Microaggressions can have a significant impact on the well-being and mental health of residents. These subtle forms of discrimination and bias can lead to feelings of isolation, imposter syndrome, and burnout which can ultimately affect the quality of patient care. Creating supportive and inclusive learning environments is crucial to combating microaggressions, building resiliency, and fostering personal growth and professional development. In this workshop, participants will explore the concept of microaggressions and their impact on residents in training programs through interactive discussions and role-playing exercises. We will discuss how to identify and respond to microaggressions in a constructive and empathetic way if you are the target, a bystander, or the aggressor. We will also discuss the importance of allyship and advocacy in addressing microaggressions and promoting equity and justice. Participants will learn how to provide practical skills for building resilience, such as self-care strategies, setting boundaries, and seeking support in residency programs. Participants will leave the workshop with a toolkit of skills and strategies for identifying and addressing microaggressions, promoting resilience, and creating more inclusive and supportive training environments including access to a sample microaggressions reporting tool they can implement at their home institutions.

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.

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.

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.

Now in its second year, this educational offering is a 13-week course for new department and division administrators (DDAs) developed by experienced administrators from Alliance member institutions. The course is designed for administrators who are in the first three years of their role or those looking for a refresh! The virtual course will consist of four live Zoom sessions where learners will hear from experts in the field and be able to discuss key topics. In addition, on-demand reading, interactive exercises, and video-based learning will make up the required weekly study time between each live session. Attendance at the live Zoom sessions is highly encouraged but not required. All live sessions will be recorded and available in the digital learning center for course participants within 3 business days. Primary topic areas include: Overview of medical school and teaching hospital components Department and division finance basics HR and faculty affairs Medical education mission of DDA role Medical research mission of DDA role Clinical care mission of DDA role Personal and professional wellness and development (PPWD)

The Internal Medicine Milestones 2.0 were implemented in July 2021 and showed promise to reduce confusion and clarify the subcompetencies. While initial feedback has been promising, there remain challenges in implementing the milestones by front-line medical educators. This interactive workshop will be led by the ACGME Vice President for Milestone Development, who has developed more than 180 distinct milestones across all specialties, as well as members of the Milestone 2.0 committee. They will share common friction points in the applying the milestones to real-world medical education scenarios and lead the group in "smoothing the bumps" in their implementation.

Health care workers are five times more likely to experience workplace violence than the average US worker with verbal aggression from patients being a common occurrence. Verbal de-escalation is the first line approach to defusing anger, but due to individual skill and inconsistent training during medical education, physicians and medical students are often unprepared to address it effectively. Despite having the least experience, the most junior physicians on the team are often the first providers called to the bedside of agitated patients. This workshop presents the CALMER approach, a novel, easy to use method to verbal de-escalation. This framework orders six evidence-based skills to efficiently de-escalate agitation, identify the underlying emotions, and find acceptable solutions to conflict. This workshop will begin with an audience reflection on past encounters with agitated patients. Presenters will discuss the differential behind patient agitation and identify the primary emotions that often fuel the presenting anger, then outline the CALMER approach. Using a real case derived from presenter experience, participants will have an opportunity to apply the six skills from the CALMER approach to the scenario utilizing worksheets to generate potential words and phrases. Participants will then work in small groups applying the framework to practice scenarios, with input from presenters. The presenters will conclude with their experience employing this curriculum at their institution, providing best practices as well as navigating potential barriers to implementation.

Looking for an easy-to-implement way to bolster community, build skills, and have fun at the same time? This workshop is an opportunity for program leaders to build a framework to develop dedicated leadership retreats in their residency educational curriculum targeted at core skill-building and creating an equitable and inclusive work environment during trainee professional transitions. Presenters will use the example of a large academic internal medicine residency program to demonstrate the vision, structure, logistics, and learning goals for retreats focused on various stages of transition within the residency program, using examples of retreats already embedded into the curriculum, including the R1 Leadership Retreat, the R2 Retreat, the Chief Resident Retreat, the Women in Leadership Development Retreat, and the Anti-Racism Retreat. After a brief description of program retreats, participants will break into groups to envision individual retreats by focusing on brainstorming core skills relevant to each transition, mapped to specific learning objectives and interactive activities. Presenters will identify how retreats can incorporate a lens of equity and inclusion to equip learners with the tools they need not only to thrive in their new role but also to create an inclusive teaching environment. The group will brainstorm solutions to barriers identified and have ample opportunity for questions. Workshop participants will walk away with tools to design or enhance their own mini-retreats for specific residency groups within their programs.

In response to the USMLE moving to pass-fail and in efforts to make the residency admissions process more equitable, many residency programs have moved towards a holistic review process when assessing medical student ERAS applications. However, the holistic review process brings unique challenges for residency programs. The recent US Supreme Court rulings prohibiting the use of race-based affirmative action in university and college admissions has added further nuance and confusion to the topic. This workshop will provide program leadership and administrators with needed skills to transition to a holistic review process at their home institution. To begin, participants will receive a brief didactic session on the underlying principles behind holistic review as well as guidance on how the recent US Supreme court ruling apply to holistic review at the GME level. After reflecting on their individual program's mission statement, participants will receive a step-by-step guide through the procedural steps in implementing a holistic review process for their residency programs. Participants will then work in small groups to assess ERAS applications to determine essential and non-essential components to guide creation of a holistic review rubric. Participants will return to their home institutions with a partial holistic review rubric, based on their individual program mission statement as well as guidance on how to overcome common barriers to holistic review.

Leveraging artificial intelligence (AI) to enhance clinical skills and provide personalized education is a transformative development in medical education. In this workshop, presenters will explore the innovative 2-Sigma platform, which utilizes generative AI to create unique clinical scenarios, providing students opportunity to practice their clinical reasoning and apply classroom learning in a novel way with the ability to as both a learning and assessment tool. Presenters will begin with an introduction to AI, its generative capabilities, and how this disruptive innovation can be applied to enhance an individual trainee's clinical reasoning skills. Participants will gain insights into how AI can offer tailored and effective learning experiences. The centerpiece of the workshop will be a detailed case study on the 2-Sigma platform used in UME. Presenters will explore how the platform provides scenario-based learning, adaptive tutoring, instant feedback, performance monitoring, and customizable learning goals. By harnessing large language models and AI technology, 2-Sigma ensures seamless interaction, content personalization, and adaptive learning to allow deliberate practice with clinical reasoning skills. Following this workshop, participants will not only understand the fundamentals of AI and its application in medical education but also be inspired by the real-world impact demonstrated through the 2-Sigma platform. They will leave equipped with actionable insights on how to integrate AI into their own teaching contexts, fostering a more personalized, efficient, and forward-thinking approach to medical education.

The Alliance presents key topics in UME and GME as weekly webinars. Led by members and organized in the same content tracks as AAIM conferences, live webinars are available free to charge and open to members and nonmembers alike. Webinar recordings are available for member viewing through the AAIM Digital Learning Center. To access recordings, select the online course; webinars are organized by fiscal year and searchable by content track.

On July 1, 2022, the new ACGME institutional requirements went into effect mandating sponsoring institutions to have leave policies that include a minimum of six paid weeks off for medical, parental, and caregiver leave. The establishment of this requirement is part of the ACGME commitment to resident and fellow well-being. Now that this final requirement is in effect, there are questions and confusion about what is actually required and how it relates to ABIM leave and sponsoring institution leave policies. This workshop will clarify the difference between the ACGME program requirements around resident leave of absence and the new six-week ACGME medical, parental, and caregiver leave as well as how and when this leave can be used and how to best document this leave. Presenters will provide two deliverables in the form of a leave of absence request form and a GME leave of absence checklist.

Have your residents or faculty ever been mad at you? Managing the expectations and experiences of residents and faculty is a challenging aspect of program leadership. When negative feedback and emotions are directed your way, it can take an emotional toll and the path forward is often unclear. Why do was ask our learners to adopt a growth mindset and be vulnerable in receiving feedback, but we struggle with this when leading our programs? This workshop will explore and normalize the psychological effects of negative programmatic feedback and provide program leaders with tools to alter their self-talk when challenges arise. We will discuss impediments to growth mindset as program directors, including shame, poor psychological safety, unrealistic time frames, and lack of a structured approach to addressing the problems of managing human resources. Often we turn to authority driven solutions to solve problems instead of learning driven approaches, and despite good intentions we make the problem worse. We will normalize the experience of sometimes failing to meet the expectations of those we serve, and provide frameworks to use when this happens, including self-determination theory, radical transparency, and systematic problem solving. We will provide specific examples of turning negative emotions into positive action. Participants will be able to practice skills learned in the workshop with problems they face at their own institutions. By the end of the workshop, participants will be equipped to manage their own emotions in response to negative feedback and develop a toolkit for effective problem-solving approaches moving forward.

Most medical education institutions lack structured career counseling. Physicians are often left with the task to fulfill this role for learners with little to no training. When encountered with these scenarios, the default is often to try to convince the learner how great the career is and why they should choose our specialty or career path. There is also the time honored phrase "you will figure it out." Learners seek out these conversations not necessarily because of who we are or what we do but because they trust us to aid them in this decision. But learners will often feel embarrassed to ask about other career options, leaving them feeling more confused after the conversation with no true reflection on the matter. It can also lead to disillusionment when asked about career guidance satisfaction on program surveys. In this workshop, presenters will take the audience through the ins and outs of guiding learners through specialty or career indecision. Presenters will teach the audience how to properly lay the groundwork for the discussion, maintain objectivity, remove judgment, and help the learner resolve internal conflict by first introducing career guidance principles and resources followed with an interactive case-based discussion using examples from experiences as a career counselor. The audience will have a chance to critique cases and ask questions.

There is an unprecedented level of growth of new internal medicine programs. Results from the annual APDIM survey showed 20% of member programs were in the initial accreditation phase. At the most recent Academic Internal Medicine Week, the new program special interest group meeting was attended by more than 60 members. Many of these program directors are new; 49% of program directors in the APDIM community have been in their role for fewer than three years. This workshop for new programs, either in development or recently accredited, is designed to work through shared challenges and offer tips for success. The speakers for this workshop have recently created both university-based and community-based internal medicine programs and undergone successful accreditation and recruitment cycles. Presenters will provide practical pearls and tips to navigate common challenges, an understanding of the ACGME accreditation process, and how to access APDIM, the Alliance, and other resources to bolster effectiveness.

On day one of residency, new interns are expected to have mastery of a standardized clinical skillset. The fourth year of medical school is critical to preparing for this transition and requires students to achieve a higher level of autonomy than experienced during clerkships. However, students often spend their fourth year involved in more passive learning than direct clinical engagement. Studies suggest that students at different institutions experience varying degrees of autonomy in patient care and clinical exposure during their final year of medical school, including both subinternships and electives. Educators working with fourth year students experience significant challenges in providing sufficient autonomy to students to adequately prepare them for residency. Maximizing autonomy for fourth year students requires a four-pronged approach: individual recognition of the need for increased student autonomy and modification of direct teaching methods in the clinical learning environment; implementation of faculty and resident development that empowers clinical teachers to encourage autonomy for fourth-year clinical rotators; curricular innovation and development of new clinical or simulation-based courses; and advocacy for policy change within institutions to allow students to take on new responsibilities (i.e. billing for documentation, cross-coverage, etc.). In this workshop, presenters will describe a variety of efforts at four institutions that promote autonomy and active learning in the fourth year through individual teaching practices, curricular change, policy change, and faculty development. Audience interaction will include think-pair-share and two break-out sessions in which participants create a draft plan for a new intervention at their institution.

The release of ChatGPT, Google Bard, and other artificial intelligence (AI) large language models (LLMs) have captured the world's attention for the potential they hold in facilitating work. While perhaps at the "peak of inflated expectations" of the Gartner Hype curve with regard to LLMs, there is little doubt that AI and LLMs will play an increasing role in our daily roles as physicians, educators, and program leaders. Among the opportunities is the use of LLMs to help with meeting program accreditation standards, from the ability to analyze and categorize large qualitative data sets (e.g., learner critiques, faculty descriptive assessments, survey results), to helping with writing reports, to a source for ideas for conducting program evaluation. In this workshop, presenters will explore how AI LLMs could be used to facilitate the work of clerkship directors, program directors, deans, and DIOs, through worked examples and real time analyses, while highlighting and discussing the limitations and concerns, including regulatory issues, with using LLMs for such purposes.

A growing number of writers and researchers describe the vast benefits of pausing in a frenetic life to intentionally appreciate joy and awe. Designer Ingrid Fetell Lee describes joy as a "momentary experience of positive emotion." Psychologist Dacher Kelter defines awe as the "feeling of being in the presence of something vast that transcends your understanding of the world." Benefits of experiencing joy and awe include reduced levels of cortisol and increased focus, efficiency, creativity, altruism, and sense of community. Joy is universal and has the potential to help transcend hierarchy and polarization. Awe connects the individual to the greater collective, quiets the inner critic, and helps promote a sense of meaning and higher purpose. Burnout among physicians and learners has reached crisis levels, and many medical educators are struggling to sustain their practices and inspire the next generation of physicians. Systemic changes remain critical to address the root causes of burnout. In this workshop, the presenters aim to empower medical educators to incorporate brief practices of joy and awe into work to overcome barriers, improve well-being, and reconnect with purpose as clinicians, educators, and learners. This workshop will explore "moral beauty," "collective effervescence," and other concepts from Kelter's eight-part framework on awe. Participants will define strategies to incorporate awe in their daily work in health care and medical education and practice Lee's "joyspotting" and other approaches to increase connection, purpose, and meaning in clinical and educational lives.

Medical students experience perceived mistreatment and bias in their clinical learning environments, which has been associated with multiple negative consequences. The LIFT framework, a communication tool, empowers trainees, educators, clinical leaders, etc. to identify and address such experiences when the impact may be different than the intended goal/message. Medical students are particularly vulnerable within the hierarchy of medicine given their dependence on performance-driven assessments to achieve their career goals. For clerkship and departmental leadership to support students by addressing episodes of perceived mistreatment and bias, learning about these episodes and contexts that students are experiencing is critical to timely intervention. Multiple avenues for students to report experiences of bias to minimize potential or a perceived impact on a student's final grade include direct reporting, peer-facilitated sessions, and both anonymous and non-anonymous web-based applications. An inherent challenge in this process is balancing protecting student anonymity with providing timely, in-the-moment feedback for the individuals/groups involved. Presenters will adapt sample reports of student mistreatment and perceived experiences of bias from our institution to facilitate discussion on sharing best practices to navigate crucial and challenging conversations with relevant stake-holders, utilizing the LIFT framework. Inherent to LIFT is providing growth opportunities for educators, a critical part of continuing medical education and prospectively supporting the learning environment.

In the years of residency, trainees balance several major life experiences: learning and working in a rigorous clinical environment; building a professional identity; forming a future career plan; and maintaining their personal well-being. Mentoring residents through these challenging years can also feel overwhelming to residency leaders and mentors who deeply invest in the personal and professional development of their residents. Compassionate mentorship is a model that supports both mentors and trainees in a partnership for growth. In this workshop, presenters from four different residency programs share key skills that they use in their roles to provide compassion-centered mentorship for residents. Presenters will also discuss how they role model these principles for and with trainees. This workshop will review key principles of compassionate mentorship: core values alignment; self-compassion; and building each resident's network of developmental mentorship. The format will use case discussions and small group reflection to facilitate application and integration of these skills.