Effectiveness of a Faculty Development Course on Delivering Learner-Centered Feedback Utilizing the Flipped Training Model.

CONTEXT: Effective feedback is an important step in the acquisition of residents' clinical skills and a key component of most adult learning strategies. Faculty-resident feedback discussions can facilitate resident self-assessment and reflection on their performance and motivate them to study and ask questions in areas where their knowledge may be evaluated as deficient. The flipped training model approach, a type of blended learning that reverses the traditional learning environment by delivering instructional content outside of the classroom, has garnered increased support within both graduate medical education (GME) and other healthcare disciplines. METHODS: The overall purpose of this exploratory pilot project was to examine the pre-post impact of a faculty feedback flipped training model course provided to a convenience sample of community-based faculty learners. After receiving campus IRB approval, the authors developed a set of five primary course goals and objectives. A convenience sample of n = 17 community-based faculty who had completed the entire course were administered a pair of pre and post-course surveys regarding their overall feedback satisfaction and comfort levels for supervising residents. RESULTS: In summary, five of the 13 total survey items increased at statistically significant levels from pre-course levels. The majority of qualitative faculty comments also positively evaluated the flipped training model approach. CONCLUSIONS: These promising pilot findings suggest that a flipped GME faculty feedback skills training model can help improve faculty learners' satisfaction and confidence as they supervise residents and/or medical students. The impact of these types of flipped training models for GME faculty needs to be more rigorously examined in project settings with larger samples to identify what specific types of curricular activities might prove to be most effective for diverse faculty learners in GME programs across the nation.

The Statewide Campus System Scholarly Activity Developmental Planning Framework for Community-Based GME Leaders.

CONTEXT: During recent years, Graduate Medical Education (GME) leaders in the United States of America have witnessed many substantive changes, including movement to a single accreditation system under the Accreditation Council for Graduate Medical Education. Both MD- and DO-trained residents and faculty must now meet an increasingly stringent set of accreditation standards outlined in Next Accreditation System standards. Specifically, updated scholarly activity standards emphasize a consistent volume and quantity of quality improvement/research projects and dissemination products. The GME literature to date has frequently provided general commentaries regarding individual project strategies or oriented to settings with greater project-related resources. There have also been few articles offering scholarly activity planning strategies for community-based GME officials striving to increase scholarly activity levels. PROPOSED PLANNING FRAMEWORK: The authors propose a customizable assessment-planning framework, largely derived from their combined decades of consultation experiences with hundreds of community-based resident and faculty projects. The authors will first describe the primary elements of their proposed scholarly activity planning approach for GME leaders so often subject to worsening resource constraints. They will describe six ongoing developmental strategies with several exemplars described. Such a framework will likely require ongoing reassessments and modification. CONCLUSIONS: The authors hope that this proposed planning framework will offer GME administrators, faculty and residents with a pragmatic set of strategies to develop scholarly activity projects and supports. Ideally, GME leaders can use this approach to inform their design of a sustainable system-customized infrastructure of scholarly activity supports.

Delivering the AAMC "Teaching for Quality" Program through a Community-Based GME Collaborative: Lessons Learned to Date.

CONTEXT: To address scholarly activity (SA) accreditation standards, the Michigan State University's College of Osteopathic Medicine Statewide Campus System has offered the Association of American Medical Colleges' (AAMC) Teaching for Quality Program for two cohorts of community-based faculty. The purpose of this paper was to describe the design and delivery of the customized program, the authors' initial lessons learned, and their plans for further evaluation and dissemination. METHODS: The authors customized the program to overcome the barriers typically faced by community-based program faculty learners through a graduate medical education (GME) consortium model. This was the first time this program was delivered in this manner. RESULTS: The authors' initial cohort of 19 learners successfully developed 15 projects, with two pairs of learners collaborating on projects. The second cohort of 15 learners developed 11 projects, with one pair of learners collaborating. The authors present a series of principles for community-based GME leaders striving to develop SA projects in their respective GME environments. CONCLUSIONS: The "consortium advantage" derived from entities such as the SCS may prove integral to efficiently coordinating SA project resources and knowledge across diverse GME systems.

Perceived Importance of Pursuing Osteopathic Recognition in the Single Accreditation System: A Survey of Medical Students, Residents, and Faculty.

CONTEXT: As graduate medical education evolves under the single accreditation system, osteopathic residency programs and consortia strive for sustainable ways to achieve and support the Osteopathic Recognition (OR) designation. OBJECTIVE: To determine whether differences existed in perceived importance of OR from 3 cohorts of osteopathic stakeholders: students, residents, and faculty. METHODS: A nonexperimental quantitative cross-sectional online survey was administered during February and March 2016 to osteopathic medical students at Michigan State University College of Osteopathic Medicine and residents and faculty from the affiliated Statewide Campus System. After examining final working dataset patterns, a series of Kruskal-Wallis tests were conducted to identify statistically significant differences in perceived OR importance response categories across sample subgroups, including program specialty and primary vs non-primary care specialty. RESULTS: The final analytic sample comprised 278 osteopathic medical students, 359 residents, and 94 faculty members. Of 728 respondents, 497 (67.9%) indicated that OR was "somewhat important," "important," or "very important." The overall perceived importance category patterns varied significantly across students, residents, and faculty cohort respondents (, P<.001) and program specialty (, P<.001), as well as between primary care and non-primary care residents and faculty (, P<.001). CONCLUSION: Based on these initial results, OR is generally valued across osteopathic stakeholder groups, but significant differences may exist between different types of students, residents, and faculty. Pre- and postgraduate educational support structures designed to reduce barriers to OR implementation may help to sustain osteopathic principles and practice in the single accreditation system.

Examination of Resident Physician Quality Improvement/Patient Safety Project Confidence Levels from Multiple Programs.

CONTEXT: It is now increasingly recognized that physicians should be engaged in quality improvement/patient safety (QIPS) activities to make their patient care systems perform more reliably and safely. In order to ensure that our nation's physicians embed this aspect of practice into their work, there also is a growing expectation for effective integration of QIPS training into graduate medical education. This exploratory pilot study was conducted to identify how residents' personal and residency program characteristics might be related to their perceived confidence to develop and conduct prospective QIPS projects. METHODS: A total non-probability convenience sample of 43 DO resident physicians from five residency programs (Family Medicine, Internal Medicine, Obstetrics and Gynecology, Pediatrics, and Psychiatry) at Authority Health were surveyed from 09/28/2015 to 01/06/2016 using online Survey Monkey software. A 38-item survey asked residents about their personal and residency program characteristics, as well as their current overall perceived confidence to develop and conduct QIPS projects. RESULTS: Two model terms that proved non-significant during analyses were residents' age category and year in residency training. In the final stepwise multinomial regression model, however, three covariates including: a) sex (p=0.045), b) being in a primary care residency program (p=0.038) and c) having had prior QIPS project experience (p=0.049) were each found to be statistically significant predictors of respondents' perceived comfort level categories. Male residents and those who were in a primary care residency program (i.e., Family Medicine, Internal Medicine or Pediatrics), and/or reported having had prior QIPS project experience, reported significantly higher confidence levels. CONCLUSIONS: Somewhat similar to earlier studies, these results suggest the need to incorporate QIPS education for resident trainees across the nation. Ideally, the findings from larger resident studies will enable GME leaders to develop and deliver evidence-based QIPS curricula that are better oriented to resident physicians' personal characteristics and preferences.