Today is Wednesday, Jul. 18, 2018

Department of

Department of Internal Medicine

Residency Programs

Evaluations & Procedure Training


Our residents benefit from one of the most robust GME assessment and feedback systems in the world.1-4 Learners are assessed and receive feedback on discrete skills called Observable Practice Activities (OPAs) which are connected to the ACGME milestones.  These OPAs are used in both adult and pediatric inpatient rotations, as well as in our Med-Peds clinic.  Residents receive assessments from multiple sources - attendings, peers, nurses, other allied health professionals, and learners.  Our focus is on using assessment data for formative purposes (assessment FOR learning) rather than only using it for summative purposes (assessment OF learning).  Our residents meet with program leadership to review their data, set goals, and develop personalized improvement plans to become the best physician possible.

Procedure Training

It has become clear that "see one, do one, teach one" is a flawed approach to procedure training that is not optimal for patients or trainees.  Therefore, we have begun developing systems of procedure training based on sound procedural and assessment principles.5  There are simulation labs at both the College of Medicine, VA Medical Center, and Cincinnati Children’s Hospital Medical Center where the residents are provided with many opportunities to learn.  Residents have opportunities to perform procedures on numerous inpatient rotations (general wards, CVICU, MICU, PICU, NICU, ED) as well as in Med-Peds clinic.  Focused procedural experiences include procedure shifts in the Pediatric ED and during ambulatory months  There is also a clinic-based physical exam practicum in which our Med-Peds residents learn directly from our best clinicians.  Our program ensures our residents meet the ACGME procedure requirements, while striving to be flexible and meet each resident’s individual procedural training needs.

  1. Warm EJ. Observable Practice Activity Assessment System
  2. Warm EJ, Held JD, Hellmann M, et al. Entrusting Observable Practice Activities and Milestones Over the 36 Months of an Internal Medicine Residency. Academic medicine : journal of the Association of American Medical Colleges. 2016;10(91):1398-1405.
  3. Kinnear B, Bensman R, Held J, O'Toole J, Schauer D, Warm E. Critical Deficiency Ratings in Milestone Assessment: A Review and Case Study. Academic medicine : journal of the Association of American Medical Colleges. 2016.
  4. Warm EJ, Mathis BR, Held JD, et al. Entrustment and mapping of observable practice activities for resident assessment. Journal of general internal medicine. 2014;29(8):1177-1182.
  5. Sall D, Kelleher M, Kinnear B, Warm E, O'Toole J. A Single Method of Assessment is not Enough: Development, Pilot Testing and Validity Evidence for a Novel Paracentesis Competency Assessment Tool. Under review with Academic Medicine. 2017.

More Information

For more information on the Medicine-Pediatrics Residency Program, please contact us at:

Medicine-Pediatrics Residency Program
UC Department of Internal Medicine
231 Albert Sabin Way
Mail Location 0535
Cincinnati, OH 45267-0535

Phone: 513-584-0397
Fax: 513-584-0369

Program Director:
Jennifer K. O’Toole, MD, MEd
Associate Professor of Internal Medicine and Pediatrics