Past Meetings

Friday, October 20, 2017
9:45 a.m. to 11:15 a.m. 

(L) 101. Who’s the Boss? Developing Your “Managing Up” Skillset

The multiple levels of senior leadership in academic medical institutions often require faculty and staff to interface with significant complex hierarchies to achieve strategic goals. In addition, several mentor-mentee relationships exist within academic medicine, the success of which is often perceived as dependent on the mentor’s vision and activities. “Managing up”—the concept of a trainee, subordinate, junior member, or mentee actively leading and engaging individuals in a more senior role—is an important skill to develop in order to thrive in such a complex leadership ecosystem as academic medicine. This workshop will go over key managing up principles, offer attendees a chance role-play in managing up exercises, and leave with actionable take-aways for implementing similar strategies in the working, mentoring, and other professional relationships. Evidence from both medicine and business literature will be reviewed and incorporated into the session. Early career physicians, new leaders, and others with an interest in refining their skills are encouraged to attend.

Educational Objectives:

• List key principles and general skills associated with managing up.
• Practice implementation of managing up skills in role-playing scenarios.
• Highlight particular managing up lessons relevant to academic medicine relationships.

Vinod Nambudiri, MD, MBA
Grand Strand Regional Medical Center 

(ACC) 102. Surviving the 10-Year Site Visit: Practical Tips for Success from the Program’s Perspective

ACGME has a new process for accreditation, the Next Accreditation System (NAS). The process has three components: program notification to begin the self study, 12 to 18 months for introspection, and a site visit. Institutions with fellowship programs will have a combined self study and site visit with the core program. Our internal medicine residency and fellowship programs were among the first to complete the self study and 10-year site visit. This workshop will explain the self study process from the program’s perspective. We will share practical tips on how we prepared our core program and 12 of our fellowship programs and share the methods we used to engage the program director, associate directors, fellowship directors, program coordinators, faculty, and residents. Because it is a new process we will demystify the expectations for programs, including reviewing the documents required by ACGME, steps to prepare for each part of the process, and share results of our site visit.

Educational Objectives:

• Review the self study process from start to finish.
• Discuss how program improvement projects are essential for the self study.
• Describe a process to align the core residency and fellowships for the self study and the site visit.

Lisa Willett, MD
Jason Morris, MD
Tammy Pickens, C-TAGME
Brandy Freiger, C-TAGME
University of Alabama School of Medicine

(M/C) 103. A Big MAC Attack: How to Implement a Mentor/Advisor/Coach Program

Given the limitations of the program leadership/resident ratio at most programs, attention is often reserved for residents with problems. Many programs struggle to give their well-performing residents the mentoring, advising, and coaching they need to continually improve. Recognizing this problem at our own institution, we developed a novel program to assign each resident in each class a unique, handpicked faculty member to serve as a mentor, advisor and coach (MAC). We provided training to the selected faculty as to how to fulfill these roles and to recognize when each of these roles is most needed and appropriate. A calendar, which prescribes coaching, advising or mentoring at specified times through the year, was given to the MACs. Finally, we linked the CCC to the MAC program by providing information about resident progress to their MACs to help them identify goals for improvement. In this workshop, we will describe the process by which we developed and implemented the MAC program for our residents. We will walk through the steps we took to choose faculty to be MACs and the faculty development created for them to perform each of the roles for their assigned residents. The workshop will also describe the tracking of the MAC meetings through the year and present the outcomes of this new program in terms of resident and faculty satisfaction. Participants will leave with a blueprint for how to roll out a similar program at their institutions as well as the tools needed to develop the faculty involved.

Educational Objectives:

• Describe the design of our novel mentor/advisor/coach (MAC) program and how it is implemented over the academic year.
• Demonstrate the faculty development workshop we used to train our faculty to be MACs and the resources we provide to them to be successful mentors, advisors and coaches.
• Review the impact the MAC program has had on our residents and faculty.

Seonaid Hay, MD
Dana Dunne, MD
Geoffrey Connors, MD
Yale School of Medicine

(CDI) 104. Unleashing the Full Potential of Simulation: Advancing Your Simulation Practice with Techniques Targeting Faculty Development and Scholarly Production

Simulation-based medical education is a powerful tool that has demonstrated meaningful educational benefits, improved patient care and outcomes, and enhanced patient safety. The AAMC Core Entrustable Professional Activities for Entering Residency (CEPAER) 10 is “recognize a patient requiring urgent or emergent care and initiate evaluation and management.” These opportunities are not always available in the clinical setting, making high-fidelity simulation a great option for teaching and providing feedback on the evaluation and management of acutely ill patients. 

The workshop will begin with a short didactic on best practices and present the latest evidence on simulation usage in the clerkship setting. Facilitators will additionally share a brief excerpt of simulation experiences at each represented institution. Participants will then have the opportunity to choose between two unique groups in a breakout session. The first will feature role play with the objective of fine-tuning core facilitation principles used in simulation, covering common pitfalls educators may encounter. The second will assist participants in creating their own simulation cases using a provided template guide. Following the breakout session, participants will have an opportunity to share small group work in the large group setting. Subsequently, the workshop will transition into a discussion of future research opportunities in simulation-based medical education. At the conclusion of the workshop, participants will receive several simulation cases to take to their own institutions as well as an outline to frame development of future simulation cases.

Educational Objectives:

• Create an outline of a high-fidelity simulation scenario providing students opportunities for acquisition or consolidation of skills in interpreting and managing acute medical problems centered around CEPAER-10.
• Describe strategies for faculty development to overcome common pitfalls faced when facilitating high-fidelity simulation sessions.
• Identify potential research areas including but not limited to interprofessional education and core entrustable professional activities.

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

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

Kendall Novoa-Takara, MD
University of Arizona College of Medicine-Phoenix 

Lisa Calvo, MD
University of Nevada, Reno School of Medicine

(FD) 105. Coaching for the Coaches: Creating a QI Workshop for Faculty Interested in Mentoring Resident QI Projects

As QI becomes a larger part of the residency curriculum, programs must find QI mentors to help coach and guide which leaves faculty with little to no QI experience mentoring residents, or a small handful of faculty mentoring a large number of residents and projects. This workshop is designed to show program directors one model to develop a QI learning community among faculty with interest in mentoring residents but needing additional training in QI techniques. The workshop will begin with a brief overview of the objectives and elements of the needs assessment to identify the learning needs of the faculty. The group will then be introduced to the QI workshop and the structure of a learning community designed to introduce key elements of QI while creating a learning community. In small groups, participants will conduct a stakeholders analysis of the key participants in the development of workshop coaches as well as develop the initial ground work for creating a QI workshop and coaching/mentoring program for the faculty. Each of the small groups will then participate in a group share of their ideas. The workshop will end with an action plan to address the faculty educational needs and the first steps to getting key stakeholders involved in the process. The workshop will incorporate aspects of systems-based practice and practice based learning and improvement.

Educational Objectives:

• Identify strategies to determine the educational needs of faculty mentoring QI projects.
• Create QIworkshops and learning community.
• Develop a coaching and peer-mentoring program for faculty mentoring resident QI projects.

Jonathan Tolentino, MD
Stony Brook University School of Medicine

Nirvani Goolsarran, MD
Stony Brook University School of Medicine 

(T/L) 106. Merit-Based Incentive Payment System (MIPS) for Residents: “Mini-MIPS” Model for Teaching Residents Quality Improvement and Business of Medicine in an Outpatient Setting

Trainees are historically underprepared in the knowledge and skills needed to navigate the business side of medicine. Our community-based internal medicine residency implemented a curriculum for business in medicine that includes education about the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. One of the key components of MACRA is the Quality Payment Program (QPP), which includes a Merit-Based Incentive Payment System (MIPS). Our residents have been learning about how this value-based model of care and reimbursement will impact their work as they graduate and enter practice.

As MIPS is being rolled out across the country beginning January 1, 2017, our program implemented its own incentive program: Mini-MIPS. Using a merit-based monetary incentive, we divided residents into teams that were rewarded for regular reporting, timely completion of outpatient care tasks, and improved glycemic control in their high-risk diabetic patients. To simulate the public reporting of the CMS Physician Compare website, we shared weekly team performance results on our private residency website.

Our residents gained practical experience in completing their own QI projects for improvement of a clinical measure, gained working knowledge of value-based incentivized care, and expanded their understanding of MACRA QPP.

In this workshop, we will share our experience and ideas for building a hands-on business in medicine curriculum in the residency outpatient setting. We will share ethical and practical challenges and successes we encountered in our own process.

Educational Objectives:

• Recognize and anticipate ethical and practical dilemmas encountered in a merit-based incentive payment system.
• Review some benefits of fusing resident education in quality improvement with a business curriculum in medicine.
• Design a merit-based incentive program that can be integrated into your outpatient resident education.

Jennifer Bolyard, MD
Rama Narayanan, MD
Canton Medical Education Foundation/NEOMED 

(W) 107. Teaching Professionalism to Promote Reflection and Physician Wellness

ACGME has recognized professionalism as one of its core competencies for physician training since it impacts important medical outcomes. As part of their professional responsibility, physicians may be expected to respond to the needs of patients that supersede their self-interest. ACGME and AAIM have acknowledged that resident wellness is an important consideration to reduce physician burnout and improve resiliency. In fact, physician wellness is an essential element in the development and sustainability of medical professionalism. Trainees are expected to apply professionalism values in patient interactions and clinical decision-making. Thus, a curriculum linking wellness and professionalism was developed to support resident reflections on how their actions affect patient safety, clinical outcomes, and their own self-care or burnout risks with oversight from an interprofessional team of faculty facilitators. Through this workshop, participants will gain an appreciation for the link between wellness and professionalism and will experience wellness exercises and strategies to teach them.

Educational Objectives:

• Describe the impact of wellness on physicians, patients, and the health care system.
• Explain the link between wellness and professional responsibility.
• Develop a curriculum using positive psychology and reflection tools to promote physician wellness.

Ronda Mourad, MD
Simran Singh, MD
Case Western Reserve University School of Medicine 

Andrea Jennings, PhD
Louis Stokes Cleveland VAMC 

(E/F) 108. I Am Watching You… Skills and Strategies for Using Direct Observation as a Meaningful Teaching Tool

Direct observation of medical trainees is a key aspect to providing quality education and ensuring clinical competence; however, direct observation is underutilized in both quantity and quality throughout medical education. Recently, there has been an increasing emphasis on using direct observation to operationalize competency-based education requirements; however, busy schedules, competing demands, and discomfort with or inadequate faculty skill pose challenges to effective implementation of direct observation. This workshop will provide attendees with the skills and strategies necessary to use direct observation as an effective and efficient teaching method.

The workshop will begin by contrasting the benefits and barriers of direct observation and participants will be asked to share their real-world experiences with direct observation. Next, we will discuss the skills necessary for effective direct observation, including: (1) considerations prior to and during the encounter, (2) providing behaviorally based, timely feedback, (3) developing an action plan with the trainee. We will role play several encounters and participants will practice delivering feedback and creating an action plan. In the latter half of the workshop, we will discuss how to effectively use direct observation across a range of encounters and levels of trainees. We will highlight the versatility of direct observation with examples from our program including remediation of learners, resident continuity clinic exam room presentations, coaching of clinician educator fellows, and faculty development using video review. Time will be reserved at the end of the workshop for participants to share or brainstorm other innovations in direct observation.

Educational Objectives:

• Compare and contrast the benefits and barriers of direct observation as a teaching tool.
• Examine and practice the key skills necessary for effective direct observation
• Demonstrate the versatility of direct observation across teaching encounters and levels of learners. 

Rachel Vanderberg, MD
Allison DeKosky, MD
Sarah Merriam, MD
Melissa McNeil, MD, MPH
University of Pittsburgh School of Medicine 

(CDI) 109. If You Build It, They Will Come – or Will They? How to Build a Successful Faculty Development Toolbox at Your Institution

Faculty development programs are essential to the success of any medical education enterprise. Medical schools, residency programs, and sponsoring institutions 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. Given that health care and medical education systems are in constant motion, 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. Additional challenges to successful faculty development programs include assuring the relevance of the program to the actual needs of the faculty, that faculty have sufficient access to the programs, and that appropriate teaching methods are employed to deliver the materials.

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 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. Last, we will come together as a large group and discuss common barriers and solutions to faculty engagement and participation in faculty development efforts.

Educational Objectives:

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

Richard Wardrop, III, MD, PhD
University of North Carolina School of Medicine

Alaka Ray, MD
Harvard Medical School Massachusetts General Hospital 

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

Robert D. Ficalora, MD
Billings Clinic 

(FD) 110. Frame of Reference Training with a Novel Short Film

ACGME requires us to use objective and observable developmental milestones sets to describe resident progression throughout training. Milestones are levels of competency supported by specific behavioral anchors intended to describe the progression of resident competence. Residency training then culminates in achievement of independent practice within the framework of the six core competencies. However, evaluators do not necessarily use the same frames of reference for resident evaluations. Learner personality, comparison amongst peers, and PGY level are commonly used to evaluate residents. Inconsistency in these frames of reference leads to unreliable assessments and to challenges for CCCs when translating multiple evaluation tools into reportable milestones for each resident. Therefore, a shared frame of reference is important for faculty to use when evaluating residents. This workshop will provide frame of reference training by analogy utilizing a nonclinical common competency: driving a car. When is one developmentally competent to independently drive a vehicle? Recognizing the progression to autonomy accomplished by a developing driver will help faculty to establish a frame of reference for evaluating residents on a trajectory of independent clinical competence.

We developed a high quality short film titled “On Her Own” (a picture is worth a thousand words). The film enables the audience to better conceptualize frames of reference, strengthen understanding of milestones, and identify behavior anchors. Our workshop will use non-clinical behavior based markers/anchors to parallel the residents progression to safe and unsupervised practice we seek to identify in graduate medical education.

Educational Objectives:

• “Calibrate” faculty to evaluate learners based on a shared frame of reference.
• Relate non-clinical rating scales and non-clinical behavior anchors with clinical rating scales and behavioral anchors and describe the utility of using behavioral anchors to evaluate residents.
• Establish more consistent inter-rater reliability within faculty with resident evaluation through a common frame of reference and better understanding of rating scales (milestones) and behavior anchors.

William Leland, MD
Brody School of Medicine at East Carolina University 

Claudia Kroker-Bode, MD, PhD
Virginia Tech Carilion School of Medicine 

(W) 111. Arts and Humanities Incorporated into a Residency Curriculum: A New Approach to Combat Fatigue and Burnout

Abundant data exists outlining the risks of fatigue and burnout in trainees in graduate medical education. Very few studies have been published, however, describing effective strategies to prevent it, especially ones that can be incorporated into the average workday with minimal resources. We describe our results of a two-year educational research study incorporating arts and humanities into an internal medicine residency curriculum to combat stress and fatigue, increase motivation to complete tasks, build camaraderie, and increase appreciation of diversity. Attendees of the workshop will actively participate in three abbreviated sessions from our curriculum. One session will allow participants to create their own rendition of a traditional Tibetan mandala. Another session will display an inspiring piece of art to stimulate discussion and discovery. A third session will include a session of mindful origami. Examples of other sessions used in our curriculum such as watercolor painting, meditation and guided visual imagery, and music will be shown with video clips and displays. An open forum for group discussion and reflection will be used at the conclusion of the workshop.

Educational Objectives:

• Learn strategies to incorporate arts and humanities into a year-long curriculum for graduate medical education.
• Find new ways to prevent stress, fatigue, and burnout in trainees during the workday.
• Increase motivation to work and camaraderie among team members.

Michele Lewis, MD
Mary S. Hedges, MD
Jose Raul Valery, MD
Chrys Yates
Mayo Clinic College of Medicine (Jacksonville) 

(IT) 112. A Cinderella Story: How to Transform Performance Dashboards into Tools for Resident Training

Dashboards are becoming increasingly common tools in clinical care. The use of dashboards to report performance measures has been shown to improve adherence to guidelines and enhance delivery of care. Current forms of dashboards are often focused on metrics that are linked to administrative or financial incentives for attending providers. In academic centers with trainees, dashboards should be designed to meet needs of learners and their patient populations. In this workshop, we will explore ways to identify meaningful, evidence based metrics for residents both in inpatient and outpatient care. We will look at key questions in dashboard design and implementation: What data should be shared? How can benchmarks be utilized in training to prepare trainees for their future practice? What benchmarks should be used for achievement? How do you make this a catalyst for QI rather than a resident report card? Should residents see only their personal data or should individual data be visible to all? Participants will discuss these questions in break out groups and then we will share our work with stakeholders, leadership, and IT in the design of resident-specific dashboards within our two programs. 

Educational Objectives:

• Describe how dashboards can be used to teach and improve population health.
• Identify metrics and delivery that are truly meaningful learners.
• Persuade institutional leadership to invest in reporting of performance measures.

Gail Berkenblit, MD, PhD
Jeremy Epstein, MD
Johns Hopkins University School of Medicine 

Craig Noronha, MD
Boston University School of Medicine 

Friday, October 20, 2017
11:30 a.m. to 12:30 p.m. 

(A/O) 203. Are Housestaff Worth the Cost at Your Institution?

As leaders and supervisors to our trainees, our primary mission is to educate through the patients we serve. Institutions, while extremely supportive of that mission, must also be mindful of the financial “bottom line.” In attempting to achieve balance between training and cost and recognizing the contracting GME dollars from Medicare, some institutions have looked to alternative staffing models because of the notion that housestaff provide an inefficient means of delivering cost-effective care. While there is 20th century literature to support this belief, 21st century health care has necessitated taking another look in an attempt to answer the question: “Are housestaff worth the cost at your institution?” Through this workshop, we will highlight some of the recent work addressing this question and provide you with the tools to better quantify housestaff value at your own institution.

Educational Objectives:

• Review the current state of GME funding.
• Describe how to conduct a workforce analysis to ensure the correct number of trainees necessary to meet the educational and service needs of your institution.
• Compare the financial implications of housestaff vs alternative staffing models via upfront costs (salary plus benefits) and performance measures (length of stay, mortality, patient satisfaction, etc.).

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

Alwin F. Steinmann, MD, FACP
Saint Joseph Hospital 

Jose Perez, MD, MBA
Methodist Hospital (Houston)

(IT) 204. Tales from the Curbside: How to Create Your Own Podcast

Social media has rapidly become intertwined with medical education and can be an effective part of multimodality learning. Audio podcasting is a simple way to create and distribute innovative lectures, interviews, and roundtable discussions to reach audiences far larger than a typical morning report or grand rounds lecture. In addition, it allows listeners to consume information at their own pace. This interactive workshop will provide you with the tools and information needed to put together your own podcast. The presenters will briefly highlight the evidence behind using podcasting in medical education as well as the professional benefits of creating a medical podcast, which include credibility, networking, and academic advancement. The presenters will also discuss the various potential formats (round table, interviews, lecture-based) and the relative merits of each. The audience will then be broken up into small groups and each group will be tasked with creating their own podcast. They will select a subject and format and develop an achievable action plan for the creation of a podcast devoted to forwarding medical education under the guidance of a facilitator. The proposed podcasts will then be discussed with the entire audience. The presenters will also discuss the “nuts and bolts” of podcasting. Logistics, necessary equipment, and software will be outlined as well as strategies to maximize your social media presence and search engine visibility. There will be time at the end for questions, feedback, and networking with other audience members.

Educational Objectives:

• Discuss the evidence behind using podcasting and social media to facilitate medical education.
• List the technological and conceptual requirements for creating a successful podcast.
• Leave with a concrete and achievable plan for creating medical education podcasts.

Paul Williams, MD
Lewis Katz School of Medicine at Temple University

Matthew Watto, MD
Stuart Brigham, MD
San Antonio Uniformed Services Health Education Consortium 

(W) 205. #NewBalance: A Novel Approach to Resident Well-Being

The prevalence of physician burnout among internal medicine (IM) residents is 50% to 75% at any given time and is associated with poorer patient care and higher rates of depression and substance abuse. Both ACGME and AMA have declared it to be an issue of national concern and an area of focus and innovation. To combat growing rates of burnout, residencies have implemented wellness curricula with variable results, we have created an extensive wellness program including large group lectures, team building activities, and small group wellness reports. We will outline our wellness curriculum with a special focus on the one-hour small group wellness sessions that are offered monthly during inpatient rotations. Participants will have the unique opportunity to hear from our clinical psychologist as she discusses various techniques that can be utilized to engage residents in both open discussion and self-reflection. She will also lead the group through a typical wellness session. Participants will receive a toolkit with discussion guides for topics (including imposter syndrome, resilience, and difficult patient conversations), a list of TEDtalks that can be utilized to introduce these topics, and a list of techniques that can be employed to help stimulate conversations and self-reflection. This workshop will also address challenges, including getting “buy-in” from both administration and residents, carving out time in your program, and putting together an impactful curriculum. We will present resident post-session survey data and discuss critical lessons learned along the way and the approaches we took to improve the program.

Educational Objectives:

• Identify components of a comprehensive wellness curriculum and barriers to its implementation.
• Experience a wellness session guided by a clinical psychologist and learn group dynamic principles to successfully engage resident physicians in open discussions and self-reflection.
• Acquire a toolkit with topic discussion guides and techniques to balance session structure with free-form conversation.

Rakhee Bhayani, MD
Carol Faulk, MD
Teresa Deshields, PhD
Washington University in St. Louis School of Medicine 

(IT) 206. Training Together: An Innovative Interprofessional Ward Team

In this workshop, we will offer a descriptive framework of an interprofessional general medicine ward team that integrates resident physicians and advanced practice provider fellows into a shared educational experience. To ensure the workshop is applicable to all attendees, we will incorporate an audience response system and large group discussion to better understand the local training environments.

Educational Objectives:

• Discuss the importance of collaboration across the health professions during clinical training for internal medicine residents and medical students.
• Illustrate an innovative model to achieve a clinical interprofessional training team.
• Identify targets within your own institution to perform authentic training experiences between residents and advanced practice providers.

Emily Gottenborg, MD
Julia Limes, MD
University of Colorado School of Medicine 

(FD) 208. After the Match: Cultivating a Community of Support, Retention and Mentoring to Enhance Diversity

The population of the United States is composed of 30% under-represented minorities (URM) while the current physician workforce identified as URM is 10%. Efforts to improve the diversity of the physician workforce have been implemented with a focus on elementary through medical school educational interventions. It is not known what specific experiences are needed to provide career enhancement and cultivation of talent for URM internal medicine residents. Through collaboration with five medical schools in the southeastern United States (Duke, East Carolina, Morehouse, University of North Carolina, and Wake Forest) we aim to better understand what factors are important for URM-specific mentoring during an internal medicine residency. This workshop will use a combination of expert presentations, large group discussion, and small group breakout sessions to examine strategies to cultivate a community of support for URM internal medicine residents. After a brief introduction, we will have a large group discussion to share experiences with retention and recruitment of URM residents. We will then share an overview of our collaborative program discussing how to conduct a focus group and also how to create a regional retreat for faculty and URM internal medicine residents. There will be two interactive breakout sessions where we will highlight the issues of isolation, creating a safe learning environment, mentorship, and recruitment and retention strategies. At the conclusion, participants will receive focus group questions to start a dialogue with residents/faculty and a template on how to host a regional event at their home institution.

Educational Objectives:

• Identify and clarify specific needs of URM physicians during residency.
• Provide tools to develop improved mentoring and retention strategies for URM residents.
• Develop a community of networking and support for URM residents.

Nancy Denizard-Thompson, MD
Wake Forest School of Medicine of Wake Forest
Baptist Medical Center 

Cristin Colford, MD
University of North Carolina School of Medicine 

Rachel Harris, MD
Morehouse School of Medicine 

Suzanne Kraemer, MD
Brody School of Medicine at East Carolina 

(M/C) 209. It Takes a Village: Teaching Residents to Build Developmental Mentorship Networks

Mentorship is vital in the field of medicine and has been shown to affect academic productivity, retention, professional development, and career satisfaction. Internal medicine residents who are able to identify mentors perceive better career preparation; however, only 50 to 60% are able to identify current or past mentors. Interns and trainees from underrepresented minorities are less likely to secure mentors during residency, and women are less likely to report adequate career preparation than men. Meeting resident mentorship needs can be challenging given limitations in faculty time, diversity of mentorship needs, and lack of skills amongst trainees in establishing and maintaining effective mentoring relationships. Traditionally, residency programs have developed internal programs that assign mentors to residents, but the utility of these relationships can be variable. In this workshop, we will review the importance of mentorship in residency and introduce the concept of a developmental network to replace the traditional paradigm of dyadic mentorship. We will reflect on the experiences from two university-based programs on implementing a structured developmental mentorship program to teach residents skills in self-reflection, building and leveraging their developmental networks, short and long-term action planning, and preparation for mentoring relationships. Finally, we will review the programmatic challenges in creating a developmental mentorship curriculum and guide participants in constructing an action plan for creating similar programs at their institutions.

Educational Objectives:

• Discuss the professional responsibility of faculty and organizations to provide effective mentorship and introduce the developmental network model as a framework to meet the mentoring needs of trainees.
• Explore a framework for developing the self-organization, self-reflection and communication skills that residents will obtain and maintain effective mentorship, integrate their goals for career development within the context of the institutional goals and effectively utilize the resources within their organization.
• Identify potential challenges and opportunities in implementing a developmental mentorship program and reflect on the experiences of two university-based residencies using such programs to meet the increasingly diverse needs of trainees in a changing health care environment.

Rachel Wong, MD
Kimberly Kranz, MD
Stony Brook University School of Medicine

Alia Chisty, MD
Ryan Schmidt, MD
Lewis Katz School of Medicine at Temple University 

(L) 210. Incorporating Advocacy into Your Training Program

Health care reform has been at the center of domestic policy debate since the 2008 presidential election. The Affordable Care Act (ACA) of 2010 has attempted to reduce the costs of health care and improve access with a focus on prevention and increasing access to primary care providers. In addition, ACA has had an impact on medical education through the expansion of primary care residency positions and training grants and a focus on quality and value. The recent federal election has put many of these changes at risk.

The federal government is the primary financier of GME with the single largest source being Medicare, which provides funding to teaching hospitals through direct medical education and indirect medical education payments. Legislation discussed during the health care debate has included specific proposals that would further impact residency programs.

This workshop will give an up-to-date review of legislation discussed at the federal level. The leaders will further present the impact that changes to health policy may have on medical education. Workshop participants will learn practical steps on how they can become actively involved to advocate for medical education at the federal and local level. Finally, participants will learn how health care policy discussions and advocacy can be built into existing educational venues so that students and residents can be empowered to advocate for policy reform.

Educational Objectives:

• Understand current health policy discussions at the federal level that relate to medical education.
• Acquire practical steps on how they can become actively involved to advocate for medical education at the federal and local level.
• Build health policy discussions and advocacy into existing educational venues for students and residents.

Niraj Sharma, MD, MPH
Harvard Medical School Brigham and Women’s Hospital

Allison DeKosky, MD
University of Pittsburgh School of Medicine 

Mark Henderson, MD
University of California-Davis School of Medicine 

Susan Lane, MD
Stony Brook University School of Medicine

(CDI) 211. The “Inter-Visit” Curriculum—Teaching Residents How to Provide Outpatient Care between Clinic Visits

As the health care delivery landscape continues to evolve, the importance of inter-visit communication with patients escalates. Inter-visit care is challenging since residents have limited time in continuity clinic, a finite number of patient care sessions, and varying continuity with their patient panel. In addition, many residents do not receive formal training in how to communicate with patients outside of the clinic visit or how to manage follow-up studies, care plans, or panel management activities. This curriculum aims to provide formal training in these domains to promote continuity in patient care and empower residents to remain engaged in the care of their patient panel between clinic visits.

The seminar will be begin with a brief discussion of the challenges in inter-visit care. Participants will then learn about our two-year spiraled interactive curriculum to provide formal training in inter-visit care. The remainder of the session will be dedicated to Q+A and brainstorming enhancements to the curriculum. Participants will be provided with a curricular overview, curricular content, and structure.

Educational Objectives:

• Identify challenges and opportunities to implementing comprehensive inter-visit care.
• Discuss the inter-visit curricular content, structure, and delivery.
• Identify opportunities for resident-led panel management activities that promote high quality inter-visit care.

Deepa Nandiwada, MD
Kathryn Anderson, MD
Marc Shalaby, MD
Patrick Sayre, MD
Raymond and Ruth Perelman School of Medicine
at the University of Pennsylvania 

(W) 212. Resilience, Compassion, Joy: Three Exercises for Fostering a Meaningful Life in the Practice of Medicine

The prevalance of physician burnout approaches 65%,which has been shown to negatively impact patient care, physician mental health, and institutional culture. Physician job stressors are well known work-life balance, regulatory issues, long hours, competing expectations, electronic medical records. Recent research has suggested several positive coping strategies. This workshop explores three such strategies which have been shown to affect positively workplace culture. First, we explore joy, compassion, and meaning by engaging the work of philosophers Miroslav Volf and Matthew Croasmun who designed the Yale course, “Life Worth Living.” Second, we reflect upon the modern interpretation of the medieval tradtion of Gaudeamus Igitur (“let us rejoice”) using the poetry of John Stone, MD. Third, we employ the art of asking meaningful questions based upon Marshall Goldsmith’s book Triggers. This “hands on” workshop with three distinct exercises could be easily replicated in other setttings to foster a workplace culture of joy and meaning.

Educational Objectives:

• Reflect upon the themes highlighted in the poem Gaudeamus Igitur by John Stone.
• Connect one’s role as clinician-educator-leader with themes of purpose, meaning, and joy.
• Consider how to apply themes of the poem Gaudeamus Igitur in one’s life, program, and institution. 

Benjamin Doolittle, MD
John Moriarty, MD
Seonaid Hay, MD
Stephen Holt, MD
Yale School of Medicine

Friday, October 20, 2017
2:45 p.m. to 4:15 p.m. 

(FD) 301. Qualitative Research 101

Surveys are a popular methodology used by medical education researchers. Clinician educators use surveys to understand the nature of educational problems and explore the perspectives of their learners. This workshop will review key characteristics of qualitative survey research and describe the differences between open (or inductive) and pre-structured (or deductive) qualitative surveys. The group will focus on general coding approaches that are used to analyze qualitative survey data. In small groups, workshop attendees will practice coding responses to open-ended survey questions and will learn how to identify themes from the analysis of survey data in a rigorous way. The group will also discuss other available resources such as online tools and software that can be used to assist in the analysis of qualitative survey data.

Educational Objectives:

• Understand the value of qualitative survey research in medical education.
• Describe the basic principles used in coding and analyzing qualitative survey data.
• Practice coding with a sample of qualitative survey data.

Diane Levine, MD
Wayne State University School of Medicine 

Briar L. Duffy, MD
University of Minnesota Medical School 

Chayan Chakraborti, MD
Tulane University School of Medicine

Katherine C. Chretien, MD
George Washington University
School of Medicine and Health Sciences 

(FD) 302. Using the Multiple Mini-Interview to Get the Applicants You Want: Logistics and First Steps

Nearly all US residency programs use an interview as a part of their selection process, with the vast majority applying standard interview methods to choose from a pool of applicants. Given the very low reliability of the standard interview (r=0.1), educators in Canada applied the principles of OSCE to develop a short, multi-station interview process they termed the Multiple Mini-Interview (MMI) that they found had high enough reliability for high-stakes decisions (r=0.7-0.85). With an ever-growing pool of applicants coupled with the need to determine the baseline abilities in the competencies of professionalism and communication, the interview has become ever more important to choose great trainees from the pool of great test-takers. In this workshop, come learn from two programs who both instituted an MMI process at their residency programs. Attendees will review the salient points to “sell” the MMI to your faculty, the necessary steps for case creation, the logistics of the MMI day, and the key pitfalls to avoid.

Educational Objectives:

• Cite two reasons for implementing MMI in residency applicant interviewing.
• Create one functional MMI scenario and be able to critique its strengths and weaknesses.
• List the structural elements and resources that are needed to utilize MMI in their programs.

Allan Markus, MD, MBA
HonorHealth Thompson Peak Medical Center 

Anthony A. Donato Jr., MD
Benjamin J. Lloyd, MD
Reading Health 

(A/O) 303. US Immigration and the IMG in Training

The session will provide an overview and discussion of the critical issues associated with the recruitment and training of international medical graduates (IMGs) within internal medicine programs in the context of the current immigration environment. We will start with a brief overview of the current status of IMGs in training programs, their varied immigrant status, and how it affects their training and subsequent integration into the physician workforce. Then we will delve into the specifics pertaining to J-1, H-1B, and other visas. The session will offer an opportunity to discuss current immigration related policies and best practices that promote the successful integration and training of IMG trainees. The panel will address open questions and concerns and seek recommendations for additional workshops on IMG issues.

Educational Objectives:

• Gain an insight into the impact of IMGs within internal medicine residency programs and the physician workforce.
• Understand the current immigration-related requirements for IMGs to enter and progress through training, specifically those pertaining to J-1 and H-1B visas. 
• Participate in a discussion of internal policies and procedures in place at their institution and identify if they need to implement changes.
• Be encouraged to collaborate with the broader internal medicine community and ECFMG in developing and maintaining consistent polices and practices that ensure the academic success and personal well-being of IMG residents and fellows.

Eleanor M. Fitzpatrick, MA 
Educational Commission for Foreign Medical Graduates 

Himangi Kaushal, MD, FACP
Memorial Health System (MHS)

Armand Krikorian, MD
University of Illinois College of Medicine at Chicago
Advocate Christ Medical Center

Sapna Kuehl, MD, FACP
St. Agnes HealthCare

Mario Sanchez
University of Texas Southwestern Medical Center at Dallas/Southwestern Medical School

(L) 304. Using Every Trick in the Book: Leadership Training and Community Building via a Longitudinal Book Club

Physicians regularly occupy leadership roles in research, educational, and clinical arenas. Given the current challenges facing health care, the need for physicians to develop effective leadership skills is paramount. Yet physician-leaders have been described as “accidental administrators,” lacking formal training in key leadership competencies. Challenges in conflict resolution, communication, negotiation, and time management can be daunting for leaders at any level. Without adequate support, feelings of workplace isolation and burnout may result. 

We have developed a longitudinal leadership skills development book club for early- and mid-career clinician educator faculty to meet these needs. Assigned readings are used to trigger discussion with a specific focus on acknowledging and normalizing leadership struggles, debriefing difficult encounters, and brainstorming strategies for success. This curriculum exhibits many “best practices” of faculty development, providing relevant, practice-based content coupled with opportunities for feedback, reflection, and intentional community building.

After introducing the rationale behind this method, the workshop will follow an interactive book club format. Participants will be expected to have read chapter three of Crucial Conversations and will be encouraged to bring forward “cases” of leadership or communications challenges as a springboard for discussion. In small groups facilitated by workshop leaders, we will teach key principles to overcome these challenges and enhance workplace resiliency. We will close with an interactive panel to discuss strategies for implementation and dissemination.

Educational Objectives:

• Report increased appreciation of the need for leadership development across all levels of faculty rank.
• Equip participants with the knowledge and skills to implement a longitudinal, learner-driven leadership book club to promote work-based application of basic leadership and managerial skills in communication, negotiation, conflict resolution, and time-management.
• Demonstrate the impact of this curriculum on participants at both the early- and mid-career levels using an interactive panel discussion.

Sarah Merriam, MD
Greg Bump, MD
Amy Kennedy, MD
Melissa McNeil, MD, MPH
University of Pittsburgh School of Medicine

(M/C) 305. A Job Well Done: Preparing Residents for the Job Search through Workshops and Individual Mentoring

The goal of this workshop is to help attendees facilitate the general internal medicine job search for trainees at their home institutions. Many residency graduates feel ill-prepared for finding a first job after residency if they do not intend to pursue fellowship training. This session will review examples of workshops to help residents with their job searches, provide guidance in developing such a workshop, and review principles of individually mentoring residents as they seek employment. Faculty from several training programs will share their experiences running sessions for residents about finding jobs in primary care and hospital medicine. The audience will break into small facilitated groups to work through the process of planning such a session, including identifying key faculty who can provide content (on writing CVs and cover letters, interviewing, negotiation, etc.) and identifying leadership from local health care organizations. We will regroup for a discussion about participant experiences and ideas from other programs. The second portion of the workshop will focus on how to mentor residents through a job search. We will review how to help trainees identify what is most important to them about their work and environment and which available jobs are the best match. We will provide materials to help attendees and provide opportunities to practice using a partnered role-play exercise.

Educational Objectives:

• Compare and contrast examples of career planning workshops held by training programs at various institutions.
• Identify key faculty at their home institutions who can provide guidance for residents in writing CVs, interviewing, negotiating job terms, and finding support for non-clinical work.
• Demonstrate effective skills to provide one on one mentoring for residents through the job search process.

Stacy Charat, MD
University of California-San Diego School of Medicine

Maryanne Overland, MD
University of Washington School of Medicine

Rebecca Berman, MD
Harvard Medical School Brigham and Women’s Hospital 

(FD) 306. Designing a Faculty Development Blueprint

Faculty development is a key component of the ACGME program requirements in all disciplines. Having a blueprint facilitates timing and implementation of activities to meet both program and faculty needs. Further correlating the blueprint to the cyclical GME calendar can better integrate topics as they are needed which addresses adult learning principles. In this highly interactive workshop, topics will be identified, categorized by target audience, and assigned to the relevant part of the calendar or season. After a brief introduction to curriculum design and strategic planning, participants will assess their own faculty development needs, taking into account resources as well as potential obstacles, and document them on a matrix. The large group will discuss a variety of modalities and venues to present their faculty development activities. Selecting one participant’s faculty development needs, small groups will add content, modes of delivery, and settings to the matrix. A flow diagram of the GME “seasons” will be distributed and the final small group activity will be to match the activities with the calendar to have an integrated package. Handouts, toolkits, and matrices will be provided for participants to continue their work for their home institution. Before leaving, attendees will be asked to develop a timeline for designing and implementing their blueprints for their program.

Educational Objectives:

• Describe the process of curriculum design and strategic planning.
• List faculty development content and modes of delivery.
• Describe elements of a faculty development blueprint and categorize topics by target audiences and the cyclic GME calendar.

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

(CDI) 307. Jumpstarting Future Educators: Designing a Clinician-Educator Track in Your Residency

How are you developing the next generation of clinician educators in your program? How can you tailor training for residents interested in academic careers and address the increasing demand for specialized teaching instruction from residency applicants? This workshop is for anyone considering or planning a clinician-educator track in your residency. Four programs, representing both new and established tracks, will share their experiences and insights. Workshop participants will compare and contrast curricular and logistical elements among the sample tracks to explore what would work best in their own program. Participants will hear presentations focused on four main areas: how to design a medical education elective, how to conduct a track without using elective time, how to integrate a track with the clerkship and the residency at large, and how to evaluate the track. Participants will then break into round-robin small groups to discuss these four focus areas using a worksheet to guide them through the design process, with the goal of outlining their curriculum by the end of the workshop. Presenters will facilitate the small groups and provide specific guidance on critical decisions and barriers in developing a successful track. Participants will receive written summaries of each sample track as well as a comparison of the tracks.

Educational Objectives:

• List the educational objectives of a clinician-educator track at your institution.
• Discuss potential options for integration of the track with both UME and GME.
• Describe options for evaluating the effectiveness of your track.

John Ragsdale, MD
University of Kentucky College of Medicine

Brian Uthlaut, MD
University of Virginia School of Medicine 

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

Gabrielle Berger, MD
L. Renata Thronson, MD
University of Washington School of Medicine 

(T/L) 308. The Seven Habits of Highly Effective Teaching Hospitalists

Teaching hospitalists provide a large proportion of clinical medical education for internal medicine residents with varying levels of training and success. Teaching hospitalists face the challenging task of trying to balance the demands of teaching with increasing pressures of hospital throughput, rapid patient turnover, heavy documentation requirements and patient satisfaction expectations. This workshop is intended to facilitate reflection on how effective teaching is incorporated in the day-to-day clinical routine of a hospitalist. We will present quantitative and qualitative teaching data from three teaching sites across two residency programs. We will demonstrate commonly identified habits of highly rated and below average rated teaching hospitalists. This workshop will enable participants to apply Stephen Covey’s Seven Habits of Highly Effective People to real hospitalist experiences that will help to tackle the myriad of barriers to effective teaching.

Educational Objectives:

• Describe the seven habits that a teaching hospitalist should adopt to ensure effective teaching on the wards.
• Practice habits through application to cases derived from real hospitalist experiences.
• Identify challenges to teaching on a day-today basis on clinical wards.

Nirvani Goolsarran, MD
Stony Brook University School of Medicine 

John Raimo, MD
Sean LaVine, MD
Hofstra Northwell School of Medicine at Hofstra University 

(W) 309. Promoting Emotional Well-Being through Coaching: A Train the Trainer Workshop

Burnout among faculty physicians is higher than their non-physician peers and has risen at a rate higher than the non-physician population. The impacts ability to care for patients, ourselves, each other, and our learners. This workshop aims to teach faculty new ways of understanding and managing themselves to promote well-being and professional satisfaction and empower them to use these skills with other physicians and learners. Positive psychology, the study of the conditions and processes that contribute to the optimal functioning of people, groups, and institutions, is one approach to enhancing physician coping skills and well-being. In recent years, positive psychology coaching has been described as a way to increase professional skills for physicians, address burnout, and promote well-being by emphasizing strengths, engagement, meaning and accomplishment. This workshop will review the principles of positive psychology coaching in a train the trainer approach, incorporating exercises with handouts. Upon completion of the workshop, participants will feel empowered to incorporate these skills in one on one and group settings with colleagues and learners.

Educational Objectives:

• Identify the role of positive psychology coaching in physician well-being and professional development.
• Identify the factors that contribute to and promote positive responses to the stressors faced by physicians.
• Identify strategies to incorporate positive psychology coaching into conversations with physicians.

Kerri Palamara, MD
Harvard Medical School Massachusetts General Hospital 

Colleen Christmas, MD
Johns Hopkins University School of Medicine 

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

Richard Wardrop, III, MD, PhD
University of North Carolina School of Medicine 

(W) 310. The Art of Caring for Self and Others

To meet our learning objectives, we will guide participants through an engaging activity during which they will imagine and actively experiment with other-oriented perspective-taking using a work of visual art. We will also lead a small group debriefing session using two key excerpts from the literature about perspective-taking. We will explore how emotional reasoning concepts link to perspective-taking and how the cultivation of growth mindset can change one’s perspective on challenge. We will also briefly discuss the work we have done in the internal medicine residency using these techniques.

Educational Objectives:

• Differentiate between self and other oriented perspective-taking.
• Describe how physician mood states may inform how physicians understand their patients.
• Understand how the cultivation of a growth mindset can aid in learning and reduce distress in the face of discomfort or challenge.

Mariah Quinn, MD
Amy Zelenski, PhD
University of Wisconsin School of Medicine and Public Health

(E/F) 311. A Better Way to Assess Exam Skills: Direct Observation and Volunteer Patients

This workshop will demonstrate a novel method for assessing and teaching physical examination skills to medical students and residents. The technique we demonstrate relies on a volunteer patient with known physical examination abnormalities. Our goal is to give clinician educators the skills needed to carry out structured physical examination assessments with their own volunteer patients. Our assessment can be used for formative or summative purposes.

Almost all current physical exam assessments rely either on simulation (e.g. computer-based tests of learner ability to identify abnormal heart sounds or on a learner’s ability to demonstrate the technique of the physical exam without actually identifying any abnormalities (e.g. Step 2 CS and mini-CEX). Our workshop will highlight strategies for overcoming these limitations. Using a role-play format with presenters and volunteers from the workshop, we will demonstrate how to lay out a patient room for a 15-minute assessment involving one learner, one volunteer patient, and two clinician-educators.

Workshop participants will have an opportunity to enter the role of both learner and preceptor. In the role of preceptor, they will examine a volunteer patient and practice “calibration”—a deliberative process in which two supervising clinician educators determine which physical findings and diagnoses should be identified by learners.

Participants will be provided with examples of scoring sheets that can be used to rate learner performance in summative versions of the assessment. We will also demonstrate methods for providing formative feedback at the end of the assessment.

Educational Objectives:

• Learn a method for physical exam skills assessment that closely mirrors clinical practice.
• Integrate formative feedback into physical exam assessment.
• Understand challenges in using volunteer patients for summative assessments along with methods for addressing these challenges.

Bennett Clark, MD
Brian Garibaldi, MD
Joan Lee, MD
Johns Hopkins University School of Medicine

(ACC) 312. Code Blue Simulation Two Ways: Novel Use of Simulation Curricula as a Mechanism for Milestone Evaluation

This workshop is designed to showcase simulation and milestone evaluation, emphasizing how the two can be combined. Collaborators from two institutions will each describe their program’s “code blue” (cardiac arrest) simulation curriculum. Although both curricula utilize simulation to address the low-frequency, high-stakes event, the differing designs allow emphasis and evaluation of different milestones. One curriculum is a longitudinal, three-year curriculum that emphasizes the transition from novice to expert, with high-performing residents becoming program instructors. The second curriculum is a team-based curriculum that emphasizes interprofessional teamwork and communication skills. Participants will be introduced to these curricula, including data on their impact and evaluation of the programs. Selected participants will have the opportunity to replicate one of the simulation scenarios during the live workshop. Using the examples and demonstrated principles, participants will then identify a program-specific low-frequency and/or high-stakes skill, scenario, or behavior that might be suitable for simulation. In small groups, participants will work to outline a curriculum that utilizes simulation to address this identified problem, but also purposefully incorporates milestone evaluation. In large group discussion, participants will share developed ideas and reflect upon strategies and barriers to implementation. At the end of this workshop, participants will walk away with the knowledge, materials, and skills to implement either of the exemplar “code blue” simulation curricula and a host of other outlined curricula which are developed during the workshop.

Educational Objectives:

• Describe how simulation-based training is a mechanism to both teach and accomplish milestone-based evaluation of resident performance in low-frequency and/or high-stakes events.
• Identify low-frequency and/or high-stakes events individual residency programs which could be suitable for simulation-based curricula.
• Design a simulation curriculum, including milestone evaluation, for implementation at home institutions. 

Lorrel Brown, MD
University of Louisville School of Medicine 

Melanie Sulistio, MD
University of Texas Southwestern Medical Center at Dallas Southwestern Medical School 

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.

Educational Objectives:

• 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.

Educational Objectives:

• 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.

Educational Objectives:

• 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.

Educational Objectives:

• 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.

Educational Objectives:

• 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.

Educational Objectives:

• 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
Reading Hospital 

(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.

Educational Objectives:

• 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.

Educational Objectives:

• 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.

Educational Objectives:

• 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.

Educational Objectives:

• 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?

Educational Objectives:

• 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.

Educational Objectives:

• 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 

Saturday, October 21, 2017
11:30 a.m. to 12:30 p.m. 

(CDI) 501. Interdisciplinary Journal Club: An Approach to Teaching Evidence Based Medicine

This workshop will demonstrate a step by step interdisciplinary method of enhancing the journal club process, including review of integrating the expertise of a medical librarian, statistician and physician leadership in the process of resident completion of journal club. Examples of how these interactions have worked for our program and a review of the resources available through the library journal club homepage will provide context to compare and contrast with the experience participants may have from other programs.

Educational Objectives:

• Demonstrate how journal clubs can be enhanced by integrating interdisciplinary expertise in a step by step process.
• Highlight the value in centralizing online resources for resident completion of journal club.
• Provide a live demonstration with audience participation of how our journal club process works to include all three phases: pre-journal club preparation, journal club presentation, and post-journal club summary.

Ross Driscoll, MD
Joseph Costello
Western Michigan University
Homer Stryker, MD, School of Medicine 

(T/L) 502. Teaching at the Bedside: Reintroduing the Patient to Resident Education

“To study the phenomena of disease without books is to sail an uncharted sea. Whilst to study books without patients is not to go to sea at all.” In an era of medicine heavily reliant on electronic medical records, duty hours, and diagnostic studies, this Sir William Osler idiom still has validity. In practice, bedside rounds can be difficult to implement as a mode of education; falling victim to resident reticence, time constraints, and the less hands-on approach of “table rounding.” Limited literature demonstrates that only 8 to 19% of rounding in this decade occurs at the bedside. Few resource are available to educate residents or attendings on bedside educational technique.

This small group discussion will introduce participants to the advantages and limitations of different rounding styles, including bedside rounds. The group will explore how the bedside teaching modality can be resident-driven and adapted for practical use on the modern teaching wards. Finally, the bedside-rounding experience will be shared and discussion led about possible implementation of bedside rounding at the participant’s home institutions.

Educational Objectives:

• Discuss the advantages and limitations of different common inpatient teaching practices and styles.
• Review the literature on the benefits and limitations of patient-centered bedside rounds for learners, attendings, and patients.
• Generate ideas for incorporating bedside encounters into duty hour restricted clinical care.

Stephen Harder, MD
Christiana Renner, MD
Roma Moza, MD
University of Texas Southwestern Medical Center at Dallas
Southwestern Medical School 

(CDI) 503. Update on AAIM Committee Work: AAIM Medical Student to Resident Interface Committee, AAIM Resident to Fellow Interface Committee, and AAIM Education Committee

This session will provide updates on the work being done by the AAIM Medical Student to Resident Interface Committee, the AAIM Resident to Fellow Interface Committee, and the AAIM Education Committee.

Educational Objectives:

• Identify strategies at the program and medical school levels to combat application inflation.
• Develop fellowship letter writing skills to align with AAIM guidelines.
• Adopt best practices for milestone-based program evaluations.

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

John P. Moriarty, MD
Yale School of Medicine 

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

Chris Williams
Alliance for Academic Internal Medicine

(IT) 504. Ready for Prime Time: A Step-by-Step Guide to Successfully Integrating Observation Medicine in Internal Medicine Residency Training

Observation units have grown in prominence as a crucial component of hospital’s operations. Historically, observation medicine (OM) has resided in the world of emergency medicine. However, internal medicine programs are beginning to recognize the important role OM plays in preparing the next generation of internists to face the challenges of this field. In addition to improved patient satisfaction and providing high quality care in a cost-effective manner, OM has the potential for a rewarding educational experience for residents. Our program pioneered an innovative OM curriculum, strengthening the confidence of medicine residents in managing observation patients, with increased understanding of regulatory requirements, billing, coding, and discharge coordination. This rotation reinforced their sense of autonomy and provides a rich source of scholarly activity in quality improvement. This workshop will outline the steps in the development of a core curriculum surrounding the intricacies of OM, including educational objectives, milestones and scheduling challenges. We will also present outcome data on resident satisfaction with OM training, comparative metrics including length-of-stay that has helped secure institutional buy-in, as well as sample quality improvement projects that are specific to OM.

Educational Objectives:

• Discuss the value of observation medicine in internal medicine residency training.
• Understand the various steps needed to establish an observation medicine rotation and curriculum.
• Evaluate the impact of an observation medicine rotation on learners, residency programs, and hospital operations.

Armand Krikorian, MD
Bela Nand, MD
Priya Sharma, MD
Sheela Metgud, MD
University of Illinois College of Medicine at Chicago
Advocate Christ Medical Center

(L) 505. May the Force Be with You: How to Effectively Leverage Your Meetings

As clinician-educators, we must work in interprofessional teams around the bedside and the meeting table. These teams often consist of individuals from different medical specialties and different professions, who are in various stages of training and have various levels of influence. Many of the projects we work on, from creating new educational curricula to quality improvement initiatives, require a collaborative team approach and multiple sessions in the conference room. Successful meetings allow a team to identify common goals, brainstorm ideas, reach a consensus, and work productively to develop a plan to attain the goals. Yet, we have all experienced unproductive meetings due to a lack of a clear purpose and agenda, disruptive and disengaged participants, or ineffective facilitation by the meeting chair. This workshop will focus on the skills to maximize collaboration and productivity to help you make the most out of your meetings. First, we will review core concepts of how teams function. Then we will describe key facilitation skills needed to run an effective meeting, including how to manage disruptive behaviors, how to keep a meeting on track, and how to rally the team together for a common goal. Finally, we will discuss common mistakes made when engaging senior leadership.

Educational Objectives:

• Classify the stages of team development.
• Summarize key facilitation skills to run effective meetings.
• Review techniques to effectively engage senior leadership.

Emily Fondahn, MD
Geoffrey Cislo, MD
Thomas M. De Fer, MD
Thomas Ciesielski, MD
Washington University in St. Louis School of Medicine 

(FD) 506. More than a Language Barrier: Teaching Trainees to Provide High-Quality Care to Individuals with Limited English Proficiency

The 2002 IOM report reviewed the high rate of behavioral and physical health disparities in the United States, which are in part due to provider factors. It is crucial that medical trainees learn to provide culturally sensitive care to an increasingly diverse population, which includes individuals with limited English proficiency (LEP). This workshop will explore the role that unconscious bias plays in the care provided to LEP individuals and how this contributes to health disparities. In addition, we will review how disparities are perpetuated through a pervasive hidden curriculum in our medical education system that teaches trainees to place lower value on overcoming communication challenges and providing high-quality care to LEP populations.

We will then discuss practical strategies that can be adopted at individual and system levels in medical schools and residency programs to better prepare learners to care for LEP patients. Specific skills will be presented interactively and will be based on current evidence, available theoretical frameworks, lessons learned from caring for refugee and other vulnerable communities, and the diverse experiences of workshop participants. Specific topics will include role modeling and curricular innovation. We will discuss how role modeling can be used to counteract the hidden curriculum and lessen biases when providing care to LEP individuals. We will also discuss how innovative curricular strategies can be used to increase cultural curiosity and improve learners communication skills. Participants will leave the workshop with a toolkit of specific skills for teaching trainees to provide high quality, culturally sensitive care to LEP patients.

Educational Objectives:

• Discover how unconscious bias contributes to disparities in treating patients with LEP and list specific strategies for how unconscious bias can be minimized.
• Identify strategies to counter the hidden curriculum in medical education that perpetuates inadequate care for LEP patients.
• List specific skills that can be used to teach trainees to provide high quality, culturally sensitive care to LEP patients.

Tanya Nikiforova, MD
Alda Maria Gonzaga, MD
Eloho Ufomata, MD
University of Pittsburgh School of Medicine 

Deepa Nandiwada, MD
Raymond and Ruth Perelman School of Medicine
at the University of Pennsylvania

(M/C) 507. Putting the Competence Back into the Clinical Competency Committee

This workshop shares insights into running an efficient Clinical Competency Committee (CCC) that fulfills ACGME requirements, is a useful tool to program directors, is less onerous on members, and provides independent feedback to learners. Our CCC comprises 15 multidisciplinary members. It is structured as an independent advisory committee to our program director and provides residents with meaningful feedback. We devised a schedule for two formal reviews of residents per year occurring six months apart. A third mid-year review period is reserved for residents whom the program director has concerns and allows the opportunity to discuss resident in-training examinations. We use a novel templated approach to capturing resident information necessary for committee review. The template is two pages long and used for the duration of the residents training, merely adding information following meetings. The committee uses a reproducible system to adjust milestone evaluations, which realigns the inflation by inexperienced preceptors not familiar with milestone evaluations. At the completion of meetings, a summative letter is generated with feedback to the resident including elements of praise, concern, or both. This letter is attached to a resident version of our faculty template to provide the resident with the raw data used to formulate their evaluation. The resident is expected to collect and sign for the letter stressing the importance of CCC reviews.

The faculty/resident templates and CCC letters are saved electronically and accessible for review/use by the program director in matters of remediation, probation, or completion of biannual reporting of the 22 reportable milestones.

Educational Objectives:

• Provide a blueprint to create and implement an efficient CCC and meeting structure.
• Share a novel template for capturing resident information for review during meetings which can also be used for future administrative tasks to include supporting evidence for remediation/probation or submissions for WebAds.
• Use CCC reviews as a meaningful feedback tool for residents beyond just punitive repercussions.

Claudia Kroker-Bode, MD, PhD
Chad J. Demott, MD
Michael X. Wiid, MD
Virginia Tech Carilion School of Medicine 

(A/O) 508. Communications Planning and Strategies for Residency Programs

This workshop will explore the creation of a communications plan for a residency program that can help with internal communications with trainees and educators, recruitment efforts with prospective residents, and rollout of institutional initiatives. We will review effective and efficient strategies, tools, and staffing models that departments and programs can use to manage up-to-date web pages, print materials, and other activities.

Educational Objectives:

• Review the range of communications strategies available to a residency program to keep its trainees, faculty, and staff informed and engaged.
• Discuss a variety of tools and resources—including websites, blogs, and social media—for improving the flow of news and announcements to your residency program and beyond.
• Discuss a sample communications plan for a residency program and discuss ways to collaborate with your department, school, or hospital communications professionals.

Anton Zuiker
Duke University School of Medicine 

(W) 509. Empowering Residency Resilience through Self-Directed Learning

During their training, residents are at risk of suffering from burnout. Burnout may be influenced by a number of factors including long work hours, challenging clinical situations, and for some the sense of inadequacy that inevitably accompanies “learning on the job.” To address burnout among residents, our program has developed a resiliency exercise that promotes self-reflection through an emphasis on self-directed learning. We developed a biannual case-based conference, where each resident self-identifies and submits a case of a patient whom they have cared for where they grew in knowledge, acquired a new skill, or overcame a challenge. All cases and learning points are compiled in a handout that is shared among residents and faculty; four cases that highlight different principles of resilience are selected by the faculty mentor for residents to present and share with their peers at a noon conference. This workshop will share with participants the positive effects of this initiative on promoting resilience among our residents in a manner that requires no extra expenditure and is fun. We will begin with an interactive discussion on burnout and resiliency programs. We will then share with participants the format and examples of our self-reflection handout and noon conference. Finally, we will share results of a survey distributed to our residents seeking to assess the effect of this initiative on resilience.

Educational Objectives:

• Recognize that residents are at risk for burnout and understand the various factors that may lead to burnout during the course of training.
• Describe how residency programs are addressing burnout and implementing programs to promote resilience among residents.
• Provide a specific example of an initiative designed to promote resilience.

Danise Schiliro, MD
Jadwiga Stepczynski, MD
Ruth Weissberger, MD
Yale-New Haven Medical Center (Waterbury)

(IT) 510. How to Create Easy, Robust Learning Modules in Just Minutes

During this workshop, all members present will partake in an interactive lesson learning the tools and skills to create a custom, robust video module/presentation using the widely available smart device software “Explain Everything.” Using their own personal smart device, users will be able to produce professional quality material that is intuitive to create, seamless to visually and vocally annotate, effortless to edit, and painless to export. All with minimal time commitment and cost. It is the perfect tool for teachers yearning to create an engaging, dynamic presentation.

Educational Objectives:

• Understand the broad range of applications “Explain Everything” can be used to create effective learning modules.
• Develop the skills to effectively navigate and utilize the software.
• Create an individual module based on templated project to encourage interactivity and hone those skills during the workshop.

Aaron Smith, MD
Oregon Health & Science University School of Medicine 

(W) 511. Enough about Burnout! Let’s Talk Emotional Well-Being and How to Make It Happen

Physician stress and burnout are tightly linked, with negative consequences for the provider and the health care system: reduced quality of care, absenteeism, cynicism, and decreased empathy. In residents, one also sees decreased motivation to learn, less adherent patients, poor chronic disease management, unnecessary test ordering, and increased medical errors. Burnout is a maladaptive response to chronic stress, associated with high intolerance to uncertainty, further exacerbating the problem. Physician wellness is vital to high quality care delivery and it is imperative that we understand this phenomenon and the contributing and protective factors. Residency programs should be empowered to recognize the traits and behaviors associated with burnout, including low resilience, grit, and hardiness; and high intolerance of uncertainty. Early identification allows for preventative strategies to empower and coach residents to build resilience and coping skills for stress. Individuals exhibiting protective factors can have these strengths identified and cultivated to enhance their buffer to stress. Understanding these traits may better identify residents in trouble, serving as more sensitive precursors to depression and burnout. The workshop will review the factors contributing to physician burnout and the protective factors that can sustain residents and promote well-being and happiness. Speakers will provide participants with five evidence-based positive psychology coaching questions tailored to promote these factors in residents by connecting them with what brings them joy in their work, the components of their work that are most meaningful to them, their strengths, and the vision of themselves at their best.

Educational Objectives:

• Define burnout, well-being, resilience, grit, and hardiness and understand the impact of these factors on residents.
• Identify the factors that contribute to and promote positive responses to the stress of uncertainty in residents.
• Incorporate five evidence-based questions to promote these factors in residents. 

Kerri Palamara, MD
Arabella Louise Simpkin, MD
Harvard Medical School Massachusetts General Hospital 

Asher Tulsky, MD
Boston University School of Medicine 

Sima Desai, MD
Oregon Health & Science University School of Medicine 

(CDI) 512. Does What We Say Define Who We Are? Innovations in Teaching Communication and Addressing the Hidden Curriculum

The development of physician communication skills requires a lifelong process of practice and reflection which starts early in medical school training. All learners start at a basic level; some naturally progress very quickly, while others require more time and attention to developing this important skill set. Communication skills training often incorporates a hidden curriculum of individual practice style and development. Without explicit direction, learners may feel certain techniques “don’t work for my personality,” not recognizing the skills can be learned and implemented without change in personality. In fact, a transparency towards application of expert communication skills helps combat the hidden curriculum that good communication is personality-based and aids in professional identity formation.

As learners grow in their ability to communicate, educators need to utilize experiential learning but also progress curricula to incorporate reflection of encounters that are both successful and challenging to highlight complex skills and advancement of communication techniques. This session will give educators the opportunity to learn different methods in which students can practice and assess communication skills in ways that can easily be individualized to learners level of skill. We will demonstrate improvisation methods, direct observation techniques, and ways to grow learners into assessors of communication skills. These techniques are for both basic and advanced teachers of communication skills.

Educational Objectives:

• Utilize improvisation techniques to demonstrate communication skills to learners.
• Use direct observation of a learner to give feedback on communications skills and aid in professional identity formation.
• Discover ways to make the learner the “assessor” to demonstrate acquisition and application of advanced communication skills.

Regan Taylor, MD
Rachel Bonnema, MD
University of Nebraska College of Medicine 

Saturday, October 21, 2017
3:15 p.m. to 4:15 p.m. 

(IT) 601. Innovations in Education: Winning Strategies from AAIM Innovation Grant Recipients

A fast-paced seminar featuring five recipients of the AAIM Innovation Grants covering the main grant domains/themes: teaching and learning, high value care/quality and safety, health care disparities, and wellbeing and burnout. Each speaker will briefly present the key concepts behind their project, including methodology, development of measurable outcomes, results, and conclusion, as well as any important challenges faced.

Educational Objectives:

• Describe models of innovative teaching and curricula.
• Identify and deploy successful management of new educational projects.
• Learn strategies to actualize great ideas.

Donna J. Astiz, MD
Atlantic Health (Morristown) 

Amy B. Zelenski, PhD
University of Wisconsin School of Medicine and Public Health 

Jane Gagliardi, MD
Duke University School of Medicine 

Shannon A. Scielzo, PhD
University of Texas Southwestern Medical Center at Dallas
Southwestern Medical School 

Mary Anderson Wallace, MD
Darlene Tad-y, MD
University of Colorado School of Medicine 

Jane Andrews, MD
Yale School of Medicine

(A/O) 603. Don’t Let Your Hospital Lose Millions of GME Dollars: The Link between RMS Schedule Making and Your Finance Department

As program administrators, we have a lot of responsibilities. One of those responsibilities includes ensuring that the schedules we input in our Residency Management System (RMS) is as accurate as possible. But do you know why? Finance departments in hospitals across the country rely on the accuracy of the program’s schedule in the RMS to generate the hospital’s IRIS report/cost report. Common errors and mistakes in schedules can create errors on the IRIS report/cost report, resulting in millions of dollars in lost GME revenue for the institution.

In this workshop, program administrators will understand the importance of keeping accurate records of schedules and how the data they enter in their RMS directly affects the reimbursement the hospital receives from CMS.

Educational Objectives:

• Show program administrators how resident schedules in their RMS affects GME finances.
• Explain how the fields in your RMS correspond to a hospital’s IRIS report/cost report.
• Review common pitfalls in managing schedules and errors in record keeping that can commonly result in lost GME revenue for the institution.

Teshana Gibbs
Saima Chaudhry, MD
Memorial Healthcare System 

(W) 604. Health Break: Implementation of a Resident Run Wellness Curriculum—How Do We Make It Work?

Physicians-in-training are at high risk for depression and burnout while practicing physicians are at higher risk for suicide. Systematic reviews and meta-analyses have confirmed these findings, demonstrating 40 to 130% higher risk of suicide than gender and age-matched individuals in the general population. Reported rates of burnout and depression of 70% and 17%, respectively, have also been confirmed. These numbers are alarming and suggest that depression and suicide are occupational hazards for physicians. Not only do physicians suffer, but their patients are also affected. Previous studies have reported perceived suboptimal care and reduced effectiveness amongst resident physicians experiencing burnout. Furthermore, the increasing health care cost of physician burnout is related to medical errors, early retirement, and reduced clinical hours in later careers. In an effort to address this issue, ACGME has dedicated many resources to training and research in this area. At our institution, we have implemented a successful resident-driven wellness curriculum focused on social, physical, and emotional well-being. We hope to share our success and challenges in the implementation of this initiative and foster peer-to-peer discussions on this very important topic. This interactive workshop will discuss tools for burnout measurement, secrets for resident engagement, program implementation tools, and “bite size” mindfulness initiatives. It will also serve as an open forum for sharing experiences, questions, and concerns in wellness curriculum implementation and design.

Educational Objectives:

• Discuss the utility and benefit of objective burnout measurement tools.
• Identify residents wellness goals and acquire tools to implement a resident-driven wellness curriculum in their respective training programs.
• Engage participants in “bite size” wellness activities, self-evaluation techniques, and open forum discussions.

Karla Curet, DO
Shannon Tosounian, DO
Albert Einstein Healthcare Network 

(CDI) 605. It’s Just a Drunk: Addressing Implicit Bias and Disparities in Care Associated with Substance Abuse in the Internal Medicine Clerkship

In April 2016, the Joint Commission released a brief advisory paper on implicit bias in health care. Although this paper focused in inequalities in treatment and outcomes based on race and socioeconomic status, a small but growing body of literature examines health care professionals’ attitudes regarding substance abuse on patient outcomes. This workshop will review the literature on these biases and their progression through medical education. It will also examine contributing factors, including lack of provider training and adequate resources, and review the effect of implicit bias on the physician-patient relationship. Finally, it will explore activities both in small groups and by review of current projects for helping students recognize implicit biases regarding substance abuse.

Educational Objectives:

• Review the current literature regarding health care provider attitudes towards patients with substance abuse issues and their effect on health care delivery.
• Identify contributing factors in patients, physicians, and society that augment the disparities created by this implicit bias.
• Brainstorm activities that are practical during a busy clerkship to help students recognize their own biases while on an inpatient ward service.

Christiana Renner, MD
Kehinde Odedosu, MD
University of Texas Southwestern Medical Center at Dallas
Southwestern Medical School 

(T/L) 606. Let’s Talk Story

Storytelling—on stage, over the radio, in podcasts—is as popular as ever. This workshop will explore ways to use storytelling in residency programs and internal medicine departments to provide physicians with ways to reflect their experiences, inspirations, motivations, and observations. We will review the “Voices of Medicine” shows that we have done at in our department of medicine, learn about podcasts from national organizations and AAIM members, and also hear stories from a few of you.

The Moth and The Story Collider are popular storytelling organizations. In North Carolina, we have The Monti, and its director Jeff Polish (molecular genetics PhD from WashU) has worked with the Duke University Department of Medicine on a “Voices of Medicine” initiative as well as a storytelling dinner for the ScienceOnline 2012 conference. The live performances were enjoyable and the resulting audio files have gotten many “listens.”

Listen to the stories at https://medicine.duke.edu/medicinenews/listen-stories-voices-medicine or http://www.themonti.org/2012/01/the-monti-at-scienceonline2012/

Educational Objectives:

• Review the benefits of storytelling activities and content for reflecting the academic missions and strengthening physician resiliency through narrative medicine.
• Review the goals, logistics, and themes of a successful storytelling activity.
• Learn to tell a story and improve narrative skills with the help of a story coach.

Anton Zuiker
Duke University School of Medicine

(W) 607. I’m No Superman: Fostering Physician Resilience through Guided Group Discussion of Scrubs

Provider resiliency and burnout are recognized issues within the medical community, with increasing focus being placed on residents. ACGME has made resident wellness a priority with recommendations to create programs or curricula designed to address this essential topic at such a critical junction of their careers. We sought to stimulate open dialogue about these key topics with our residents, in an open group discussion format, by incorporating episodes from Scrubs, a popular medical television series, to present various topics that may contribute to burnout in an internal medicine residency program. We have reviewed episodes of Scrubs and generated a faculty episode guide to facilitate and guide a housestaff discussion group to ensure that a discussion of issues relating to physician burnout is simultaneously enjoyable, but focused and effective. Participants will experience two different uses of our episode guide (a focused approach and an expanded approach) by being the target audience for one of our guided discussion groups while watching an episode. Following the episode, a ready-made faculty episode guide will be distributed, and the participants will have the opportunity to edit and customize the discussion topics/questions based on their own needs and experiences. At the end of the workshop, a complete set of episode guides to support a year-long curriculum implementation will be provided.

Educational Objectives:

• Create awareness in a collegial environment of the possible factors contributing to burnout in the medical profession.
• Make accessible and feasible similar discussion programs at other health care facilities teaching programs.

Christopher Colombo, MD
Arthur Holtzclaw, MD
Jack Ellis, DO
Meredith Hays, DO
Dwight David Eisenhower Army Medical Center 

(IT) 608. Improving In-Hospital ACLS Response: Using Simulation and Interdisciplinary Teams to Practice, Re-Train, and Identify Opportunities for Improvement

Most internal medicine (IM) programs are responsible for responding to in-hospital emergencies, but the opportunities for real-time evaluation of psychomotor skills, clinical decision making and opportunity to exchange valuable peer feedback are quite limited. This workshop will highlight the opportunity for interdisciplinary learning, patient safety improvements, and maintenance of skills in the area of ACLS response promoted by a regular series of mock “code blue” situations. In two of our institutions, an interdisciplinary team of internal medicine physicians, nurses, and respiratory therapists have created a team to provide realistic immersive simulation experiences to help our teams practice and improve their response in structured clinical scenarios in a fully interactive manner that center around management of an in-hospital code blue. Sessions last no more than 20 minutes and occur within the standard work day. We will share the key elements of this program along with opportunities to replicate in other settings. Though the use of high-fidelity simulators is a plus, this sort of program can be implemented without such tools. We will share feedback from learners as well as staff and will also demonstrate realized opportunities for improvements in patient safety surrounding critical arrest situations.

Educational Objectives:

• Identify key elements of and improvements possible through training and real-time evaluation of ACLS/code blue response teams in training hospitals.
• Recognize the importance of in situ simulation in identifying systems gaps that threaten patient and team safety.
• Design a program that can replicate this effort in your own program and hospital, even if you do not have access to high-fidelity simulation.

Ross Hilliard, MD
Michael Carnevale, RRT
Drew Nagle, MD 
Warren Alpert Medical School of Brown University 

Max Dannecker, NREMT
Lifespan Medical Simulation Center 

Ara Millette, MBA, MSN, RN
The Miriam Hospital

(FD) 609.  Using the New AAIM Program Director Letter of Recommendation Template: Case Studies

In May 2017, AAIM released new guidelines developed jointly by ASP Council, APDIM Council, and the AAIM Resident to Fellows Interface Committee for residency program director letters of recommendation for fellowship applicants. The guidelines reflect efforts to overcome challenges of the current LOR variation in terminology, length, interpretation, and meaningful comparison.

The workshop will begin with a review of the rationale and evidence behind the new guidelines, followed by small group case studies. Through these studies of residents with varying degrees of milestone achievement, participants will learn how to efficiently and effectively use the new templates to serve as an advocate for residents and provide an objective assessment of capabilities.  Participants will share lessons learned and potential best practices with the larger group.

Educational Objectives:

• Identify rationale and benefits of new letter of recommendation template
• Apply template to convey information efficiently and effectively
• Define best practices in reporting competencies for varying levels of resident accomplishment

Richard L. Alweis, MD,
Rochester Regional Health/Unity Hospital (Rochester) 

Melanie Sulistio, MD
University of Texas Southwestern Medical Center at Dallas, Southwestern Medical School 

Nancy Day Adams, MD
University of Connecticut School of Medicine 

Caroline Milne, MD
University of Utah School of Medicine 

Melvin Blanchard, MD
Washington University in St. Louis School of Medicine 

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