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UW Program Director

Train the Trainer


on 29 April 2013

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Transcript of UW Program Director

No conflicts of interest to report Disclosures ANNUAL PROGRAM REVIEW, 2007 Atlanta Conference, 2011 Competency-based assessment
Instructional technologies
Hidden curriculum
Communication skills
Supervision Call to Improve Faculty Development Training the Trainer:
Empowering Program Directors to
Encourage Faculty Development ~Albert Einstein Imagination is
more important
than knowledge The Next GME Accreditation System — Rationale and Benefits
Thomas J. Nasca, M.D., M.A.C.P., Ingrid Philibert, Ph.D., M.B.A., Timothy Brigham, Ph.D., M.Div., and Timothy C. Flynn, M.D. N Engl J Med; 366:1051 - 1056 March 15, 2012 Faculty Development Understand the leadership role of PDs in faculty development

Discuss ways to identify PD educational needs

Understand University of Washington's process to implement a comprehensive curriculum that addressed our PD needs

Apply concepts learned and develop a process that fits your institution’s unique culture Today’s Goals WWAMI Region The University of Washington Medical Center UW GME Major Areas of Citation Why we started The Dean
Program director financial support
Eight Parker Palmer recipients
Six RRC members
Established program administrator development
Monthly administrative/operational meetings
Biannual orientation
Message board UW GME Strengths No formal education for program directors
Individual silos
Random program director specialty training
Support for program directors
Unreliable FTE support
Inadequate rewards and recognition
Variable accounting of efforts for academic promotion
Lack of leadership among program directors
Improper knowledge as managers
Insufficient amount of influence over program
Assistant professors
"Foreign language" of GME UW GME Weaknesses Competing priorities of program directors
Lack of engagement
Lack of sense of community amongst program directors
Variable perceptions of topic relevance
Little accountability to GME Office
Content expertise
Departmental support
The Dean Potential Institutional Obstacles Too junior
Too little power
Too clinically busy
Too busy to ask for help
Too afraid to ask for help
Too much to understand
Too little community
Too much isolation The “Too” Problem The team has to have a common goal
The team has to believe in the goal
The goal has to be communicated
Priorities must be established and agreed upon
Teamwork and communication are hard work
Everyone has to be committed to the process
Leadership is critical
Having fun is important Debriefing = GME Office
job description GRA DIO Core Competencies Maintaining the Institution’s ACGME Accreditation
Maintaining the Institution’s Residency Programs’ ACGME Accreditation
Improving the Institution’s Education Program
Developing and Supporting Residency Program Directors
Managing the Institution’s GME Budget and Advocating for Resources
Managing and Representing the Institution’s GME Operations
Overseeing the Well-being of the Institution’s Residents
Providing Guidance on GME Legal Matters
Functioning Effectively in the Larger Medical Context
Working in the Health Policy Context
Developing Further as a GME Leader 11 DIO Core Competencies 11 DIO Core Competencies Maintaining the Institution’s ACGME Accreditation
*Maintaining the Institution’s Residency Programs’ ACGME Accreditation
*Improving the Institution’s Education Program
*Developing and Supporting Residency Program Directors
Managing the Institution’s GME Budget and Advocating for Resources
Managing and Representing the Institution’s GME Operations
Overseeing the Well-being of the Institution’s Residents
Providing Guidance on GME Legal Matters
Functioning Effectively in the Larger Medical Context
Working in the Health Policy Context
Developing Further as a GME Leader Byron Joyner, MD, MPA Amity Neumeister, MBA
Associate Dean, GME Assistant Dean GME Reorganization of leadership
New Associate Dean position responsible for:
Improving the institution’s educational program
Developing and supporting program directors
New Director of Education position responsible for:
Improving programs’ education curriculum
Improving the performance assessment system New Resources from GME 2007 CPRs mandated “sufficient protected time and financial support”
Certain RRCs (Peds, IM, FAMED, Psych) provided specific FTEs
In 2008, leveraged Institutional Site Visit and Children’s support to obtain FTE support for remaining PDs
In 2009, reinforced PD responsibilities and need for true protected time PD Financial Support & Protected Time To improve the health of the public – one resident and fellow at a time UW GME Vision Statement uide physicians to be compassionate and altruistic professionals providing high-quality patient care and service

otivate physicians to continue to wonder as part of a life-long learning process

nlighten the next generation of physicians with exceptional medical knowledge and skills UW GME Mission Statement Welcome Question Table-Top
Discussion List the 10 most important roles of a program director Program Director Roles Supervisor
HR specialist
Party Planner Educator
Leader Program Director Responsibilities Mentorship as a support system
Senior PD help junior PD
Assist new PD in adjusting to their new role
Identified quality senior PD
Assigned new PD to senior PD
Defined roles of both participants
Check-up on both parties Program Director Mentoring Program Basic introduction to
Describe program structure & functions
Share UW GME resources
Build community and relationships Goals of New PD/PA Orientation System of PD Education Provide PDs with resources/information
Share best practices
Provide CME
Build community
Discuss trials and tribulations
Celebrate successes
Respond to changing needs Program Director Development Series (PDDS) Geography
93 programs with PDs at ~4 sites
Content/variations in RRC requirements
Frequency and times
Cultural differences medicine vs. surgery
Value proposition/marketing
Attendance expectations/requirements
Whether to invite Program Administrators Considerations for the PDDS Implementing the Process Strategy, Logistics, Marketing and Application Time and Venue
Decided on biannual, multi-session seminar series
Eight 4-hour sessions over two months in the fall and spring
Letters to Chairs & PDs regarding new PDDS
Tied pre-existing program director support ($$$) to protected time for participation in PDDS
Face-to-face conversations with key PDs and Chairs
GME newsletters
On-line RSVP system Strategy Built initial curriculum based on CPRs, needs assessment and citations
Invited PDs and other content experts as speakers
Selected an off-site, centralized venue
Scheduled 3 - 6 months in advance
Requested RSVPs and sent reminders
Established ground rules for participation
Invited PAs to selected sessions Logistics Secured PD protected time
Surveyed PD/needs assessment
Involved chairs and PDs in the process
Secured CME (added bonus)
Letters to PDs re: PDDS 4 – 6 months in advance
Letter to chairs announcing PDDS
Ongoing announcements in GME newsletters
Letters to Chairs re: participation rates
Presented PDDS to the Clinical Chairs & Dean Marketing Improving the Institution’s Education Program Developing and Supporting Residency Program Directors Measuring Quality and Reviewing Your Program
Preparing for the ACGME Site Visit
Challenging HR Issues
Leadership and Promotion
The Difficulty Resident and Other HR Topics
GME Finances
Building Quality in your Program
Evaluation and Feedback PDDS Topics: Fall 2011 - Spring 2012 All About Quality
Site Visit Practicum
HR Issues in GME
The Art of Leadership
Evaluation, Remediation and Termination
Integrating Quality in Your Program
Improving Faculty Feedback & Evaluation of Trainees
Revisiting the Competencies: Tying Them To Clinical Outcomes PDDS Topics: Fall 2012 - Spring 2013 GME Quality Metrics Spreading the word
Attendance drop-off
Low participation amongst surgeons
Repetitive topics
Coordination with CME
Logistics (speakers, rooms, recording)
Maintaining momentum Challenges Participation Rate by Department for PDDS Why didn’t you attend? Planning for the 2012-2013 PDDS Quality
Process System of PD Education Ken Steinberg - Internal Medicine
Quarterly meetings with 13 fellowship directors

Eileen Klein - Pediatric Emergency Medicine
Quarterly meetings with fellowships

Terry Massagli - Rehabilitation Medicine
Quarterly 90-minute faculty meetings Creating Educational Leaders Organization and structure?
Needs assessment?
Institutional commitment? Generalizability Define the mission
Understand the process
Establish a leader/champions
Educate the constituents
Gather data
Work in teams
Develop a system
Build community Summary “Celebrating what we do well inspires
others to do better.” Thank You! G M E Improving the Institution’s Education Program Developing and Supporting Residency Program Directors Interested in sessions for experienced program directors? GME Orientation 101 & 102 SES095 ~Albert Einstein Putting the Pieces Together Goal of PDDS Roger Bush, MD
Billings Internal Medicine Common Program Requirements V. C. Program Evaluation and Improvement

1. The program must document formal, systematic evaluation of the curriculum at least annually. The program must monitor and track each of the following areas:
a) resident performance;
b) faculty development;
c) graduate performance, including performance of program graduates on the certification examination; and,
d) program quality. Background 1. Stuffed animals represent the pieces of the program
2. Blind folded person symbolizes the program director
3. Teams represent various constituents which have competing priorities
4. Activity area represents the policies and parameters of the program How we started Our Standard Program Directors 93 ACGME-accredited training programs, 2 ABOG approved fellowship programs and 5 CODA accredited dental programs
~1250 residents and fellows at
~260 teaching sites
~10th largest in number of trainees
~5th largest in number of programs Institutional Site Visit October 2008
Continued Accreditation, 5-year cycle following progress report
84 training programs
Average cycle length 3.9 years
256 citations
43 - Faculty
55 - Evaluation
114 - The Educational Program
Quarterly PD meetings & monthly PA meetings
Financial support for PDs variably tied to protected time and lacked accountability to UW GME Where We Started 1. Does your institution have formal educational opportunities geared specifically toward program directors? 2. Are program directors viewed as leaders at your institution? VA Puget Sound Health Care System Harborview Medical Center Seattle Children's Hospital Dr. Einstein Syzygy of NAS Institutional Accreditation Program Accreditation CLER Visits We should not fail others because the work is too hard Who are you?
1. Program Director
2. Designated Institutional Official
3. Program Administrator
4. Chairperson
5. Other Question Questions for Discussion Table-Top Discussion Who we are Prepare
Reward GME Program Director Program Director's Perception MAPPING UW GME Teambuilding Activity Debriefing Duke University Medical Center The Curriculum 101 102 Data GRA survey
Internal reviews
Annual Program Reviews
ACGME Resident/Fellow Surveys
Best practices
Common problem areas
Evaluation & Assessment
Finances 93 programs Medical vs Surgical Session frequency 10 sites Attendance expectations Communicating the message Participants Program directors
Hospital administrators
Medical directors
Parker Palmer recipients
Department chairs
Trainees Program directors
Program administrators
Associate program directors
Faculty Speakers Engage De-silo Value GRA DIO Core Competencies/GME Office Job Description GRA Core Competencies for Institutional GME Leadership Survey Divide into Teams of 4

Each Team will have
1 person who will be blind-folded
3 people who will be the verbal guides

GOAL is to have the blind-folded person retrieve as many stuffed animals as possible in 1 minute

*Please be careful of the electric cords! Instructions PD Appointment Process Formal request from Chair to GMEC
Attestation of delegated responsibilities of PD
FTE commitment
Support to participate in national and local PD development opportunities 32 volunteers
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