UMKC IM Residency Faculty Newsletter January 2011 Inside: Residency News: Interview Season & 2012-2013 Chief Residents announced ACGME spotlight: Systems-based practice Teaching tool website: EKGs Focus on evaluations: Observing the learner at the bedside. IM Residency News The UMKC IM residency is currently wrapping up another busy season of interviews. We are expanding the residency program thanks to a HRSA grant and contributions from both UPA and TMC. We will plan to have 19 categorical interns (2 will be dedicated to the Primary Care Track) and 9 preliminary interns in July 2011. We expect to have another successful match season. Match day is March 17th, so stay tuned. We are also excited to announce the Chief Residents for the 2012-2013 academic year: Heath Wilt and Anna Grodzinsky. Heath is currently a 3rd year Internal Medicine-Pediatric resident who graduated from KCUMB and Anna is currently a 2nd year Internal Medicine resident who graduated from UMKC. We are excited for them to join our Leadership team. The Chief residents for this next academic year are Heidi Huseth and Gopi Astik. ACGME Competency Spotlight: Systems-based practice This competency focuses on the ability of the resident to demonstrate awareness of and responsiveness to the health care system. The resident demonstrates this by the ability to work in different health care settings, coordinating patient care within various settings, incorporating cost awareness, advocating for their patient, working with inter-professional teams to enhance patient safety and participating in identifying system errors. We can teach systems-based practice by discussing patient safety, how to control cost and how to utilize resources within your clinic or specialty. In our residency program we have a Patient-Safety conference once a month to focus on a recent case at either hospital. The case is chosen by the resident and the case is discussed using the “Swiss Cheese” model. The residents are encouraged to find where system errors occur and to come up with a solution. We faculty are also evaluated on our discussion of cost-based care with the team. Below is a copy of the matrix used to evaluate the residents. This matrix highlights expectations by PGY-level within the Systems-based practice competency. Please consider using this during your next set of evaluations. Works with all health care professionals effectively to provide patient focused care Advocates for quality patient care and assists patients in dealing with health system complexity Demonstrates constructive skepticism Patient advocate Intern Participates in developing methods to improve systems of practice and health management Uses systematic approaches to reduce errors Applies knowledge of how to partner with health care providers to assess, coordinate, and improve patient care Works with all health care professionals effectively to provide patient focused care Advocates for quality patient care and assists patients in dealing with health system complexity Demonstrates constructive skepticism Patient advocate Second Year Resident Practices effective health care resource allocation that does not compromise the quality of care Knowledgeable about types of medical practices and health care delivery systems Understands how individual practices affect other health care professionals, organizations, and society Adapts to changes in medicine throughout career Provides cost-effective care Participates in developing methods to improve systems of practice and health management Uses systematic approaches to reduce errors Applies knowledge of how to partner with health care providers to assess, coordinate, and improve patient care Works with all health care professionals effectively to provide patient focused care Advocates for quality patient care and assists patients in dealing with health system complexity Demonstrates constructive skepticism Patient advocate Third Year Resident Brian Aboff, M.D., of Christiana Care Health System, Wilmington, Delaware is the author of this matrix. Teaching Resources: EKG websites Here are a few great sources for teaching EKGs on the go: The Alan E. Lindsay ECG Learning Center: http://library.med.utah.edu/kw/ecg/ EKG wave Maven by Harvard: http://ecg.bidmc.harvard.edu/maven/mavenmain.asp Focus on Evaluation: Directly observing your learners at the bedside. Faculty semi-annual evaluations are coming out this month. If you have not received yours by February, please contact me at [email protected] You should continue to receive this report twice a year. These evaluations are collected over a six month period to allow for anonymity and to give a trend to your evaluation. Take time to review your report and see where you fall amongst your peers. Soon, we will be offering modules to help bolster your medical education skill set. In the past newsletter I offered ways to improve your feedback and setting expectations with your learners. In this letter I would like to focus on observing your learners at the bedside. Take a moment to ask yourself if you have observed your resident perform an exam. We would all like to hope that our residents know how to perform a solid physical exam. Our residents have varied medical school backgrounds and experiences. ACGME requires that our residents have an observed patient encounter each quarter, called a “Mini-CEX”. This is to be a focused encounter and not a full H&P. Depending on your rotation, consider observing your residents performing portions of an exam. For example, while on Gastroenterology you could observe the resident palpating the liver or assessing for ascites. Think of yourself as the coach of your team and give feedback regarding the interaction and correct any incorrect techniques by demonstrating the correct technique and discussing the difference. It would then be beneficial to follow up on this exam skill and ensure that the resident is performing it correctly.