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2017 APDIM Chief Residents Meeting Workshop Descriptions

Workshop Session I

Workshop Session II

Workshop Session III

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 2017 APDIM Chief Resident Meeting (PDF). 

Workshop Session I
Monday, March 20, 2017
8:00 a.m. to 9:30 a.m.

101. From Mini-Me to Yao-Ming: Adjusting Your Psychological Size to Maximize Impact as a Chief Resident
The transition from resident to chief resident can be difficult owing to new teaching roles and leadership positions as well as drastic responsibility changes. The chief resident role comes with high expectations based on past performance; however, the skill set needed to excel as a resident does not guarantee success as a chief resident. These roles can be accompanied by a number of overt and implicit expectations, in which the chief resident is expected to perform adroitly. Chief residents are often underprepared for this transition as many have no training in leadership and management, meeting facilitation and presentation, or teaching theory and methodology. This gap in training is felt perhaps most acutely when new chief residents assume the role of the attending physician. New chiefs may struggle to adapt to their ever-changing environments as well as to the highly variable clinical and administrative responsibilities they suddenly face. In the capacity of being a new attending physician, many chief residents also feel as though they are imposters and that they need to “know everything.” These new roles and responsibilities often require very different approaches which can be challenging for new chief residents. One universal method of addressing these gaps is to adjust psychological size; defined as the perceived status one person has relative to another. During this interactive workshop incoming chief residents will learn methods of altering their psychological size to allow them to work effectively with individuals that range from the hospital CEO to newly branded medical students.

Educational Objectives:

  • Explain three key components involved in the concept of psychological size.
  • Describe how you would modify your behavior to increase or decrease psychological size in a given situation.
  • List three statements you can use to adjust your psychological size when attending with learners and three statements with colleagues/supervisors.

Patrick Rendon, MD
Justin Roesch, MD
University of New Mexico School of Medicine

Deepa Bhatnagar, MD
Tulane University School of Medicine

Winter Williams, MD
University of Alabama School of Medicine

Bradley Sharpe, MD
University of California-San Francisco School of Medicine

102. Hiding in Plain Sight – How We Know What We Know
Metacognition is the study of how we know what we know. Disparate academic disciplines have detailed the fallibility of our judgments in medicine and in life. These blind spots have been called cognitive biases, the illusion of explanatory depth, normalized deviance, the unknown unknown quadrant of the Johari window, unconscious incompetence, the Dunning-Kruger effect, and many other names. During this workshop, you will learn about these concepts and how they may cause trouble for medical training and practice. We will demonstrate multiple entertaining techniques that you can use in your residency program to engage your learners in identifying these blind spots. We will discuss the science behind blind-spot mitigation and discuss techniques you can use in your residency program.

Educational Objectives:

  • Describe ways of thinking that can lead to errors in decisions and judgments.
  • Create innovative, entertaining, and engaging teaching strategies to identify these errors.
  • Develop a program to mitigate these errors within a residency program.

Eric J. Warm, MD
Bradley Mathis, MD
Lauren Ashbrook, MD
Justin Held, MD
University of Cincinnati College of Medicine

103. Human Knot v. Happy Hour: Enhancing Teamwork, Resiliency, and Identity Formation during Intern Orientation and Beyond
Every year, residency programs implement orientations for incoming residents to welcome them to the proverbial family. These orientations are often clinically focused, created to promote institution-specific knowledge. Team-building activities, which promote resiliency and development of group identity, are often an afterthought, left to individual chief residents to design. This workshop will present quantitative and qualitative data from multiple institutions about the effectiveness of a variety of orientation activities and the cognitive psychology behind these tasks. As a large group, participants will explore resident-level survey data collected over the past three years. These data examine resident satisfaction and the perceived effectiveness of a variety of orientation events with the goals of creating unit cohesion, improving communication in the clinical setting, promoting resiliency, and developing respect and trust among new housestaff. Data from across training sites and across years will be compared to evaluate the effectiveness of these activities in different settings. Participants will then work in small groups to share their own orientation experiences and develop the goals of their orientations. They will also explore how these activities could be employed at other times throughout the year to meet program goals. Participants will then select from a number of team-building activities, identify their own limitations, and tailor their orientations to their pre-specified goals. Ultimately, attendees will leave the session with a toolbox of exercises, which they can use to enhance residency cohesion, promote resiliency, and develop respect and trust among new housestaff at their home institutions.

Educational Objectives:

  • Develop a toolbox of exercises for effective team-building based upon cognitive principles.
  • Demonstrate strategies that foster resiliency.
  • Determine potential methods to enhance the professional identity among new housestaff.

Erin Vipler, MD
George Washington University School of Medicine and Health Sciences

Benjamin Vipler, MD
Naval Medical Center (Portsmouth)

Adam Barelski, MD
Walter Reed National Military Medical Center

104. Your Chiefly Role as an Inpatient Attending: Moving Beyond “Seen and Agree”
Identified roles of the chief resident include leader, administrator, educator, mentor, and counselor. For many chief residents, the role also includes attending on the inpatient service. Common feelings prior to attending for the first time include excitement, angst, enthusiasm, and anxiety. It is a role that is unfamiliar and demanding for any new faculty member, but presents special challenges for the chief resident. This workshop is designed to prepare rising chief residents for this challenge - what to anticipate as a teacher, leader of the team, and manager of an inpatient service in today’s fast-paced world.

Educational Objectives:

  • Understand the complicated and multifaceted role of the attending on an inpatient service.
  • Have the tools needed to set expectations for the team and individual team members, balance the demands of teaching and patient care in a busy clinical setting, and to give timely and effective feedback to learners at multiple levels.
  • Feel more comfortable and prepared for the chief resident role as a new attending.

Debra L. Bynum, MD
Maureen Dale, MD
University of North Carolina School of Medicine

Donald R. Bordley, MD
William Novak, MD
University of Rochester School of Medicine and Dentistry

105. “Stuck in the Middle With You”: The Chief Resident as Middle Manager
The role of the chief resident is comprised of educational, clinical, and administrative tasks. While the chief resident may be familiar with their educational and clinical roles, the administrative role is likely new. Despite the lack of formal instruction in managerial techniques and an almost certain lack of a business background, the chief is immediately responsible for disseminating policy from above (faculty, program director, division chief, department chair), advocating for those below (housestaff), and working with peers (co-chiefs, chiefs in other programs, fellows). It can be a challenging and daunting task for a new chief resident, who may face difficulty transitioning from a peer to supervisory role, implementing decisions made by residency leadership, knowing their own boundaries of authority, and triaging decision making. Using a case-based approach derived from experiences at our institution, various proven strategies to improve the effectiveness of this middle manager will be discussed.

Educational Objectives:

  • Define the role of an effective middle manager.
  • Describe various management styles and relate them to each member of the chief resident team.
  • Apply the strategies outlined above to real-world case simulations which require the chief resident to manage conflicting priorities across multiple levels of the institutional hierarchy.

Nicholas Macpherson, MD
Sarah Merriam, MD
Nicholas Macpherson, MD
University of Pittsburgh School of Medicine

106. Breaking the Glass Ceiling Together: A Collaborative Near-Peer Mentorship Program in Leadership by Junior Female Faculty for Women Chief Residents
Female faculty face many challenges in academic advancement. They are less likely to advance academically than their male colleagues and more likely to leave academic careers. Lack of mentorship has been touted as a reason for this disparity. Junior women who seek female mentors are often limited by the scarcity of women of advanced academic rank. The AAMC report on the status of women showed females make up only 15% of chairs of departments and deans of medical schools. Therefore, junior women faculty seeking a traditional dyadic model often have difficulty identifying gender-matched mentors. Chief residents are recognized as leaders among their peers; however, few residency programs offer skill-building programs in leadership for their trainees. Female chief residents are at an additional disadvantage without sufficient female mentors. In an effort to promote leadership skills among our female chief residents, junior female faculty at Lewis Katz School of Medicine at Temple University created a leadership curriculum in collaboration with our female chief resident in a near-peer mentorship model. Cooper Medical School of Rowan University began a similar program this year. Participants in this workshop will be introduced to the near-peer framework of mentorship. They will review important skills necessary of leaders in academic medicine and identify challenges for female chief residents and junior faculty in leadership positons. Ultimately, participants should be able to identify potential female collaborators, delineate key components of a leadership program for women in academic medicine, and develop an action plan for implementing a near-peer mentoring program at their institutions.

Educational Objectives:

  • Describe a near-peer model of mentorship focused on building leadership and management skills for female chief residents and junior faculty.
  • Identify unique challenges and address barriers that chief residents and junior faculty face in leadership positions that are particular to women and brainstorm solutions for overcoming these challenges.
  • Develop a targeted and specific action plan to implement a near-peer mentorship program in leadership for early career female physicians at your institution.

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

Alexandra Lane, MD
Navi Jain, MD
Cooper Medical School of Rowan University

107. Reinventing Report: How You Can Develop Resident Expertise in High Value Clinical Reasoning
The foundation of high value care, or optimizing utility and quality of care compared to cost, lies in thoughtful diagnostic approaches. We have all observed the master clinician who effortlessly arrives at a narrow differential and chooses a focused selection of tests to clinch a diagnosis. We have also all observed a reflexive, broad workup with multiple tests performed in parallel, leading to confusing or conflicting data, unnecessary harm to patients, and excessive cost. The cognitive psychology and medical education literature describe specific techniques and skills that master clinicians use to solve challenging diagnoses, avoid diagnostic error, and deliver high value care through clinical reasoning. We have developed a clinical reasoning case-based curriculum which provides a roadmap for residents to understand how expert clinicians reason, teaches residents these skills, and allows residents to apply those skills in real case discussions. During this workshop, we will discuss core concepts in clinical reasoning, provide you with an interactive experience of our clinical reasoning report format with a focus on high value care, and present a blueprint for your institution to use in implementing a high value clinical reasoning curriculum.

Educational Objectives:

  • Develop knowledge of the key elements of clinical reasoning as described in the medical education and cognitive psychology literature.
  • Apply skills as a moderator of metacognition as a case unfolds—highlight thinking about how we think.
  • Identify and correct errors in resident perceptions of the value of data obtained through history, physical examination, and diagnostic testing.

Jason H. Maley, MD
Kathleen Murphy, MD
Erin Haley, MD
Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania

108. Digestible EBM Teaching Slices: Tactics to Regularly Feed Your Residents
Significant progress has occurred within residency programs to address skills to practice evidence-based medicine (EBM). However, there is still much further to go to instill it as a practical component of clinical problem-solving and explicit clinical reasoning. Because chief residents have a broad range of patient based teaching opportunities—from the wards to clinics to case conferences—they possess immense potential to alter the perceptions and daily habits toward EBM. We believe that this potential can be unleashed through judicious use of teaching slices (often using just-in-time resources) alongside a fearlessness to integrate best evidence from clinical research within other educational priorities. This workshop is highly interactive using multiple techniques to bolster personal understanding of EBM concepts and showcase practical approaches to broaden your teaching menu.

Educational Objectives:

  • Explore practical approaches to weave best evidence into your clinical teaching.
  • Tackle commonly encountered challenging EBM concepts.
  • Gain a healthy swagger at the intersection of EBM content knowledge and its application during clinical teaching and patient care.

Joseph F. Szot, MD
Manish Suneja, MD
University of Iowa Roy J. and Lucille A. Carver College of Medicine

109. Modeling Resiliency: How Prevention Is the Best Medicine for Burnout
As leaders in medical education at our hospitals and universities, our mission is not only to teach patient care, but to prepare the next generation of physicians to enter into and sustainably practice medicine for the entirety of their professional life. In an era where physician burnout is at an all-time high, it is important that we coach, model, and practice resiliency as a key component of medical education. Chief residents are well-poised to model resiliency for not only the residents, but also program faculty and students. This workshop aims to help chiefs better understand the concepts behind resiliency, learn what valuable resources exist for teaching resiliency, and finally, practice techniques to coach resiliency for the trainees they lead. We will explore the key components of resilience: acceptance, gratitude, reflection, empathy, attention, and joy. This interactive workshop will begin with a live polling program self-assessment, followed by an in-depth discussion about the role of resiliency in preventing (and/or treating) burnout. After a formal review of resources available to programs to teach and coach resiliency, attendees will have the opportunity to discuss and share ideas on how to combat program-specific weaknesses. Program resources will be distributed post-workshop to attendees via social media. Spanning three generations of former chief residents in military, university, and community programs, our presenters are passionate about keeping the spark alive and well in medicine.

Educational Objectives:

  • Define and understand the meaning of resiliency in medicine.
  • Learn about new and valuable resources for teaching resiliency.
  • Learn and practice resiliency coaching techniques that can be used with individual learners or program-wide.

Laurel Fick, MD
Wesley Prichard, DO
Michelle Solik, MD
Lannie Cation, MD
St. Vincent Hospital and Health Care Center

110. The Chief Resident/Program Administrator Partnership: On Our Adventure Together

This workshop is designed to make the transition from peer to chief resident by creating a forum and allowing the freedom to ask questions and/or address concerns to a panel of experienced program administrators in a comfortable, conversational setting. These program administrators, have over 100 years of experience combined in graduate medical education. This forum will be an opportunity to ask questions and have an open discussion on what to expect in the role of chief resident throughout the academic year. We will share stories, best practices, and provide solutions to any areas of concern. Our goal for the session, is to inform you about the chief year and how your program administrator can assist you during the academic year and beyond.

Christina B. Edwards
Sidney Kimmel Medical College at Thomas Jefferson University/Christiana Care Health

Cara A. Giacomo
Greenwich Hospital Association

Misty M. Hodel
Charleston Area Medical Center
West Virginia University (Charleston Division)

Denise M. Keyser
Geisenger Health System

Eileen T. Kruck
New York Methodist Hospital

Deena W. Segal
Case Western Reserve University School of Medicine

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Workshop Session II
Monday, March 20, 2017
1:15 p.m. to 2:45 p.m.

201. Difficult Conversations for the Chief Resident: Making Your Office a Safe Space
The chief resident wears many hats, from advisor to advocate to enforcer. Meeting the needs of various stakeholders (e.g., residents, program director, administrative staff) is challenging, and requires the ability to navigate conversations involving differing opinions, strong emotions and high stakes. Chief residents are in danger of making the false choice between being the “nice” or the “mean” chief, between accommodation or imposition, when often there is a better way. To best keep daily operations running smoothly, chief residents must create a supportive and structured space for dialogue and develop the communication skills necessary to preserve relationships and achieve common goals. This workshop will focus on personal reflective techniques and communication tools to set the stage for successful dialogue and mutual decision-making. We will first describe the hallmarks of difficult conversations using common scenarios encountered by chief residents. Using a large-group, case-based approach derived from experiences at our institution, we will discuss proven strategies to improve the effectiveness of high-stakes conversations and negotiations.

Educational Objectives:

  • Describe the many types of difficult conversations a chief resident will encounter and identify each type in case-based scenarios.
  • Provide and then practice the personal reflective techniques that help prepare for a successful difficult conversation.
  • Practice concrete communication skills that promote a safe space for effective dialogue.

Ben Sprague, MD
Sarah Merriam, MD
Alda Maria Gonzaga, MD
Gaetan Sgro, MD
University of Pittsburgh School of Medicine

202. Chief Negotiator: Skills for the Medicine Department, Not Just the State Department
Successful chief residents are skillful negotiators. An intern wants to go to a wedding instead of his or her ICU call; the program leadership wants to create time in the already full ambulatory rotation to implement a new curriculum on measuring quality; the program director wants to restructure the ICU call schedule to decrease the total number of residents needed on the rotation. 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 on negotiation Getting to Yes by Fisher, Ury, and Patton, readers are advised to “separate the people from the problem.” However more 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 strategies to effectively use emotion in negotiation, including how to be mindful of your emotions going into the negotiation, name emotions in others, take action on your emotions when beneficial, compartmentalize your emotion if not beneficial, recognize what throws you off emotional balance during a negotiation, and learn strategies to regain your cool. We will present specific case scenarios from experiences at our institution and work in small groups to use the 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.

Christopher Davella, MD
Eliana Bonifacino, MD
Andrea Carter, MD
University of Pittsburgh School of Medicine

Shanta Zimmer, MD
University of Colorado School of Medicine

203. Chief Resident Mistakes Workshop
Winston Churchill said, “All men make mistakes, but only wise men learn from their mistakes.” Here is your opportunity to learn from other chief resident mistakes. In this workshop, you will be presented with case vignettes of several commonly reported chief resident mistakes featured in A Textbook for Today’s Chief Medical Resident. Faculty will guide a group discussion on how the mistake happened and explore strategies to avoid similar mistakes during your chief resident year. The learners will dissect each scenario in real time with the help of the faculty and in doing so re-orient themselves to their new leadership position. Facilitators will guide the group discussion and solicit the audience to augment the discussion with mistakes they have witnessed their own chief resident make. After completing this workshop, chief residents cannot expect to have a mistake free year but will have their eyes and minds opened to potential pitfalls they will face, learn strategies to avoid them, and realize how easy it is to make a mistake even with the best of intentions.

Educational Objectives:

  • Recognize and understand common mistakes made by chief residents.
  • Learn strategies to avoid common chief resident mistakes.
  • Appreciate the complex role played by the chief resident and leverage it to minimize mistakes.

Jess Edison, MD
National Capital Consortium

Cecily Peterson, MD
Duke University College of Medicine

George R. Mount, MD
Patricia Short, MD
Madigan Healthcare System

204. In the Paint: Mapping Curriculum Progress to Help Residents Shoot, Score, and Pass the Boards
As a rising chief resident, you need a gameplan to ensure a successful season. Residency education is predominantly the role of the chief residents and you only have one year to make a meaningful impact. Didactic education in any residency curriculum is complicated, and its scope is vast. Deliberate choices in developing your curriculum playbook must be made with regard to content specifics, format, and timing. A curriculum that is too formal lacks the flexibility to identify and rapidly target areas of need, but too much flexibility risks the inadvertent omission of core content. To improve this process, we are developing a creative portfolio of dynamic and interactive curriculum mapping tools. These tools incorporate the weighted importance of ABIM blueprint categories as a framework for colorful visual representations of academic and clinical concepts. More than a study guide, these tools allow program leadership to track resident performance on in-training exams. They also have potential to increase resident engagement during didactic sessions, as residents can track their own academic progress and see how each conference or morning report contributes to their overall educational experience. This workshop will incorporate small group collaboration to assist participants in generating ideas to create their own residency curriculum playbook.

Educational Objectives:

  • Enable program directors and chief residents to plan educational conferences to align with relative importance of concepts within the ABIM blueprint.
  • Yield diverse and innovative approaches to developing or refining a robust and comprehensive didactic curriculum.
  • Discuss strategies for incorporating mapping tools into a didactic curriculum with the goal of inventory, management, and improvement of educational opportunities.

Stevie Carraro, MD
Trevor Neal, MD
Krupa Sheth, MD
Brody School of Medicine at East Carolina University

205. Running a Morning Report with Unscripted Cases
Morning report has been rated by residents to be their most important educational activity. While senior and chief residents are usually responsible for facilitating morning report, most receive little or no training on how to do so effectively. Traditional report preparation often involves hours spent developing slide shows and teaching points, pressures the facilitator to speak as a content expert, and results in a low level of learner interaction. In this workshop, we will present impromptu case facilitation (ICF), an approach to running morning report with unscripted and spontaneously presented cases that are unknown to the facilitator and other audience members. By discussing a case using ICF, the facilitator shifts his or her focus from content mastery to clinical reasoning and decision making. Rather than PowerPoint slides and bulleted teaching points, it is the case – and the challenges facing the presenting physician – that becomes the focus. Attendees will learn how to shift the culture to ICF and review effective strategies for dealing with uncertainty, encouraging audience participation, redirecting incorrect learner responses, utilizing content resources in real time, and providing unscripted teaching on-the-fly. Although leading the discussion of an unprepared case may seem daunting, we will show that ICF reduces facilitator pressure to be the content expert. By mastering a few key skills, participants will learn to harness the collective knowledge of the room and focus on clinical reasoning, while allowing conference attendees to teach each other.

Educational Objectives:

  • Prepare a general outline for an ICF, with variation for different types of cases (e.g. full length case versus short case versus clinical image).
  • Identify components of effective real-time conference facilitation, such as time management, whiteboard management, and identification of key learning points which can be used in morning report and other case-based teaching sessions.
  • Recognize techniques for managing the unique learning environment of an unscripted morning report, including strategies for refocusing incorrect responses and disagreements in management, optimizing participation, framing precise questions, and sharing teaching responsibilities.

Daniel Wheeler, MD
University of Minnesota Medical School

Manuel Diaz, MD
Juan Lessing, MD
University of Colorado School of Medicine

Jessica Beaman, MD
University of California-San Francisco School of Medicine

206. Teaching the Unteachable: Linking Evidence-Based Medicine and Technology to Teach Diagnostic Reasoning
One important job of clinician-educators is to teach students and residents how to reason through diagnostic dilemmas which is often done by educators sharing their mental model and diagnostic reasoning on rounds. However, rarely are diagnostic decisions quantified and articulated in a way that learners can truly understand the utility and limitations of various tests. This disconnect can lead to learner frustration when they have a teacher who has a different diagnostic approach – one that is more “conservative” or “test-heavy” than they are. It should serve as a valuable learning opportunity where different aspects of diagnostic reasoning are “mapped out” in a way that elevates learner understanding of the process. One reason for this missed learning opportunity is lack of educator comfort with concepts such as pretest probability, action thresholds, and likelihood ratios. Another is that clinicians are unaware of simple tools available on smartphones and tablets that allow for fast, real-time integration of these concepts into rounds. These tools can help educators seamlessly integrate quantified diagnostic reasoning into rounds, and give learners tools to better articulate their thought process. During this workshop, chief residents will be challenged to become comfortable with the often inexact science of determining a pretest probability. They will learn about action thresholds in diagnostic reasoning and how they contribute to differences in clinician approaches to diagnosis. They will also use likelihood ratios to properly interpret test results and learn how to use simple smartphone applications to integrate this process into clinical teaching.

Educational Objectives:

  • Teach how to generate specific pretest probabilities and action thresholds (test and treat) for clinical scenarios.
  • Teach the use of likelihood ratios to arrive at appropriate posttest probabilities and relate them to stated action thresholds.
  • Demonstrate the use of smart phone applications for real-time teaching of the diagnostic process using pre/posttest probabilities, action thresholds, and likelihood ratios while on rounds with learners.

Benjamin Kinnear, MD
Courtney Ohlinger, MD
Matthew Kelleher, MD
University of Cincinnati College of Medicine

Jonathan Tolentino, MD
Stony Brook School of Medicine

207. How to Identify the Struggling Intern
A cardiology fellow walks into the chief resident office in May informing the chief residents that a particular intern did not exhibit appropriate clinical judgment in the cardiology ICU and he is concerned that the intern is not ready to be a senior resident. Upon review of the intern’s formal evaluations, the milestone scores are near the mean and there are no major issues on other evaluations. Unfortunately, this scenario may be all too common when interns with critical deficiencies are detected late in the year. Do you need an efficient and simple method to identify which interns require early intervention and to ensure they are ready to be great PGY-2 residents? If you answered yes, then this seminar is for you.
You will brainstorm with your co-chiefs on red flag intern characteristics and learn how to identify these characteristics using an objective intern check-in tool. Our chief residents created this tool to identify maladaptive actions using a “yes, no, and how frequently” format to reduce subjective interpretation. The chiefs fill out the check-in tool during a sit-down discussion with the interns’ senior residents after the intern completes an inpatient service rotation or multiple ambulatory weeks. This tool helps identify which specific intern actions require further monitoring and intervention. After attending this seminar, you will be able to implement our check-in tool at your institution. You will be able to use this tool to screen all interns and identify struggling interns early in the year who require extra assistance.

Educational Objectives:

  • Understand the benefits of early evaluation of interns.
  • Learn how to screen all interns to identify struggling interns early in the academic year.
  • Utilize an easy and practical approach with a check-in tool for interns.

Diana L. Snyder, MD
Perry Formanek, MD
Lawrence Mollo, MD
Daniel Sisbarro, MD
Stritch School of Medicine Loyola University of Chicago

208. Coaching the Coach: A Toolkit for Chief Residents
One of the most rewarding and challenging responsibilities of being a chief resident is coaching resident learners. A great coach is able to both recognize specific skill domains that a learner needs to focus on and also formulate an individualized plan for improvement. In sports, an effective coach is able to identify precise deficiencies within a particular skill. For example, a coach may note that a player is struggling to throw a ball and further identify that the deficiency is in the mechanical release. In medicine, we are not formally trained and often struggle to identify the area of greatest deficiency, which hinders the formulation of improvement plans. Without concrete identification of skills to improve, the learner continues to struggle, lengthening the time it takes to reach full potential. From the program standpoint, it leads to resident dissatisfaction, ineffective evaluations, and suboptimal milestone advancement. Chief residents, when armed with a practical framework, have the unique opportunity to identify specific domains for improvement and to create and monitor individualized improvement plans. During this interactive workshop, we will define coaching and contrast it to traditional feedback from evaluations. We will emphasize the unique role of chief residents and provide a toolkit to implement coaching in their residency competency-based improvement plans using a take-home milestone based assessment tool. We will provide a framework for identification of a deficiency and practice creating concrete examples will be utilized to practice these skills in small groups. In addition to developing their own coaching confidence, chief residents will develop skills to help other faculty and senior residents become effective coaches.

Educational Objectives:

  • Learn techniques to drive a culture of coaching within their own program among all faculty engaged in education.
  • Practice using an efficient milestone-based assessment tool to identify a learner’s strengths and weaknesses to provide quality competency-based feedback.
  • Acquire techniques to improve the coaching skills of senior residents and faculty.

Ryan Kelly, MD
Kendahl Moser-Bleil, MD
University of Minnesota Medical School

Reza Sedighi Manesh, MD
Tim Niessen, MD
Johns Hopkins University School of Medicine

209. Combating Burnout: Supporting Your Residents to Enhance Resilience
Rates of burnout are high among residents, and burnout is associated with depression and poor clinical performance. Chief residents are often the first line of help for residents and developing skills to support residents facing burnout and challenges are crucial for this role. Resilience training is one promising method to help mitigate burnout and help residents overcome challenges especially after difficult clinical events. This workshop will focus on helping chief residents recognize burnout in residents and give chief residents practical tools for teaching resilience skills, supporting residents, and helping residents debrief after difficult clinical events. After providing a brief background on burnout and resilience, participants will practice recognizing signs and symptoms of burnout in residents. In small groups, participants will share their experiences with resident burnout and brainstorm areas in which their residents need help developing resilience. Next we will briefly introduce resilience strategies such as healthy coping behaviors, supporting each other, setting realistic goals, managing expectations, letting go, and finding gratitude. We will provide groups with real scenarios of resident challenges and they will discuss how to approach them applying these resilience strategies. Groups will share and discuss their ideas. Finally, we will discuss difficult clinical events and a resilient debriefing framework that can be used to debrief after these events. Participants will examine cases of difficult clinical events with their small groups and practice team debriefing. Finally, we will share our experiences and recommendations for successful chief resident led resilience programs.

Educational Objectives:

  • Identify evidence of burnout in residents and recognize the impact of burnout on clinical performance and work-life balance.
  • Identify and understand resilience concepts that may be used to help residents combat burnout. 
  • Recognize difficult clinical events and practice a resilient debriefing framework to help residents debrief after difficult clinical events.

Michelle Martinchek, MD
Amber T. Pincavage, MD
University of Chicago Division of the Biological Sciences Pritzker School of Medicine

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

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

210. Implementing a Quality Improvement/Patient Safety Curriculum: Tales from Three Chief Residents, Past, and Present
ACGME is focused on enhancing internal medicine resident education in quality improvement and patient safety (QI/PS), subject matter which directly relates to two of the six ACGME core competencies, practice-based learning and improvement and systems-based practice. The San Antonio Uniformed Services Health Education Consortium (SAUSHEC), the largest group of residency programs in the US Department of Defense, created the position of chief of quality improvement and patient safety for residents (Chief of QI/PS for Residents) in academic year 2014-2015 to improve training in these topics, taking on and expanding responsibilities formerly tasked to an internal medicine associate program director (APD). This workshop details the experiences of the initial three chiefs of QI/PS for residents, the evolution of the internal medicine-specific QI/PS curriculum, successes and challenges, and future directions for curriculum innovation. We detail a points-based system developed to encourage resident involvement in various QI/PS activities, review how our large residency program meets ACGME requirements through annual QI/PS projects, and provide example lecture topics from our QI/PS didactic curriculum, which has recently been supplemented with an optional self-directed QI/PS elective.

Educational Objectives:

  • Summarize QI/PS points-based policy used to define success in meeting ACGME QI/PS metrics.
  • Detail the evolution of the internal medicine-specific program QI/PS curriculum, which includes an annual QI project, regular didactic lectures, and an optional self-directed QI/PS elective.
  • Discuss common roadblocks to success and potential future directions for curricular development in QI/PS in small group sessions.

Kristen Glass, MD
Caroline Green, MD
Rebecca Shapira, DO
Kelly Ferraro, MD
San Antonio Uniformed Services Health Education Consortium

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Workshop Session III
Monday, March 20, 2017
3:00 p.m. to 4:30 p.m.

301. “You’ve Got Mail”—Leveraging Electronic Communication to Manage Information Overload, Improve Compliance, and Get Your Points Across
Electronic communication via emails is today an integral part of any professional organization. When used well, emails can be a powerful tool for data organization, communication, and time management. Chief residents receive and send multiple emails daily. Emails can be used as a means of communication with program leadership, hospital administration, and residents to document and keep track of events and encounters and as a tool for coordination of teaching engagement, among other uses. The biggest challenge of electronic communication is information overload. Tools provided in this workshop will help the participants to write emails that their recipients will want to read and prioritize when skimming through their inbox. Those tools will guide the users to write emails that are clear, easy to read, and provide all the relevant information in an accessible way. Being an effective communicator will help your recipients deal with electronic information overload, prioritize your communications, and result in greater compliance. Participants will break into small groups to review sample emails and discuss methods by which their readability and structure contributes to their impact or lack thereof. This workshop will lay the foundation for looking at electronic communication objectively. Structured guidance for meaningful and efficient use of electronic communication is lacking in most medical and academic training programs. We will utilize and practice a standardized approach to email creation as well as review tips for email organization.

Educational Objectives:

  • Understand the importance and relevance of electronic communication as well as the various uses of emails in the various functions of the chief resident.
  • Recognize the pitfalls and common mistakes which make electronic communication less effective.
  • Use valuable tools and concrete techniques for meaningful, effective, and efficient electronic communication.

Olga Karasik, MD
Kelli King-Morris, MD
University of Central Florida College of Medicine

Lawrence Wolf, MD
Maimonides Medical Center

302. Recognizing and Addressing Unconscious Gender Bias in Morning Report and Educational Conferences
Gender bias and internalized societal expectations for gender norms impact group interactions in the workplace. Though women now represent half of physicians-in-training, women physicians still encounter gender bias in the workplace from patients, staff, and colleagues. These dynamics frequently manifest as unconscious gender bias in the educational context, including conferences such as morning report, and can significantly impact the learning climate for women residents. Chief residents are key leaders in promoting a supportive workplace culture and leadership development for female residents. Through an interactive, case-based discussion, chief residents will learn to identify common manifestations of unconscious gender bias that may occur in educational conferences and ways to address it at their institutions.

Educational Objectives:

  • Understand the impact of gender bias in medical education.
  • Recognize ways that unconscious gender bias and societal norms for gender roles manifest in educational conferences.
  • Learn skills to address unconscious gender bias in educational conferences at your institution.

Larissa Thomas, MD
University of California-San Francisco School of Medicine

Robin Klein, MD
Emory University School of Medicine

Anna Volerman, MD
University of Chicago Division of the Biological Sciences Pritzker School of Medicine

Erin Snyder, MD
University of Alabama School of Medicine

303. Developing an Academic Research Curriculum: Five Years of Experience
Do your residents have protected research time, but minimal research is being published? Do you have a journal club that puts your residents to sleep? Do you struggle to balance a combination of residents seeking basic research knowledge and high achievers that may benefit from an additional formal research curriculum? Are you a chief resident in charge of research activities, but you have no idea where to start? If you answered “yes” to any of these questions then this workshop is designed for you! Five years ago, our residency program implemented an academic research curriculum to promote research output and knowledge of published research. Our curriculum has been shaped by five years of experience that we will share without pretense for your benefit! During this seminar, you will learn how our experience with four distinct versions of our academic research curriculum has worked over the past five years. It will be a frank discussion to identify how curriculum innovations that seemed promising to leadership fell completely flat with the residents. You will have the opportunity to share with your peers the barriers and successes that your program has experienced in promoting resident research. By the end of this workshop, you will receive the format and resources to use with each of four distinct research curricula that you can choose to implement in your program. You will learn how to maximize resident engagement in designing the curriculum itself.

Educational Objectives:

  • Learn how to design a research curriculum that fits your needs.
  • Decide on the optimal format to deliver the curriculum to your residents.
  • Discover the available resources to assist in designing your research curriculum.

Diana L. Snyder, MD
Alexander Turin, MD
Stritch School of Medicine Loyola University of Chicago

304. Mitigating Burnout: Lessons in Resiliency from a Military Residency
This interactive workshop will explore the burnout epidemic by applying the lessons learned during the research and development of a resiliency-specific “Cura Personalis” curriculum at San Antonio Uniformed Services Health Educational Consortium internal medicine residency program, the US Department of Defense’s largest training hospital. Designed for chief residents and program directors, attendees will learn strategies to assess levels of burnout in their residents, identify potential causes, and most importantly, develop program-specific curriculum to mitigate burnout and resolve the issues central to its cause. Designed to create a positive learning environment and supportive social network, we will share our resident-driven “Cura Personalis” curriculum.

Educational Objectives:

  • Learn strategies to identify and quantify levels of burnout in their residents.
  • Gain exposure to the system to actively address burnout and its derivatives.
  • Be equipped with the tools to implement a similar model at their institutions to ensure continued improvement in resident wellness.

Caroline Mary Green, MD
Brandon Kuiper, MD
Kathryn Lago, DO
Lauren Lee, MD
San Antonio Uniformed Services Health Education Consortium

305. Micro-Skills for the Highly Effective Chief Resident
Chief residents are typically clinically excellent, passionate teachers with outstanding interpersonal skills. These skills are relatively easily assessed during residency. However, the day-to-day job of a chief resident demands a multitude of other, less familiar, less easily assessed, and sometimes less well-developed skills. To succeed in this challenging role and develop as future leaders, the chief resident must embrace and enhance these new skills, allowing a balance of educational, clinical, and administrative roles. This workshop, led by a team of former chief residents who wish they had such a workshop, seeks to teach attendees several of the micro-skills necessary for success. Specifically, attendees will participate in an interactive session focusing on the micro-skills of chief residency: communication management (email, cell phones, and pagers), task prioritization including delegation of tasks and saying no, medical student interactions with a focus on letters of recommendation, recruitment and applicant interview skills, focused teaching skills relevant to bedside attending rounds, and protection of one’s own time. The presenters will seek to convey focused, practical, useful information that will allow attendees to gain insight into the complexities of each micro-skill. At the conclusion of the workshop, attendees will be given a handout with reference documents and tip sheets summarizing the skills reviewed.

Educational Objectives:

  • Develop essential communication skills for the chief resident job, including email management and cell phone etiquette.
  • Understand key principles of time management, including task delegation.
  • Identify important aspects of attending on medical wards, including bedside teaching skills, supervising learners at all levels, and writing recommendation letters for medical students.

Judd Flesch, MD
Jessica C. Dine, MD
Todd P. Barton, MD
Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania

Karen Warburton, MD
University of Virginia School of Medicine

306. Residents in Trouble: Coaching for the Chief Resident
Chief residents are often the “first responders” when a resident is not meeting a milestone trajectory. They frequently are the first to learn of concerns and work with the resident. However, efforts by the chief resident to help may be undermined by the struggling trainee’s poor confidence, low self-esteem, and sense of “being under the microscope.” 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 by chief residents in an early intervention that is both supportive and effective in improving performance by engaging the learning in the process in a positive and strength-focused way. 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 performance 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.
  • Apply a strengths-based approach to help a learner overcome a weakness.
  • Appreciate the value of a trusting relationship that coaching provides in effectively working with a struggling learner and how to establish that relationship through a coaching approach.

Asher A. Tulsky, MD
Boston University School of Medicine

Kerri Palamara, MD
Harvard Medical School Massachusetts General Hospital

Zuzanna Czernik, MD
University of Colorado School of Medicine

307. Teaching Clinical Reasoning: Using a Novel Online Teaching Toolkit
As highlighted by the Institute of Medicine’s recent report, Improving Diagnosis in Health Care, diagnostic errors are common and cause significant harm. While we strive to build our learners medical knowledge and differential diagnoses, we often fail to articulate a framework for clinical reasoning to inoculate trainees against the pitfalls that reduce accuracy. The clinical reasoning process and common cognitive traps are left under the surface, leaving learners to infer how experts arrive at sound diagnoses. Trainees are expected to develop competency through observation and trial and error without understanding the metacognitive strategies that underlie this complex process. Learners miss opportunities for critical reflection on both errors and diagnostic successes, and fail to undertake deliberate practice to improve their reasoning skills. Recent duty hour limitations might reduce the quantity of cases trainees encounter, which will require new strategies to ensure that all learners attain clinical competence. By focusing attention on how physicians reason, we can help learners organize their growing knowledge in a way that will be most useful in clinical practice. This workshop introduces a case-based method, utilizing a free and novel online resource through the Journal of General Internal Medicine’s website, to teach clinical reasoning. Participants will actively engage with a didactic model that highlights effective clinical reasoning teaching.

Educational Objectives:

  • Define and apply foundational concepts useful for teaching diagnostic reasoning.
  • Access, navigate, and use a free online toolkit for teaching core concepts in clinical reasoning to housestaff (http://www.sgim.org/web-only/clinical-reasoning-exercises).
  • Brainstorm institutional barriers in implementing a clinical reasoning curriculum and develop strategies to overcome such obstacles.

Reza Sedighi Manesh, MD
Johns Hopkins University School of Medicine

Denise M. Connor, MD
Mark C. Henderson, MD
Jeff Kohlwes, MD
University of California-San Francisco School of Medicine

308. The Seven Habits of Highly Effective Chiefs
Chief residents encounter unique challenges throughout the year that require a variety of management skills. Regardless of the management style that each chief employs, there are some skills which are essential. These are the “seven habits of highly effective chiefs.”

  • Playing to your strengths as a leadership team: Some issues need to be addressed as a group but many tasks can be effectively managed individually. Knowing each other’s leadership style and matching tasks to those styles improves teamwork. 
  • Agenda setting for the year: Early in the year, chief residents need to identify their personal and professional goals and be proactive and purposeful in making a yearly agenda. 
  • Saying no – how to negotiate: both housestaff and faculty expect chiefs to solve any issue at any time. Learning when say “no” and when to negotiate a middle ground is imperative. 
  • Giving constructive feedback: chief residents give feedback to both housestaff and faculty on a regular basis. Giving feedback effectively will hone leadership skills for the chief resident and improve performance of all parties involved. 
  • Embrace what you don’t know: chiefs don’t need to know everything! Finding ways to embrace and explore knowledge gaps will alleviate pressure and improve learning for both chiefs and housestaff. 
  • Delegating: ask: “is this chief work?” If not, who is the most appropriate person to address this issue? Advocate for and empower your housestaff: empowering the housestaff helps foster leadership and conflict resolution skills and minimizes risk of burnout.

Educational Objectives:

  • Identify seven habits that all chief residents should develop to ensure a successful year.
  • Describe real-life scenarios when chief residents should utilize the seven habits.
  • Identify challenges in implementing the seven habits and describe strategies to overcome these challenges.

Nicholas S. Duca, MD
Molly Fisher, MD
Jennifer Corbelli, MD
University of Pittsburgh School of Medicine

309. Crisis Intervention – A Chief Resident’s Guide to Approaching a Crisis
Chief residents are likely to encounter a crisis situation, broadly defined as a critical event that is perceived as overwhelming, at some point during their academic year. A crisis can come in many forms, such as unprecedented patient volume during a flu season, natural disasters, or even unexpected resident absence resulting in inadequate coverage for the program. All of these examples require fast problem-solving, regular communication with residents, and an ability to remain calm while still maintaining a sense of urgency. The goal of our workshop is to provide a framework for approaching a crisis, and strategies to cope with crises when they arise.

Educational Objectives:

  • Discuss various examples of crisis and methods of identifying them as soon as possible.
  • Identify vital strategies required when approaching and dealing with a crisis.
  • Structure your own framework for approaching a crisis, incorporating key methods discussed in the workshop.

Anastasia-Stefania Alexopoulos, MD
Jeffrey Hedley, MD
Katie Lohmann, MD
Rich Ramonell, MD
Iris Wang, MD
Andrew Webster, MD
Emory University School of Medicine

310. Improving GME Program Interconnectedness Utilizing Technological Resources
Our two part innovative technology based medium strives to improve interconnectedness between residents, their program director, and coordinators. The web based portal and native iOS application are designed to allow seamless integration. With features such as a friendly user interface, order set references, community blogs, automatically updating contacts directory, conference schedules, anonymous surveys and voting—this technological resource is bound to promote camaraderie and keep everyone in the loop.

Educational Objectives:

  • Provide program directors and chief residents with a first hand look at the benefits of incorporating technological resources into their own programs and how it can promote interconnectedness and valuable information to members of their graduate medical education program.
  • Discuss the collected survey results from our current working model and how they can translate to their own operations.
  • Demonstrate the features of the residency portal through a live working demo to provide program directors and decision makers a first hand experience of the user interface and capabilities of this technological resource.

Ahmed Ali, MD
Ali Rahimi, MD
Mountain View Hospital

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