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Assessment & Procedure Training

Success has to do with deliberate practice. Practice must be focused, determined, and in an environment where there is feedback.” -Malcolm Gladwell

Practice doesn’t make perfect, practice makes permanent. That is why deliberate practice, in which feedback on performance is used to guide improvement, is so important. Having robust assessment systems that are focused on learner improvement are key to developing mastery. This is the over-arching philosophy of our assessment and procedure training systems.

Resident Assessment

At UC you will benefit from one of the most robust GME assessment and feedback systems in the world.1-12 Residents receive assessments from multiple sources - attendings, peers, nurses, other allied health professionals, and students. 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 regularly with program leadership to review their assessment data, set goals, and develop personalized improvement plans to become the best physician possible.

Med-Peds residents also have access to an advanced patient care dashboard for their clinic patients. This dashboard allows residents to see updated data on the quality of care they deliver to their clinic patients. We believe this is important because high-quality education requires high-quality clinical care, and data are required for deliberate practice.

 

 

Procedure Training

procedure-mp-photo

"See one, do one, teach one" is a flawed approach to procedure training that is not optimal for patients or trainees.13,14 Therefore, we have begun developing systems of procedure training based on sound procedural and assessment principles. We ensure that our residents meet the ACGME procedure requirements, while striving to be flexible and meet each resident’s individual procedural training needs.

  • There are simulation labs at 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, Advanced Critical Care/Procedure Electives at the UC MICU and the VA, and a point of care ultrasound (POCUS) elective.

 

References

  1. Warm EJ. Observable Practice Activity Assessment System  https://www.youtube.com/watch?v=t5JVRZrXBbU&spfreload=102014.
  2. Warm EJ, Kinnear B, Kelleher M, Sall D, Holmboe E. Transforming Resident Assessment: An Analysis Using Deming’s System of Profound Knowledge. Academic Medicine. 2019;94(2):195-201.
  3. Warm EJ, Kinnear B, Kelleher M, Sall D, Schauer DP, Friedstrom S. Variation in entrustment when sharing a single assessment system between university-and community-based residency programs: a comparison. Academic Medicine. 2020;95(4):590-598.
  4. Schauer D, Kelleher M, Kinnear B, Sall D, Schumacher DJ, Warm EJ. Developing the Expected Entrustment Score: Accounting for Variation in Resident Assessment. Journal of general internal medicine. 2021, in press.
  5. Kinnear B, Kelleher M, Sall D, et al. Development of Resident-Sensitive Quality Measures for Inpatient General Internal Medicine. Journal of general internal medicine. 2020:1-8.
  6. Kinnear B, Warm EJ, Hauer KE. Twelve tips to maximize the value of a clinical competency committee in postgraduate medical education. Medical teacher. 2018:1-6.
  7. Kelleher M, Kinnear B, Sall D, et al. A Reliability Analysis of Entrustment-Derived Workplace-Based Assessments. Academic Medicine. 2020;95(4):616-622.
  8. Kinnear B, Kelleher M, May B, et al. Constructing a validity map for a workplace-based assessment system: Cross-walking Messick and Kane. Academic Medicine. 2021;96(7S):S64-S69.
    1. 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.
    2. Warm EJ, Held J, Hellman M, et al. Entrusting Observable Practice Activities and Milestones Over the 36 Months of an Internal Medicine Residency. Academic Medicine. 2016;91(10):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. 2017;92(6):820-826.
    4. Warm EJ, Kelleher M, Kinnear B, Sall D. Feedback on Feedback as a Faculty Development Tool. Journal of graduate medical education. 2018.
    5. Sall D, Warm EJ, Kinnear B, Kelleher M, Jandarov R, O’Toole J. See One, Do One, Forget One: Early Skill Decay After Paracentesis Training. Journal of general internal medicine. 2020:1-6.
    6. Warm EJ, Ahmad Y, Kinnear B, et al. A Dynamic Risk Management Approach for Reducing Harm From Invasive Bedside Procedures Performed During Residency. Academic Medicine. 2021;96(9):1268-1275

    Jennifer K. O'Toole, MD, MEd, SFHM
    Program Director
    Phone: 513-558-4074
    Email: Jennifer.otoole@cchmc.org

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    Department of
    Internal Medicine

    Medical Sciences Building Room 6065
    231 Albert Sabin Way
    PO Box 670557
    Cincinnati, OH 45267-0557

    Phone: 513-558-4231
    Fax: 513-558-0852
    Email: imoffice@uc.edu