Many providers in service-oriented professions experience compassion fatigue. Unlike compassion fatigue described toward patients, many clinician-educators and program administrators are experiencing compassion fatigue for learners and colleagues. During the COVID pandemic, learners experienced more lenient sick policies and numerous burnout mitigation strategies. With the end of the COVID public health emergency, many institutions and programs are returning to pre-COVID expectations that might differ from what trainees have experienced in their programs to date. When learners make personal requests that might adversely impact their peers, program leaders may experience compassion fatigue for their trainees. When learners reach out afterhours and on weekends asking for immediate action on non-urgent requests, these behaviors might amplify compassion fatigue for trainees. Program leaders might also be seeing reduced empathy for the current stresses of residency and might hear references to reduced resilience in this generation from faculty, which can also contribute to compassion fatigue for faculty. During this workshop, participants will review the various elements of compassion fatigue. Participants will complete an individual self-reflection exercise using the validated Professional Quality of Life Scale (ProQOL) to understand their own unique experience with burnout and compassion fatigue. Workshop facilitators will review evidence-based strategies for recognizing compassion fatigue in themselves or others, increasing coping skills, and building strategies for augmenting compassion satisfaction. Participants will leave the workshop with an individualized plan for personally addressing compassion fatigue, a framework for recognizing and approaching compassion fatigue in others, and a cadre of successful mitigation strategies from other institutions.

ACGME requires programs to incorporate individualized learning plans (ILPs) for all learners in the process of self-directed, lifelong learning. Recently, AAIM developed an ILP template to identify specific learning goals and potential knowledge gaps in incoming interns. Given the emphasis on ILP utilization at both the UME and GME level, educational leaders need a cohesive approach for ILP development, implementation, and education which this workshop provides. Presenters will review the core sections of the ILP and present the development of a customizable ILP template using ACGME competencies and programmatic vision; describe the process of incorporating the ILP form into the academic calendar as part of a mentorship toolkit and semi-annual assessment for all residents, while acknowledging pitfalls and barriers to implementation; share a program's approach to providing faculty and resident development on ILPs as well as an evaluation tool for ILP review; and discuss how to use this data to further develop the ILP form and processes. The workshop will conclude with a breakout group in which participants will discuss how they can use the tools provided during the workshop to implement ILPs in their setting. Workshop participants will leave with actionable takeaways and feel more confident in applying ILPs to their programs.

Active learning in a fun, engaging learning climate may mitigate some of the forgetting curve observed in learning research. This workshop will explore gamification in education via interactive demonstration, didactic presentation, and skills practice. Participants will identify the core elements of easily recognized childhood games (e.g. Clue, Monopoly) as well as more modern virtual contexts (e.g. Wordle, Animal Crossing) and escape rooms. This discussion will be followed by a review of up to four games of varying complexity presenters use and an opportunity to play one in real time. Equipped with this information and experience, the workshop will explore and evaluate the background literature on the impact of these game elements and highlight opportunities for additional study for interested educators. To conclude, participants will collaborate to find opportunities to gamify their existing teaching and leave with an educator's resource toolkit for broader game design and application.

Surveys are a popular methodology in medical education assessment and are used to understand the nature of educational problems, explore the perspectives of learners and educators, and assess performance, knowledge, attitudes and well-being. As such, the Alliance fields national annual surveys and offer members the opportunity to propose survey sections. Every year more submissions are received than can be accepted. Additionally, the usefulness of data collected can be limited by the construct and design of survey questions, meaning some proposed survey topics do not always successfully translate into medical education scholarship. CDIM Survey and Scholarship Committee members will review basic principles of survey use in medical education research and how educators can design surveys that can contribute to scholarship. Opportunities for members to submit survey questions for the CDIM annual survey and an overview of the selection process and criteria for high-quality thematic survey submissions will be discussed. Specifically, the workshop will cover how to define constructs of interest, design sound survey questions and avoid common pitfalls. The presenters will touch on the steps required for survey development, including expert review of questions and beta-testing. Participants have the opportunity to learn how the CDIM Survey and Scholarship Committee works with authors to refine their survey questions, analyze results, and assist with manuscript preparation and publication. Additionally, examples of survey submissions that resulted in peer-reviewed publications will be shared. Participants will practice writing survey questions relevant to their interests and develop plans for submission to the CDIM annual survey.

Clerkship and subinternship leaders face the eternal challenge of finding the optimal balance between teaching curriculum material through didactic sessions versus experiential learning on the wards. Educators hope that didactic sessions are a valuable use of learner time, preparing them to best take care of their patients and for national exams. Leaders also aim for an equivalent educational experience for learners at different clerkship sites with exposure to different patient populations, medical diagnoses, and preceptors with varying areas of expertise. Some sites may lack experts in a certain topic area, such as point-of-care ultrasound, and may rely on didactic teaching or simulation to cover that material. Material used in didactic sessions may be recycled from years prior and show evidence of racial or gender bias that goes unnoticed. In this workshop, presenters will guide participants through step-by-step directions on how to evaluate their current curriculum offerings and adjust them to meet the national guidelines. Participants will be shown an example curriculum from a workshop presenter's institution and be lead through a SWOT (strengths, weaknesses, opportunities, threats) analysis. In separate breakout groups for clerkship and subinternship leaders, participants will begin to identify strengths and weaknesses in their current didactic curriculum, a process they can continue at their home institution. Presenters will provide resources to mitigate bias in their curriculum. Participants will also be able to crowdsource how to best meet the needs of their students in areas of deficit in their curriculum.

This panel discussion will focus on the leadership styles and approach to administrative leadership from members of the CDIM CA Advisory Council past and present, alongside techniques to communicate feedback across multiple positions and levels. Some of the topics to be discussed will include time management of leadership versus administrative duties, presenting feedback to employees you manage versus supervisors or clinical leaders, and how to leverage university-level experiences and resources into national changes. Audience members are encouraged to bring your own questions.

As more measures of medical student skills and knowledge move to pass-fail, there is increased focus on clerkship grades and summative comments. Medical educators and administrators strive to ensure grades and comments are accurate, but after reviewing their grades, students may have concerns and wish to appeal. Data from the 2019 CDIM Annual Survey indicates that most clerkship directors believed that grade appeals were constant or increased over the prior three years; since then, many perceive the numbers have increased further. The effect of moving to a two-tiered grading system on grade appeals has not been well studied, but students are likely to increasingly appeal comments in a system where both the pre-clerkship and now Step I is pass-fail. Appeals are stressful and time consuming for educators, clerkship administrators, and students. During this workshop, presenters will describe factors that could contribute to grade appeals, review grade appeal processes from specific institutions, and discuss national recommendations. The audience will work together to brainstorm proactive actions that may decrease the number of appeals and spend the majority of the session performing SWOT analysis of grade appeals processes in participants clerkships and institutions. Participants will leave with a framework for proactively decreasing grade appeals and building a more robust grade appeal process at their institution.

Complete and detailed medical documentation is imperative to providing high-quality patient care. However, ongoing institutional success is reliant upon a strong financial foundation. As health care institutions navigate current financial markets and as many health centers look to productivity-based compensation models, it is important for providers to have the tools and resources available to them to maintain complete and detailed documentation which supports the care performed and services provided. During this workshop, we will provide an overview of the department of internal medicine's coding and education processes, which focus on ensuring high quality provider documentation and billing. This process ensures superb patient and referring provider communication. Presenters will begin by providing best practice recommendations on data reporting and share recommendations on how to utilize data to identify areas of opportunity. Presenters will then provide an overview of the current educational processes and highlight modifications implemented to enhance the educational experience, including a streamlined onboarding process that provides additional and in-depth specialty-specific education to support providers in capturing revenue for the expert care provided. Presenters will further discuss optimizations to documentation templates to eliminate documentation burdens and discuss implemented physician-leadership relationships to ensure provider buy-in. Finally, presenters will offer insight to future steps as it relates to hiring in-house educators to build upon current practices as well as ensuring compliance and optimization of changing CPT and coding rules and regulations. Workshop participants will be equipped and encouraged to utilize recommendations at their institution.

Presenters will outline the staff development program for department of medicine administrative staff. The goals of which were to create a framework that would guide a current staff member who is interested in exploring a different position or area of expertise; satisfy staff member desire for skills-building and professional development; and develop a pipeline for promotion and/or recruitment of staff as well as retention for high-performing staff. The program consists of two tracks: finance & data analytics and research administration, both areas of which surveyed staff expressed interest in. Participants were self-selected or nominated by their supervisors and completed a detailed application and were interviewed by program admininstrators. Five applicants were selected for the research admin track and seven were selceted for the finance track. The programs take place across 3.5 months and consist of a mix of live in-person and online self-paced trainings. Each participant is assigned a mentor to guide them through the process and help them select and complete a final project. Projects should solve a real-life problem or give the participant the opportunity to contribute a work product to their section when possible. Participants are expected to spend one to three hours per week on the trainings, mentor meetings, and additional assignments/readings. At the end of the program, participants receive a certificate of completion at a formal ceremony and will be given the opportunity to participate in future cohorts of the program as a mentor or trainer.

Learners frequently struggle with underperformance on clinical vignette-based, multiple-choice tests, which carries serious potential professional consequences. Unfortunately, most methods for remediating learners lack grounding in educational theory. This workshop aims to empower participants by offering a method to diagnose test-taking problems and implement learner-centric techniques for improvement. The workshop starts by exploring reasons for poor test performance, memory function, intuition vs. metacognition, script theory, and test development. To enhance comprehension, presenters will showcase illustrative videos of residents answering test questions, then introduce the theoretical basis for the assessment method Self-Regulated Learning and Microanalytic Assessment and Training (SRL-MAT). SRL-MAT involves forethought (goal setting, strategy choice, self-efficacy), performance (self-monitoring), and reflection (self-evaluation, casual attributions, and adaptive inferences). A question review form (QRF) based on this theory is a published tool for effective learner remediation. The QRF, completed by the learner after answering a question, allows faculty to classify the learner's problem(s): lack of script recognition, lack of script specificity, premature closure, underconfidence, inappropriate causal attribution, inappropriate adaptive interference, or isolated learning deficits. The workshop culminates with participants actively practicing using the SRL-MAT QRF to diagnose learners after viewing engaging video portrayals. Using the results, they will craft learner-centered remediation plans based on specific problems identified. Participants will receive a practical handout with SRL-MAT details, a step-by-step implementation guide, and customized strategies for distinct learner problems.

It has long been recognized that there is a long standing disparity between the training environment of males and females. Despite females outnumbering males matriculating from medical school, their training is often hindered by implicit biases held within the profession. Studies have shown females more often receive less feedback, receive feedback that is more focused on personality traits, and when starting at similar milestones, progress slower along these milestones. Through embarkeing on a years-long journey to identify and change this culture, the presenters have, on a semi annual basis, utilized a text analysis system that identifies average length of written evaluations comparing males to females, number of words used that are identified as important traits in residents comparing males to females, and total number of evaluations written among males and females by faculty member. This information is integrated into a larger DEI coaching cirriculum that is designed to teach each individual to identify their own biases using objective data and assist these individuals in their journey to mitigate their own implicit bias. As the program has progressed, data collection has shown a significant shift in the way evaluations are written and how mindful individuals are when talking to residents. This workshop will teach participants how to create a similar system within their own training institutions.

The mean tenure of an internal medicine program director is 5.4 years. As such, transitions in leadership happen frequently. The program director role is complex with many responsibilities. This complexity creates a difficult start for an incoming program director, and a challenging handoff for departing program directors. An effective transition can be achieved with thoughtful planning and implementation, and sets up the successor, the program, and the residents for success. The presenters (three program directors who recently stepped out of the program director role) will share guiding principles, practical logistical suggestions, considerations for overlapping time between outgoing and incoming program directors, and other lessons learned from transitions using illustrative cases for discussion. Rising program directors will also be invited to share their perspectives.

This workshop will provide participants with a concise, objective review of the relevant medical education research in internal medicine graduate medical education published in 2023. Articles selected for discussion will be those that are considered innovative, of greatest interest to the APDIM membership, and of highest research quality (based on a validated medical education research assessment tool). Participants will be provided with a brief synopsis of the 10 to 12 selected research articles, focusing on the strengths and limitations of the research, as well as the practical implications of the studies for program directors. APDIM members who are authors of selected studies will be invited to attend the workshop in advance of the meeting. Participants will have the opportunity to engage in group discussion and to ask questions of the presenters and authors in attendance.

Current clinical reasoning assessment focuses heavily on outcomes. For example, common tools include checklists of information that should be gathered, lists of differential diagnoses, and whether a supervisor agrees with the next diagnostic or management decision a trainee makes. These approaches appropriately assess whether a learner has reached the appropriate conclusions, but do not provide detailed feedback to improve a learner's clinical reasoning process. Recognizing the complexity of assessment in medical education, NBME used a creative community approach to spark collaborative innovation. Participants in the OSCE for Clinical Reasoning Creative Community have thought in depth about the assessment of clinical reasoning for over two years. In this workshop, presenters will discuss experiences and lessons engaging in research to enhance the formative feedback given to learners and coaches on clinical reasoning skills using simulation-based OSCEs in two areas: hypothesis-driven information gathering (HDIG) and problem representation. HDIG is a synthesis of the subcomponents of hypothesis generation and information gathering, reflecting the iterative and entwined nature of hypothesis generation and information gathering in which each subcomponent feeds back to the other (hypothesis generation leads to information gathering which leads to hypothesis refinement and further information gathering). Through multiple rounds of development and co-production, the community created rubrics that can be used to rate the clinical reasoning process in observed interactions and provide feedback.

Every clinician-educator has the opportunity and responsibility to help struggling learners improve across the medical education continuum. Struggling learners are defined as trainees who fail to "meet the expectations of a training program," i.e. experience deficiencies tied to LCME and ACGME competencies. The ability to remediate learners who struggle is imperative given the personal and clinical consequences of ongoing educational and professionalism deficiencies. Many educators struggle to remediate struggling learners due to lack of time, skills, and best practices for remediation. While best practices have focused on formal remediation processes (i.e. individual development plans and escalation of remediation needs), this workshop focuses on giving clinician-educators a practical and systematic approach to addressing learner difficulties in real time that includes forming a competency-based differential diagnosis and aligned behavioral strategies. Presenters will use the SOAP (subjective, objective, assessment, and plan) framework to leverage clinician-educator clinical and educational skills. A blend of small and large group activities including role play and think-pair-share will help apply these skills to a simulated case in GME and give time for participants to reflect on a struggling learner in their own educational practice. As the discipline moves toward a unified system of competency-based medical education, faculty will need to employ the skills presented in this workshop to help learners succeed on an individual and institutional level.

Subspecialty fellowship is a popular career path for residents in internal medicine. The process of applying for and matching into fellowship is challenging and often highly competitive, made more so when a resident's home institution does not have a robust set of their own fellowship programs. Program directors, associate program directors, and faculty advisors at such residency programs may struggle to find sufficient resources to provide effective guidance to their trainees as they seek to match into fellowship. As the presenters discuss effective practices to facilitate successful fellowship application that they have employed in their own programs, they will help participants construct their own roadmaps to use. These roadmaps will include specific tasks and recommendations for each critical step on the path to matching into a fellowship program, from determining an area of interest early on in residency to cultivating a rich CV in the middle stages of residency to composing the application, deciding on which programs to apply, interviewing and ultimately creating a rank list.

Longitudinal integrated clerkships (LICs) are increasingly prevalent in medical schools around the world. LICs have demonstrated improved learning outcomes, and when created to foster workforce retention, lead to more students choosing careers in primary care. While large-scale curriculum reform shifting from traditional internal medicine clerkships to LICs can be daunting, there are multiple best practices from the LIC model that clerkships can adopt to improve curricula and ultimately student outcomes. The workshop presenters direct three LICs across two sites at an institution that recently shifted the entire clinical year to an all-LIC model during for the 2022-2023 academic year. In this workshop, presenters will share experience and outcomes with two main components of the LIC model that clerkship directors can easily adopt within their existing curricula: clerkship concentrations and panel patients. Concentrations and environment within the LIC year may influence career choice, so each LIC carries a theme: advocacy, health equity, patient and population health, quality and safety, and inquiry. Presenters will explore four LIC concentration assignments for inquiry-themed LICs (including outcomes data) that can be easily adopted to foster clinical curiosity during the clerkship. An additional defining characteristic of LICs is their longitudinal nature. Participants will apply the longitudinal panel-patient concept to their existing clerkship to increase patient-centeredness and empathy for those navigating the health care system.

It is vital that the diversity of the patient population be reflected in health care experiential education but many standardized/simulated patient/person (SP) programs face challenges recruiting and retaining SPs that reflect that diversity. In this workshop, presenters will identify common barriers to inclusivity in written materials for SPs and practice editing them for greater inclusivity. Presenters will share protocols for developing new simulation education events that center on patients from historically marginalized groups. Together, these processes can build a work community that increases SP engagement and retention.

Imposter syndrome is prevalent among residents and junior faculty and can lead to increased rates of burnout and depression. It has been estimated that approximately 70% of the population has experienced imposter syndrome at some point in their lives. It occurs many times throughout medical training as new interns question their skill set, upper-level residents have difficulty leading teams, and junior faculty question their decision making. It is a spectrum that can range from small thoughts of being fraudulent to being unable to work or advance because of the constant fear of being incompetent. Many factors place residents at high risk for imposter syndrome; for one, it is often seen in high achieving individuals and in high stress situations, which describes the current health care environment. Individuals often struggle, feel inadequate, and alone in their feelings, which can lead to burnout and poor patient outcomes. In this workshop, presenters will contextualize the contributing factors that lead to imposter syndrome including the psychological and the social-psychological perspectives at the societal, institutional, and interpersonal levels. Through understanding the contributing factors, participants will evaluate strategies to alleviate imposter syndrome through program improvement using a think-pair-share model, rewriting the narrative, and developing of a driver diagram. Participants will leave with a better understanding of the varied contributing factors leading to imposter syndrome, a mental model to help residents work through their imposter syndrome, and an approach that can support program improvement efforts.

The presentation will aim to determine student desires, attitudes, and behaviors. It will compare this to students from previous generations and identify ways to promote positive interactions between students and leadership. This will also include an interactive portion to help identify goals and guidelines, with suggestions on how to share with students.