Building a Boot Camp: Pediatric Residency Preparatory Course Design Workshop and Tool Kit.
ABSTRACT: Introduction:Although many medical schools are adding residency preparatory courses or boot camps to their curricula, there is little published guidance for faculty tasked with designing them. We developed a workshop and accompanying boot camp course design tool kit to assist faculty in creating a pediatric boot camp course following the initial steps of Kern's framework for curriculum development. Methods:Learners participated in a 2-hour workshop incorporating short didactics, guided independent reflection, and group discussions. Workshop facilitators guided faculty through the tool kit materials including a literature overview, a needs assessment worksheet, session prioritization and schedule planning worksheets, a module design worksheet, and implementation strategies. Results:Twenty-seven attendees at a national meeting of undergraduate pediatric educators participated in the workshop. Feedback was solicited via an anonymous electronic survey (41% completion rate), which indicated that attendees' self-assessed confidence significantly increased for each component of the tool kit. For the five tool kit components surveyed, average confidence increased 26% (range: 17.5%-37.1%) after completing the workshop. All respondents also indicated that the tool kit would be moderately helpful to very helpful as a stand-alone resource for independent faculty use, corresponding to a 3.57 out of 5 weighted average for this Likert-scale question. Discussion:We developed a pediatric boot camp course design workshop and tool kit to assist faculty in developing pediatric boot camps. Initial implementation was through a workshop, but the resource could be used individually and also adapted for use by other specialties.
Project description:<h4>Introduction</h4>Resident training has changed significantly in recent years, resulting in reduced experiences and practice. Because pediatric residents have fewer required intensive care unit (ICU) rotations, we introduced a neonatal ICU (NICU) boot camp (2014-2015) that continues today to prepare residents immediately prior to beginning an NICU rotation.<h4>Methods</h4>The NICU boot camp consists of three 1-hour sessions: two interactive lectures with case-based application and one hands-on, integrative learning using simulation. The sessions are designed to cover basic information to assist in daily rounding and decision making while in the NICU. After their NICU rotation, residents complete a 12-item questionnaire. Program evaluation includes direct observation during sessions, faculty debriefing, and a postprogram resident survey.<h4>Results</h4>Fifty-seven residents participated; questionnaire responses were available from 46 (80.70%). Combined percentages of <i>very useful</i> and <i>extremely useful</i> responses for the three sessions were 82.61%, 78.26%, and 82.60%, with 86.95% for the overall program; 80.40% agreed that repeating boot camp prior to each NICU rotation would be useful. Analysis of narrative responses revealed that participation in boot camp enhanced residents' readiness and confidence for patient care in the NICU and as stated for each educational objective.<h4>Discussion</h4>Program evaluation results support highly effective and sustainable implementation and achievement of educational objectives. Minor refinements continue for enhancing active learning and content materials and for increasing rigor of program evaluation. Results also suggest that our boot camp may benefit other pediatric programs and serve as a model for use in other resident specialty programs.
Project description:Internal medicine (IM) interns start continuity clinic with variable ambulatory training. Multiple other specialties have utilized a boot camp style curriculum to improve surgical and procedural skills, but boot camps have not been used to improve interns' ambulatory knowledge and confidence. The authors implemented and assessed the impact of an intern ambulatory boot camp pilot on primary care knowledge, confidence, and curricular satisfaction.During July 2014, IM interns attended ambulatory boot camp. It included clinically focused case-based didactic sessions on common ambulatory topics as well as orientation to the clinic and electronic medical records. Interns anonymously completed a 15-question pre-test on topics covered in the boot camp as well as an identical post-test after the boot camp. The interns were surveyed regarding their confidence and satisfaction.Thirty-eight interns participated in the boot camp. Prior to the boot camp, few interns reported confidence managing common outpatient conditions. The average pre-test knowledge score was 46.3%. The average post-test knowledge score significantly improved to 76.1% (p<0.001). All interns reported that the boot camp was good preparation for clinics and 97% felt that the boot camp boosted their confidence.The ambulatory boot camp pilot improved primary care knowledge, and interns thought it was good preparation for clinic. The ambulatory boot camp was well received and may be an effective way to improve the preparation of interns for primary care clinic. Further assessment of clinical performance and expansion to other programs and specialties should be considered.
Project description:Introduction:Interprofessional collaboration (IPC) is important for improving patient outcomes and patient safety; however, interprofessional education (IPE) is required to develop skills necessary for successful IPC. IPE is resource intensive and requires advance planning and negotiation of logistical challenges. The goal of this faculty development workshop is to train administrators and educators from academic health care institutions to address potential challenges faced during design and implementation of IPE programs. Methods:This educational module presents best practices for implementing simulation-based IPE to enhance patient safety through an interactive workshop. We utilize hands-on practice with coaching through a facilitated small-group tabletop simulation followed by a large-group discussion driven by the case-based method to maximize learning and engage a diverse audience. The materials associated with the module include a workshop outline, a PowerPoint slide show, and a summary handout for the participants. To facilitate the tabletop simulation and the subsequent large-group discussion, we have included two versions of the small-group prompts, a worksheet for the participants to complete during the tabletop exercise, and a facilitator guide. Results:We have received positive feedback regarding the learning value of the module from faculty attendees at a regional simulation conference as well as the International Meeting on Simulation in Healthcare in January of 2016. Discussion:Implementing simulation-based IPE curricula to address patient safety initiatives comes with a unique set of challenges that require prior training and knowledge. We provide insight and evidence-based strategies in this module to help interested parties successfully implement their own programs.
Project description:Introduction:The National Academy of Medicine recently published "A Multifaceted Systems Approach to Addressing Stress Within Health Professions Education and Beyond," which calls for greater attention to the wellness of health care providers, students, and educators. Suggested actions include "creating and training positive role models." In order for faculty to role-model behaviors of wellness, they need to understand what this means and how to incorporate it into their lives. At present, there is only one other MedEdPORTAL resource on wellness and resilience that includes faculty as audience members. Methods:This 60-minute workshop is designed to provide faculty with a basic framework for wellness, with an emphasis on the emotional process aspect of resilience. Strategies for stress and anxiety management are reviewed. The workshop is interactive, with large- and small-group discussions, as well as a guided meditation. Results:This workshop was given at the 2017 Council of Faculties Business Meeting at the American Dental Education Association Annual Session, with 40 participants. Workshop evaluations, completed by 34 (85%) attendees, showed an overall rating of 4.0 on a 5-point Likert scale, with 5 = excellent. The workshop was repeated at the School of Dentistry at the University of California, San Francisco, with 11 attendees; there, the overall rating was 4.7. Discussion:In order to contribute to a culture of wellness and resilience in their organization, faculty need training on the concepts, as well as practical skills for implementation. This workshop provides introductory-level knowledge and skills.
Project description:<h4>Introduction</h4>Medical errors can occur any time resident physicians transition between rotations, especially to unfamiliar areas such as subspecialty pediatrics. To combat this, we created and implemented the pediatric resident education in pulmonary (PREP) boot camp using Kern's six-step approach to curriculum development.<h4>Methods</h4>PREP was a 5-hour session with multiple high-yield components held on the first day of each new rotation, aimed to prepare residents to care for complex pulmonary inpatients, including those with tracheostomy and ventilator dependence, asthma, and cystic fibrosis. The curriculum was evaluated at multiple time points through surveys of residents and faculty and two formal resident focus group sessions.<h4>Results</h4>PREP was successfully implemented in July 2018 with continued monthly sessions held. Thirty-five residents participated in the first year. Resident perceived preparedness and confidence in taking call duties increased significantly following PREP. All residents rated PREP as <i>extremely helpful</i> or <i>very helpful</i>, the highest ratings possible. Overall, residents preferred active learning strategies. All qualitative data revealed positive effects of PREP. Clinical faculty in the pulmonology division found PREP similarly helpful and felt that PREP better prepared residents to provide care to pulmonary inpatients than our previous model.<h4>Discussion</h4>Our monthly preparatory boot camp on the first day of residents' inpatient pulmonary rotation has improved resident experience, preparedness, and ability to care for complex pulmonary patients. The curriculum was adjusted in response to feedback to increase hands-on time and interactive sessions. Protected time for residents and active learning strategies were key to success of PREP.
Project description:The National Science Foundation and others conclude that institutional transformation is required to ensure equal opportunities for the participation and advancement of men and women in academic science, technology, engineering, mathematics, and medicine (STEMM). Such transformation requires changing the habitual attitudes and behaviors of faculty. Approaching implicit bias as a remediable habit, we present the theoretical basis and conceptual model underpinning an educational intervention to promote bias literacy among university faculty as a step toward institutional transformation regarding gender equity. We describe the development and implementation of a Bias Literacy Workshop in detail so others can replicate or adapt it to their setting. Of the 220 (167 faculty and 53 nonfaculty) attendees from the initial 17 departments/divisions offered this workshop, all 180 who completed a written evaluation found the workshop at least "somewhat useful" and 74% found it "very useful." Over 68% indicated increased knowledge of the workshop material. Of the 186 participants who wrote a commitment to engage in new activities to promote gender equity, 87% incorporated specific workshop content. Twenty-four participants were interviewed 4-6 months after attending the workshop; 75% of these not only demonstrated increased bias awareness, but described plans to change-or had actually changed-behaviors because of the workshop. Based on our sample of faculty from a Midwestern university, we conclude that at least one third of STEMM faculty who are invited will attend a 2.5-hr Bias Literacy Workshop, that nearly all will find it useful, and that most will complete a written commitment to promoting gender equity. These findings suggest that this educational intervention may effectively promote institutional change regarding gender equity.
Project description:Pediatric residents report a lack of confidence and competence with procedural skills at graduation. Training programs could benefit from improved approaches to target these needs. Using the Institute for Healthcare Improvement (IHI) Model for Improvement and three Plan-Do-Study-Act (PDSA) cycles, we examined the impact of a procedure simulation boot camp on self-reported procedural confidence and competence as well as the longitudinal impacts of these sequential interventions on Accreditation Council for Graduate Medical Education (ACGME) Graduating Resident Survey (GRS) results.Three rapid cycle interventions were performed in successive academic years. The interventions included 1) increased awareness of available procedural experiences, 2) institution of procedural educational conferences, and 3) implementation of a senior resident procedure boot camp. Senior resident self-reported procedural confidence was measured before and after the boot camp. Procedural competence was measured using the ACGME GRS. Results: Thirty-two of 34 senior residents (94%) completed the 2016 ACGME GRS, similar to the response rates of 2014 (92%) and 2015 (94%), and 30 of 34 third-year residents participated in the procedure boot camp (88%). Resident confidence and competence with procedural skills improved after the institution of the quality improvement intervention. ACGME GRS-reported competency increased in bag and mask ventilation (77% to 94%), neonatal endotracheal intubation (39% to 69%), peripheral IV placement (10% to 50%), and umbilical catheter placement (35% to 53%).A quality improvement intervention with three rapid PDSA cycles was successful in improving senior pediatric resident confidence and competence with ACGME required procedural skills.
Project description:<h4>Background</h4>Accumulating data suggest that team-based learning (TBL) is more effective than lecture-based teaching strategies. Educational sessions at national meetings, however, tend to be lecture-based, and unlike most examples of TBL, involve participants who do not know each other or the instructor.<h4>Objective</h4>We evaluated a 1-day TBL genomic pathology workshop for residents held at 3 national meetings.<h4>Methods</h4>A committee of experts developed the workshop. Prior to attending, participants were provided access to readings and asked to answer preparation questions. Each of the 4 modules within the workshop consisted of a 60-minute TBL activity flanked by 15- to 30-minute preactivity and postactivity lectures. We used surveys to acquire participant evaluation of the workshop.<h4>Results</h4>From 2013-2014, 86 pathology residents from 61 programs participated in 3 workshops at national meetings. All workshops were well received, with over 90% of attendees indicating that they would recommend them to other residents and that the material would help them as practicing pathologists. An incremental approach facilitated decreasing faculty presence at the workshops: the first 2 workshops had 7 faculty each (1 facilitator for each team and 1 circulating faculty member), while the final workshop involved only 2 faculty for 6 teams. For this final session, participants agreed that circulating faculty provided adequate support. Participant "buy-in" (requiring completion of a preworkshop survey) was critical in enabling a TBL approach.<h4>Conclusions</h4>These results demonstrate that TBL is a feasible and effective strategy for teaching genomic medicine that is acceptable to pathology residents at national meetings.
Project description:Introduction:Qualitative coding is a tool for analyzing data involving strings of meaningful words. While many schools and universities have staff who can assist faculty with quantitative data analysis, qualitative data analysis is interpretive and requires both content-specific knowledge and research methodology tools. In this qualitative coding boot camp, we introduce clinician-educators, staff, and administrators to a general overview of qualitative coding and analysis. Methods:We designed and implemented an in-person training to help researchers who had limited exposure to qualitative research gain a general orientation to it. We provided an overview of qualitative data collection and qualitative coding and developed focused research questions related to sample interviews for participants to use in working together to develop a codebook. We concluded by discussing the iterative process of coding, how to work from codes to themes for a manuscript, and how to present and disseminate results. Results:To examine participants' learning during the boot camp session, we used a series of nonparametric sign tests to compare pre- and postsession responses on our evaluation form. The results of these tests showed significant growth in participant comfort with undertaking qualitative analysis. Discussion:Qualitative coding is an important skill for clinicians and their research teams to have, as it can help them to understand the experiences of those around them through an empirical lens. With this 2-hour training, we were able to increase participants' comfort level with the set of skills required to analyze qualitative data rigorously.
Project description:The framing of issues is part of the tool kit used by lobbyists in modern policy making, yet the ways in which framing works to affect lobbying success across issues remain underexplored. Analyzing a new dataset of lobbying in the news on 50 policy issues in five European countries, we demonstrate that it is not individual but collective framing that matters: Emphasis frames that enjoy collective backing from lobbying camps of like-minded advocates affect an advocate's success, rather than frames being voiced by individual advocates. Crucially, it matters for advocacy success whether the advocate's camp frames its policy goals on an issue in unity with "one voice" and whether the actor's camp wins the contest of framing the issue vis-à-vis the opposing camp. Our results emphasize the need to consider the collective mechanisms behind the power of framing and have implications for future research on framing as an advocacy tool.