Weekly Updates - April 29, 2013

By residency1

From the Director

Hi everyone!  Believe it or not, only two months left of this year.  We've got a lot of exciting things happening between now and June 29th when the new interns officially hit the wards....first of all, thanks to everyone who completed the ACGME survey. We well-exceeded the required 70% and I appreciate you taking time to fill it out. Compliments this week also go to Kevin Trulock and Deng Madut for teamwork at the VA, to Lindsay Boole and Nancy Lentz  for helping out with some challenging situations at the DOC and to Carling Ursem for running the DM education group's 20 patient full house. Shortly thereafter, Carling set out on vacation, only to assist a passenger in distress. All in a days work, I guess.  Plus, the DOC and Pickett teams were very happy with the block 1 clinic schedule - thanks chiefs and Laura and Lauren! Thank you to Steve Crowley and the Warren Society for hosting a night at the Ronald McDonald house (taco night!) and also to Matt Crowley, Marianna Papademitriou, Meredith Edwards Clement and the Kempner Society for an amazing 2nd annual Stead Tread. While I was doing my other job as a soccer mom on the fields of SC, over 100 people were out supporting the Lincoln Clinic at the Stead Tread. Final tallies are pending, but word is that the lightning fast Ethan Bowlby (son of DOC fearless leader Lynn) won it all, with Meredith Clement winning for housestaff female and Adam Banks winning for housestaff male.  Very proud of this new tradition. stead tread picture                 Congrats to John Yeatts and family on the birth of Walter Ferrell Yeatts! Walter Farrell Yeatts               Randy, Dr. Woods and I are going to be learning more about more about milestones and the next Accreditation System this week at the Program Directors meeting in Orlando.  Looking forward to sharing what we learn when we are back on Thursday.  Please take a few minutes to do your "self reflection" evaluation using the new ACGME reporting milestones...it's in medhub waiting for you. Have a great week and see you at the HS-faculty basketball game on Wednesday night.  Thanks to Chris Hostler and Tony G for organizing! Aimee Pubmed for this week goes to Lindsay Anderson! Anderson, L., D. Dai, A. Miller, M. Roe, J. Messenger, T. Wang. Percutaneous Coronary intervention in older patients with syncope and coronary artery disease: A report from the NCDR. American College of Cardiology Conference, San Francisco, California. Marcy 9 – 11, 2013. Have a great week Aimee

QI Corner (submitted by Jon Bae, MD)

Quality Improvement and Patient Safety Noon Conference Thank you to Melissa King from Dept of Pharmacy for her informative presentation on SRS reporting. Clearly there are opportunities for physicians to report more and get more involved.  If interested, please let one of your quality chiefs know! Also, save the date for our next Quality and Safety conference 6/10 when Zuben Eapen will be discussing opportunities to improve care transitions for our CHF patients April Quality Champion: This month we would like to acknowledge Jason Rose as our April Quality Champion.  Jason was an advocate for patient safety by identifying an unsafe condition and intervening quickly to ensure the patient received the needed care. If there is anyone you would like to nominate as a quality champion, please tell your Quality Chiefs! GME Quality and Safety Concentration: Please see the attached flyer for details about you can apply for a GME Concentration in Patient Safety and Quality! Its a great opportunity for anyone interesting in getting more training and experience Concentrations Brochure July 2013 [box]

What Did I Read This Week

(submitted by Suzanne Woods, MD)

Operationalizing the Internal Medicine Milestones – An Early Status Report Journal of Graduate Medical Education, March 2013:  130-137 [/box] Why did I read this article: Given the upcoming ACGME new requirements starting July 2013, it is prudent that program directors keep up with literature related to the Next Accreditation System.  One new requirement is the reporting of milestones data directly to the ACGME on each trainee semiannually. Milestones describe levels of clinical competence along a developmental trajectory during training. Summary:   The internal medicine (IM) milestones were created to “advance outcomes based residency training” and was a mandate by the ACGME.  The IM residency program of New York Medical College at Winchester Medical Center implemented a milestones based evaluation process in 2010.  They included 26 residents in the study and concluded that both educators and trainees found that milestones “promoted a common understanding of what knowledge, skills and attitudes should be displayed at particular stages of training; permitted greater specificity in performance feedback; and enhanced uniformity and fairness in promotion decisions.” Of note, initially the medicine milestones working group created 141 milestones which was impossible for any program director to conceive how we could collect data on that number of areas.  Fortunately they have since limited the reporting to 22 milestones. My initial response to this article…oh bother!!!  Dr. Jane Trinh (Med-Peds Assoc PD) and I had just submitted a manuscript to JGME with our Duke experience and hoped we had not been scooped.  But…we have not yet had our manuscript rejected so will keep our fingers crossed. The Duke experience…yes we have experience so far! We created milestones-based evaluations for our Medicine-Pediatrics residency continuity clinic, the Pediatric Emergency Department (ED) rotation, and a resident self-assessment using milestones from the ABP/ACGME Pediatrics Milestone Working Group last Fall.  The medicine milestones had not yet been released. Our experience during this pilot project implementing milestones-based evaluations demonstrates that evaluations based on new milestone terminology can be developed and implemented successfully.   Feedback by our residents and faculty was very positive.  Early implementation of new evaluations is important to be able to review and assess processes to identify areas of improvement.  Continued work is needed to develop accurate evaluations based on milestones, and to educate faculty and residents on milestones and the evaluation and reporting process to the ACGME.  Advancements in MedHub will improve the process for aggregate data reporting to the ACGME.   Take home points:
  • Faculty and resident education must occur for successful implementation of milestones evaluations.
  • In person feedback is critical to pair with the MedHub evaluation.
  • Increased direct observation will help collect information to inform milestones reporting.
  • I am looking forward to milestones based evaluations for more accurate evaluation of our trainees!
 

From the Chief Residents

Grand Rounds

Date                     Speaker                        Topic May 3, 2013    Dr. Susan D. Block      VA Chief Speaker

Noon Conference

Day Date Topic Lecturer Vendor
Monday 4/29 PCOS Dr. Ann Brown The Pita Pit
Tuesday 4/30 "Prostate and Me" Dr. Galanos Sushi
Wednesday 5/1 IM-ED Combined Conference: Pleural effusions/chest tubes Momen Wahidi Rudinos
Thursday 5/2 EKG Conference Dr. Greenfield Dominos
Friday 5/3 Visiting Professor Dr. Susan Block Chik-Fil-A
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From the Residency Office

Maestro Training and Retirement of E-Bowser Scheduled

Wave 4 - Maestro Training has begun! All Internal Medicine Residents who need Maestro Inpatient Training have been scheduled for it in  Wave 4 – For most, this will mean two 4-hour sessions (IP MC 400 & 500).  Your schedule in Amion has been updated to show when your training will be.  PLEASE ALSO USE THE LINK BELOW (YOU SIGN IN USING YOUR DUKE NET ID AND NET ID PASSWORD) TO DOUBLE-CHECK YOUR TRAINING DATE, START TIME AND LOCATION! https://vmwlmsweb.duhs.duke.edu/SabaLogin If you have any questions or concerns, please feel free to contact Jen Averitt in the MedRes office 919-681-4510 The plans for retiring legacy systems, including E-Browser, have also been announced.  Please refer to the following attachment for the details:   Retirement of Ebrowser Begins   We are excited to accept applications from residents and fellows for the 2013 cohort of Duke GME Concentration participants.  GME Concentrations were developed, with support from the GME Innovation Fund, in response to resident/fellow and program feedback to provide critical content to better prepare physicians for practice in the current & future health care system. Four Concentrations are being offered as an optional  "minor" for residents and fellows (PGY level 2 and above) across specialties at Duke. Residents/fellows will participate in development of their individualized education plan by choosing from a list of educational opportunities related to their concentration. Participation will span over the course of their training and last a minimum of one year (some exceptions may apply) resulting in the awarding of a Certificate of Completion. GME Program Directors must approve resident/fellow participation in order to ensure this commitment will supplement training and benefit the program overall. Expert champions have been identified to serve as part of an Advisory Committee for each concentration identifying and developing educational objectives, opportunities/assignments, and assessment strategies. Committees will guide and assess the work of residents/fellows participating in each concentration and determine individuals' successful completion. Concentrations include:
  • Resident as Teacher
  • Patient Safety & Quality Improvement
  • Law, Ethics & Health Policy
  • Leaders in Medicine
Additional information can be found on the GME Concentrations website at: http://sites.duke.edu/gmeconcentrations/ Applications can be found under the "How to Apply & Timeline" tab. The first round of applications are due by Friday May 17th. We look forward to working with your residents/fellows to enhance their Duke GME experience.  If you have questions, please contact: Alisa Nagler Mariah Rudd Saumil Chudgar Kathryn Andolsek

Survey

Please complete a 3-minute survey evaluating technology use among physicians.  This is the continuation of an on-going study that has been previously published.  The survey can be completed HERE.  All information is anonymous and results will be publicly available. Thank you for your help, Orrin Franko, MD Resident Physician, Post-Graduate Year 4 University of California, San Diego Once again:  SURVEY LINK HERE  

violin

VOICES IN MEDICINE!! Our program's annual Humanities in Medicine event for the year

We invite you to participate in a Voices of Medicine program for the Talk Story narrative variety show, featuring the stories, poetry, music and other artistic outlets of physicians and housestaff in the images piano Department of Medicine. Come join in a unique and fun opportunity to share your outlets of creativity and see who each other are outside of medicine!
  •  Date: Wednesday, May 15th, 2013
  • Time: Doors open at 7:00pm, Event Starts at 7:30pm
  • Location: Casbah, 1007 West Main Street, Durham, NC 27701
If you are interested in participating please contact Erin Payne <erin.payne@dm.duke.edu> For questions, feel free to contact Jason Webb, Juliessa Pavon, Anton Zuiker, or Erin Payne. Please note: Jeff Polish from the Monti organization will be providing professional storytelling coaching for those who are interested in sharing a story. Jeff has a PhD in genetics from Washington University in St. Louis. This is a great opportunity to help bring your story to life!

SAR Board Review Schedule

Board Review Sessions will be held in the MedRes Library, Duke North, 8th Floor. Please contact Megan Diehl or Jeff Clarke if you would like to attend.  The schedule is as follows:
Date Topic Faculty  
Tuesday April 30 Pulmonary Dr.   Govert
Wednesday May 8 Gastroenterology Drs.   Choi and Desai
Tuesday May 14 Endocrine Dr.   Matt Crowley
Wednesday May 22 Renal Dr.   Butterly
Tuesday May 28 Neurology Dr.   Skeen
Wednesday June 5 Dermatology/Rheumatology Dr.   Criscione
Tuesday June 11 Mixed Bag (Medical ethics, Palliative Medicine, Psych) Dr.   Zaas, Chiefs

Contact Information/Opportunities

STL_HospitalistAndNocturnistFlyer STL_InternalMedicineFlyer2

Upcoming Dates and Events

  • May 1:  Annual Resident/Faculty BB Game
  • May 14/15:  Conflict Management Workshop     Register for the morning session, 7-9 am     Register for the afternoon session, 4-6 pm
  • May 15:  Voices of Medicine /  Humanities in Medicine
  • May 24:  Chief Grand Rounds - Jason Webb, MD
  • May 31:  Chief Grand Rounds - George Cheely, MD
  • June 4:  Resident Research Conference, Searle Center
  • June 7:  Chief Grand Rounds - Nicole Greyshock, MD
  • June 8:  SAR Dinner, Hope Valley Country Club
  • June 14:  Chief Grand Rounds - Ryan Schulteis, MD
  • June 21:  Chief Grand Rounds - Jeffrey Clarke, MD

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