Saturday, October 21, 2017
9:45 a.m. to 11:15 a.m.
(E/F) 401. Samuel Is Smart and Hannah Is Helpful: Mitigating Bias in Written Evaluations and Letters of Recommendation
Gender, racial, and ethnic disparities persist in academic medicine across leadership roles, promotion, and pay; the same disparities exist in representation across various medical specialties. Studies have shown that faculty commonly describe their learners in ways that promote common implicit biases regarding background in written evaluations and letters of recommendation. These skewed evaluations play a role in both how learners perceive their own fitness for various specialties as well as how they are selected for further training opportunities. Many evaluators do not realize how their own implicit bias can seep into written comments. Without a change in our nationwide practice, we may not be able to systematically address the problem of under-represented groups in medicine, nor balance gender representation in various specialties and practice settings. In this interactive workshop, we will explore existing stereotypical constructs and start a discourse on how we can change current practice.
We will start with a brief overview of the science behind implicit bias and then review some data from our local experiences. Next, we will have small groups examine examples of written comments for evidence of stereotypical language. After summarizing this evidence, small groups will brainstorm techniques to ameliorate stereotypical language in written comments at their home institutions. The workshop will conclude with a large group discussion of best practices in bias mitigation in these written forms and the creation of a consensus document that will be distributed to all participants to be shared at their home institutions.
- Differentiate explicit and implicit bias.
- Identify stereotypical language in written evaluations.
- Employ at least two strategies to mitigate bias in written comments.
Briar Duffy, MD
Mumtaz Mustapha, MD
Sophia Gladding, PhD
University of Minnesota Medical School
(T/L) 402. Making It Stick: Applying the Science of Learning to Everyday Teaching during Lectures, in Clinic, and on the Wards
Many commonly used teaching strategies in medical education are rooted in tradition rather than science, and can actually be counterproductive. For example, encouraging re-reading and repetition of tasks creates an illusion of mastery for learners but is not the most effective way to cultivate deep understanding or long-term retention. By adopting evidence-based teaching strategies, we can foster more durable and complex mastery of medical knowledge for our learners. In this workshop, we will discuss evidence-based teaching strategies and how to apply them to make everyday teaching during lectures, in clinic, and on the wards more effective.
The workshop will begin with an introduction to the growing body of literature behind the science of learning. This literature draws from many fields including psychology, cognitive sciences, education, and anthropology. Specifically, we will discuss how the brain encodes, consolidates, and later retrieves learned information. This understanding of the mechanics of memory has informed the development of specific evidence-based teaching strategies that foster development of deep and well-connected neural pathways that make information retrievable when needed.
We will then discuss several of these evidence-based teaching strategies including promoting retrieval, introducing desired difficulties, spacing out practice, interleaving, and self-explanation. Small groups will brainstorm applications of these strategies during lectures, in clinic, and on the wards, and we will debrief in the large group adding examples from our own teaching. Workshop participants will leave with a handout containing a toolkit of evidence-based teaching strategies and practical ways to implement them.
- Describe the basics of how the brain encodes, consolidates, and retrieves learned information.
- Understand the reasoning behind evidence-based teaching strategies such as promoting retrieval, introducing desired difficulties, spacing out practice, interleaving, and self-explanation.
- Identify practical applications of these evidence-based strategies to improve everyday teaching during lectures, in clinic, and on the wards.
Andrea Carter, MD
Andrew Klein, MD
Melissa McNeil, MD, MPH
University of Pittsburgh School of Medicine
(ACC) 403. The Power of Collaboration – A Benefit of the Self-Study
As part of the self-study process, ACGME requires core and subspecialty program to collaborate. What felt like an extra burden to an already laborious process held surprising results – the ability to streamline workflow and share resources and ideas led to improvement in many programs. Using the self-study as a template and example, our workshop will examine the benefits of coordinating core and subspecialty internal medicine programs at two large academic institutions. We will discuss department-wide data comparison and collection; recruitment resources and collaboration; centralizing responsibility; and leveraging the power of a group to advocate for better resources.
- Participants will be able to form a plan to coordinate activities between the core program and the dependent subspecialty programs, using the self-study as a catalyst.
- Participants will be able to explain how to use the self-study to effect change.
- Participants will be able perform a SWOT analysis and describe how to use PDSA cycles for program improvement.
Megan Wren, MD
Bethany Millar, C-TAGME
Washington University in St. Louis School of Medicine
Terry Bennett, C-TAGME
Brian S. Uthlaut, MD
University of Virginia School of Medicine
(FD) 404. Cultivating Professional Growth: The Role of Grade Appeal Committees
Assigning grades during clinical clerkships is challenging due to the expertise of the clinical evaluator, the changes in learning environment, and the highly subjective nature of the evaluation. Many medical schools are moving to a pass/fail curriculum during the pre-clinical years which puts more emphasis on the grades received during the clinical clerkships for residency placement. Given the highly competitive nature of various residency programs, students are understandably anxious and can at times focus on the grade rather than the utility of the evaluation for their professional growth. Due to the crowded clinical environment, evaluating faculty have varying levels of experience and training on how to properly evaluate learners and use the evaluation tools. Most clerkship directors serve as an informal grade appeal committee through review of all evaluations and communication with faculty in the event of perceived incongruence. However, this process is not transparent to all students or faculty and has inherent flaws of potential bias and possible variance. The introduction of a clerkship grade appeal Committee can address both the student and faculty needs by reviewing grade appeals with important stakeholders, standardizing the evaluation process, and providing structured feedback to both the student and the faculty involved. During this workshop, we will discuss our experiences with implementing grade appeal committees on various clerkships and provide attendees with lessons learned and resources for faculty and student professional development so they can establish grade appeal committees in their individual institutions.
- Review the literature on the grade appeals process, including common factors resulting in grade appeals.
- Discuss potential advantages and disadvantages of a grade appeal committee.
- Discuss possible dissemination strategies and resources for student and faculty professional development that may minimize or eliminate the need for appeals.
Reeni Abraham, MD
Blake Barker, MD
Kathlene Trello-Rishel, MD
Zaiba Jetpuri, MD
University of Texas Southwestern Medical Center at Dallas
Southwestern Medical School
(A/O) 405. Traditional Model, X+Y, Ambulatory Long Block, Hybrid…Oh My ‒ How to Determine the Right Resident Scheduling Models for Your Program
Medical training programs across the country are struggling with efforts to design resident schedules to accommodate various goals and requirements. To ensure adequate learning in outpatient medicine, ACGME has several requirements related to resident schedules, requiring all internal medicine residents to spend at least one-third of their training in the ambulatory setting and minimize inpatient-outpatient conflicts. Furthermore, duty hour regulations add additional restrictions on resident scheduling. There is a wide diversity in how each program approaches its schedules to satisfy these requirements. Each scheduling model has advantages and disadvantages in curriculum dissemination, rotation scheduling, team and patient continuity, and schedule flexibility. This interactive workshop will review the nuts and bolts of residency scheduling and a review of the current data related to different scheduling models. The workshop presenters will provide experiences from multiple residency programs that use traditional, hybrid, accordion, full day, and X+Y scheduling systems as well as perspectives from both large university-based and small community programs. This workshop will emphasize the impact of scheduling models on ambulatory education. Using a toolkit, participants will have the opportunity to evaluate current scheduling systems and how they may best fit their individual institution’s goals, values, and challenges. Participants will also brainstorm ideas for handling common issues in residency scheduling, such as identifying potential reasons for transitions, identifying potential obstacles to change, and how to evaluate a transformation.
- Describe the requirements of residency scheduling and the various scheduling models currently in use.
- Compare and contrast different scheduling options based on their impact on residency scheduling and curriculum.
- Evaluate current residency scheduling systems in the context of institutions goals and challenges.
Craig Noronha, MD
Boston University School of Medicine
Alaka Ray, MD
Harvard Medical School Massachusetts General Hospital
Danielle Jones, MD
Emory University School of Medicine
Catherine E. Apaloo, MD
Piedmont Athens Regional
Maryann Overland, MD
University of Washington School of Medicine
(W) 406. Walk Like a Champion: A Walking Challenge to Increase Employee Wellness
Physician wellness and burnout have become hot topics in both the lay literature and targets for novel wellness interventions. Mindfulness training as well as encouraging sleep and exercise have been common targets. This workshop is intended to detail the process of initiating a novel, physician initiated wellness program, integrating human resources and industry partners. Workshop participants will learn from the experiences of an institution that implemented a hospital-wide competitive fitness initiative utilizing wearable fitness technology devices. This eight week team challenge achieved 62% hospital-wide participation among its 6,900 employees, and generated approximately 4,200 pounds weight loss and enough combined steps to walk around the world 51 times. Participation among our residents was significantly higher than the general employee population with 77% participation. The program’s success has blossomed into several new subsequent innovative wellness programs since inception nine months ago. This workshop will detail the steps needed to initiate a fitness-based wellness program as well as strategies to avoid potential pitfalls and tackle common barriers.
- Explore avenues for system-wide wellness programs within your institution.
- Conduct examination of barriers to implementation of a wellness plan.
- Develop the first steps of a plan of action to implement a wellness program.
Sarah Luber, DO
Anthony Donato, MD
(CDI) 407. Resident Career Development: A Longitudinal Curriculum
We have created a novel longitudinal curriculum focused on resident career development that has been integrated into the educational experience starting from early intern year through the end of residency. We have combined didactic educational content with hands-on workshops to help residents cultivate practical skills as they transition into fulfilling careers after their internal medicine training. In this workshop, we will share our didactic content and demonstrate how we facilitate mock interviews for residents.
- Review the components of a longitudinal curriculum for residents applying for general internal medicine attending positions in the workforce including information about various practice settings, recommended job application timelines, crafting a curriculum vitae, practicing mock interviews, and how to approach contract negotiations.
- Review the components of a longitudinal curriculum for residents applying for subspecialty fellowships, including: fellowship application timelines, CV review, and mock interviews.
- Discuss the elements of a mock interviewing workshop in detail.
Sharon B. Kim, MD, FACP
Providence Health & Services
Oregon/Providence Medical Center
(CDI) 408. An Educational Curriculum in Cultural Humilty: A Framework for Actionable Goals and Objectives
Prior surveys of internal medicine program and clerkship directors have identified barriers to developing curricula in cultural competence and health disparities, Elements of entrustable professional activities and milestones, require assessment of a learner’s ability to display cultural humility during patient care. Utilizing the steps of curriculum development during this workshop, participants will discuss and learn how to build a curriculum in cultural humility to address how it relates to health disparities and a diverse and inclusive work environment. Participants will gain knowledge of existing education resources and suggestions on how to engage their institution and community resources to implement change. This workshop offers the opportunity to participate in discussions and consider what elements to select to implement a curriculum in cultural humility in light of their own institutional culture, interdisciplinary efforts, and unique health care delivery needs.
- Define cultural humility and its relation to disparities in health care and quality of care.
- Gain an understanding and appreciation for the evolving terminology of cultural humility that embraces not only competency, but the demonstration of skills and attitudes in a clinical environment. .
- Develop strategies to educate learners on cultural humility.
- Learn educational strategies that currently exist to teach learners cultural humility.
- Review the ACGME milestones and EPAS as they relate to cultural competency and humility in internal medicine.
Monica Yepes-Rios, MD
Uniformed Services University of the Health Sciences
F. Edward Hebert School of Medicine
Katherine Walsh, MD
Ohio State University College of Medicine
Tina Kumra, MD
Johns Hopkins University School of Medicine
(FD) 409. You Won’t Find This at Home Depot: Building Your Remediation Toolbox
Remediating struggling learners is challenging. To promote learner success, a training program must create activities which address the learner’s weakness, can be measured for success and can be achieved with the resources available. Often, it feels like the program is constantly “reinventing the wheel.” A remediation toolbox can help to end this inefficient process. This session, a second iteration from the evaluation precourse at the 2016 Skills Development Conference, will focus on the benefits of creating a residency “toolbox” composed of various focused activities and experiences tailored to trainees with identified deficiencies in each of the ACGME subcompetencies. By collecting these items electronically and grouping by subcompetency, programs can streamline the process of planning either informal focused training or formal remediation efforts, whichhelps to both identify options for aiding struggling trainees as well as reduce re-work on the part of program directors, core faculty, and members of your Clinical Competency Committee. During this workshop, we will review the process of assembling an ACGME milestone based toolbox. We will show how to develop a tool, fill the box with tools, use the appropriate tool for the job and assess for success. Each tool in our toolbox consists of a detailed description of the remediation activity, resources needed, pearls, advantages, limitations and a corresponding evaluation. The toolbox is an evolving resource for programs, and serves as a reference point that can save time in cases where institutional memory is shorter. It also is more easily shared both within and between programs.
- Identify efficiencies in creating a toolbox of remediation activities for struggling trainees organized by the ACGME subcompetencies and eliminate wasted time “reinventing the wheel.”
- Demonstrate the benefit of a toolbox using cases of struggling learners, identify deficiencies by subcompetency, and select an applicable remediation tool.
- Design a plan to collect existing activities and create your own toolbox to be used by your program, including some existing tools from our toolbox as a starting point if desired.
Ross Hilliard, MD
Dominick Tammaro, MD
Jennifer Jeremiah, MD
Stephanie Catanese, MD
Warren Alpert Medical School of Brown University
(FD) 410. Yes Doctor, There Is Life after Being a Program Director
Being a program director is a special role, fabulous opportunity, and can also further your career in medical education leadership. The skills developed can be directly applied or modified to other significant leadership positions. This interactive workshop will focus on next career positions and the pathways to attain them. As a collaborative discussion, the group will develop a list of potential next step leadership opportunities within and outside of their institutions. Workshop leaders will facilitate the discussion, providing typical responsibilities for each role and the expected skill sets needed to attain and excel in the positions Barriers and challenges will also be addressed. The participants will then develop personal road maps to attain such positions followed by sharing in either pairs or in small groups. Volunteers will be asked to present their road map to the large group for discussion. The workshop will conclude by asking participants to develop an action plan for taking their next career step. Templates for road map development and position descriptions/definitions will be provided for participants to continue the process after returning to their home institution.
- Identify career roles in medical education.
- Describe skill sets necessary to be successful in a new role.
- Develop a pathway to attain position after being a program director.
Alwin Steinmann, MD, FACP
Saint Joseph Hospital
Andrew Yacht, MD
Hofstra Northwell School of Medicine at Hofstra University
Miriam Bar-on, MD
University of Nevada School of Medicine (Las Vegas)
(T/L) 411. Applying Growth Mindset to Residency Training
What are growth and fixed mindsets? How might they apply to the training of residents? A mindset is an implicit or explicit theory a person believes which explains how they understand how the world works. A person with a growth mindset understands that their talents, skills, and abilities are all things that can change with deliberate practice and feedback. In contrast, a person who holds a fixed mindset understands that their talents, skills and abilities are gifts or traits (i.e., they were born with them) and that these traits are immutable. Educators have embraced growth mindset in grade schools and high schools. Large companies have embraced growth mindset to foster learning and creativity. In this workshop, we explore how growth mindset might be applied in medical education. How might our learners benefit from understanding their own mindsets? How might faculty benefit from understanding their mindsets for themselves and as it relates to how they teach and provide feedback? Finally, what are the pitfalls, traps, and cautions when applying growth mindset in your program?
- Explain growth mindset and describe how we have applied it in our programs.
- Practice applying growth mindset when giving feedback to a learner and when developing faculty in a highly interactive breakout session.
- Appreciate benefits and the pitfalls of applying growth mindset in your program.
Alvin Calderon, MD, PhD
Virginia Mason Medical Center
Daniel Pomerantz, MD
Montefiore Medical Center/Albert Einstein College of Medicine (New Rochelle)
Sandhya Wahi-Gururaj, MD
University of Nevada School of Medicine (Las Vegas)
(L) 412. Resilient Leadership: Building Strategies to Managing Interpersonal Conflict
The focus on teamwork has never been as important to an academic physician’s essential job function as it is now. Unsuccessful leaders fail to recognize the importance of resolving team conflict, thus contributing to dysfunctional teams, increased career dissatisfaction or burnout, and decreased faculty retention. A leader who is skilled in conflict resolution can cultivate an environment that emphasizes collaboration, a higher level of organized care, productive teams, and improved satisfaction in the workplace. In this workshop, participants will learn to optimize their interpersonal relationships by understanding and identifying personality styles using the DiSC assessment a behavior assessment tool that is based on the recognition of distinct personality styles and how they interact with their environment. We will outline the four personality styles and strategies for working with each style. Based on given team conflict scenarios in academic medicine, participants will identify personality styles and apply conflict management strategies to each scenario using the DiSC assessment framework. Participants will have an opportunity to discuss challenges in their respective roles and apply these techniques to mitigate interpersonal conflicts that occur with supervisors, peers, and learners. They will also develop a plan and leave with materials for delivering a conflict resolution workshop at their home institutions to optimize their team dynamics. Participants will leave this workshop with fundamental conflict resolution skills that they can apply to their leadership positions, enhance their organization’s dynamics, and build resilience in their work teams.
- Identify personality styles and apply personality-specific strategies to mitigate interpersonal conflict using the DiSC assessment tool.
- Discuss and apply personality-specific strategies to mitigate team challenges at your home institution.
- Using workshop materials, formulate an action plan for delivering a workshop to address conflict resolution at your home institution.
Elizabeth Lee, MD
Lewis Katz School of Medicine at Temple University
Shanu Gupta, MD
Rush Medical College of Rush University Medical Center
Vinod Nambudiri, MD, MBA
Grand Strand Medical Center