Gathering Trainee Feedback to Improve Programs With Low Annual ACGME Survey Content Area Compliance: A Pilot Study.

Problem: Systematically investigating annual Accreditation Council for Graduate Medical Education (ACGME) Resident/Fellow Survey results by directly gathering trainee feedback could uncover training program problems and clarify misunderstandings as they arise, leading to faster corrective actions and program improvement.

Approach: The Focus Group Forum (FGF) was created based on the utilization-focused evaluation approach to systematically gather comprehensive, high-quality, actionable trainee feedback on specific annual ACGME survey results and involve trainees in program improvement (Henry Ford Hospital, 2021). Trainees from programs with survey results indicating <80% compliance within several content areas were invited to attend FGF sessions.

Designing a Yoga Intervention Program to Improve Well-Being for Physician Trainees: Challenges and Lessons Learned.

Well-being activities may help to counteract physician burnout. Yoga is known to enhance well-being, but there are few studies of yoga as an intervention for physicians in training. This prospective methodology-development study aimed to explore how to establish a yoga-based well-being intervention for physician trainees in a large urban training hospital.

Does physician engagement affect satisfaction of patients or resident physicians?

This study examined whether change in physician engagement affected outpatient or resident physician satisfaction using common US measures. Surveys were administered by Advisory Board Survey Solutions for staff physician engagement, Press Ganey for Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CGCAHPS) for outpatient satisfaction, and Accreditation Council for Graduate Medical Education (ACGME) for the ACGME Resident/Fellow Survey. Survey sample sizes were 685, 697, and 763 for physician engagement and 621, 625, and 618 for resident satisfaction in 2014-2016, respectively; only respondents were available for CGCAHPS (24,302, 34,328, and 43,100 for 2014-2016, respectively).

Health Care Disparities: a Practical Approach to Teach Residents about Self-Bias and Patient Communication.

Studies have shown that the education of resident physicians on health care disparities (HCDs) needs improvement. We implemented a system-wide program on HCD for residents and evaluated outcomes across 1 year. Designed in 2015 by a multidisciplinary team, the HCD program incorporated information about our health system's patient population and the tenets of unconscious bias.

Socioeconomic and Racial Disparities: a Case-Control Study of Patients Receiving Transcatheter Aortic Valve Replacement for Severe Aortic Stenosis.

Background: We sought to quantify socioeconomic disparities in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) at an urban, tertiary referral center.

Methods: This retrospective case-control study identified 67 patients with severe AS (aortic valve [AV] area ≤1 cm or AV area index ≤0.60 cm/m or AV velocity ≥40 mmHg) who underwent TAVR from November 5, 2013 to June 10, 2014.

Health Disparities in Hepatitis C Screening and Linkage to Care at an Integrated Health System in Southeast Michigan.

With recommended screening for hepatitis C among the 1945-1965 birth cohort and advent of novel highly effective therapies, little is known about health disparities in the Hepatitis C care cascade. Our objective was to evaluate hepatitis C screening rates and linkage to care, among patients who test positive, at our large integrated health system. We used electronic medical records to retrospectively identify patients, in the birth cohort, who were seen in 21 Internal Medicine clinics from July 2014 to June 2015.

Mapping Direct Observations From Objective Structured Clinical Examinations to the Milestones Across Specialties.

Background: Little is known about residents' performance on the milestones at the institutional level. Our institution formed a work group to explore this using an institutional-level curriculum and residents' evaluation of the milestones.

Objective: We assessed whether beginner-level milestones for interpersonal and communication skills (ICS) related to observable behaviors in ICS-focused objective structured clinical examinations (OSCEs) for postgraduate year (PGY) 1 residents across specialties.

A time-efficient web-based teaching tool to improve medical knowledge and decrease ABIM failure rate in select residents.

Aim: The American Board of Internal Medicine (ABIM) exam's pass rate is considered a quality measure of a residency program, yet few interventions have shown benefit in reducing the failure rate. We developed a web-based Directed Reading (DR) program with an aim to increase medical knowledge and reduce ABIM exam failure rate.

Methods: Internal medicine residents at our academic medical center with In-Training Examination (ITE) scores ≤ 35 th percentile from 2007 to 2013 were enrolled in DR.

System-based approach to educating internal medicine residents on preventable hospital readmissions.

Background: A literature gap exists in educating internal medicine residents about hospital readmissions and how to prevent them.

Intervention: The study aimed to implement a readmissions education initiative for general internal medicine inpatient resident teams in 3 general practice units at an urban, tertiary hospital.

Methods: Senior residents were given access to a daily list of readmissions, used a readmission assessment tool to investigate causes and to assess whether each readmission was preventable, led a monthly general practice unit team meeting to discuss each case, and presented their findings at the monthly multidisciplinary readmissions meeting for additional feedback.

Internal medicine residents' time study: paperwork versus patient care.

Background: Multiple factors affect residency education, including duty-hour restrictions and documentation requirements for regulatory compliance. We designed a work sampling study to determine the proportion of time residents spend in structured education, direct patient care, indirect patient care that must be completed by a physician, indirect patient care that 5 be delegated to other health care workers, and personal activities while on an inpatient general practice unit.

Methods: The 3-month study in 2009 involved 14 categorical internal medicine residents who volunteered to use personal digital assistants to self-report their location and primary tasks while on an inpatient general practice unit.

Patient-centered plan-of-care tool for improving clinical outcomes.

Purpose: In developing our Patient-Centered Team Care (PCTC) program, we designed a Plan-of-Care (POC) tool to facilitate the physician-patient discussion for setting health goals. This study aimed to determine the effectiveness of the POC tool in improving clinical outcomes.

Methods: We compared baseline and 6-month or greater follow-up values for hemoglobin A1c (HbA1c), low-density lipoprotein (LDL), systolic blood pressure (SP), diastolic blood pressure (DP), and weight for PCTC patients (intervention group) and non-PCTC patients (control group).

Continuity clinic satisfaction and valuation in residency training.

Background: Internal Medicine residency training in ambulatory care has been judged inadequate, yet how trainees value continuity clinic and which aspects of clinic affect attitudes are unknown.

Objectives: To determine the value that Internal Medicine residents place on continuity clinic and how clinic precepting, operations, and patient panels affect its valuation.

Design And Measurements: A survey on ambulatory care was developed, including questions on career choice and the value of clinical training experiences.