Project description:IntroductionPhysicians are at much higher risk for burnout, depression, and suicide than their non-medical peers. One of the working groups from the May 2017 Resident Wellness Consensus Summit (RWCS) addressed this issue through the development of a longitudinal residency curriculum to address resident wellness and burnout.MethodsA 30-person (27 residents, three attending physicians) Wellness Curriculum Development workgroup developed the curriculum in two phases. In the first phase, the workgroup worked asynchronously in the Wellness Think Tank - an online resident community - conducting a literature review to identify 10 core topics. In the second phase, the workgroup expanded to include residents outside the Wellness Think Tank at the live RWCS event to identify gaps in the curriculum. This resulted in an additional seven core topics.ResultsSeventeen foundational topics served as the framework for the longitudinal resident wellness curriculum. The curriculum includes a two-module introduction to wellness; a seven-module "Self-Care Series" focusing on the appropriate structure of wellness activities and everyday necessities that promote physician wellness; a two-module section on physician suicide and self-help; a four-module "Clinical Care Series" focusing on delivering bad news, navigating difficult patient encounters, dealing with difficult consultants and staff members, and debriefing traumatic events in the emergency department; wellness in the workplace; and dealing with medical errors and shame.ConclusionThe resident wellness curriculum, derived from an evidence-based approach and input of residents from the Wellness Think Tank and the RWCS event, provides a guiding framework for residency programs in emergency medicine and potentially other specialties to improve physician wellness and promote a culture of wellness.
Project description:Although undergraduates have long held a role as teaching assistants for introductory science courses at liberal arts colleges and universities, educational institutions often do not provide these students with opportunities to explore science teaching and pedagogy. At Brandeis University, we designed an internship course to help increase the motivation, understanding, and knowledge of teaching pedagogy for undergraduate teaching assistants that is offered concurrently with their teaching responsibilities. Weekly sessions with faculty mentors are guided by readings in current science education literature, and throughout the semester students are asked to develop new course material based on the pedagogical frameworks discussed. To evaluate the effectiveness of this course, we surveyed students at the close of the semester. We found an overall increase in student confidence levels with regard to teaching and better awareness of the difficulties faced in science education. All students who participated in the course expressed interest in participating in future educational internships. We believe that the Educating Young Educators internship has the potential to be a catalyst for personal and professional growth from a novice into an informed young educator.
Project description:BackgroundQuality improvement (QI) skills are learned during residency, yet there are few reports of the scholarly activity outcomes of a QI curriculum in a primary care program.InterventionWe examined whether scholarly activity can result from a longitudinal, experiential QI curriculum that involves residents, clinic staff, and faculty.MethodsThe University of Pittsburgh Medical Center Shadyside Family Medicine Residency implemented a required longitudinal outpatient practice improvement rotation (LOPIR) curriculum in 2005. The rotation format includes weekly multidisciplinary work group meetings alternating with resident presentations delivered to the entire program. Residents present the results of a literature review and provide 2 interim project updates to the residency. A completed individual project is required for residency graduation, with project results presented at Residency Research Day. Scholarly activity outcomes of the curriculum were analyzed using descriptive statistics.ResultsAs of 2014, 60 residents completed 3 years of the LOPIR curriculum. All residents satisfied the 2014 Accreditation Council for Graduate Medical Education (ACGME) scholarly activity and QI requirements with a literature review presentation in postgraduate year 2, and the presentation of a completed QI project at Residency Research Day. Residents have delivered 83 local presentations, 13 state/regional presentations, and 2 national presentations. Residents received 7 awards for QI posters, as well as 3 grants totaling $21,639. The educational program required no additional curriculum time, few resources, and was acceptable to residents, faculty, and staff.ConclusionsLOPIR is an effective way to meet and exceed the 2014 ACGME scholarly activity requirements for family medicine residents.
Project description:BACKGROUND: As part of an ongoing evaluation of our residency program, a needs assessment was performed to assess resident and attending perspectives on current methods of surgical skills training in the operating room. METHODS: Participants included obstetrics-gynecology residents and faculty at a university program. Two surveys were developed and validated. Results were analyzed with 2-sample t tests, comparing Likert scores. Findings were significant if the difference between means was >1. RESULTS: Thirty of 31 residents and 40 of 60 attending physicians responded to the survey. Residents and attending physicians agreed that the surgical skills training program needs improvement (difference in mean, -0.39; confidence interval [CI]: -0.98 to 0.20). The areas of most disagreement were regarding feedback on surgical skills and instrument handling (difference in mean, 2.53; CI: 1.81-3.26, and difference in mean, 2.24; CI: 1.44-3.05). CONCLUSIONS: A significant proportion of surgical skills training during residency occurs as on-the-job training, and operating room time provides a key learning opportunity. This report demonstrates that there is a noteworthy difference in the perception of attending physicians and residents about the quality of teaching and feedback that is currently occurring in the operating room. The difference in perspectives among residents and attending physicians reported in this survey suggests a need for improved communication and systematic feedback in order to capitalize on operating room time as a critical surgical skills training arena.
Project description:IntroductionA common career aspiration among residents is to become a clinician-educator, though standard postgraduate training may not prepare trainees for the academic and scholarly requirements of this career. To address this need, we designed and implemented an asynchronous, interactive webinar series detailing a systematic approach to medical education research and scholarship. The series was piloted as part of a new track at the University of Chicago for residents interested in additional training and completing an educational learning project in medical education.MethodsWe aimed to use this series to introduce relevant frameworks in curriculum development, program evaluation, and learning theory. Materials associated with this publication include six webinars and corresponding summary reference handouts, discussion assignments, and answer keys. Additional materials include a faculty course director packet and sample feedback for discussion assignments. Each webinar is an 8- to 20-minute narrated presentation with goals and objectives, an overview of each session's content, and example vignettes. Residents viewed presentations and completed a two-part discussion assignment for each webinar, which included reflection on the educational material and vignettes, faculty feedback on this reflection, and application of webinar material and faculty feedback to their own experiences in medical education.ResultsAll residents in the pilot completed the webinars and assignments. Residents' reactions to the webinar series have been positive, and residents have commented that self-paced learning with directed faculty feedback is a desirable instructional method for this material.DiscussionThis series is well suited to introduce fundamental concepts in medical education scholarship and inspire self-directed study for motivated learners.
Project description:Quality improvement (QI) is essential in clinical practice, requiring effective teaching in residency. Barriers include lack of structure, mentorship, and time.To develop a longitudinal QI curriculum for an internal medicine residency program with limited faculty resources and evaluate its effectiveness.All medicine residents were provided with dedicated research time every 8 weeks during their ambulatory blocks. Groups of 3 to 5 residents across all postgraduate year levels were formed. Two faculty members and 1 chief resident advised all groups, meeting with each group every 8 weeks, with concrete expectations for each meeting. Residents were required to complete didactic modules from the Institute for Healthcare Improvement. Current residents and alumni were surveyed for feedback.Over 3 years, all eligible residents (92 residents per year in 2012-2014, 102 in 2014-2015) participated in the curriculum. Residents worked on 54 quality assessment and 18 QI projects, with 6 QI projects showing statistically significant indicator improvements. About 50 mentoring hours per year were contributed by 2 faculty advisors and a chief resident. No other staff or IT support was needed. A total of 69 posters/abstracts were produced, with 13 projects presented at national or regional conferences. Survey respondents found the program useful; most (75% residents, 63% alumni) reported it changed their practice, and 71% of alumni found it useful after residency.Our longitudinal QI curriculum requires minimal faculty time and resulted in increased QI-related publications and measurable improvements in quality indicators. Alumni reported a positive effect on practice after graduation.
Project description:IntroductionMedical errors can occur any time resident physicians transition between rotations, especially to unfamiliar areas such as subspecialty pediatrics. To combat this, we created and implemented the pediatric resident education in pulmonary (PREP) boot camp using Kern's six-step approach to curriculum development.MethodsPREP was a 5-hour session with multiple high-yield components held on the first day of each new rotation, aimed to prepare residents to care for complex pulmonary inpatients, including those with tracheostomy and ventilator dependence, asthma, and cystic fibrosis. The curriculum was evaluated at multiple time points through surveys of residents and faculty and two formal resident focus group sessions.ResultsPREP was successfully implemented in July 2018 with continued monthly sessions held. Thirty-five residents participated in the first year. Resident perceived preparedness and confidence in taking call duties increased significantly following PREP. All residents rated PREP as extremely helpful or very helpful, the highest ratings possible. Overall, residents preferred active learning strategies. All qualitative data revealed positive effects of PREP. Clinical faculty in the pulmonology division found PREP similarly helpful and felt that PREP better prepared residents to provide care to pulmonary inpatients than our previous model.DiscussionOur monthly preparatory boot camp on the first day of residents' inpatient pulmonary rotation has improved resident experience, preparedness, and ability to care for complex pulmonary patients. The curriculum was adjusted in response to feedback to increase hands-on time and interactive sessions. Protected time for residents and active learning strategies were key to success of PREP.
Project description:Background: Leadership and teamwork are critical to the performance of a multidisciplinary team responding to emergencies in the intensive care unit; yet, these skills are variably taught to pulmonary and critical care trainees. Currently, there is no standardized leadership curriculum in critical care training. Objective: We developed a longitudinal crisis leadership curriculum for first-year pulmonary and critical care fellows using high-fidelity simulation as a medium to practice and solidify skills. The goal was to improve leadership skills and trainee confidence when leading a team during life-threatening emergencies. Methods: Guided by a needs assessment of current and recently graduated fellows, we developed a leadership curriculum from a review of the available literature and local expert opinion. Four sessions were conducted over the academic years of 2016 to 2017 and 2017 to 2018, each including small-group teaching on effective leadership behaviors, followed by simulation with postsession leadership debriefing to review performance. Fellows were surveyed regarding their experiences with the curriculum. Results: Over two academic years, 100% of targeted fellows (N = 13) completed every session. Participants reported improved understanding of key elements of effective leadership, greater confidence in leading a multidisciplinary team, and increased preparedness to lead during a crisis. Simulation with debriefing was viewed as an effective medium for learning leadership skills, and fellows provided positive feedback regarding the experience. Conclusion: Implementation of a longitudinal crisis leadership curriculum within the first year of pulmonary and critical care fellowship was feasible and highly valued by learners. More research is needed to determine effective methods for teaching and assessing leadership skills.
Project description:Background Curriculum development is an essential domain for medical educators, yet specific training in this area is inconsistent. With competing demands for educators' time, a succinct resource for best practice is needed. Objective To create a curated list of the most essential articles on curriculum development to guide education scholars in graduate medical education. Methods We used a modified Delphi method, a systematic consensus strategy to increase content validity, to achieve consensus on the most essential curriculum development articles. We convened a panel of 8 experts from the United States in curricular development, with diverse career stages, institutions, gender, and specialty. We conducted a literature search across PubMed and Google Scholar with keywords, such as "curriculum development" and "curricular design," to identify relevant articles focusing on a general overview or approach to curriculum development. Articles were reviewed across 3 iterative Delphi rounds to narrow down those that should be included in a list of the most essential articles on curriculum development. Results Our literature search yielded 1708 articles, 90 of which were selected for full-text review, and 26 of which were identified as appropriate for the modified Delphi process. We had a 100% response rate for each Delphi round. The panelists narrowed the articles to a final list of 5 articles, with 4 focusing on the development of new curriculum and 1 on curriculum renewal. Conclusions We developed a curated list of 5 essential articles on curriculum development that is broadly applicable to graduate medical educators.
Project description:IntroductionBurnout in medical trainees is extensive and a critical issue. It is associated with increased rates of depression, suicide, and poor clinical performance. Enhancing resilience, the ability to adapt well in the face of adversity, is a potential tool to mitigate burnout and improve professional development. Our resilience curriculum consists of novel skill-building workshops to help programs cultivate resilience in their trainees.MethodsThis curriculum serves as an introduction for medical trainees and educators to the concept of resilience and teaches skills to help cultivate resilience and promote wellness. The sessions allow for identification of and reflection on stressful clinical events and consist of resilience-enhancing exercises, including setting realistic goals, managing expectations, letting go after medical errors, and finding gratitude. Through small-group reflection, the sessions also help participants discuss challenges with peers. This curriculum is intended for use with intern, junior, and/or senior residents and allows residency programs to address Accreditation Council for Graduate Medical Education milestones in the areas of professionalism, identification of system error, and advocating for system improvement. Materials include an introduction to resilience topics, guidelines for small-group facilitators, a learner precurriculum survey, and an evaluation form.ResultsSessions were well received by interns. The majority of attendees felt more comfortable talking about burnout and medical errors and learned new ways to approach challenges.DiscussionThis resilience curriculum has been continued in the intern curriculum and has been presented at a national conference. Resilience training is an effective educational intervention to help trainees manage feelings of distress during residency training.