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Sunday October 29

8:00 - 10:00a

GEA/GSA Mini-Workshop Session
Using AAMC Data Resources

Organizer:
Rajeev K. Sabharwal, MPH
Association of American Medical Colleges

Faculty:
Heather Hageman, MBA
Washington University School of Medicine

Brian Mavis, PhD
Michigan State University College of Human Medicine

Purpose and Rationale: An increasing number of medical schools are building outcomes assessment data bases to analyze the impact of curricular initiatives, track their graduates progress through the medical educational continuum and to address the LCME requirement to assess the extent to which educational objectives have been met. However, medical school faculty and administrative staff may not be fully aware of the extent of resources/data available through the Association of American Medical Colleges (AAMC). Because different reports from the AAMC are directed to different departments/offices within a medical school, many schools might not fully recognize and utilize the extensive resources available to them through the AAMC as part of their outcomes assessment. And while many schools have robust course evaluations and alumni surveys, the AAMC offers data with unique characteristics such as the ability to benchmark individual institutions against others and over long time periods. Schools should look for methods to maximize opportunities for dissemination of appropriate data to faculty and other stakeholders in the medical education process.

Specific Objectives: Participants will: 1)understand how to access, and develop a working knowledge of the wide array of data resources available from the AAMC including questionnaires such as the Prematriculating Medical Questionnaire (PMQ), Matriculating Student Questionnaire (MSQ) and Graduation Questionnaire (GQ); the American Medical College Application Service (AMCAS), GME Track and Faculty Roster data bases; and the AAMC Data Book and Minorities in Medical Education Facts and Figures Report; 2) recognize important issues to consider when using these data, such as response rates to questionnaires (who responds), value of programmatic vs. individualized data; what additional types of data the AAMC can provide by request, such as providing GQ individualized data , etc; and 3) develop an approach for identifying and incorporating relevant AAMC-based data and resources of value in addressing specific questions pertaining to educational outcomes for their schools.

Intended Audience: Medical school faculty and administrative staff, particularly those who are not familiar with the resources the AAMC provides to its constituents.

Seattle Convention Center - Room 205

8:00 - 10:00a

GEA/GSA Mini-Workshop Session
Creating the Teaching Commons - Forming and Sustaining Communities of Educators

Organizer:
Deborah Simpson, PhD
Medical College of Wisconsin

Faculty:
Karen J. Marcdante, MD
Medical College of Wisconsin

James L. Sebastian, MD
Medical College of Wisconsin

Cheryl A. Maurana, PhD
Medical College of Wisconsin

Laura Roberts, MD, MA
Medical College of Wisconsin

Purpose and Rationale: At the AAMC-GEA Consensus Conference on Educational Scholarship (February 2006), Patricia Hutchings, PhD, from the Carnegie Foundation for the Advancement of Teaching, presented the concept of a "commons". Well-established commons exist for disciplinary scientists for research (e.g., visiting professors, lab meetings) and for clinicians involved in patient care (e.g., morning report, M&M conferences). But, as Hutchings pointed out, "until recently the same could not be said for teaching, which, for faculty in many settings, has been largely private work, guided by tradition, but uninformed by shared inquiry or understanding of what works."

In a teaching commons, educators come together as a community to engage in critical conversations, informed by the literature and guided by experience, about teaching and learning. The challenge is how, as medical educators, do we create the teaching commons?

In 2000, two articles in Academic Medicine highlighted the key organizational infrastructure elements needed to support scholars in education (i.e. the key elements of a teaching commons). Using the four frames model of Bolman and Deal, Fincher et al., outlined how medical schools and professional organizations can be structured to support the scholarship of teaching; Simpson et al. illustrated how these frame features could be used to analyze the infrastructure elements supporting educational scholarship, including establishment of a Society of Teaching Scholars at one medical school. More recently, Irby et al. and Dewey et al. critically examined the society/academy movement as an approach to advancing the educational mission of educators at medical schools. MCW's society, established in 1990, was the first created, with seven more academies established by 1999 and an additional 11 developed from 2000-2003. The speed of culture change in medical schools has been likened to moving a cemetery or changing the direction of a battleship. Thus, Hutchings emphasizes the need to take an evolutionary/developmental perspective on the creation of a teaching commons. MCW is uniquely positioned, given its 15-year society history, to examine how such an activity, in partnership with other structural, political, human resource, and symbolic components of the organization, can evolve to create a community-wide teaching commons.

To capture this evolution/progression towards creating a teaching commons, we use the concept of a teacher pyramid. The base of the pyramid is the content expertise of faculty in their respective discipline/specialty. The evolution to expert requires teachers who are public about their interests in teaching and learning and who, over time assume leadership in creating forums/commons in which educators come together to critically examine teaching and learning. The pyramid is a useful construct as it frames the foci for the teachings commons at each stage of evolution.

The purpose of this workshop is to briefly review the teacher pyramid and then use each of its stages to help participants develop strategies for creating a commons in their own setting. For example, how can one assemble the "expert teachers" and create a meaningful forum for discussion? Who are the individuals who "profess" the importance of teaching and learning at your institution? How and where do /can they get together to create a teaching commons? What role does your society/academy have within the institution? For each stage of the pyramid, participants will be asked to analyze the organizational culture using Bolman and Deal's four frames (structural, political, human resources/training, symbolic) to insure that they are creating a commons that will be sustainable.

Our discussion will also be informed by the literature on creating communities and our experience with community-academic partnerships a teaching commons is in essence a community of educators working in partnership towards shared goals. Building from the success of our community-academic partnerships, our work has taught us that effective partnerships require: (1) adherence to a shared set of principles; (2) understanding of the environment for partnerships and the stages of development; and, (3) creation of a mutually beneficial agreement. Principles that guide our partnerships include developing common goals, building trust and respect, and emphasizing strengths and assets. Open communication and feedback are also critical, as are flexibility, mutual benefit, and shared resources and credit.

Applying these principles to creating a community of educators we have sought to establish a:

1. Clear vision
2. Results orientation (e.g., demonstrated program success through measurable results)
3. Strategic resources orientation (e.g., ability to identify the resources needed to develop and sustain their activities)
4. Ability to quickly adapt to changing conditions (e.g., changing leadership, economic, and political changes)
5. Key champions
6. Sustainability plan

Using a combination of individual worksheets, facilitated small group discussions, large group formats and brainstorming to generate ideas and critique solutions, participants will leave the session with a work plan and timetable for creating a teaching commons aligned with their institution's unique culture/infrastructure and stage of progression in the teacher's pyramid.

Specific Objectives: At the conclusion of the workshop, participants will be able to:

1. Articulate the key elements associated with establishing and sustaining a teaching commons - a community of educators who critically discuss teaching and learning.
2. Present a work plan with a timetable for creating a teaching commons in their home institution (e.g., division, department, medical school)
3. Identify 2-3 colleagues at other institutions who are engaged in similar efforts as part of creating a teaching commons colleague network

Intended Audience: Faculty, administrators, teachers, education leaders (formal and informal) and those individuals interested in advancing education and educators at their institution.

Seattle Convention Center - Room 203

8:00 - 10:00a

GEA/GSA Mini-Workshop Session
Longitudinal Faculty Development: Beyond Teaching

Organizer:
Gwen Lombard, PhD
University of Illinois College of Medicine at Peoria

Faculty:
Meenakshy Aiyer, MD
University of Illinois College of Medicine at Peoria

Larry D. Gruppen, PhD
University of Michigan

Purpose and Rationale: Faculty development programs are increasing in medical schools and academic centers and are accepted as an important resource for the enhancing the teaching skills of clinical-educators. In addition to teaching skills, faculty development programs also develop faculty skills in research, administration, leadership, medical informatics just to name a few. Even though faculty development is recognized as integral to fostering high quality patient care and education, resource, and personnel often interfere with effective implementation and assessment of the FDP. Aligning the goals and objectives with the mission of the institution and identifying innovative ways to implement the program might be beneficial.

Specific Objectives: To assist faculty in the creation of a longitudinal faculty development program that encompasses teaching, scholarship, and leadership based on their institution mission.

At the end of the workshop the participants will be able to:

1. Identify the critical elements of a longitudinal faculty development program
2. Tailor a longitudinal faculty development program to fit the mission/vision and cultural of their organization or institution
3. Define the goals for a longitudinal faculty development program that meets the needs of their institution and faculty.

Intended Audience: Faculty, educators and administrators

Seattle Convention Center - Room 211

8:00 - 10:00a

GEA/GSA Mini-Workshop Session
Giving Feedback Across the Continuum: Addressing Professionalism in Students, Residents and Faculty

Organizer:
Rachel Stark, MD
Mount Sinai School of Medicine

Faculty:
Lisa D. Bensinger, MD
Mount Sinai School of Medicine

Erica Friedman, MD
Mount Sinai School of Medicine

Janet Hafler, EdD
Harvard Medical School

Jennifer Koestler, MD
Mount Sinai School of Medicine

Mary Y.. Lee, MD
Tufts University School of Medicine

David Muller, MD
Mount Sinai School of Medicine

Suzanne Rose, MD, MEd
Mount Sinai School of Medicine

Purpose and Rationale: Professionalism has been identified as an educational competency across all levels of medical education. The explicit teaching of professionalism is endorsed by the AAMC for undergraduate medical education, and by the ACGME for graduate medical education. A code of professional practice also exists for each medical specialty. Yet, specific feedback on professional behaviors is conspicuously absent in the training of students and residents, and in the ongoing evaluation of faculty. Providing feedback can be challenging and addressing behaviors that reflect a learner's personal characteristics can be particularly difficult. This workshop will help to identify the specific professional behaviors, across all levels of training, which can be targeted for feedback. The group will identify barriers to feedback and work together to brainstorm approaches for effective feedback on professionalism for students, residents, and faculty. Additionally, we will demonstrate that structured feedback sessions, specifically dedicated to professional behaviors is, in itself, an educational intervention which makes the concept of professionalism a part of the explicit curriculum.

Specific Objectives: After attending this workshop, participants will be able to:

1. Recognize how feedback about professional behaviors can be used as an educational intervention.
2. Identify and develop strategies to overcome barriers to giving effective feedback about professionalism
3. Determine appropriate domains of professionalism amenable to feedback
4. Use effective language in providing feedback to learners at all levels

Intended Audience: Medical Educators who are responsible for providing feedback at any and all levels of medical education.

Seattle Convention Center - Room 212

8:00 - 10:00a

GEA/GSA Mini-Workshop Session
Longitudinal and Interdisciplinary Evaluation of Clinical Skills and the Appropriate Use of "Forward Feeding" of Clinical Performance Information

Organizer:
Lynn M. Cleary, MD
Upstate Medical University

Faculty:
Susan M. Cox, MD
University of Texas Southwestern Medical Center

Louis Pangaro, MD, FACP
Uniformed Services University

Jeffrey A. Stearns, MD
University of Wisconsin

Purpose and Rationale: The goal of this workshop is to review methods of evaluating clinical skills in a longitudinal and interdisciplinary fashion. Traditionally, the clinical skills of medical students are evaluated by each individual course and clerkship in isolation. This is problematic, since most core clinical skills are developed and refined over a period of several years, including medical school and postgraduate training. Many recent curriculum projects and white papers have emphasized a longitudinal, developmental approach to teaching and assessment of these skills. In the traditional model, individual clerkships must spend the first several weeks assessing the status of student skills, consuming time that could be used to focus earlier on areas of need for the individual student, building on prior observations from past performance. There are some risks of communicating student performance between and among clerkship directors, but the needs for individualized and progressive improvement of skills provides ample rationale for collaborative, longitudinal, and interdisciplinary assessment. Participants in this workshop will receive information and resources to support progress toward interdisciplinary, collaborative responsibility for the teaching and assessment of clinical skills in their own institutions. This workshop is jointly sponsored by members of the Alliance for Clinical Education (ACE) and the Steering Committee of the Undergraduate Section of the GEA. ACE's mission is "to foster collaboration across specialties to promote excellence in clinical education of medical students." Members include representatives of the seven national organizations of clerkship directors, representing the core clinical clerkship disciplines at most medical schools. The UGME section of the GEA fosters "the development and continued improvement of undergraduate medical education programs to enhance medical students' learning and subsequent performance as graduate physicians."

Specific Objectives: At the end of the workshop, participants will be able to:

1. Describe the advantages of longitudinal and interdisciplinary assessment of core clinical skills of medical students.
2. Identify the pitfalls of forward-feeding performance information.
3. Outlines steps involved in developing policy and procedure for longitudinal assessment of clinical skills.
4. Choose methods of assessing clinical skills longitudinally and across course boundaries that are appropriate to individual schools.
5. List the resources needed to provide systematic support to the longitudinal development of clinical skills, including those needed for students at academic risk.

Intended Audience: This workshop is designed for curriculum and education deans, clerkship directors, and pre-clerkship clinical skills course directors involved in the teaching and assessment of core clinical skills. Faculty involved with early identification and support of students at academic risk may be interested.

Seattle Convention Center - Room 213

8:00 - 10:00a

GEA/GSA Mini-Workshop Session
The Challenge of Peer Evaluation in the Context of Team Based Learning

Organizer:
Ruth E. Levine MD
University of Texas Medical Branch, Galveston

Faculty:
Dean X. Parmelee, MD, FAACAP
Boonshoft School of Medicine, Wright State University

Nagaswami Vasan, PhD
University of Medicine and Dentistry of New Jersey

Kathryn McMahon, PhD
Texas Tech University Health Sciences Center

Purpose and Rationale: Peer evaluation can be a valuable tool to enhance learners' performance. Using peer evaluation to assess interpersonal and professional behaviors is becoming increasingly important in medicine. While limited data about peer evaluation in medical education settings exist, proponents highlight its potential to foster insight, reinforce other evaluations, and predict future performance. Studies of peer evaluation demonstrate positive correlations with faculty evaluations1-3 and written exam performance, 4-7 however, the literature to date paints a complex picture. In some settings, learners believed that they benefited from peer evaluation; in others they resisted the process. 8-16 Learners who accepted the method believed that the quality of their work improved based on the feedback given.8, 10 In other studies, learners who disliked peer evaluation believed that it interfered with their relationships with fellow learners. 14, 16 As educators who have used a particular format of instruction known as "team based learning" which relies on peer evaluation to ensure that students are held accountable to their teammates, we have struggled with a variety of issues inherent in the practical application of peer evaluations in medical student education. In this workshop, we will share a variety of peer evaluation methods that we have used, and give workshop attendees the opportunity to grapple with the issues inherent in peer evaluation.

Specific Objectives: By the end of this workshop, the learner will:

1. List an advantage and disadvantage of each of 4 different methods of peer evaluation.
2. Define the concept of "gaming" the system in the context of peer evaluation.
3. Appreciate the importance of preparation when introducing the concept of peer evaluation into a learner's environment
4. Analyze how learner culture affects use of peer evaluation.

Intended Audience: Clerkship directors, course directors, residency training directors, undergraduate and graduate medical educators.

Seattle Convention Center - Room 308

8:00 - 10:30a

GEA/GSA Mini-Workshop Session
The Multiple Mini Interview: A New Method of Assessing Applicants for Medical School

Organizer:
Jocelyn Lockyer PhD
University of Calgary Faculty of Medicine

Faculty:
Harold Reiter MD, MEd, FRCPC, DABR
McMaster University Michael G. DeGroote School of Medicine

Kevin Eva PhD
McMaster University Michael G. DeGroote School of Medicine

Jean-Francois Lemay, MD FRCPC
University of Calgary Faculty of Medicine

Purpose and Rationale: While applicants to medical school and residency training programs can often be differentiated reliably on the basis of cognitive ability by assessments of grade point average, university-level transcripts, and MCAT scores; differentiation on the basis of non-cognitive attributes (personal qualities) is more difficult. Research studies point to the fallibility of the traditional interview, reference letters, and essays as reliable and valid tools for assessment.

In response to this, the Admissions Office at McMaster University pioneered the Multiple Mini Interview (MMI). The MMI is an OSCE-style interview process in which applicants are scored by several assessors who are faculty members, medical students, and community members on the basis of a series of scenarios with probing questions. Stations are designed to assess such non-cognitive attributes as reliability, empathy, ethics, communication skills, and collaboration. Research at McMaster University shows this approach meets the selection goals of reliability (i.e., is able to discriminate reproducibly between applicants to medical school) and offers predictive validity (in medical school and clerkship assessments and national licensing examinations), feasibility and acceptability. This approach has been adopted in 5 countries and 15 schools (including programs for occupational and physical therapy).

Development of a system uniquely designed to the needs of an individual medical school or large residency training program can be accomplished in a manner parallel to the methodologies conducted at McMaster University and University of Calgary. The system requires identification of the attributes, the creation of scenarios, a scoring system, recruitment of assessors, appropriate physical space and an implementation plan.

Specific Objectives: By the conclusion of the workshop, participants should have the ability to:

1. Develop a selection process specific to the needs of their particular program, which will, using an OSCE-style interview system, differentiate between applicants on the basis of their non-cognitive attributes in an acceptable, feasible, reliable and valid fashion.
2. Describe the key steps in developing an MMI assessment program.

Intended Audience: Faculty and staff associated with medical school admissions and larger residency training programs.

Seattle Convention Center - Room 306

8:00 - 10:30a

GEA/GSA Mini-Workshop Session
Developing High-Quality Multiple-Choice Tests to Assess Application of Basic Science Knowledge using Patient Vignettes

Organizers:
Kathleen Z. Holtzman
National Board of Medical Examiners

David B. Swanson, PhD
National Board of Medical Examiners

Faculty:
Paul M. Wallach, MD
University of South Florida

Purpose and Rationale: Writing good tests is a challenging task. Multiple-choice questions (MCQs) often contain technical flaws providing advantages to "test-wise" examinees, and they sometimes focus on content that is relatively unimportant from clinical and life-long learning perspectives. Reflecting world-wide shifts toward integrative curricula, this workshop focuses on writing MCQ exams for basic science courses that assess application of knowledge to clinical situations, rather than recall of isolated basic science facts.

Specific Objectives: At the conclusion of the workshop, participants will be able to:

1. Recognize, correct and avoid commonly occurring technical flaws in MCQ phrasing
2. Write (and rewrite) MCQs assessing application of basic science knowledge to clinical situations rather than recall of isolated basic science facts.
3. Organize item-writing efforts for basic science courses " Participate effectively in group review of MCQs.

Intended Audience: Medical school faculty involved in writing exams, including course directors, members of medical education departments, curriculum deans and others interested in achievement testing.

Seattle Convention Center - Room 307

8:00 - 10:30a

GEA/GSA Mini-Workshop Session
Beyond "Cultural Competence:" Critical Consciousness and Multicultural Pedagogy in Medical Education

Organizer:
Arno K. Kumagai, MD
University of Michigan Medical School

Faculty:
Monica Lypson, MD
University of Michigan Medical School

Purpose and Rationale: This workshop is to help participants understand educational theory and approaches to multicultural education that shift emphasis from a static knowledge base of "competencies" to the development of critical consciousness, i.e., an awareness of disparities and injustices in the world in which medicine is practiced, of the impact that one's own and society's values, perspectives, and biases in the delivery of effective health care, and a commitment to address social inequalities in health care delivery. The format for this type of learning is student-centered, engaged small group discussions of issues of ethics and of race, gender, sexual orientation, and class in the context of medical care. This workshop is designed to present key pedagologic theories underlying this approach and to model small group interactions and facilitation that stimulate engaged discussions and the development of critical consciousness among adult learners.

Specific Objectives:

1. 1. To discuss the overall aims of the multicultural curriculum and to critically re-examine the concept of "cultural competency."
2. To explore the concept of "critical consciousness" in medical education and clinical practice.
3. To model techniques for stimulating engaged small group discussions and the fostering of critical consciousness.
4. To discuss obstacles and possible solutions facing multicultural pedagogy in medical education.

Intended Audience: This workshop is intended for undergraduate and graduate medical educators and students for use in improving small group interactive learning among medical students in multicultural education. With the skills gained from this workshop, participants will be able to develop similar small group discussions in which they can engage medical students in active, engaged reflection and discussion of societal issues in the practice of medicine.

Seattle Convention Center - Room 305

8:00 - 10:30a

GEA/GSA Mini-Workshop Session
Medical Education Research Certificate (MERC) Workshop: Basic Statistics and Data Management

Organizer:
Patricia S. O'Sullivan, EdD
University of California, San Francisco, School of Medicine

Faculty:
Ann W. Frye, PhD
University of Texas Medical Branch at Galveston

Purpose and Rationale: Data Basics is a workshop focused on data management and the basic issues surrounding analysis. We address how to record data and set up files including the development of a codebook. We cover the procedures for checking and preparing data for analysis. We describe statistical tests to consider for a few situations with the guiding principle that the researcher will consultant with a statistician. Finally, we describe statistical issues that the researcher should consider prior to or in conjunction with such a consultation including level of significance, Type I and Type II error, power and effect size.

Seattle Convention Center - Room 206

Tuesday, October 31

1:00 - 3:00p
(CANCELLED)

GEA/GSA Mini-Workshop Session
How Foreign is This Topic to You? Teaching International Medical Graduates Communication and Interpersonal Skills

Organizer:
Kathy Cole-Kelly, MS, MSW
Case School of Medicine

Faculty:
Gerald Whelan, MD
Educational Commission for Foreign Medical Graduates

Purpose and Rationale: 40 percent of Family Medicine residents are currently International Medical Graduates (IMGs). Similarly, in pediatrics, internal medicine, psychiatry, a significant percentage of the residents have attended medical schools in other countries. All IMGs have to achieve ECFMG certification to be eligible to get into a residency programs. Certification includes a requirement to pass the USMLE Step 2 CS examination. However, many of the more advanced psychosocial, communication topics that residents typically encounter in primary care practices are less familiar to these interns than to their US medical school trained colleagues. Residency programs need to assess and devise curriculum that will address these potentially 'foreign' topics to the IMGS. American medical graduates can benefit from learning about their colleagues' experiences and from reviewing their own skills, often variable depending on their UGME experience.

Specific Objectives:

1. Participants will be able to describe common psychosocial/communication topics that are not familiar to the international medical graduates in their programs.
2. Participants will be able to describe a model that will be useful for addressing topics 'foreign' to the international medical graduate.
3. Participants will practice addressing some of the topics less familiar to International Medical Graduates.
4. Participants will discover the value of eliciting resident's family genogram when introducing psychosocial / communication topics.
5. Participants will design their own curriculum to address the psychosocial/communication topics idiosyncratic to their residency program.

Intended Audience: Anyone involved in teaching international medical graduates in their residency program, will benefit from this workshop. Although many of the topics are drawn from primary care residencies, all disciplines can benefit from implementing this curriculum.

Seattle Convention Center - Room 605

1:00 - 3:00p

GEA/GSA Mini-Workshop Session
Using Deliberate Practice to Develop Expertise as Medical Educators

Organizer:
Karen J. Marcdante, MD
Medical College of Wisconsin

Faculty:
Robin Deterding, MD
University of Colorado School of Medicine

Deborah Simpson, PhD
Medical College of Wisconsin

Kristi Ferguson, PhD
University of Iowa Carver College of Medicine

Purpose and Rationale: The development of expertise in any activity requires deliberate practice which includes the repetition of a defined task, timely and useful feedback or reinforcement, reflection and motivation to improve. While this is easier to quantify and understand for elite athletes and musicians, the same principles apply in the world of medicine (1). The use of simulations and other methods that required repeated performance within the context of medical situations are useful in developing skills (2). This learning was optimized if the practice involved comparing and contrasting items (e.g. electrocardiogram tracings)(3). This finding of the need to evaluate various options is also seen in Norman's recognition that a learner needs to acquire multiple representations of knowledge to develop expertise in decision making in medicine (4).

These same concepts can and should, we believe, be applied to the development of expertise as medical educators. While numerous faculty enter the academic medical environment with an interest in teaching, few have been trained as educators. Opportunities to teach often abound, allowing repetition of the task, but few faculty participate in the other deliberate practice concepts. They often lack timely, useful feedback and, as their other responsibilities increase, may lack the explicit motivation to improve. While they may think about how to improve the next presentation, it is often performed without really knowing what strategies could be useful in improving teaching skills. This workshop will introduce the concepts of deliberate practice and, through the personal stories of the presenters as well as small group activities, identify strategies that can be used to improve participants' expertise as medical

Specific Objectives: At the end of this workshop, participants will be able to:

1. List the key components of deliberate practice
2. Identify how deliberate practice can be incorporated into the lives of medical educators
3. Apply the concepts to create a personal plan for improvement through deliberate practice.

Intended Audience: This workshop is intended for basic science and clinical faculty as well as educational administrators who are involved in the education of medical and graduate students, residents and/or fellows and are interested in developing their own expertise as educators.

Seattle Convention Center - Room 618

1:00 - 3:30p

GEA/GSA Mini-Workshop Session
Spirituality and Medicine Curricular Development: How to Start New Courses or Expand Your Current Curriculum

Organizer:
Christina M. Puchalski, MD, MS
George Washington University School of Medicine

Faculty:
Benjamin Blatt, MD
George Washington University School of Medicine

Beverly Lunsford, DNSc, RN
George Washington University Medical Center

David Musick PhD
Brody School of Medicine at East Carolina University

Jacqueline Glover, PhD
University of Colorado at Denver and Health Sciences Center

Victor Sierpina, MD
University of Texas Medical Branch School of Medicine

Purpose and Rationale: This workshop will provide participants with the opportunity to develop their curricula in spirituality and medicine under the guidance of award-winning spirituality and medicine educators.

In 1992, the George Washington University School of Medicine developed a course on spirituality and health. The course, initially an elective, was integrated into the required Practice of Medicine curriculum at GW and offered since 1996. Through a grant from the John Templeton Foundation, the George Washington Institute for Spirituality and Health (GWish), has directed a competitive awards program which gives grants to medical schools for excellence in curricular development in this topic area. In addition, in collaboration with a task force with the AAMC, Gwish developed learning objectives and outcome goals for these courses as well as ethical guidelines for spiritual care in the clinical setting.

The courses are based on theoretical and ethical principles of patient-centered care. By respecting patient's beliefs and values, we believe care is more compassionate. The American College of Physicians has specified that it is the obligation of physicians to be attentive to all dimensions of suffering in their patients, including spiritual and existential suffering. Also, the first AAMC Medical School Objectives report notes that physicians must be willing to understand patients' stories in the context of their beliefs and values.

Furthermore, there is increasingly more evidence that patients wish to have their spiritual beliefs discussed in the clinical setting; evidence also suggests that beliefs may affect healthcare outcomes.

In a survey of all medical and osteopathic schools of medicine, called the Compendium of Spirituality and Medicine Courses in US, 70 percent have courses in spirituality and health. Of those offering the courses, 70 percent are required, 43 percent are integrated and 58 percent offer greater than one course. Diverse topics are offered utilizing creative teaching methodologies. Most courses adhere to the learning objectives developed with the AAMC.

Currently, GWish is collecting narratives from the award winners through web based dialogue on Blackboard. These narratives address learning objective and course development, teaching strategies and evaluation. Awardees are sharing innovative teaching methods, how they overcame challenges, important lessons learned and how they are ensuring sustainability to their curriculum.

Many schools who have not received the award have inquired about curriculum development in this subject area as well as ways to improve current courses and integrate them into medical school curricula. This workshop will afford participants guidance in curriculum development and evaluation from GWish faculty and three outstanding award winners. Participants will be able to interact with the curriculum experts to help them develop a plan for a curricular innovation in their own institutions.

In this workshop, after summarizing research findings from the Compendium of Spirituality and Medicine and the narratives from the blackboard project, each award-winning school will briefly present their curriculum and evaluation strategies. The bulk of the workshop will be devoted to providing opportunities for the participants to develop their own curricula through interaction with the award-winning education experts.

Specific Objectives:

1. Learn about current state of the art in spirituality and medicine curriculum development
2. Learn what three model programs have developed and how they accomplished their goals
3. Develop a plan for curriculum innovation in spirituality and health for the participants' own institutions.
4. Join the online, GWish blackboard discussion group for ongoing interactions with award winners and GWish faculty for development and implementation of their curriculum. This discussion group will provide resource postings as faculty develop their courses and extend beyond the workshop.

Intended Audience: Medical educators, medical ethicists, and other faculty interested in developing new courses on spirituality and health or expanding their current courses.

Seattle Convention Center - Room 213

1:00 - 3:30p

GEA/GSA Mini-Workshop Session
Cultural Competence: from Medical Students to Faculty

Organizer:
Janet P. Hafler, EdD
Harvard Medical School

Faculty:
Roxana Llerena-Quinn, PhD
Harvard Medical School

Emily Rickards, MA
Harvard Medical School

Carmi Z. Margolis, MD, MA
Medical School for International Health, Ben Gurion University

Agneta Golan MD
Soroka University Medical Center

Linda Barnes, PhD, MA, MTS
Boston Medical Center

Chi Huang, MD
Boston Medical Center

Jennifer M. Litzow, MD
Boston Medical Center

Purpose and Rationale: Few academic clinicians receive any formal training in providing culturally competent care (CCC), yet they are expected to be educators and caregivers in classroom settings, in teaching hospitals, and in clinics where culturally competent care skills are required. The goal of this workshop is to improve the culturally competent care skills of faculty members and to share some CCC program ideas from three institutions: Medical School for International Health (MSIH) at Ben Gurion University, Beer-Sheva, Israel, in cooperation with Columbia University Medical Center; Boston University School of Medicine (BUSM) and the Boston Medical Center (BMC); and Harvard Medical School (HMS). While the search for the most effective teaching strategies in this area is on-going, some methods have been tried with good success. This session builds on the success and feedback from the workshop implemented at the AAMC last year. Participants will have the opportunity to discuss and critique three different programs used to teach and promote cultural competence, from a developmental perspective that addresses the medical students, residents, fellows and faculty needs. Participants will be able to identify and discuss effective teaching strategies currently in use at the three institutions that include learners from medical students to faculty.

Specific Objectives:

1. Be able to identify skills necessary to develop and design programs in culturally competent care.
2. Explore a variety of program designs from a developmental perspective that teach culturally competent care.
3. Explore a variety of teaching strategies that can be used to teach culturally competent care.
4. Share experience with colleagues who have a special interest in designing and implementing CCC programs.

Intended Audience: Educators and faculty who are involved in teaching or who have expressed an interest in culturally competent care will benefit from participation because each school will focus on the separate and distinct components of programs that promote cultural competence.

Seattle Convention Center - Room 206

1:00 - 4:00p

GEA/GSA Mini-Workshop Session
Nuts and Bolts of building an outcomes assessment program: Why? What? How?

Organizer:
Brian Mavis, PhD
Michigan State University

Faculty:
Heather Hageman, MBA
Washington University School of Medicine

Anthony Paolo, PhD
University of Kansas Medical School

Purpose and Rationale: A program for assessment of medical education outcomes is a requirement for Liaison Committee on Medical Education (LCME) accreditation of U.S. medical schools. Educational outcomes assessment can measure the extent to which medical school undergraduate educational objectives are achieved, and is a critical component of a dynamic medical education program. However, there is not a single set of outcome measures that can be uniformly applied to every medical school in order to fully assess outcomes of the medical education process. Rather, each school's outcomes assessment program will incorporate a unique set of outcomes measures that closely match the specific educational objectives of the institution. The scope of data collected and analyzed can range from programmatic assessments, such as anonymous student evaluations of specific courses, to long-term, individualized, follow-up information pertaining to each graduate through residency training and beyond.

By definition, a comprehensive outcomes assessment program of the entire medical school experience involves ongoing collection of data from a wide range of sources and analyzed on an integrated basis. While broad outcomes assessments might drive curricular overhauls, they also are important in informing a more stepwise approach to curricular evolution.

Interest in comprehensive outcomes assessment programs is increasing throughout the medical education community, but there is also a growing recognition of the complexity of designing and implementing an outcomes assessment program. The process involves a collaborative effort among numerous individuals, offices and departments within the medical school to address and resolve issues such as data acquisition and management, data security and confidentiality, data ownership and access, as well as outcomes reporting. Because each medical school has unique features structurally and administratively, as well as unique educational objectives, there is not a single prescribed outcomes assessment program that will be appropriate for every medical school.

However, there are common principles that can direct a proactive, deliberate approach to developing an outcomes assessment program at any medical school. A well-defined set of outcomes measurements should provide specific information pertaining to individual student and program outcomes on a longitudinal basis, which fit the medical school culture, mission and objectives. A comprehensive outcomes assessment program will likely involve utilization of currently available data as well as development of additional assessment instruments. The outcomes measures are essentially the "building blocks" of an outcomes assessment program; the coordination of medical school personnel and resources involved in data collection, analysis and distribution is the "mortar" that cements these components together into a structurally sound, functional outcomes assessment program.

The purpose of our mini-workshop is to provide each participant with the knowledge and skills to develop an outcomes assessment program tailored to their institutional setting. Through identification of institution-specific applications of outcomes assessment data, prospective development of a tentative set of educational outcome measures and recognition of potential logistic problems (as well as potential solutions) associated with data management and distribution, workshop participants will be able to develop a draft of a "blueprint" for a coordinated outcomes assessment program in their medical educational setting that is:

1. tailored to their unique education environment
2. coordinated by, and accessible to, appropriate parties within the medical school community in a secure manner; and;
3. organized to effectively and efficiently address issues of curricular program development, facilitate medical education research and fulfill oversight review requirements.

Specific Objectives: Participants in the workshop will be able to:

1. Define relevant outcomes measurements for their educational setting
2. Develop a plan for implementation of an educational assessment program tailored to fit their institutional culture and structure, including identification of potential difficulties in outcomes assessment program development and strategies to address these proactively
3. Generate a list of outcomes assessment program development priorities that appropriately reflect their medical school mission, state of change of the curriculum and interests of key stake holders.

Intended Audience: This workshop is intended for individuals involved in school-wide and/or discipline-specific aspects of outcomes assessments in undergraduate medical education.

Seattle Convention Center - Room 612

1:00 - 4:00p

GEA/GSA Mini-Workshop Session
Effective Application Exercises Teaching Critical Thinking in the Basic Sciences

Organizer:
Dan M. Mayer, MD
Albany Medical College

Faculty:
John Pelley, PhD
Texas Tech University Health Sciences Center

Scott Zimmerman, PhD
Missouri State University

Purpose and Rationale: A trend in medical education to teach the basic sciences as a passive process of rote memorization prevents students from learning to mature intellectually and improve their critical thinking skills. Medical school teaching faculty members are being asked to incorporate more active teaching strategies. Team Based Learning (TBL) is a method of teaching that incorporates innovations to foster active learning, critical thinking, self-study, advance preparation, and team communication among students in large groups. Medical education must teach through the use of higher order skills (from Bloom's taxonomy) rather than simple regurgitation of knowledge and comprehension.

In this workshop, participants will learn principles of TBL and skills that can be used to teach basic science concepts and enhance student use of higher order thought processes. This will help the students to more firmly learn the underlying material and critically appreciate the implications of the material learned in the Basic Sciences. Promoting small group (team) engagement in large group settings, TBL gives students the opportunity to acquire and practice critical thinking competencies involving content knowledge, problem solving and communications.

Developed over 20 years in business education, TBL is new to medical education. Activities funded by a FIPSE dissemination grant at Baylor Medical College have demonstrated that the method has wide appeal and interest to preclinical and clinical educators because of its inherent ability to foster active learning and team work in typically passive learning settings with large audiences. The Baylor faculty gave peer-reviewed or invited workshops or presentations at six national professional meetings (IAMSE, SGEA, CGEA, and SDRME) during the first 18 months of the program. Since then, workshops have been given at several medical schools (e.g., UCSF, Rochester, University of Oklahoma, Wake Forest, Arizona, Texas Tech, UTMB, Wright State, Albany, and Baylor). There have been two, two-day "public" workshops at Baylor and four national TBL meetings with over 80 attendees at each meeting representing over 40 different institutions. These have all been well received and highly evaluated.

TBL is an effective method of teaching that goes beyond the simple presentation of facts to the students. It increases students' interest in the process of their education by focusing on the application of knowledge to real life situations in a manner that meaningfully enhances communication, clinical reasoning, and teamwork, rather than a simple accumulation and regurgitation of retained facts. The presenters have successfully used TBL in the medical curriculum to teach various courses (Biochemistry and Cell Biology, Physiology, EBM and the Health Care System).

The workshop will help the attendees better understand how TBL can be used to incorporate critical thinking in the Basic Science. This can help to increase competencies of learners at all levels (UME, GME, and CME). We will demonstrate how multiple competencies can be structured into the application exercise in TBL lessons in the Basic Sciences. The workshop will include a wide range of examples, drawing upon the experiences at several institutions that incorporate TBL into multiple courses.

Specific Objectives: At the conclusion of the workshop, participates will be able to:

1. Explain the core principles and methods of TBL.
2. Describe what TBL is like from the learners' perspective (having had the opportunity to experience team learning in a simulated classroom.)
3. Indicate when and how to use Application exercises to stimulate higher order thinking in the Basic Sciences.
4. List the elements for creating an effective Application Exercise.
5. Use the TBL process to decide on the value of different types of Application Exercises.
6. Describe specific formats in which TBL has been integrated into medical education courses at Texas Tech University Health Sciences Center, Albany Medical College, and Missouri State University.

Intended Audience: Directors of curriculum development and faculty teaching Basic Science courses across the curriculum (UME, GME, and CME) who are interested in getting a hands-on and in-depth understanding of why, where, and, how to use TL in the medical curriculum.

Seattle Convention Center - Room 304

1:00 - 4:00p

GEA/GSA Mini-Workshop Session
Assessing and Improving the Transfer of Patient Care Responsibilities: Implementing the 2006 JCAHO Patient Safety Goal for Safe and Effective Handoffs

Organizer:
Julie K. Johnson, MSPH, PhD
University of Chicago

Faculty:
Vineet Arora, MD, MA
University of Chicago

Paul Barach MD, MPH
University of Miami

Purpose and Rationale: For many industries that operate 24-hours a day, seven days a week, the exchange of information and responsibilities that occur during shift changes is critical for maintaining continuity and safety. In hospitals, "hand-offs" serve as the basis for transferring care of patients from outgoing to incoming healthcare teams across shifts. The complexity associated with this process presents a "vulnerable gap" in patient care that results in errors, "near misses", and adverse events. There is little standardization and great variation across settings, disciplines and healthcare organizations in the ways in which hand-offs are performed. As a result, effectiveness of patient care is reduced and the potential dissatisfaction for patients and providers is increased. Furthermore, there is little training and education provided to students and trainees as to what constitutes effective and safe transitions of care.

The JCAHO, in 2006, made a "standardized approach to hand-off communications" a National Patient Safety Goal. To date, however, there is little direction on how hospitals and providers should meet this standard. Academic hospitals can use this opportunity to improve hand-offs of patient care and set standards that will guide students, residents and faculty to learn generalizable approaches to conducting safe hand-offs.

During our highly interactive workshop, we will present the results of our research that has used a variety of methods, including focus groups, direct observation, interviews, and surveys to explore how hand-offs are conducted across disciplines in hospitals. In our research we found gaps in written and verbal exchanges at the time of the hand-off or "sign-out" from the preceding shift as well as failures at retrieval of sign-out in the morning.[1-4]. We also discovered that important and intricate relationships exist among the people, processes, technology, and clinical settings in which hand-offs occur.[5] These relationships have the potential to facilitate or impede the hand-off process and directly impact patient outcomes. Understanding gaps in the content and dynamics of hand-offs from multiple perspective using a variety of methods offers the possibility of creating a standardized approach to hand-offs that is effective, efficient, and generalizable across disciplines.

We will guide the participants through a highly interactive workshop based on a model to implement a standardized hand-off protocol in clinical settings.[6] We will share lessons and best practices for conducting better transitions of care among the workshop participants.

Specific Objectives: The objectives of the workshop are to engage participants in an interactive session that will enable them to:

1. Determine which methods are most appropriate for exploring hand-offs in their clinical settings
2. Develop a standard process to optimize hand-offs using a process mapping methodology
3. Create a checklist of critical patient and process information
4. Design a strategy for dissemination and training
5. Identify and overcome barriers to implementation
6. Develop a plan to evaluate and monitor hand-off protocols

Intended Audience: This workshop is intended for medical educators, residency directors, GME leaders and Deans, residents and students.

Seattle Convention Center - Room 205

1:00 - 4:00p

GEA/GSA Mini-Workshop Session
Professionalism: Assessment and Remediation of Resident Physicians

Organizer:
Louise Arnold, PhD
University of Missouri, Kansas City School of Medicine

Faculty:
Michele D. Raible, MD, PharmD
University of Illinois College of Medicine at Chicago

Christine Sullivan, MD
University of Missouri, Kansas City School of Medicine

Ernest Yoder, MD, PhD, FACP
Providence Hospital and Medical Centers

Purpose and Rationale: To meet ACGME accreditation standards for residency programs, faculty members must attest to the professionalism of their residents and to the effectiveness of their teaching and learning programs in professionalism. Although faculty recognize the importance of promoting and evaluating professionalism, they are often reluctant to provide accurate assessment of residents' professional behavior because they believe they have neither appropriate tools to assess professionalism nor adequate programs to remediate residents who act unprofessionally. The overall objective of the workshop is to enable residency program directors and other individuals involved in graduate medical education to improve their understanding and skills in assessment and remediation in order to develop or refine a useable assessment tool and remediation plan.

This workshop was presented in a more compressed format at the CGEA Spring 2006 Meeting, and the feedback received prompted submission of this workshop to the AAMC 2006 National Meeting.

Specific Objectives: By attending this workshop, participants will be able to:

1. Explain why a transparent definition of professionalism is critical for effective assessment of professionalism and remediation of unprofessional behavior;
2. Generate a clear and succinct definition of professionalism that is useful for measuring residents' professionalism and characterizing progress of residents in remediation programs;
3. Discuss the pros and cons of frequently-used approaches to assessing residents' professionalism;
4. Identify potentially effective ways to assess professionalism of residents;
5. Craft or refine an assessment tool for use in their residency programs;
6. State general principles for remediating unprofessional behavior;
7. Describe a potentially effective technique to remediate residents' unprofessional behavior; and
8. Craft or refine a remediation plan to correct professional lapses of residents in their programs.

Intended Audience: Stakeholders in graduate medical education, particularly residency program directors, faculty members in residency programs, and deans or directors of institutional programs in graduate medical education.

Seattle Convention Center - Room 203

1:00 - 4:00p

GEA/GSA Mini-Workshop Session
Bringing Out the Ed In Med: The Latest On Medical Students-As-Teachers Programs

Organizer:
Benjamin Blatt, MD
George Washington University

Faculty:
Jonathan Rosen, MD
Albany Medical College

Linnie Newman, MS, ANP
Albany Medical College

Lynn Kosowicz, MD
University of Connecticut School of Medicine

Maurice Clifton, MD, MSEd
University of Pittsburgh School of Medicine

Richard Pretorius, MD, MPH
State University of New York at Buffalo

Lisa Bensinger, MD
Mount Sinai School of Medicine

Susan J. Pasquale, PhD, MT-BC, NMT
University of Massachusetts Medical School

Alex Stagnaro-Green, MD, MHPE
New Jersey Medical School

Norma S. Saks, EdD
New Jersey Medical School

Eileen CichoskiKelly, PhD, MEd
University of Vermont School of Medicine

Rainier P. Soriano, MD
Mount Sinai School of Medicine

Purpose and Rationale: Competence in teaching is expected of residents by the Accreditation Council on Graduate Medical Education. Though many residencies have designed residents-as-teachers training programs, a strong case can be offered for teacher training prior to residency, throughout the years of medical school. From their position, medical students see peers below them, eager for their guidance, and above them, the teaching responsibilities of residency. They are in a developmentally ideal stage for training as teachers, and more so than residents, they have the time to incorporate a new set of skills.

In a session led by faculty from 3 medical schools at the AAMC last year (Albany, George Washington, and Nevada), the following advantages for a medical students-as-teachers (MATS) program were presented:

1. Improving the clinical skills of medical students
2. Improving the clinical skills of their peer learners through the special relationship that emerges through peer teaching
3. Providing faculty development opportunities by training seniors to be standardized students
4. Preparing seniors for house staff duties and careers in academic medicine
5. Expanding the faculty teaching force
6. Involving students in curriculum development and educational research
7. Promoting the ability of students to discover their own educational blind spots, enhancing their quest to become life long learners.

More than 30 educators attended last year's discussion session, signaling widespread interest. There has also been a recent burst of interest as evidenced by e-mail traffic over the past two weeks on the Dr-Ed list serve. It is our intention to build upon last year's session by offering: 1) the results of a preliminary survey (the MATS Survey) of a small group of MATS programs to be conducted over the summer; 2) the opportunity to discuss a series of exciting MATS innovations with the innovators in a highly interactive small group format.

This workshop will be presented by 9 NEGEA medical schools which have been engaged in medical students-as-teachers efforts. Participants will thus be exposed to the highlights of a wide spectrum of programs. Participants will serve as workshop collaborators, since they will be encouraged to share their own ideas and experiences during the small group sessions.

Specific Objectives: By the end of this symposium participants will be able to:

1. Summarize the initial results of the preliminary MATS Survey (they will be able to take home a copy of the survey).
2. Describe cutting edge curricular and evaluation innovations in ongoing MATS programs (they will be able to take home a MATS Innovations booklet).
3. Formulate a preliminary plan and evaluation criteria to begin or to expand a MATS program in their home institutions.
4. Participate in the further development of the MATS Survey.

Intended Audience: Medical educators interested in initiating or expanding a MATS program in their home institutions.

Seattle Convention Center - Room 308

1:00 - 4:00p

GEA/GSA Mini-Workshop Session
The Under-Performing Medical Student: How to Identify and Address Learning and Emotional Difficulties in the Preclinical and Clinical Years

Organizer:
Laurie Raymond, MD
Harvard Medical School

Faculty:
Karen Wulfsberg
Harvard Medical School

Loring Brinckerhoff, PhD
Harvard Medical School

Purpose and Rationale: Since the Americans with Disabilities Act of 1990, an increasing number of students who received educational assistance in elementary, secondary, and post-secondary school are now entering graduate school. Medical school faculty and administrators are just beginning to grapple with the complexities of serving these advanced students with documented or newly identified learning and attentional difficulties/disabilities. At the same time, emotional issues including depression, bipolar, anxiety, post-traumatic stress and other disorders are being increasingly diagnosed in high school and college students, accompanied by treatment with psycho-pharmacological medications. In medical school, students faced with a new set of educational challenges may experience emotional difficulties newly or recurrently, as primary disorders, or secondary to additional learning and/or attentional problems.

Given the enormous personal and institutional investment involved in the successful training of every medical student, medical students who under-perform need early, accurate diagnosis for effective, strategic interventions to take place. Learning and emotional issues affecting a medical student's performance can be difficult to sort out without a collaborative, multi-disciplinary approach of administrators, faculty, education specialists and mental health consultants. The purpose of this workshop is to give Student Affairs administrators and faculty some composite case-based practice at differential diagnosis of medical student under-performance, drawn from our Office of Advising Resources' seven year case-load. We will also discuss as a group the range of options for strategic interventions and subsequent monitoring of under-performing students to assure relevance for participants' own institutions.

Specific Objectives:

1. To discuss three composite cases specific to Attention Deficit Disorder, with and without Hyperactivity (ADHD, ADD - Case #1); Learning Disabilities, Verbal and Non-Verbal ( LD -Case #2); and Depression (Case #3), in order to demonstrate how each of these disorders tends to present in medical students in the preclinical and clinical years.
2. To discuss the associated strengths of students with these disorders.
3. To discuss the features of students with these disorders, who successfully compensate in medical school.
4. To provide our own Learning Survey to participants and demonstrate its use as a screening tool.
5. To discuss the related neuropsychological testing results typical of ADHD, ADD, LD, and Depression and what criteria might qualify for learning, attentional, or emotional disability accommodations.
6. To discuss strategic educational interventions, including assistive technology, for ADHD, ADD, LD, and Depression.
7. To discuss as a group monitoring of under-performing students' progress as it applies to participants' own institutions.
8. To ensure that participants at the end of this workshop would know what features of ADHD/ADD; LD; and depression are likely to be evident in medical students with these disorders in the preclinical and clinical years; how to use a screening tool and review neuropsych testing for information relevant to disability accommodations; and how to plan interventions and monitoring appropriate to one's own institution.

Intended Audience: Health Professional Medical Education and Student Affairs Administrators and Faculty

Seattle Convention Center - Room 214

1:00 - 4:00p

GEA/GSA Mini-Workshop Session
Introducing a Modular, Web-based Genetics Curriculum focused on ELSI (Ethical, Legal, Social, and cultural Issues) for Residency Education

Organizer:
Michael S. Wilkes, MD, PhD
University of California School of Medicine, Davis

Faculty:
Wyllie Burke, MD, PhD
University of Washington

Roberta A. Pagon, MD
University of Washington

Linda E. Pinsky, MD
University of Washington

Douglas S. Diekema, MD, MPH
University of Washington

Purpose and Rationale: Continuing advances in genetic knowledge and technology raise new opportunities for genetic testing and, in some cases, improved clinical management. However, genetics education in primary care training is limited, as a result of both limited faculty experience with medical genetics and residency time constraints. Moreover, little attention has been paid to the ethical, legal, social, and cultural implications (ELSI) related to genetic information. This web-based curriculum seeks to address these gaps and is suitable for self-directed learning as well as small-group instruction.

Specific Objectives:

1. Describe the possible implications of genetic testing for patients and family members " Describe the rationale for genetic testing when a positive result does not affect clinical management
2. Identify "discussion hooks" and major teaching points for medical genetics in the context of primary care
3. Discuss how these cases could be implemented within the existing curriculum (e.g., in related clinic blocks)

Intended Audience:

1. Primary care faculty in family medicine, general internal medicine, and pediatrics
2. Faculty with responsibility for training medical students and/or residents in interviewing, communication, and doctor-patient relations
3. Medical genetics faculty interested in understanding genetics issues in primary care, and in making medical genetics more relevant for primary care trainees

Seattle Convention Center - Room 303

1:00 - 4:00p

GEA/GSA Mini-Workshop Session
Medical Education Research Certificate (MERC) Workshop: Measuring Educational Outcomes with Reliability and Validity

Organizer:
Larry D. Gruppen, PhD
University of Michigan Medical School

Faculty:
Paul F. Wimmers, PhD
University of California School of Medicine, Los Angeles

Purpose and Rationale: Measuring the educational outcomes and variables influencing these outcomes is one of the most challenging aspects of conducting medical education research. Because such constructs as knowledge, preferences, attitudes, professionalism and the like are not directly observable, investigators must develop indirect measures of these dimension. Reliability and validity are evaluations of the quality of these measures and are relevant to all types and varieties of measurement. Through this workshop, participants will be able to: describe the concepts of reliability and validity and the relationship between them, identify three classes of reliability measures and their related statistics, identify six types of evidence for score validity, select the best form of reliability quantification and relevant validity evidence for measures that they are currently using or expect to use.

Seattle Convention Center - Room 212

3:30 - 5:30p

GEA/GSA Mini-Workshop Session
Communicating Evidence: The Final Frontier

Organizer:
Laura Zakowski, MD
University of Wisconsin School of Medicine and Public Health

Faculty:
Shobhina Chheda, MD, MPH
University of Wisconsin School of Medicine and Public Health

Christine S. Seibert, MD
University of Wisconsin School of Medicine and Public Health

Purpose and Rationale: Evidence-based medicine (EBM) has been described as "the integration of the best research evidence with clinical expertise and patient values".(1) Since EBM came on the scene, there has been significant emphasis on the steps of EBM that include framing an evidence-based question, retrieving and appraising the evidence, and understanding the results. However, the real challenge may lie in the clinician's ability to communicate research evidence to patients to help patients make informed decisions.

Unfortunately, there is little known about how to most effectively communicate evidence to patients. In 2004, Epstein and colleagues published a systematic review that identified original research in this area but their search yielded only a few potentially relevant articles (2). Because little evidence was found in their systematic review of the communication of evidence to patients, Epstein and colleagues proposed a 5-step process to guide clinicians in incorporating evidence into to decision-making discussions with patients:

1. Understand the Patient's (and Family Members') Experience and Expectations.
2. Build Partnership.
3. Provide Evidence, Including Uncertainties.
4. Present Recommendations.
5. Check for Understanding and Agreement

Though research in evidence-based communication is at an early stage, some medical schools are teaching evidence-based communication skills as part of their larger curriculum efforts in EBM. At University of Wisconsin Medical School, second year students participate in a small group exercise where they find research evidence to answer a standardized patient's clinical question and they communicate that evidence to the patient with emphasis on demonstrating appropriate communication skills. This skill is then tested at an Objective Structured Clinical Examination (OSCE). Although communication with patients has always been important, a new emphasis on teaching students the skills required to explore patient values and translate research evidence to patients is critical.

1. Sackett DL, Strauss SE, Richardson WS, Rosenberg W, Haynes RB. Evidence-Based Medicine: How to Practice and Teach EBM. 2nd ed. Edinburgh: Churchill Livingstone; 2000.

2. Epstein RM. Alper BS. Quill TE. Communicating evidence for participatory decision making. JAMA. 2004;291:2359-66.

Specific Objectives:

1. Identify challenges to communicating evidence to patients.
2. Identify key resources in EBM communication.
3. Delineate practical strategies for teaching and learning how to communicate evidence.
4. Delineate advantages and pitfalls to evaluating students' EBM communication skills.
5. Develop a practical checklist of skills that reflect a learner's acquisition of EBM communication skills.

Intended Audience: This workshop will focus on innovative methods to teach and evaluate students' evidence-based medicine (EBM) communication skills. It is therefore designed for those who develop medical student curriculum and those who teach EBM and communication skills.

Seattle Convention Center - Room 605

Wednesday, November 1

8:00 - 10:00a

GEA/GSA Mini-Workshop Session
Promoting Resident Research at Your Institution "Tips and Tools Gleaned from a Successful Residency Research Curricular Initiative"

Organizer:
Jacqueline Fischer, MD
University of Illinois College of Medicine, Peoria

Faculty:
Tinoy Kizhakekuttu, MD
University of Illinois College of Medicine, Peoria

Meenakshy Aiyer, MD
University of Illinois College of Medicine, Peoria

Purpose and Objective: Demonstrating evidence of scholarly activity during internal medicine (IM) residency training is not only required in accredited programs, it can be highly beneficial to the resident and training program alike. Research among residents furthers intellectual curiosity and increases resident collaboration with faculty. A strong track record of resident research activity augments a training program's credentials to the prospective student applicant. Research activity offers trainees and their programs heightened success in subspecialty fellowship placement. For these and other reasons, most faculty involved in graduate medical education would agree that resident research activity is an essential component to the success of today's IM training programs.

Despite this, many IM training programs struggle with how to get the research done. What strategies are available to increase resident research activity? What are the barriers to the implementation of such strategies? How well do these strategies work to increase resident involvement in research? Possible solutions to these questions will be discussed in the context of our experience at a university-based IM training program with a successful residency research program.

Specific Objectives:

1. To make participants aware of the multiple beneficial aspects that may occur when resident research is promoted at an institution.
2. To help participants recognize common barriers to resident research activity both globally and at their own institutions.
3. To help participants create strategies to overcome the identified barriers to resident research activity.
4. To help participants develop plans of action for implementing those identified strategies most likely to increase resident research at their institution.

Intended Audience:

1. Physician educators
2. Program Directors
3. Residents

Seattle Convention Center - Room 306

8:00 - 10:00a

GEA/GSA Mini-Workshop Session
Formative and Summative Computerized Assessments in Medical Education

Organizer:
Peter G. Anderson, DVM, PhD
University of Alabama at Birmingham

Faculty:
Kristina T. C. Panizzi Woodley, MAE
University of Alabama at Birmingham

Purpose and Rationale: Medical education is a multifaceted process which involves (1) extensive information delivery, (2) integration and assimilation of basic sciences and clinical sciences knowledge, (3) a conglomeration of instructional strategies and media, and (4) efforts to instill lifelong learning behaviors which will transcend from the classroom into the clinical environment. Formative and summative assessments provide a measuring stick to evaluate learners in all aspects of their medical education. Computerized delivery of assessments in medical education has become more prevalent in recent years with the digitization of instructional materials and computer-based administration of the USMLE, but there remains considerable variation as to how computerized assessments are incorporated among various medical curricula for formative and summative assessment. This mini-workshop will provide participants with an overview of the development and incorporation of formative and summative assessments in the medical curriculum from real-world application in select undergraduate medical courses at the University of Alabama School of Medicine, Birmingham, AL. As an example, formative and summative computerized assessments which incorporate images and illustrations have been administered in the pathology education curriculum to more than 1,100 students over the past five years, and data will be shared with participants regarding implementation and delivery of this computerized assessment component in the curriculum. The ultimate purpose of this mini-workshop is to encourage discourse among participants regarding formative and summative assessments in medical education and to illustrate computerized delivery of assessments which is applicable to all areas of medical education. Participants may then be able to use this information for developing and delivering computerized assessments in their respective curricula.

Specific Objectives:

Objective 1: To demonstrate and discuss the computerized delivery of assessments for low stakes and high stakes assessments in medical education. Upon completion of the workshop, participants should be knowledgeable about the means by which low stakes and high stakes assessments may be delivered in medical education using the computerized environment.

Objective 2: To demonstrate and discuss principles of assessment, importance of course objectives, and learning outcomes. Upon completion of the workshop, participants should be more informed regarding principles of assessment, importance of course objectives, and learning outcomes and may be able to use this information in designing courses and assessments in their curricula.

Objective 3: To demonstrate and discuss application of formative assessment techniques in medical education using computerized delivery processes. Upon completion of the workshop, participants should be knowledgeable about the means by which they may assess students using computerized delivery of formative assessments in their curricula.

Objective 4: To demonstrate and discuss application of summative assessment techniques in medical education using computerized delivery processes. Upon completion of the workshop, participants should be knowledgeable about the means by which they may assess students using computerized delivery of summative assessments in their curricula.

Intended Audience: Intended participants include faculty, staff, and administrators who currently employ or are interested in employing computerized assessments in their curricula. Participants will benefit from this workshop with the information provided as to the development, delivery, and administration of computerized formative and summative assessments in a medical school curriculum. This workshop will be beneficial to participants in providing them with real-world application of formative and summative assessments in computerized testing environments.

Seattle Convention Center - Room 203

8:00 - 10:30a

GEA/GSA Mini-Workshop Session
Methods to Study Small Group Learning

Organizer:
Antoinette S. Peters, PhD
Harvard Medical School

Faculty:
Janet P. Hafler, EdD
Harvard Medical School

Purpose and Rationale: Since the early 1950's, research on small group process has demonstrated the predictability of types of behaviors that occur throughout the lifetime of the group. Innumerable methods have been devised over the years to guide the study of small group interaction and to answer a range of research questions, including how learning occurs in small groups. Little work has been done, however, to examine learning within problem-based learning (PBL) groups, leaving researchers wondering whether lack of consistent outcomes from the method could be related to variations in group dynamics, structures or tasks. To provide researchers in medical education tools to conduct studies of small group process, we propose a workshop in which participants will practice two research approaches: First, using an open-ended, observational strategy, we will explore broadly how group process facilitates or inhibits learning, and how such data can lead to hypothesis generation; second, using an a priori structured format, we will practice coding small group behaviors.

Specific Objectives:

1. To explore how small group interaction and discussion affects learning
2. To develop skills in two research methods useful in studying small group learning

Intended Audience: This workshop should be of interest to medical educators who conduct or study problem-based learning tutorials or other small instructional groups.

Seattle Convention Center - Room 303

8:00 - 11:00a

GEA/GSA Mini-Workshop Session
Medical Education Research Certificate (MERC) Workshop: Formulating Research Questions and Designing Studies

Organizer:
Carol S. Hodgson, PhD
University of Colorado School of Medicine

Faculty:
Robin R. Deterding, MD
University of Colorado School of Medicine

Purpose and Rationale: The production of scholarly work in some form is a requirement for all faculty. However, not all faculty members receive sufficient training to conduct research, particularly in the area of medical education. Clinician educators interested in conducting medical education research and evaluation often need additional research training to begin their scholarly activities. This training includes how to write a measurable research question, what is the appropriate research design to answer the research question, and what factors pose a threat to the study. In addition, tips on how to collaborate with medical educators can be useful for clinicians who have little time and few resources to pursue new research interests. In this workshop, we will provide practical exercises to begin the process of conducting medical education research. Individually and in small groups, participants will brainstorm about areas of interest and will practice writing research questions that will help answer the everyday and far-reaching questions that intrigue us. Lastly, participants will leave the session with an understanding of the best research design for their question that takes into account practical limitations within their institutional setting and how to make the best out of what they have within and outside their institution.

Intended Audience: This workshop is intended for individuals, medical educators and clinician educators, who want to learn how to design a medical education research study starting with the development of a measurable research question.

Seattle Convention Center - Room 614

8:00 - 11:00a

GEA/GSA Mini-Workshop Session
Harvesting Learning from the 'Hidden'/Informal Curriculum: Demonstration of a Teaching Method Founded on Student Narratives About Professionalism

Organizer:
Thomas S. Inui, ScM, MD
Indiana University School of Medicine, Regenstrief Institute

Faculty:
Richard M. Frankel, PhD
Indiana University School of Medicine, Regenstrief Institute

Purpose and Rationale: It is widely recognized that considerable student learning takes place in the informal or 'hidden' curriculum, as students watch faculty take care of patients, interact with one another, work in teams, and juggle multiple responsibilities. For better or worse, the role models we create strongly affect students' perceptions of professional values, how ethical issues are resolved, the relationship among health professions, and how we work with patients in difficult situations. There are a number of challenges faculty face in understanding and facilitating appropriate student learning from the informal curriculum, including: (1) Developing our capacity to discern the content of the hidden curriculum; (2) Finding trustworthy methods to capture student experience; (3) Creating an environment for reflection and guided dialogue focused on student experience, in order to facilitate and deepen their learning.

Indiana University School of Medicine (IUSM) has created a unique program of education on professionalism and professional values based on narratives of students' experiences during their clinical clerkships. The purpose of the proposed workshop is to describe the IUSM program, invite the audience into a demonstration of the teaching/learning method, and discuss the theoretical foundations of learning that involves experience/reflection, narratives, and facilitated dialogues.

Specific Objectives: At the conclusion of the workshop participants will:

1. Understand the concept of the 'hidden'/informal curriculum and its importance to teaching/learning professionalism and professional values.
2. Be introduced to seminal event reporting as a way to surface the content of the informal/hidden curriculum.