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2/5/2019
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H e i d i K r o m r e i , P h DC l i n i c a l F a c u l t y , M i c h i g a n S t a t e U n i v e r s i t y C o l l e g e o f O s t e o p a t h i c M e d i c i n e
A s s i s t a n t D e a n , W a y n e S t a t e U n i v e r s i t y S c h o o l o f M e d i c i n e
Proven Practical Approaches to
Increasing Scholarly Activity for Residents
and FacultyWebinar for the Statewide Campus System
College of Osteopathic Medicine at Michigan State University
February 5, 2019
1. Understand the evolving ACGME requirements and expectations for scholarly activity in residency programs
2. Recall strategies to increase program scholarly activity
Session Goals
2018 ACGME REQUIREMENT:FACULTY SCHOLARLY ACTIVITY
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Participation in Professional Activities/Committees Publications Presentations Chapters/TextbooksGrant Leadership Leadership or Peer-
Reviewed Role Teaching Formal Courses Participation in Quality
Improvement Projects
How is Scholarly Activity Currently Measured by ACGME?
ACGME FACULTY SCHOLARLY ACTIVITY DEFINITIONS
Source: ACGME Web ADS
Professional Activities/Committees
Bibliography
Review Articles, Chapters, Textbooks
Presentations, Abstracts, Grants
ACGME CURRENT FACULTY SCHOLARLY ACTIVITY
REPORTING (INITIAL TO CONTINUED)
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2018 ACGME REQUIREMENTS: RESIDENT SCHOLARLY ACTIVITY
RESIDENT SCHOLARLY ACTIVITY DEFINITIONS
Source: ACGME Web ADS
ACGME CITATION: INITIAL APPLICATION
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2019 ACGME COMMON PROGRAM
REQUIREMENTS: SCHOLARLY ACTIVITY
CHANGES
Current (2018-2019) ACGME requirements for faculty members to demonstrate scholarship will not be a part of the 2019 ACGME Common Program Requirements
2019 ACGME REQUIREMENT CHANGES
2019 ACGME SCHOLARSHIP DEFINED
This seems like a very big shift in a good direction
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Among their scholarly activity, programs must demonstrate accomplishments in at least three of the following domains:1. Research in basic science, education, translational science,
patient care or population health2. Peer-reviewed grants3. Quality improvement and/or patient safety initiatives4. Systematic reviews, meta-analyses, review articles, chapters
in medical textbooks, or case reports5. Creating of curricula, evaluation tools, didactic educational
activities, or electronic education materials6. Contribution to professional committees, educational
organizations, or editorial boards7. Innovations in education
2019 ACGME CPR: PROGRAM SCHOLARSHIP REQUIREMENTS
ACGME Review Committees will choose to require
# 1 OR BOTH #1 AND #2
1. Faculty participation in grand rounds, posters, workshops, quality improvement presentations, podium presentations, grant leadership, non-peer-reviewed print/electronic resources, articles or publication, book chapters, textbooks, webinars, service on professional committees, or serving as journal reviewer, journal editorial board member of editor
2. Peer-reviewed publication
ACGME REVIEW COMMITTEE SCHOLARSHIP REQUIREMENTS
Residents must participate in scholarship
The ACGME review committee may further specify
2019 ACGME RESIDENT SCHOLARSHIP
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Practical Strategies for Program Requirements for Scholarship
Strategies
Engage in system-level projects (posters)
Build on IRB-approved protocols (amendments)
Collaborations with academic affiliates and departments (tenure-track faculty)
Challenges
Time Burden Research expertise and
experience required Level of rigor Longitudinal project
management Lack of research
support
RESEARCH IN BASIC SCIENCE, EDUCATION, TRANSLATIONAL SCIENCE, PATIENT CARE OR POPULATION HEALTH
Strategies
Begin small (pilot projects)
Apply for internal grants
If not funded, seek other resources (hospital, department)
Try, try again (If you don’t apply you WILL NOT get it)
Challenges
Highly-competitive Knowledge/Skills Grant writing support
access varies Time Burden Resources
PEER REVIEWED GRANTS
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Strategies
Review articles require less capital and resources
Consider editing a book on educational topic and engage your faculty to write chapters (control)
Double down on case reports (faculty, residents) and submit often
Challenges
Significant writing time
Statistical skills (meta analyses)
Time
Sustained interest
SYSTEMATIC REVIEWS, META ANALYSES, REVIEW ARTICLES, CHAPTERS IN MEDICAL TEXTBOOKS, CASE REPORTS
Strategies
Program Director Specialty Groups
Knowledge/resource sharing – work distribution
IRB not always required Residents tech savvy
and interestedMedical Ed Journals, QI
poster days
Challenges
Tool reliability/validation
Lack of technology skills/access to tools
Lack of knowledge of electronic resources and publishers
CREATE CURRICULA, EVALUATION TOOLS, DIDACTIC EDUCATIONAL ACTIVITIES, ELECTRONIC EDUCATION
MATERIALS
Strategies
Engage both residents & faculty
Consider meeting frequency
Serve as judge or reviewer for conference submissions, research day
SCS, PD, Faculty Development Committees
Network, Invite yourself
Challenges
Time Burden Networking ability Opportunities lost due to
being unaware of opportunities
Longitudinal commitment
CONTRIBUTION TO PROFESSIONAL COMMITTEES, EDUCATIONAL ORGANIZATION, OR EDITORIAL BOARDS
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Strategies
Seek resident and junior faculty participation & guidance
Start small, think big Technology used in
different ways Look to other fields (non-
health care) for ideas and support
Think out of the box
Challenges
Time Burden Networking ability Lack of resources
INNOVATIONS IN EDUCATION
PRACTICAL STRATEGIES TO INCREASE
SCHOLARLY ACTIVITY
1. Scholarly Activity Strategic Plan 2. Develop QI projects to address reported non-compliance in
ACGME Resident Survey 3. Think low hanging fruit4. Identify areas of interest to faculty and residents in the clinical
setting (carrots!)5. Identify and uti l ize institutional resources6. Create a template for managing QI and research projects and
use it routinely (Coordinator collect)7. Increase your knowledge about QI and research (volunteer!) 8. Create or join a team of other GME folks and spread the work
and wealth (Specialty PDs, Faculty Group, Inter-Professional Team, SCS group, Coordinator Group, etc.)
9. Develop useful, practical QI projects that wil l help in future practice
10. Double, triple, quadruple dip
PLANNING FOR PROGRAM SCHOLARSHIP
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2019 SCHOLARLY PROJECT STRATEGIC PLANNING
Project Description Team Members
Start Date
End Date
Presentation/Publication
IHI Training Resident/Faculty Open School Online Training in QI
PD, APD, Coordinator
2/5/19 Local ConfTier 3 publication
Barriers to effective clinic scheduling
Understand the barriers to effective clinic scheduling in ambulatory clinic
CSR, F-3, R-7, PCA, CC
2/1/19 4/1/19 Local ConfRegional ConfNational ConfJournal XJournal Y
Sign Out Implement the IPASS sign out process
Hospital Admin, R-1, F-1, PD, Nurse 1
3/1/19 5/1/19 Local ConfRegional ConfNational ConfJournal XJournal Y
Set goals and timelines
Develop a management plan for each project
Delegate and distribute tasks
Nothing fancy required for tracking
Project Task
Assigned to:
Deadline:
PDSA Outline
Resident X, Faculty A
02/28/19
Finalize Project Plan
Resident C, Faculty A
03/15/19
Implement Survey
Resident D 03/30/19
Survey Analysis
Faculty B, Resident D
04/15/19
SCHOLARLY ACTIVITY PLANNING
Strategy: Develop QI Projects to address areas of reported non-compliance with ACGME Resident Survey Results
Include all relevant GME stakeholders (Hospital Admin, Nursing, CSR, Technicians, Faculty, Residents, Med Students)
Use the Plan, Do, Study, Act Model Develop and Implement Project Plan Report results at program meetings (Faculty, Resident, PEC) If you have a citation for it, report the results of your PDSA and
note the increased compliance in your next ACGME Resident Survey in your program’s response to ACGME RC
If no citation yet, tell the ACGME RC about it in your Major Changes Section to avoid citations and let them know you are on task
Continue to report results/findings to stakeholders until resolved Triple Dip: Resolve citation, improve survey, increase
resident/faculty engagement in scholarship
ACGME SURVEY NON-COMPLIANCE: EDUCATIONAL/EVALUATION QI PROJECTS
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ACGME SURVEY NON-COMPLIANCE CITATION RESPONSE EXAMPLE
Analyze call schedule frequency and complexity by site (service) Identify drivers for patient wait times and recommend solutions
(then implement them and evaluate – multiple projects) (service) Develop a new evaluation form and survey residents and faculty
to determine util ity and ef ficacy (faculty feedback, evaluation) Conduct a root cause analysis to determine cause of duty hour
violations on a rotation (CLE and Work Environment) Develop a Residency Operations Committee to address problems
with abil ity to raise issues and concerns and evaluate its outcomes/effectiveness (# projects initiated and completed, resident satisfaction) (abil ity to raise issues concerns)
Develop a resident wellness program and assess resident/faculty satisfaction (new wellness section)
Develop and implement a strategic plan for program scholarship and measure its ef fectiveness by productivity (scholarly activity)
Chart Audit Activity (provided data about practice habits)
IDEAS FOR QI PROJECTS TO ADDRESS SURVEY NONCOMPLIANCE
Projects that are interesting and motivating
Projects that can be used in multiple places
Projects that GME folks want to do
Start small, build big (PDSA, case report, review article, expand existing project, etc.)
LOW HANGING FRUIT
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Clinical Practice Fellowship Enrollment Process Improvement Private Practice Business of Medicine Technology in Medicine Communication Academics Leadership Innovations in Medicine Hospital Administration
WHAT ARE THE INTERESTS OF THE RESIDENTS & FACULTY?
MSU COM Statewide Campus System Research Support
MSU COM SCS Online Journal for GME
Statistical Support
Local Delivery of Research Methods Seminar
MSU COM SCS Statewide Research Day (Judges, Residents/Fellow/Faculty Participants)
Hospital Research Days
Consortium Resident and Faculty Training
Online Courses
Local Subject Matter Experts and Mentors
UTILIZE INSTITUTIONAL RESOURCES
GO TO IHI SCHOOL!
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Specialty Program Director Group – develop an evaluation or curriculum or multi-institutional survey/QI project
Regional or national committee (joint projects, shared ideas)
AAMC GME Leadership Academy (national networking, poster, joint projects, mentorship)
Specialty conference faculty development and resident training – QI and Research, Evaluation and Teaching
National Committees (AAMC, AOA, GRA, ACOS, etc.)
JOIN SOMETHING!
Every project should have at least one resident and faculty member participating
QI project to poster(s) to presentation(s) publication(s)
Multiple settings in which to publish work
Look for the helpers (who need publications?)
PRACTICE THE ART OF THE DOUBLE, TRIPLE, QUADRUPLE DIP
Susan Seman, DO, Program Director for Sinai Grace General Surgery Program at DMC
Initial Application citation for lack of Program Director Scholarly Activity, Continued Pre-Accreditation
Action Plan: IHI Open School QI training PD QI projects with residents and faculty Volunteer judge at DMC QI Research Day, MSU Research Day,
Michigan Summit QI Statewide competition SCS QI Boot Camp Attendee Attends other Training/Seminars QI Posters at regional and statewide research days
Outcome: Citation removed, ACGME Initial Accreditation with Commendations
ROLE MODEL FOR SCHOLARSHIP
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GOT SCHOLARSHIP PROJECTS, NOW WHAT?
Program Scholarship…It’s important!
Source: ACGME Webinar @ http://acgme.org/acgmeweb/Portals/0/PFAssets/Dec12Ophthalmology.pdf
Track your projects and outcomes
Program DirectorFacultyResident Planned, completed,
in processTell the ACGME and
remind your residents and faculty!
Present and publish your work
DOCUMENT
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Academic Medic ine Journal o f Graduate Medical Educat ion Medica l Educat ion Medica l Educat ion Onl ine Medica l Sc ience Educator Medica l Teacher Teaching and Learn ing in Medic ine Journal o f Cont inuing Education in the Heal th Professions Advances in Heal th Sc iences Educat ion Best Ev idence in Medic ine Journal of the Internat ional Assoc iat ion of Medical Sc ience Educators BioMed Centra l Medica l Educat ion Educat ion for Heal th Journal o f the Scholarsh ip of Teaching and Learn ing The C l in ica l Teacher Journal of Medica l Educat ion and Curr icular Deve lopment MedEd Por ta l Spec ia l ty Journals
MEDICAL EDUCATION JOURNALS
PUBLICATION RESOURCE GUIDES
https://www.ohsu.edu/xd/education/schools/school-of-medicine/education/educators-collaborative/resources/journals.cfm
Impact Factor of Medical Education Journals and recently developed indices: Can any of them support academic promotion criteria? J Postgrad Med. 2016 Jan-March; 62(1): 32-39 PMID: 2673194
Medical Education Journals, McGill Faculty Development Office: Accessed online on February 4, 2019 at: https://www.mcgill.ca/medicinefacdev/links/journals
ACGME Common Program Requirements (2019 Tracked Changes Version). Accessed online on February 4, 2019 at: https://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/CPRResidency2019-TCC.pdf
REFERENCES
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hkromrei@med.wayne.edu
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