From the Director
Buenos Dias! Vacation is great, and it made my day for my once daily email check to have emails about the awesome care provided by Trevor Poseneau in the ED, Yvonne Mowery and Kathleen Kiernan's gold stars and a compliment from Jon Menachem's med student about the fantastic teaching at DRH Gen Med. Plus, I hear that Ryan Nipp and Charlie McCormick did a wonderful job on their SAR talks, despite some eager people trying to get in the room!
Congrats to Aaron Mitchell as our MiniCEX madness winner of the week!
Keep it up, as we are nearing the end of MiniCEX madness. It is definitely going better than my bracket - so much for my hometown heroes of SLU.
Have a great week!
Aimee
QI Corner (submitted by Jon Bae, MD)
Quality Improvement and Patient Safety Noon Conference
Its time to get your quality on at Quality Improvement Noon conference this week
When: Wed 3/27
Who: Dr. Eric Peterson discussing national perspective on QI (also George and Ryan with QI updates)
Why: Because quality is awesome
Additional QI Champion: Matt Chung for work in looking at Clopidogrel compliance after PCI and operator adherence to safety guidelines regarding BMS vs. DES
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What Did I Read This Week
(submitted by Saumil Chudgar, MD)
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MiPLAN: A Learner-Centered Model for Bedside Teaching in Today’s Academic Medical Centers
Chad Stickrath MD, Eva Aagaard MD, and Mel Anderson MD
Academic Medicine 2013; 88(3): 322-27
Why I read this?
I am always interested to learn about new methods for effective teaching. I had seen the MiPLAN model presented during a workshop at a meeting last year and had stayed in communication with the authors so was excited to see it published.
What they found?
Stickrath et al. developed a new model for efficient teaching during bedside rounds, a priority that is becoming more crucial in the era of duty hours and increasing clinical volumes. It is based on adult learning theory in that it takes into account learners’ preexisting knowledge and uses it as a basis for further learning. The “M” is a meeting at the start during which there are introductions and expectations set for the rounds. The “i” focuses on teachers’ behaviors during a learner’s presentation; the teacher should introduce the team to the patient, be in the moment as a focused listener, use inspection to start the physical exam of the patient, minimize interruptions, and encourage independent thought. After the learner is done with the presentation, the “PLAN” portion provides an algorithm to prioritize teaching opportunities. Initial questions can related to patient care with clarifications as needed. After that, learners are allowed to choose the teaching topics. If the learners have no questions, the attending can choose what to teach. Finally, the attending can end with next steps for the learner with feedback and suggestions on what they could read about before moving to the next patient.
What I learned?
They describe an interesting new approach to bedside rounding. They take many of the skills that I have seen in my attendings and colleagues and put them into a format that can be remembered and applied. Placing learners at the center of determining the teaching agenda is a little different, similar to the SNAPPS model used in the outpatient setting. Residents (especially Duke Gen Med SARs) could try this model when leading work rounds. As we begin to implement the Next Accreditation System in July, this may be one method that can be used by residents to teach effectively. Faculty can also try this system; I look forward to trying it during my next rounding block.
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Welcome to the (NEW) “All-in one” Ambulatory Evaluation Form for Resident Continuity Clinic
In keeping with the ACGME’s move to requiring milestone-based evaluations beginning in July 2013, and building on the extremely thoughtful work behind the scenes by Murat Arcasoy and Bill Hargett in coming up with such an evaluation for inpatient Gen Med (coming soon), a new ambulatory care evaluation form has been developed that will be pilot tested starting now until the end of the academic year.
The goal is to have more documented real-time observations of specific behaviors important in the practice of primary care medicine, in order to help inform comprehensive clinical evaluations and to provide immediate and focused feedback to housestaff.
This “all-in-one” form will be used for both spot observations and the three “classic” ambulatory Mini CEXs residents are currently required to complete each year as part of their procedure logs. It will also double as the form for summative evaluations the program completes of residents’ performance in their continuity clinic settings.
Please note, corresponding levels in this new format are NOT grades, but show expected progression through milestones of residency training, to align with new standards for resident evaluation (e.g., the first few bubbles correspond to where a new intern might be expected to be).
WE WANT YOUR FEEDBACK! Please send comments by email (Subject: Mini CEX- Ambulatory Feedback) to Alex Cho at
alex.cho@duke.edu.
From the Chief Residents
Grand Rounds
| Date |
Division |
Speaker |
Title |
| 29-Mar |
Neurology-1 |
Dr. Mark Skeen |
MS |
Noon Conference
| Date |
Topic |
Lecturer |
Vendor |
| 3/25 |
Echocardiograms |
Joseph Sivak |
Jersey Mike's |
| 3/26 |
SAR talks |
Matt Chung, Josh Thaden |
Moe's |
| 3/27 |
QI/Patient Safety Conference |
Jon Bae |
Saladelia |
| 3/28 |
Outpatient management of CHF |
Joe Rogers |
Bullocks BBQ |
| 3/29 |
Medicine Research Conference |
John Rawls PhD Mol Gen & MicroB |
Panera |
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From the Residency Office
Congratulations to Dustin Norton and his wife on the birth of their beautiful baby girl!
Beginning on Tuesday, March 26, 2013, there will be a series of Board Review Sessions 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:
SAR Board Review Schedule
| Date |
Topic |
Faculty Discussants |
| Tuesday, March 26 |
General Internal Medicine, EBM |
Drs. Zipkin, Cho, Phelps |
| Wednesday April 3 |
General Internal Medicine, EBM |
Drs. Greenblatt, Phelps, Simel |
| Tuesday April 9 |
ID |
Dr. Zaas |
| Wednesday April 17 |
Cardiology |
Dr. Jones |
| Tuesday April 23 |
Hem/Onc |
Drs. Riedel and Diehl |
| 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 |
All sessions will be from 5-6pm in the Med Res Library.
2012-13 Uniform Allotment
Deadline for ordering your 2012-13 uniform allotment is March 31, 2013. If you have not yet ordered your labcoats/scrubs, you must go to the bookstore and place your order by the end of the month.
Trainees continuing in your current program or transferring to a new program within Duke in 2013 will have the opportunity to place a one-time order for new labcoats, for the 2013-14 academic year, beginning on July 1, 2013 thru December 31, 2013.
Contact Information/Opportunities
Billings Clinic
Northeastern Colorado Internist
Utah Internist
Bingham Memorial Hospital
Upcoming Dates and Events
- March 25, 2013; 1:00 PM - 2:30 PM ED: A Survivor's Journey: Understanding the Health Impact of Abuse and Paths to Promote Wellness; For more information, go to website
- March 25-28: BLS Blitz (registration: blsblitz )
- March 29: Faculty Resident Research Grant Application Deadline
- April 19: Residency Program Pictures (rain date May 10)
- April 28: 2nd Annual Stead Tread
- June 4: Resident Research Conference, Searle Center
- June 8: SAR Dinner, Hope Valley Country Club
Useful links
Keep it up, as we are nearing the end of MiniCEX madness. It is definitely going better than my bracket - so much for my hometown heroes of SLU.
Have a great week!
Aimee
Beginning on Tuesday, March 26, 2013, there will be a series of Board Review Sessions 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:
SAR Board Review Schedule