Regina A. Kovach

Competency-Based Education and Training in Internal Medicine

Recent efforts to improve medical education include adopting a new framework based on 6 broad competencies defined by the Accreditation Council for Graduate Medical Education. In this article, the Alliance for Academic Internal Medicine Education Redesign Task Force II examines the advantages and challenges of a competency-based educational framework for medical residents. Efforts to refine specific competencies by developing detailed milestones are described, and examples of training program initiatives using a competency-based approach are presented. Meeting the challenges of a competency-based framework and supporting these educational innovations require a robust faculty development program. Challenges to competency-based education include teaching and evaluating the competencies related to practice-based learning and improvement and systems-based practice, as well as implementing a flexible time frame to achieve competencies. However, the Alliance for Academic Internal Medicine Education Redesign Task Force II does not favor reducing internal medicine training to less than 36 months as part of competency-based education. Rather, the 36-month time frame should allow for remediation to address deficiencies in achieving competencies and for diverse enrichment experiences in such areas as quality of care and practice improvement for residents who have demonstrated skills in all required competencies.

Peer Assessment of Professionalism: A Five-Year Experience in Medical Clerkship

IntroductionFaculty assessment of students’ professionalism is often based upon sporadic exposure to students. Peers are in a unique position to provide valid judgments of these behaviors.Aims(1) To learn if peer assessments of professional conduct correlate with traditional performance measures; (2) to determine if peer assessments of professionalism influence the designation of honors, and (3) to explore student and faculty opinions regarding peer assessment.SettingInternal Medicine Clerkship at Southern Illinois University.Program DescriptionSince 2001 anonymous student peer assessments of professionalism have been used in assigning clerkship grades.Program EvaluationPeer assessments of professionalism had weak, though significant, correlations with faculty ratings (r = 0.29), performance on the NBME subject test (r = 0.28), and performance on a cumulative performance assessment (r = 0.30), and did not change the total number of honors awarded. A majority of students (71%) felt comfortable evaluating their peers, and 77% would keep the peer evaluation procedure in place. A majority of faculty (83%) indicated that peer assessments added valuable information.DiscussionPeer assessments of professional conduct have little correlation with other performance measures, are more likely to have a positive influence on final clerkship grades, and have little impact on awarding honors.

Educational Technology in Medical Education

This article aims to review the past practices of educational technology and envision future directions for medical education. The discussion starts with a historical review of definitions and perspectives of educational technology, in which the authors propose that educators adopt a broader process-oriented understanding of educational technology. Future directions of e-learning, simulation, and health information technology are discussed based on a systems view of the technological process. As new technologies continue to arise, this process-oriented understanding and outcome-based expectations of educational technology should be embraced. With this view, educational technology should be valued in terms of how well the technological process informs and facilitates learning, and the acquisition and maintenance of clinical expertise.

AAIM Report on Master Teachers and Clinician Educators Part 2: faculty development and training.

AIM Report on Master Teachers and Clinician ducators Part 2: Faculty Development and Training tephen A. Geraci, MD, Regina A. Kovach, MD, Stewart F. Babbott, MD, Harry Hollander, MD, aquel Buranosky, MD, Donna R. Devine, BS, Lee Berkowitz, MD Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Mississippi School of edicine, Jackson; Division of General Internal Medicine, Department of Medicine, Southern Illinois University School of edicine, Springfield; Division of General and Geriatric Medicine, Department of Medicine, University of Kansas School of edicine, Kansas City; Division of Infectious Diseases, Department of Medicine, University of California, San Francisco; Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pa; Department of Medicine, niversity of Washington, Seattle; Department of Medicine, University of North Carolina at Chapel Hill.

AAIM Report on Master Teachers and Clinician Educators Part 4: Faculty Role and Scholarship

AIM Report on Master Teachers and Clinician ducators Part 4: Faculty Role and Scholarship tephen A. Geraci, MD, Harry Hollander, MD, Stewart F. Babbott, MD, Raquel Buranosky, MD, onna R. Devine, BS, Regina A. Kovach, MD, Lee Berkowitz, MD Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Mississippi School of edicine, Jackson; Division of Infectious Diseases, Department of Medicine, University of California, San Francisco; Division of General and Geriatric Medicine, Department of Medicine, University of Kansas School of Medicine, Kansas ity; Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Penn; Department of edicine, University of Washington; Division of General Internal Medicine, Department of Medicine, Southern Illinois niversity School of Medicine, Springfield; Department of Medicine, University of North Carolina at Chapel Hill, Chapel ill.

How we developed and piloted an electronic key features examination for the internal medicine clerkship based on a US national curriculum

Abstract Background: Key features examinations (KFEs) have been used to assess clinical decision making in medical education, yet there are no reports of an online KFE-based on a national curriculum for the internal medicine clerkship. What we did: The authors developed and pilot tested an electronic KFE based on the US Clerkship Directors in Internal Medicine core curriculum. Teams, with expert oversight and peer review, developed key features (KFs) and cases. Evaluation: The exam was pilot tested at eight medical schools with 162 third and fourth year medical students, of whom 96 (59.3%) responded to a survey. While most students reported that the exam was more difficult than a multiple choice question exam, 61 (83.3%) students agreed that it reflected problems seen in clinical practice and 51 (69.9%) students reported that it more accurately assessed the ability to make clinical decisions. Conclusions: The development of an electronic KFs exam is a time-intensive process. A team approach offers built-in peer review and accountability. Students, although not familiar with this format in the US, recognized it as authentically assessing clinical decision-making for problems commonly seen in the clerkship.

AAIM Report on Master Teachers and Clinician Educators Part 3: Finances and Resourcing

AIM Report on Master Teachers and Clinician ducators Part 3: Finances and Resourcing tephen A. Geraci, MD, Donna R. Devine, BS, Stewart F. Babbott, MD, Harry Hollander, MD, aquel Buranosky, MD, Regina A. Kovach, MD, Lee Berkowitz, MD Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Mississippi School of edicine, Jackson; Department of Medicine, University of Washington, Seattle; Division of General and Geriatric edicine, Department of Medicine, University of Kansas School of Medicine, Kansas City; Division of Infectious Diseases, epartment of Medicine, University of California, San Francisco; Division of General Internal Medicine, Department of edicine, University of Pittsburgh, Pa; Division of General Internal Medicine, Department of Medicine, Southern Illinois niversity School of Medicine, Springfield; Department of Medicine, University of North Carolina at Chapel Hill.

Ambulatory Education in the Internal Medicine Clerkship at Southern Illinois University School of Medicine.

The Internal Medicine Clerkship at Southern Illinois University has included an ambulatory experience in its curriculum for 3 years. Six students at a time rotate through the required 3‐week ambulatory block; this block is repeated three times during the 11‐week Internal Medicine Clerkship so that all 18 students each clerkship are accommodated. The schedule provides students with extensive clinical exposure in a variety of ambulatory settings and includes formal educational activities such as small‐group seminars on ambulatory topics and a workshop utilizing standardized patients in outpatient settings. In their evaluations of the ambulatory experience, more than half the students felt the ambulatory block made them more positive about the specialty of internal medicine. Despite many barriers to ambulatory education, including the burden imposed on faculty time and the strain on office productivity, the quality of education in the ambulatory setting has improved, and students have prospered. Future direc...