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Admission Clinical Diagnosis and Assessment: An Innovative Curriculum and Experiential Learning Opportunity
Initial clinical assessment, diagnostic workup and triage of patients newly admitted to the hospital are essential clinical skills gained during internal medicine residency training. However, increasing external pressures across the health care system have made teaching and practicing these skills with resident learners more challenging. A focus on hospital bed flow, length of stay, and early discharge, in combination with nurse and ancillary staffing shortages have shifted focus away from clinical assessment and more towards patient throughput and disposition. In addition, emergency department boarding of admitted patients has led to fractured and inefficient healthcare delivery. Our workshop will detail how we applied Kern's 6-step curriculum development methodology to the creation of an innovative admitting and triage general internal medicine (GIM) service geographically located in the emergency department. Residents on this rotation work directly with GIM faculty on the triage, initial workup, and assessment of newly admitted patients. We will discuss the entire curriculum development process from needs assessment to curriculum evaluation. Additionally, we will share the content of the didactic curriculum created for this rotation that focuses on clinical assessment, interdisciplinary care team communication, and healthcare system navigation. We will also show our resident evaluation process, which is mapped to the ACGME milestones. Finally, we will share preliminary assessment and evaluation data, including resident attitudes and confidence in the selected subset of ACGME milestones.
1Learn MoreMastering Medical Error Disclosure: Innovative Strategies for Improving Patient Safety Outcomes Using Simulation
Medical errors are a challenging aspect of healthcare that requires physicians to possess strong emotional intelligence and communication skills to disclose errors to patients and families. The systems-based practice requirement mandates that residents should be able to participate in simulated or actual medical error disclosure and contribute to the analysis of patient safety events. However, many residents feel uncomfortable leading these conversations and fear medicolegal consequences. This interactive workshop aims to equip faculty with the necessary tools and skills to ensure their residents can confidently disclose medical errors and report them for analysis of patient safety events. We will discuss the medicolegal requirements for error disclosure and provide practical tips for effective communication. Additionally, we will provide faculty with evaluation tools to provide feedback to residents. Through our workshop participants will gain insights into the challenges of medical error disclosure and reporting, as well as acquire the necessary skills to overcome these challenges. We will share data we collected, including residents' testimonials on the effectiveness of our tools. Our goal is to enable other programs to easily adapt our tools and workshop to their local environment. Overall, our workshop provides a safe and supportive environment for residents to learn, practice, and receive feedback on their skills, ensuring that they are well-prepared to participate in medical error disclosure and reporting.
1Learn MoreA Systematic Approach to Address and Prevent Microaggressions and Harassment Directed Towards Residents
Residents who identify as underrepresented in medicine, women, have strong spiritual or faith beliefs, and other minority groups experience a high prevalence of microaggressions. Studies have shown microaggressions lead to higher rates of burnout, increased rates of depression, and decreased academic performance. Faculty and residents have reported the need for training in how to address and report microaggressions. Studies thus far have described approaches to upstander training but there is less of a focus on a program wide or institution wide response. In this workshop, we will describe our institutions' approaches to addressing microaggressions. Successful bystander training workshops for faculty and trainees will be highlighted. We will discuss different approaches to create safe and confidential methods to report microaggressions that they have experienced and/or witness. We will review different approaches to systematically analyze microaggression reports including how to create a centralized reporting system to help detect patterns across other disciplines or settings. We will review how we have categorized the data in order to best target interventions for microaggressions coming from patients, interdisciplinary staff, and physicians. Finally, we will discuss how to address reported microaggressions with a systematic approach that is supportive of the trainee and emphasizes re-education as opposed to shaming. This workshop will be interactive and will leverage the experiences of the participants to share additional ideas and approaches for data collection, data organization, and program level interventions.
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