes introducing the basic skill of reasoning and connecting it to key concepts (i.e. genesis of a differential diagnosis) using a concept mapping modality.  We will take you through what we teach our students on the art of clinical reasoning, sharing with you the creativity of the use of concept mapping to initiate their thinking process and ways to turn those ideas into solid clinical reasoning.  We will share with you why we saw a need for this, as well as the necessary steps we took to develop this session for the students.  We will lead you through the session that we present to our students so that you can see how each stage helps to further expand their minds to develop the critical thinking skills they need to effectively care for their patients.  We will also share with you ways to identify those students struggling with clinical reasoning, as well as suggestions for improvement.  This will be an interactive workshop where attendees will develop their own concept map and learn the nuances of making it work in the classroom.

Educational Objectives:
•    The attendee will learn to teach the basic concept of clinical reasoning
•    To define and demonstrate concept mapping
•    The attendee will learn to develop the art of clinical reasoning through interactive reasoning.

Oliver Cerqueira, DO
Ginger Wilson
University of Oklahoma School of Community Medicine (Tulsa)

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Workshop Session V
Tuesday, March 21, 2017
3:30 p.m. to 5:00 p.m.

AIM Educational Conference—501. Marketing and Branding Your Division or Department
The goal of this presentation is to discuss with administrators and physicians the importance of marketing and branding your area. Often in health care administration, we struggle on how to get our products and services out to the public. The goal of this talk will be to give administrators and physicians the tools required to build and efficient and effective marketing campaign.

Educational Objectives:

  • Discuss what marketing is and how it plays a role in health care.
  • Discuss what branding is and how it plays a role in health care.
  • Give everyone cost effective ways to market and brand their divisions or departments.

Craig DeGarmo
Asia Lawson
Ashley Jacoby
Georgetown University School of Medicine

AIM Educational Conference—502. Reducing Readmissions by Improving Transitions: Process and Outcomes
The workshop will describe how we engaged community stakeholders in strategic initiatives to coordinate efforts to deliver care to shared patients and improve care transitions. Participants will learn how we developed a care transitions model that promotes care continuity across organizational boundaries and bridges gaps in care by creating an integrated care network through strategic partnerships with regional stakeholders including nursing homes, assisted/independent living facilities, and home health care organizations. The workshop will walk participants through our first initiative to collaborate with external stakeholders to align our collective practices with value-based care initiatives. We will describe how a similar strategic approach can be adopted as a model for organizations that are struggling to remain successful in a fee-for-service model while transitioning to value-based care. The workshop will focus on the challenges and opportunities identified during the implementation of the project including the development of strategic partnerships; evidence-based identification of high risk of re-hospitalization based on chronic conditions, socioeconomic factors, and patient characteristics; the role of transition care coordinator; and how we engaged with patients, staff and caregivers through education and literature to address patient expectations. The presentation will also include preliminary data that indicates success. Several community stakeholders will be present in the audience to field questions.

Educational Objectives:

  • Illustrate the benefits of engaging key external stakeholders to develop a coordinated approach to implement care initiatives that align with value-base care.
  • Learn how academic institutions can leverage their educational mission to promote improved patient outcomes by developing educational opportunities for community stakeholders, focusing on areas that need immediate improvement.
  • Learn how to deliver patient-centered care through patient/caregiver engagement.

Jay Torres
Tammie Michael
Mukaila Raji
Dayna Villarreal
University of Texas Medical Branch at Galveston

AIM Educational Conference—503.  Stress and Wellbeing: Assess Your Stress and Take a 360 Approach to Resilience

Attendees will learn how to examine stressful situations and apply a well-being approach to build resilience. Techniques from positive psychology and mindfulness research will be shared, and participants will consider a personalized approach for managing stress in an era where many are overwhelmed and overworked.

This workshop will help attendees consider the difference between managing stress and building resilience to stress by using a holistic a rooted in well-being. Such an approach considers stress and life satisfaction in a way that blends our work, self, social, love, and spiritual tasks together to build resilience and manage stress.

 Educational Objectives:

  • Identify key variables to stress and individual tolerance to it.
  • Discuss different types of stress that are relational, situational, and work related.
  • Assess individual stressors then apply a coping strategy that is sensitive to our ability or lack of ability to control stress.
  • Identify the difference between managing stress and building resilience.
  • Create a personal stress and resilience strategy.

Michelle Carlstrom
Johns Hopkins University and Health System

APDIM Spring Meeting—504. A Unique Approach to Faculty Development Using an Objective Structured Teaching Encounter (OSTE)
Our 312-bed hospital is affiliated with a large health care system that supports a 38-person internal medicine residency, a growing full-time hospitalist group, and a substantial voluntary faculty. We have ongoing challenges with low patient satisfaction scores and mediocre resident evaluations of voluntary faculty. Almost all inpatients are admitted through our emergency room: 75% by voluntary faculty; 25% by full-time hospitalists. We designed a faculty development OSTE simulation study at the Northwell Center for Learning and Innovation using clinical scenarios, standardized patients (SP), standardized learners (Hofstra fourth year students trained as “interns”), faculty, and validated OSTE checklists to assess attending communication with interns and patients and attending teaching of/feedback to interns. Our faculty development initiative provides the framework for this workshop. Workshop participants will assume the role of SP, “intern,” or “attending.” Two clinical cases will serve to simulate a real interaction with each OSTE lasting 20 minutes. An attending debriefing will occur between and after the OSTEs to discuss the teaching and appropriateness of attending feedback to the intern. All checklist data will be available at the conclusion of the exercise. Pre- and post-intervention data from our study, including patient satisfaction scores and resident evaluations, will be presented at the workshop. Applicability, resource utilization, and ongoing challenges will be discussed as well.

Educational Objectives:

  • Develop the methodology to create this OSTE simulation exercise.
  • Understand the components involved in utilizing an OSTE for enhancing faculty teaching and feedback skills.
  • Appreciate the challenges of applying this tool to a large health care system.
Miriam A. Smith, MD
Regine Cherazard, MD
Hofstra Northwell School of Medicine at Forest Hills Hospital

Patti Adelman
Michelle Snopkowski
Center for Learning and Innovation, Northwell Health

APDIM Spring Meeting—505. Developing Your Faculty to Directly Observe Entering Intern Performance in Two Communication Entrustable Professional Activities
Intern boot camps in GME are a common method for evaluating the skills of entering interns prior to starting residency training. Boot camps are popular assessment tools in the era of competency-based medical education as they rely upon direct observation with immediate feedback to trainees. Most intern boot camps are directed at assessing procedural skills, such as central line insertion or surgical technique. Advanced communication skills, such as the ones required to call a consultation and perform a patient handoff, are skills that entering interns must frequently employ on day one of residency training, but may not be systematically assessed. Additionally, these areas address competency in two of the 16 internal medicine entrustable professional activities (EPAs): provide general medicine consultation to nonmedical specialties and manage transitions of care. Faculty may be unfamiliar with strategies for direct observation for these types of skills. We have successfully employed intern boot camp as a mechanism of teaching and assessing not just procedural but also advanced communication skills in entering interns. As part of their GME orientation prior to entering residency, all incoming interns undergo a boot camp experience in standardized consultation communication and patient handoffs. This workshop aims to share this experience and teach faculty skills to incorporate these kinds of assessments in their own programs with a special emphasis on using direct observation to assess advanced communication skills.

Educational Objectives:

  • Identify the elements of a successful faculty development initiative and will reflect on the presence or absence of these elements in their program’s efforts to engage faculty in direct observation of trainee advanced communication skills.
  • Acquire tools to improve their program’s assessment of advanced communication skills in trainees for calling a consultation and performing a patient handoff, including trigger videos, instructional modules, observed structured clinical examinations and checklists.
  • Describe how to incorporate evaluation methods related to direct observation of advanced communication skills into their programs.

Shannon K. Martin, MD
Vineet M. Arora, MD
Keme Carter, MD
University of Chicago Division of the Biological Sciences Pritzker School of Medicine

APDIM Spring Meeting—506. Catalytic Communication: Engaging Institutional Leadership to Create Learning and Practice Environments that Support Wellness
Strategies to combat burnout and restore joyful practice must go beyond individual self-improvement methodologies. A growing body of literature supports the concept that health systems can be more effective and productive when their workforce has a greater sense of well-being. Organizational solutions that augment satisfaction and reduce toxicity in the practice environment are essential and need to be discussed with institutional leaders. Skillful communication is the foundation, catalyst and currency of environmental transformation; yet these skills have not figured prominently in our professional training. Physicians often have difficulty articulating their mission and vision to institutional leaders. Effective communication skills are the catalysts for preventing burnout and promoting wellness among health care providers. This workshop will help participants communicate more effectively with institutional leadership by providing communication skills that will promote effective advocacy for practice and institutional transformation.

Educational Objectives:

  • Effectively articulate reasons to foster an institutional culture change that better promotes provider well-being blending narrative and supporting data.
  • List possible strategies and deliverables to achieve the aim of changing your institution’s culture to one that values wellness, and “pitch” these to your institutional leadership.
  • Negotiate a change, implement a new program, and strategize for a longitudinal plan to continue to monitor and promote wellness at the institutional level using validated communication techniques.

Andrea S. Cedfeldt, MD
Oregon Health & Science University School of Medicine

Paul R. Chelminski, MD
University of North Carolina School of Medicine

Diana B. McNeill, MD
Duke University Medical Center

Jonathan C. Ripp, MD
Icahn School of Medicine at Mount Sinai

APDIM Spring Meeting—507. From Biomedicine to Human Medicine: Precepting Social Determinants of Health in Ambulatory Teaching Clinics
Social determinants of health (SDH), defined by the World Health Organization as “the conditions in which people grow, live, work and age” have a profound impact on health. Physicians have been increasingly called upon to take a proactive role in addressing SDH, and educators have been tasked with teaching trainees how to intervene on SDH in their ambulatory continuity clinics. While experienced clinicians may have acquired expertise in addressing SDH, they may lack the confidence, knowledge and teaching skills to effectively coach learners to do the same. Time pressures and learner knowledge and motivation may pose additional barriers. In this interactive workshop, we will train educators to address SDH using the structure of the One-Minute Preceptor (OMP) model. We will begin with an introduction to SDH and ways SDH can be incorporated into a resident continuity clinic. We will then review the OMP model and consider how it can be used to diagnose learner understanding of SDH and offer targeted teaching points around identifying and addressing SDH. Next, the facilitators will roleplay a precepting encounter in which the OMP model incorporates teaching about SDH. Participants will identify the microskills demonstrated. Participants will break into small groups and discuss sample clinic cases relating to SDH. Each group will assess the learner’s knowledge of and motivation to act on SDH, identify a teaching point related to SDH, and practice the precepting encounter. In conclusion, presenters will share strategies for SDH education and faculty development at their institutions.

Educational Objectives:

  • Consider the role of the preceptor in teaching SDH.
  • Review the OMP model and describe how it can be adapted to teach about SDH.
  • Practice using the One Minute Preceptor model with learners of variable knowledge and interest in SDH.

Maggie Benson, MD
Thuy Bui, MD
University of Pittsburgh School of Medicine

Jennifer Siegel, MD
Catherine Rich, MD
Boston University School of Medicine

APDIM Spring Meeting—508.  The Experience of Women Residents in Internal Medicine

Gender and implicit bias may negatively influence the experience of women in medicine.  There is a paucity of information in the medical education literature defining the specific issues experienced by women in internal medicine residency training, and investigating the culture changes needed in our residency programs.  By exploring the experiences of women in our residency programs through pre-workshop data-gathering at the speakers’ institutions, we aim to delineate experiences which may be unique to women trainees, and to explore best practices to address these issues.  Following a brief overview of the available literature regarding issues faced by women residents, we will present preliminary results of this multi-institution effort to better define issues faced by women residents in our internal medicine programs.  A panel of residents will discuss their personal experiences, followed by large group discussion.  Themes emerging from this workshop will be shared with AAIM leadership.

Educational Objectives:

  • Review the available literature regarding issues faced by women residents, and raise awareness of the increased need for study of this subject.
  • Discuss the experience of women residents in internal medicine residency using data from 3 institutions and via resident discussion panel.
  • Allow for participants to engage in large group discussions about the experiences of women in internal medicine residency programs, to share best practices for addressing this topic, and to identify issues to bring to the attention of AAIM leadership.

Jennifer A. Koch, MD
Kristan Milam, MD
University of Louisville School of Medicine

Katherine Julian, MD     
University of California-San Francisco School of Medicine

Kerri Palamara, MD
Harvard Medical School Massachusetts General Hospital

APDIM Spring Meeting—509. The Development of Resident and Faculty Skills Training for Difficult Conversations: Code Status
This workshop will describe how two residency programs designed curricula to teach the necessary content and skills for effective yet challenging discussions of code status and goals of care. The workshop will describe how each program developed their curricular intervention, including the resources used, its placement within the curriculum, and the structure and components of the interventions. The assessment methods currently used and in development will also be presented. The presentation will include the details of each intervention, including the development of the clinical scenarios and cases, and the training techniques for acting patients. We will present how the actual sessions with the acting patients were conducted and how debriefing and feedback sessions were incorporated by either a time-in/time-out approach to feedback or a post encounter reflection and feedback discussion. The faculty development components will also be described. Assessment techniques, including learner feedback on the experience, currently used will be described and results shared. The longitudinal assessment techniques currently in development will be presented, and comments invited. Both programs will describe the differences and similarities of the two interventions.

Educational Objectives:

  • Apply a developmental approach to determine the best placement of a new teaching activity or intervention within the existing curriculum.
  • Describe the components needed to develop a successful curriculum for conducting difficult conversations, including the use of simulation.
  • Develop or adapt assessment techniques to assess the long-term retention of knowledge and skills taught during a one-time teaching session.

Mary Philbin
Vandana Nagpal, MD
University of Massachusetts Medical School

Christine Bryson, DO
Diane Dietzen, MD
University of Massachusets Medical School-Baystate

APDIM Spring Meeting—510. Training for Engagement and Advocacy for Community Health: A Novel Way to Teach Residents Skills to Address Key Problems in Community and Population Health
Despite progress in the management of chronic conditions and health resource availability, significant disparities in disease burden and health outcomes persist. Social factors contribute to many of these health inequalities. Residency programs are well positioned to address health inequalities because residents often care for community members at highest risk for poor health outcomes. Further, ACGME requires that residency programs address health disparities through quality improvement. Training for engagement and advocacy for community health (TEACH) is a longitudinal residency curriculum dedicated to the integration of teaching about the social determinants of health in a variety of clinical experiences throughout residency. Further, this curriculum teaches residents to provide care that is culturally competent and gives them the skills to communicate the impact that social factors have on health. One of the key components of TEACH allows residents in continuity clinic to work in inter-professional teams assigned the responsibility to learn about the social determinants of health in ZIP codes served by our medical center. They also work together on solutions to specific health problems unique to their continuity clinic patient population. This workshop will describe how this innovation was developed and implemented in a resident continuity clinic. Participants will work in small groups to participate in an interactive exercise designed to highlight how teaching this type of team-based problem solving around population health can be easily integrated into the ambulatory setting. Participants will leave the workshop with a blueprint to design a team-based population health project at their own programs.

Educational Objectives:

  • Explain the importance of teaching population health in the ambulatory setting.
  • List at least two questions to ask residents while precepting in the ambulatory clinic that allow for teaching about the consequences of population health.
  • Describe at least two ways population health concepts can be integrated into the existing ambulatory curriculum at one’s institution.

Erica Johnson, MD
Johns Hopkins University/Bayview Medical Center

Manasa Ayyala, MD
Stephanie Nothelle, MD
Johns Hopkins University School of Medicine

APDIM Spring Meeting—511. A Humanities Rotation: How to Successfully Innovate and Implement a Medical Humanities Curriculum to Promote Resident Well-Being
While the medical humanities are often taught at the UME level, many residency training programs are lacking a formal curriculum. Residents are at high risk for depersonalization, emotional exhaustion, and for losing meaning in their work. Integration of a humanities curriculum can serve to promote wellness and encourage interconnectedness as well as build emotional intelligence and communication skills. This highly interactive workshop will serve to highlight an innovative, interdisciplinary curriculum for residents designed to emphasize humanities in medicine. This curriculum, originally developed in 2006 by faculty without formal training in humanities, integrates various resources in both the institution and community setting, including community arts and music, narrative writing, and improvisation. In large and small group settings, we will explore challenges and pitfalls of humanity curriculum implementation and introduce strategies for development.

Educational Objectives:

  • Recognize that an emphasis on medical humanities can build emotional intelligence, and promote wellness as well as prevent and mitigate burnout.
  • Discuss challenges to implementing a humanities curriculum and identify non-traditional resources that can be used to overcome barriers.
  • Formulate an action plan of how to incorporate components of the curriculum at your home institution.

Amanda Clark, MD
Lisa Arfons, MD
Charles LoPresti, MD
Case Western Reserve University School of Medicine

Gopal Yadavalli, MD
Boston University School of Medicine

APDIM Spring Meeting—512. Documentation as a Tool for Assessing Early Subcompetency Deficiencies
Highly interactive workshop to illustrate the use of medical documentation to identify milestone deficiencies early during the internship, for targeted and timely remediation. This workshop will consist of multiple excercises and examples to define and identify clinical reasoning deficiencies, according to ACGME outlined subcompetencies in patient care, medical knowledge and interpersonal, professional skills. The workshop will also consist of group exercises, sample initial progress notes/H&P provided, and templates to try to identify milestone deficiencies/strengths.

Educational Objectives:

  • Identify of essential subcompetencies deficiencies for earlier correction and remediation.
  • Structure the documentation process to enhance diagnostic reasoning, and rationale for patient management through systematic thought process generation.
  • Identify lagnuage barriers, and communication deficits.

Maimoona Inayat, MD
Nargiz Muganlinskaya, MD
Louis Saade, MD
MedStar Union Memorial Hospital

ASP Annual Meeting—513. So You Think You Want to Be a Leader?
In this highly interactive workshop, participants will explore what it means to be a leader in the current environment of academic medicine and science.  Participants will learn the difference between leadership and management and the importance of adopting new leadership behaviors that are critical for success. The session will allow individuals to come to a better understanding of their potential as leaders. 

Educational Objectives:

  • Learn the difference between knowing about leadership, acting as a leader, and being a leader – and how it applies to them as persons considering leadership roles.
  • Explore new leadership behaviors that will enhance the ability to lead.
  • Engage with other participants to demonstrate and practice using new leadership behaviors.

R. Kevin Grigsby
Association of American Medical Colleges

ASP Annual Meeting—514. How to Recruit and Retain Faculty
Workshop description and educational objectives TBA

Don C. Rockey, MD
Medical University of South Carolina College of Medicine

CDIM National Meeting—515. “John Was a Pleasure to Work With…”: Enhancing Narrative Evaluations through Faculty Development
Narrative evaluations remain central to high stakes decisions regarding trainees (e.g. summative evaluations for grading and recommendations, clinical competency) as well as an important source of feedback for continuing development of trainees. Thus, it is imperative for faculty to provide robust, high-caliber narratives in their written feedback. Unfortunately, there is significant variation in the quality of narrative evaluations. While much faculty development has focused on oral feedback, less attention has been given to developing frameworks and tools to help faculty improve their narrative evaluation skills. This workshop is designed to provide participants with concrete strategies for eliciting more robust narrative evaluations from their faculty. In a “teach the teacher” format, this workshop will demonstrate faculty development strategies that participants can implement at their home institutions to enhance the quality of narrative evaluations of trainees. We will begin by discussing the richness of feedback narratives and utilize small groups to brainstorm elements of high-caliber narrative evaluations. We will then describe frameworks and strategies that participants can disseminate to faculty to transform poorly written feedback into robust, informative narratives. Speakers will briefly discuss data showing strategies that have been successful at their own institutions. Lastly, we will again utilize small groups to identify barriers to obtaining high-quality narratives and brainstorm strategies to overcome the barriers. The large group will reconvene to discuss methods of obtaining buy-in from faculty and for a question session to end the workshop.

Educational Objectives:

  • Appreciate the richness inherent to high quality narrative evaluations as compared to numerical assessments.
  • Discuss faculty development strategies to help transform poorly written narratives into robust, informative evaluations that facilitate ongoing student achievement.
  • Identify barriers to obtaining high quality narrative evaluations and brainstorm strategies for overcoming those barriers.

Nadia Bennett, MD
Keith Hamilton, MD
Corrie Stankiewicz, MD
Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania

Dan Henry, MD
University of Connecticut School of Medicine

CDIM National Meeting—516. Flipping the Teacher: Novel Ways to Engage Medical Students in Teaching and Learning
Clerkship directors often struggle to balance the wide array of didactic material against the limits of time students spend on their clerkship. Moreover, finding busy faculty to craft and lead a recurring learning session every few weeks is a challenge. Students often respond well to the challenge of presenting information to their colleagues and gain a level of understanding not always obtained when passively learning in class. As the educational buzz around flipped classrooms has grown, we have responded by recruiting students as teachers, providing unique opportunities to deliver content, and affording realworld experience with teaching skills. This workshop will present our experiences with employing students as teachers in clerkship didactics in varied settings, including student led presentations, peer coaching on clinical skills, and student-authored study guides.

Educational Objectives:

  • Review novel methods employed by the internal medicine and primary care clerkships to engage medical students in providing curricular content. 
  • Discuss the pros and cons of this method and the steps needed to employ this strategy for clerkships of participants.
  • Identify curricular content that could be taught by medical students and create a plan to implement this curricular change at the participant’s home institution.

Eva Rimler, MD
John Richard Pittman, MD
Emory University School of Medicine

Cinnamon Desgres
University of Massachusets Medical School-Baystate

CDIM National Meeting—517. A Medical Student, Pharmacy Student and Nursing Resident Walk into a Room… Using Human Patient Simulation to Teach Interprofessional Collaboration
Working among interprofessional teams is an essential skill for health care providers. It has become a core competency in many professional fields. Despite this need, there is little that currently exists in the clinical curriculum for students to learn with and about other professional trainees.
Beyond scheduling issues, bringing such diverse learners together for effective learning poses many challenges. Each must feel comfortable in the group and empowered to participate. Differing backgrounds and varied paces with which learning occurs in professional training programs adds greatly to the complexity of an effective educational experience. The successful collaborative experience must overcome these challenges and ideally improve all domains of interprofessional collaboration, including roles/responsibilities, values/ethics, communication, and teamwork. Simulation of patient care provides a common and relevant focus for all. Devising scenarios that hinge on the expertise of each profession involved enhances the development of an appreciation for one another. Concurrently teaching the basics of “teamwork” level the playing field for all and provide additional common focus to the activities. This interactive session will begin by deriving common goals and barriers to achieving them in interprofessional education. Presenters will share their experiences with simulation-based interprofessional education as well as qualitative and quantitative data that have helped refine the program. Small groups will be tasked with designing a simulation activity to achieve core competencies among their medical students and various other professional trainees at their home institutions.

Educational Objectives:

  • Describe how simulation can be used to achieve several core competencies in interprofessional education.
  • Design a simulation-based activity to teach teamwork and interprofessional collaboration.
  • Avoid common pitfalls when implementing interprofessional educational activities.

Michael Picchioni, MD
University of Massachusets Medical School-Baystate

CDIM National Meeting—518. Embracing Complexity but Acting with Simplicity – Grading Frameworks, EPAs, and RIME
Assessment drives curriculum. In 2014, AAMC proposed 10 core entrustable professional activities for entering residency (CEPAER) as a framework to fill a documented practice gap in graduating medical students; in 2015, AAIM endorsed the use of EPAs as well. Frameworks in medical education help faculty and trainees develop a “shared mental model of success.” But in and of themselves, such frameworks do not engage individuals in the complex task of developing a shared mental model. Only a minority of programs have trained core faculty doing evaluation, and new and more elaborate forms are not the answer. While there have been profound and rapid changes in assessment in both UME and GME with the adoption of EPAs and milestones embedded in multiple subcompetencies of the ACGME competency framework, RIME (reporter-interpreter-manager-educator) can serve as a broader, overarching, and integrating approach; it may be particularly relevant in UME where, in contrast to GME, running educational programs typically spans multiple geographically separated sites over hundreds or even thousands of miles. RIME is simple without being simplistic; has demonstrated reliability and acceptability; maps to the ACGME competency framework; maps to the proposed CEPAER, and has published outcome data for more than 20 years. By the end of the workshop, participants will be able to visualize the complementary use of RIME and EPAs as a way to embrace the complexity of the assessment process yet allow individual faculty to act with simplicity in workplace based assessment in the clinics and on the ward.

Educational Objectives:

  • Describe existing frameworks for grading clerkship students, including supporting theories and limitations.
  • Develop an explicit mapping of RIME and EPAs.
  • Review published outcome data for using RIME and EPAs and develop a plan for needed future studies.

William F. Kelly, MD
Paul Hemmer, MD
Louis N. Pangaro, MD
Eric Meyer, MD
Uniformed Services University of the Health Sciences F. Edward Hebert School of Medicine

CDIM National Meeting—519. The Old and the New: Teaching Methodologies to Integrate the Expanding Curriculum in Medicine Clerkships
The content that internal medicine clerkships are expected to cover has been growing rapidly, incorporating essential new topics such as patient safety, quality improvement, high value care, and interprofessional teamwork into an already dense curriculum. This workshop is aimed at assisting participants in prioritizing their curricular demands and strategizing effective, efficient ways to integrate these new topics into their clerkships. Using the CDIM-SGIM Core Medicine Clerkship Curriculum as the basis for the traditional curriculum, the workshop faculty will facilitate small group discussion among participants in how the traditional and new content may be balanced in their own clerkships. Faculty will review a range of successfully implemented methodologies including: online modules, asynchronous learning, problem-based learning, simulation, reflective exercises, and team-based learning. Participants will collaborate on how these methodologies may be used to deliver integrated content in their own clerkships. They will discuss the strengths and feasibility of each methodology to provide a more efficient integration of curriculum, addressing the needs of their particular students and institutions. Key discussion points and strategies will be shared with the group as a whole.

Educational Objectives:

  • Wrestle with the tension between traditional and new content in internal medicine clerkships given shortened timeframe.
  • Learn about successes using new teaching methodologies at other institutions to address core training problems from the CDIM-SGIM Core Medicine Clerkship Curriculum guide.
  • Develop strategies to maximize delivery of traditional and new content at attendees institution.

Nersi Nikakhtar, MD
University of Minnesota Medical School

Marty Muntz, MD
Medical College of Wisconsin

Viju John, MD
Rush Medical College of Rush University Medical Center

Shobhina G. Chheda, MD
University of Wisconsin School of Medicine and Public Health

CDIM-Clerkship Administrators—520. It’s All About the Soft Money: A Primer for Educational Grants
This workshop will cover writing, submitting, management and report writing for education grants; this workshop is not intended for NIH or RO1 grants. This workshop will cover how to gather a team together, how to decipher "Requests for Proposal" (RFP), as well as how to budget, manage "in-kind" support, the writing process and managing deliverables. The workshop leader will go through two successful grant proposals with the audience and then take a proposal from the audience and work through a possible project with group.

Educational Objectives:
•    To decipher ""Requests for Proposal"
•    To discuss the steps for grant writing
•    How to manage the budget

Lisa Oliver
State University of New York Upstate Medical University College of Medicine

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Workshop Session VI
Wednesday, March 22, 2017
10:15 a.m. to 11:45 a.m.

AIM Educational Conference—601. Timeline to Sanity for New Coordinators
This workshop is an in-depth overview of the academic year responsibilities we face and help make sense of the “alphabet soup” that is propelled at the new coordinator. The overview will help clarify what needs to be done and when. We will break down tasks month-by-month, beginning with July and the intern orientation. As we move through the year, we will cover topics important to all coordinators, no matter the specifics (size, location, and specialty) of their program. We will discuss acronyms, ADS updates, IM-ITE, ERAS, recruitment, match, schedules, and orientation. Year-round issues such as residency verifications, expense reimbursements, schedule issues, and tracking mechanisms will also be covered. After this workshop, the new coordinator should have a better command of what needs to be done and when, be able to effectively prioritize responsibilities, and be more efficient and productive in their coordinator role.

Educational Objectives:

  • Give a new coordinator a better command of what needs to be completed and when.
  • Prioritize responsibilities effectively.
  • Be more efficient and productive while in the coordinator role.

Karyn M. Rosinski
St. Joseph Mercy Hospital
Liz Thompson
Henry Ford Hospital/Wayne State University

AIM Educational Conference—602. Medical Group Practice Process Improvement: Impact of Optimizing Visit Duration and Patient Interaction on Patient Experience and Access to Care
The purpose of our workshop is to discuss standards around appointment duration and its relationship to patient access to care and patient experience and satisfaction measures. The two presenters are leading a Northwell Health medicine service line initiative to standardize visit times and the workshop will discuss challenges and successes of this project. We will also explore best practices across the industry and open up discussion regarding hurdles that participants might have experienced at their organizations.

Educational Objectives:

  • Increase participant understanding of the landscape of appointment visit duration standards across the industry.
  • Increase participant awareness of scheduling strategies aimed at increasing patient access, such freezing and thawing of appointments to allow more short-term access to appointments.
  • Foster a collaborative environment for dialog between participants.

Nicole K. Casey
Gina Pezza
Hofstra Northwell School of Medicine at Hofstra University

AIM Educational Conference—603. Developing Relationships across Administration and Physicians
The goal of this presentation is to showcase the relationship between administrators and physicians and how to build that relationship. Often the communication between administrators and physicians is minimal; the goal of this presentation is to bridge that gap.

Educational Objectives:

  • Explain the relationship between administrators and physicians.
  • Showcase in groups how to improve the communication between administrators and physicians.
  • Give each person attending actionable items and a toolbox of ideas how to move forward with building lasting relationships between administrators and physicians.

Craig DeGarmo
Joseph Lightfoot
Pamela Williams
Georgetown University School of Medicine

APDIM Spring Meeting—604. Charting a Course in Communication Education: An Innovative Longitudinal Approach
Communication with patients and colleagues is an essential competency of medical practice. Strong communication skills are necessary for leading interprofessional teams and navigating complex patient interactions. It is challenging to teach and evaluate communication skills, and many residents learn these skills indirectly through observation and role modeling. Feedback is often centered on communication skills observed during patient presentations, since opportunities for direct observation of patient and interprofessional communication are limited. We developed an innovative longitudinal curriculum in communication for internal medicine residents that focuses on key aspects of patient and interprofessional communication and includes both formative and evaluative components. Specific content addresses skills in behavioral counseling, breaking bad news, error disclosure, advanced care planning, and leading the interprofessional clinical emergency team. The curriculum employs a variety of teaching methods, including use of standardized patients, small group role plays and discussions, didactic presentations, high fidelity simulation, and reflective exercises. During this workshop, we will review the literature on communication education and introduce participants to our innovative multifaceted curriculum. Participants will have opportunities to view sample content and simulate teaching methods used in the curriculum as they move between small group breakout sessions. During small group sessions, they will complete a worksheet to serve as a guide for creating a communication curriculum in their own institution and they will be encouraged to brainstorm ways to create a curriculum using local educational resources.

Educational Objectives:

  • Identify key elements and skills that can be incorporated into a longitudinal, competency-based communication curriculum for residents.
  • Describe educational methods and resources that can be used to teach residents communication skills.
  • Receive sample materials that can be incorporated into designing a communication curriculum and discuss how to creatively apply these materials and techniques into their own training programs.

Laura Dingfield, MD
Carol Chou, MD
Stacey Kassutto, MD
Serena Cardillo, MD
Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania

APDIM Spring Meeting—605. Consistency Is Key: Tools and Strategies for Developing a "Litigation-Light" Competency-Based Remediation Plan for Your Residents
Many internal medicine residency programs struggle with identifying, evaluating and successfully remediating residents who demonstrate deficiencies in one or more of the six ACGME competency areas. Remediation of professionalism without fears of litigation remains problematic with the least likelihood of success. Our institutions have developed remediation programs that equip program leadership to identify struggling residents early, evaluate struggling resident learning needs in all competency areas, and develop an improvement plan that maximizes potential for remediation success, especially regarding issues of professionalism. In this workshop, we present a step-wise remediation plan with a structured algorithm for consistently investigating poor evaluations, engaging residents in self-reflection, and creating a resident-specific improvement plan based on observable deficiencies mapped to core competencies. We will share action plans and measurable outcomes used to remediate deficits in all competency areas and we will address the legal questions that often arise during this process. We also introduce a professionalism curriculum focused on communication skills, emotional intelligence, and metacognition that has been successfully utilized to remediate residents in the areas of professionalism and communication skills. We will guide participants through the process of creating a resident improvement plan and will then break into small groups to develop individual improvement plans for sample fictitious residents. Afterwards, participants will reconvene as a large group to share ideas and discuss strategies generated by the small group work. Finally, presenters will facilitate discussion of the implementation of these strategies and tools at participant home institutions.

Educational Objectives:

  • Demonstrate structured, consistent approaches to resident remediation used at two institutions.
  • Discuss available tools and strategies to address learner deficiencies in all six core competency domains.
  • Address legal concerns or questions related to remediating residents in graduate medical education.
Ellizabeth Ann Yakes, MD
Donald W. Brady, MD
John A. McPherson, MD
Vanderbilt University School of Medicine

Hilary F. Ryder, MD
Harley P. Friedman, MD
Dartmouth-Hitchcock Medical Center

APDIM Spring Meeting—606. Discharging and Educating, One Observation at a Time
Prior to this past year, our internal medicine residency program did not have formal training for PGY-1 to correctly and properly discharge a patient. We created a formal educational didactic with a tool to help interns learn the discharge process. We implemented a directly observed discharge process called “discharge rounds,” by which attending physicians observe and evaluate training physicians discharging a patient from the hospital. In this workshop, we will distill what an intern needs to know to successfully discharge a patient. We will review a reminder tool that we built in our electronic record and review the process for discharge rounds using observation and a formal evaluation.

Educational Objectives:

  • Discover the educational needs that an incoming PGY-1 has to learn to performing a proper discharge.
  • Learn what tools can be created for the PGY-1 to use and reflect on for the process.
  • Understand discharge rounds and how to implement at your institution.

Josh Collins, MD
Sean Drake, MD
Henry Ford Hospital/Wayne State University

APDIM Spring Meeting—607. Patient Satisfaction 101: Helping Residents to Understand the Patient Experience
In this new age of quality improvememt, performance measures, and patient satisfaction, we risk only seeing the check boxes and missing the patient-centered importance of these terms. Patient feedback has always been a part of the ACGME program requirements; however, the new term, patient satisfaction, has a higher degree of pressure for residents, who may see only their grade and overlook the value of this window into the patient perspective. Residents may not be aware of the real life application of patient satisfaction scores where their attendings have their evaluations posted on the internet and their salary incentives tied to these scores. In the past year, our residents have started to receive their patient satisfaction survey comments. Although most are positive, we were concerned that the negative comments could be demoralizing and confusing to young residents. To avoid the pressure and negativity, we built a curriculum around the outpatient patient satisfaction survey reports to help them to better understand the patient’s perspective, teach them about how patient satisfaction scores may impact their future practice and compensation as attendings, promote self-reflection and individual goal setting, and review best practices for patient-centered communication. We will describe our curriculum in detail as well as the faculty development session that supports our curriculum. Participants will be asked to share their experiences and ideas for teaching residents about patient satisfaction.

Educational Objectives:

  • Describe a curriculum that emphasizes understanding patient experiences through use of patient satisfaction survey responses.
  • Teach residents how to use patient feedback for constructive self improvement reflection and individual goal setting.
  • Improve faculty comfort in using patient feedback to improve resident skills in areas of self-improvement, empathy and communication.

Raquel Buranosky, MD
Robert C. Brooks, MD, PhD
Peter D. Bulova, MD
Carla L. Spagnoletti, MD
University of Pittsburgh School of Medicine

APDIM Spring Meeting—608. “None of Us Is as Smart as All of Us”: Building an Effective Leadership Team
This highly interactive workshop is intended to help program director leadership teams better understand themselves and to facilitate group synergy and collaboration. The stages of group formation and components of highly effective and functional teams will be reviewed followed by ample time for reflection and discourse with an eye towards better understanding group dynamics and enhancing faculty satisfaction. Facilitated discussion in breakout groups will help program directors, associate program directors, and core faculty strategize how to capitalize on the strengths and talents of their team. Participants will have opportunities to reflect on their current stage of group formation, share ideas to bolster team functionality at their home institution, and troubleshoot problems impacting their team.

Educational Objectives:

  • Discuss the Tuckman stages of group formation and analyze your current team through this model.
  • Describe and differentiate the components of effective teamwork / highly functional teams.
  • Design strategies to bolster teamwork and personal satisfaction at your institution.

Gina Luciano, MD
Michael Rosenblum, MD
Reham Shaaban, DO
Raquel Belforti, MD
University of Massachusets Medical School-Baystate

Abby L. Spencer, MD
Cleveland Clinic Foundation

APDIM Spring Meeting—609. Medical Chopped: Applying Adult Learning Theory and the Food Network to Teach Clinical Reasoning
Traditional clinical case conferences infrequently engage the larger audience. Participation is often limited to the presenter, discussant, and a few learners. Accordingly, many participants, while present, miss opportunities for learning. The use of gamification in conference has been employed to increase learner engagement; however, it is often limited to “Jeopardy”-based trivia games demonstrating recall of facts rather than the application of conceptual knowledge. Using concepts grounded in adult learning theory and gamification, our workshop goal is to improve learner engagement, clinical reasoning and medical content acquisition, premised on the Food Network game show “Chopped.” In this workshop, facilitators will discuss the development of “Medical Chopped,” including a brief overview of the dual process theory of clinical reasoning, the value of generation in learner consolidation, and the power of gamification in learner engagement. Finally, attendees will participate in “Medical Chopped” to highlight the application of conceptual knowledge and clinical reasoning.

Educational Objectives:

  • Identify learning strategies that can be incorporated into educational conference development.
  • Understand the value of gamification in increasing learner engagement in conference.
  • Compare and contrast the presentation of idiopathic versus drug induced systemic lupus erythematosus.

Patrick Cocks, MD
Gregory Katz, MD
Jennifer Mulliken, MD
Barbara Porter, MD
New York University School of Medicine

APDIM Spring Meeting—610. Building a Strong Foundation: Training Physicians in Skills of Resilience
In this workshop, participants will receive an overview of techniques to teach resilience skills to physicians. Techniques presented will be feasible and adaptable for any program to facilitate skills and behaviors that can be incorporated into the daily life of a physician, particularly those in training. Topics include setting realistic goals, managing expectations, identifying sources of gratitude, processing stressful clinical events, mindfulness, laughter, forgiveness, priority setting, and physical health as well as the relevance of particular topics at various stages of training. Methods of instruction presented will be diverse including large group training, small group discussion, mentoring, coaching, reflection, and blog reflection exercises. During this workshop, participants will engage in resilience skill exercises that have been successfully used with trainees at multiple institutions. Participants will work in small groups with facilitators to practice skills and lead one another through exercises to gain familiarity with the concepts. Participants will leave a set of micro skills that have been combined in our various programs in different models and venues, including retreats, orientation, and longitudinal curricula.

Educational Objectives:

  • Learn simple techniques to teach resilience to physicians in training.
  • Practice exercises to build resilience in oneself and with others.
  • Implement tools in teaching resilience at one’s own program.

Rebecca E. Miller, MD
Stephanie Call, MD
Virginia Commonwealth University School of Medicine

Michelle Katherine Martinchek, MD
University of Chicago Division of the Biological Sciences Pritzker School of Medicine

Amber-Nicole Bird, MD
Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania

APDIM Spring Meeting—611. Coordinating Complex Care – Teaching Internal Medicine Residents a Framework for Managing High-Risk Patients
In the era of the Affordable Care Act, primary care and the patient centered medical home have taken center stage in the push to reduce health costs, improve outcomes/satisfaction, and improve population health. Not surprisingly, it has prompted increased attention for “high risk” or “super-utilizer” patients in the primary care setting. Moreover, payment reform models are now incentivizing physicians to improve outcomes and reduce cost for outpatients with chronic disease. While reducing risk and improving outcomes for these vulnerable patients is difficult and often multi-factorial, a growing body of evidence shows success requires risk stratification, interdisciplinary care coordination, and innovative care delivery systems beyond the primary care clinic structure. The Penn Center for Primary Care has developed the coordinated complex care clinic for high risk patients as a novel clinical innovation to expose residents to the complex needs of this patient population to utilize an inter-disciplinary team to develop integrated longitudinal care plans, and offer targeted interventions to improve health outcomes. This clinical immersion process aims to provide residents with a framework to improve health and reduce costs for high risk, complex medical patients. Our workshop will focus on teaching participants the basics of how to organize such a clinic, logistical considerations, and designing a curriculum in longitudinal care planning.

Educational Objectives:

  • Create a step-by-step outline to create a high risk residency clinic which can be easily integrated within a regular resident clinic schedule.
  • Provide a framework for resident high risk patient visits which will teach residents primary, secondary, and tertiary prevention strategies, triage various of social determinants of health, and prioritize patient-centered goals.
  • Demonstrate the components of our longitudinal care plan curriculum which help residents better communicate, define, and enact the role of the medical physician within an interdisciplinary care team.

Rebecca Lauren Davis, MD
Riley Lipschitz, MD
Robin Canada, MD
Marc Shalaby, MD
Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania

APDIM Spring Meeting—612. RRC-IM Update
This workshop will provide participants with up-to-date interpretations of the core and subspecialty program requirements from RRC-IM and highlight changes in the accreditation process

Christian Cable, MD
Residency Review Committee for Internal Medicine

CDIM National Meeting—613. Subspecialty Services and Core Clerkship Students: A Good Educational Opportunity?
The increased demands on physician time coupled with the increased number of students needing opportunities for clinical training have required clerkship directors to think about options for clinical experiences outside of general internal medicine. Placing early students on subspecialty rotations for their required medicine clerkship, either inpatient or outpatient, remains controversial. Concerns have been voiced as to whether a subspecialty rotation provides the optimal learning environment and appropriate patient variety for a core clerkship student with limited prior exposure to internal medicine. Students may lack the experience or depth of knowledge needed to appreciate the focus of the patients seen by the subspecialist, and the physicians may lack an understanding of how to best guide the student for level-appropriate learning. Students may simply “slip into the background” as observers rather than actively engaging in their full educational opportunity. A review of the literature provided no articles offering practical suggestions or best practices to guide educators in this situation. This workshop will explore the ways to optimize student experiences on subspecialty clinical rotations. The workshop facilitators will present examples of programs currently using both general medicine and subspecialty rotations in the core clerkship and review techniques that have been applied to enhance the experience for both the physician-teachers and the learners. Participants will be encouraged to share their experiences with successful processes. Practical application of these principles will be explored through workshop exercises focused on curriculum and program development.

Educational Objectives:

  • Review the potential benefits and challenges of assigning core clerkship students to subspecialty rotations.
  • Propose and discuss techniques that can optimize student rotations on subspecialty services, from the perspective of both the student and the physician-teacher.
  • Apply principles discussed in the workshop to develop guidelines for a medicine clerkship student experience on a subspecialty services.

Karen E.M. Szauter, MD
University of Texas Medical Branch at Galveston

Alisa Peet, MD
Lewis Katz School of Medicine at Temple University

Christopher Knight, MD
University of Washington School of Medicine

CDIM National Meeting—614. From Student Doctor to Doctor: Enhancing the Transition from UME to GME
Becoming an intern is an important milestone for a medical trainee. It is an exciting yet stressful transition where expectations and pressure for success are high. There is a growing interest in how to best ensure medical students are prepared for this important next step in their career. Clerkship directors and residency program directors must agree on what minimum skill set is needed for a medical student to be considered ready to become an intern. They must also agree on how to best communicate student strengths and weaknesses so that residency programs can continue to work with the students from day one on improving any deficiencies. In this interactive workshop, we will discuss “the present state of affairs” with regard to assessment and preparation of students, describe innovative curricula at presenter institutions, and brainstorm new creative transition curricula and evaluation tools for both medical schools and residencies.

Educational Objectives:

  • Discuss program director and clerkship director expectations for medical students as they transition to internship and the use of entrustable professional activities.
  • Identify successful curricular elements during the fourth year of medical school that adequately prepare students for residency.
  • Brainstorm about new curricular and evaluation tools that could help better prepare medical students.

Maria A. Yialamas, MD
Harvard Medical School Brigham and Women’s Hospital

Alexander R. Carbo, MD
Harvard Medical School Beth Israel Deaconess Medical Center

Jonathan S. Appelbaum, MD
Florida State University College of Medicine

CDIM National Meeting—615. “It’s the End of the Rotation and I Don’t Know What to Write for Feedback!” How to Turn Angst into Answers
Feedback is one of the most powerful tools available to clinician educators and learners, because it enables learner-centered teaching. Feedback is also emerging as an antidote to burnout yet it is often avoided or given ineffectively. In the best of cases, feedback should focus on a learner’s actions, provide next steps for those actions, and describe specific outcomes. We found these qualities to be lacking when we reviewed written feedback from faculty to students and residents in our department of medicine. Because of this deficiency, we developed a faculty development session that has been useful in providing tools our faculty can use to formulate effective feedback. We focused this session on the principles of deliberate practice and acquisition of expert performance. Just like any skill, we can improve our ability to give feedback through use of educational methods also applied to other areas of learning in medicine. At this workshop, after a short didactic presentation of our framework, participants will work in groups to critically review written feedback looking for areas for improvement. By using cases, participants will then apply the steps to effective feedback learned at the didactic session by writing statements that reflect the principles of effective feedback. To further use principles of deliberate practice, participants will use their written statements to formulate oral feedback to learners, using a role play model. Lastly, groups will discuss barriers to implementing these steps at their home institution and strategies to overcome these barriers.

Educational Objectives:

  • Name the components of effective feedback.
  • Apply a framework for effective feedback to clinical scenarios.
  • Commit to changes they can implement in their future provision of feedback at their home institution.

Laura J. Zakowski, MD
Amy Zelenski, PhD
Scott Saunders, MD
University of Wisconsin School of Medicine and Public Health

CDIM National Meeting—616. Cooking Up a Better OSCE: What Can Televised Cooking Shows Teach Us about Assessment?
Objective structured clinical examinations (OSCEs) have been welcomed into medical curricula for their purported ability to assess learner clinical competence in a standardized environment. However, as OSCEs have become more widespread in education, these tools have been applied in varying ways, sometimes without clear understanding of what can or should be measured. Some OSCEs assess numerous elements of the patient encounter, while others assess a more focused set of skills; some provide a study guide beforehand, some do not. When these issues are not carefully considered, studies have indicated it may decrease reliability and introduce bias while promoting excess stress, which negatively impacts student performance and is not an accurate reflection of abilities. Seeking a better model, we have found inspiration with examples from popular culture. In televised cooking shows, participants are judged on the application of skills in the context of a specific challenge—a model that correlates intuitively with OSCEs. Some challenges reward improvisation under high stress, while others reward specific preparation under controlled conditions. Each situation has its analogue in medical assessment. We present our experience designing a summative OSCE in the internal medicine clerkship, using models from competitive cooking shows to illustrate how the OSCE can be deliberately designed to incentivize learning, reduce student anxiety, and more closely align OSCE assessments with learning objectives. We also present our experiences with an interprofessional, collaborative approach to OSCE design with input from both clinician educators and educational specialists in our clinical skills center.

Educational Objectives:

  • Discuss the advantages and limitations of the OSCE as a summative evaluation.
  • Consider how assessment prototypes from alternative resources may inform assessment in medical education.
  • Identify the benefits of an interdisciplinary approach to OSCE design and implementation with input from clinician educators and clinical skills center specialists.

Karen Law, MD
Richard Pittman, MD
Gina Shannon
Emory University School of Medicine

CDIM National Meeting—617. Developing a Curriculum in Patient Safety and Quality Improvement for Your Clerkship
Preventable medical errors are estimated to cause 440,000 deaths and annually are the third leading cause of mortality in United States after heart disease and cancer. Integration of patient safety training across the continuum of medical education is essential to prevent medical errors. AAMC has endorsed increased patient safety education during medical school; however, a cross-sectional study found that medical students have low knowledge of patient safety and quality improvement (PS/QI). With development of the core entrustable professional activities for entering residency (CEPAER), incorporating PS/QI into medical school curricula will be mandatory to align with these graduation requirements that include a focus on the culture of safety and improvement. This interactive workshop will help participants learn about the core competencies of patient safety and quality improvement as they pertain to medical students. We will present curricular innovations that have been successfully implemented during the internal medicine clerkship and discuss outcome measures. Finally, we will guide participants in identifying and addressing barriers and provide a worksheet for development of their own patient safety innovations.

Educational Objectives:

  • Become familiar with the CEPAERs that relate to patient safety and quality improvement. 
  • Identify two opportunities in the internal medicine clerkship to integrate a patient safety or quality improvement curriculum. 
  • Generate an idea and plan for a PS/QI initiative in their clerkship.

Diane L. Levine, MD
Wayne State University School of Medicine

Leigh Simmons, MD
Harvard Medical School Massachusetts General Hospital
Amy Shaheen, MD
University of North Carolina School of Medicine

Allison Heacock, MD
Ohio State University College of Medicine

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