Rebecca D. Blanchard

AM last page: Applying Knowles' Andragogy to resident teaching

3. Knowles MS. Andragogy in Action: Applying Modern Principles of Adult Education. San Francisco, Calif: Jossey Bass; 1984. 2. Knowles MS, Holton EF, Swanson RA. The Adult Learner: The Definitive Classic in Adult Education and Human Resource Development. 6th ed. Boston, Mass: Elsevier; 2005. Adult Learning Theory Developing teaching skills in residents is a critical component of medical education because residents spend up to 20% of their time teaching junior learners.1 They often rely on the traditional pedagogical approaches that they observed during their years of formal schooling, but these often do not translate well with their adult learners.

Cultivating Medical Education Research Mentorship as a Pathway Towards High Quality Medical Education Research

ABSTRACTThe lack of effective and consistent research mentorship and research mentor training in both undergraduate medical education (UME) and graduate medical education (GME) is a critical constraint on the development of innovative and high quality medical education research. Clinical research mentors are often not familiar with the nuances and context of conducting education research. Clinician-educators, meanwhile, often lack the skills in developing and conducting rigorous research. Mentors who are not prepared to articulate potential scholarship pathways for their mentees risk limiting the mentee’s progress in early stages of their career. In fact, the relative paucity of experienced medical education research mentors arguably contributes to the perpetuation of a cycle leading to fewer well-trained researchers in medical education, a lack of high quality medical education research, and relative stagnation in medical education innovation. There is a path forward, however. Integration of doctoral-level educators, structured inter-departmental efforts, and external mentorship provide opportunities for faculty to gain traction in their medical education research efforts. An investment in medical education research mentors will ensure rigorous research for high quality innovation in medical education and patient care.

Applying Clinical Research Skills to Conduct Education Research: Important Recommendations for Success

Imagine a physician who wants to research options to help her patients lose weight. As a clinical researcher, she may first explore the efficacy of a medication. Not only is there an instrument that accurately collects patient weight but also the link between the intervention (medication) and the outcome (weight) has been established. Her study manipulates the behavior of the physician (what should be prescribed), and the intervention is administered to the patient, who in this case, is a relatively passive recipient.

AM Last Page: A Snapshot of Three Common Program Evaluation Approaches for Medical Education

References 1. Fitzpatrick JL, Sanders JR, Worthen BR. Program Evaluation: Alternative Approaches and Practical Guidelines. 4th ed. Upper Saddle River, NJ: Pearson Education; 2011. 2. Christie CA, Alkin MC. An evaluation theory tree. In: Alkin MC, ed. Evaluation Roots. 2nd ed. Thousand Oaks, CA: Sage; 2013:11–57. 3. Stufflebeam DL. The relevance of the CIPP evaluation model for educational accountability. J Res Dev Educ. 1971;5:19–25. 4. Durning SJ, Hemmer P, Pangaro LN. The structure of program evaluation: An approach for evaluating a course, clerkship, or components of a residency or fellowship training program. Teach Learn Med. 2007;19:308–318. 5. Musick DW. A conceptual model for program evaluation in graduate medical education. Acad Med. 2006;81:759–765. Author contact: Rebecca.BlanchardPhD@baystatehealth.org Program evaluation, or programmatic assessment, is the application of defensible criteria to determine the worth or merit of a program, project, or curriculum.1 “Decision-oriented,” “outcomes-oriented,” and “expert-oriented” are three common approaches to program evaluation1 in medical education. This snapshot provides a brief review of program evaluation within each approach along the following dimensions: Do internal stakeholders or external stakeholders drive the evaluation? Is the evaluation examining a broad scope of the program or delving deeply into one or two particular aspects in greater detail? Is this evaluation reasonably straightforward to complete, or does it require specialized knowledge and resources? Do the evaluation results benefit local decision makers or those in a broader audience? Does the evaluation rely on a theory, or is it largely atheoretical?

Harvest the Low-Hanging Fruit: Strategies for Submitting Educational Innovations for Publication

The field of medical education, including graduate medical education (GME), is fertile ground for creativity. With more outlets for medical education scholarship than ever before, 1 the national discourse should be flush with descriptions of educational innovations. However, there are many medical education innovations that are never submitted successfully for publication, and educators often are derailed at various points in the writing and submission process. To address this problem, we present opportunities and strategies for educators to conceptualize and articulate their innovations for scholarly outlets. Ultimately, we encourage educators to ‘‘harvest the low-hanging fruits’’ of their innovative efforts.

Building chief residents’ leadership skills

What problem was addressed? In many American residency programmes, chief residents are selected for an additional year by programme leaders to provide educational and administrative leadership to other residents. Traditionally, chief residents have acquired leadership skills ‘on-the-job’ and have long felt that the demands of their role without formal leadership training have been challenging. The chief resident year is a unique opportunity for those residents to formally acquire leadership skills, not only with their own departmental leaders, but also via interaction with other hospital colleagues. To realise this potential, we created an intra-institutional leadership seminar series to help chief residents develop leadership skills through formal discussion and reflection. What was tried? Medicine, medicine–paediatrics and paediatric chief residents and programme directors at Baystate Medical Center were invited to attend a 1-hour session every other week over the course of an academic year. Seminar topics were selected initially by facilitators, internal medicine programme directors. However, topics and their order evolved quickly during the first year as a community of practice evolved and as the group itself identified skills that addressed commonly encountered institutional, programmatic and individual challenges that arose. To formalise this process, incoming, current and past chief residents completed a ‘chief resident year survey’. Incoming chief residents were asked to describe their fears about their upcoming role; current and past chief residents were asked to identify leadership skills to be acquired prior to the chief resident year, plus those best built during the chief resident year itself. Facilitators also reviewed relevant literature. Incoming chief residents worried most about overcoming the impostor syndrome (feeling undeserving of one’s role), handling conflicts, saying ‘no’ and maintaining a healthy work–life balance. Current chief residents felt that conflict resolution, giving feedback and managerial skills were important skills built during the chief resident year. Past chief residents suggested adapting one’s leadership style, diplomacy and learning to use one’s leadership strengths. Topics address common challenges and responsibilities chief residents face at particular times throughout the year. For example, as chief residents are often nervous about both the managerial and the hierarchical responsibilities of their roles early in the year, concepts of prioritisation and organisation, impostor syndrome and psychological size (the status relationship between two people) are covered. Later, discussions focus on conflict resolution, management and communication. Before each session, chief residents complete preparatory topic-related reading. During sessions, participants engage in a community of practice through sharing, critiquing and contrasting their own relevant experiences. A complete description of our seminar series with resources can be found at http://libguides.baystatehealth.org/ CRleadership_curriculum. What lessons were learned? Two major lessons arose from a review of anonymous seminar evaluations collected at the end of each year. First, a major success of the seminar is the development of an active community of practice, which has fostered educational and practice exchanges, enhanced by peer support, topic-related anecdotes and problem-solving of current cases. Chief residents have asked that the series be offered to all hospital chief residents to expand that community of practice. Second, we now vary topic timing slightly from year to year to reflect individual and programmatic evolution. The topic order is now a mutual decision by the group based on current, immediate needs.

Integrating Quality Improvement With Graduate Medical Education Lessons Learned From the AIAMC National Initiatives

Quality and safety initiatives (QI) are national priorities for health care, yet the role of residents in QI has not always been clear. In academic medical centers, residents and fellows play a critical role in patient care and, as such, their integration into QI presents a unique opportunity to affect change. The Alliance for Independent Academic Medical Centers (AIAMC) began a national campaign in 2007 to harness the potential of infusing graduate medical education (GME) with QI, through their AIAMC National Initiative: Improving Patient Care Through Medical Education. This article describes the National Initiatives (NIs) and the reflections of NI participants, including their reflections on the goals they set for integrating GME with QI, the barriers they encountered along the way, and their advice to others beginning the challenge. These reflections provide some insight into the pathways of promoting organizational change and offer practical insight and inspiring advice for others embarking on the journey.

From the coliseum to the convention centre: a reflection on the current state of medical education conferences and conference-goers.

The advancement of knowledge and development of policy in the field of medical education require critical academic discourse among the most intelligent medical educators; and critical academic discourse requires coffee. In this essay, we reflect on the state of professional development conferences in the field of medical education and the rituals that surround their success. Having begun in ancient Greece, symposia were ripe with debauchery. Today, sedated by the light brown walls of hotel conference centres, symposia are more serious endeavours, engaging men and women in the sometimes turbulent waters of epistemological debate. The abstract submission process (summed up by: ‘Yay! It was accepted for presentation’ [Deep breath] ‘Oh no…it was accepted for presentation’), the ‘juggling act’ of parent attendees, the acting prowess of abstract presenters and the unapologetic approach to buffet eating are all by‐products of the collision of true intellects among medical education scholars. We hold these rituals in high regard and argue that they are required to advance the field of medical education. These rituals bind the walls supporting true progressive thought and innovative research, all fuelled by the glass of wine purchased with that one coveted drink ticket.