Program Director Best Practices:
Initial Survey Results
University of Utah GME
Annual Program Director Retreat
Susan Stroud, MD
Sonja Van Hala, MD, MPH, FAAFP
September 25, 2014
Educational Objectives
• Describe the varied approaches applied across
GME programs to meet common program
requirements and conduct operations
• Identify resources to help you improve your
program operations
Special Thanks to Survey Committee
• Amy Motta
Program Coordinator, Pathology
• Christine Carlson
Program Manager, Emergency Medicine
• Chris Springman
Manager, Graduate Medical Education
What Survey and Why?
• Conceived after a discussion during a GME
Committee meeting
– Is it possible for PD’s and PC’s to have a shared
pool of resources available within our institution
to meet program requirements?
• NAS rollout
• Institution wide EMR
• New CLER requirements for programs and institution
Goals
• Identify requirements our programs are
commonly having difficulty achieving
• Identify resources to assist PD’s and PC’s in
compliance and operations
• Identify common tools/reports/resources that
GME could advocate for hospital administration
to provide to help us address these needs
Survey Specifics
• Survey monkey designed by committee and
distributed to all program coordinators in
August (thank you GME office)
• 54 Questions
• 16 respondents (it was a BIG survey)
Survey Categories
• PEC’s and CCC’s
• Evaluation Process
• Curriculum Goals and
Objectives
• Final Summative Eval
Letters
• Procedure Logs/Case
Logs/Patient Encounters
• Quality and Patient Safety
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ACGME Annual Survey
Duty Hours
Meetings
Resident Rehabilitation
Recruiting
ACGME and other web
sites
• National Program
Director Organizations
First Up: NAS Growing Pains
• Program Evaluation Committee (PEC)
• Clinical Competency Committee (CCC)
Program Evaluation Committee
• Chair of PEC?
– 72% PD
– Others: attending faculty, chief residents
• Member of PEC?
– 43% did not include residents or fellows
• How often does PEC meet?
– 50% annually
– Others: monthly to quarterly
– One: “as needed”
What Information does PEC review?
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Program Curriculum
Policies
Review of Last Meeting
Progress on historical changes
Plans for monitoring changes
that will be implemented
Faculty survey
Resident survey (internal and
ACGME)
Trainee quality improvement
projects
Procedure and case logs
Resident involvement in
community service/advocacy
committees
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In-service results
Board score pass rates
Teaching methods
Evaluation methods
Annual program evals by
residents and faculty
RRC citations
Resident evals of faculty
Resident evals of rotations
Conference evaluations and
attendance
Trainee research efforts and
publications
Graduates employment
demographics (academic vs.
private)
What information does PEC review?
• “all”
• “We have a checklist with 10 items. We cover
everything from the written evaluation of our
program (attendings, fellows and mid-levels),
reports from ACGME, ABS, RRC etc), Previous
goals and future goals.”
Clinical Competency Committee
• Similar findings
– 43% chaired by PD
– Lots of different kinds of members, 14% included
chief residents
– Meet anywhere from yearly to 6 times per year
– An exhaustive list of information is reviewed
What about just using the ACGME
Website to find the specific
requirements?
What problems do you have navigating
ACGME or WebADS?
• 7 responses
– 4 have no problems
– Slow pages, browser incompatibility
– “I find it difficult to find what I need and the
search function is useless”
Oldies but Goodies
• Evaluations
– New twist: patient satisfaction
• Procedures
• Case Logs
• Patient Encounters
Evaluations: “The program must”
• Provide objective assessments of competence
in the 6 core competencies (includes
procedural skills as part of patient care) based
on the specialty-specific Milestones
• “Use multiple evaluators (e.g. faculty, peers,
patients, self, and other professional staff)”
Opportunities for Improvement?
• Press-Ganey
– Already being used for the faculty, with results
published on our website, and the U has gained
national recognition for this move
• An alternative institution wide GME sponsored
mechanism
– If PG not possible, what about an alternative specific
to trainees?
How do Residents Track Their
Procedures (software programs)?
• 12 responses
– 58% in E*Value
– 33% in ACGME Case Log/ ADS personal portfolio
– “E*Value and Excel”
– “minimum required in E*Value, all others they
track in a paper book”
How do your residents track their
patient encounters (software
program)?
• 11 responses
– 27% NA (don’t have patient encounters)
– 36% EPIC
– Others – E*Value, excel spreadsheet, personal
portfolio, “I’m not sure this is happening”
How does your program ensure
residents are recording these data?
• 12 responses
– 8% use EPIC
– Others are mostly a review of submitted logs by
PD or CCC
– Best answer: “whip”
Opportunities for Improvement?
• Many of the methods we are using to
document these events require residents to
double document
• Should we be able to access this info through
EPIC reports?
– Procedures are documented by residents
– Patient encounters are documented by residents
Common Challenges with Common
Solutions?
• We’ve gone poll crazy!!!!
• Bust out your smart phone, iPad, laptop,
google glasses (just kidding) and help us out
with a poll right now
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Pollev.com/susanstroud214
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