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Academic Internal Medicine Week Workshops

By registering for an Academic Internal Medicine Week 2018 primary meeting (AIM Educational Conference, CDIM National Meeting, APDIM Spring Meeting, ASP Annual Meeting, or MPPDA Meeting), participants can attend any of the following workshops.

Workshop Session I | Workshop Session II | Workshop Session III | Workshop Session IV | Workshop Session V | Workshop Session VI

Printable Workshop Descriptions (Current as of January 5, 2018)

Workshop Session I
Monday, March 19, 2018
9:45 a.m. to 11:15 a.m.

101. Welcome Aboard! Developing a Successful On-Boarding Program
This workshop will outline how a proactive on-boarding process that starts with the recruitment process continues through the first months of employment can improve new faculty satisfaction and increase retention as well as reduce lost productivity time for new faculty. The participants will be able to tailor a process specific to their departments needs.

Educational Objectives:

  • Understand how a proactive on-boarding process improves new faculty satisfaction and retention.
  • Understand the role of on-boarding throughout the recruitment, hiring, and new employment stages.
  • Develop a custom on-boarding process for their department.

Lenora C. Rogers
Mercer University School of Medicine

102. Assessing Faculty Development Needs: Business of Medicine Leadership Program
As healthcare changes, so does our academic and clinical responsibilities. In order for this alignment to work, we need leaders that can navigate both spaces. At Indiana University School of Medicine we recognized the professional development needs of our faculty in relation to the intersection of business and medicine. This workshop describes the process to assess competencies and professional development needs as well as an overview of the intrapreneurship mindset, system, and roadmap.

Educational Objectives:

  • Learn to assess the leadership competencies of divisional chiefs, section leaders, and emerging leaders.
  • Identify critical gaps and prioritized development needs.
  • Increase innovation capability via the development of an “intrapreneur” mindset, system, and roadmap.

Sylk Sotto, EdD, MBA, MPS
Mark W. Geraci, MD
Indiana University School of Medicine 

103. Update in Internal medicine Graduate Medical Education: Systematic Literature Review of High Quality Medical Education Research in 2017

The purpose of the workshop is to provide participants with a concise, objective review of the relevant medical education research in Internal medicine graduate medical education published in 2017. Articles selected for discussion are considered innovative, of greatest interest to the APDIM membership, and of highest research quality (based on the Medical Education Research Scoring mechanism). Participants will be provided with a brief synopsis of the 10 to 12 selected research articles, focusing on the strengths and limitations of the research as well as the practical implications of the studies for program directors. APDIM members who are authors of selected studies will be invited to attend the workshop. Participants will have the opportunity to engage in group discussion and to ask questions of the presenters and authors in attendance.

Educational Objectives:

  • Be able to describe the characteristics of high quality medical education research.
  • Be familiar with the top 10 to 12 key medical education research papers in Internal medicine GME.
  • Engage in active discussion with the authors of key graduate medical education publications in Internal medicine in 2017.

Brian M. Aboff, MD, MMM
Reena H. Hemrajani, MD
Steven Bishop, MD
Virginia Commonwealth University School of Medicine 

105. Holistic Applicant Selection in the Environment of High Volume Applications

According to ERAS statistics, in 2017, the total number of applicants to Internal medicine programs was 24,669 with an average of 37 applications per person. Programs received on average 1,250 and 773 applications from International and US graduates respectively. The struggle to develop the best system to select applicants that meet individual program needs perplexes all programs and becomes increasingly difficult with large applicant volumes. During this workshop, the presenters will review the literature surrounding applicant volumes and effective selection techniques. Each of the three presenters will review their unique holistic approaches to applicant selection and tips to maximize the utilization ERAS filters in a holistic process. Participants will use a small group format to identify the key traits used to select their applicants and create a priority list. Groups will report out so the large group can learn from the collective wisdom. Participants will be provided with mock applicant files. Each small group will review applicants using a scoring system they develop. Each group will then report to the larger group on how they used a scoring system to develop their applicant selection and rank list. The three presenters will then discuss our thoughts and lessons learned. Each presenter represents a different applicant pool, region and program size and have different priorities for their applicant pools.

Educational Objectives:

  • Maximize the use of screening filters in ERAS in the applicant selection process.
  • Identify the traits that your program desires in an applicant pool that are consistent with program aims.
  • Understand three unique holistic methods used in applicant selection for interviews and create a scoring system to assist in the selection and ranking of applicants for your match.

Stefanie R. Brown, MD, FACP, FAAP
University of Miami Leonard M. Miller School of Medicine

Sonny Lee, MD
Loma Linda University School of Medicine 

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

106. Building Lifelong Paths: Utilizing Milestones for Individual Assessment and Growth

As one of the required elements for the ACGME Next Accreditation System, core and subspecialty Internal medicine training programs biannually report individual learners progress in Internal medicine milestones. Outside of reporting requirements, residency and fellowship training programs have begun utilizing milestones to help individuals with educational and professional development. The AAIM Education Committee has solicited membership for ways in which residency and fellowship programs are utilizing the milestones for purposes beyond reporting to ACGME for accreditation purposes; in this workshop, we will share several of these examples.

The workshop will focus especially on self-assessment and professional development during times of transition and will include two opportunities for interactive small group activities. In the first, participants will use the milestones to create an individualized professional development plan for a soon-to-be graduating third year resident who will be starting in fellowship or in independent practice. In the second activity, participants will use the milestones to create an individualized professional development plan for themselves or for junior faculty they are mentoring.

The workshop is targeted to educators and directors of residency and fellowship programs interested in helping trainees develop lifelong self-assessment and professional development tools. Division and departmental leaders may also find this workshop helpful in coaching junior faculty to articulate self-directed professional development plans.

Educational Objectives:

  • Give at least three examples of ways programs are using milestones beyond reporting learners’ progress to ACGME.
  • Use milestones to “diagnose” specific learning or professional deficits for oneself, a trainee, or a junior faculty member.
  • Use milestones to create an individualized professional development plan for oneself, a trainee, or a junior faculty member.

John H. Choe, MD, MPH
University of Washington School of Medicine 

Saba A. Hasan, MD
Capital Health Regional Medical Center 

Isitri Modak, MD
Methodist Health System Dallas 

Janice Gilden, MD, MS
Chicago Medical School at Rosalind Franklin University of Medicine and Science 

107. Strategies for Teaching Social Determinants of Health in Residency

Social determinants of health (SDH) have long been recognized as important contributors to individual and population health. SDH often serve as major barriers to wellness but have historically not been explicitly considered in individual patient-physician interactions. Recently, there has been renewed focus on incorporating SDH concepts and interventions directly into residency education in an effort to train physicians to identify, actively consider and help create a plan to address SDH that are negatively impacting patient health outcomes. Two residency programs, Montefiore Medical Center in New York and University of Pittsburgh Medical Center, have developed residency curricula in SDH that incorporates triggers for identifying SDH among patients, faculty precepting techniques in SDH, case-based and evidence-based questions on SDH, resource sheets for identifying clinic services and community organizations that can help address SDH, home visits, and community immersion experiences. During this workshop, presenters from both institutions will describe their experience implementing their curriculum, utilizing audience participation to demonstrate key aspects of the curriculum, and then facilitate an interactive discussion among workshop participants regarding experiences, resources, barriers and next steps required to implement an SDH curriculum at their own institutions. Audience members will be provided with adaptable educational tools they can use as part of a resident SDH curriculum in their own institutions.

Educational Objectives:

  • Describe the structure and implementation of at least three unique techniques successfully used to incorporate SDH into residency curriculum.
  • Identify resources, barriers and next steps in their own institutions required to implement one component of a SDH curriculum.
  • Implement the SDH educational tools provided, including case-based questions, triggers for SDH, and resource templates, in their own residency programs.

Iman Hassan, MD
Shadyside Hospital 

Lauren Shapiro, MD
Albert Einstein College of Medicine 

Maggie Benson, MD
Etsemaye Paulos Agonafer, MD
University of Pittsburgh School of Medicine 

108. Decisions on Day One: Encouraging Resident Leadership to Build Excellence

With the advent of competency-based training, quantifying trainee readiness for unsupervised practice is more important than ever. We have seen that prioritizing resident leadership and autonomy from the beginning of training is an essential component of building the skills and character traits necessary for excellence in our contemporary medical context. However, resistance to early resident autonomy comes from many sources: program leadership, hospital administration, supervising physicians, and even residents themselves.

This workshop builds a framework that centralizes resident leadership and autonomy as essential building blocks for excellence in the Internal medicine milestones. Through a large group discussion, participants will identify barriers to encouraging resident autonomy within a residency program. Facilitators will then share a framework for residency programs to encourage resident autonomy and overcome these barriers through three domains: clinical leadership, educational leadership, and systems change. In small groups, participants will brainstorm strategies for programmatic and curricular change to apply to their institutions, such as resident-led rounds, resident-driven quality and patient safety initiatives, curricula on developing resident educators, and resident-driven system or curricular changes. Participants will leave the workshop with concrete tools to centralize resident leadership in all aspects of training, preparing residents for the systems in which they will work.

Educational Objectives:

  • Identify barriers to building resident autonomy in their respective programs.
  • Demonstrate a framework centralizing resident leadership development as an essential component of future independent practice.
  • Develop solutions to encourage resident autonomy in three domains: clinical practice, education, and systems-based practice.

Catherine Jones, MD
Deepa Bhatnagar, MD
Logan Davies, MD
Tulane University School of Medicine 

Ryan Kraemer, MD
University of Alabama School of Medicine 

109. From Practicing Medicine to Deliberately Practicing Medicine

There is increasing evidence that expertise in any field is most effectively developed through deliberate practice - repeated, focused activities with specific goals, consistent feedback and tireless commitment to improvement. One of the most important areas of focus in Internal medicine training is the development of diagnostic reasoning abilities. Despite this focus and the draw that complex diagnostic reasoning has for those who choose Internal medicine, there is substantial room for improving diagnostic performance. Overconfidence abounds and diagnostic errors remain prevalent. Strikingly, almost all diagnostic reasoning skills in residency are learned through caring for patients and thus developing and refining illness scripts rather than through formal curricula. Residents certainly practice making diagnoses, but there are few formal means to ensure that this practice is deliberate and thus likely to lead to expertise formation.

This workshop will focus on applying the principles of deliberate practice to diagnostic reasoning. Using two successful programs as exemplars, this workshop invites attendees to develop locally implementable approaches to build systematic feedback processes and identify effective methods to learn from real cases to develop and refine learners diagnostic skills. After a brief introduction to deliberate practice and exemplar programs, attendees will identify what open feedback loops exist in their training programs and how these loops may be effectively and pragmatically closed. Attendees are invited to identify challenges to implementing such innovations and how these challenges will be overcome. Ample time will be left for discussion and learning from other attendees.

Educational Objectives:

  • Attendees will identify open feedback loops with respect to diagnostic reasoning in their training programs as well as two pragmatic, potential options to close these loops.
  • Attendees will discuss the principles of deliberate practice and how educational programs may be adapted to embrace these principles.
  • Attendees will discuss how learning from one’s own decisions is more effective in leading to behavior change than other less personal learning modalities.

Andrew Olson, MD, FACP, FAAP
Kathleen Lane, MD
University of Minnesota Medical School 

Robert L. Trowbridge, MD
Maine Medical Center 

Juan N. Lessing, MD
University of Colorado School of Medicine

110. Less Boot, More Camp: Developing an Intern Boot Camp for Residency Orientation

There are large gaps between program directors expectations and the skills of their entering residents on day one of residency. An orientation boot camp is one such program to address these gaps. Currently, there is no uniform method to create a boot camp. This workshop will present one institution’s experience developing and implementing an orientation boot camp. As a group, we will brainstorm the commonly encountered gaps in skills and knowledge of medical students transitioning into internship as well as barriers to a standardized teaching process. We will then review the experience of: selecting skills appropriate for boot camp style learning, developing stations and materials, implementing an orientation boot camp logistically, building a process for improvement each year. Participants will be divided into small groups for learner role-play of three sample boot camp stations: handoffs, eyeballing/rapid response, and common overnight pages. Each group will rotate through the stations to obtain skills practice. Facilitators will lead each group, addressing challenges and providing additional guidance on engagement with learners and pacing. Participants will then break into pairs and, using resources and tools available in the workshop session and at their home institution, will discuss and troubleshoot commonly encountered problems during skills practice and the next steps to improve their home institution’s orientation. Facilitated large group discussion will be used to share potential solutions to these problems.

Educational Objectives:

  • Identify basic skills and institutional and medical knowledge that interns need at the start of residency and outline development of an intern orientation boot camp at one institution.
  • Practice participating in mock boot camp stations to understand learning environment.
  • Reflect on home institution needs to improve intern orientation using a boot camp style activity.

Sreekala Raghavan, MD
Julie Kanevsky, MD
Albert Einstein College of Medicine 

Dustin Saltiel Pardo, MD
Lewis Katz School of Medicine at Temple University 

111. Suspect Knowledge Gaps? Use Concept Maps—A Tool to Assess Progress and Promote Meaningful Learning in Remediation

Learner performance on standardized exams carries highstakes for training programs and trainees alike. Given the weight of these exams, programs commonly implement remediation efforts to fill knowledge gaps and improve performance of trainees thought vulnerable to exam failure. Multiple-choice questions (MCQs) frequently double as tools for studying exam content and assessing remediation efforts. We generally infer that improved performance on MCQs results from the evolution of more advanced and accurate conceptual understanding; however, performance may be influenced by other factors (i.e., familiarity with MCQ items, inappropriate heuristics, etc.).

In this workshop, we demonstrate the use of concept maps as a tool to clarify gaps in conceptual understanding, monitor progress over the course of remediation efforts, and promote meaningful learning. We introduce a free, computerized concept mapping tool and review empirical and theoretical evidence supporting the use of concept maps to assess conceptual understanding. Workshop participants will gain experience with the use of concept maps, including practice creating a concept map with this software. We will introduce a method of linking key features from MCQs to a concept map to illustrate the conceptual understanding of learners completing those MCQs. Using examples from actual learners, participants will use concept maps to identify knowledge gaps, monitor changes in conceptual understanding, and learn about a tool for meaningful learning.

Educational Objectives:

  • Understand empirical and theoretical basis of concept mapping.
  • Complete a concept map using free concept mapping computer software (CmapTools©).
  • Practice identifying gaps and monitoring changes in conceptual understanding based on concept maps prompted by MCQs.

Luke Surry, MD
Kristen Glass, MD
San Antonio Uniformed Services Health Education Consortium 

Steven J. Durning, MD, PhD
Dario M. Torre, MD, PhD
Uniformed Services University of the Health Sciences
F. Edward Hebert School of Medicine

112. Creating a Universal Language—Development of a Longitudinal Feedback Curriculum for Student to Resident to Fellow to Faculty

Feedback is a valuable tool that describes an individual’s performance in a specific activity. Feedback exchange is commonly utilized by all members of a department including students, residents, fellows, and faculty. Within each training level, specialty, and faculty position, there are specific needs and barriers in relation to giving and getting feedback. Creating a universal language and culture of feedback exchange is vital in the development and improvement of clinical and professional skills. A formal curriculum can reduce potential barriers and enhance the impact and execution of feedback.

This workshop is intended to help faculty and departments develop a comprehensive feedback matrix. The presenters will demonstrate use of feedback related tools and lesson plans currently employed across Boston University School of Medicine. Participants will identify specific needs and barriers for different training levels in regards to giving and getting and feedback. The presenters will guide participants through outlining the components of a feedback matrix including a needs assessments, curriculum development, and creation of a culture supportive of feedback. There will be a focus on tailoring the feedback curriculum to the individual needs of each training level and faculty role including both procedure and non-procedure based specialties. Participants will generate a template for a feedback curriculum for their institution.

Educational Objectives:

  • Identify the benefits of a longitudinal feedback curriculum.
  • Describe distinct goals and barriers to feedback exchange based on training level or faculty role.
  • Create a template for a departmental feedback curriculum.

Craig F. Noronha, MD
Sonia Ananthakrishnan, MD
Boston University School of Medicine 

113. Recruiting Ambulatory Faculty

Alpesh N. Amin, MD, MBA, MACP, SFHM, FACC
University of California-Irvine School of Medicine 

Sara B. Fazio, MD, FACP
Harvard Medical School Beth Israel Deaconess Medical Center 

Amy Shaheen, MD, MSc
University of North Carolina School of Medicine 

114. Thinking Out Loud: Using Principles from “Example Based Learning” in a Clinical Reasoning Case Conference Format

While components of clinical reasoning are infused into standard residency education, explicit instruction regarding these principles is often lacking. Trainees may be expected to intuit the reasoning processes used by their clinical teachers. The quality of this learning experience can be highly variable when a common language for discussion of clinical reasoning principles does not exist and when clinical teachers lack the skills to make their reasoning processes explicit. Traditional “unknown case conferences” are sometimes used to teach clinical reasoning. However, these tend to focus on the ability of an expert discussant to reach a difficult or unusual diagnosis, often without an explicit focus on clinical reasoning principles that can be applied more broadly by learners. In our case-based interactive conference series, a focus on the clinical reasoning process and on potential for cognitive bias has contributed to the development of a shared clinical reasoning vocabulary within our program and to the dissemination of clinical reasoning skills.

During this workshop, we will introduce our “clinical reasoning case conference,” which includes sequential delivery of clinical information from a real patient case to an expert discussant, who in turn describes their approach to the unknown case in a “think-out-loud” format. The conference is facilitated by a “clinical reasoning expert” faculty member, who, in keeping with principles from example based learning, provides explicit commentary regarding the clinical reasoning processes being used. This interactive workshop will provide attendees with a framework for developing a clinical reasoning case conference at their own institution.

Educational Objectives:

  • Identify the challenges to teaching clinical reasoning in a case-based conference format.
  • Describe and demonstrate how to employ principles from example-based learning in a conference format to teach clinical reasoning.
  • Apply a provided framework to creation of a plan for a “Clinical Reasoning Case Conference” at one’s own institution.

Deborah J. DiNardo, MD
Sarah Tilstra, MD
Thomas D. Painter, MD
University of Pittsburgh School of Medicine 

115. Bringing Your Q & A Game: Practical Strategies for Mastering Post-Lecture Questions and Answers

There are a growing number of opportunities and expectations for learners to give formal lectures and presentations. While extensive attention is given to content and actual presentation delivery, little to no formal instruction or mentoring is offered for one of the most critical pieces—the post-lecture question and answer period. We have developed a practical approach to ready learners to think through and subsequently answer questions logically and with self-reliance following a formal presentation. The overarching goal is to provide a toolkit for mentors and advisors to guide learners through this critical component of a successful presentation while strengthening their own skills—recognizing that the lecture isn’t over until the final question is answered.

Educational Objectives:

  • Identify and apply a five step approach to addressing questions following lectures.
  • Recognize differences in types of questions, motivations behind queries/commentary, and strategies for crafting logical, concise and confident responses.
  • Apply techniques for effective Q & A through real-time scenarios and discuss strategies for coaching and preparing individual learners for questions after lectures.

Kimberly Manning, MD
Lesley Miller, MD
Emory University School of Medicine 

Khadeja Johnson, MD
Morehouse School of Medicine 

116. Value-Based Payment Is Here—Are Your Faculty and Trainees Ready for Population Health Management?

Population health management has become a necessary competency for practicing physicians and health systems as we move towards an ever-increasing emphasis on quality payment programs, improved patient outcomes, and health care cost reductions in American medicine. Today’s physicians need to adjust their approach to health care delivery and redesign their practices, in order become experts at patient engagement and interprofessional team leadership, incorporate technology, and be able to critically analyze large pools of patient data. However, undergraduate and graduate medical education and faculty development have lagged in incorporating training on this multidimensional topic. We will describe our efforts to introduce a Population Health Management curriculum for Internal medicine trainees at an ambulatory medicine teaching site through didactic content and workshops, as well as the direct application of information technology-enabled tools [including risk prediction analytics] and care coordination resources. Workshop participants will reflect on opportunities to enrich their curricula related to Population Health Management, and will leave with practical tools such as a curriculum sample and bibliography of educational references to realize this change.

Educational Objectives:

  • Understand the essential components of population health management and quality payment programs.
  • Recognize the curricular additions needed to educate trainees about population health management.
  • Complete a curriculum development plan around population health management using the resources (including curriculum sample and bibliography of educational references) discussed and shared at the workshop.

Tabassum Salam, MD
Gretchen Rickards, MD, MPH
Sidney Kimmel Medical College
at Thomas Jefferson University
Christiana Care Health Services 

117. Double the Impact of Your Attending Rounds: Using Dual Process Theory to Teach and Decrease Diagnostic Error

Clinician educators can improve patient care by educating learners on an approach to clinical reasoning. In this workshop, we will present an approach to clinical reasoning grounded in educational theory which is easy to incorporate into attending rounds and case conferences and is well received by learners at our institution. At the onset of the session, participants will draw upon their experiences and struggles with teaching clinical reasoning. We will then introduce core concepts including dual process theory, problem representation, illness scripts, and worst case scenario consideration as tools to broaden and prioritize the differential diagnosis. We will review a framework that organizes these concepts in a shared mental model for an approach to clinical reasoning. Lastly, we will introduce some of the most common cognitive errors that occur in every day practice and provide tips to avoid them and a handout on how to apply them during teaching sessions to help prevent these errors and promote reflection and dialogue. Participants will apply these techniques to a complex case in the breakout sessions guided by workshop faculty, first developing a problem representation then building incrementally to apply the clinical reasoning concepts presented. Participants will work together, sharing their experiences and modeling a teaching encounter as they collaborate on how each would approach teaching the case. The session will end with a wrap-up where participants will reflect on their use of this approach to clinical reasoning and discuss how they will implement these newly learned techniques in their clinical and educational practice.

Educational Objectives:

  • Apply the clinical reasoning educational pillars of dual process theory, problem representation, and illness script to clinical cases and practice teaching these concepts.
  • Identify strategies to teach prioritizing and broadening the differential diagnosis.
  • Recognize common diagnostic errors and discuss how to teach learners to avoid them.

Verity Schaye, MD
Michael Janjigian, MD
New York University School of Medicine 

118. Preparing Future Educators: Teaching Near Peers in Internal medicine Clerkship

The role of a fourth year medical student as a teacher of near peers has been traditionally underdeveloped, especially in the Internal medicine clerkship setting. In this workshop, we will discuss performing a needs assessment for your home institution on coaching motivated student educators. We will discuss our institution’s response to this need with the creation of a medical education elective for fourth year medical students. We created specific opportunities for them to formally teach third-year Internal medicine clerkship students for their mutual benefit. We will review the development of our objectives, curriculum, and assessments for this elective. We will share feedback about the student-led teaching sessions from both the third and fourth year medical students and the faculty facilitators. We will explain the benefits of the sessions and the challenges we faced. During small group breakout sessions we will discuss innovative methods to incorporate senior student teaching in the Internal medicine Clerkship that are mutually beneficial for third-and-fourth year students. We will also discuss further opportunities for curriculum and assessment development within a medical education elective. At the end of the workshop, participants will have tools to implement a medical education elective that includes a near-peer teaching exercise in their Internal medicine clerkship curriculum at their home institution.

Educational Objectives:

  • Explain the need for and approach to implementing a medical education elective for senior medical students.
  • Develop curriculum and assessments for a medical education elective for senior medical students.
  • Develop opportunities for fourth year students to educate third year Internal medicine clerkship students.

Michell Sweet, MD
Viju John, MD
Irene Hossain
Rush Medical College of Rush University Medical Center 

119. “I’ve Got Your Back: ”Supporting Residents When Patients and Families Ask for a “White” Doctor

Every day, a small proportion of hospitalized patients request a physician who looks like them—a white physician, a non-Muslim, a man, or a woman. Many attendings do not know how to support residents through such situations. Even less often, residents of color may experience overt racism by being called derogatory racial slurs, not infrequently in the presence of the entire medical team. However, the team, led by the attending, often do not discuss the incident—either to check in with the emotional wellbeing of the resident or to discuss how to handle such situations in the future. Rather, the team disperses from the bedside to do the day’s work and the resident who was subjected to racism is left feeling isolated, not knowing if the attending and team realized how hurtful it was. Perhaps the most common form of discrimination for physicians of color (and for female physicians) is being mistaken for a nonphysician despite wearing a white coat and stethoscope; residents of diverse backgrounds report being mistaken for the nurse, food service workers, or housekeepers.

Participants will develop skills to support residents experiencing race, religious, or gender discrimination in Internal medicine or pediatric clinical experiences. Through small group case discussion, participants will learn strategies to create a safe environment in clinical educational settings to openly discuss discrimination with the resident team. Participants will leave with a detailed toolkit of strategies to accomplish these goals including articles, case vignettes, a slide set to be used for faculty development around support residents of diverse backgrounds.

Educational Objectives:

  • Understand microaggressions.
  • Apply strategies to respond to microaggressions you witness.
  • Support residents who experience microaggressions.

Alda Maria R. Gonzaga, MD
University of Pittsburgh School of Medicine

Mumtaz Mustapha, MD
University of Minnesota Medical School 

120. Self Study and Site Visit Preparation for Med-Peds Programs

ACGME implemented the Next Accreditation System in 2013. One of the new steps in this process was the opportunity for programs to complete a self-study as part of their 10–year review cycle and as a means to engage the program in continuous quality improvement. The focus of the self-study would be on improvements and innovations that were achieved by a program prior to the site visit as opposed to areas of improvement. Because of this new approach to accreditation and the perception that programs must “start from scratch,” it is a challenge for programs to consider how to embark on the process: how to best engage stakeholders, to develop aims, to identify threats and opportunities, and strengths and areas for improvement, and to establish a timeline for preparation. Med-peds residency programs have the additional task of incorporating perspectives from two departments who may have contrasting aims, threats, and opportunities. They are considered a dependent of one of the core programs and have their site visit linked to the core program. Consideration must occur of how best to deliver key information about the other core program during the site visit, in the context of how it impacts the med-peds program’s ability to innovate and continuously improve. This workshop would provide med-peds programs with perspectives on how to help other med-peds programs prepare for their self-study and upcoming site visits.

Educational Objectives:

  • Introduce med-peds programs to the key steps of the self-study process as outlined by ACGME.
  • Provide med-peds programs with perspectives from programs who have completed their self-study summary.
  • Provide med-peds programs with perspectives from programs who have completed their site visit and compare and contrast experiences from programs linked to medicine or pediatrics.

Jane V. Trinh, MD, FACP, FAAP
Duke University School of Medicine 

Workshop Session II
Monday, March 19, 2018
11:30 a.m. to 1:00 p.m.

201. Our Responsibility: Courageous Conversations about Race, Equity, and Inclusion

Recent events demand that all academic medicine constituents pay attention and discover ways to dialogue about race, equity, and inclusion. The surge in cultural competence and unconscious bias training is not the be all magic pill. While curriculum development may thread culturally responsive pedagogy, many times faculty, staff, and trainees are not able to facilitate conversations about race, equity and inclusion.These topics are not ones that should be completely relegated to offices of diversity and inclusion or multicultural affairs.There is an opportunity for professional and faculty development to engage everyone in a model of inclusive excellence.

The proposed workshop will discuss personally mediated racism, internalized racism, and institutionalized racism. We will then practice the Courageous Conversations about Race strategy and protocol. As professional development, the goal of this workshop is to help faculty and trainees facilitate conversations about race while acknowledging our own identities.

Educational Objectives:

  • Recognize personally mediated racism, internalized racism and institutionalized racism.
  • Understand concepts of Inclusive Excellence that translate into organizational structure and development.
  • Recognize the six conditions for racial equity leadership and facilitation

Sylk Sotto, EdD, MBA, MPS
Indiana University School of Medicine 

202. Are Clinical Institutes in Your Future? Lessons Learned at Mt. Sinai

Brian L. David
Dominique Archer
Ayeisha Brown
Sara Rapoport
Icahn School of Medicine at Mount Sinai 

203. Farming for Behavior Change: Tilling Soil with MI and SBIRT

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an integrated, evidence-based approach aimed at early intervention to prevent and reduce substance misuse including alcohol, opioids, and other substances. Moderate-risk patients may undergo brief intervention via the primary care provider, with more severe cases referred to a substance abuse treatment specialist. In standard SBIRT practice, “at-risk” patients undergo a brief intervention which relies on a motivational interviewing (MI) approach. If done well, MI highlights discrepancy regarding substance use for the patient and thereby increases the patient’s motivation toward behavior change. MI (and SBIRT) are under-utilized, in part because MI skills are challenging to develop and may seem counterintuitive to most providers who are accustomed to taking a more directive approach with patients.

Given the current opioid misuse and addiction crisis, federal and state agencies continue to fund millions of dollars supporting SBIRT training for medical and other health professionals. In this workshop, we review evidence supporting the relevance of SBIRT and MI training for internists, and share the curriculum we have implemented for the past two years. We will share examples of video review, role play, and information technology-assisted instruction. Additional benefits of establishing an SBIRT/MI curriculum include opportunities for interdisciplinary learning, promoting a more effective communication style as well as potentially enhancing physician resiliency.

Educational Objectives:

  • Demonstrate reasons why training in SBIRT and MI is relevant for internists.
  • Explore curriculum ideas that enhance the development of effective communication skills.
  • Relate SBIRT and MI to interdisciplinary practice and provider resilience.

Dean A. Bricker, MD
Paul Hershberger, PhD
Boonshoft School of Medicine Wright State University 

204. Educational Leadership 360—The Full Circle of Opportunities for What Comes Next

We propose an interactive and skills-based workshop for internist leaders preparing for new and different challenges in the medical education space. The faculty leading the workshop includes four educational leaders who have transitioned to new responsibilities within and also outside the conventional hierarchy of Internal medicine and institutional educational leadership. The workshop participant will reflect on why such transitions are possible and how to develop new skills and refine existing ones to succeed at a different level.

Specific scenarios highlighting different career options will be discussed. Participants will reflect on the question: “Why do you want to be an education leader?” The ideas will be shared and will serve to frame further discussion. The participants will then discuss the prepared leadership scenarios and identify the needed skills and the process for obtaining such skills to succeed in the new leadership position. Scenarios will include moving to a new institution; becoming a DIO; developing a new program, such as an academy; and developing a new integrated curriculum.

Participants will leave with a draft of their own personal mission statement. They will identify three important leadership goals to share with a partner. They will receive a bibliography of core readings to help them navigate personal and cultural change.

Educational Objectives:

  • Write your own personal mission statement.
  • Acquire tools to tackle the first 90 days of a new position: How to identify allies, champions, and mentors (i.e. how to design your “help” system).
  • Learn to speak persuasively to make a positive first impression and avoid critical mistakes and “rookie” errors in communication. 

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

Diana B. McNeill, MD, FACP
Duke University School of Medicine 

Lia S. Logio, MD
Weill Cornell Medicine 

Brian M. Aboff, MD, MMM
Virginia Commonwealth University School of Medicine 

205. “I’ve Got Your Back:” Supporting Residents in the Face of Microaggressions or Discrimination

Residents of diverse backgrounds frequently face “microaggressions” which are dismissals and/or insults from patients, typically due to their appearance, gender, or other identifying feature. Microagressions can take many forms: from a request from a patient for a physician who looks like them—a white physician, a non-Muslim, a man or woman, by overt use of derogatory racial slurs towards the resident, or perhaps the most common form of discrimination for physicians of color (and for female physicians) is being assumed by the patient to be the nurse, food service worker, or housekeeper despite wearing a white coat and stethoscope. These situations may occur in the presence of the entire medical team, and many attendings do not know how to address them, which leads to a missed opportunity to discuss how to handle similar situations in the future, or to check in on the emotional wellbeing of the resident. Typically, the team disperses from the bedside to do the day’s work, and the resident who was subjected to the microaggression is left feeling isolated, not knowing if the attending and team realized how hurtful it was.

Participants will practice the communication skills to support residents experiencing race, religious, or gender discrimination. Through role play and small group discussion, participants will learn and practice strategies to create a safe environment in clinical educational settings to openly discuss discrimination with the resident team. Participants will leave with a detailed toolkit of strategies to accomplish these goals including articles, case vignettes, a slide set to be used for faculty development around support residents of diverse backgrounds.

Educational Objectives:

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

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

Shanta M. Zimmer, MD
University of Colorado School of Medicine 

206. Structuring Recruitment Interviews and Decreasing Bias: How to Meet the Best Practice Standards

Residency programs understand the importance of the applicant selection process and as a result spend a great deal of effort screening, interviewing, and ranking applicants with the hopes of matching “the best” incoming residency class. Currently, little is known about how residency programs account for the influence of bias on this process.

In an effort to improve the residency selection process, AAMC has undertaken several initiatives and made many recommendations. “Best Practices for Conducting Residency Program Interviews” includes the foundation for structured interviews and the use of behavioral questioning, all with the aims to reduce unconscious bias and enhance physician workforce diversification. With those same aims, we developed a pilot project within our Internal medicine residency program that trained faculty on the use of the AAMC’s recommended best practices. We sought to increase standardization of the interview process, measure and reduce bias within the interview evaluation process and positively impact the proportion of underrepresented minorities in the program.

In this workshop, we will walk you through the faculty development portion of our training session that includes three main component: a mini-didactic, a video-role play and, skills application experiential task. The theory and use of behavioral questioning, components of the STAR (situation/task, action, results) acronym, and concepts and effects of unconscious bias will also be reviewed. We will also provide tips and suggestions to help reduce bias in your own selection process.

Educational Objectives:

  • Describe the current best practices for conducting residency program interviews.
  • Describe the role of unconscious bias in interviewing.
  • Apply the knowledge of structured interviews and the STAR acronym to a mock interview scenario using a scoring rubric. 

Karen Ann Friedman, MD, FACP
Kyle Katona, MD, FACP
Johanna Martinez, MD
Donald and Barbara Zucker School of Medicine at Hofstra Northwell 

207. Implementing Educational Value Unit system at a Community Academic Center

This workshop will focus on design and implementation of educational value unit (EVU) system in a community–based academic medical center for the Internal medicine teaching faculty. Similar to a work RVU system clinicians, EVUs document the non-clinical activities performed by clinician educators. In response to requests by hospital administration for documentation of non-clinical activities by their employed teaching physicians, we developed an EVU system based on reports in the literature and tailored to our residency program. With support of hospital administration, this EVU system was incorporated into our faculty incentive plan. Since implementing our EVU system in 2013, we have improved accountability for administrative time and increased our faculty involvement in hospital committees and scholarly activity. Workshop participants will be shown an active EVU system model for a medium sized community based Internal medicine residency program. We will also review the challenges in implementation and discuss tips for success as well as lessons learned.

Educational Objectives:

  • Understand the background and principles for developing an EVU system at their program.
  • Identify barriers and tactics for an implementing EVU system.
  • Discuss ways to incorporate an EVU system into your incentive plan to boost faculty non-clinical activities.

Kapil Mehta, MD
Anthony L. Martin, DO
Lannie J. Cation, MD, FACP
St. Vincent Hospital and Health Care Center 

208. Planning Your Future: Abstract to Concrete and Back

The ability to articulate goals aligned with a personal vision is crucial for success. Yet future planning is difficult because it requires abstract thinking that often feels unfamiliar to physicians. As a result, physicians may struggle when asked to build a personal vision that supports plans for growth, development, and achievement. This workshop provides a practical, structured approach to developing a personal vision and career roadmap.

We begin with the concept of a five-year plan, a common emphasis in future planning. We stress the importance of having such a plan and the difficulties in creating one. We then reverse engineer a robust plan, introducing participants to the ideas of an elevator speech and personal brand statement. The elevator speech concept will be introduced with examples. Next, participants will create their own personal leadership brand using a stepwise approach based on the work of Ulrich and Smallwood (Harvard Business Review, 2007). After creating their personal brands, participants will expand their brand into the core components of an effective elevator speech. They will generate a formal, draft elevator speech and practice delivering it in small groups. We will then discuss tools to convert the elevator speech into a more comprehensive five-year plan.

Educational Objectives:

  • Generate a unique personal brand statement.
  • Create and deliver an elevator speech.
  • Explore how tools for future planning exist on a spectrum.

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

Read Pierce, MD
University of Colorado School of Medicine 

209. Level Up!

Residents are a unique and diverse group of learners. However, many of us use generic evaluation forms that do not account for our learners’ individual strengths and weaknesses. Level up is an innovative and dynamic online evaluation tool that automatically adapts to the learner. Preceptors receive three simple yes/no questions per day per learner. These questions are taken from a pool of questions that are derived from the ACGME milestones. Each EPA was then converted to a series of five questions highlighting milestones of competency. Each successive question correlates with a higher level of competency for that EPA. All interns start with level one questions and will progress to level two only after they have received “yes” answers five times.This process will continue through five levels for each EPA. Therefore, residents have completely individualized assessments based on their growth. Biases inherent to traditional Likert scale based evaluations are avoided and the resident gets feedback on real time progress for each sub competency. Furthermore, preceptors will have a rapid assessment tool in the form of a phone app that will allow them to complete their evaluations in just a few minutes per day.

Educational Objectives:

  • Appraise your home institution’s assessment tools, critically.
  • Understand the inherent biases present in traditional forms of assessment and discuss novel ways to obtain meaningful data on learners.
  • Use EPAs to create a set of five sequential evaluation questions that highlight progressive milestones in a sub competency.

Johnathan Frunzi, MD
James F. Pierce, DO
Samaritan Health Services—Corvallis

210. Are Your Learners Ready to Hold the Admission Pager? Building a Resident Curriculum for Triage and Disposition Decision-Making

In the context of Internal medicine , “triage” refers to a constellation of activities related to determining the most appropriate disposition/management plans for patients. Triaging occurs across the care continuum and represents entrustable professional activities and skills across multiple ACGME domains that internists must master for patient safety and appropriate utilization of health care resources. After ACGME implemented resident duty hour restrictions in 2003, many activities and duties have been transitioned from resident learners to staff physicians, which has created a gap in skills and knowledge in resident training.

Our workshop will provide a framework to create a resident triage curriculum based on their local institutional needs focused on three foundational competencies: inter-professional communication, evidence-based decision making, and systems-based practice. The workshop includes large and small group sessions where participants will evaluate a video illustration and use a triage curriculum tool to complete an institutional specific needs assessment. We will discuss the creation of an e-module, funded by the AAIM Innovation Grant, and focused on the first competency for triaging: inter-professional communication and professionalism. The conclusion focuses on assessing residents using an evaluation developed with the AAIM three-step process for assessing EPAs. Faculty will give an example by role play and participants will have the opportunity to use the evaluation form.

Educational Objectives:

  • Define the role of the triagist and demonstrate the relevance and importance of teaching residents the triage and disposition decision-making skill set.
  • Construct the foundations of a triage and disposition skills curriculum focused on inter-professional communication and professionalism, evidence-based clinical decision making, and systems based practice.
  • Demonstrate and evaluate residents triage skills using an assessment tool linked to relevant ACGME milestones and entrustable professional activities.

Emily S. Wang, MD
Sadie A. Trammell Velasquez, MD
University of Texas School of Medicine at San Antonio 

Christopher J. Smith, MD
University of Nebraska College of Medicine 

Sherwin Hsu, MD
Olive View/UCLA Medical Center 

211. RRC-IM Update

Christian Cable, MD
Residency Review Committee for Internal medicine 

212. The Curse of Knowledge: A Challenge to Teaching in Subspecialty Clinics

The curse of knowledge is a cognitive bias that impairs communication due to a bias that causes the educator to believe that learners understand more than they actually do. A sentiment often expressed by clinician educators in subspecialty practice is that they do not have anything to offer medical students in the clinic setting. There is a feeling that the distance between the knowledge and skills the students possess and those applied by the expert in the care of very complex patients is too great. This workshop presents the perspectives of educators in a cognitive subspecialty (endocrinology), a procedural subspecialty (cardiology), and primary care (Internal medicine), comparing and contrasting the substrate and style of learning in the ambulatory setting. 

Educational Objectives:

  • Learn the basic terminology and tenants of cognitive learning theory.
  • Understand the unique challenges posed by the three main types of ambulatory clinics: primary care clinics, cognitive subspecialty clinics, and procedural subspecialty clinics as learning environments for medical students.
  • Explain approaches to most effectively establish learning objectives, expectations, and measurements of success for students navigating learning within the three varieties of ambulatory clinics.

Jeffrey A. Colburn, MD
Kelvin N. Bush, MD
Adrian R. Barron, MD
San Antonio Uniformed Services Health Education Consortium 

213. Issues in Family Medical Leave in GME: Promoting Wellness with Standardized Proposals

“Wellness” is at the core of the new ACGME Common Program Requirements instituted in July 2017. One aspect of wellness, the birth or adoption of a child, is a common part of the lives of our graduates. AAIM formed a task group to address family leave, to propose solutions to improve standardization and equity of family leave across GME training programs and to preserve the educational mission of training while incorporating parental leave.

This workshop will start with didactic information on gender bias, maternity and paternity issues, and well-being of the child. We will discuss regulations imposed by ABIM, ACGME, and Family Medical Leave Act (FMLA).

We will submit proposals for standardization that could accommodate trainees needs and create flexibility to improve wellness.

Following the didactic session, we will present several cases for group discussion. These cases will involve trainees from both genders who are in residency and fellowship programs. Small groups will work out solutions for these groups and present the solutions to the workshop attendees.

Educational Objectives:

  • Be aware of the issues surrounding maternity leave, paternity leave, adoption of an infant child, and caregiver care leave for residents and fellows in GME.
  • Understand the rules of ACGME, ABIM, and FMLA.
  • Consider specific examples and role-play as program directors and key clinical faculty members.

Frances A. Collichio, MD
University of North Carolina School of Medicine 

Patricia Vassallo, MD
Feinberg School of Medicine Northwestern University

Jennifer Jeremiah, MD
Warren Alpert Medical School of Brown University 

214. Using Self-Regulated Learning Microanalysis to Diagnose and Remediate Poor Test-Takers

Learners who struggle on multiple choice tests are ubiquitous throughout all levels of medical education. Medical educators need feasible, theoretically sound methods for remediating poor test-takers that may also help with clinical performance. In this session, we will introduce a method for assessing and remediating struggling test-takers that is grounded in self-regulated learning (SRL) theory and script theory. Participants will learn how to use a form of SRL microanalysis—a semi-structured, think-aloud, direct observation protocol to identify seven struggling test-taker subtypes, each of which can be linked to a deficient SRL subprocess. Participants will also learn the appropriate remediation strategy to target and improve the SRL deficiency. Using video depictions of different struggling test-takers as well as hands-on practice via role play, participants will leave this session with a useful tool for identifying and remediating SRL subprocesses in poor test-takers.

Educational Objectives:

  • Describe SRL theory, script theory, and SRL microanalysis.
  • Illustrate how SRL microanalysis can be used to identify and remediate deficient regulatory processes in poor test-takers.
  • Apply a method of SRL microanalysis to diagnose struggling test-takers depicted in videos and by using role-play.

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

Kent J. DeZee, MD
Tripler Army Medical Center

215. Designing Immersive Learning Simulations for Patient Safety and Interprofessional Education: Practical Strategies to Maximize Learner Engagement and Skill Development

The workshop presents an evidence-based, systematic approach for the design and development of Immersive Learning Simulations (ILS) for patient safety and interprofessional education. ILS solutions offer tremendous possibilities for patient safety and interprofessional education topics due to their ability to illustrate complex scenarios and promote active, experiential learning. Leveraging the science of learning principles, the workshop will provide a practical “blueprint” for creating compelling and impactful learning experiences that maximize learner engagement and promote skill development. Special emphasis will be placed upon discussing the multi-disciplinary nature of the ILS design and development and how to promote shared understanding and teamwork between the experts from different disciplines during the process. The authors will share best practices and lessons learned from ILS development efforts using real-life content examples at different levels of fidelity. Recommendations for using the ILS approach at different phases of physician professional development, including UME, GME, and CME, will also be provided.

Educational Objectives:

  • Review instructional systems design principles and processes for creating immersive learning simulations for patient safety and interprofessional education.
  • Explore evidence-based instructional strategies and practical examples for maximizing learner engagement and skill development in immersive learning simulation environments.
  • Apply relevant instructional principles and strategies towards the conceptual design of an immersive learning simulation on a topic of choice using the template “blueprint” provided.

Anya Andrews, PhD
Analia Castiglioni, MD
Caridad A. Hernandez, MD
University of Central Florida College of Medicine 

216. Moving Value to the Bedside: Developing and Implementing a Robust Bedside High Value Care Curriculum

In the current landscape of rising health care costs and growing focus on quality, teaching Internal medicine learners to consider high value care is increasingly important. Educational regulatory bodies have underscored this when recommending that learners be assessed on their ability to provide high value care, such as ACGME Milestone 10 which specifically addresses value in clinical care. Multiple tools have been developed to help educators teach students and residents how to practice high value care, but there has been no focus on utilizing these tools at the bedside in a multi-modality educational model. Our workshop will utilize our experience teaching high value care at the bedside to help participants practice using these tools to help learners of multiple levels to understand and practice high value care. Participants will then have the opportunity to develop a script that is customized to their unique needs, which blends multiple tools to create a robust educational experience at the bedside. The presenters will use their own experience developing and implementing a bedside curriculum for students and residents to demonstrate how a multi-modality curriculum can succeed at the bedside. At the completion of the workshop, participants will have expanded their own tool box of strategies for teaching high value care at the bedside and will have an actionable plan for a bedside curriculum that can be used at their institution.

Educational Objectives:

  • Participants will recognize the common challenges and solutions to creating a bedside high value care curriculum.
  • Participants will create and utilize a unique bedside high value care script for their institution.
  • Participants will develop a robust tool box of bedside high value care teaching tools.

Christopher J. King, MD
Darlene Tad-y, MD
Emily Gottenborg, MD
University of Colorado School of Medicine 

Amit K. Pahwa, MD
Johns Hopkins University School of Medicine 

217. Disruptive Curricular Innovation—Breaking Down Silos to Build Better Education

Medical schools are increasingly redesigning curricula to prepare students to be successful interns; preclinical and clinical curricula are being melded together to create interdisciplinary, interactive, and innovative courses. Courses—such as Doctoring, Clinical Reasoning, and Reflective Practice—are exciting opportunities to help close curricular gaps and ensure that specific “hidden curriculum” learning objectives are explicitly addressed in medical education. As exciting as these courses are, however, the design, implementation, and assessment of such complex educational innovations can be daunting; faculty must work collaboratively to identify stakeholders, analyze curricular gaps, and work interdepartmentally to design effective curricula. Building on the diversity and success of three innovations at three different medical schools, this workshop will empower attendees to identify how innovative, novel courses may be designed and implemented in their own institutions. In a highly interactive format, presenters will briefly introduce the “why and how” of their specific curricular innovations and then facilitate small groups with attendees to begin to formally think about how their “curricular dreams” may come to fruition. Special attention will be paid to how to involve students (and even patients!) in curricular design toward the goal of co-production of both education and health.

Educational Objectives:

  • Identify common and locally relevant areas where large curricular gaps exist in their current educational programs.
  • Identify key stakeholders at their own institutions as well as collaborators at other institutions that may be helpful in the design, implementation, and evaluation of novel educational programs.
  • Identify how non-traditional topics, such as patient safety, resilience, reflection, decision-making, and feedback training can be woven into medical student education.

Andrew Olson, MD, FACP, FAAP
Anne G. Pereira, MD, MPH
University of Minnesota Medical School 

Joseph Rencic, MD
Tufts University School of Medicine 

Patrick Rendon, MD
University of New Mexico School of Medicine 

218. Stronger Together: Strategies to Help Clerkship and Site Directors Keep Their Clerkship Comparable across Multiple Sites

According to the most recent AAMC data, the medicine clerkship curriculum is delivered across an average of six clinical sites. These sites are often geographically diverse and a combination of profit, non-for profit, and university hospitals. Even within a specific site, students on their medicine clerkship may be assigned to a variety of services, including general medicine teaching services, direct-care hospitalists services, and subspecialty services. Ensuring that all students have a comparable clinical experience and the opportunity to meet the course objectives is paramount to clerkship directors and a priority for the Liaison Committee on Medical Education (LCME).

This interactive workshop aims to address challenges and offer solutions for ensuring a comparable clerkship experience across a variety of clinical settings. It will begin by defining “comparability” and a group discussion during which the key clinical experiences important to the medicine clerkship are identified. Following this discussion, a clerkship director with two site directors, who oversee students from multiple medical schools, will facilitate a discussion on the challenges of ensuring that the educational needs of each student are meet in different clinical settings. We will then share a successful strategy that one institution implemented to address issues with comparability across clerkship sites in preparation for a recent LCME site visit. Finally, participants will be given a set of outcomes that can be used to track comparability across clinical sites, and methods to help monitor these outcomes within their own clerkship.

Educational Objectives:

  • Define “comparability” as it relates to the medicine clerkship or sub-internship, and identify outcomes that can be used to track comparability across multiple clerkship sites.
  • Identify common challenges to ensuring a comparable clerkship experience and discuss possible solutions.
  • Develop a strategy to monitor comparability across clerkship sites that could be implemented at your institution.

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

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

Jaspreet K. Virdi, MD
Abington Memorial Hospital

219. A Clinical Reasoning Teaching Toolbox to Promote Students’ Learning Clinical Reasoning throughout Medical School Curriculum.

Clinical reasoning (CR) is vital to practitioners in the health professions. We believe that the use of different clinical reasoning teaching strategies at different stages of medical students training can be beneficial and sequenced in a developmental approach across the undergraduate curriculum.

The goal of this workshop is to illustrate, analyze, and compare instructional features of four CR tools, which, using a constructivist approach, can be sequentially implemented: Clinical Integrated Puzzle, Clinical Reasoning Mapping Exercise, Collaborative Concept Mapping and Script Concordance Test. Presenters will describe the theoretical components and practical features of these CR instructional tool, and how they could be implemented at different points in the medical school curriculum. Small group work will focus on the features and uses of each tool, comparing and differentiating the instructional processes associated with each. The workshop will conclude with a facilitated discussion where participants will share lessons learned from small group discussions and provide suggestions for the application of such a clinical reasoning toolbox in different learning contexts throughout the medical school curriculum.

Educational Objectives:

  • Understand of theoretical tenets and practical applications of clinical reasoning CR instructional tools.
  • Analyze and discriminate distinguishing features of CR instructional tools.
  • Use different clinical reasoning tools at your own institutions.

Dario M. Torre, MD, PhD
Paul A. Hemmer, MD
Louis N. Pangaro, MD
Steven J. Durning, MD, PhD
Uniformed Services University of the Health Sciences
F. Edward Hebert School of Medicine 

220. Sometimes I Feel Crazy...The Intricacies of Multiple Personalities in Med-Peds Program Management

Residency program management is often something that is stressful and challenging, but is also incredibly rewarding. med-peds programs are faced with more challenges with this due to the nature of being a combined program. Not only is there the med-peds program to consider, but one must also consider each categorical program and the leadership for these programs. One way to mitigate stressors related to this is the utilization of tools to ensure that the lines of communication are clear and concise. Without these communication lines, it is easy for program details to get lost within the day to day of program management. This course will focus on some tools that help to create seamless med-peds program management, which will ensure for a stronger program.

Educational Objectives:

  • Explore the different personalities that are in the work force today to make sure that the programs are well run and seamless in the management aspect.
  • Utilize tools that are available through different schools of organizational psychology related to how to best work with each of these personalities.
  • Provide some take home materials that will allow for successful implementation of these program management skills.

Allison Blatchford, C-TAGME
University of Nebraska College of Medicine 

221. If You Build It, They Will Come—or Will They? How to Build a Successful Faculty Development Toolbox at Your Program

Faculty development programs are essential to the success of any medical education enterprise. Residency programs are required to have robust programs in place to ensure that faculty are equipped to perform effectively despite the ever-evolving roles and tasks placed upon them. Faculty who feel successful in their teaching roles are also less prone to burnout. Designing effective faculty development programs is a daunting challenge, especially when considering the many needs that must be met to remain timely and aligned with current accreditation standards. Challenges to successful faculty development programs include assuring the relevance of the program to the actual needs of the faculty, assuring that faculty have sufficient access to the programs, and that appropriate teaching methods are employed to deliver the materials. Med-peds programs have additional unique challenges in faculty development due to the fact that faculty are often dispersed over two departments rather than one.

This workshop will focus on how to conceive and implement a successful faculty development intervention. We will start with a brief overview of the current literature on the need for and benefits of faculty development. Participants will then identify their program’s specific faculty development needs in small groups. We will then describe, and solicit from our audience, examples of successful interventions with a focus on adult learning tools and methods. Participants will then design an intervention for the need they initially specified. Lastly, we will come together as a large group and discuss common barriers and solutions to faculty engagement and participation.

Educational Objectives:

  • Define the faculty development needs within their program.
  • Apply the appropriate adult learning tools and methods in the faculty development program they are building.
  • Define best practice methods to assure meaningful participation in faculty development activities. 

Richard M. Wardrop, III, MD, PHD, FAAP, FACP
University of North Carolina School of Medicine 

Alaka Ray, MD
Harvard Medical School Massachusetts General Hospital 

Alpesh N. Amin, MD, MBA, MACP, SFHM, FACC
University of California-Irvine School of Medicine 

Robert D. Ficalora, MD, FACP
Billings Clinic 

Workshop Session III
Tuesday, March 20, 2018
10:00 a.m. to 11:00 a.m.

301. Three Commitments and Three Questions to Increase Your Emotional Intelligence

Your emotional intelligence (EI) affects how you manage behavior, navigate social complexities, and make personal decisions in life and work. In fact, decades of research point to EI as being the critical factor that sets star performers apart from the rest of the pack. The EI-connection is so strong that 90 percent of top performers measure high on emotional intelligence. Sounds good, but interacting with others is challenging—and we all have room for improvement. So can we actually increase our levels of emotional intelligence? If so, where do we begin?

Join us in this engaging and interactive workshop and we will start with two foundations of EI: emotional self-awareness and self-control. We will explore three commitments and identify three questions designed to grow these two important elements of emotional intelligence. We will learn, practice, and work through a brief case study so we are better prepared to manage the EI-related challenges we encounter each day.

Educational Objectives:

  • Summarize emotional intelligence (EI), why it is important to success, and distinguish two EI competencies (emotional self-awareness & self-control).
  • Practice and apply three commitments that research demonstrates will increase emotional self-awareness.
  • Recall three questions that, when rehearsed, will increase their emotional self-control.

Jim Nieman, MBA
Duke University School of Medicine 

302. Using Data Visualization to Understand Our Department, Drive Decisions, and Manage Our Book of Business

This workshop will introduce data visualization as an analytical tool and demonstrate the ways in which Duke Department of Medicine is using data visualization to analyze trends in our research funding, understand human resources and demographic data, gain insights into clinical productivity, and manage our day-to-day book of business. They will be able to compare and contrast traditional spreadsheet data analysis with the analyses possible using data visualization tools. At the conclusion of the workshop, participants will have heard from multiple Duke Department of Medicine presenters who will present examples of current dashboards, business management tools, and "data stories" and how they have changed the way the department operates across missions. Participants will also have heard from division administrators who will share examples of how they are utilizing interactive, action-oriented dashboards to drive decision making at the division level.

Educational Objectives:

  • Acquire concrete knowledge of opportunities for data visualization that is applicable to their work environment.
  • Recognize the transition from older data tools to data visualization tools (primarily Tableau) as a means of understanding our ever-increasing quantities of data.
  • Identify the advantages of these tools for data discovery, action-oriented reporting, and self-service business intelligence.

David M. Staples
Catherine G. Wood, MBA

Chris Weymouth
Duke University School of Medicine 

303. Fostering the Development of the Master Adaptive Learner in GME: Teaching Self Regulated Lifelong Learning through Metacognitive Awareness

In the current clinical learning environment, residents often miss opportunities for learning through patient care because of their perception that service is in opposition to education and because of their struggle to reconcile their role as student with their role as employee. We aim to reframe service as education rather than service in opposition to education by teaching residents metacognitive strategies using the conceptual framework of the master adaptive learner and empowering them to see the central role they play in their own learning and development.

In this workshop, facilitators will present their three-year curriculum on fostering the development of the master adaptive learner. A discussion of the metacognitive skills needed in the transition from learning as a medical student to learning as a resident will ensue, including identifying the skills of self-regulated learning and introduction the the master adaptive learner framework. The curriculum includes explicit discussion with residents on self-monitoring to identify knowledge and skill gaps, developing strategies to consolidate learning, and celebrating curiosity through the development of clinical questions. Attendees will participate in a novel case discussion designed to highlight the role of curiosity in lifelong learning, the differences between workplace and classroom learning, and the value of colleagues in knowledge acquisition and development. This discussion will lead to how attendees can integrate using metacognitive strategies into their existing curriculum and recognize opportunities to enhance the curiosity of their residents.

Educational Objectives:

  • Reframe the conflict of service versus education into service as educational opportunity.
  • Identify metacognitive strategies that can be incorporated into a lifelong learning curriculum.
  • Appreciate the value of the shared mental model of patient care as learning opportunity which enhances learners curiosity, metacognitive skills, and engagement in patient care.

Patrick Cocks, MD
Barbara A. Porter, MD
Margaret Horlick, MD
New York University School of Medicine 

304. Direct Observation of Inpatient Faculty Teaching to Enhance Teaching Skills

High-quality teaching is critical to the training and growth of future physicians. While teachers in undergraduate and graduate medical education level are experts in their content areas, few have had significant training in educational methods. The most common methods to enhance teaching at individual programs include local and national continuing medical education courses, which may be helpful but are periodic and time-intensive.

This workshop will describe logistics and outcomes of an innovative program to provide regular weekly formative real-time feedback to inpatient ward physicians. For the past seven years, weekly 15-minute direct observations were performed by a rotating member of the faculty on their colleagues, followed by a 10-minute feedback session later that day. Observations were recorded on an anonymized feedback tool and collated for selection of larger group faculty development sessions. This workshop will review data from seven years of the program (including 439 direct observations of bedside and board teaching) as well as data regarding the comfort level and value to the attending participants, along with the direct effects on teaching effectiveness as seen from resident annual surveys and resident in-training scores.

Educational Objectives:

  • Describe effective tools for augmenting teaching skills.
  • Create a feedback loop for instructors at your home institution to deliver and receive formative feedback.
  • List opportunities and liabilities with regards to initiating a direct observation of teaching program at your institution.

Anthony A. Donato, Jr., MD, MHPE
Sarah Luber, DO
Benjamin J. Lloyd, MD
Reading Hospital 

305. The Lonely Planet Guide to Fellowship: Guiding Residents to Fellowship “on a Shoestring”

As any program director can attest, one of the most commonly asked questions at interview days for residency is “how can this program help me get the fellowship I want?” In answering this question, many programs have created special tracks to enable residents to get more involved in research and find research mentors. However, smaller programs often are trying to help residents navigate the pathway to fellowship without a dedicated track or a strong research base in some subspecialties at their institution.

The workshop aims to provide programs with simple solutions to recruit, mentor, and prepare fellowship-bound residents without a dedicated pathway. The workshop will describe the practices of two institutions—Hennepin County Medical Center (a university-affiliated county hospital) and Abbott Northwestern (a university-affiliated community program)—in guiding residents to fellowship.

During the workshop, we will break up the group into programmatic improvements focused on three general areas throughout residency—recruitment, mentorship, and faculty development. The breakout sessions will allow attendees to select among areas of coaching residents toward fellowship in which their program may need support.

In the final portion of the session, the larger group will reconvene to discuss how smaller programs can partner together to find novel opportunities for their trainees on the pathway to fellowship.

Educational Objectives:

  • Learn methods of recruiting residents that will be successful at matching into fellowship and how to address applicant questions on fellowship at institutions that do not send the majority of applicants on to fellowship.
  • Learn ways to mentor residents early in training to be able to participate meaningfully in research and build a research portfolio that prepares them for fellowship interviews.
  • Discuss ways that smaller residencies can find mentors even if the host institution does not have a wealth of scholarship in a given subspecialty area. 

Samuel Ives, MD
Hennepin County Medical Center 

Amy K. Holbrook, MD
Abbott-Northwestern Hospital 

306. Walking the Tightrope: Achieving Balance Between Direct Observation and the Busy Ambulatory Setting—An Interactive Video-Based Session

Training programs and medical schools are investing tremendous time and effort into creating an evaluation portfolio for each of their learners that incorporates milestones or Student Physcian Athletes (SPAs). However, much of what faculty are being asked to assess is dependent on frequent, ongoing, and effective direct observation of trainees in a variety of contexts. Historically, many programs have relied on fairly traditional methods such as the mini-CEX template to guide and capture feedback. Unfortunately, these tools can be unwieldy and/or too time consuming in busy outpatient clinics. Now, with an enhanced focus on observable behaviors, as well as the ever-present need for actionable feedback, teaching faculty have to become increasingly facile not only with direct observation and feedback in multiple settings, but identifying and creating the right opportunities for both from the bedside to the team work room.

Our workshop, presented by faculty from four different institutions, will focus on direct observation in the outpatient setting where the pace and setting can create barriers that are unique. During this workshop, participants will be given an opportunity to practice and hone direct observation, exam room teaching, and feedback skills in a guided setting with the aid of videotaped encounters. Participants will be introduced to a toolkit which aids in structuring efficient but effective teaching and evaluation designed for ambulatory settings. There will also be substantial opportunity for dialogue about the best practices for increasing rates of direct observation and how that observational data may be used for learner feedback and evaluation.

Educational Objectives:

  • Recognize ACGME milestones and LCME SPAs that are best evaluated by direct observation.
  • Identify methods and tools to regularly employ direct observation, bedside teaching, and feedback in the ambulatory setting.
  • Compare and contrast best practices for increasing rates of direct observation and improving the quality of formative and summative feedback.

Danielle Jones, MD
Emory University School of Medicine 

Catherine E. Apaloo, MD
Piedmont Athens Regional 

Jenny Siegel, MD
Boston University School of Medicine 

Alaka Ray, MD
Harvard Medical School Massachusetts General Hospital 

307. Stop Struggling! Using Change Management Strategies to Lead Innovation in Medical Education

You have developed innovative ideas around curriculum, assessment, and other educational topics. You’ve tried to make it work and convince others to follow. But…it never seems to go as planned. Wouldn’t it be great if you could get expert advice on how to turn theory into action? This workshop begins with presenters and attendees sharing anecdotes of education initiatives at various degrees of implementation, ranging from successful to stalled. Attendees will then learn about each of John Kotter’s eight principles of change management and see how they can and have been applied to medical education. Participants will help one another identify which change management principle was (is) the weak link in their projects. Workshop participants will then map out a specific action plan for moving their education initiatives forward using a change management framework. The presenters and other attendees will provide feedback on these action plans, helping to refine a final blueprint for when participants return to their home institutions.

Educational Objectives:

  • Diagnose which steps of change management that needs improvement in a struggling education initiative.
  • Create a sense of urgency for one specific educational endeavor.
  • Use change management strategies to innovate in medical education.

Benjamin Kinnear, MD
Matt Kelleher, MD
Dana Sall, MD
Eric J. Warm, MD
University of Cincinnati College of Medicine 

308. Giving Feedback of a Sensitive Nature:  How to Say What Everyone Else Is Thinking

Remember that awkward conversation when you “had to” tell a resident or student that they smelled, that their dress was a little too revealing, or that they were just a bit too loud? Candid conversations about body odor, attire, and behavior are challenging even for the most seasoned educator. This highly interactive (and entertaining) workshop will be a first-step in helping educators to stop sweating about sweating.

Essential steps for delivering sensitive feedback will be reviewed and modeled with substantial time devoted to group reflection and discussion. Facilitated breakout groups will support faculty and coordinators in GME and UME to become more comfortable with discussing taboo topics and methods for delivering sensitive feedback effectively. Participants will have the opportunity to reflect on challenges they have faced during past experiences, plan strategically for more candid and aligned future discussions, and give feedback to one another for more effective open conversations.

Educational Objectives:

  • Describe the importance of delivering sensitive feedback for learner development and success.
  • Compare and contrast strategies for effectively delivering sensitive feedback.
  • Discuss and practice the steps for candidly delivering feedback of a sensitive nature.

Gina Luciano, MD
Mercy Medical Center 

Rebecca A. Griffith, MD
Atlantic Health (Morristown) 

Jackcy Jacob, MD
Albany Medical College 

Michael Picchioni, MD
University of Massachusetts Medical School-Baystate 

309. Ultrasound as a Second Language (USL): Learning the Lingo of Ultrasound for the Clinician Educator

Point-of-care ultrasound (POCUS) is the standard of care in many emergency medicine clinical assessments, and POCUS education is being integrated in many medical schools. While Internal medicine POCUS courses have largely been limited to national professional organization meeting precourses, faculty development courses are even fewer, which can leave attending physicians who did not train with this technology at a loss in terms of how to interpret their learner’s findings, how confident to be in reported findings, and how to teach diagnostic reasoning incorporating this technology. This workshop was created based on feedback from leadership at our multiple institutions (academic and community) to support educators in learning the “second language” of bedside ultrasound. The workshop will begin with a didactic covering the basics of POCUS and what sets it apart from comprehensive, sonographer-performed ultrasound. Participants will next engage in a series of small-group, expert-facilitated discussions of projected case images/questions. Each small-group discussion session will be followed by a large group debrief including participant-centered discussion of the findings highlighted on the slide, test characteristics, and most common reasons for false positives and false negatives. This workshop will focus on the four common ultrasound findings in practice: reduced left ventricular function, volume status assessment, fluid in the lungs, and free abdominal fluid. Participants will leave with a toolkit with key resources to build upon and use with other educators at their institutions. This workshop is not intended to teach image acquisition skills.

Educational Objectives:

  • Describe point of care ultrasound and what sets it apart from comprehensive, sonographer-performed ultrasound.
  • Explain at least five basic point of care ultrasound terms.
  • Identify four ultrasound findings pertinent to everyday practice in Internal medicine.

Benji K. Mathews, MD, FACP
University of Minnesota Regions Hospital 

Gigi Liu, MD
Johns Hopkins University School of Medicine 

Kevin Piro, MD
Oregon Health & Science University School of Medicine 

Gordy Johnson, MD
Legacy Emanuel Hospital and Health Center 

310. “This Is on Us”: Building Addiction Treatment Education in Primary Care Resident Clinic

Most physicians would agree that the growing scale and threat of the opioid epidemic demands new responses. Many general internists have led the way in decreasing the supply of prescription opioids in the community, but there is continued need to treat those who already have life-threatening addictions. There are barriers—real and perceived—to opening one’s own practice to MAT, let alone integrating it into a resident clinic.

Our seminar will focus on the logistical and practical aspects of starting a medications assissted treatment (MAT) practice embedded within the resident clinic environment through comparing and contrasting two different academic primary care resident clinics. The Yale and UPenn clinics have slightly different aims and patient populations, and are in different stages of development, but these contrasts serve to show how MAT can be adopted to local circumstances.

Topics covered within this session include reimbursement, pharmacy regulations, testing, and clinic flow. We will also highlight the scope of milestones and novel EPAs that are covered in an experiential MAT clinic session ranging from communication to systems based practice.

Participants will brainstorm about challenges they imagine for prescribing MAT in their residency programs, and how they might make use of their own program resources and structures to design solutions. We also aim to highlight and develop a mentorship network and support system amongst the participants that will carry forward.

Educational Objectives:

  • Detail the steps required to build a general medicine substance use disorder clinic for resident education.
  • Compare the UPenn and Yale clinics as examples of how clinic design must match local resources, expertise, and patient needs.
  • Identify the barriers to treating opioid use disorder in a resident clinic and specific solutions developed by UPenn and Yale clinics.

Deepa Rani Nandiwada, MD
Marc Shalaby, MD
Benjamin Larson, MD
Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania 

Stephen R. Holt, MD
Yale-New Haven Medical Center (Primary Care) 

311. ACGME 10 Year Accreditation Site Visit: Lessons from Early Survivors/Thrivers

Program presenters have recently participated in an ACGME 10 year site visit, which occurred approximately 18 months after the submission of Self Study Reports and participation in an optional Pilot Self Study visit by ACGME. Panelists have differing perspectives—residency and fellowship program directors, program manager and designated institutional official—and will each describe lessons learned through the steps in the process leading up to and including the visit. Strengths, weaknesses, opportunities and threats (SWOT) analysis proved to be integral to the processes throughout. Take home points will be provided for all GME constituencies.

Educational Objectives:

  • Describe the relationship between the ACGME Self Study processes and the 10 year site visit.
  • Identify the data which must be organized and presented at the 10 year site visit and describe the preparation required of trainees, faculty and program leadership for the 10 year site visit.
  • Describe the relationship between Program Evaluation Committees, Annual Program Reviews, and the 10 year site visit. 

David A. Wininger, MD
Kristin B. Chamberlain
Jennifer McCallister, MD
Scott A. Holliday, MD
Ohio State University College of Medicine

312. Creating an Implicit Bias Curriculum for Graduate Medical Education: Integrating One Program’s Experience

Implicit bias refers to the attitudes or stereotypes that affect our understanding, actions, and decisions in an unconscious manner. These unconscious biases cause us to have feelings and attitudes about other people based on characteristics such as race, ethnicity, age, and appearance and can impact behavior, interpersonal communication, and clinical decision making. Our workshop will offer a brief overview of implicit bias, its relevance to the medical profession and graduate medical education, and will review a curriculum created and piloted for our trainees. Through small group breakout sessions, participants will discuss successes and roadblocks in the creation and implementation of this type of innovative curriculum with the goal of developing a curriculum within their own GME program.

Educational Objectives:

  • Review implicit bias and its relevance to graduate medical education.
  • Discuss potential challenges to the implementation of an implicit bias curriculum for graduate medical learners.
  • Conceptualize elements of a successful implicit bias curriculum for your own learners.

Martina C. Murphy, MD
Julia L. Close, MD
Merry-Jennifer Markham, MD
Jennifer Duff, MD
University of Florida College of Medicine 

313. Physician Recruitment and Onboarding Strategies

Physician recruitment and onboarding are multi-faceted/labor intensive processes that are vital for the overall success of every department. Both processes require strategic planning amongst the department chair, division chief, division administrator, faculty and staff. The goal of this presentation is to share recruitment strategies that can enhance the recruiting efforts for institutions and streamline onboarding of newly hired physicians. The onboarding process is the next step after successful recruitment. Efficient onboarding is an important component of physician satisfaction and ultimately faculty retention.

Educational Objectives:

  • Provide physician recruitment strategies utilized at University of Florida Department of Medicine and identify solutions to common recruitment roadblocks.
  • Provide best practice guidelines to onboard new faculty members in academic Internal medicine.
  • Understand how onboarding is tied to faculty retention and satisfaction.

Chris Pintado, MPH
Shaima Ramadan Coffey
University of Florida College of Medicine 

314. Improving Medical Student Empathy through a Simulation Exercise

Studies have suggested that medical student empathy declines over time throughout their education. While there has been research to support this finding, little has been studied regarding ways to prevent the drop in empathy. Workshop participants will experience a curricular activity which will aim to preserve and perhaps even improve student empathy. Medical students at the Paul L. Foster School of Medicine build a budget on a minimum wage job and experience life events, both positive and negative, with the goal of continuing mandatory health care visits. At the end of the exercise, students write a reflective 55-word short story on their experience with the exercise. Workshop participants will participate in an abbreviated PLFSOM empathy exercise. They will then break into small groups to discuss ways to apply a similar concept into their own clerkship or program.

Educational Objectives:

  • Recognize the fact that student empathy drops during medical school.
  • Describe the current curriculum used at Paul L. Foster School of Medicine designed to improve student empathy via a simulation exercise.
  • Develop ideas on building an empathy-based curriculum for students at their own institution.

Laura Cashin, DO, FACP
Marissa Tafoya
Paul L. Foster School of Medicine Texas Tech University Health Sciences Center 

315. Spirituality and Medicine: Enhancing Understanding for Improved Care of the Patient and Care of Self

Patient-centered care depends on the ability to effectively communicate with patients regarding the values and the beliefs that are important in their lives. Initiatives such as the AAMC Medical School Objectives Program have helped to define the spiritual competencies that should be developed in learners. These competencies include knowing how to apply knowledge about spirituality, faith, and religion in patient care; integrating spirituality and an understanding of patients’ religious values into clinical practice; establishing compassion and communication with patients, families, and colleagues; and incorporating spirituality into professional and personal development. [1] AAMC defines spirituality as “an essential element of humanity. It encompasses individuals’ search for meaning and purpose; it includes connectedness to others, self, nature and the significant or sacred; and it embraces secular and philosophical, as well as religious and cultural beliefs and practices.” With the Joint Commission’s requirement that patients admitted to an acute care hospital have a spiritual assessment, it is important for clinicians to understand how to address the spiritual needs of patients. Incorporating spirituality into one’s professional development can also help mitigate burnout and be a vital aspect of self-care. Teaching how to take a spiritual assessment and encouraging those learners who have a spiritual practice to continue should be considered integral in the holistic development of learners.

Educational Objectives:

  • Educate participants on how a patient’s religion and/or spirituality can intersect with their health care so that participants can apply this knowledge in holistic patient-centered care.
  • Describe techniques to teach learners how to use standardized assessments such as the FICA tool to understand the role spirituality plays in their lives of their patients.
  • Learn how to incorporate spirituality into professional and personal development as a tool against burnout.

Kristin M. Collier, MD
Cornelius Alfred James, MD
Matthew Ettleson, MD
University of Michigan Medical School 

Thomas Barber, MD
Boston University School of Medicine 

316. Raising the Bar: Creating a Differentiated Experience for Subinternship Students Compared to the Third Year Clerkship

This workshop will examine the goals for subinternship rotations and explore ways to make these rotations reflect an advanced level of performance for final year medical students. Subinternship rotations often lack formalized curriculum and attendings may struggle to teach the advanced skills to students. We will present background information about subinternships and use small group and large group activities to brainstorm and discuss teaching and curriculum options for participants to improve their subinternship rotations.

A formalized subinternship curriculum was developed in 2002 by the CDIM Subinternship Task Force, but may not be widely utilized. This curriculum was informed by surveys of subinternship clerkship directors, residency program directors, and housestaff. However, there continues to be variability in expectations for students on these rotations, optimal assessment methods, and ways to make the rotations an advanced clinical experience for students. Since this initial curriculum development there have been many changes in UME and GME, including competency-based assessment, increased emphasis on patient safety initiatives, and rapid expansion of electronic health records to name a few. These changes make the transition from clerkship student to intern more challenging and highlight the need for more structured and effective Internal medicine subinternship. This workshop will give guidance to address these challenges.

Educational Objectives:

  • Recognize the curriculum component differences for Internal medicine subinternship compared to the third year clerkship.
  • Describe advanced learning goals for students on subnternship rotations and recognize ways to challenge subinternship students.
  • Design EPA based evaluation/feedback for students on the subinternship service.

David Gugliotti, MD
Cleveland Clinic Foundation 

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

317. Brief Technology Enhanced Learning Videos for Inpatient Teachers to Teach Feedback and Evaluation Skills to Inpatient Clinical Faculty.

All medical schools rely on their ranks of clinical faculty to perform hospital-based observations and evaluations of undergraduate and graduate learners in Internal medicine. Training our faculty to deliver effective feedback and to perform meaningful assessments is vital but difficult to achieve for so many busy geographically scattered educators. A solution that is portable, affordable, accessible, and convenient can be found within online, instructional tools if developed to flexibly provide the faculty member what they need; private reflection or an interactive group reflection that we plan to demonstrate in our workshop.

Despite substantial research on cognitive learning theory and effective multimedia learning, many online resources currently available do not appear to utilize best practices in instructional technology. Many of us can recall watching poorly recorded lectures, or dutifully reading Power Point slides and webpages, experiencing what has been dubbed “death by bullet points.” In response, we have created brief, 10 minute videos using best practices in instructional technology to allow faculty to view, pause, and reflect on their teaching practices, wherever, whenever, and however is most convenient.

The areas of feedback and evaluation were identified as two problem areas needing improvement, particularly for our inpatient clinician educators whose tacit teaching skills are often shaped by experience rather than pedagogical training. We believe these videos represent a novel tool for supporting our pressured clinician educators as they train tomorrow’s physicians.

Educational Objectives:

  • Recognize research based principles of instructional technology as applied in brief, teaching videos.
  • Gain hands-on experience with using online multimedia videos to enhance the feedback and evaluation skills of their faculty.
  • Identify one teaching behavior in the areas of feedback and evaluation that they can improve on. 

Jennifer Roh Hur, MD
LeeAnn Cox, MD
Joseph P. Smith, MD
Meghan Elise Geraghty, MD
Indiana University School of Medicine 

318. Clerkship Milestones: Tools for Providing Developmental Feedback to Students and Evaluators

Milestones and EPAs are important elements in assessing students development during medical education, though using them to assess whether a student has performed satisfactorily in one clerkship is challenging. They are also difficult to apply at various times in a clerkship (beginning, middle, and end), and they are not specific enough to be interpreted in the same way by students and evaluators alike. At our institutions, we have developed a detailed evaluation form including milestones assessed within a medicine clerkship mapped to the AAMC core EPAs, providing detailed descriptions of behaviors and skills expected of students from the beginning, middle, and end of the rotation. This detail allows for formative and summative evaluations and student self-assessment.

These milestones are detailed descriptions based on collaborative input from students, residents, and faculty. They allow learners and evaluators to have a standardized measure of expectations at multiple points during the students progression through the clerkship.

In this workshop, presenters review the milestones and how they apply to clerkship requirements. They discuss their experiences, successes, and results from using the tool at their institutions, including how to use the evaluation for formative feedback and faculty development. Participants then work in groups to adapt the specific milestone behaviors and skills to the requirements of their own clerkship and generate ideas for adapting the tool to use at their own institutions. In the end, participants will have an individualized feedback tool for students, residents, and faculty in their own institutions’ clerkships.

Educational Objectives:

  • Identify milestones for each of the core competencies for students at the beginning, middle, and end of an Internal medicine clerkship.
  • Incorporate the clerkship milestones into formative feedback to clerkship students.
  • Use the clerkship milestones to train new faculty and residents to set expectations for feedback and to evaluate students.

Nersi Nikakhtar, MD
Benjamin Webber, MD
Demetrios T. Andrisani, MD
University of Minnesota Medical School 

Laura J. Zakowski, MD
University of Wisconsin School of Medicine and Public Health 

319. Developing Faculty Empathy through Group Processing of Reflection and Its Potential Impact on the Learning Environment

In recent years, medical education has witnessed the development of new curricula designed to promote resiliency, professionalism, and humanistic attitudes. A longitudinal curriculum at Loma Linda University trains students in the skill of reflection starting their first year. Students receive training in self-reflection and produce written reflections in subsequent years. In the past five years, this curriculum has expanded to include group reflection sessions led by faculty members for students in the third and fourth year. Evaluation of this curriculum in whole has demonstrated that participating students reflect more critically compared to students who did not receive such training. Moreover, the addition of group reflection sessions has also impacted our faculty. Participating faculty report feeling more empathetic towards students. Creating opportunities for meaningful student-faculty engagement may enhance faculty empathy, thereby contributing to an environment more conducive to student learning.

 This workshop will present the longitudinal curriculum at our institution, focusing specifically on group reflection sessions. Attendees will then have the opportunity to role-play as faculty and students in simulated group reflection sessions. Large group discussion following the simulation will provide an opportunity for participants to explore the impact of this session on empathy and the student- faculty interaction. Post-simulation discussions will also allow attendees opportunity to explore ways this process may be incorporated into existing curriculum at their home institution.

Educational Objectives:

  • Identify ways group reflection promotes greater student-faculty engagement and how it may result in more meaningful interaction with students: further challenging, encouraging and supporting students in response to their reflections.
  • Explore the impact of group reflection on the development of faculty empathy for students through simulation and role-play.
  • Learn how to more effectively lead a small group of learners that will promote lasting faculty-student relationships.

Tamara Shankel, MD
Carolyn Pearce
Loma Linda University School of Medicine 

320. Eliciting, Collecting, and Using Narrative/Descriptive Data of Learners Performance for Evaluation and Enhancing Decisions about Progress and Competence

With the current focus on competency-based assessment and competency-based progression, medical educators are developing ways to gather and manage assessment data relevant to entrustable professional activities, milestones, and other frameworks of competence. Numerical scales and checklists conveniently collect data but these data often lack the breadth, depth, and specificity needed for valid, meaningful decisions about performance and progress. Qualitative, narrative descriptions of observations of learners’ actual performance in clinical settings add depth, meaning, and validity to assessment of learners competence and progress but pose challenges for organizing, categorizing, summarizing, and managing large quantities of written or recorded descriptions. This session will provide three exemplars (medicine & longitudinal integrated clerkships and pediatric residency) of evaluation systems used to illicit and use narrative data and will demonstrate their processes to develop narrative evaluations. Participants will discuss ways to overcome barriers they foresee with eliciting narrative data and practical approaches for organizing and using narrative data to make decisions about progress and competence of learners across the continuum of medical education.

Educational Objectives:

  • Review three exemplars (medicine and longitudinal integrated clerkships and pediatric residency) that illustrate different ways of eliciting and incorporating narrative data into an evaluation system.
  • Develop processes to transform from quantitative to descriptive evaluations, discuss the anticipated barriers, and the ways to overcome them.
  • Understand how descriptive evaluations can determine learner progression and competence.

Rechell G. Rodriguez, MD
Paul A. Hemmer, MD
Uniformed Services University of the Health Sciences
F. Edward Hebert School of Medicine 

Jennifer Adams, MD
Janice L. Hanson, PhD
University of Colorado School of Medicine 

321. The Tale of Two Exams: Preparing Med-Peds Residents for Successful Dual Board Certification

The challenge of med-peds residency doesn’t end with completion of four years of clinical training. For many med-peds residency graduates, the daunting task of passing two board certification exams can be the greatest training challenge they face. Board passage is important not only to the individual graduate, but also to the respective residency program that must achieve a minimal board passage rate to maintain accreditation. This workshop will address recent trends in med-peds board passage rates on the ABIM and ABP certification exams and help identify factors that may put residents at risk for poor performance and failure. We plan to present survey data compiled from Med-Peds program directors nationally to better inform our collective knowledge of effective board review resources, general board preparation and remediation policies, and local institutional supports that may be available. We plan to facilitate an interactive session with short segments of didactic presentation with focus on the available evidence to help with development of effective board preparation curricula. 

Educational Objectives:

  • Review recent trends in Med-Peds board certification passage rates and consider reasons for variation over time and in comparison with the categorical residencies programs.
  • Examine strategies to help identify residents at risk for board certification failure.
  • Discuss various approaches to general board preparation and remediation for at risk residents based on data collected from med-peds programs across the country.

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

Himani R. Divatia, DO
Allen R. Friedland, MD, FACP, FAAP
Sidney Kimmel Medical College
at Thomas Jefferson University/Christiana Care Health Services 

Workshop Session IV
Tuesday, March 20, 2018
11:15 a.m. to 12:45 p.m.

401. New Faculty Onboarding and Clinical Integration—A Department and Divisional Perspective

We all know that an effective onboarding and orientation process is the cornerstone of a successful transition for new faculty, but many of us struggle with the complexities of doing so in our complicated and matrixed organizations. Over the past year, the Department of Medicine at Duke University Medical Center has focused on streamlining and improving this process by:

  • Working to establish collaboration and buy in with the appropriate institutional offices/groups (i.e., CVO, PDC, PRMO, SOM) to eliminate redundancy and duplication of effort.
  • Implementing an updated onboarding checklist which has many “global” items that apply to all departments in the institution but is easily customizable to reflect department specific items.
  • Creating an Office of Faculty Affairs (OFA) within the department to not only manage the transactions related to APT and credentialing, but with a focus on assessing/addressing gaps and driving improved quality and processes related to all phases of the faculty lifecycle.
  • Forging stronger relationships between OFA and each division in the department to create a seamless and integrated process for our faculty.
  • Implementing division-specific processes to ensure new faculty feel welcomed and supported by everyone from support staff to practice leadership.

Educational Objectives:

  • Outline structure of Duke University Medical Center to highlight complexity of structure and point out inefficiencies in process.
  • Discuss the department-level initiatives/responsibilities in the onboarding/orientation process.
  • Share improved integration and support within the practice and division. 

Cathy O'Neil
Angie Cain
Duke University School of Medicine 

402. Internal Communications

The session will provide an overview and discussion of the benefits and challenges associated with the development of an internal communications office within the Internal medicine program. We will start with a brief overview of the administrative structure within the Internal medicine program, and describe the need for and scope of this position and how it interacts with various major players within the department. Then we will delve into the specifics pertaining to major projects undertaken by this division and their results and the two- and five-year goals of this unique unit. The session will offer an opportunity to discuss goals and best practices that promote the successful implementation of communications policies in the Internal medicine unit, including best practices for community outreach, program course design and development, and utilizing resources within a matrixed academic environment. We will provide examples of tools and process flows created by this unit to enhance the delivery of our educational programs, and enhance our outreach with colleagues, students, and recruits. The panel will address open questions and concerns and seek recommendations for additional workshops on communications issues.

Educational Objectives:

  • Describe the process of curriculum design and strategic planning.
  • Gain an insight into the impact of a communications office within Internal medicine residency programs and the support it provides to the greater education initiatives within the department.
  • Participate in a discussion of internal policies and procedures in place at their institution and identify opportunities for course development and procedure implementation.

Christine DeLuca
Richard H. Kelley
Jennifer B. Felten
Rana Khalifeh, MSW
Feinberg School of Medicine Northwestern University 

403. When Remediation Fails: When and How to Withdraw “Life Support”

At least seven to 28% of medical learners require some form of remediation during their training. Few studies address the outcome of remediation and even less information exists on what to do when remediation fails. As “healers”, we are loath to discontinue remediation efforts even when additional intervention seems futile. For a variety of reasons, program directors retain struggling learners even when little tangible improvements are made. There is a delicate balance between the cost of dismissing a resident versus the negative impact that retaining a struggling learner may have on morale, faculty time, and patient safety. When remediation fails, several difficult dilemmas emerge including probation, dismissal and how to deal with future requests from employers or training programs for letters of recommendation.

The presenters of this workshop will use case vignettes and available literature to illustrate the aftermath of failed remediation, and will specifically address the generation of future letters of recommendation, the dismissal process, due process and, most importantly, career counseling when appropriate; providing access to mental health services may also be an important part of this process. Breakout sessions will give the workshop participants an opportunity to discuss these cases and determine whether further remediation is warranted and, if not, generate an action plan.

The deliverables of the workshop will include:

  • Redacted examples of important types of documentation including critical incidents and verbal conversations.
  • Best practices for maintaining a paper trail for failing learners.
  • Templates for adverse action letters to trainees with consideration for legal concerns.

Educational Objectives:

  • Develop a framework for determining when further remediation is unlikely to succeed.
  • Discuss a menu of options available to program leadership when remediation fails.
  • Provide guidance on the preparation of letters of reference for trainees who do not successfully graduate from a residency program.

Randall S. Edson, MD
California Pacific Medical Center 

Jason S. Schneider, MD
Dominique L. Cosco, MD
Emory University School of Medicine 

Denise M. Dupras, MD, PhD
Mayo Clinic College of Medicine 

404. A Practical Guide to Creating and Enhancing your Learning Community of Medical Educators

A learning community of medical educators is an asset for both individual clinician-educators and medical education institutions. For individuals, a learning community provides a sense of connectedness, resources for refining teaching skills, and inspiration for continued innovation and scholarship. At the institutional level, a learning community provides faculty development, enhances job satisfaction, and promotes retention of teaching faculty.

This workshop will provide attendees with the knowledge and skills to develop or enhance a learning community of medical educators at their home institutions. We will introduce the workshop with a description of a learning community’s positive impact. The workshop subsequently will contain three sections: the process of building a learning community, community activities, and resources for joining online or national learning communities. The first section will include a perspective regarding the development of the University of Pittsburgh learning community at the divisional and institutional level as well as attendees’ experiences establishing learning communities. Throughout this discussion, we will highlight common challenges and key components of building a learning community including establishing a mission, identifying like-minded individuals, and obtaining stakeholder support.

In the third section, again with the input of audience members, we will generate a list of community activities or faculty development ideas, such as lectures and conferences, applicable for both large and small communities. Finally, we will close the workshop with a discussion of national and online resources, related to the broader medical education community, for those who have limited local support and are seeking additional opportunities.

Educational Objectives:

  • Describe the positive impact of a community of medical educators at both the level of the individual clinician-educator as well as the institution.
  • Deconstruct the process of building a community of medical educators through sharing our own experiences and inviting other attendees to share their experiences.
  • Generate a list of community activities or faculty development ideas and also to identify online or national resources for those with limited local support looking to join an established learning community.

Rachel Vanderberg, MD
Melissa A. McNeil, MD
Eloho Ufomata, MD
Tanya Nikiforova, MD
University of Pittsburgh School of Medicine 

405. How to Set Up a Successful Resident Research Program: Best Practices in Resident Research

Research training in residency has benefits both for residents and faculty, including an increase in scholarly success, development of academic interests among residents, overall satisfaction in residency training, becoming proficient in critical appraisal of literature and faculty promotion. Additionally, a robust research experience is a pipeline for physician scientists. Despite the many benefits, numerous barriers to successful implementation of research exist, including a lack of curriculum, mentoring, funding and protected time.

Many programs struggle identifying the best mechanism to engage their trainees in research. Best practices vary per the characteristics of each program. To better understand the resident research experience, the AAIM Research Committee has developed a questionnaire and conducted interviews among fifteen Internal medicine residency programs that have established resident research curricula. The overarching goal was to highlight best practices in how programs promote research among trainees. We have collected extensive data on research oversight and support, formal research process, research track or rotation structure and trainee related factors associated with research success.

During this workshop, we will use these data as a springboard for engaging workshop participants in creating strategies that promote engagement of residents in research and overcome barriers to successful implementation of a research curriculum. Workshop participants will be divided into groups based on common program characteristics. The small group participants will utilize elements of research best practices as the basis for creating an action plan to implement or improve resident research in their programs.

Educational Objectives:

  • Introduce best practice elements and discuss specific logistics that contribute to the implementation and maintenance of a successful research program.
  • Construct time-proven effective interventions while avoiding common mistakes utilized by well-founded research-oriented residency programs.
  • Identify factors contributing to a well-structured research program and demonstrate oversight and support modalities necessary to promote trainee engagement and productivity in research.

Nacide Ercan-Fang, MD
University of Minnesota Medical School 

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

Mai A. Mahmoud, MD
Weill Cornell Medicine 

Ali R. Rahimi, MD
Mountain View Hospital 

406. Geographic Cohorting—The Good, the Bad, and the Ugly

Geographic cohorting (unit-based teams) seems to be the “holy grail” of inpatient care. If properly executed, unit-based residents function seamlessly with nursing, social work, and other clinical staff to create a true interprofessional team dedicated to patients on that unit. When well done, unit-based teams improve communication and patient care. Increased efficiency allows more time for learning, and residents learn systems-based care by leading quality improvement projects and reviewing unit-specific outcomes such as patient satisfaction scores. If poorly executed, however, geographic cohorting can yield imbalanced resident workload, delays in care, and frustration from all involved. In this workshop, four residency programs—two university programs and two community teaching hospital programs—will share their experiences with geographic cohorting.Through round-robin discussion, we will share experience in creating unit-based teams, challenges with implementation and operation, the value and dangers of “compromises” to the floor-based team, and outcome data from mature programs. We will also guide participants through exercises to help them identify and mitigate challenges they would face in this process.

Educational Objectives:

  • Describe challenges when implementing geographic cohorting in a teaching hospital.
  • Compare and contrast different methods of geographic cohorting.
  • Identify strategies to mitigate challenges to implementing geographic cohorting at their home institution.

Eric H. Green, MD
Mercy Catholic Medical Center 

Shelley S. Schoepflin Sanders, MD
Providence Health & Services-Oregon
St. Vincent Hospital & Medical Center 

Harley P. Friedman, MD
Geisel School of Medicine at Dartmouth 

Stephen J. Knohl, MD
State University of New York Upstate Medical University
College of Medicine 

407. Preparing Learners to Receive Feedback

There remains a well-known educational practice gap between what learners say they want and do and what teachers say and do with when both parties are actively engaged in the practice of feedback and evaluation. While much of the literature on feedback and evaluation has focused on how teachers should give feedback, less attention has been paid to the importance of to how to prepare learners to receive feedback & evaluation. Historically, the medical education literature has framed feedback as a unidirectional content-delivery process (i.e. what the teacher does to the learner). Instead, consideration should be given to how a more dialogic process in which the context and relationship interact to affect change in behavior (i.e. the teacher working with the learner to form a therapeutic alliance). This workshop draws on the growing neurocognitive sciences, cognitive and educational psychology, and sociology literature on preparing learners to receive feedback. We glean 10 best educational practices to achieve this goal and role model the professional development session that we have used for medical students, residents, and faculty to highlight the importance of this critical but often underestimated role of preparing learners to receive feedback.

Educational Objectives:

  • Apply 10 best educational practices to prepare learners to receive feedback.
  • Describe the limitations of self-assessment when interpreting feedback and why our brains are hard-wired to do this poorly.
  • Identify three key emotional triggers when receiving feedback and how to respond.

Lawrence K. Loo, MD
Van Geslani, MD
Loma Linda University School of Medicine 

408. Self-Promotion in Career Development: Communication Strategies for “Bragging” Professionally

Health care providers are not usually encouraged to “brag” about their accomplishments since their mission is to serve others, especially their patients. However, it is increasingly important to brag not as a choice, but as a necessity for advancing one’s career. As Peggy Klaus, a Fortune 500 communication and leadership coach, has said “staying quiet about your achievements only leads to being under appreciated and overlooked.” The purpose of this workshop is to give faculty strategies for verbally communicating their successes with their peers and supervisors in a professional way as well as sharing techniques for documenting the same in written format for career advancement. These techniques can be used in interviews, elevator speeches, and in the development of accurate curriculum vitae for promotion. At the end of the workshop, participants will be asked to develop a personal plan that they may use when they return to their institutions to support their career development and advancement using some of the self-promotion techniques that they learned in this workshop.

Educational Objectives:

  • Review data on role of self promotion in career advancement.
  • Practice oral communication strategies when sharing accomplishments with peers and supervisors.
  • Outline a written format for sharing accomplishments with peers and supervisors.

Diana B. McNeill, MD, FACP
Saumil M. Chudgar, MD
Jenna McNeill, MD
Duke University School of Medicine 

409. A Scholar’s Council: Curriculum, Innovative Tools, and Interactive Sessions to Increase Resident Scholarly Productivity

A scholar’s council curriculum is provided to all residents at our institution. The purpose was to better capture our residents’ research activities; provide guidance, collaboration, and resources for a variety of projects; and to increase exposure to important research skills.

Sessions occur approximately three times per year for each cohort of residents. Prior to each session, residents update their scholarly project lists across a productivity pipeline. The curriculum has included a letter to the editor workshop (residents submit letters in small groups to learn the process of writing and submitting to a journal), a manuscript review workshop (residents review a peer’s manuscript draft in small groups with specific checklists and discuss all together at the end), resident research panel discussion (experienced senior residents discuss institution or fellowship specific tips to develop research projects), and lectures on working with a statistician to design and implement longitudinal research.

Since starting this curriculum, our residents have reported increased satisfaction for scholarly activity at our institution, improved confidence and skills in research, and have increased their annual scholarly output.

What can you expect to bring to your program from this workshop? Learn the vocabulary of a productivity pipeline to use when tracking resident projects. Implement a web-based tool that can help your residents organize their projects (from their phone or computer), allowing you to communicate regarding each specific project, and track projects completed throughout the year. A small group skills sessions will be modeled during the workshop, with handouts that can be incorporated at your program.

Educational Objectives:

  • Highlight institutional and general resources for scholarly activity.
  • Use web-based technology to track resident scholarly activity (conference presentations, publications) along a productivity pipeline to follow and encourage productivity throughout the year.
  • Learn from and with each other! Use small group sessions to engage residents with all levels of research skills and interests.

Kellee Oller, MD
Kevin Huang, MD
University of South Florida Health Morsani College of Medicine

410. Here’s to “Life”—How to Develop an Innovative Public Speaking Curriculum in Your Program

At Internal medicine residency programs around the country, trainees are required to give formal podium presentations to include grand rounds, clinical pathological case conferences, and regional and national meetings. Unfortunately most trainees do not have formal public speaking training, and most residency programs do not offer such training. We developed and implemented a formal curriculum at multiple teaching hospitals within the military health system focused on improving the structure and delivery of formal podium presentations for Internal medicine interns and residents. The curriculum is structured around an introductory lecture on important components of how to give a great formal presentation. Before a scheduled presentation, trainees meet with a faculty mentor who attended this workshop to review slides and presentation technique. During a trainee’s formal presentation, their mentor creates sample video clips (approximately 5 one-minute clips) from the audience and reviews these with the trainee during a debriefing and feedback session. During the workshop, we intend to teach the audience the finer components of a presentation, and then demonstrate an example of our structured presentation review.

Educational Objectives:

  • Gain the knowledge and tools to implement a public speaking and presentation curriculum at any residency program.
  • Learn how everyday technology such as smartphones can be used to augment the presentation curriculum.
  • Understand the important components of effective (but not necessarily positive) feedback.

Benjamin S. Vipler, MD
Gregory Condos, MD
Ashley Fang, DO
Naval Medical Center (Portsmouth) 

411. Osteopathic Recognition: Enhancing Your Internal medicine Trainees’ Experience 

Steven V. Angus, MD, FACP
Jaclyn Cox, DO, FACP
University of Connecticut School of Medicine 

Don Nelinson, PhD
American College of Osteopathic Internists 

412. How to Make Fellowship Recruitment More Successful by Decreasing Tension for Applicants

This workshop will discuss the results of a national survey of fellowship applicants experiences during the 2016 recruitment season, to include prevalence of inappropriate questions and applicant patterns. Fellowship recruitment is a high-stakes process for both applicants and faculty. All want to achieve the “best fit” of previous training, personalities, and goals and objectives. There are multiple considerations for the applicants besides the qualities of the training at a particular program, including preferred geographic locations, opportunities for significant others and their families, and whether they feel comfortable in that training environment, which contribute to make the application process a tense experience. There are codes of conduct that are intended to decrease the likelihood of interview and post-interview questions that may enhance tension or discomfort of applicants. This workshop will provide background information about the reports from the 2016 season, and then will break into small groups to discuss faculty interview strategies, approaches to recruitment that may decrease costs and increase comfort for applicants, and how to share these techniques at your home institution.

Educational Objectives:

  • Explore ways to educate faculty members about interview skills that are consistent with requirements.
  • Explore ways to streamline the recruitment process that can enhance comfort of applicants.
  • Explore ways to educate faculty about these new techniques.

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

Richard I. Kopelman, MD
Tufts University School of Medicine 

Teresa K. Roth
David Geffen School of Medicine
at the University of California, Los Angeles 

Michael Frank, MD
Medical College of Wisconsin 

413. Evidence Based Education: Medical Knowledge Acquisition and Associations with Patient Relevant Outcomes

Furman S. McDonald, MD, MPH
American Board of Internal medicine 

414. Sub-I QI Curriculum: Longitudinal Project Work for Lasting Change and Learning.

Integrating quality improvement (QI) is a recognized deficit in medical education. Initiatives such as the AAMC Teaching for Quality (Te4Q) exemplify a push for integrating QI. Many institutions have struggled to successfully implement QI education, particularly with project work. There are, however, emerging strategies for medical school and health system collaboration involving students in QI projects that transform clinical environments and processes.

We have developed a longitudinal QI curriculum, which involves identifying QI projects that are aligned with the goals of the health system and targeting problems with data support and opportunities for intervention. The highlight of this curriculum is it helps prepare students to be well-rounded physicians that participate in health care more broadly and does so through two mechanisms. First, the project occurs while students are busy clinically modeling how practicing physicians can be involved in clinical systems improvement. Second, students share their findings and provide specific recommendations through formal oral presentations and written executive summaries. Using a validated learner assessment tool, the QIKAT-R the curriculum can be easily evaluated. Ultimately, this approach engages learners and teaches QI, an ACGME milestone across multiple specialties, and a critical skill for residency and eventual practice.

This workshop helps attendees understand the importance of engaging learners in QI project work that contributes to a larger vision, teaches how to successfully implement a project focused QI curriculum, and provides a framework for learner assessment and program evaluation.

Educational Objectives:

  • Describe how best to create and implement a longitudinal educational quality improvement project sequentially across groups of learners.
  • Identify key project characteristics and teaching behaviors necessary for successful implementation of a longitudinal quality improvement project for sequential groups of learners.
  • Use the QIKAT-R for assessing QI knowledge gained during the project to inform program evaluation.

Tyler Anstett, DO
Adam Trosterman, MD
Juan N. Lessing, MD
Samuel Porter, MD
University of Colorado School of Medicine

415. Student-Centered Resilience Skills Education during Clerkship Training

The rates of burnout and depression are high among medical students. Burnout in students has been correlated with depression and a less positive perception of the learning environment. Depressive symptoms have been attributed to stress from the medical school environment more than personal stressors alone. Resilience is the ability to cope well with adversity and can be learned. Fostering resilience therefore is a promising way to mitigate the negative effects of stressors, prevent burnout, and help students succeed after difficult experiences. Because medical students encounter new, salient stressors and experience burnout during their clinical years, resilience skills can be particularly helpful for clinical experiences.

This interactive workshop will define resilience, highlight common stressors that medical students encounter during their clinical training, and engage participants in creating curricula to enhance resilience and wellness during clinical clerkships. Participants will work in small groups to brainstorm stressful events that students encounter and the learning environments in which they are encountered. We will regroup to discuss student perceptions of stressors in the clinical learning environment, including patient deaths, straining team dynamics, disappointment, and uncertainty. We will highlight potential topics to target in clerkship wellness curricula from student data and group discussion. Small groups will then brainstorm feasible ways to design and align resilience skill curricula with specific clerkship content and anticipate barriers to implementation. Finally, we will share our experience developing reflective resilience skill-based workshops and using technology and social media during clerkships to promote wellness.

Educational Objectives:

  • Identify encounters and experiences that students identify as distressing during clinical training.
  • Describe practical resilience skills useful during clinical training to help students overcome challenges.
  • Identify curricular methods and platforms to implement wellness curricula during clinical training.

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

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

416. Walking the Walk: Using Simulation to Teach Health Equity

Approximately 20 million Americans are members of underserved populations that face significant health disparities. Underserved populations represent diversity in terms of location, race/ethnicity, and economic resources. The Liaison Committee on Medical Education (LCME) requires medical schools to provide opportunities for medical students to learn and recognize how diverse cultures and belief systems impact the health care delivery process. In addition, LCME wants students to recognize health disparities and to understand the importance of working with the medically underserved. Many institutions have begun work on creating curriculum on reducing health disparities; however, it can be challenging to develop engaging experiential learning activities.

This workshop will use a combination of expert presentations, simulations, and large group discussions to examine strategies to incorporate simulation experiences into a health disparities curriculum based on experiences at Wake Forest University School of Medicine and Emory University School of Medicine.

After a brief introduction, we will perform a language barrier simulation and share strategies on how it could be implemented in a curriculum. Attendees will participate in a health equity simulation, which is an experiential learning activity in which participants take on the role of a member of the community and experience challenges in a patient’s life through learning tasks, research, and reflection. Participants will learn about several strategies to teach students about how privilege and power can affect our lives—even when we are not aware—through several interactive activities. At the conclusion, participants will receive several strategies to incorporate simulation in their health disparities curricula.

Educational Objectives:

  • Appreciate simulation as an experiential and innovative tool for exposing medical students to different cultures and demographics and teaching about health equity and the social determinants of health.
  • Experience a simulation first-hand as a method of faculty development and leave with a concrete example of how to incorporate simulation teaching for medical students.
  • Gain comfort teaching about sensitive topics and be prepared for potentially challenging but important conversations with students that result from simulations.

Nancy M. Denizard-Thompson, MD
Deborah Ann Griffith, PhD
Wake Forest School of Medicine of Wake Forest Baptist Medical Center

Maura George, MD
Jada C. Bussey-Jones, MD
Emory University School of Medicine 

417. Time for a Change: Innovation in the Subinternship

Earlier residency applications, increased patient complexity, growing prevalence of hospitalist educators, and reduced availability of clinical rotation spots for students have pushed Sub-I directors to explore new and unique rotations for sub-I. This workshop is a resource for educational leaders who are interested in exploring options beyond a traditional subinternship on a ward medicine service. Topics include incorporating sub-I into resident-uncovered hospitalist teams, interprofessional collaboration with advanced practice providers (APPs), nighttime rotations, and unique formal curricula, including low-tech simulation.

Educational Objectives:

  • Identify four innovations in the subinternship, including integration with APPs, night time rotations, and formal curricula.
  • Address common barriers to implementation of unique subinternship rotations.
  • Identify concrete ideas for implementing unique subinternship rotations.

Valerie J. Lang, MD, MHPE
University of Rochester School of Medicine and Dentistry 

Susan Merel, MD
University of Washington School of Medicine 

Sarah E. Ahrens, MD
University of Wisconsin School of Medicine and Public Health 

Adam M. Garber, MD
Virginia Commonwealth University School of Medicine 

418. How to Improve Your Surveys for Trainee and Programmatic Evaluations in UME and GME: You Can’t Fix with Analysis What You Have Bungled by Design

Surveys remain one of the most commonly utilized study design methodologies in medical education research, and data from these surveys are often relied upon by medical educators around the world. Despite this broad use, there is little guidance or standardization regarding best practices of survey design. Additionally, the tenets of good survey design can easily be applied to the development of both trainee and programmatic evaluations, but are rarely, if ever, utilized for this purpose. It will be increasingly important to develop accurate and appropriate scales to address learners in both UME and GME with the goal of creating actionable items in well-defined domains to enhance the education process. The initial portion of the workshop will feature a brief introduction to a seven-step process for survey design. Participants will then have the opportunity to discuss various constructs related to the study of medical education and to develop evaluations in a small group setting. Participants will actively engage in the development of an appropriate survey scale to assess a specific construct related to learner ability or program evaluation. Emphasis will be placed on creating a valid and reliable survey scale in addition to identifying common mistakes that occur in writing survey items and how that impacts survey and evaluation results. Lessons learned from the small group activity will be shared with the entire group, emphasizing common themes that arise during this initial development phase of survey design. Finally, the benefits of expert validation, cognitive interviewing, and pilot testing will be discussed.

Educational Objectives:

  • Demonstrate an understanding of basic survey design techniques.
  • Develop survey items from an appropriate construct.
  • Critically appraise survey items and construct development.

Jeffrey LaRochelle, MD
National Capital Consortium 

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

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

Saima Chaudhry, MD
Memorial Healthcare System (Hollywood, FL) 

419. How to Play in the Same Sandbox: Using Improvisational Theater to Teach Interprofessional Communication Skills

During professional training, we learn how to speak the language of our discipline; however, most of the work we will do after training is interdisciplinary. In the health professions, the lack of quality interprofessional communication and teamwork contributes to medical errors. Equally important is the benefit professionals get from forming supportive relationships with those who are with them in high stress hospital and clinic environments. The IPEC competencies have helped medical educators codify what it means to be proficient in the areas if interprofessional communication and teamwork; now we need to investigate how best to teach these skills. We use improvisational theater to teach health professionals collaborative communication skills and have fun doing it! This session is an opportunity to engage in hands on exploration of these techniques.

Participants will take part in activities designed to help them discover their own communication patterns and practice making other choices in the moment if their patterns are not working in any communication scenario. We will play improv games, write, and debrief together.

Educational Objectives:

  • Name the rules of improv and explain how improv is related to collaborative communication.
  • Understand, through discussion and reflection, how practicing complex communication tasks can increase skill in even a brief time.
  • Lead several quick improv games with your own students, colleagues, and/or friends; and design games that would fit in their own context and content using the rules of improvisational theatre.

Amy B. Zelenski, PhD
Shobhina G. Chheda, MD, MPH
Mariah Quinn, MD
Samantha Murray-Bainer, MD
University of Wisconsin School of Medicine and Public Health 

420. Navigating Crucial Conversations: How to Survive “Rough Seas” as an APD

Associate program directors (APDs) are often called upon to manage difficult conversations and conflicts with little training. These skills are frequently called upon during difficult and crisis moments, which make on-the-job training ill-timed and challenging. As a result, these crucial conversations often result in poorer outcomes than anticipated for multiple parties. In this interactive workshop, we will train attendees to recognize when conversations are crucial or high stakes and provide them with strategies on how to initiative the discussion around these crucial topics. Examples of strategies include focusing on what you want, looking for when the conversation becomes crucial, and how to identify and guarantee safety during the conversation. These strategies will be introduced via knowledge bursts followed by small group work in which attendees will be apply these strategies using simulated scenarios reflecting the common conflicts that arise in graduate medical education. Mid-career leaders from this workshop team will provide reflective comments and perspectives gained through personal leadership experiences, as well as from their experiences mentoring emerging leaders. At the conclusion of this workshop, attendees will acquire strategies to address crucial conversations and will develop their confidence to become a successful leader in graduate medical education through the ability to thoughtfully and effectively manage conflict in their career.

Educational Objectives:

  • Identify sources of conflict in graduate medical education.
  • Successfully plan a strategy to start a crucial conversation.

Jonathan L. Tolentino, MD, FAAP, FACP
Stony Brook University School of Medicine 

Benjamin Kinnear, MD
Jennifer K. O'Toole, MD
University of Cincinnati College of Medicine 

Alda Maria R. Gonzaga, MD
University of Pittsburgh School of Medicine 

Workshop Session V
Tuesday, March 20, 2018
3:00 p.m. to 4:30 p.m.

501. Present to Persuade

Jose Rosario Garcia
Dale Carnegie Institute 

502. Transforming Operations and Physician Engagement in an Academic Outpatient Practice: A Commitment to Lean Management

Have you struggled with overcoming academic entitlement to achieve significant improvement in a faculty practice? This outpatient academic clinic shares the keys to their success in moving from chaos to quadruple aim performance by pursuing a lean transformation, based on the principles of “respect for people” and relentless “continuous improvement.”

Lean has made patient lives better, our staff lives better, and our physician lives better. In addition to the improvement in the metrics, the culture of lean process improvement is now entrenched in clinic, manifest by daily huddles, visual management of metrics for the staff and physicians, weekly value stream steering teams directing on-going improvement efforts, and successful transition of our staff into care teams for each of our sub-specialties. The lean management system implementation can be the methodology to achieve the quadruple aim in an academic medical specialty outpatient clinic. Leaders, staff, and physicians in the clinic and the medical group have learned to trust the process as they have witnessed breakthrough improvements in their outpatient clinical workflow.

Educational Objectives:

Upon completion of this activity, participants should be able to…

  • Understand the leadership behaviors and attributes that are key to moving from physician resistance to engagement.
  • Identify key factors in driving meaningful change to clinical operations in an academic outpatient subspecialty clinic.
  • Implement processes for metric-driven workflow redesign with a principle-based Lean management approach.

Sylk Sotto, EdD, MBA, MPS
Lee McHenry, MD
Mike Ober, MD
Indiana University School of Medicine 

503. “The Pipeline Is Still Leaky”: Mentoring Schemes for Success for Women in Academic Medicine

Approximately half of all medical school matriculants have been women since 2001. However, women account for only 21% of full professors and 24% of division chiefs. This phenomenon has been referred to as the “leaky pipeline” of medicine. Mentorship has been proposed as a tool to help foster female leadership. Mentorship is associated with improved work satisfaction, faculty retention, scholarship, and promotion, yet the optimal mentoring model has yet to be elucidated. In the traditional model, a mentee establishes a longitudinal relationship with a more senior mentor that would help to guide her. However, there are many barriers to this mentorship model, across all levels of training. To address these challenges to traditional models of mentorship, many institutions have implemented novel mentorship programs.

In this workshop, we will describe the results of a literature review detailing the benefits of mentoring, gender issues in mentorship, and components of an effective mentoring relationship. We will then discuss mentoring models that have been successfully implemented and the results of such programs as well as describe methods that have worked at our home initiations. Participants will have the opportunity to discuss facilitators and barriers they have encountered in developing sustainable mentorship for themselves and their female faculty, residents, and students. We will then brainstorm ways to implement successful mentorship models. While we will spotlight strategies that focus on mentorship of women, these principles can be applied to both genders. We encourage mentors and mentees to attend, especially men who mentor women.

Educational Objectives:

  • Describe importance of mentorship for women in academic medicine and gender issues in mentorship.
  • Understand the different mentoring models and benefits and disadvantages of each.
  • Strategize generalizable methods to implement successful mentoring models for female faculty, residents, and students.

Eliana Bonifacino, MD
Jennifer Corbelli, MD
Sarah Tilstra, MD
University of Pittsburgh School of Medicine 

Jennifer Rusiecki, MD
University of Chicago Division of the Biological Sciences
Pritzker School of Medicine 

504. Swimming with the Sharks: Teaching Residents Value-Based Medicine through Resident-Led, Faculty-Mentored Projects

We created an innovative value based medicine (VBM) curriculum to integrate quality, patient safety, and cost-awareness into an interactive project development and implementation plan that is led by housestaff with faculty mentorship. Housestaff are expected to incorporate considerations of value and risk-benefit analysis in patient care as part of the ACGME systems-based practice competency. Quality improvement and patient safety have, however, traditionally been taught in a siloed fashion outside the clinical and financial operations of the medical center. Our approach provides support from institutional leadership in quality, safety, and value as well as the informatics and financial departments to align housestaff innovations in care delivery with system-wide VBM initiatives. Over two weeks, residents develop their own VBM projects with faculty mentorship. Each project is provided with institutional quality and financial data to help establish realistic and meaningful goals for the intervention, and then subsequently presented to hospital leadership in a “Shark Tank” style pitch.

The format for this workshop will be a brief presentation to introduce key concepts, followed by interactive small group sessions where participants will work on mock-projects, and finish with a wrap up including participants experience and some practical advice on how to implement this curriculum.

Educational Objectives:

  • Translate housestaff observations of their work environment into quality improvement and value projects.
  • Use process mapping to identify potential system solutions.
  • Utilize institutional data to evaluate the quality and cost impact of a proposed solution.

Kerrilynn Carney, MD
Yale School of Medicine 

Kevin Hauck, MD
Albert Einstein College of Medicine 

Matthew Durstenfeld, MD
Andrew Dikman, MD
New York University School of Medicine 

505. Social Determinants of Health, Unconscious Bias, and the Internist: An Introduction to Addressing Health Inequities in Practice

Internists play key roles in influencing health care access and health care delivery and can help enhance patients’ sense of dignity during treatment. Vulnerable populations are at risk for health inequities owing to socio-economic or social characteristics such as race, culture, gender, age, sexual orientation, disability status, religion, language or insurance status. These populations experience higher rates of hospital utilization, lower access to outpatient care services, and higher death rates from low mortality diseases. The ability to provide high quality care to vulnerable populations is a core competency and requires specific knowledge and skills. How do we prepare to treat patients from diverse backgrounds effectively?

Unconscious biases, defined as assumptions, attitudes, or stereotypes that are often inaccessible to conscious awareness, affect both health care delivery and the patient/provider experience and relationship. To address issues of health inequities more effectively, internists and other health professionals need first to understand the role that social determinants of health and unconscious bias play in their daily care of patients. This understanding can lead to the adoption of practices that discourage and reduce the negative effects of unconscious bias; the process may also enrich a clinician’s sense of meaningful work and professional efficacy.

This workshop will fully equip participants with a framework that broadens their understanding of social determinants of health and unconscious bias and explore the role that these factors can have in achieving equitable high-quality patient care. We will share practical tools and strategies that can facilitate our role as effective clinicians for diverse patients.

Educational Objectives:

  • Define and characterize structural vulnerabilities and social determinants of health.
  • Utilize an enhanced social history tool that has been designed to expand understanding of patients values, social context, and potential barriers to accessing medical care.
  • Objectively discuss unconscious bias and our attitudes and behaviors related to factors such as race, ethnicity, and culture; explain how they may impact quality of care, clinical outcomes, and education of trainees.

Jonathan T. Crocker, MD, FHM
Leonor Fernandez, MD
David A. Cohen, MD
Daniele Djenaba Olveczky, MD
Harvard Medical School Beth Israel Deaconess Medical Center 

506. Precepting the Preceptors - Bringing Precepting Frameworks into the 21st Century

As the balance of patient care and trainee education shifts towards the outpatient setting, it is imperative to give graduating residents and new faculty skills to provide expert teaching simultaneously with superior patient care. Additionally, junior faculty and trainees approach medicine as digital natives, eager to enhance learning through technology. In this workshop we provide participants with multiple innovative strategies for impactful precepting, which can be adopted by clinic directors and ambulatory faculty to create training for junior faculty as well as a precepting curriculum for senior residents.

We will discuss the use of online and educational technologies to enhance precepting and extend the reach of the preceptor. We will begin by facilitating a large group discussion exploring challenges in ambulatory precepting. We will poll attendees regarding ongoing faculty development, junior precepting initiatives, and technology integration that address clinic challenges. Precepting models, including SNAPPS and the one-minute preceptor, will be discussed and role-play will be used to demonstrate these techniques. We will then discuss incorporating technology through online resources, clinical decision aids, and electronic accountability to enhance precepting. We will have a large group discussion about utilizing resources such as twitter, blogs, and journal watch to help motivate self-directed learning. Using small group break-out sessions, we will explore select electronic tools and attendees will brainstorm how they might enhance teaching/learning at participants’ home institutions. We will reserve the end of the session for a question/answer session to share successes and best practices.

Educational Objectives:

  • Teach faculty frameworks for organizing outpatient precepting that can be incorporated into daily practice.
  • Plan how to integrate technology and online resources during precepting.
  • Brainstorm ways to incorporate these tools into a faculty development session at your home institution.

Rebecca Lauren Davis, MD
David Aizenberg, MD
Corrie A. Stankiewicz, MD, MSEd
Rani Nandiwada, MD
Raymond and Ruth Perelman School of Medicine
at the University of Pennsylvania 

507. Evidence-Based Physical Diagnosis: Developing a Curriculum for Residents

It is widely recognized that diagnostic examination skills have declined over the last 50 years. Some of this decline is due to the widespread use of superior technologies of diagnosis, but it is also clear that trainees are losing valueable bedside diagnostic, in part because of reduction in the frequency of dedicated bedside teaching by faculty. This decline has fueled a contemporary reaction (e.g. Abraham Verghese’s “Stanford 25” program,) that seeks to preserve and develop traditional techniques essential to excellent patient care while exploring new technologies (such as point-of-care ultrasound) that extend the range of diagnoses that can be made at the bedside.

Four years ago, our residency program began developing a curriculum in evidence-based bedside diagnosis, which is mandatory for all Internal medicine residents, and during which they are protected from all other obligations. Each resident completes 12 bedside diagnosis sessions during their three-year residency, taught by an experienced faculty member and a chief resident working in tandem. Residents learn about high-yield findings for which a favorable evidence base exists and then practice their technique on real patients with pathological findings that are unknown to the residents.

During this workshop, we will describe the process of developing this curriculum, demonstrate a model session, and present data demonstrating that housestaff confidence in their skill at bedside diagnosis has improved since the implementation of the curriculum

Educational Objectives:

  • Understand the importance of teaching bedside diagnosis to Internal medicine trainees.
  • Accurately evaluate the evidence-base pertaining to a given physical finding or diagnostic maneuver.
  • Outline a plan for developing a curriculum in evidence-based bedside diagnosis at their home institution.

Nick Nelson, MD
Indhu Subramanian, MD
Tamsin Levy, MD
Alameda Health System-Highland Hospital 

508. Practical Tips for Mentoring Women of Color during Residency

This workshop will use personal experiences, small group breakout, and role play to help the audience gain a better understand challenges facing female residents of color and provide practical tools to help identify and correct mentorship gaps within their programs.

Educational Objectives:

  • Gain awareness of issues faced by women of color in residency, as well as ability to identify particular challenges within their own residency programs.
  • Develop a plan to improve open dialogue, support, and communication with female residents of color in their residency program.
  • Return to their programs with improved ability to mentor and sponsor female residents of color as well as gain practical tips for coaching female residents of color for leadership roles and self advocacy.

Holli Sadler, MD
Raquel Lyn, MD
Gloria Oyeniyi, MD
Beth Miller, MD
University of Texas at Austin Dell Medical School 

509. Resuscitation Is Not Just for Annie, Programs Need It Too

Substantial growth in graduate medical education due to the single accreditation system and high demand to increase physician supply has led to a rise of applications for initial ACGME accreditation. Significant effort goes into sustaining a successfully accredited training program. Program directors who have had a negative outcome from an ACGME site visit receive little guidance on how to address a poor outcome and have limited opportunity to remedy their challenges prior to a follow-up visit in order to maintain their accreditation. In this workshop, participants will develop a strategic plan to address concerns and re-invigorate their program to put it back on the pathway to success. After introductions to ascertain participants experiences with ACGME site visits, the session will begin with a description of strategies the facilitators have used to address challenges that were revealed during a visit and after receipt of the review committee’s letter. Next, small groups will be formed to address sample scenarios which include citations and concerns raised by ACGME to formulate a strategic plan. The groups will debrief their approach with all attendees. Finally, the large group will develop a stepwise protocol to manage these difficult situations. The take-home strategies developed by participants will be compiled and shared after the meeting.

Educational Objectives:

  • Strategize how to address ACGME citations.
  • Develop creative solutions to revitalize a troubled training program.
  • Prioritize efforts for program improvement.

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

510. Thinking Outside the Visit: Innovative Ways to Engage Trainees in Panel Management

Panel management, or population health, is a proactive approach to the care of a medical community. It provides a means of caring for all patients in a community and not simply those that present for office evaluation. During residency, Internal medicine trainees spend approximately a third of their time in the outpatient setting with the majority being in direct patient care encounters. However, there are few formal panel management curricula for residents. The existing studies in UME literature focus on didactic teaching that is not easily adaptable to the GME setting, where trainees are actively caring for their own continuity panel. Few published educational interventions exist that highlight innovative ways to engage residents in panel management by leveraging the electronic health record.

During this workshop, we will define panel management and review reactive versus proactive patient care in ambulatory residency training. In small groups, participants will share their experiences with panel management and brainstorm areas where proactive patient care exists in their own institution. We will then review our approach to developing resident report cards on quality metrics and highlight innovative ways to use the electronic medical record to provide real-time panel management data. In groups, participants will brainstorm areas to incorporate panel management at their own institution and anticipate barriers to trainee engagement or implementation. We will then share our experiences teaching panel management in a hands-on clinical setting that allows for experiential learning, including common pitfalls and our tips for success.

Educational Objectives:

  • Define panel management and explain the differences between reactive and proactive patient care.
  • Develop a framework for teaching panel management in an Internal medicine residency clinic.
  • Describe ways to leverage the electronic medical record to engage residents in panel management.

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

Julie L. Oyler, MD
University of Chicago Division of the Biological Sciences
Pritzker School of Medicine 

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

511. Use Balint to Bust Burnout

What is your program doing to help combat burnout and teach residents to deal with challenging patients? Consider adding Balint groups to your resilience curriculum! Balint groups provide a structured format to practice empathy and gain a better understanding of the doctor-patient relationship. In Balint groups, a group member shares a case of a challenging patient relationship and allows the group to explore what the doctor and patient may be feeling and why.

In this workshop, participants will learn the Balint structure and then participate in a live Balint group lead by workshop faculty. Through group practice and debriefing, workshop participants will learn introductory skills to become Balint group leaders at their institution. Participants will discuss ways to incorporate Balint groups into their curricula and learn about opportunities for additional training. Could Balint help teach your residents to manage uncertainty, increase empathy for patients and colleagues, and get them “unstuck” from a difficult case? Let’s find out together.

Educational Objectives:

  • Describe Balint group structure and purpose.
  • Practice the Balint structure and process through participation in a group followed by debriefing.
  • Discuss how Balint groups can be incorporated into a residency program.

Megan Lemay, MD
Thomas Iden, MD
Virginia Commonwealth University School of Medicine 

512. Internal medicine Subspecialty Milestones: Where We Started, Where We Are, and Where to Next

Eric S. Holmboe, MD, MACP, FRCP
Accreditation Council for Graduate Medical Education 

513. The Value of Additional Academic Degrees for Faculty Leadership Opportunities


514. Looking at Clinical Reasoning Assessment and Evaluation through an EPA Lens

Learning how to practice sound clinical reasoning is fundamental to a medical student’s education, yet the complexity of the process of clinical reasoning makes both assessment and evaluation challenging. To address this multi-faceted skill, medical educators often employ a variety of standardized and workplace-based assessment methods to guide learners toward proficiency with different strengths and weaknesses. Recent reports from AAMC on the implementation of EPAs in undergraduate medical education present an opportunity for educators to re-evaluate their own methods of assessing and evaluating clinical reasoning and documenting milestones.

In this workshop, attendees will have an opportunity to collaborate with and learn from one another in how to optimize clinical reasoning assessment and evaluation across the undergraduate learner continuum. First, we will provide a brief review of the literature on standardized and workplace-based assessment tools and examine how each fits within the context of EPAs. Next, participants will divide into two large groups focused on either preclinical or clinical learners, and the remainder of the workshop will be split into two halves. In the first half, attendees will discuss strengths and weaknesses of their current assessment practices. For the latter half, groups will brainstorm innovative models of assessment in smaller groups, each charged with implementing a different method for assessing clinical reasoning at their hypothetical institution.

Educational Objectives:

  • Identify several evidence-based tools for the assessment and evaluation of clinical reasoning and how they can be utilized in the context of EPAs.
  • Reflect on strengths and weaknesses of clinical reasoning assessment and evaluation techniques across institutions.
  • Empower participants to take the lessons learned from other institutions to improve their own clinical reasoning assessment and evaluation curricula.

Jason Alexander, MD
Amber Pincavage, MD
University of Chicago Division of the Biological Sciences
Pritzker School of Medicine 

Irene Alexandraki, MD, MPH
Florida State University College of Medicine/Tallahassee Memorial Healthcare 

Jeffrey LaRochelle, MD
National Capital Consortium 

515. Addressing Implicit Bias in Medical Education—Works in Progress

Implicit (unconscious) bias is universal. As medical leaders it is incumbent upon us to both understand and adapt to biases that could undermine our attempts to optimize patient care and educational training programs. While we are unaware of definitive proven strategies for recognition and mitigation of implicit bias, many institutions have initiated multi-pronged programs with these goals in mind. This workshop seeks to share a series of those ongoing projects and to use the AAIM community to reflect upon, and improve upon, those projects.

Our primary hope is that attendees will leave enriched and inspired by the ongoing works, with specific ideas for interventions or discussions to be held at their own institutions. Materials specific to the more successful ongoing programs would be prepared as deliverables; it is hoped multi-institutional collaborations will spring from the group.

Educational Objectives:

  • Recognize implicit bias in themselves and the larger work environment, and understand its potential effects on medical education and patient care.
  • Learn about ongoing projects designed to recognize and mitigate the impact of implicit bias at several educational institutions.
  • Participate in small group discussions designed to promote design and early implementation of such programs at their own institutions, in collaboration with other workshop attendees.

Todd D. Barton, MD
Marisa Rogers, MD
Raymond and Ruth Perelman School of Medicine
at the University of Pennsylvania 

Sarah C. Schaeffer, MD
Rene Salazar, MD
University of California-San Francisco School of Medicine

516. Preventing a Failure to Communicate: Introducing the New AAIM Subinternship Curriculum

The subinternship continues to be a vital component of a dynamic fourth year that is expected to bridge medical school to residency. The CDIM subinternship curriculum was updated in 2017 to focus on four specific skills identified by program directors as essential for graduating medical students to achieve prior to starting residency. The four skills are recognizing sick v. non-sick patients, knowing when to ask for assistance, managing time wisely, and communicating effectively within health care teams. While there are a wide array of elective courses available in the fourth year, the subinternship is the ideal venue for development of these skills given the authentic nature of this rotation.This workshop will focus on the portion of this curriculum that is dedicated to the topic of Communicating Effectively in Health Care Teams. The four specific skills as identified by program director are also covered in four of the thirteen EPA. Participants in this workshop will review the new curriculum and brainstorm to develop materials to teach specific types of communication including transfer/accept notes, discharge summaries, and cross-cover notes. We also will also work with participants to identify ideal methods of assessing these skills in the learners.

Educational Objectives:

  • Review the new CDIM subinternship curriculum centered on the skill of communicating effectively in health care teams.
  • Develop specific educational activities to deliver the new curriculum to subinterns.
  • Identify assessments to evaluate subintern communication skills.

Nadia J. Ismail, MD, MPH, MEd
Baylor College of Medicine 

Allison H. Ferris, MD
Drexel University College of Medicine 

Emily Stewart, MD, FACP
Sidney Kimmel Medical College at Thomas Jefferson University 

T. Robert Vu, MD
Indiana University School of Medicine 

517. Small Initiatives, Big Impact: Low-Effort, High-Yield Innovations in Promoting Wellness

Burnout is highly prevalent among physicians and may start during medical school and persist throughout the post-graduate years and into practice. AGCME has recognized the importance of improving trainee wellness in an attempt to prevent burnout, which is now a required mandate for training programs based on ACGME regulations. Programs may struggle to find ways to incorporate wellness initiatives based on limitation of resources. Workshop attendees will learn about unique low-cost initiatives that can be adapted and easily incorporated into any training program. Participants will then break into small groups and be given case scenarios illustrating common wellness issues encountered at various institutions. The groups will work together to come up with low-effort, high-impact initiatives to improve the issues at hand. Small groups will present their ideas to the larger audience.

Educational Objectives:

  • Summarize ACGME requirements on monitoring wellness within a training program.
  • Illustrate low-effort, high-yield wellness initiatives at three different institutions.
  • Practice addressing wellness concerns by developing low-effort, high-yield innovations for presented scenarios.

Amy S. Oxentenko, MD, FACP, FACG, AGAF
Mayo Clinic College of Medicine 

Laura Cashin, DO, FACP
Paul L. Foster School of Medicine Texas Tech University Health Sciences Center 

Rakhee K. Bhayani, MD
Washington University in St. Louis School of Medicine 

518. Disseminating Your Work: Writing High Quality Abstracts

Dissemination of innovations and research in medical education is essential for advancing the field and for personal professional growth and recognition. Having work accepted for presentation at regional or national meetings typically requires the submission of an abstract which then must undergo peer review. An abstracts which is poorly written may result in rejection of high quality work and a missed opportunity to share creative ideas. This workshop will guide participants through theoretical points of abstract writing with immediate practical application of skills.

Educational Objectives:

  • Review literature-based recommendations for writing abstracts.
  • Analyze published abstracts, attending to both content and structure.
  • Apply skills to writing and providing peer feedback on an abstract.

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

Amy Shaheen, MD, MSc
University of North Carolina School of Medicine 

Workshop Session VI
Wednesday, March 21, 2018
10:15 a.m. to 11:45 a.m.

601. AIM Special Interest Group: Division Administrators

Nancy Masucci
Unviersity of Alabama School of Medicine 

602. AIM Special Interest Group: Chief Administrative Officers
603. Healthcare Hackathons: Promoting Team-Based Quality Improvement in Graduate Medical Education

The term “hackathon” was first coined in 1999 by computer programmers. The concept of team-based problem-solving competitions has been part of continuing medical education since the early 1970s. Hackathons align with increasingly popular team-based methods in medical education such as team science, problem-based learning, simulated case learning, and case competitions. Health care hackathons begin by defining important problems and identifying specific pain points. New teams form and then bond as they iterate solutions and develop a final pitch to promote their final design. Each team’s innovative solution is then pitched to expert judges, and finalists are selected. Winning projects are supported through successful implementation and outcome measurement. At Wake Forest School of Medicine, we have hosted two health care hackathons in 2016 and 2017 involving residents and fellows in interprofessional teams (with nursing, physical therapy, pharmacy, chaplaincy, and case management) to address major issues facing our health system.

This workshop will use a combination of expert presentations, small group break out sessions, and large group discussions to examine strategies to implement a hackathon to teach quality improvement techniques. The workshop will begin with a brief introduction and review of the literature on hackathons. Participants will take part in a hands-on “mini-hack” to experience the initial “pitch” stage of a hackathon.Through this workshop, we will share this highly innovative approach to enhance education, interprofessional teamwork, and quality improvement for learners in graduate medical education.

Educational Objectives:

  • Review recent trends in health care hackathons for team-based problem-solving.
  • Describe benefits of the use of hackathons as an experiential teaching strategy for interprofessional graduate medical education.
  • Outline hackathon design stages to replicate at your home institution.

Hal H. Atkinson, MD
Nancy M. Denizard-Thompson, MD
Kirsten Feiereisel, MD
Christopher Jones, DrPH
Wake Forest School of Medicine of Wake Forest Baptist Medical Center 

604. Advancing Resident Clinic with Advanced Practice Providers

Ambulatory medicine is an integral component of Internal medicine education for all residency programs. However, the balance of residency training is heavily weighted towards inpatient rather than outpatient, and it creates unique challenges for continuity clinic sites. Most residents frequently rotate in and out of clinic for large gaps of time, making it difficult to ensure patient-physician continuity and provide consistent high quality care to resident patients. Our home institution has about 120 residents, each of whom serve as PCP for 70 to 100 patients. In an attempt to improve the continuity, quality of care, and health outcomes of our resident patients, our program has integrated advanced practice providers (APPs) into resident clinic. At this workshop, we will present the history of our experiences and evolution of the APP role in co-managing patients with residents. We will describe initiatives we have instituted in our clinics where APPs are integral players in group visits, panel management projects, and care coordination of complex patients who are high-utilizers of health system resources. We will explore the challenges we have faced, the impact of those efforts on patients and trainees, and lessons learned along the way. Following brief presentations, the majority of the workshop will be in small groups where participants will brainstorm how to introduce or better utilize existing APPs in resident clinics at their home institutions.

Educational Objectives:

  • Describe strategies for integrating advanced practice providers (APPs) into an outpatient resident clinic practice logistically and culturally.
  • Review experiences and data from initiatives which incorporate APPs in co-management of resident patients.
  • Explore how APP integration can enhance resident panel management to improve continuity and affect outcomes. 

Marguerite Balasta, MD
Jennifer Kraft
Pennsylvania Hospital of the University of Pennsylvania Health System 

Eric Palecek, MD
Abbey Vij, MSN
David Aizenberg, MD
Raymond and Ruth Perelman School of Medicine
at the University of Pennsylvania 

605. Sharing Approaches That Work: Key Steps in Designing a Global Health Program

There is growing interest in global health (GH) education, with increasing importance to applicants during residency recruitment season. It can be daunting to create a GH program or to troubleshoot the challenges of an existing program in a silo. We would like to share our experience in partnering with several institutions (Oregon Health & Science University, Beth Israel Deaconess, University of Minnesota, and University of Botswana) to develop a successful GH curriculum at two large academic Internal medicine residency programs, including sharing barriers, successes, and ongoing challenges, and facilitate discussions on how other programs can be successful in developing GH education at their institutions. Utilizing small group activities in a workshop setting, we would like to help other programs explore ways to create or further develop a GH curriculum, with a focus on benefits of partnering with other institutions. We will start briefly by reviewing our history in creating a GH program, focusing on process and outcomes, followed by three small group breakout sessions that focus on needs assessment and identifying stakeholders, defining their ideal global health program and exploring barriers to achievement, and reviewing their current core curriculum and where they anticipate fitting in a GH curriculum i.e., asynchronous leaning versus creation of a “GH track.” Participants will create worksheets during this process and leave the workshop having formed relationships with other institutions and with clear next steps for how to proceed.

Educational Objectives:

  • Share the trials and successes of developing a global health (GH) program, from the perspective of two collaborating institutions.
  • Develop an action plan for establishing or improving an existing GH curriculum.
  • Create a collegial environment for establishing inter-institutional partnerships with programs looking to start a global health curriculum or partner with an existing program, and facilitate mentorship from programs with experience in GH.

Claire Zeigler, MD
Oregon Health & Science University School of Medicine

Jonathan T. Crocker, MD, FHM
Harvard Medical School Beth Israel Deaconess Medical Center 

606. Life beyond Program Director: What Happens Six Months to Five Years down the Line as DIO?

This workshop will provide participants with a short and long term view of life as a designated institutional official. We review how to find such roles, what to look for at the interview stage, and how to negotiate important elements of the job before accepting the offer. We present a timeline of important goals to set at the start of the job, at the two year mark, and at the five year mark. We will compare and contrast responsibilities for the DIO in University v. community settings and in established v. start-up programs. We will also explain how the stand alone DIO role differs in scope and size to that of the closely related chief academic officer role. An emphasis on the financial, regulatory, and legal expertise needed for the role will be touched upon. We will emphasize leadership skills and how to interact with the c-suite. Finally, in a small group activity, we will divide workshop participants into those who are definite about wanting the role, those who are pretty sure they want the role, and those who are unsure they want the role. Each small group will have a facilitator to provide more specific advice and mentorship to participants according to their stage in considering the job.

Educational Objectives:

  • Provide participants with an overview of the immediate, two year, and five year responsibilities they should expect to have if they transition from Program Director to DIO.
  • Compare and contrast what the role might look like in various settings and with various administrative structures.
  • Provide mentorship and advice in a small group setting to those potentially considering the role.

Saima Chaudhry, MD
Memorial Healthcare System (Hollywood, FL) 

Alwin F. Steinmann, MD, FACP
Saint Joseph Hospital 

Brian M. Aboff, MD, MMM
Virginia Commonwealth University School of Medicine 

Andrew C. Yacht, MD
Donald and Barbara Zucker School of Medicine at Hofstra Northwell 

607. Shame Resiliency: Moving from Perfectionism to Self Compassion Changing Our Medical Culture to Cultivate Authenticity

Learners training in medicine experience shame on a regular basis and struggle with perfectionism and people pleasing. While these tendencies might produce academic success, they can contribute to exhaustion, burnout, depression, and addiction. One study showed that 85% of learners remember something so shaming from their school experience that it changed how they think of themselves as learners. Shame is the feeling of being flawed and not good enough which leads to isolation and emotional distress. Shame resilience involves moving towards empathy and away from the fear, blame, and disconnection.

Participants will learn about Dr. Brené Brown’s Shame Resilience Theory which can be easily applied to medical education. They will hear stories from faculty and learners who have used the tools of identifying shame and shame resilience. By listening, participants may experience the power of diffusing the shameful experience.

Participants will then break into small groups and identify key parts of the stories that triggered shame. We will share our experience of implementing a curriculum at our institution. Small groups will also explore ways they can facilitate shame resilience at their institution. Participants will take away tools that can encourage connection, promote empathy for themselves and be used when coaching learners. We will brainstorm in small and large groups how to prevent a culture of shame in medicine.

Educational Objectives:

  • Appreciate the negative effects of shame experiences in medical education and its affect on burnout.
  • Discuss Shame Resilience Theory and how it can be used to help learners reflect on their challenging experiences.
  • Begin to develop a community of collaborators who will implement successful shame resilience curriculums at their institutions and share lessons learned.

Amy Hayton, MD
Amy Schill-Depew, MD
Suzannah Luhn RN, MSN, FNP-BC, PMHNP
Loma Linda University School of Medicine 

608. Developing the Future Leaders in High Value Care: Lessons from the HVPAA Future Leaders Program

Health care spending in the United States is consistently the highest in the world; however, outcomes are often far below other developed nations. Physicians are estimated to be responsible for up to 80% of national health care costs, and hold the greatest potential to create measurable improvements in value by orchestrating quality-driven programs to eliminate unnecessary practice and reduce variability. A physician’s ability to practice cost-conscious care has been linked to the residency program from which they graduate, underscoring the importance of integrating cost-conscious practice into training. In response to the health care financing crisis, the High Value Practice Academic Alliance (HVPAA) has developed a national curriculum and mentorship model for residents throughout the country: the Future Leaders Program (FLP). Residents in this program participate in a range of educational activities related to high value practice and are required to lead a value based quality improvement initiative at their home institution. Our workshop will use the FLP national model to help participants understand how they can develop their own residents into local high value practice leaders. Participants will gain an understanding of the projects that are popular with residents, the most effective interventions, and what barriers others have faced in implementing their high value practice curricula and quality improvement projects. Finally, the workshop will help participants identify strategies to mentor their residents through implementation barriers. At the completion of this workshop, participants will have the knowledge and tools necessary to empower residents at their home institution to become high value practice leaders.

Educational Objectives:

  • Recognize the importance of engaging residents in value-based quality improvement, as an effective means of preparing the next generation of physicians to become stewards of healthcare value.
  • Understand national resources available to support high value practice curricular.
  • Understand how to mentor residents in the process required for successful value-related quality improvement, including designing effective interventions, overcoming implementation barriers, and evaluating quality and safety outcomes.

Christopher J. King, MD
University of Colorado School of Medicine 

Remus Popa, MD
Riverside Community Hospital 

Kshitij Thakur, MD
Crozer-Chester Medical Center 

Venkata Andukuri, MD, MPH
Creighton University School of Medicine 

609. Speak “C Suite” to Negotiate Resources

Have you ever had a great idea that would improve patient care and enhance medical education, but couldn’t get the resources to implement or sustain it? In today’s world of diminishing resources and increasing expectations for quality and productivity, program directors must be able to speak the language of the “C suite” or dean’s office to justify organizational investment in projects. It requires a working understanding of the organization’s mission, vision, and strategic priorities; identifying metrics that speak to these priorities; and excellent negotiating skills. In this workshop, participants will work through familiar scenarios to advocate for resources for the educational program. To assist participants, the presenters will lead the groups in ways to identify the value that the educational programs bring to the priorities of the institutions. This workshop will provide participants with a worksheet to assist educational programs in developing data-driven project proposals aligned with their organizations’ priorities, and a strategy for negotiating the resources.

Educational Objectives:

  • Describe how to identify their organizations’ strategic priorities.
  • Communicate the purpose of a medical education project and its alignment with organizational priorities.
  • Demonstrate how to leverage language and data to negotiate for the resources to support their medical education project.

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

Susan Lane, MD
Stony Brook University School of Medicine 

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

Alpesh N. Amin, MD, MBA, MACP, SFHM, FACC
University of California-Irvine School of Medicine 

610. RRC-IM Update

Christian Cable, MD
Residency Review Committee for Internal medicine 

611. Faculty Development and Clinical Reasoning; A Toolbox for Engaging our Learners

In an effort to develop clinical reasoning skills in our learners, a fundamental understanding of the theory, semantics, and biases that drive the process of reasoning must be effectively mastered by the teachers tasked with the responsibility of training our clerkship students. The AAMC Clinical Skills report as well as the Institute of Medicine position statement addressed the importance of enhancing skills in diagnosis, with little prescriptive information on how best to do this. We have developed a methodology to enhance the skills of pre-clerkship students. This faculty development workshop is meant to serve as a resource for delivery in your own institution. It takes advantage of knowledge in the area of cognitive psychology (pattern recognition, hypothetico-deductive reasoning, dual-process theory, etc.), terminology (illness scripts, problem representation, etc.) and biases (anchoring, premature closure, etc.). An overview with a didactic presentation defining the above elements will serve as a reminder or an introduction to the basic concepts that define clinical reasoning. Following this update, small groups will convene staffed by a workshop facilitator. The participant will be able to utilize cases we furnish, and that are representative of what is encountered on the medicine clerkship, to diagnose a learners domain of clinical reasoning difficulty and to identify strategies to remediate them.

Educational Objectives:

  • Describe fundamental concepts in learning theory, clinical reasoning terminology, and common biases.
  • Recognize the five domains of clinical reasoning difficulty.
  • Use case examples to diagnose and remediate a medicine clerkship students gaps in clinical reasoning.

Joel L. Appel, DO
Wayne State University School of Medicine 

Roshini Pinto-Powell, MD
Geisel School of Medicine at Dartmouth 

Shanu Gupta, MD
Rush Medical College of Rush University Medical Center 

612. Learning Theory Redux: Putting Theory into Practice

In the clinical phases of their education, students and residents sometimes struggle to apply their well-developed book knowledge into hands-on practice. Additionally, learners face time constraints and a new rapid flow of information from their clinical experiences. More and more frequently, lectures are seen as an inefficient way to convey knowledge. Furthermore, written and verbal feedback often encourage learners to “read more” when more advanced strategies to assist learners in processing and retaining knowledge exist.

This workshop will provide much needed guidance on how to apply validated learning theories, like cognitive load theory, metacognition, spaced repetition, and deliberate practice into clinical learning situations. Our session will provide an overview of evidence-based learning theories and give attendees the opportunity to apply these learning theories in small groups with interactive discussion. By the end of this workshop, the participants will be equipped with multiple techniques to apply validated learning theories and to help their learners better retain the vast amount of information presented in diverse clinical settings.

Educational Objectives:

  • Apply cognitive load theory and metacognition to enhance medical education.
  • Modify their curriculum to incorporate more effective long-term learning strategies.
  • Teach using spaced repetition, deliberate practice, testing effect, and reflective practice.

Chad J. DeMott, MD
Shari Whicker, EdD
Emily Holt, MA
Virginia Tech Carilion School of Medicine 

G. Dodd Denton, MD, MPH
Ochsner Clinic Foundation 

613. Fostering Medical Decision Making in the Sweet Spot of Undergraduate Medical Education

In a recent report, “Improving Diagnosis in Healthcare,” the IOM identified diagnostic error as an important contributor to adverse patient outcomes and highlighted the urgent need for better training in decision-making at all levels. Although the demonstration of sound clinical reasoning is identified as a core competency in undergraduate medical education by AAMC, the optimal strategies for teaching clinical reasoning across the spectrum of learners within internal medicine are unknown. Advanced undergraduate learners who have completed their core clinical rotations (with some first-hand clinical experience) are perhaps ideally suited for educational interventions to refine clinical reasoning skills and increase awareness regarding diagnostic error in preparation for post-graduate training. In this workshop, we will introduce our framework for teaching and refining clinical reasoning skills in advanced undergraduate learners. Educational methods discussed will be mapped to the encapsulation-illness script paradigm for development of medical expertise, with focus on methods ideally suited for these learners. Specifically, we will present a framework that combines asynchronous online learning through use of interactive online modules with in-person small group case-based practice of a variety of clinical reasoning skills. Finally, we will discuss how encouraging reflection on a diagnostic error with learners at this level can set the stage for continued reflective practice in post-graduate training and beyond.

This interactive workshop will provide attendees with a framework for teaching clinical reasoning to advanced undergraduate learners, introduce specific teaching techniques with opportunities for practice.                  

Educational Objectives:

  • Summarize a leading theory regarding how expertise in clinical reasoning develops with focus on the advanced undergraduate learner.
  • Identify educational methods ideally suited to teaching and refining clinical reasoning processes to advanced undergraduate learners, with focus on delivery of skills that will optimize preparation for post-graduate training.
  • Provide case-based opportunities for skills practice in teaching clinical reasoning to advanced undergraduate learners.

Deborah J. DiNardo, MD
Melissa A. McNeil, MD
Sarah Tilstra, MD
Eliana Bonifacino, MD
University of Pittsburgh School of Medicine 

614. S.O.S.-Introducing the New AAIM Subinternship Curriculum to Enable Learners to Ask for Help and Maintain Their Well-Being

The subinternship remains a vital component of a dynamic fourth year that should bridge medical school to residency. The CDIM subinternship curriculum was updated in 2017 to focus on four specific skills identified by program directors as essential for graduating medical students to achieve prior to starting residency—a time of high stress for most new interns. As such, the well-being of trainees has become an emerging area of great interest for medical educators. This workshop will focus on portions of this curriculum that are dedicated to the topics of “Knowing When to Ask for Help” and “Wellness.” Students understanding and development of these skills will be vital to succeed in residency and beyond, but these topics have traditionally been underemphasized in undergraduate medical education. Students need to learn how to identify when they have reached the limits of their abilities to manage their daily clinical work and ask for help. Likewise, they must simultaneously be able to identify and manage when they have reached their personal limits and also ask for help, as warranted. Participants in this workshop will review the new curriculum and share current best practices to teach these concepts to their learners. We will also brainstorm to develop new teaching activities that can be incorporated into or adapted for participant’s own subinternship curriculum. We also will also work with participants to identify ideal methods of assessing these skills in their learners.

Educational Objectives:

  • Review the new CDIM Subinternship Curriculum skills of “Knowing When to Ask for Help” and “Promoting Wellnes.s”
  • Develop specific educational activities to deliver the new curriculum to subinterns.
  • Identify assessments to evaluate subintern ability to recognize both personal and patient care related limitations.

Allison H. Ferris, MD
Drexel University College of Medicine 

Michelle Sweet, MD
Rush Medical College of Rush University Medical Center 

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

Brian Kwan, MD
University of California-San Diego School of Medicine 

615. When the Going Gets Tough, Look to Each Other: How Clerkship Education Committees Build Community and Facilitate Grading Decisions

Internal medicine clerkships are increasingly complex with multiple sites. Given the challenges with workplace-based assessment and LCME requirement for identical methods of assessment across sites, learning best practices around evaluation and grading standardization is of increasing interest to clerkship leaders. Using a clerkship education committee is one strategy to help clerkship leaders deal with the challenging topic of grading while providing opportunities for building community. Education (or competency) committees have been shown to help members develop a frame of reference for grading standards, allow for clarification of a student’s performance in the context of challenging cases, and provide participants with faculty development. A recent national CDIM survey indicated one third of medicine clerkships use some form of grading meetings. In this workshop, we will describe and analyze three Internal medicine clerkships experiences with their education committees, with a focus on the process of determining student grades. During this workshop, we will describe different approaches to establishing or refining an education committee, including goals, selecting members, delineating processes for grading, and measuring outcomes. We will also discuss best practices and pitfalls with running clerkship education committees, with the goal of providing audience members a framework on how to successfully establish and run a clerkship education committee.

Educational Objectives:

  • Summarize the literature on medicine clerkship education committees.
  • Compare and contrast the goals, membership, processes, and outcomes of three medicine clerkships education committees.
  • Brainstorm and summarize best practices for standardizing evaluation and grading through the use of clerkship education committees.

Cindy Lai, MD
University of California-San Francisco School of Medicine 

Temple A. Ratcliffe, MD
University of Texas School of Medicine at San Antonio 

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

616. Assessment of Learning, Assessment for Learning

Medical students commonly use self-assessment questions as a study tool for learning clinical medicine, with or without their clerkship directors’ awareness or guidance. A background on the advantages, disadvantages, and best methods for using self-assessment questions as a study tool will be provided, along with an introduction to new self-assessment questions and the summative key features exam developed by CDIM members to align with the CDIM core curriculum and the SIMPLE course. This workshop will provide an overview on the use of assessment of learning v. assessment for learning, with a focus on the assessment of medical knowledge and clinical reasoning. Participants will explore the use of assessments of and for learning in their own educational programs and develop plans for guiding their own students in the best use of these tools.

Educational Objectives:

  • Describe the advantages and disadvantages of self-assessment questions as a studying tool.
  • Distinguish the overlapping roles of assessment of and for learning.
  • Discuss the role of the key features approach in medical student assessment. 

Valerie J. Lang, MD, MHPE
University of Rochester School of Medicine and Dentistry 

Kirk A. Bronander, MD
University of Nevada, Reno School of Medicine 

Joseph T. Wayne, MD, MPH, MACP
Albany Medical College

L. James Nixon, MD, MHPE
University of Minnesota Medical School 

617. Help Me Help You: Peer Mentoring for Success in Academic Medicine

Many academic departments find it challenging to provide mentorship to their faculty—availability of senior mentors, lack of aligned interests, and power differentials can make the classic mentor-mentee model problematic. Emerging research suggests that peer mentoring groups can help faculty clarify career goals, improve career satisfaction, and increase academic productivity. In this workshop, participants will learn about models of peer mentoring (including details of successful programs with evaluation data) and work on a blueprint for creating peer mentoring groups at their own institutions.

Educational Objectives:

  • Describe an evidenced-based model for peer mentoring.
  • Outline benefits and drawbacks of the peer mentoring model.
  • Apply a blueprint for creating a peer mentoring group at their institution

Sarita Warrier, MD
Kate E. Cahill, MD
Rebekah Gardner, MD
Warren Alpert Medical School of Brown University