2005 Annual Meeting Program
GEA/GSA Mini-Workshop Session Overviews

Sunday, November 6

8:00 - 10:00a

GEA/GSA Mini-Workshop Session
Adopting and Integrating Online Learning Resources for Training in Systems-based Practice and Practice-based Learning and Improvement

Organizer:
Rosalie Phillips, MPH
Tufts Health Care Institute

Faculty:
Cynthia Silber, MD
Jefferson Medical College

David A. Davis, MD
University of Toronto Faculty of Medicine

Ralph Halpern, MSW
Tufts Health Care Institute

Purpose and Rationale: A major change and challenge for residency programs is training and assessing residents in the competencies of Systems-based Practice (SBP) and Practice-based Learning and Improvement (PBLI). Faculty and learners may be unfamiliar with the content and unsure of how to apply the associated knowledge and skills to clinical care. Online resources can help by providing instructional materials and supporting assessment and documentation functions. Used appropriately, these online resources can ease the time and effort needed by faculty and residents to address new content in the framework of a busy training program.

Tufts Health Care Institute and several partnering academic health centers undertook a three-year project, funded by the Department of Education's Fund for the Improvement of Post-secondary Education (FIPSE), to pilot, evaluate, and refine strategies for integrating centralized online learning resources in SBP and PBLI into diverse GME programs and curricula. Resources include online learning modules, clinically focused exercises, assessment tools, a portfolio, bibliographic resources, and report-writing capabilities to help faculty teach, and residents to acquire and demonstrate knowledge and skills. Partner sites experienced the challenges and successes frequently encountered when adopting an innovation.

This workshop, led by project coordinators, an external evaluator, and a Designated Institutional Official from a partnering academic health center, will present observations and findings from this diffusion-of-innovation project, including types of instructional and assessment resources that can be posted online, ways of integrating online learning in SBP and PBLI into the residency curriculum, and strategies for engaging faculty as well as learners in this new approach. Workshop participants will share their own experiences with online learning as well as initiatives to integrate the competencies of SBP and PBLI throughout residency training. They will engage in an exercise to plan where and how online resources in SBP and PBLI can be integrated into their crowded curriculum.

Specific Objectives: By the end of the workshop, participants will:
1. Identify approaches and activities that support the integration of online applications for training residents in Systems-based Practice and Practice-based Learning and Improvement.
2. Identify barriers and opportunities to engaging faculty and residents in adopting online resources for training in these two competency areas.

Intended Audience: GME Program Directors, Assistant Program Directors, and faculty; GME Institutional Directors.

Marriott - Wilson A

8:00 - 10:00a

GEA/GSA Mini-Workshop Session
Providing Guidance for Junior Faculty: Lessons Learned from Junior Faculty "Quick Starters"

Organizer:
Martha S. Grayson, MD
New York Medical College

Faculty:
William A. Anderson, PhD
Michigan State University

Dale A. Newton MD
Brody School of Medicine

Purpose and Rationale: Educational leaders are becoming increasingly concerned about the multiple demands placed on new junior faculty. These faculty are given demanding in-patient and ambulatory clinical assignments, teaching and supervision responsibilities for residents and medical students, clinical and educational committee assignments, and are also expected to generate peer-reviewed scholarship. Many of these faculty flounder in this chaotic environment, and may become unsuccessful and leave academic medicine. There is, however, a small percentage of faculty (known as "quick starters") who have figured out how to survive and thrive in this chaotic academic medicine environment.

In this workshop, participants will learn findings from the literature on the characteristics of junior faculty "quick-starters". They will then strategize about how to share these strategies with junior faculty at their institution. This workshop will use brief presentations, assessment exercises, and small group discussion.

Specific Objectives: At the end of the session, participants will be able to:
1. Explain the characteristics of "quick starter" junior faculty.
2. Assess the personal strengths and weaknesses of their junior faculty against the characteristics of "quick starters". 3. Develop strategies for mentoring junior faculty to learn the skills and habits of "quick starter" faculty.
4. Discuss problems and issues in implementing the proposed strategies at their home institutions.

Intended Audience: Chairman, Deans, Division Chiefs, Medical Educators and other academic administers interested in and responsible for developing junior faculty within a medical school.

Marriott - Johnson

8:00 - 10:00a

GEA/GSA Mini-Workshop Session
A Mini-Curriculum for Educational Policy Committee Members

Organizer:
Mary Thoesen Coleman, MD, PhD
University of Louisville

Faculty:
Kyle E. Rarey, PhD
University of Florida College of Medicine

Steven A. Lieberman, MD
University of Texas Medical Branch

Purpose and Rationale: Appointed and elected members of an educational policy or curricular committee often receive no training or formal preparation or clear expectations for their roles on a key committee responsible for curricular oversight. This workshop is designed to address this gap in faculty development.

Specific Objectives:

1. Key skills/competencies needed to be an effective member of an Educational Policy or Curricular Committee will be identified and defined through participant interaction.
2. A curricular approach for addressing the needed skills/competencies of committee members will be developed by participants.

Intended Audience: Chairs of Educational Policy or curricular committees, Faculty Development Deans, Medical Education and Curricular Deans.

Marriott - Truman

8:00 - 10:00a

GEA/GSA Mini-Workshop Session
The Why and How of Integrating Simulation Throughout the Medical School Curriculum

Organizer:
John F. Mahoney, MD
University of Pittsburgh School of Medicine

Faculty:
Emil R. Petrusa, PhD
Duke University School of Medicine

Purpose and Rationale: Participants in this workshop will review a broad spectrum of simulation that can enhance learning across the continuum of medical education, including standardized patients, high-fidelity mannequin simulators, desktop programs, and virtual reality. Participants will analyze the pedagogical principles behind simulation in medical education. As a result, participants will take home a plan for increased use of simulation throughout their curriculum, complete with rationale, goals/objectives, logistics and assessment questions. Overall, this workshop will facilitate discovery and redesign of the use of simulations at participants' home institutions.

Utilizing the full spectrum of simulators, from human standardized patients, to desktop programs and full-scale simulators, students practice application of key competencies tailored to the particular learning goal, with as much repetition as needed, without risk to patients. Gaps in clinical problems may be filled with simulations. Complexity of simulations ranges from a fore arm to practice inserting an IV to management of a patient's vital signs during an operation.

Often simulations are purchased due to the fidelity of the simulation or the persistence of a champion. The champion uses the simulation within his or her specialty or subspecialty despite the simulator's relevance to other portions of the curriculum. Learners will be better served by first determining the learning outcome desired and then obtaining a simulator to accomplish that and other goals.

Specific Objectives: Participants will develop an understanding of:
1. The various simulation modalities and technologies that are currently available for support of medical education.
2. The opportunities that exist in their curricula to enhance learning across the continuum of learners and improve quality through the application of simulation.
3. The pedagogical principles behind the use of simulation in medical education.

Intended Audience: This workshop will appeal to faculty and staff with little to moderate experience in simulation. This workshop will also serve administrators and others in educational leadership roles, including deans and curriculum committee chairs. Faculty with a great deal of expertise with simulation will also benefit, by refreshing their understanding of the pedagogical principles behind the use of simulation. Professionals in the medical library (often simulators are placed in the library's "media center"), the curriculum support office, the graduate and continuing medical education offices, will also benefit from this workshop.

Omni - Congressional A

8:00 - 10:00a

GEA/GSA Mini-Workshop Session
Improving Resident and Clinical Clerk Global Performance Appraisals

Organizer:
John Littlefield, PhD
University of Texas Medical School at San Antonio

Faculty:
Judy L. Paukert, PhD
Methodist Hospital, Houston, Texas

Debra Klamen, MD, MHPE
Southern Illinois University College of Medicine

Purpose and Rationale: All residency and clerkship programs must accurately assess performance related to clinical competencies. Global performance appraisals are the most frequently used method for performance assessment (PA), but this approach to PA is often criticized as providing imprecise data. Few Program Directors know how to improve the quality of PA completed by clinician faculty We recently published the results of a three-year study that examined three quality assurance indicators of PA in two residency programs before and after interventions to improve the two PA systems.1 The study found significant pre-post intervention improvements on all three quality assurance indicators: 1. number of forms returned, 2. numeric precision of scores (generalizability), and 3. frequency of behaviorally-specific narrative comments. This mini-workshop shares what we learned while conducting that study. The opening presentation will describe a systems approach to improving PA. A PA system consists of three interrelated aspects: 1. individual faculty evaluators, 2. program director (decision making), and 3. organizational infrastructure. PA systems are complex adaptive systems therefore small focused changes can substantially affect system outputs. The second presentation will describe relatively small interventions in two residency programs that resulted in significant improvements to the three quality assurance measures compared to baseline year measures. The third presentation will describe how the diagnostic checklist developed during the study can be used to improve resident and clinical clerkship PA systems (Appendix 1). Participants will then use the diagnostic checklist in small groups to critique their PA systems and plan improvements.

Specific Objectives:
1. Describe three aspects of a clinical performance assessment (PA) system and how relatively small procedural changes can improve the quality of PA system outputs.
2. Critique a currently-used clinical PA system using a research-based diagnostic checklist.
3. Propose changes to a currently-used clinical PA system to lessen problem areas without compromising those system elements that function satisfactorily.

Intended Audience: Residency and Clinical Clerkship Directors

Marriott - Wilson B

8:00 - 10:30a

GEA/GSA Mini-Workshop Session
Clinical Skills Remediation after Standardized Patient Examinations

Organizer:
Karen E. Hauer, MD
University of California, San Francisco (UCSF)

Faculty:
Lynn Cleary, MD
SUNY Upstate Medical University

Erica Friedman, MD
Mount Sinai School of Medicine

Eugene Corbett, MD
University of Virginia Health Science Center

Purpose and Rationale: Most medical schools in the United States (US) now require that students demonstrate mastery of core clinical skills in history taking, physical examination, and communication by participating in clinical skills examinations using standardized patients. Further, a standardized patient examination was recently implemented as the United States Medical Licensing Examination (USMLE) Step 2 Clinical Skills Examination (CS) for students graduating in 2005. At the graduate medical education level, and to a lesser extent in undergraduate medical education, the introduction of the ACGME core competencies has prompted additional discussion about enhancing methods of evaluating trainees. Thus medical school faculty now face the challenge of identifying students deficient in core skills and remediating them to ensure competency.

There is little literature to guide the remediation of students with failing performance. Although multiple studies have evaluated the process by which medical students learn to solve clinical problems, the differences in the ways that novice medical students approach clinical problems compared to the approach used by clinical experts raises the question of how best to set pass/fail marks when evaluating clinical skills using standardized patients. Multiple methods of setting pass/fail marks have been described with no clear consistency in practice. Once failing students are identified, a further goal is that they will learn from their errors and consequently improve their skills prior to graduate medical education. The lowest-scoring students at many schools receive individual feedback and performance review with faculty, possibly with an individualized learning plan. The ways in which this feedback and remediation are conducted are not standardized. Some schools require students who fail the examination to repeat it until a passing score is achieved, whereas others require students to participate in remedial individual clinical preceptorships. Other schools require participation in a standardized patient exam but do not require any students to remediate.

Specific Objectives: By the end of this workshop, participants will be able to:
1. Identify the various methods of standard setting in clinical skills examinations and their specific strengths and weaknesses.
2. Identify the specific types of learning deficits that result in a failing performance on a Standardized Patient clinical skills examination.
3. Identify various strategies for remediating students with specific deficits in clinical skills.

Intended Audience: Medical student educators, including clerkship directors, curriculum deans, directors and deans of assessment, standardized patient program coordinators.

Marriott - Wilson C

8:00 - 10:30a

GEA/GSA Mini-Workshop Session
"What's In It For Me?": Building A Coalition For Change

Organizer:
Karyn Baum, MD, MSEd
University of Minnesota

Faculty:
Sarah Peyre, MSEd
University of Southern California

Cheryl Resnik, PT, DPT
University of Southern California

Steve Roey, MD, MSEd
Santa Clara Valley Medical Center

Samuel Saied, MD
Children's Hospital Los Angeles

Jo Ann Wood, MD, MSEd
University of Louisville

Jennifer Wu, MD, IBCLC, MSEd
University of California, San Diego

Purpose and Rationale: Creating successful lasting change is challenging, and often fails.

Bringing the "right people" to the table is often the key to successful innovation. But academic health centers and health professions schools, as well as individual departments and even divisions, are as complex as many businesses; many of the rules and players are unwritten and behind the scenes. This workshop is designed to educate change agents in the skills required to build a coalition for successful transformation in any situation.

Bringing diverse players together to achieve lasting change in complex organizations is a challenging process. However, at its root, this process consists of two steps:
1. identifying the stakeholders for the proposed change or process, and 2. bringing those stakeholders together to form a coalition for change ("coalition building").

This workshop will use lessons taken from business management literature to educate participants in methods to fully identify those that have a stake in the change process, as well as the source of their power. Participants will review and utilize several landmark methods of stakeholder identification and analysis, including those of Freeman (Strategic management: A stakeholder approach, 1984) and Mitchell et al (Toward a theory of stakeholder identification and salience: Defining the principle of who and what really counts, 1997).

Once change leaders know who "counts" when planning a change, they need to bring those parties together by building a coalition for change. Coalitions have been used in many settings, including politics (from grassroots groups to international diplomacy), healthcare, environmental movements, and even city planning. Bringing these often diverse groups of stakeholders together to achieve a common goal involves several steps. One of the most important steps is to align the needs of the stakeholder group with the aim of the change. This workshop will use a variety of interactive techniques so participants can practice utilizing the skills required to begin building a coalition for change including alignment of stakeholder needs.

Specific Objectives: By the end of the workshop, participants will be able to:
1. Identify the stakeholders involved in a proposed change.
2. Prioritize the importance of bringing each stakeholder into the coalition supporting the change. 3. List the steps in building a coalition.
4. Design an approach to address each stakeholder's likely response to the proposed change.

Intended Audience: Anyone leading or involved in change at their institution at any level. The workshop is appropriate for junior or senior faculty. Questions about the workshop may be directed to Karyn Baum at kbaum@umn.edu.

Marriott - Harding

8:00 - 10:30

GEA/GSA Mini-Workshop Session
Integrated Model of Aging and Geriatric Education in a Medical School Curriculum

Organizer:
Margaret Drickamer, MD
Yale University School of Medicine

Faculty:
Liza Cariaga-Lo, PhD
Yale University School of Medicine

Ellen Roberts, PhD
University of North Carolina School of Medicine

Deborah E. Simpson, PhD
Medical College of Wisconsin

Lawrence Rizzolo, PhD
Yale University School of Medicine

Purpose and Rationale: The purpose of this workshop is to present models of the vertical integration of material throughout medical school curriculum with an emphasis on education in geriatrics. For many subjects, vertical integration has been mandated, among them genetics, palliative medicine, and cultural diversity. Many more, if not most, elements in medical education would benefit from vertical integration. The "time" pressures within the medical curriculum are monumental and the ever expanding areas of knowledge make "carving out a niche" virtually impossible. The field of aging and geriatrics lends itself well to an approach which integrates material throughout the curriculum in this graduated manner. From basic science to ethics to clinical care, aging and geriatrics are highly relevant topic that builds on itself throughout the four years of medical school.

In this workshop we will approach methods of integrating material, tracking curriculum and measuring competencies. Identifying matches between courses and material, using the clinical experience to illustrate the basic science and re-applying the basic science during the clinical years are all elements in a vertical integration of material. Innovative methods of presenting material and structuring experiences are necessary for such curricular change. Following the actual content of classes through the use of PDAs and searchable mapping tools will help to assure the successful and continued integration of material. Using overarching competencies that are then measured in the evaluation of individual elements will assure the focus and the completeness of the educational experience.

Specific Objectives:

1. The learners will be exposed to methods of integrating geriatrics in a graduated manner into the four years of medical school curriculum. Examples of specific knowledge (e.g. aging and the cardiovascular system), skills of patient assessment (cognitive evaluation) and attitude towards structuring patient approach (setting goals with patient preferences) will be demonstrated.
2. The learner will become familiar with resources that can enhance this type curriculum. Examples of specific patient-based methodologies in teaching (small group workshops, computerized simulated patients and vertically accessible computer exercise) will also be presented.
3. The learner will be given information on how to track and evaluate geriatric curricula through PDA and computer access programs.
4. The learner will take from the workshop an action plan for his or her own institution.

Intended Audience: Because of the vertical nature of the curriculum and its applicability to many aspects of medical learning, this session would be relevant to Deans of Education, professional medical educators, basic science and clinical coordinators as well as faculty involved in geriatric education.

Marriott - Coolidge

8:00 - 10:30a

GEA/GSA Mini-Workshop Session
Promoting Professionalism through an on-line Professional Development Portfolio: Successes, Joys and Frustrations

Organizer:
Adina Kalet, MD, MPH
New York University School of Medicine

Faculty:
Joseph Sanger, MD
New York University School of Medicine

Julianne Chase, PhD
New York University School of Medicine

Mariano Rey, MD
New York University School of Medicine

Student Members of the Professional Development Committee
New York University School of Medicine

Purpose and Rationale: As Medical Educators we strive to promote the development of professionalism in our learners and yet it is challenging to design, implement and sustain fair and meaningful assessments of professional development to ensure we accomplish this goal. For the past 2 years at NYU we have had an on-line Professional Development Portfolio that requires students to regularly collect and reflect on evidence of their professional development. At the end of every year student reviews their own year, assesses themselves based on pre-determined criteria, and writes goals for the coming year. This end-of-year assessment is reviewed and negotiated with a Faculty-partner. Despite a fair amount of controversy created by this new assessment process we believe based on our experience that this rather novel approach to professionalism assessment has tremendous potential to promote a clear understanding of medical professionalism and a strong set of life long learning skills for both students and faculty. In addition this project has provided a forum for lively and honest debates concerning the meaning and behavioral manifestations of professionalism in our medical school.

Specific Objectives: By the end of this workshop participants will:
1. Discuss the promoters and barriers to feasible, effective, assessment of professionalism in medical training.
2. Review a variety of methods used in Medical Education to assess Professionalism emphasizing qualitative student centered techniques such as portfolio learning and structured self-reflection.
3. View an interactive demonstration of the Professional Development Portfolio used at NYU including actual data from our 2-year experience with this method of professionalism assessment.
4. Consider the role of student leaders and facilitators in the assessment of Professionalism.
5. Practice a Portfolio review and receive individualized feedback from students.
6. Get advice on technology requirements and application development for professionalism portfolio development from an expert.
7. Develop a detailed plan for development of a portfolio system.

Intended Audience: Medical Educators, Information Technologists, and students responsible for and interested in student assessment strategies which are learner centered and narrative based.

8:00 - 10:30a

GEA/GSA Mini-Workshop Session
Resident as Teacher: Creating Your Own Program

Organizer:
Lisa Bensinger, MD
Mount Sinai School of Medicine

Faculty:
Barrett Fromme, MD
University of Chicago, Pritzker School of Medicine

Janet P. Hafler, EdD, MEd
Harvard Medical School

B. Price Kerfoot, MD, EdM
Harvard Medical School

Mary L. Lee, MD
Tufts University School of Medicine

Joshua Nagler, MD
Harvard Medical School

R. Ellen Pearlman, MD
New York University School of Medicine

Christine Taylor, PhD
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University

Purpose and Rationale: Residents are often the primary teachers of interns and medical students in academic medical centers and many residency program directors and faculty are eager to incorporate a Resident as Teacher program into their residency training curriculum. In fact, the ACGME required competencies for residency training include "the teaching of students and other health care professionals" as part of the core competency, Practice Based Learning and Improvement. Teaching skills courses for residents have been shown to improve residents' self confidence and self-assessed use of effective teaching behaviors and improve residents' evaluations by students.

Introducing new curriculum is often challenging. In this workshop, we will explore the key aspects of designing a resident as teacher program. This will include choosing the purpose, format, content, and method of evaluation and faculty development to best suit the needs of each participant's institution/department. Participants will have the opportunity to rotate through "stations" to explore these design components in more depth and learn how different institutions have designed and implemented successful resident as teacher programs. Participants will be active in each discussion group and after a brief overview, the session will be dedicated to questions and to helping participants begin to plan their own programs. Participants will also be provided with useful resources, references, and faculty contacts to assist them as they embark on creating their own curriculum.

Specific Objectives: After completing the workshop participants will be able to:

1. Identify the key components in creating a teaching program for residents: program development, curriculum design, and evaluation.
2. Recognize a variety of program designs and the literature supporting them.
3. Compare possible teaching formats and choices of content areas.
4. Explore advantages and disadvantages of various evaluation methods.
5. Identify the resources and logistics necessary to implement their own course.
6. Review examples of faculty development programs designed to train faculty facilitators.
7. Recognize barriers and identify solutions for implementing a successful resident as teacher course in their own institutions/departments.
8. Outline a preliminary program design that they could initiate at their own institution.

Intended Audience: Faculty, GME directors, department chairs, and residency program directors interested in starting a resident as teacher curriculum in their departments or institutions.

Marriott - McKinley

8:00 - 10:30a

GEA/GSA Mini-Workshop Session
Medical Education Research Certificate (MERC) Workshop: How to Analyze Qualitative Data

Organizer:
Ilene B. Harris, PhD
University of Illinois at Chicago College of Medicine

Faculty:
Sara Axtell, PhD
University of Minnesota Medical School, Minneapolis

Purpose and Rationale: Qualitative data from focus group discussions, interviews, observation field notes, and responses to open-ended questions is increasingly used in medical education settings. The purpose of this workshop is to provide participants with perspectives on the role of qualitative data in program development, evaluation, and research; and to enhance their repertoire of skills in analyzing qualitative data.

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

1. Describe the role of qualitative data in admissions, program development, curriculum evaluation, needs assessments, performance evaluation, and research applications.
2. Perform the essential task in analyzing qualitative data - identifying themes and categories within qualitative data sets, with attention to validity, trustworthiness and reliability.

Intended Audience: Physicians and generalists in medical education, as well as faculty and staff involved in student affairs, who wish to develop perspectives and skills for analyzing qualitative data, such as data from focus group discussions, interviews, observation field notes, and responses to open-ended questions - used in admissions processes, program development, curriculum evaluation, needs assessments, performance evaluation, and various research applications.

Marriott - Virginia C

Tuesday, November 8

1:00 - 3:00p

GEA/GSA Mini-Workshop Session
$how Me the Money: Practical Negotiation Skills

Organizer:
Jo Ann Wood, MD, MSEd
University of Louisville

Faculty:
Karyn Baum, MD, MSEd
University of Minnesota

Shawn Harrity, MD, MSEd
University of California, San Diego

Carol Koprowski, PhD, RD, MSEd
University of Southern California

Wadi Najm, MD, MSEd
University of California, Irvine

Sarah Peyre, MSEd
University of Southern California

Nirupama Subramanian, MD, MSEd
University of California, Davis

Sylvia L. del Castillo, MD
Childrens Hospital, Los Angeles

Pupose and Rationale: Have you ever found yourself in a situation where you believed you were powerless to negotiate because of your position within an organization? Do you view negotiation as a win-lose process where only one person leaves happy? The ability to negotiate successfully is important whether you are negotiating for a better salary or deciding where to eat for dinner. A successful negotiation will result in everyone leaving the table pleased with the outcome and each other.

Unlike traditional methods of negotiation where opposing parties take sides, the strategy for successful negotiation is not dependent upon your position or whether the other party is willing to play fair. This approach is known as principled negotiation, which was developed at the Harvard Negotiation Project, and is described in Getting to Yes: Negotiating Agreement without Giving In by Fisher, Ury, and Patton. It is not about giving up on a relationship to get what you want or giving up what you want to maintain a relationship; this skill set is based on looking at the merits of the situation, separating the people from the problem, looking for mutual gains, and using objective criteria to find a solution.

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

1. Identify problems likely to be encountered when using traditional methods of positional bargaining.
2. Describe the four principles of "principled negotiation" described by the "Harvard Negotiation Project." 3. Apply the principles of principled negotiation to real-life situations 4. Develop a plan to employ the principles of principled negotiation under less-than-ideal conditions (e.g., the other side is more powerful, the other side does not want to play along, and the other side does not play fair).

Intended Audience: This workshop is designed to provide faculty and staff with a skill set to enable them to negotiate successfully in today's complex medical infrastructure.

Marriott - Washington 1

1:00 - 3:00p

GEA/GSA Mini-Workshop Session
Enhancing Cultural Competence by Training Medical Students as Interpreters

Organizer:
Portia Jones, MD, MPH
Albany Medical School

Faculty:
Wilma Alvarado-Little
SUNY, Albany

Arpita Badami
Albany Medical School

Fazila Lalani
Albany Medical School

Jeremy Smith
Albany Medical School

Purpose and Rationale: As we train medical students to work in culturally diverse environments, one of the key skills is working with interpreters. By training bi-lingual medical students to serve as interpreters in the hospital, they learn a new skill, and become advocates for this important skill, as well as providing a service.

Specific Objectives:

1. Participants will experience working with interpreters, and some of the professional and ethical considerations of interpretation.
2. Participants will discover how we developed our program, and acquire tools to develop a similar program in their institution.
3. Participants will understand how interpreter training can enhance teaching cultural competence.

Intended Audience: Faculty, Administrators, Students

Marriott - Washington 2

1:00 - 3:00p

GEA/GSA Mini-Workshop Session
Transform Clerkship and Residency Program Didactic Sessions into Team-based Learning Modules

Organizer:
Dean Parmelee, MD
Wright State University School of Medicine

Faculty:
Ruth Levine, MD
University of Texas Medical Branch

Paul Haidet, MD
Baylor College of Medicine & the Houston Veterans Affairs Medical Center

Purpose and Rationale: Team-based Learning (TBL) is an educational strategy that is being used increasingly in medical education because it is highly engaging, requires the learner to prepare ahead of time and to work collaboratively with peers, and requires only one instructor for a large number of learners who work in teams in the classroom. The didactic components of clerkships and residency programs involve fewer learners at any one session (10-30) than medical school classes, but many faculty are "on cycle" to teach many topics, usually through lecture. Medical students and residents are usually required to attend didactic sessions, but more often than not, their preparation for the sessions is minimal since they expect to be "taught." TBL sessions can replace the traditional didactic sessions, engage learners and instructors in active discussion and problem-solving, reinforce the importance of team-work skills, and possibly increase the academic performance level of the learner on traditional measures of academic achievement.

Specific Objectives:

1. To review the core principles and method of TBL and recently published information on its use in clinical training settings.
2. To "actively" demonstrate how TBL is conducted by assigning participants to "teams" and having them solve IRAT, GRAT, and Group Application problems from three specialty areas. (Internal Medicine, Pediatrics, Psychiatry)
3. To understand the principles of writing effective Individual, Group Readiness Assessment Test (I/GRAT) questions, and Group Application questions.
4. To learn about several methods of grading and incentive setting for learners in the clinical teaching setting.
5. To learn about the peer evaluation process in TBL and how this process can be applied in the clinical teaching setting.

Intended Audience: Clerkship directors, residency training program directors, faculty who teach medical students and residents in clinical settings.

Marriott - Washington 3

1:00 - 3:30p

GEA/GSA Mini-Workshop Session
Basic Scientists are from Venus and Clinicians are from Mars (or Vice Versa): Bridging the Educational Culture Gap to Achieve Interplanetary Travel

Organizer:
Lynn Cleary, MD
Upstate Medical University

Faculty:
Mary L. Lee, MD
Tufts University School of Medicine

Dan Mayer, MD
Albany Medical College

Matthew Mintz, MD
George Washington School of Medicine

Suzanne Rose, MD
Mt. Sinai School of Medicine

Richard Pretorius, MD
University of Buffalo

W. Scott Schroth, MD, MPH
George Washington School of Medicine

Stephen R. Smith, MD
Brown Medical School

Nagaswami Vasan, I, DVM, PhD
New Jersey Medical School

Purpose and Rationale: At this year's spring Northeast GEA regional meeting, undergraduate section representatives came together for the first time in this region to explore common interests and concerns. The group included basic science faculty, clinical faculty, and the ubiquitous (sometimes dreaded) education dean types. A topic that rose recurrently to active (not quite heated) discussion was the tension between basic science education and clinical education, especially in the first two years of medical school, as early clinical education has become more prominent in medical student education. We also discussed successful examples of teachers and curricula that help bridge this gap (e.g., basic scientists going on clinical rounds, "bench to bedside" curricula, and fourth year basic science selectives). We acknowledged that basic science and clinical medicine each have unique cultures, and that bridging these cultures can provide substantial benefit to students, faculty, patients, and research, and the institutions in which they learn, teach, perform research, receive and provide patient care. Just as translational research benefits from collaboration between basic scientists and clinicians, so does the education of physician scientists and evidence-minded physicians.

So why do we all struggle so much to accomplish this? This workshop will provide historical context for this tension, identify culture and values that contribute to it and to opportunities for collaboration, review elements contributing to successful educational collaboration, and provide opportunities to apply lessons learned to the specific development or trouble-shooting for projects at the home institutions of participants. An exploration of the unique cultures and values of each may help us take greater advantage of the opportunity inherent in this juxtaposition. Examination of well-received curriculum projects that integrate basic science and clinical content will serve the goal of identifying elements that facilitate communication, collaboration, and relationships between and among basic science and clinical educators.

Specific Objectives: At the end of this workshop, participants will be able:
1. To describe and appreciate characteristics of the unique cultures of basic science and clinical medicine that impact student education.
2. To identify elements that characterize synergistic collaboration between basic science and clinical educators in the delivery of effective curricula.
3. To recognize obstacles to synergistic collaboration and bring solutions to bear in approaching these obstacles.
4. To apply ideas from the workshop to specific projects at their own institutions that enhance the collaboration of basic science and clinical faculty in educating medical students to deliver patient-centered care based on the best that science has to offer.

Intended Audience: This workshop is organized for medical student educators and education deans who are working to integrate curricula across disciplines. A combination of basic science and clinical faculty is ideal.

Marriott - Wilson C

1:00 - 3:30p

GEA/GSA Mini-Workshop Session
Linking Tomorrow's Doctors with Tomorrow's Clinical Outcomes: The Healthcare Matrix at Work

Organizer:
Doris Quinn, PhD
Vanderbilt University Medical Center

Faculty:
John Bingham, MHA
Vanderbilt University Medical Center

Mary Thoesen Coleman, MD, PhD
University of Louisville

Cherri Hobgood, MD
University of North Carolina, Chapel Hill

Purpose and Rationale: Academic medicine is being challenged to modify both the structure and content of medical education, particularly the relationship between medical training and practice. The Core Competencies, which are meant to accomplish this aim, have been a challenge for many organizations. To meet this challenge, Vanderbilt University has developed an innovative educational tool, the Healthcare Matrix . This tool juxtaposes the six IOM Aims with the six ACGME Core Competencies and guides the analysis and evaluation of the performance of medical students, residents and practicing physicians. Medical students at the University of Louisville and University and North Carolina were able to identify more areas of improvement in the video "Do No Harm" using the Matrix. A database of 28 matrices from Vanderbilt Department of Neurology demonstrate how data from the Matrix can inform the organizations of improvements needed in patient care as well as in education related to the core competencies.

Specific Objectives:

1. To demonstrate how the Matrix is used to analyze a patient care in a way that teaches the competencies, particularly system-based practice and practice-base learning and improvement
2. To discuss the information derived from aggregating many Matrices within a specialty, which shows the linkages between outcomes of care and education.
3. Provide opportunities in using the Matrix through analysis of a written case example or a case from their own organization/practice
4. To discuss the future research agenda for the Matrix as it relates to the phases of ACGME Outcomes Project implementation.

Intended Audience: This workshop would benefit medical school faculty, program directors, residency faculty, CME officials (competencies are needed for maintenance of certification) and anyone with administrative responsibilities for hospitals.

Marriott - Wilson A

1:00 - 3:30p

GEA/GSA Mini-Workshop Session
Curriculum Content Review: A Peer-Review Process to Initiate Change

Organizer:
Nancy Kheck, PhD
Mount Sinai School of Medicine

Faculty:
Lisa Bensinger, MD
Mount Sinai School of Medicine

Laurie Brown, MA
Mount Sinai School of Medicine

Erica Friedman, MD
Mount Sinai School of Medicine

Purpose and Rationale: In compliance with the LCME mandate for periodic evaluation and update of medical school courses and curricula, we developed an objective peer-review mechanism to review course content. This markedly contrasts the annual review of courses/clerkships - a process that integrates student feedback, course director self-assessment, and each year director's subjective evaluation of course performance in comparison to other courses. Our model provides an effective framework for a curriculum content review that can be scaled to address the individualized needs of any school (at the course, departmental, programmatic or school-wide level) depending upon the desired outcome and the resources available.

The goals of content review are fairly universal and address the challenges faced by most schools:

• To assure that the curriculum provides the appropriate level of depth and detail to prepare the pleuri-potent medical student for residency
• To demonstrate that the curriculum adequately facilitates self-directed learning
• To evaluate whether our course and clerkship assessments mirror course content and assess ability to apply information to patient-based clinical scenarios
• To provide meaningful feedback to course directors, clerkship directors and curriculum oversight committees about the strengths and weaknesses of the curriculum
• To create a plan for enhancing identified deficiencies

The goal of this workshop is to help other faculty, at all levels, develop an effective means of critically evaluating the content of their courses. By sharing our collective experience, process, and successful interventions, we hope to guide others in designing their own review process.

Specific Objectives: By the end of this workshop, participants will gain insight and guidelines for planning this step-wise process and should be able to:

1. Recognize the potential for and the level at which a curriculum review may be conducted
2. Identify infrastructural elements at their respective institution that will influence the process
3. Define barriers to content review
4. Identify the resources required to initiate and conduct the process
5. Identify strategies get stakeholders and peer-reviewers invested in the process

Intended Audience: Medical Course and Clerkship Directors, Directors and Deans for Education, Curriculum, Assessment, Evaluation, and medical student educators in general.

Marriott - Hoover

1:00 - 3:30p

GEA/GSA Mini-Workshop Session
Sampling the Toolkit: 360 Degree or Multisource Evaluations

Organizer:
Miriam Bar-on, MD
Loyola University Chicago Stritch School of Medicine

Faculty:
Franklin Trimm, MD
University of South Alabama School of Medicine

Purpose and Rationale: The definition of medical competence continues to evolve. Once only including medical expertise and clinical decision making, competence now includes many of the other components included within the MSOP and ACGME competency domains. As a result, evaluation of students and physicians now needs to include measures of competence in the remaining domains and other methods of evaluation need to be implemented. The 360 degree or multisource evaluation is becoming a popular method to assess these new competency domains.

Specific Objectives:

• Describe the concept of 360 degree/multisource evaluations
• Discuss the benefits of and difficulties with 360 degree evaluations
• Discuss 4 elements of successful 360 degree evaluations
• Begin to develop a 360 degree evaluation
• Identify methods for implementing a 360 degree feedback process

Intended Audience: Medical educators.

Marriott - Coolidge

1:00 - 4:00p

GEA/GSA Mini-Workshop Session
Collaborative Mentoring: An Approach for Senior Faculty and Administrators

Organizer:
Linda Pololi, MD
Brandeis University

Faculty:
Adina Kalet, MD, MPH
New York University School of Medicine

David E. Kern, MD. MPH, FACP
Johns Hopkins Bayview Medical Center

Mack Lipkin, MD
New York University School of Medicine

Purpose and Rationale: As we advance in academic medicine and achieve more senior roles we require new skill sets but lack available mentoring. Even though very helpful in the past, relationships with former mentors may have changed. Our needs change and understanding possible options or directions in medicine, or changing career trajectory thrusts us into territory for which we have little experience or preparation. The purposes of this workshop are to discuss with colleagues ways to obtain the mentoring we need for ourselves as senior faculty and administrators in academic medicine and to experience collaborative group mentoring. Anecdotally, we recognize an unmet and compelling need expressed by senior colleagues around professional choices and decision making in senior career stages. In this workshop we challenge the traditional notion that mentoring is only for junior faculty; indeed, it may be that by providing mentoring for senior faculty, as a profession we would be better able to mentor junior colleagues had we experienced effective mentoring for ourselves. An alternative or complement to contracting with an "executive coach" is to enter into a mentoring relationship with other senior colleagues. Another often heard dilemma is that at later career stages, how do we balance our desire to be generative and mentor junior faculty, as well as address our own needs? This interactive workshop will invite discussion and identification of methods of effectively addressing needs as we advance in academic medicine and provide participants with a facilitated and innovative session of collaborative mentoring for themselves and draw upon the cumulative experience of workshop participants.

Specific Objectives: As a result of participating in this workshop:

• Individuals will have clearer idea of their own needs and goals for the next several years;
• Individuals will gain some help from colleagues about how to proceed;
• Participants will learn about the goals and needs of other senior faculty and how they make their choices and proceed;
• Participants will experience the potential of collaborative mentoring for senior faculty.

Intended Audience: Senior faculty and administrators from academic medicine

Marriott - Truman

1:00 - 4:00p

GEA/GSA Mini-Workshop Session
"Nuts And Bolts of Building an Outcomes Assessment Program": Why Construct an Outcomes Assessment Program, What are the Components of an Outcomes Assessment Program and How is Construction of an Outcomes Assessment Program Coordinated?

Organizer:
Dorothy A Andriole, MD
Washington University School of Medicine

Faculty:
Brian E. Mavis, PhD
Michigan State University

Anthony Paolo, PhD
University of Kansas Medical School

Alison J. Whelan, MD
Washington University School of Medicine

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 medical 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 will involve ongoing collection of data from a wide range of sources that must be analyzed on an integrated basis. While broad outcomes assessments may drive curricular overhauls they can also, importantly, inform a more stepwise approach to curricular evolution. Interest in comprehensive outcomes assessments programs is increasing throughout the medical education community, but there is also a growing recognition of the complexity of outcomes assessment program design and implementation. The process involves a collaborative effort among numerous different 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 outcomes assessment 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 outcomes assessment program development 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 while 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:

• Tailored to their unique education environment
• Coordinated by, and accessible to, appropriate parties within the medical school community in a secure manner
• 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:

• Define relevant outcomes measurements for their educational setting
• 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
• 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: Our workshop is intended for individuals involved in school-wide and/or discipline-specific aspects of outcomes assessments in undergraduate medical education.

Marriott - McKinley

1:00 - 4:00p

GEA/GSA Mini-Workshop Session
Improving Written Narrative Appraisals of Student/Resident Performance: Making "Comments" Count

Organizer:
Christine Taylor, PhD
The Cleveland Clinic Lerner College of Medicine of Case Western Reserve University

Faculty:
Eric Holmboe, MD
American Board of Internal Medicine

Jennifer Kogan, MD
University of Pennsylvania

Margaret McKenzie, MD
The Cleveland Clinic Foundation

Purpose and Rationale: As students develop from neophyte to competent physician, they are continuously bombarded with cues concerning their performance. The rich environment of the academic health center provides countless opportunities for students/residents to reason, practice skills and interact with patients, attendings, senior and junior learners as well as other health professionals. The environment itself will provides feedback as students or residents work through their clinical rotations as patients respond to attention and treatment, smile and say "thank you" or frown and look puzzled. Students must be attuned to these subtle hints as they comb the environment for validation and/or correction. These purely environmental cues are important, yet often unreliable and certainly not sufficient to guide development. As experienced practitioners, the clinical faculty have a major responsibility for observing student performance and providing descriptive feedback and ultimately evaluation.

Students and residents have a critical need for observation and feedback regarding their performance. However, several studies have indicated that students are rarely if ever directly observed by faculty and that feedback and formal assessments are more likely based on recollections of case presentations and second-hand information. As learners, medical students and residents are bound to make errors in judgment as well as mistakes in performing examination skills. In the absence of corrective feedback, these errors develop into habits that become more difficult to change. In fact, several studies have indicated that when critically observed, both residents and students continue to demonstrate errors in common fundamental skills.

As trained observers of their patients, clinical faculty have developed highly sensitive schemes for attending to important clinical signs. Unfortunately, the literature suggests that these sensitive observational skills have not generalized to include meaningful schemes for observing and assessing student and residents. Again, studies suggest that when faculty do observe their learners' performance, their ratings often exhibit poor inter-rater reliability and do not correlate well with more objective measures. Training in observation and feedback skills, usually focuses on at least two skills. Trained observation requires that the observer concentrate on essential attributes and filter out extraneous features of the setting. To do this, the observer must become familiar with the attributes, or "performance dimensions" that have been identified as key to quality performance. For clinical faculty, familiarizing themselves with students' learning objectives and assessment criteria is the first step in becoming a skilled observer.

Subsequent steps in observation and feedback training depend on whether the observations are recorded as narrative comments or translated into a numerical rating scale. In the case of narrative comments, training in standardization, or "frame of reference training" prompts faculty to consider common descriptive "qualifying language" when writing about observations. For example, observers may agree that "completeness", "consistency" and "accuracy" will be qualifying descriptors used when describing observations across all performance dimensions. Both Performance Dimension Training and Frame of Reference Training have proven effective training methods. .

The focus of this workshop will be on observation training with written feedback through narrative comments. Narrative comments that are appropriately specific and focused on criteria have been found to be instrumental in improving subsequent performance. A recent study conducted in a surgical residency program found that written comments on the rotation evaluation detected resident deficiencies better than numerical rating. However, other studies have found that the majority of written comments are neither specific nor criteria driven, but rather overly general and predominately positive. Skill building in writing descriptive narrative comments that reflect trained observation completes the training cycle and should lead to improved performance feedback to students.

This workshop with its focus on direct observation training recorded as meaningful narrative comments is particularly timely as competency-based education filters into both undergraduate and graduate medical education. Competency training in professionalism, interpersonal communication and practice-based learning and improvement, for example do not lend themselves to numeric rating strategies in the same way we might rate medical knowledge or even procedural skills. As we ask our residents and students to be more reflective in their self assessments we should be prepared to act in-kind. Providing direct observation documented through specific and criteria-driven narrative comments provides meaningful feedback, assessment and role modeling for reflective practice and should be skill every faculty member achieves.

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

a. analyze common existing problems with written narrative assessments
b. employ newly learned strategies for improving the connection between performance dimensions and written narrative assessments
c. use training videos to document faculty member's ability to attend to and record accurate observations of students/residents
d. write narrative assessments/feedback that addresses performance criteria and uses common descriptive qualifiers
e. discuss the unique cross-rater consistency issues that arise in narrative assessments.

Intended Audience: All medical school and residency program faculty who wish to improve direct observation skills and the fidelity and quality of written narrative assessments at their school or program.

Marriott - Wilson B

1:00 - 4:00p

GEA/GSA Mini-Workshop Session
Building a Continuum for Teaching the Teachers of Medical Education: Cultivating Skills in Medical Students, Residents, Fellows, and Faculty

Organizer:
Huiju Carrie Chen, MD, MSEd
University of California San Francisco School of Medicine

Faculty:
Eva Aagaard, MD
University of California San Francisco School of Medicine

Daniel Federman, MD
Harvard Medical School

Janet P. Hafler, EdD, MEd
Harvard Medical School

David Irby, PhD
University of California, San Francisco School of Medicine

Kathy Julian, MD
University of California, San Francisco School of Medicine

Jessica Muller, PhD
University of California, San Francisco School of Medicine

Margo Vener, MD
University of California, San Francisco School of Medicine

Maria Wamsley, MD
University of California, San Francisco School of Medicine

Purpose and Rationale: Many institutions have created faculty development programs to advance the teaching skills of their general faculty. Some institutions have developed teaching-to-teach curricula targeted at medical trainees who comprise much of the teaching efforts in medical school and residency education. Most of these programs were established to ensure a minimum teaching competency for the majority of teachers.

With the growing recognition of the need for skilled clinician educators with special expertise and dedication to the educational mission of our medical schools, it has become ever important to identify and cultivate the skills of current or future faculty who have a strong interest in medical education. We will describe, compare, and contrast a series of programs at two academic institutions designed to focus resources on and advance the skills and knowledge in medical education of students, residents, fellows and faculty members. Several of these programs identify individuals early in their careers (medical school, residency, and fellowship), and utilize innovative approaches such as a Medical Education "minor" for medical students and the Objective Structured Teaching Evaluation (OSTE). Other programs focus on developing the teaching skills and scholarly activities of junior or mid-career faculty. We will also discuss the challenges and rewards of institutionalizing these programs and creating a pipeline for future clinician educators.

Specific Objectives: Upon completion of the workshop, participants will be able to:

1. Identify key components of a medical education "minor" program for medical students including the learning styles inventory and Educator's Portfolio
2. Discuss the advantages and disadvantages of a general versus specialty-specific approach to a medical education training program for residents
3. Describe key elements of a medical education training program for fellows and faculty
4. Discuss the contributions of a teaching scholars program for careers of junior faculty
5. Describe the use of Objective Structured Teaching Evaluations (OSTE's) for training of and provision of feedback to teachers
6. Describe the impediments and opportunities that exist at participants' institutions for the development and implementation of medical education programs across the continuum of medical training

Intended Audience: Medical school leadership and faculty who are interested in developing and implementing programs at their home institutions to support and advance medical education skills of their faculty, fellows, residents, and medical students.

Marriott - Virginia C

1:00 - 4:00p

GEA/GSA Mini-Workshop Session
Medical Education Research Certificate (MERC) Workshop: Getting Started in Educational Research

Organizer:
Judy A. Shea, PhD
University of Pennsylvania School of Medicine

Faculty:
Carol S. Hodgson, PhD
University of Colorado Health Sciences Center

Karen Richardson-Nassif, PhD
University of Vermont College 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 obtaining knowledge of the existing medical education literature, 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.

Specific Objective: Participants will receive information on "best practices" for efficiently searching the medical education literature. Lastly, participants will leave the session with an understanding of the best research design for their question that take 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.

Marriott - Maryland C

3:30 - 5:30p

GEA/GSA Mini-Workshop Session
Educational Encounters of the Third Kind: Para-Curricular and Intra-Curricular Forays Into Ethics and Humanities

Organizer:
Elissa L. Kramer, MD
New York University School of Medicine

Faculty:
Lois LaCivita Nixon, MLitt, PhD
University of South Florida

Allen S. Keller, MD
New York University School of Medicine

Purpose and Rationale: What is your overall goal and why is this an important topic? Our overall goal will be to impart the value of looking to other academic fields (bioethics, philosophy, literature, art, history) to enrich the medical student's perspective on their chosen profession. Our rationale is based on the understanding that physicians who are familiar with these disciplines and can view medicine, their patients and society through the lens of the ethicist, historian, writer, or artist will bring a more mature, more humanistic and, ultimately , more effective perspective to the practice of medicine. Within this workshop we plan to: 1) share our experience in developing a paracurriculum in ethics, arts and humanities. 2) identify potential synergisms between traditional medical school curriculum and these other disciplines. 3) Explore mechanisms for introducing these subjects into the medical school paracurriculum and/or curriculum.

Specific Objectives: Describe the information and skills to which participants will be exposed and list specifically what participants will be expected to know or be able to do upon completion of the workshop.

1. Describe the range of activities at our institution that use non-medical academic disciplines to address areas of interest to medical students. Describe the elements that are helpful to improve the relevance for medical students.
2. Describe particular areas of synergy between traditional curriculum and extra-medical paracurricular or nontraditional curricular activities in terms of our own experience and engage participants in a discussion to elicit their ideas and experiences. We will use examples from our own experiences to illustrate these synergies.
3. Describe the organization of several venues for providing arts and humanities curriculum/ paracurriculum at our the institution; discuss and elicit experience and ideas from other participants in the workshop.

Intended Audience: Who will specifically benefit and why? This is directed to Medical School Faculty and Administrators who believe that the future physicians we are educating will benefit in their understanding of their roles as physicians with their patients, their colleagues, their institutions, and their communities if they can incorporate these topics from other academic disciplines into the traditional medical school curriculum and that a familiarity and facility with these academic disciplines will complement the practice of medicine. This workshop will not only provide specific ideas for intracurricular and paracurricular multidisciplinary endeavors, but will also explore connections between "non-medical" academic disciplines and medicine.

Marriott - Washington 1

3:30 - 5:30p

GEA/GSA Mini-Workshop Session
Moving Beyond Cultural Competence: Transnational Competence in Undergraduate Medical Education

Organizer:
Herbert Swick, MD
Institute of Medicine and Humanities

Faculty:
Peter Koehn, PhD
University of Montana

Patricia Barrier, MD
Mayo Medical School

Mary Lindholm, MD
University of Massachusetts Medical School

Joseph Varley
NEOUCOM

Delese Wear
NEOUCOM

Purpose and Rationale: Physicians are being increasingly called upon to care for patients whose national, cultural, racial, class and experiential backgrounds are much different from their own. In an era marked by globalization, migration and increasing world-wide challenges to public health, physicians must acquire a broad range of skills and perspectives that will enable them to interact effectively and in a humanistic manner with patients from multiple and changing cultures. For these reasons, preparing students to deal effectively with patients from diverse backgrounds remains an important goal of undergraduate medical education. Many schools of medicine have implemented educational programs to ensure the "cultural competence" (CC) of their students and graduates, but too often these curricula have not proved effective in reducing health disparities, in part because CC often focuses on limited cultural attributes and fails to deal with broader issues such as the social, economic, and power inequities that so often accompany individuals from distinct cultural and ethnic backgrounds.

Transnational competence (TC) comprises a specific set of interpersonal skills derived from research findings in international relations, development studies, international business negotiations, cross-cultural psychology, and intercultural communication. The five domains of TC provide the skills that enable physicians to work with patients from many backgrounds without relying on commonly assumed (and often stereotypical) characteristics of "other" cultures.

In July 2004, an intensive five-day invitational workshop brought together teams of experienced medical educators from four U.S. medical schools to explore TC as a new conceptual model by which physicians could learn how better to care for patients from diverse and distinct backgrounds. Three of these schools have since introduced a pilot curriculum for clinical clerkships based on the domains of TC.

This GEA mini-workshop will explore TC as a new and potentially more appropriate model than CC for educating undergraduate medical students. Workshop faculty will review the principles of TC, contrast this model and its core skill-acquisition strategies with the approaches currently in use at most U.S. medical schools, and share early experiences with the pilot TC curriculum at three medical schools.

Specific Objectives:

1. to explain the principles and domains of TC, and contrast TC with CC
2. to explore advantages of the TC model
3. to discuss the pilot TC curriculum and skill-acquisition strategies initiated in three schools of medicine
4. to disseminate the TC model and pilot curriculum among additional schools who may be interested

Intended Audience: Curriculum deans, course directors, clerkship directors, medical education and curriculum specialists.

Marriott - Washington 2

3:30 - 5:30p

GEA/GSA Mini-Workshop Session
The Educational Impact of Assessment - Getting Feedback Right

Organizer:
Julian Archer, MBChB, MRCPCH, LLTM
Sheffield Children's Hospital

Faculty:
Helena Davies, MBCHB, MRCP, MD
Sheffield Children's Hospital

John Norcini, BA, PhD
Foundation for Advancement of International Medical Education and Research)

Professor Dame Lesley Southgate, DBE, DSc, FRCP, FRCGP
St. George's Hospital Medical School Medical and Healthcare Education

Purpose and Rationale: Performance assessment methods are often evaluated in terms of their validity, reliability and feasibility. However van der Vleuten's utility index goes beyond these three measures 1. It is said that assessment drives learning 2 and it is often the primary role of any assessment process. However the evidence for how feedback should be delivered and its potential effects is sparse and varied in the medical literature.

Canadian work with multi-source feedback with doctors in practice has provided some support for behavioral change in response to feedback 3 4. However the manner in which performance is fed back can be influential in terms of outcomes 5 including creating a negative response 6. Crucial to the success of feedback appears to be in its explicit linkage to the individual's perceived benefits and goals in the workplace 4 6 7. Holmboe et al. 8 provide a potential model for this.

Specific Objectives:

1. Current research into the effects of feedback and what is best practice.
2. Examples of good and poor practice with the opportunity to explore and discuss the best approach(es). 3. Opportunity to use national assessment tools being implemented across the UK.
4. What research is needed to maximize the potential positive effects of feedback?

Intended Audience: Health care professionals and researchers who are interested in developing the positive educational impact of feedback.

Marriott - Washington 3

Wednesday, November 9

8:00 - 10:00a

GEA/GSA Mini-Workshop Session
Classroom Presentations and Power Point: A Teacher's Best Friend or a Learner's Worst Nightmare? Applying Adult Learning Theory to Enhance Education

Organizer:
Matthew Mintz, MD
George Washington University School of Medicine

Faculty:
Dewesh Agrawal, MD
George Washington University School of Medicine

Elizabeth Jacobs, MD
George Washington University School of Medicine

Terry Kind, MD, MPH
George Washington University School of Medicine

Purpose and Rationale: A considerable portion of teaching occurs in the classroom, even though didactic presentations are the antithesis of how adults learn best. Though technical advances such as Power Point have the potential to enhance learning, they may have the opposite effect. The purpose of this workshop is to improve participants' understanding of how adults learn and show participants how to apply these theories to several strategies, both technical and non-technical, that can enhance the learning for students, residents and faculty in the classroom setting.

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

• Appreciate the advantages and disadvantages of didactic classroom presentations, specifically those incorporating Power Point.
• Understand the key principles underlying adult learning theory and how they might relate to classroom presentations
• Identify specific techniques utilized during a classroom presentation that incorporate adult learning principles
• List examples of how to utilize adult learning principles to enhance classroom learning
• Discover ways to use technology to incorporate adult learning principles into classroom presentations
• Incorporate adult learning principles into their own classroom presentations

Intended Audience: Classroom presentations occur in small or large groups; in actual classrooms, conference rooms, or lecture halls; and are generally given by a faculty presenter who often uses a didactic Power Point platform. This workshop is intended for any faculty who teach medical students, residents or other adult learners in the classroom setting; as well as course directors, program directors, deans and others involved in any medical education curricula which utilize classroom presentations in their programs or courses.

Marriott - Hoover

8:00 - 11:00a

GEA/GSA Mini-Workshop Session
Developing Culturally Competent Care Faculty

Organizer:
Janet P. Hafler, EdD, MEd
Harvard Medical School

Faculty:
Emily Rickards, MA
Harvard Medical School

Augustus White, MD, PhD
Harvard Medical School

Carmi Z. Margolis, MD, MA
Ben Gurion University Faculty of Health Sciences

Yaakov Henkin, MD
Ben Gurion University Faculty of Health Sciences

Michael A. Karplus, MD, MPH
Soroka University Medical Center
Ben Gurion University Faculty of Health Sciences

Chi Huang, MD
Bolivian Street Children Project

Benjamin S. Siegel, MD
Boston University School of Medicine

Linda L. Barnes, PhD, MA, MTS
Boston University School of Medicine

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. 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 at Ben Gurion University in Cooperation with Columbia University Medical Center, Bersheva, Israel, Boston University School of Medicine and Harvard Medical School. While the search for the most effective teaching strategies in this area is on-going, some methods have been tried with good success. Participants will have the opportunity to rotate through three stations where different pro