Our selection as one of only 21 programs in the Accreditation Council for Graduate Medical Education’s (ACGME) Educational Innovations Project led us to six evidence-based approaches to learning and care:
Evidenced-Based Learning Strategies
These are more than just words to us. Over the past decade and half our residency program has been a learning laboratory putting ideas into action.
Have you ever felt you couldn't address your patient's concerns because you were rushing around so much? The average intern in the United States spends only 12% of their time in direct patient care. How can this be?
Our patient-centered bedside rounds focuses the care system around the patient, not the computer. You will learn how to help patients leave the wards with a sense of self-efficacy. Do they know enough to go home? Can they take care of themselves? If, not, how can we assist them?
In the clinic, our award-winningAmbulatory Long Block provides an authentic primary care experience and the kind of real-life continuity needed to manage patients with complex problems. We see ourselves as teachers of the patients. What good is a treatment plan if the patient doesn't understand it? We close the loop of knowledge by providing clear written instructions from the electronic medical record and by having the patients “teach-back” the plan to us to ensure they understand it.
Relationships are your most important therapeutic tools. We have designed care systems to allow these to blossom.
We are a team on the wards, in the clinic, and in the classroom.
Patient-centered rounds puts patients at the center of an interprofessional team that includes you, faculty members, students, and many excellent non-physician colleagues (nurses, case managers, social workers, therapists, educators). When we round together we introduce ourselves and our roles to the patients. We say: ‘the reason there are so many people in the room today is because we will all be taking care of you.’
During the Ambulatory Long Block you and your peers will form a large group practice. You will learn how to manage individual patients and whole populations together. The amazing (and award winning!) nurses, social workers, administrators, pharmacists, mental health specialists, surgeons, and sports medicine physicians you work with will help you deliver superior care in our safety net practice.
We also work together in the classroom. During Academic Half Day you and your team will use the Growth Mindset and a shared sense of purpose to learn medicine. The goal is not to show what you know, but to find out what you don’t know, and fix it. Growing like this requires vulnerability, and good teamwork creates the psychological safety that allows this to happen.
As master educators we have studied evidence-based techniques for learning and we’ve become educational innovators.
We believe in Growth Mindset, and organize our learning experiences around these principles.
Our state-of-the-art Milestones Evaluation System provides you with thousands of data points about your performance, and our Coaching team helps you use this information to grow. At this point in your life most of your evaluations have probably represented risk (think about grades in your 3rd year clerkship – what would happen if you weren’t above average?). In our residency we are not concerned with averages or ranking people. We ask: are you better tomorrow that you were yesterday?
When you come to our conferences you will not see dark rooms and PowerPoint. Instead, you will encounter active small-group learning exercises challenging you to think rather than just passively receive knowledge.
If you’re thinking about becoming an educator yourself you might consider clicking on the links in the prior sentence to see what each of these things is about. We geek out on this stuff (because it works!) and have used our growing expertise to create a Medical Education Pathway for residents, and a Medical Education Fellowship that occurs after residency for those who want to delve deeply into the science of learning. The graduates of these programs have become fabulous medical educators in our residency and around the country. We can help you become one too.
What are we trying to improve? We are not afraid of this question, and we ask our residents to be vocal when things need improving. We always have multiple improvement projects going on at the same time, suggested and co-led by residents.
What change can we make the will result in an improvement? When you’re in the Ambulatory Long Block you will receive personalized data reports showing how well your patients are doing. It’s rare for residents to be assessed on the quality of care they deliver. The true value comes when you use improvement science to advance your performance. It’s not a test – it’s real life: your patient’s.
If you are particularly interested in improvement science you can join our Improvement Pathway.