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Workshop Descriptions

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Workshop Session I

Workshop Session II

Workshop Session III

Workshop Session IV

Seminar Session

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 the 2016 AAIM Skills Development Conference (PDF).

Workshop Session I
Friday, October 21, 2016
9:30 a.m. to 11:00 a.m.

(PM) 101. One-Page Project Management:  How to Get it Done in Departments of Medicine

Do you hold a position in which you are accountable for completing projects, but you don’t control all of the people whose engagement is essential to your project’s success?  Moreover, do you find that you have more idea-generators than implementers? If so, this workshop is for you. 

Departments of medicine, populated with highly active bright people, tend to generate many more ideas than we have staff and resources to implement them. How do we sort through all of the ideas? Once we select our most important initiatives, how can we increase the odds of their success?

Using an example from the clinical mission, this session will introduce processes and tools to help you set priorities among many ideas and build sponsorship, commitment, structure, and engagement across organizational silos to get things done.

For the past year, department of medicine at Duke University School of Medicine has implemented a new project management process resulting in accelerated project prioritization, framing, and completion in the areas of clinical practice, research administration, communications, and development. This interactive workshop will introduce the project management processes and tools used, highlight lessons learned, and provide you with the opportunity to begin building a one-page project management plan to take back to your organization. Further, we’ll explore 10 reasons why projects fail and how you can manage these risks.

To get the most from this workshop, please bring with you a project you are accountable for completing.

Educational Objectives

  • Understand the application of a set of project planning and management tools to prioritize projects, enlist sponsorship, negotiate support across organizational silos, structure a project for success, simplify reporting and communication, and understand the top 10 reasons why projects fail and how to manage these risks.
  • Demonstrate understanding of an Excel-based project management tool by beginning a one-page project management plan to take back to your organization.

Mary H. Trabert
Duke University School of Medicine

(TT) 102. The Voice of Reason:  Teaching Your Faculty to Diagnose and Remediate Learners Deficits in Clinical Reasoning

High caliber clinical reasoning skills are a prerequisite to providing high-quality, high-value, patient-centered care. Faculty members are charged with facilitating the development of learner clinical reasoning skills, yet most faculty members have had little training in the foundations of clinical reasoning. Without a robust conceptual model, faculty are left with gestalt: I know it (good/poor clinical reasoning) when I see it (good/poor clinical reasoning). Additionally, few faculty have had instruction in how to make this essential, yet somewhat abstract, skill tangible for their learners. This workshop is designed to provide participants with a concrete framework and toolkit, so that they are better-equipped to identify and remediate learners with clinical reasoning deficits. First, we will briefly discuss heuristics, basic principles and diagnostic theory that serve as a foundation for clinical reasoning. Then we will make explicit the steps inherent in the clinical reasoning process, and provide participants with a framework to help identify clinical reasoning deficits among learners. With this framework in place, participants will brainstorm methods to address common deficits at each step in the clinical reasoning process. Participants will then gain practical experience localizing the clinical reasoning lesion, through role play and case-based vignettes. Last, we will discuss methods to incorporate teaching clinical reasoning into the everyday work flow of precepting and rounding. We will provide participants with the knowledge and tools to immediately disseminate techniques and strategies for addressing learner clinical reasoning difficulties among their own faculty at their home institutions.

Educational Objectives 

  • Describe key models and theories used to conceptualize clinical reasoning.
  • Develop a concrete framework to help your faculty identify and remediate learners with clinical reasoning deficits.
  • Practice incorporating strategies for teaching learners clinical reasoning into everyday work flow.

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

(H/Q) 103. Practice Makes Perfect:  High Value Care Practice Audits

Up to one-third of health care spending in the United States may be wasteful, much of which can be attributed to provider practices. The Society of Hospital Medicine, in its Choosing Wisely Campaign, stated two of the top five things physicians and patients should question is repeat laboratory testing in the setting of clinical and lab stability and the appropriateness of telemetry use.  In an attempt to impact this area of overuse, our institutions developed high value care (HVC) practice audits for our learners.  Practice audits and reflective practice are key skills health professionals should develop during the course of their training. When tailored with a focus on HVC, they are a powerful tool with the potential to reduce spending in our clinical settings at the point of care.

In this workshop, the presenters will introduce HVC practice audits utilized with medical students and residents at University of Minnesota and Indiana University, including data demonstrating how the audits have been received by residents and milestone-based assessments developed for practice audits and cost conscious care.  The presenters will describe their audit tools and provide guidance on assessing appropriate telemetry and laboratory ordering practices. Working within facilitated small groups, participants will practice performing a HVC practice audit on a sample patient. The larger group will then engage in an interactive discussion of how to tailor this exercise for their own institutions and how to overcome challenges to implementing this curriculum.

Educational Objectives 

  • Understand the advantages of practice audits and self-reflection on your ordering practices and its impact on high value care.
  • Perform a high value care practice audit for a sample patient with hospital charges.
  • Engage in reflective discussions about high value ordering practices, including barriers and challenges at the point of care.

Alisa Duran, MD
Jill Bowman Peterson, MD
L. James Nixon, MD
University of Minnesota Medical School

Emily P. Machogu, MD
Indiana University School of Medicine

(G/L) 104. Build a Better Workshop

Do you have a great idea for a workshop that you would love to share with fellow teachers?  Do you require presentations on the regional or national stage for promotion?  This workshop targets faculty who are interested in developing a workshop for an educational meeting and are unsure of the best way to get started.  We will review principles of adult learning theory relevant to planning a workshop and best practices of the most successful workshops. We will review the theoretical underpinnings including  planning of objectives, performing needs assessments, reactivating prior understanding, motivating learners and building flexible understanding to promote learning transfer. We will review the real-world application of these principles, including choosing topics and speakers, timing your speakers and breakouts, choosing effective techniques to enhance understanding, using the wisdom of crowds, and key pitfalls to avoid. Facilitated small group sessions will allow audience participants to plan workshops using the relevant learning theory.

Educational Objectives

  • List two adult learning theory principles that are related to teaching a workshop.
  • Apply two organizational and management skills related to teaching a future workshop.
  • Describe common pitfalls that detract from a successful workshop.

Gretchen Diemer, MD
Sidney Kimmel Medical College at Thomas Jefferson University

Anthony A. Donato, MD
Reading Hospital

Marc Shalaby, MD
Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania

Gopal Yadavalli, MD
Boston University School of Medicine

(U/G) 105. From Student Doctor to Doctor:  Enhancing the Transition From UME to GME

Becoming an intern is an important milestone for a medical student. It is an exciting yet stressful transition where expectations and pressure for success are high. There is growing interest in how to best ensure medical students are prepared for this important next step of 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 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 EPAs.
  • Identify successful curricular elements during the fourth year of medical school that adequately prepare students for residency.
  • Brainstorm about new curricular and evaluative tools that could help better prepare medical students.

Maria A. Yialamas, MD
Nora Y. Osman, MD
Harvard Medical School Brigham and Women's Hospital

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

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

(E/A/R) 106. Understanding Unique Characteristics of Millennials to Improve Communication, Remediation, and Wellness

The millennial generation has unique views and attitudes towards education, work, wellness, and work-life integration. Understanding these characteristics of this generation, which now makes up most of our current learners, will allow us to better align the goals and objectives of the training program and its learners. This workshop will provide participants with a better understanding of the views, goals, and communication styles of the millennial generation. The presenters will then review the literature and common approaches to generating remediation highlighting areas were current techniques may need to be adjusted to meet the needs of the millennial generation. Small group work will focus on developing remediation plans focusing on issues with communication and professionalism unique to millennial learners. Participants will learn to recognize the general principles of remediation plans and begin to create their own remediation plans specifically for millennials. The workshop will then focus on principles of mentoring and creating individualized learning plans for the later residency goals of millennial learners. Small group work will focus on creating individualized learning plans especially focusing on learners in need and incorporating wellness into the educational objectives.

Educational Objectives 

  • Describe characteristics of the millennial generation, including communication styles, preferences and attitudes, and expectations about wellness.
  • Outline principles of remediation for millennial learners.
  • Mentoring and creating individualized learning plans for later residency goals such as scholarship.

Jessica Dine, MD
Todd D. Barton, MD
Eric Goren, MD
Karen Warburton, MD
Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania

(C) 107. There Is No “I” in Team – Strategies for Enhancing Interprofessional Teamwork among
Health Professionals

The practice of health care has changed dramatically over the last decade with increasing emphasis on team-based, interprofessional care.  Historically, physician educators have been charged with a crucial professional transformation. We shepherd medical students and residents as they transition from a knowledge-based perspective on their profession--one that is student centered to one that is experiential, social, and altruistic.  The focus of this transformation has usually been on the individual learner rather than the team.  Even less common are educational efforts focused on building high functioning teams from the diverse care-giving disciplines that serve our patients.  Interprofessional practice is now the norm; yet, there is still a lack of the systematic interprofessional education that should be the prerequisite for the new practice reality.  Truly patient-centered care mandates this foundation.  The purpose of this workshop is to help the participants identify the components of effective patient-centered, team care and to develop curricular elements at their institutions to promote interprofessional education.  We will explore professionalism as a group as well as an individual attribute.  We will present case-based strategies for improving communication and effective action among team members caring for patients.  We will discuss the use of the team “huddle” and other practical ways to help members respect and understand their roles in the patient care team.  This highly interactive discussion of experiences and best practices will be moderated by two experienced medical educators now responsible for interprofessional education at their institutions.

Educational Objectives

  • Identify the components of effective patient centered, team care using a prioritized q-sort.
  • Identify the need for inter professional education as a prerequisite for interprofessional practice and share best practices for including such education and practice in existing learner activities.
  • Learn why interprofessional huddles improve safe patient care and learn strategies for the effective use of huddles in busy clinical situations.

Diana B. McNeill, MD
Duke University School of Medicine

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

(W/R) 108. Residency Wellness:  Changing Culture through Experiential Learning

There has been renewed attention on the identification and care for housestaff who suffer from mental illness and burnout. However, given the continued stigma of these conditions, housestaff often do not seek help in these situations. Training faculty and chief residents to identify these housestaff officers, engage them in conversation, and activate resources requires targeted faculty development. This workshop will lead participants through an experiential faculty development session. We will begin with an interactive discussion of the impaired physician and the epidemiology of substance abuse, burnout, and mental illness in our profession. Participants will then participate in a group OSCE with cases of struggling learners. In debriefing the cases and the group OSCE experience, participants will learn the skills needed to lead their own session.  At the conclusion of the workshop, participants will be provided with materials (PowerPoint, sample cases, faculty discussion guides, and a case template) to create a session at their own home institutions.

Educational Objectives 

  • Describe the role of faculty and chief residents in identifying and assisting struggling residents.
  • Recognize problem behaviors in residents and develop skills to effectively discuss their concerns with a resident who may be impaired.
  • Construct an experiential faculty development session on identifying impaired residents to change institutional culture around the approach to burnout and mental illness.

Margaret Horlick, MD
Patrick Cocks, MD
Louis Miller, MD
Sondra Zabar, MD
New York University School of Medicine

(T) 109. The Electronic Health Record as a Teaching Tool:  Tips for Learner-Centered Electronic Health Record Use

Documentation in the electronic health record (EHR) is an essential skill for students “one that must, according to the AAMC, become part of the educational experience from the beginning.  EHR has the potential to impact every domain of clinical competency as defined by the ACGME.  Variable faculty experience and satisfaction with EHR threaten student development of this crucial skill.  It is unclear how students will gain sufficient EHR skills to practice in the current system, particularly with varying levels of EHR access and engagement.

This workshop, based on an AAIM Innovation Grant, will provide busy clinicians practical tips to learn how to use the EHR as a real-time clinical and educational tool.  A didactic session will review skills intended to facilitate patient-centered EHR use.  Then the concept of learner-centered EHR use will be introduced and explored.  Barriers to both patient- and learner-centered EHR use will be addressed, and specific clinical scenarios will be used to highlight techniques for teaching while using an EHR.  Participants will have an opportunity to practice these skills and receive feedback.  An electronic tool will be available to participants to facilitate further faculty development for their home institutions.  

Educational Objectives

  • Educate participants regarding documentation, billing, and compliance issues with EHRs.
  • Review skills intended to facilitate patient-centered EHR use and introduce and explore the concept of learner-centered EHR use.
  • Provide opportunities for participants to practice the skills of both patient- and learner-centered EHR use with feedback from the presenters and other participants.

Christopher A. Klipstein, MD
University of North Carolina School of Medicine

Nancy Weigle, MD
Duke University School of Medicine

(E/A/R) 110. Using Self-Regulated Learning Microanalysis to Diagnose and Remediate Struggling Test-Takers

Test performance is critical to professional success and learners who underperform on tests require considerable time and effort to remediate. This session will describe a method to diagnose the learner’s test-taking problem(s) and introduce a learner-centered technique to improve test-taking and study skills.

First, we will explore reasons why learners struggle on standardized tests and introduce self-regulated learning as a framework for identifying and classifying those reasons. We will also discuss the role of script theory in improving test-taking as well as clinical performance. We will then introduce our method of test-taking analysis which is a form of self-regulated learning microanalytic assessment and training.  This method is grounded in social cognitive theory and assesses self-regulation or the use of self-generated feedback to optimize the strategic pursuit of goals. Using a question review form and a semi-structured interview protocol administered while the learner thinks aloud through a test question, the faculty will be able to classify the learner’s problem: lack of script recognition, lack of script specificity, premature closure/anchoring bias, underconfidence, causal attribution problems, adaptive interference problems, and isolated learning deficits.

Last, attendees will view video portrayals of learners, diagnose them using the question review form, and develop learner-centered remediation plans. Attendees will be given a handout describing this test-taking assessment, a step-by-step method of implementation, and suggested courses of action based on specific learner problems.

Educational Objectives

  • Use self-regulated learning theory to identify reasons why a learner may not be successful in taking standardized tests.
  • Use self-regulated learning theory to identify remediation strategies for specific test-taking deficiencies.
  • Describe how to apply script theory to test taking.

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

(R) 111. Validity is Not a Four Letter Word! Appraising the Evidence in Medical Education

The volume of published literature in medical education has expanded significantly in the past 10 years.  As clinician educators work to incorporate evidence into instructional design and implementation, there is a growing need for faculty to expertly evaluate medical education studies, including assessing the validity of study design, the results of the study, author interpretations and conclusions, and the applicability of studies to a learner population or setting.

In this workshop, we will review different types of study design and current sources of medical education publications.  We will introduce several frameworks and tools for assessment of medical education studies.  We will discuss key concepts such as strength of study design, validity, reliability, statistical analysis, and, strength of outcome measures as we introduce existing tools for assessment.  Questions will be encouraged throughout the session. After training in these concepts and tools, participants will apply the tools by critiquing several studies.  Workshop facilitators will give interactive feedback on audience member critiques.

Educational Objectives 

  • Be familiar with key concepts in critical appraisal of educational literature including, but not limited to, strengths of different study designs, content validity, reliability, predictive validity, appropriateness of statistical methods, andstrengths of different outcome measures.
  • Be familiar with tools and resources that serve as guides for critical appraisal of medical education studies and publications.
  • Practice applying a critical appraisal tool to several studies (with feedback).

Stephanie A. Call, MD
Steven E. Bishop, MD
Reena H. Hemrajani, MD
Virginia Commonwealth University School of Medicine

Christopher Stephenson, MD
Mayo Clinic College of Medicine

(G/L) 112. Maximizing the M to M Relationship:  A Mentorship Toolkit

The role of mentorship for clinician researchers is generally well-established and project-centric. However, in the clinician educator world, mentorship may be less structured and require a broader perspective. This workshop will explore how to maximize the mentor-mentee relationship in clinician educator training and development. We will review how to effectively identify appropriate mentors as well as the importance of building a network of different types of mentors.  A key aspect of a successful mentor-mentee relationship is identifying the mentee’s overarching and specific goals. Workshop participants will be given a framework for creating professional mission statements to help mentees identify these goals. Mentees should use these mission statements to direct their career goals and decisions, and mentors can use these mission statements to effectively guide their mentees in the right direction. Workshop participants will also discuss qualities and skills of successful mentors and mentees and how to practically and effectively employ these skills. Specifically, we will discuss setting expectations from both sides of the table, use of mentor-mentee contracts, and meeting management including agenda setting and follow-up. Finally, we will review potential mentorship miscues, including generational differences in perceptions of the mentorship relationship, and how to effectively overcome these challenges to maximize the mentor-mentee relationship.

Educational Objectives

  • Demonstrate how to develop an effective professional mission statement.
  • Describe how to identify appropriate mentors.
  • Identify qualities and skills of effective mentors and mentees.

Swati Shroff, MD
Raquel Buranosky. MD
Rachel Vanderberg, MD
Natasha Parekh, MD
University of Pittsburgh School of Medicine

(E/A/R) 113. We Can See Clearly Now:  Reinvigorating 360° Evaluations to Capitalize on Observations of Learners in a Milestones-Based Format

Traditional evaluations of students, residents, and fellows by faculty often fail to capture the full picture of learners strengths and weaknesses. 360° evaluations address this gap. The advent of the Next Accreditation System (NAS) and reporting of milestone data to ACGME has fostered interest in 360° evaluations as a method for capturing competencies that faculty have limited opportunities to observe. 360° evaluations create assessments using information from those who work closely with an individual. In clinical medicine, these individuals include members of the interdisciplinary team: peers, subordinates, administrators, patients, and nursing staff. Residency programs at the presenters’ home institutions have distinctive approaches to developing and implementing milestone-based 360° evaluations that provide a nuanced, panoramic look into learners overall performance, trajectory, and developmental needs.

This highly interactive workshop will define 360° evaluations and their role in enhancing milestone-based assessment and feedback.   We will describe the process and content of our successful, reproducible 360° evaluation systems, discuss how to implement 360° evaluations, and provide sample evaluation tools. Workshop participants will dialogue about lessons learned in using these tools with an eye toward helping other programs capitalize on the strengths of 360° evaluations and avoid pitfalls. Facilitated group discussion will foster a climate of innovation and attendees will benefit from the insight of multiple perspectives. In break-out sessions, participants will work to develop their own 360° evaluation to enhance learner feedback and performance in communication, systems-based practice, and professionalism.

Educational Objectives

  • Understand how to utilize 360° evaluations to fill in gaps in reporting milestones to ACGME.
  • Appreciate the challenges and rewards of using milestone based 360° evaluations to assess and provide feedback on learner performance.
  • Build and share a milestone based 360° evaluation to use at their home program.

Hilary F. Ryder, MD
Geisel School of Medicine at Dartmouth

Sara L. Swenson, MD
California Pacific Medical Center

Donna Williams, MD
University of California-Davis School of Medicine

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Workshop Session II
Friday, October 21, 2016
1:00 p.m. to 2:30 p.m.

(G/L) 201. So You Want to Be a Designated Institutional Official (DIO)?

This workshop is intended for Program Directors who want to know more about the position of DIO as a possible career path as well as current DIOs who would like to engage in a discussion to further their knowledge and skills for this position.  The workshop will include an interactive didactic session followed by a panel discussion with question and answer that will involve other DIOs from a variety of different types of institutions.

Educational Objectives

  • Understand the basic job duties and skill sets of a DIO.
  • Appreciate the unique senior leadership role of the DIO within the institution. 
  • Appreciate the differences between university and community settings with respect to the role of the DIO.
  • Have a basic understanding of GME finance as it applies to institutions.
  • Be aware of the DIO’s role in GME governance and oversight, development of appropriate policies, and influence around new institutional initiatives (eg fellowship start dates, CLER, cultural diversity, and learner experience in quality and safety).

Alwin F. Steinmann, MD
Saint Joseph Hospital

Andrew C. Yacht, MD
Hofstra NorthWell School of Medicine at Hofstra University

(TT) 202. Using Tool Kits to Teach Learners Communication Skills

Excellent communication skills are essential for the delivery of high quality patient centered care. This workshop uses different interactive scenarios, assessment forms, and tool kits to teach internal medicine residents or students specific communication skills.  The purpose of this session is to facilitate creating an interactive and experiential half day or one day learning session on specific communication skills for internal medicine residents or students. Attendees will identify the learning needs of their learners and available resources at their institution to deliver a feasible and effective interactive session. We will discuss examples of role play, interactive videos, and OSCE as well as best fit for the specific skill to be learned.   Attendees will create an outline of a case and building blocks for interactive scenarios that can serve as a spring board to implement communication skills sessions at their institution. We will discuss building a specific communication skills tool kit utilizing validated communication skills assessment tools, clinical pearls, and validated surveys and resources from the literature. This tool kit is handed to the learner at the end of the training session to be used as clinical pearls they can easily reference on future patient interactions and are valuable tools across many different clinical settings.

Educational Objectives

  • Identify the learning needs of residents or students with regard to communication skills and to identify your teaching resources.
  • Identify which skills would be appropriate for role play exercises, video review, or an OSCE.
  • Write an OSCE case addressing a specific communication skill, an accompanying evaluation rubric, and a tool kit for the learner to take home.

Joanne Chang, MD
National Capital Consortium

Monica Yepes-Rios, MD
Uniformed Services University of the Health Sciences, F. Edward Hebert School of Medicine

(WR) 203. Whose Line Is It Anyway? Applied Theatre and Emotional Intelligence

As medical educators, it is incumbent upon us to learn skills to work with the emotional content of our lives and workplaces--and to teach these skills to our learners.  At UW- Madison, we have been using improvisational theatre techniques to teach interns how to notice, interpret, and respond to emotional cues in themselves and their patients build their own capacity for empathy and cultivate greater resilience in their work.  During the Empathy Course, a multimodal course that draws heavily on the humanities, interns experience two-hour sessions based on improvisational theatre to learn how to notice visual and auditory information, respond in the moment to their own and other’s emotions, relax and create ease even in stressful situations, create boundaries that allow for connection, mine emotions to enhance the therapeutic relationship, and use their words, voice, and gestures to communicate empathy.  During this workshop, we will share the work we have done by leading participants in a course session.  Come ready to move around and play!

Educational Objectives

  • Describe a model of emotion processing and apply this knowledge to communication situations.
  • Engage in and conduct performance training activities designed to practice identifying and responding to emotional cues in others.
  • Strategize about how to apply these concepts to the work they do with colleagues, learners, leaders, and patients.

Amy B. Zelenski, PhD
Mariah Quinn, MD
Joan Addington-White, MD
University of Wisconsin School of Medicine and Public Health

(C) 204. Building Successful Evidence-Based Medicine and Journal Club Curriculum and Assessments

Competency in practice-based learning and improvement (PBLI) and practicing high value care requires deliberately and rigorously questioning current practice, locating and accurately interpreting relevant literature, and incorporating evidence into clinical decision-making. Internal medicine milestone 15 requires residents to be able to “independently appraise clinical research reports based on accepted criteria...routinely translate new medical information needs into well-formed clinical questions...and utilize information technology with sophistication”. Internal medicine residents can attain PBLI knowledge, skills, and behaviors for successful lifelong learning and achieving relevant PBLI milestones through a multi-step, layered curriculum in evidence based medicine (EBM) spanning the three year residency training. We plan to engage participants in challenges and struggles with effectively impacting PBLI milestones at their own institutions and integrate discussion around EBM curriculum development and/or augmentation at their own institution through innovative execution and assessment strategies within the curricular infrastructure.

Educational Objectives 

  • Design and implement an EBM and Resident Journal Club curriculum that focuses on interactivity and active learner engagement, within any size academic or community program.
    • Design engaging and interactive resident-led journal club sessions that learners will enjoy.
    • Incorporate active article interpretation, facilitated by expert EBM faculty, into various components of the curriculum.
  • Integrate learner assessments of searching and article interpretation skills into residency PGY-level-specific promotion and graduation criteria; and provide structured feedback (and/or remediation) to learners for specific skills.
  • Utilize online and CME resources and deliver necessary development to support faculty and learners for successful implementation and maintenance of EBM curriculum and resident journal club.

Daniel D. Dressler, MD
Bhavin Adhyaru
Mikhail Akbashev
Hannah Rutledge
Emory University School of Medicine

Daniel I. Steinberg, MD
Icahn School of Medicine at Mount Sinai (Beth Israel)

(E/A/R) 205. Residents in Trouble:  A Coaching Way Out

Residents who fall below the expected growth trajectory in any competency are in the minority yet consume the most resources in terms of time and effort of faculty and staff. Complicating remediation efforts for the learner can be poor confidence, low self-esteem, a sense of “being under the microscope,” and alienation that can interfere with progress in the remediation effort and increase resident distress. Further, remediation frequently falls to a faculty member who has some evaluative role and is seen as having a major role in determining the success or failure of the resident. Professional development coaching uses the principles of positive psychology and a strengths-based model to effectively partner with the coachee and achieve performance improvement in the context of a safe and trusting relationship. This workshop will explore how a coaching model can be used in a remediation effort that is both supportive and effective in improving performance. Participants will get a brief overview of professional development coaching, followed by case studies and opportunities to develop specific coaching skill sets for a few of the more common remediation problems seen in training.

Educational Objectives

  • Describe the key elements of positive psychology and how they can be utilized in coaching learners who are remediating.
  • Describe how using a strengths based model can help a learner overcome a weakness.
  • Appreciate the value of a trusting relationship that coaching provides in effectively working with a struggling learner.

Asher A. Tulsky, MD
Boston University School of Medicine

Zuzanna Czernik, MD
University of Colorado School of Medicine

Kerri Palamara, MD
Harvard Medical School Massachusetts General Hospital

(P/M) 206. The X+Y Schedule – How To Turn The Rubik’s Cube into Paint By Numbers

The X+Y scheduling system is continuing to grow in popularity within internal medicine residency programs. There are numerous advantages to having an X+Y scheduling system, but there are also several challenges. In particular, the X+Y schedule creates challenges for scheduling residents with reduced flexibility, difficulty scheduling vacation, preserving elective time, and integrating with residents on other services  Advantages include increased ambulatory time, decreased conflicting inpatient and outpatient care responsibilities, and opportunity for schedule templates.

This workshop is intended to review the basics of an X+Y scheduling system, inherent bonuses in this scheduling system, and potential road blocks a residency program may encounter with the schedule.  We will review three different approaches to X+Y scheduling including a 3+1 model, a 4+1 model, and a 4+2 model and discuss how to practically build each schedule model. We will discuss the strategies that multiple programs have used to overcome X+Y scheduling difficulties both in large academic programs and within smaller programs.  We will include discussions on schedule templates, splitting blocks, negotiating with other programs within the hospital, realistic timelines for implementation, and consequences of deviating from the schedule.  Additionally, we will discuss how to maximize the resident experience during the ambulatory “Y” weeks by considering experiences in outpatient sub specialties, urgent care, dedicated time for didactics, and time for resident-led performance improvement.

Educational Objectives

  • Define the components of a X+Y scheduling system.
  • Review the advantages and challenges of a X+Y scheduling system.
  • Identify potential structures for X+Y scheduling systems.

Craig F. Noronha, MD
Boston University School of Medicine

Julia Clemons, MD
Kathleen Suddarth, MD
University of Colorado School of Medicine

John Donnelly, MD
Sidney Kimmel Medical College at Thomas Jefferson University Christiana Care Health Services

(E/A/R) 207. Hitting Your Milestones? Educational Theory Versus Practical Reality

In 1999, ACGME started the Outcomes Project. The goal was to change the residency program accreditation process from evaluating structure (nuts and bolts) to one of outcomes measuring learner accomplishments and competence. The six core competencies were introduced and residency programs applied these to curriculum and evaluation systems. However, while these six core competencies framed the idea of competence they were not specific enough to assess the detailed behaviors that make up competence. Milestones, which are more specific and observable behaviors, were introduced in 2009 as a way to drill down in assessing learner trajectory to independent practice. Twice yearly, Clinical Competency Committees (CCCs) are expected to rate their residents on the 22 reporting milestones. The incorporation of reporting milestones as an academic theory to milestones in actual practice has proved both exciting and challenging.  At the AAIM’s Clinical Competency Committee Clinical Learning Collaborative, participants have recognized the wide variation in application of reporting milestones among different residency programs. During discussions it became clear that milestones also raise challenges. The milestones are a “living, breathing document” and as we all get comfortable with their use, it is time to share what is working and what could be enhanced.

Educational Objectives

  • Debrief how reporting milestones are used in their evaluation systems and their clinical competency committee.
  • Identify implementation challenges with the reporting milestones including the scale, language and application to level of learner.
  • Recognize areas for resident competence that are missing from the reporting milestones.
  • Practice creating a new milestone to gain a better understanding of theory versus practical application.

Saba A. Hasan, MD
Capital Health Regional Medical Center

Stephanie A.C. Halvorson, MD
Oregon Health & Science University School of Medicine

Kathleen M. Finn, MD
Harvard Medical School Massachusetts General Hospital

(G/L) 208. Mentoring across Differences:  An Innovative Case-Based Workshop

Mentoring is a proven strategy to provide emotional and social support to individuals at critical points in their career development. Unconscious bias affects every aspect of medical education, from mentoring relationships to feedback and assessment. Too often, the issues that may come up when mentoring across differences are unseen or unaddressed. As academic leaders, it is our responsibility to develop a health workforce including researchers, educators and administrative leaders who can recognize bias and work through inevitable challenges in communication and understanding. Conscious efforts to address this content can lead to important and lasting institutional change.

In this highly interactive workshop, we will demonstrate a case-based curriculum we have implemented at our institution to explore some of the pitfalls of unconscious bias as well as introduce tested strategies to enhance mentoring relationships. The objective of this workshop is to provide mentors with the skills and tools to enhance communication and improve outcomes for mentees across the full spectrum of diversity, leading ultimately to a flourishing workforce fully representative of the rich diversity of our society.

After a brief introduction to the topic of mentoring, challenges we face with mentoring across differences, and core principles of unconscious bias, participants will break into small groups for facilitated discussion of a mentor-protégé relationship. Participants will be provided with trigger questions to stimulate discussion and will be encouraged to join tables with faculty from other institutions. The larger group will reconvene for a facilitated de-brief and wrap-up.

Educational Objectives

  • Model a method for creating a safe environment to promote self-reflection and the capacity to disclose and discuss biases.
  • Recognize and implement ways to approach cross-difference mentoring relationships.
  • Develop communication skills that sensitively and effectively traverse real or perceived boundaries defined by differences in race, class, culture, gender, and generation.

Nora Y. Osman, MD
Barbara Gotlieb, MD
Harvard Medical School Brigham and Women's Hospital

Denise Connor, MD
University of California-San Francisco School of Medicine

(U/G) 209. Deciphering the Code:  Writing and Interpreting Letters of Recommendation

Letters of recommendation (LORs) are an integral component of intern recruitment used by program leadership. With the explosion of the number of applicants, reviewing LORs has become a shared activity between members of the departmental faculty. To support students and residents applications, faculty are asked to write letters but may not have the “inside knowledge” as to what constitutes a strong LOR. Conversely, LOR reviewers may also not be familiar with the descriptive language that puts learners in a variety of categories. This workshop is designed to provide guidance to letter writers and letter reviewers as they decode the language of the LOR. Using a train-the-trainer model, the session starts with participants writing words or phrases to describe characteristics of learners followed by discussion on language selection. A mini-didactic outlining the various sections of a letter, appropriate descriptive language and word selection as well as what to request from the learners will be presented. Participants will work in small groups analyzing examples of redacted LORs across the spectrum style, language, and quality of the applicant. Analysis will focus on big picture and nuances of the letters. Groups will identify well selected language versus poor word choice accompanied by collaborative edits. A lexicon will be compiled consisting of words and phrases both “good and bad” that the attendees can take home. The session will end with large group discussion to determine if alternative language should be used and propose word selections. Materials will be provided to implement this workshop at participants home institutions.

Educational Objectives

  • List key components of LORs.
  • Discuss descriptive language used in the letter writing and interpreting processes.
  • Describe challenges letter confronting letter writers.
  • Analyze and reflect on examples of LORs.

Aditi Singh, MD
Miriam E. Bar-on, MD
Sandhya Wahi-Gururaj, MD
University of Nevada School of Medicine (Las Vegas)

(R) 210. Medical Education Research: Studying What We Do With the Resources We Have

Participants in this session will learn to generate a novel and interesting educational research question that results from their own work in medical education.  Panelists will review existing data that is already being generated by, and available to, educational programs and rotations and begin to appropriately match and use the available data to answer research questions.

Jessica Dine, MD
Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania

Jonathan Doroshow, MD
Main Line Health System/Lankenau Medical Center

Stacey M. Kassutto, MD
Pennsylvania Hospital of the University of Pennsylvania Health System

William D. Surkis, MD
Main Line Health System/Lankenau Medical Center

(T) 211. Navigating Uncharted Waters:  How to Help Learners Successfully E-Communicate During Training and Beyond

Professionalism and interpersonal and communication skills are core clinical competencies taught and assessed during medical school and residency training. Social network (like Facebook and Twitter) and technology (smartphones and tablets) use has skyrocketed in the last five to ten years with medical students and residents being at the forefront of this growth. Medical schools and residency programs have developed “best use” policies to guide learners on the use of social media and professional online communication. However, students and learners need guidance on how to properly use their electronic devices on rounds, professionally communicate via email, and navigate social media. We will discuss principles of “netiquette,” appropriate use of emailing and texting, how to professionally use a cellphone during rounds, and methods to manage identity online. Participants will work through real cases and develop e-communication guideline policies applicable to common e-communication challenges in residency training. We will share a process of overarching policies for the development of guidelines or policies. Participants will be able to share these policies with learners and faculty at their own institutions.

Educational Objectives 

  • Discuss why teaching learners professional electronic communication skills is essential in today’s training environment.
  • Discuss principles of “netiquette” to safely and effectively communicate via email, text and social media, and how to professionally use electronic devices in the clinical setting.
  • Share how to develop a policy at your institution for e-communication.

Analia Castiglioni, MD
University of Central Florida College of Medicine

Mukta Panda, MD
University of Tennessee College of Medicine at Chattanooga

Lisa L. Willett, MD
University of Alabama School of Medicine

(TT) 212. Teaching Bedside Teachers – Developing Skilled and Empathetic Teachers

Bedside teaching is a long-honored tradition in internal medicine and many educators chose their respective career path because of interaction with master teachers at the bedside of patients.  However, demands on educators continue to increase and modern health care workflows often draw educators and their learners away from the bedside, making the inspiration and development of master bedside teachers difficult.  Bedside teaching allows for demonstration of empathetic and evidence based methods for history-taking and physical examination as well as empathy and patient-centered care.  Further, it allows engages the patient as a member of the diagnostic team and is highly valued by learners.  

As assessment in medical education moves toward workplace-based means of assessment, teaching at the bedside as well as observation of developing teachers interaction at the bedside with learners are opportunities to perform direct observation in learner’s workplace.   While many educators in internal medicine are valued as and skilled in bedside teaching, the translation of these skills to developing teachers tends to occur through observation and subsequent emulation rather than mentoring and coaching.  This workshop will focus on soliciting attendees experiences in developing new bedside teachers and provide evidence-based skills practice sessions for educators to learn methods to facilitate coached bedside teaching by learners, give feedback to developing teachers and learners in the presence of patients and families, and help developing teachers engage with learners of all levels.

Educational Objectives

  • Demonstrate the ability to give constructive and reinforcing feedback to a learner about her bedside teaching skills in the presence of a patient and/or family member.
  • List three ways to empower and support residents and students in bedside teaching.
  • Discuss methods to encourage learners to engage patients as teachers during bedside educational activities.

Andrew Olson, MD
Briar L. Duffy, MD
L. James Nixon, MD
University of Minnesota Medical School

(WR) 213. Write to Be Well:  Incorporating Written Reflection and Facilitated Discussion into Your Residency Well-Being Program

This workshop introduces techniques for incorporating topical reflection sessions into residency well-being programs, with a focus on written reflection.  Experiences that are associated with feelings of guilt or regret, such as medical errors and patient deaths, can cause feelings of isolation that can be difficult to share openly, even if a confidential space is assured.  Workshop attendees will learn a technique that combines anonymous written reflection with facilitated small group discussion to provide space to process difficult experiences of medical training.  Attendees will learn ways to incorporate this technique into well-being programs either as a stand-alone reflection session or as part of a structured workshop that can introduce skills for lifelong reflective practice.

Educational Objectives 

  • Learn a simple technique to facilitate written reflection about difficult experiences in medical training such as medical errors and patient deaths.
  • Introduce strategies for incorporating structured topical reflection sessions into a residency well-being program within curricular time constraints.
  • Expand group facilitation skills, particularly when dealing with sensitive topics in training.

Larissa Thomas, MD
Elizabeth Harleman, MD
Vanessa Thompson, MD
University of California-San Francisco School of Medicine

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Workshop Session III
Friday, October 21, 2016
2:45 p.m. to 4:15 p.m.

(G/L) 301. Medicine as a Calling:  Accomplishing High Educational Goals in a Service Oriented Endeavor

We are told by the quality improvement community that we cannot improve what we cannot measure. For years, ACGME has measured the effectiveness of training programs by asking learners whether their education is compromised by service obligations. How can we reconcile the ideal of “pure education” with the fundamental foundation of medicine as a service and a calling? This workshop will explore the relationship between the central function of a physician to serve patients and the program in which new physicians are trained. We will begin with an appreciative inquiry of the skills to be acquired as a medical provider. After elucidating a representative group of skills, we will describe the ideal venues and tasks in which to establish competence. The key to establishing that these tasks, while providing service to patients, are in fact educational milestones will be shown to be the deep sense of satisfaction that learners gain by mastering them. Routine primary care goals can form the basis of quality improvement projects, interdisciplinary rounds translate directly to improved patient satisfaction, and medication reconciliation saves lives. Reviewing the principles of direct observation will show that service to patients becomes teaching when a supervising physician is present. We will try to find out how many times a service is performed is too many making that task into pure service. We will then demonstrate how to frame the service so that learners learn from it again.

Educational Objectives

  • Use appreciative inquiry as a tool with which to set goals.
  • Match goals to specific venues and tasks to accomplish.
  • Relate patient outcomes to success in mastering skills involved in each task.

Ethan D. Fried, MD
Ladan Ahmadi, MD
Nazish Ilyas, MD
Sherri L. Sandel, DO
Hofstra Northwell School of Medicine at Lenox Hill Hospital

(TT) 302. Lights! Camera! Feedback!  Video-Based Coaching to Improve Teaching Skills

Feedback is an essential part of the learning cycle at all stages of development for medical educators.  Unfortunately, direct observation and formative feedback of teaching skills rarely occurs after medical training, save for student evaluations on a semi-annual basis which limits the ability to continually improve teaching skills.  Time “and the cost of that time “are the major challenges in obtaining feedback on directly observed teaching.  Arranging for a coach or colleague to observe teaching means that they must take time out of their busy day to attend that session.  There must then be another meeting to discuss the observations and for the teacher to receive the feedback. 

Video-based coaching has emerged for professional development in K-12 education to help teachers improve their classroom teaching.  It adapts well to medical education, both in a classroom setting and in a team room on the wards.  In this workshop, we will demonstrate the use of a web-based platform for video-based coaching that only requires the use of a smartphone and discuss the process of asynchronous coaching to improve teaching skills.  The session will begin with a brief introduction to the concept of coaching and feedback for developing expertise.  We will then break out into groups for discussion on coaching and demonstrate the video-based coaching process using actual video and one of the web-based coaching platforms.  The session will end with a discussion of what resources are needed for audience members to introduce this technology at their institutions.

Educational Objectives

  • Discuss the concept of teaching as a skill.
  • Review the basis of video-based coaching for teacher development.
  • Illustrate the operational process of video-based coaching.

Stephanie Harman, MD
Stanford University School of Medicine

David E. Kern, MD
Johns Hopkins University School of Medicine

Lisa Podgurski
University of Pittsburgh School of Medicine

(C) 303. An Evidence-Based Medicine Faculty Development Course

We have been teaching internal medicine residents and third-year medical students to critically appraise articles and apply the results to patient care, but we found that evidence based medicine (EBM) was not consistently modeled on the wards.  Barriers to practicing EBM cited in the literature include lack of time, EBM skills, and availability of evidence. The internal medicine residency program director, internal medicine clerkship director and pediatrics associate clerkship director developed a faculty development course based on the JAMA Users Guide to the Medical Literature to help attending physicians practice and teach EBM.  Participants learn how to formulate clinical questions, search the literature, and critically appraise articles on diagnosis, prognosis, harm, and therapy.  During this workshop, we will share our experience in developing an EBM faculty development course.   We will describe how we developed this course and the resources we needed.  We will discuss the format and content of our sessions.  Participants will also have the opportunity to experience how our sessions are taught.  We will review the challenges we faced and explain the lessons we have learned from our first four iterations of the course.  Finally, we will provide an opportunity to plan the development of an EBM faculty development program at your home institution.   

Educational Objectives

  • Explain our process of developing an EBM faculty development program.
  • Provide the lessons that we learned while developing an EBM faculty development program.
  • Formulate a plan to develop an EBM faculty development program at your institution.

Viju John, MD
Richard I. Abrams, MD
Rush Medical College of Rush University Medical Center

(WR) 304. The Fourth Aim:  A Toolkit for Medical Educators to Develop Resilience, Maintain Professional Satisfaction, and Restore Joy to Teaching and Medical Practice

Research on burnout in medicine has revealed an epidemic. Higher prevalence (40 to 80%) is noted among medical residents and fellows compared to medical students, physicians, or college graduates of similar age. Among internists, burnout approaches 60%. High rates of burnout also apply to medical educators, which is especially troubling given that we serve two constituencies: patients and learners. There is potential for triple damage: to ourselves, our patients, and our learners. This erosion of professional satisfaction in a profession charged with healing is troubling. It forces us to ask a difficult question; How can we effectively enhance a sense of self-worth and physical integrity in the people we serve, if we ourselves have become seriously deficient (even impaired) in these areas? The Triple Aim, developed by the Institute for Healthcare Improvement, is a framework for optimizing health care by improving the patient experience and population health, and reducing the cost of health care.  Recently, there have been calls for a fourth aim. This fourth aim proposes to redress the erosion of professional satisfaction by improving work life, cultivating resilience, and restoring joy to the practice and teaching of medicine.  Achieving this aim will require individual and organizational solutions.  The purpose of this workshop is to share best practices, evidence-based tools and strategies with medical educators to optimize well-being at the individual, program (residents), and institutional levels.  This workshop is presented through a collaboration of AAIM and the Collaborative on Healing and Renewal in Medicine (CHARM).

Educational Objectives: 

  • Identification of challenges to professional satisfaction at individual, programmatic and institutional level.
  • Define and deploy strategies that promote professional satisfaction and wellbeing at individual, program and institutional level.
  • Help participants share strategies and identify resources that they can apply in their own educational environments to maintain the Fourth AIM.

Mukta Panda, MD
University of Tennessee College of Medicine at Chattanooga

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

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

Carrie A. Horwitch, MD
Virginia Mason Medical Center

(E/A/R) 305. Standard Setting:  Introduction and Application to ABIM Assessments

The overall goal of this workshop is to provide participants with an understanding of basic key concepts about standard setting processes. All assessments used to make classification decisions (e.g., pass/fail, novice/expert, grades) face the important task of identifying the point that distinguishes between individuals who fall into each classification. Such decisions are judgments. There are no “true” decision points. For example, on what basis might 90% or better be classified an A or the top 10% of examinees be considered masters. The process of identifying classifications points (e.g., setting a minimum passing score) is known as standard setting.

Our goal is to have an interactive workshop with opportunities to ask questions throughout. In addition, time will be set aside at the end of the session for deeper questions and broader conversation about standard setting. This workshop will provide attendees with insight into high-stakes assessment standard setting; participants will actually help inform these future assessments at ABIM; and they can use what they learn to apply to lower stakes assessments in residency training.

Educational Objectives

  • Understanding of basic key concepts about standard setting processes.
  • Identify the characteristics of the “borderline” or minimally qualified examine which could be applied to future assessments. 
  • Help inform future assessments at ABIM.
  • Apply to lower stakes assessments in residency training.

Furman S. McDonald, MD
Jerome Clauser
Louis Grosso
American Board of Internal Medicine

(C) 306. How Can a Hospital Medicine Track Improve Your Resident Education?

Caring for hospitalized patients is complex and constantly changing. Residents learn to manage patient care in the inpatient setting, but often receive insufficient teaching to develop a deep understanding of how to help the inpatient systems function optimally.  Inpatient physicians need to possess knowledge and skills to be leaders of change for care-delivery systems in the hospital, including critical knowledge and skills in patient safety, quality improvement, transitions of care, and value in healthcare, as well as interdisciplinary care, team management, and other areas.  Hospital medicine tracks provide an opportunity for focused educational experiences and set the stage for development of skills these residents need to become change agents in the hospital.  This workshop will help participants identify core curricular elements, teaching venues and techniques, and important resources to effectively teach these concepts to residents.  We will provide a brief overview about the development, implementation, and growth of our own hospital medicine tracks with specific examples from three institutions, describe the fundamental tenets of a successful track, and identify strategies for overcoming common barriers to achieving and sustaining a successful track.  Participants will work collaboratively in large and small group formats to develop an effective curriculum, discuss how local resources may be employed, and share ideas about teaching systems of care.  Participants will leave this workshop with detailed curriculum examples, concrete ideas for implementation, and an inventory of options for teaching content focused on hospital systems of care to residents.

Educational Objectives 

  • Identify ways in which hospital medicine tracks can be beneficial to individual residents, residency programs, and divisions or groups of inpatient physicians interested in resident education.
  • Develop goals and objectives for a hospital medicine track curriculum to teach key elements of hospital-based care to internal medicine residents and describe instructional techniques to deliver this content.
  • Recognize common barriers to creating, growing, and sustaining a successful hospital medicine track curriculum and develop strategies to overcome these barriers.

David Gugliotti, MD
Jessica Donato
James C. Pile, MD
Cleveland Clinic Foundation

Julia Clemons
University of Colorado School of Medicine

Nathan Houchens
University of Michigan Medical School

Joseph R. Sweigart, MD
University of Kentucky College of Medicine

(GL) 307. Group Peer Mentoring Way to Improve Career Vitality among Academic Physicians

This workshop will be an innovative experience that will introduce faculty to the concept of group peer mentoring, which can improve career vitality and productivity.  We will provide evidence behind the impact of mentorship on professional development.  Traditional mentoring models in which a person with more experience mentors someone with less experience can be fraught with problems.  First, finding a mentor can be difficult.  Second, a mentor may not be able to provide guidance in all of the areas that a mentee needs, necessitating a larger mentoring network for the mentee. Third, and most importantly, mentoring within a hierarchical schema may pose barriers to honest, two-way feedback with the goal of improving the mentee’s career.

Educational Objectives

  • Enumerate the importance of mentoring and its relationship to career vitality.
  • Engage in a group peer mentoring experience exploring the importance of values in one’s career.
  • Illustrate the ways in which group peer mentoring could improve career vitality among academic physicians in participant’s home institutions.

Sharon Wretzel, MD
Raquel Belforti, MD
Christine Bryson, DO
Rebecca S. Starr, MD
Baystate Medical Center/Tufts University School of Medicine

(H/Q) 308. SOAP-V and the One Minute Preceptor: A Framework to Teach High Value Care at the Bedside

The “One Minute Preceptor” is a useful framework for clinical teaching following medical student and resident patient encounters. The five components (get a commitment, probe for supporting evidence, teach general rules, reinforce what was done right, and correct mistakes) allow the preceptor to guide learner decision-making while providing feedback. However, the framework does not expressly consider high value care in this process. We propose a workshop that combines the one minute preceptor with a novel framework called “SOAP-V” to remind the preceptor and learners to consider high value care during patient delivery. As a modification on the traditional “SOAP” model, “V” incorporates “value” in patient management decisions through three prompting questions on evidence of value for tests/treatments, patient goals, and relative cost (present and downstream). We have used the SOAP-V format with third year internal medicine clerkship students, who reported increased empowerment to address the healthcare crisis, increased comfort in discussions about unnecessary tests or treatments, and increased likelihood to consider potential costs to healthcare systems (ref). The model has been used at five schools, and currently SOAP-V is being used in internal medicine residency ambulatory clinics at two medical centers. This workshop will describe the one minute preceptor framework, while layering on the SOAP-V tool, to remind clinician educators, medical students, and residents to consider value at the point of care.

Educational Objectives

  • Describe the importance of teaching learners the principles and practice of high-value, cost-conscious care.
  • Review the technique of incorporating discussions of value into daily presentations and notes using SOAP-V as a tool.
  • Integrate the SOAP-V technique with the one-minute preceptor in working with students and residents."

Sara  B. Fazio, MD
Grace C. Huang, MD
Harvard Medical School Beth Israel Deaconess Medical Center

Eileen M. Moser, MD
Susan Glod, MD
Pennsylvania State University College of Medicine

(E/A/R) 309. The Impaired Resident:  From Burnout to Substance Abuse – A Guide to Managing the Crisis

Fatigue, burnout, and their effects on the physician-in-training are one of the core focus areas of ACGME.  The CLER process has chosen to look at the interconnectedness of resident fatigue on patient safety and quality within training institutions.  The impact of resident burnout is felt broadly, from the inability to adequately acquire and process medical knowledge to the potential to impact patient care practices, leading to lapses in quality/patient safety. A resident suffering from burnout is also at higher risk of turning to drugs or alcohol, either in an attempt to self-medicate or as an inappropriate coping mechanism.  This workshop will explore the continuum of resident impairment, from fatigue and burnout to mental health conditions and substance abuse.  While many impaired residents can be helped within the confines of the program and its resources, some cases require a more comprehensive action plan that can include institutional GME and human resources, local and regional resources, and occasionally licensing boards.  Through sample cases, participants will identify residents at various points along the impairment continuum and those with risk factors for entering the continuum; stratify cases by etiology and severity into one of three suggested pathways for management, and develop preliminary action plans for residents at various points along the continuum of impairment.  Time will be left for discussion at several points throughout the workshop.

Educational Objectives

  • Describe the various types of impairment that may affect learners, ranging from fatigue and burnout to substance abuse and mental health concerns.
  • Discuss the resources available to address the various etiologies of resident impairment, both within organization and through regional and state resources.
  • Determine the appropriate involvement of GME, human resources, and other institutional officials when impairment is impacting patient care abilities.

Nicole Swallow, MD
Eliana Hempel, MD
Pennsylvania State University College of Medicine

(PM) 310. J-1 Visas from A to Z

This workshop will help participants to understand all aspects of J-1visa sponsorship and provide best practices for onboarding these residents. The various types of visas available to residents will be covered briefly to provide a frame of reference. The workshop will cover in detail initial J-1 visa processing, J-1 visa transfers, maintenance of J-1 visa status, unusual circumstances and updates from the ECFMG. The workshop will also cover how to transition a J-1 visa holder to a non-standard chief resident position or fellowship position.

Educational Objectives 

  • Understand the steps and documents required to process an initial or transfer J-1 visa.
  • Understand unusual circumstances involving J-1 visa holders and the corresponding ECFMG policies.
  • Identify relevant updates in J-1 visa processing, including updated rules for Canadian citizens.

Andrea Mortley
University of Miami
JFK Medical Center Palm Beach Regional GME Consortium

Sandra Ordonez
Boston University School of Medicine

(TT) 311. Re-Invigorating the Practice of Bedside Medicine – A Practical Guide to Teaching at the Bedside

“Medicine is learned at the bedside and not in the classroom.” These words by Sir William Osler still ring true but a number of factors have limited the amount of time learners spend at the bedside. There is a growing national movement to reinvigorate the practice of bedside medicine. In this workshop, participants will learn the key elements of a successful bedside teaching session and recognize the barriers that challenge bedside teaching implementation. Learners will explore the dynamics essential to small group learning, and examine how to effectively engage patients as partners in the bedside teaching endeavor. In breakout groups, participants will develop a short bedside teaching activity using a physical examination finding or technique of their choosing. Bedside medicine facilitators will help with selection and development of the session. Using a fellow participant as a mock patient, learners will practice their bedside teaching session and receive real-time feedback from faculty. At the end of the session, participants will have the necessary skillset to implement successful bedside teaching sessions in their own program or practice settings.

Educational Objectives

  • Describe the basic components of a successful bedside teaching session.
  • Demonstrate effective teaching strategies in a small group environment that involves patients, learners, and interdisciplinary staff.
  • Develop framework for creating a bedside teaching session, using a physical examination maneuver as the focal point.

Brian T. Garibaldi, MD
Reza Manesh, MD
Johns Hopkins University School of Medicine

Stephen Russell, MD
University of Alabama School of Medicine

(E/A/R) 312. Problem Learner Morning Report:  Demystifying Remediation for Faculty

Problem learners challenge all faculty from ward attendings to program and clerkship directors.  Creating regularly scheduled venues for earlier, in-the-moment interventions help make faculty at all levels more comfortable helping these learners succeed. Problem learner morning report provides a regular venue for faculty to develop tactics for in-the-moment remediation and provides faculty development on available remediation strategies. It is very different from the traditional clinical competency committee sessions, which happen more intermittently and target the program as a whole.  By having briefer, more frequent sessions that reach out to more faculty members, remediation becomes more preventative than reactive. The morning report format critically assesses the learner and develops a remediation plan that can be closely tailored and followed up on. Skills to successfully run a problem learner morning report, including early identification and ability to define the learner’s chief complaint, critical assessment of the problem learner differential, and knowledge of effective remediation strategies, will be reviewed. Master educators will then present a series of problem learners and use examples from the group’s experience utilizing the morning report format to demonstrate how to methodically analyze and strategize about a problem learner while teaching key concepts to facilitate this session at their own institution.  Participants will facilitate their own small group problem learner morning report sessions to practice these skills. By the end of this workshop participants should feel comfortable leading a problem learner morning report at their own institution.

Educational Objectives 

  • Identify the core problem behind a learner’s behavior.
  • Develop a targeted differential for a learner’s chief complaint.
  • Apply and facilitate a morning report presentation to develop a remediation plan for a struggling learner.

Deepa Rani Nandiwada, MD
Elena Lebduska, MD
Melissa A. McNeil, MD
Thomas D. Painter, MD
University of Pittsburgh School of Medicine

(C) 313. Developing Residents-as-Teachers Training Programs:  Multi-Institutional Approaches and Challenges

This workshop will focus on the design and implementation of residents-as-teachers (RAT) curricula in internal medicine residency programs. The interactive session will begin with a brief overview of current literature on RAT curricula. The participants will then break up into small groups according to training program characteristics (such as program size, community versus university setting) to discuss several areas: 1) resources required to create a RAT curriculum; 2) pros and cons of specific design features of RAT curricula (longitudinal versus immersive programs such as lectures/workshops throughout the year versus dedicated elective; multiple resident participants versus one learner at a time; focus on educational theory versus experiential teaching opportunities); 3) incorporation of resident self-reflection and identity formation; and 4) methods of evaluation.

After small group discussions, the participants will reconvene to share their insights with the larger group. The workshop presenters will share their experiences with RAT programs, comparing and contrasting the designs and highlighting the successes and challenges in each instance. Finally, the workshop will conclude with a summary of different curricular options that participants can choose to utilize at their own institutions.

Educational Objectives

  • Identify the different resources required for creation of RAT curricula at unique institutions and the possible barriers inherent in these needs.
  • Review the diverse phenotypes of RAT curricula that currently exist in residency training programs.
  • Recognize the importance of resident self-reflection and identity formation in RAT curricula.

Stephanie V. Sherman, MD
Zaven Sargsyan, MD
Baylor College of Medicine

Knapa Kornsawad, MD
Christopher Moreland, MD
University of Texas School of Medicine at San Antonio

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Workshop Session IV
Saturday, October 22, 2016
8:00 a.m. to 9:30 a.m.

(G/L) 401. Going Up?  Effective Elevator Pitches

Sometimes you only have a couple of minutes to get your message across, and that “elevator pitch” can often make the difference between success and stagnation. Learn how to create a clear and convincing summary of research so that it’s compelling for any audience. Video examples of effective elevator pitches will be shown and analyzed. Participants will create, practice, and receive peer feedback on their own pitches during the workshop.

Melissa Marshall
Melissa Marshall Consulting

(R) 402. How to Create Effective and Actionable Surveys

In this workshop, we present techniques for creating surveys that yield actionable and publishable results.
Whether you are creating a survey for research or evaluating your program, faculty, or residents, this workshop will help you develop important skills in survey creation.  The hands-on portion of this workshop will provide you with practice in creating surveys that you can use in your home institution.  We will also review how surveys can be leveraged for obtaining resources, making changes to program curricula or advancing scholarly activity for faculty and residents.

Educational Objectives 

  • Practice developing a survey that measures outcomes you wish to measure.
  • Review 10 common mistakes in survey question creation.
  • Practice specifics survey question writing for research or evaluation purposes.

Saima Chaudhry, MD
Memorial Healthcare System

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

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

Lisa L. Willett, MD
University of Alabama School of Medicine

(TT) 403. Indirect Observation with Guided Reflection:  A Novel Method for Continuing Teaching Education

Practicing clinicians are held to well-established standards for the ongoing development and maintenance of clinical knowledge/skills through CME requirements.  While no such standard exists for the cultivation of teaching skills, it is an equally critical component of professional development for medical educators. Direct observation, which provides real-time assessment of skills coupled with immediate and actionable feedback, is a widely accepted means of medical learner evaluation.  While it would likely be an equally efficacious means to provide feedback to faculty regarding teaching skills, usability is limited by time constraints and the need to identify skilled teachers of teachers. We have developed a novel method for teaching skills development that incorporates indirect observation and emphasizes reflection skills.  In indirect observation with guided reflection (IO-GR), faculty meet as a group to review self-selected video segments of their own teaching sessions.  A master educator moderates the group and guides members to reflect on observed skills and discuss teaching skills that may be used in the future.  This ongoing and continuous faculty development method is time efficient and allows skills of the master educator to be leveraged across many learners. This workshop will provide attendees with the knowledge and skills to implement IO-GR at their own institution. After introducing the rationale for IO-GR, a mock debriefing session will be held; participants will have the opportunity to submit videos for review. A master educator will facilitate attendees in reflection upon teaching observed and in identification of skills that can be incorporated during future teaching encounters.

Educational Objectives

  • Report increased appreciation of the need for continuing teaching education faculty development efforts.
  • Identify three essential components for use of direct observation as a teaching tool.
  • Describe how indirect observation with guided reflection can be used as a teaching tool for enhancing teaching skills in clinician educators, and list the advantages and disadvantages of this method.

Sarah Merriam, MD
Debbie J. DiNardo, MD
Thomas C. Grau, MD
University of Pittsburgh School of Medicine

(WR) 404. All the World’s a Stage:  How to Use Improv Comedy Skills to Make Teaching Challenging Conversation Fun

Improvisational comedy is a form of theater in which actors create the story, setting, characters and plot in the moment without prior scripting. Similarly, many physician encounters are not scripted and require skills to spontaneously build relationships and plots/plans in spite of the setting. Improv rules can be applied to many challenging conversations providing skills and structure. At University of Pittsburgh Medical Center, this practice has been integrated into faculty development retreats and residency noon conference as an improvised performance of a challenging conversations performed by the moderators followed by an in-depth discussion of communication structure and skills. Through this workshop, participants will be introduced to the basic rules of improve including: agreement (yes, and…), behavior based statements, attentive listening, nonverbal communication, building trust, and turning mistakes into opportunities. Participants will learn how to apply these rules to challenging conversations utilizing basic communication skills to build a relationship and plan. This workshop will focus on challenging topics, including dealing with difficult patients, learners, colleagues and senior faculty. Workshop presenters will perform improvised challenging conversations utilizing the rules of improv. Workshop attendees will identify skills and rules utilized. Attendees will break off into small groups and the presenters will lead a discussion debriefing the demonstration and brainstorming methods for dealing with challenges in teaching this practice. The large group will re-convene to discuss “take home points” from their small group discussions and how attendees will integrate these skills into curricular efforts at their home institutions.

Educational Objectives

  • List the basic rules of improv and apply these rules to challenging conversations.
  • Identify improvisation skills in simulated challenging conversations.
  • List common challenges to the use of medical improv and provide possible solutions.

Jennifer Rusiecki, MD
Jill Allenbaugh
Alda Maria R. Gonzaga, MD

Melissa A. McNeil, MD
University of Pittsburgh School of Medicine

(E/A/R) 405. How to Handle Lapses in Professionalism – It Is Not a “Me, Myself and I” Kind of Job

The ABIM Charter on Medical Professionalism describes professionalism as the basis of medicine’s contract with society and as a daily expression of what originally attracted physicians to the field of medicine. Teaching residents how to maintain a high level of medical professionalism throughout their career is a goal of every residency program. Complicating the issue is that many lapses of medical professionalism occur outside of monitored clinical settings including areas such as administrative duties, interactions with administrative staff, and social media postings. This interactive workshop will review the tenants of medical professionalism as identified by the both presenting institutions and national organizations, highlight cases that involve lapses in professionalism across a variety of settings and degrees of severity, and identify step-wise approaches to handle lapses in professionalism. Workshop faculty will include a program director, associate program directors, and an administrative director from university and community-based programs. Participants will develop a shared mental model for identifying and addressing professionalism issues within their residency program and institution. The workshop will explore how information comes to the attention of the program from various sources. Also, we will identify the stakeholders beyond the clinical competency committee involved in the management of professionalism issues. There will be interactive small group sessions during the workshop focusing on case studies. Participants will leave the workshop with medical professionalism vignettes, a template for managing lapses in professionalism, and a map of the network for addressing these issues.

Educational Objectives

  • Analyze and discuss examples of lapses in medical professionalism.
  • Identify networks, including the clinical competency committee, involved in handling professionalism cases.
  • Describe stepwise approaches to lapses in medical professionalism.

Craig F. Noronha, MD
Rachel Simmons
Boston University School of Medicine

Inez R. Hudlow
Florida State University College of Medicine
Tallahassee Memorial Healthcare

Nicole Swallow, MD
Pennsylvania State University College of Medicine

(C) 406. Strategies to Intern Integration:  Designing an Immersive Orientation to Ambulatory Medicine

Every year, there is an influx of new interns that enter continuity clinics at our programs. They each have varied backgrounds and knowledge bases in outpatient medicine. From their perspective, there is significant uncertainty about what it means to be a primary care physician for a panel of patients. Furthermore, effectively interacting with office staff and understanding the intricacies of practice workflow is far from their top priority. Many programs have brief orientations to their continuity clinic that review the essentials. It is our experience that interns quickly forget much of what is taught during orientation without brisk reinforcement. Our program’s transition to a 6+2 scheduling structure allowed us to develop a two week innovative immersive experience during our intern’s first ambulatory blocks. This rotation included various components including a mix of didactics, shadowing, direct coaching, EMR utilization, and skills training. The rotation emphasized medical knowledge, outpatient clinical skills and practice-specific information with the goal to rapidly build new interns efficiency, effectiveness, and confidence. This interactive workshop will guide participants through the first steps in planning a similar orientation immersion experience by performing a preliminary needs assessment and strategizing what components to include at their home institutions. Participants will review data that we collected from outgoing interns that evaluated what “they wished they would have known” about clinic at the start of their intern year. Participants will also review our program’s comprehensive plan and we will discuss lessons that we learned through implementation.

Educational Objectives 

  • Identify basic topics in medical knowledge, clinical skills, and practice-specific operations that interns should know early in their outpatient clinic experience.
  • Strategize how best to deliver orientation content in an immersive outpatient experience.
  • Review lessons learned from the presenter’s experience running an immersive outpatient orientation.

David Aizenberg, MD
Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania

Marguerite Balasta, MD
Eric Palecek, MD
Pennsylvania Hospital of the University of Pennsylvania Health System

(PM) 407. Build It and They Will Come:  Website Design and Analytics to Meet the Needs of Programs and Applicants

As current residents are mostly part of the millennial generation, there is an overwhelming expectation for the electronic availability and dissemination of information pertinent to their training. This expectation is borne from the digital culture of speed, convenience, and flexibility prompted by the availability of smart phones and the use of social media. Consequently, a significant online presence has become an increasingly important foundation for a well-run residency program. It can be a daunting task for program directors and chief residents with limited technical expertise. At our residency program, we have developed a comprehensive website that provides resources to both prospective applicants and current residents. We have used website builders, Google Apps, and social media to establish a sustainable electronic presence for our residency program and used Google Analytics to gather meaningful data on patterns of use. This workshop will focus on the development and implementation of a comprehensive residency website, starting from domain acquisition to content development and interpretation of analytics.

We will provide attendees with information about the utilization of third party web builders, Google Apps, and social media as well as the application of Google Analytics and Google Webmaster to increase the online searchable presence of the website and customize its deployment based on its usage. Our goal is to simplify the entire process in an easy-to-understand and readily adaptable format for any residency program.

Educational Objectives

  • Introduce the process of developing an internal and external website for a residency program.
  • Understand the various tools available online to customize and deploy your website.
  • Learn how to use advanced metrics to dynamically shape your website and content.

Madhav Upadhyaya, MD
Richard Gargiulo, DO
Armand Krikorian, MD
Ruchita Patel, DO
University of Illinois College of Medicine at Chicago Advocate Christ Medical Center

(E/A/R) 408. Debunking Miller’s Pyramid:  Gleaning What We Can from the Milestones and Teaching and Assessing from a More Intuitive, Ergonomic (and ACGME Compliant) Shared Mental Model – The Resident Growth Chart/er

The presenter will introduce a novel teaching and assessment tool called the “Resident Growth Chart/er (RGC),” demonstrates its use, and explain certain contemporary competency-assessment concepts that underpin it. The RGC represents a shared mental model; it is a qualitative narrative tool that describes, using prose, who we would like our residents to be at each stage of their development, and how we would like them to think and behave as physicians and “citizens” of our internal medicine residency program. RGC spells out progressive expectations for residents to strive for and for faculty to “teach to” and assess (thus the term “charter”), and it allows for plotting of a resident’s progress over the course of his or her training (thus the reference to “growth chart”).  RGC incorporates the ACGME core competencies and milestones; in fact, RGC “grades” can be automatically mapped to the milestones document. Full use of the RGC requires dedicated and involved faculty who must understand and put to use several contemporary paradigms of workplace learning and assessment. To this end, the presenters will 1) review Wertheimer’s Gestalt, Govaerts’ research on workplace-based assessment, BD Hodges concerns for faddish competency definitions, and Bowden’s critique of competency-based assessment and his proposed hierarchy of competence and its assessment, and 2) introduce a more synthetic, holistic revision of Miller’s pyramid. Participants will gain experience using the RGC in assessing samples of videotaped resident behaviors.

Educational Objectives

  • Explain Wertheimer’s Gestalt, Govaerts’ research on workplace-based assessment, B.D. Hodges concerns for faddish competency definitions, and Bowden’s critique of competency-based assessment and his proposed hierarchy of competence, and know how to apply these concepts to teaching and assessment.
  • Understand the differences between the original and revised Miller’s pyramids and how the latter may “fit” better with experts’ approach to assessment.
  • Know/show how to use RGC and know what it requires from core faculty, contrast how using the RGC “feels” to using the (internal medicine) milestones document and finally contemplate developing their own, unique, locally relevant, RGC.

Ruaa Elteriefi, MD
Oakland University William Beaumont School of Medicine

Jonathan Zimmerman, MD
Oakwood Hospital

(U/G) 409.  Designing a Course:  A Closer Look at GATEWAY to Internship – Implementing a Class-Wide Required Transition to Internship Course

Many medical schools and residencies are currently undergoing major curricular reform as medical education across the spectrum of UME to GME transitions to competency based education. In recent years, several medical schools have implemented a capstone or transition to internship course in effort to improve the preparedness and confidence of emerging interns. At Sidney Kimmel Medical College at Thomas Jefferson University, we were asked to create a four week capstone course from scratch to address specific areas that were underdeveloped in our graduates, including: clinical reasoning in acute care situations, advanced communication skills (informed consent and patient handoffs), advanced diagnostic skills, procedural skills, care of the dying patient, and maintaining health and personal well-being. It was piloted for three years with 40 to 60 students and launched for 280 in 2015.  During the workshop, we will discuss the elements of course design and subsequent redesign based on faculty and student feedback, how to identify and secure necessary resources, and selecting assessment methods and course evaluation using our capstone course as an example.

Educational Objectives

  • List components for course design and content.
  • Design multiple assessment techniques to design student and course evaluation.
  • Identify required resources for a proposed course besides time and money.
  • Share solutions to anticipated logistical challenges common to new courses.

Tasha Kouvatsos, MD
Gretchen Diemer, MD
Emily Stewart, MD
Sidney Kimmel Medical College at Thomas Jefferson University

(C) 410. Flipping Faculty to Active Learning for Residents

Team-based learning (TBL) (a form of the flipped classroom) is an active learning strategy gaining favor in graduate medical education. With TBL, residents typically acquire knowledge through self-study and to apply the knowledge by working through a set of problem-solving exercises in small groups lead by a faculty facilitator.  In this workshop, participants will learn how we flipped to a lecture-free TBL curriculum which now includes 140 topics taught by over 70 faculty members. We will detail its planning, development, and implementation, including the logistics of topic selection, choice of readings, recruitment and development of faculty, creation and organization of individual TBL resident conferences. We will demonstrate a method to divide the curriculum into weekly 90-minute hospital-based medicine sessions and a one half day session during the ambulatory 4 + 1 block schedule. We will provide results for both resident and faculty satisfaction over two years of experience.  Workshop participants will work on developing a complete plan for a single topic of their choosing. Participants will be provided a take-home template including print and web-based TBL resources useful in creating our curriculum.

Educational Objectives 

  • Demonstrate ability to prepare a single topic for conversion from lecture to TBL.
  • Develop a preliminary plan for disseminating TBL session tools for ongoing TBL-faculty development.
  • Develop a satisfaction survey for faculty and residents.

Joseph T. Wayne, MD
Gerald Schynoll, MD
Raymond Smith
Albany Medical College

(H/Q) 411. Vanderbilt Choosing Wisely:  A Model for Resident Leadership in High Value Care Education

Vanderbilt University Medical Center has had a resident-led, faculty-mentored Choosing Wisely Steering Committee since December 2013. This group, with multi-department leadership support, has launched initiatives in implementing Choosing Wisely recommendations to limit unnecessary lab and chest X-ray utilization on medical, surgical, and intensive care unit services throughout our hospital. We will discuss the model used by this group of both resident-hospital leadership collaboration and organizational change principles of John Kotter (Eight Stages of Organizational Change).  The session will be interactive and led by the co-chair of the committee, the program directors of the med-peds and internal medicine programs, and the designated institutional official.

These combined perspectives will provide a framework for attendees to launch similar work at their institutions. This workshop will be an update of a similar workshop presented at the ACGME annual meeting in February, 2015.  This work was awarded a 2017 AAIM Innovation Grant.

Educational Objectives

  • Recognize the value of resident-leadership collaboration in approaching institutional changes.
  • Apply the principles of organizational change to specific program needs with a broad array of learners and constituents.
  • Articulate the primary drivers and barriers to change implementation among learners.

Wade Iams, MD
Donald W. Brady, MD
John A. McPherson, MD
Sandra A. Moutsios. MD
Vanderbilt University School of Medicine

(G/L) 412. Using Emotion in Negotiation:  Skills for the Medicine Department, Not Just the State Department

Successful faculty members in academic internal medicine are skillful negotiators. Difficult situations arise commonly in the workplace: the program leadership wants to create time in the already full ambulatory rotation to implement a new curriculum on quality improvement, a faculty member wants to give a conference on their specific research interest instead of your requested topic, a resident wants to take a golden weekend during an inpatient rotation, an associate program director position opens up in your department. All of these situations require negotiation to reach a mutually beneficial outcome. Historically, emotion has been viewed as a barrier to reaching an agreement. In the classic book Getting to Yes, readers are advised to “separate the people from the problem.”  However recently, there has been interest in the study of emotion in negotiation.

Multiple articles and books have been published showing that understanding, channeling, and learning from emotions leads to more successful negotiation. In this workshop, we will discuss how to:

  1. Be mindful of your emotions going into the negotiation. 
  2. Name emotions in others.
  3. Take action on your emotions when beneficial. 
  4. Compartmentalize your emotion if not beneficial.
  5. Recognize what throws off your emotional balance during a negotiation and learn strategies to regain your composure.  
  6. We will present specific case scenarios from experiences at our institution and work in small groups to use the above strategies to negotiate effectively using emotion.

Educational Objectives 

  • Recognize the importance of emotional awareness in negotiation.
  • Practice regulating emotion and creating an ideal climate for negotiation.
  • Implement strategies to use emotion in creative and adaptive ways.

Eliana Bonifacino, MD
Andrea Carter, MD
Raquel Buranosky, MD
Tanya Nikiforova, MD 
University of Pittsburgh School of Medicine

(T) 413. Technology and Innovation:  How to Create an Online Curriculum

Would you like to implement an on-demand, self-directed online education platform into your medical school, residency program, or medical home?  There is a growing body of evidence that adult learning takes place best at the discretion of the adult learner. The use of online learning management systems can enhance and standardize your educational objectives across training sites, resulting in improved efficiency and quality of learning.  Educators with minimal information technology backgrounds can easily build these interactive curriculums.

Online learning management systems can be used to tailor educational objectives to the adult learner’s schedule, experience, and knowledge base. Implementation of an online interactive curriculum at our institution has resulted in a seamless, developmentally appropriate educational experience across multiple training sites and variety of clinical experiences.  The development of online tools such as personalized learning plans or “passports,” recorded academic conferences, panel management tools, assignments and quizzes, journal clubs, and standardized feedback and evaluation forms have improved faculty and learner satisfaction as well as patient care and board pass rates.

Educational Objectives 

  • Define what an online learning management system is and how it can benefit the adult learner.  
  • Identify educational objectives that could be incorporated into an on-demand online educational platform. 
  • Demonstrate how to develop an online learning environment to standardize expectations across varied learning experiences and knowledge backgrounds. 
  • Possess the skills and ability to create their own online curriculum using existing free open-sourced learning management systems.
  • Share online tools that are in current use by medical students, residents, off-service rotators, and faculty including personalized learning plans or “passports,” journal club templates, standardized feedback and evaluation forms, and panel management tools.

Amanda B. Hooper, MD
Justin Lafreniere, MD
Naval Medical Center (Portsmouth)

Jacob Cole, MD
Sanh Gao, MD
Uniformed Services University of the Health Sciences, F. Edward Hebert School of Medicine

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Seminar Session
Saturday, October 22, 2016
11:30 a.m. to 12:30 p.m.

(H/Q) A.  Improving Patient Workflow and National Research Corporation Scores

This workshop will address the difficulties in reducing patient throughput time and improve National Research Corporation (NRC) scores. It tackles efficiency in the clinic by motivating residents to prepare ahead of time for their clinic schedule, auditing time spent with patients per provider, auditing time spent with preceptors, and establishing preceptor expectations, specific improvements in documentation so that the visit flows. Reducing unnecessary interruptions by assigning rooms to residents. It will foster a team approach at a morning huddle to discuss goals of patient care for the day: identifying patients who need immunization for that day, and those requiring an updated health preventive service. Both nurses and physicians advocate reminders from check-in which reduces time spent in educating patients on relevance of a specific vaccine or test if another member of the health care team has spoken with them.  Prior to new patient visits, try to obtain medical records so that providers are prepared for the visit. Attempt to have an introductory phone call with patient to determine level of complexity of the visit and be specific as to amount of records required. Once it is completed, providers can request specific items from medical records, such as consult notes, labs with specific dates included, and specific imaging reports.  Periodic meetings with Information Technology will improve electronic health records utilization of pre-existing resources will improve the way providers and the team document to gather data from the chart. 

Educational Objectives 

  • Improve patient satisfaction scores by addressing NRC picker scores and tackling the difficulties. 
  • Improve residency preparation prior to clinic visits.
  • Foster a team approach in educating staff and peers about daily goals to encourage teamwork in the workplace.
  • Work with clerical staff to improve their efficiency and reduce providers frustration.

Ingrid Jones-Ince, MD
Gregory K. Todd, MD
Florida State University College of Medicine
Tallahassee Memorial Healthcare

B. Update on AAIM Committee Work:  AAIM Medical Student to Resident Interface Committee, AAIM Resident to Fellow Interface Committee, and AAIM GME Funding Task Force
Description TBD

T. Robert Vu, MD
Indiana University School of Medicine

Kelly J. Caverzagie, MD
University of Nebraska College of Medicine

Susan Lane, MD
Stony Brook University School of Medicine

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

(G/L) C. Career Advancement Strategies for Clinical Educators

Clinician educators need to acquire and strengthen career advancement skills to succeed in academic medicine.  This workshop will review career advancement strategies, such as developing dialogue to make your achievements known and creating mentor and sponsor relationships.   First, we will review career advancement strategies that work for men and women and how they are different. We will also discuss the differences in mentors and sponsors and how they are vital to careers.  Participants will then create brief introductions that demonstrate who you are, what you do, and how you create impact through a think-pair-share activity. Finally, each participant will create an individualized action plan which includes action items about what should be done differently to take charge of his or her career, whose support will be needed, what the success metrics will be, and a timeframe for completion of action items.

Educational Objectives

  • Identify effective career advancement strategies.
  • Recognize the importance of mentor and sponsor relationships. 
  • Develop dialogue to make accomplishments known and create an individualized action plan for implementing specific career strategies.

Rakhee Bhayani, MD
Thomas M. De Fer, MD
Emily Fondahn, MD
Washington University in St. Louis School of Medicine

(E/A/R) D. Helping Residents to See, See, See What the CCC Is All About:  Resident Engagement in Clinical Competency Committees

According to ACGME, residents must be active agents in the processes of the clinical competency committee (CCC), yet data we have collected suggest that residents have limited understanding of the function and role of the CCC and that resident engagement is in its infancy. The AAIM Collaborative Learning Community (CLC) has explored residents understanding of CCCs and has examined best practices of resident engagement in CCC processes. Engaging learners in all aspects of the CCC process, including analysis of assessment data, self-evaluation, and creation of an action plan should improve learner outcomes on the trajectory to independent practice. During this workshop, we will present data describing resident understanding of CCC function, process and level of engagement. This data is derived from focus groups and a survey of residents in the 15 programs represented in the CLC.  We will next explore potential best practices to engage residents in the CCC process before, during, and after the CCC semi-annual milestone reporting meetings.  Four methods will be described in detail with review of their strengths and limitations.  Finally, we will report information gathered from the focus groups describing how the residents believe they can be most useful in the CCC process.  Workshop participants will then break into small groups based on common program characteristics to create novel actionable strategies.   These strategies will be shared with the larger group.  The presented strategies and participant innovations will be disseminated to workshop participants.

Educational Objectives 

  • Review current status of resident engagement in CCC.
  • Explore mechanisms of resident engagement before, during, and after CCC semi-annual milestone reporting meetings.
  • Create program specific mechanisms to engage learners in CCC process.

Jennifer Jeremiah, MD
Warren Alpert Medical School of Brown University

Jacqueline Darcey, MD
Atlantic Health (Morristown)

Nacide Ercan-Fang, MD
University of Minnesota Medical School

Candice Mateja, MD
University of South Florida Health Morsani College of Medicine

(T) E. Moving Beyond the Probes:  Implementing a Point of Care Ultrasound Curriculum into Your Residency Program

While point of care ultrasound (POCUS) has been used for decades, only recently has its full utility started to become realized in the field of internal medicine. With increased applications in both the procedural and diagnostic realms, there is increasing need for formal training throughout the three year internal medicine residency.  Limited by lack of medical society guidelines or hospital policy as well as lack of ultrasound equipment and faculty trained on its use, many residency programs are struggling to develop a means for implementing ultrasound training within their program. This workshop is aimed at identifying common obstacles and offering ideas, suggestions, and solutions from institutions who have overcome these struggles to implement successful POCUS curricula.

Educational Objectives

  • Understand the need for developing POCUS curricula. 
  • Compare and contrast various existing models of POCUS education.
  • Discuss various obstacles to implementing a POCUS curriculum at their own institution.

Charles LoPresti, MD
Case Western Reserve University School of Medicine

Daniel Schnobrich, MD
University of Minnesota Medical School

Frank M. Schembri, MD
Boston Medical Center

(C) F. Building Interprofessional Education into Your Clerkships

In 2011, an expert panel sponsored by the Interprofessional Education Collaborative (IPEC) with many contributors including AAMC 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 which will then lead 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. 

This interactive workshop will help participants learn about the core competencies of interprofessional education and methods to incorporate it in the internal medicine clerkship.  The audience will learn about how several institutions have built interprofessional educational activities into their clerkships covering diverse themes.  Then participants will be given time to go through a worksheet reflecting on how to incorporate an interprofessional activity into their own clerkship and then share in small groups.  Key points from each small group will be shared with the large group.  We will end with a presentation on the group’s experiences as far as trials and tribulations learned from incorporation of interprofessional activities, summarize the main points, and allow for questions.

Educational Objectives 

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

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

Amy Blatt, MD
University of Rochester School of Medicine and Dentistry

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

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

Christina Renner, MD
University of Texas Southwestern Medical Center at Dallas Southwestern Medical School

(U/G) G. Residency Application Inflation:  Challenges and Best Practices in Internal Medicine

The purpose of our workshop is to identify challenges and best practices for medical students, medical school advisors, and residency program leadership in the internal medicine residency application process.  Between 2010 and 2015, the average number of ERAS applications for all categories of individual applicants applying to ACGME-accredited categorical internal medicine residencies rose from 44 to 54.  The average number of applications per international medical graduate rose from 54 to 67 and per US allopathic senior student from 22 to 30.  Preliminary ERAS data suggest that 2016 shows an additional increase in these numbers.

This increase in the number of applications per applicant creates an increasing demand for resources from students (time, money) and programs (personnel time, interview expenses).  However, there is evidence to suggest that this increase in applications does not increase any individual applicant’s likelihood of matching at their desired program.

First, the presenters will set the stage with a review of the available data describing the current state of the residency application process.  They will also review recent NRMP Match Data that suggest that the internal medicine Match is not becoming more competitive and is becoming increasingly costly to students and programs.  Next, we will engage the audience in a discussion of challenges and best practice in the interview process. 
This workshop at an AAIM conference provides an opportunity to engage both UME and GME leaders to discuss challenges and propose best practice.

Educational Objectives 

  • Describe current trends in the number of applications per applicant in the internal medicine residency Match.
  • List evidence that the internal medicine residency Match has not become more competitive for US allopathic senior medical students over the past decade.
  • Identify best practices for medical students, medical school advisors, and residency program directors during the application process.

Anne G. Pereira, MD
University of Minnesota Medical School

Steven V. Angus, MD
University of Connecticut School of Medicine

Jeffery Becker, MD
Case Western Reserve University (MetroHealth)

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

Alita Mishra, MD
Inova Fairfax Medical Campus

(TT) H. Equipping Staff for Inpatient Teaching Success:  How to Successfully Implement High-Yield Teaching Workshops

Inpatient medical education has undergone dramatic changes recently, with hospitalist clinician-educators asked to provide quality teaching opportunities while working within more intense time constraints. Many institutions do not have a specific approach to equipping these individuals with the skills necessary to provide high value internal medicine education in this setting. Given these changing conditions, professional development focused on cultivating teaching skills in a dynamic environment is critical.  This workshop will tailor its content and delivery to the needs of its participants. We will provide a framework for the creation and delivery of interactive content devoted to building and honing teaching skills of inpatient providers. The workshop will identify overarching goals and objectives of a teaching skills course, describe the fundamental tenets of successful courses including content, instructional techniques, and methods of assessment, and describe common barriers to achieving and sustaining successful implementation while brainstorming on how to overcome these barriers. A sample curriculum detailing content, methods of instruction and assessment, and experiences will be provided to review core concepts. Effective methods of measurement (e.g. teaching scores, confidence levels) will be reviewed and assessed. This curriculum has been integrated into the academic environment by the workshop presenters, and has been optimized utilizing a highly interactive small-group environment. The workshop will reflect these principles by using small and large group discussion, case-based examples, and varying formats to model the structure and characteristics of a successful inpatient teaching skills course.

Educational Objectives 

  • Identify the goals of an intensive inpatient teaching workshop and a method to enhance teaching skills of clinician-educators in the dynamic inpatient environment working within challenging time constraints.
  • Compare ideas and suggestions for faculty development teaching workshops with the experiences of a group of academic hospitalists that have successfully implemented such a workshop on a recurring basis, and import/adapt these ideas into their home institutions and groups.
  • Describe methods to qualitatively and quantitatively assess the success of a faculty development inpatient teaching workshop.

James C. Pile, MD
David Gugliotti, MD
Robert Mayock, MD
Abby L. Spencer, MD
Cleveland Clinic Foundation

Nathan Houchens, MD
University of Michigan Medical School

(PM) I. A Roadmap for New Program Applications and Lessons Learned

With the growing number of medical school graduates, the shortage of ACGME-accredited training positions (residencies and fellowships) has been realized.  In addition, the emergence of a single accreditation system has resulted in the need for academic leadership to be facile with the transition.  Creativity in determining sites for new programs is one challenge and submitting a successful application is another.  Beyond requirements outlined by specialty-specific Residency Review Committees, a roadmap to successful development of new postgraduate training programs does not exist. This workshop aims to share presenters insights and experience with successful and unsuccessful development of new training programs. The session will begin with a short review of the new program application process. Following this review, real world examples of residency and fellowship applications will be provided to small groups. Attendees will review various excerpts from actual program applications and critique the information provided. These small group critiques will be compared with actual feedback from ACGME as a method to inform participants of potential key issues that may impact a new program application. After completion of this activity, the presenters will summarize lessons learned that may lead to a potentially positive or negative outcome. Finally, a large group brain-sharing will focus on selecting sites for new programs.

Educational Objectives 

  • Become familiar with elements of a new program application.
  • Describe the application process and the associated challenges.
  • Further understanding of potential strengths and weaknesses in new program applications.

Sandhya Wahi-Gururaj, MD
Miriam E. Bar-on, MD
University of Nevada School of Medicine (Las Vegas)

(E/A/R) J. Faculty Development:  Evaluation and Effective Feedback in the Continuity Clinic – Challenges and Innovations in an X+Y Block System

Redesign of residency training in internal medicine programs has led to the transformation of ambulatory experience to an X+Y block scheduling system. While this system effectively deconflicts inpatient from outpatient learning experiences, balancing measures have included decreased continuity between learners and teachers, and consequent challenges in evaluating residents in a way that effectively informs clinical competency committees. This workshop explores the barriers to effective evaluation and feedback in a high-volume PCMH-based continuity clinic, and focuses on faculty development using milestones-based assessment tools.  Methods of direct observation, focused clinic evaluations and effective delivery of feedback will be discussed as will known and potential barriers and solutions to implementation.

Educational Objectives

  • Identify challenges and barriers to performing effective evaluation in the continuity clinic in an X+Y block schedule system.
  • Promote faculty development in both evaluation of residents and delivery of resident-valued feedback. 
  • Introduce innovative tools that facilitate more assessments in the clinic setting and promote direct observation.
  • Identify methods that allow for increased meaningful feedback and promote self-reflection in learners.

Julie M. Chen, MD
Renee Mallory, MD
National Capital Consortium

Monica Yepes-Rios, MD
Uniformed Services University of the Health Sciences F. Edward Hebert School of Medicine

(WR) K. Finding Meaning in a Day:  How to Successfully Implement a Retreat Fostering Resiliency and Wellness in the Setting of Your Residents as Teacher Curricula

This workshop aims to describe our experience with the successful implementation of winter retreats focusing on wellness, resilience, and meaningfulness for our internal medicine residency program.  During the retreat, we used small group formats to foster reflection and sharing amongst participants.   Each retreat commenced with a modified Balint group activity to provide a forum to share and reflect on challenging but rewarding patient experiences.  It was followed by two activities that demonstrated effective strategies regarding coaching and guiding learners, and thus finding meaning by making a difference as a teacher and leader.  The final small group encouraged each participant to identify what gives them professional meaning and discuss personal strategies to combat burnout.  Each retreat ended with a broader discussion of burnout and the administration of a wellness survey.  

This workshop will allow participants to discuss their ideas and experience with incorporating curricula regarding meaningfulness for each resident class.  It will engage them in developing skills to facilitate small group activities that were focused on during our retreats.  Each participant will also have the opportunity to participate in small group activities that mimic those from our retreat. 

Following the conclusion of the workshop, we hope participants feel more confident discussing meaningfulness with their residents and recognize how meaningfulness relates to teaching and leading as well as promoting wellness and resiliency among physicians.  

Educational Objectives

  • Describe the successful implementation of a class specific winter retreat focused on meaningfulness in the context of our resident as teacher and leader curriculum.
  • Share the skills and resources needed for implementation of a meaningfulness retreat combining teaching, wellness, and resiliency for residents.
  • Discuss ways to both measure well-being and combat burnout during residency.

Hannah Raverby, MD
Ji Hoon Baang, MD
William M. Brady, MD
Bizath S. Taqui, MD
Lewis Katz School of Medicine at Temple University

(E/A/R) L. Surveyed to Death:  Creative Data Collection Techniques for Evaluating Educational Innovations

As clinician educators, we are expected to create novel curricula, evaluate if each met its objectives, and then ideally disseminate the innovation to other educators. Often, evaluation of these innovations takes the form of questionnaires and surveys, leaving many of our learners with survey fatigue. In this interactive workshop, participants will learn and experience several creative non-survey methods of collecting data to evaluate educational interventions and discuss how and when they could be used.
The workshop will begin with a brief overview of why surveys and questionnaires are popular but overused. For the remainder of the workshop, attendees will be active participants in several different and creative data collection techniques that can be used in evaluating educational innovations.  We will describe different sources of evaluation data including information gathered from individuals, information gathered from groups, and observation.  We will then describe and simulate creative and participatory techniques for collecting data from each of these sources, including interactive technologies such as audience response systems; Q-sorts and other types of card sorts; and a value line.  After simulating each evaluation technique with participants, we will discuss the advantages and disadvantages of each technique, appropriate times to use each technique, and whether or not it is an appropriate technique for use in data collection for research purposes.  We will conclude with a discussion of the opportunities and challenges of evaluating educational innovations.

Educational Objectives 

  • Identify multiple sources of data for evaluations of educational innovations.
  • Demonstrate how to participate in creative techniques for data collection.
  • Identify the advantages and disadvantages of different data collection techniques.

Briar L. Duffy, MD
Michael J. Aylward, MD
Sophia Gladding, PhD
Mumtaz Mustapha, MD
University of Minnesota Medical School

(G/L) M. Leadership Training:  Why Your Program Can and Should Provide it to Your Learners

Physicians must be able to lead complex, multidisciplinary teams. Regardless of whether we work in large university programs or smaller community settings, it is our duty to train our residents in this competency. In 2012, our residency program implemented a leadership development program for all residents with the goals of helping residents to develop new leadership skills and cultivate natural leadership abilities and to illustrate how effective leadership skills can improve patient care.  Over the past four years, we have utilized resident discussion groups, annual surveys, and program evaluations to gain valuable insight into how residents view the importance of leadership skills in their careers as physicians, how they perceive the value of leadership training during residency, and how they have responded to the training we provided. This information is important for programs interested in delivering leadership training to all residents as there are significantly varying levels of interest in leadership training, varying levels of experience with prior leadership training, and varying levels of proficiency with leadership skills among residents. In this session, we will discuss what we have learned through our own experiences in creating a leadership training program with a specific focus on detailing how participants can translate our experiences into developing leadership programs at their own institutions.  We will share tools we have used to analyze our residents perceptions of leadership and leadership training and we will share our curriculum and strategies we have used to engage residents in this training.

Educational Objectives 

  • Understand how leadership training can help residents prepare to be successful, independent physicians by promoting the development of skills in the areas of interpersonal communication, systems based practice, and professionalism.
  • Identify common barriers to resident engagement in leadership training and how they may overcome these barriers in their own programs.
  • Develop strategies for developing resident leadership training at their own institutions by tapping into readily available resources within and outside their own department.

Jared Moore, MD
Christopher Esber, MD
David A. Wininger, MD
Ohio State University College of Medicine

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     Workshop/Seminar Track Key

C = Curriculum
R = Research
TT = Teach the Teacher
WR = Wellness/Resiliency
T = Technology
U/G = UME to GME transition
G/L = Professional Growth and Leadership
PM = Project Management
H/Q = High Value Care/Quality Improvement
E/A/R = Evaluation/Assessment/Remediation