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Organization of Resident Representatives

2004 Professional Development Conference

SANTA MONICA, CA
MARCH 11-14, 2004
SESSION SUMMARIES

Promoting Quality and Creativity in Faculty and Students

In the past, research productivity has been commonly evaluated using readily available metrics, such as HIG research funding success rates, and publishing in prestigious journals. While traditional measures have been useful, their utility in ascertaining quality is increasingly suspect, especially when it comes to assessing cutting-edge research and in "big science" performed by teams of multi-disciplinary peers. Evaluating creativity is even more of a challenge. In this session Dr. David Baltimore, Ph.D., President of the California Institute of Technology and 1975 Nobel Laureate in Physiology or Medicine, gave a brief review of the history of biological sciences and proposed the emerging structure of biological research in the next two decades. Because we need a combination of theorists, experimentalists, and small scale researchers to be on the frontiers of the future of medicine, he emphasized the need to restructure our training of researchers in a way that will help trainees develop faster, while promoting independence, creativity, and quality.

Summarized by Cristen Page, M.D.

Plenary: Promoting Quality in Clinical Service

Quality of care was the topic for the opening plenary for our spring meeting and the topic set the stage for many of the other sessions during the meeting. Lloyd Michener, M.D. reminded participants that while we spend 14% of our Gross Domestic Product on health care, the care we provide is still inaccessible to many and expensive. Improvement in the quality of the care we provide is a primary mission of academic health centers. Thomas Garthwaite, M.D. shared his experience of improving quality by instituting patient centered care initiatives in the Veterans Affairs Hospitals. Carolyn Clancy, M.D. drew on her experience as the director of the Agency for Healthcare Research and Quality and provided the sobering message that only half of Americans are receiving evidence based medical care. Finally, Mark Chassin, M.D., M.P.P., M.P.H wrapped up the session with the following message: "Achieving and sustaining major improvements in quality of patient care is the greatest challenge for our health care system in the 21st century."

Summarized by Jane E. D. Broecker

Defining the Future Scope of Physician Practice: Joint ORR and CAS Session

Lively discussion occurred at this joint ORR / CAS breakfast session that focused on defining the factors involved in resident education with regard to preparation for future scope of practice. How well residents are trained to enter into today's fast paced, outpatient, and increasingly sub-specialized world of medicine was discussed, and ideas for improvement were suggested. The need for feedback from recently graduated residents was considered a first step for assessing how well today's residencies are preparing resident physicians for actual practice. Many participants felt that the guidelines for educational emphasis are outdated and should be revised to ensure that residents are trained to cope with the problems they will face after graduation. Many ideas were proposed to begin addressing the problem.

Summarized by Jane E. D. Broecker

Author Mary Roach on Stiff: The Curious Lives of Human Cadavers

The recent scandal reported at a large academic willed body program this year has helped to make cadaver donation a hot discussion topic. Mary Roach, author of the New York Times bestseller, Stiff, has written an entertaining, yet respectful book about the extensive history regarding uses of post-mortem human bodies. Ms. Roach gave a reading from one of her chapters during our luncheon session. She related a few interesting anecdotes about the difficulties she encountered while doing research about this sensitive topic. She also discussed her recent interactions with reporters and the misconceptions that the general public has regarding willed body programs. Ms. Roach answered questions regarding the process of getting a book published and receiving the support to do the necessary research. She remains a strong supporter of organ donation and an advocate of willed body programs.

Summarized by Eric Wang

Starting Your Career as a Clinician Educator: Keys to Promotion

In this era of changes for academic medical centers, none is more evident than the increasing reliance on clinical revenue. Balancing this demand with the needs of research and education has led many institutions to expand the role of faculty dedicated to patient care and education missions - known as clinician-educators. Unfortunately, there is growing evidence to support the perception that within the traditional systems of faculty reward and recognition, the clinician-educator is at an inherent disadvantage. Dr. Seine Chiang, Associate Professor of Obstetrics & Gynecology at the University of Alabama at Birmingham, provided session participants with a practical primer on the keys to promotion as a clinician-educator. Dr. Chiang serves as director of the Ob/Gyn Continuity Clinic and Medical Student Clerkship at the University of Alabama School of Medicine. During her interactive presentation, Dr. Chiang reviewed the promotion and tenure mechanisms and highlighted the ways clinician-educators need to catalogue and report the unique contributions that they make to the academic mission. The session materials included a sample CV and informative resources. Visit the links below for more information:

Speaker Slides

Sample CV

Submitted by Francis Nuthalapaty, M.D.

A New Method for Evidenced-Based Practice

Susan Horn, Ph.D., gave a description of Clinical Practice Improvement (CPI)-a methodology that analyzes content and timing of individual steps in health care processes for the least necessary cost over a continuum of a patient's care. She described how large, mostly prospective datasets using process factors (interventions, medications, management strategies) and controlling for patient factors (diseases, severity of illness) can be associated with outcomes (clinical outcomes, health status, cost, length of stay, MD visits). Results of these studies can then be used to develop dynamic, executable practice guidelines. She described differences between randomized clinical trials and CPI, but stressed that each has its place and together the methodologies are, in fact, complimentary. Dr. Horn then reviewed examples of CPI studies; she described some surprising outcomes that could only be detected by this methodology. Lastly, Dr. Horn discussed how CPI could be used in residency programs to assess the 6 core competencies and be used to study the optimal structure of a residency program.

Submitted by Cori Horn, M.D.