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GME Leadership Development: Educating the Next Generation of GME Leaders. W Wiese- Rometsch , MD & H Kromrei , PhDc Detroit Medical Center. 83 Residency Programs > 1000 Trainees. Formal Leadership Training ?. GME Conceptual Model: Performance Domains. Evaluation. Clinical. - PowerPoint PPT Presentation
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GME Leadership Development:GME Leadership Development:Educating the Next Generation of Educating the Next Generation of
GME LeadersGME Leaders
W Wiese-Rometsch, MD & H Kromrei, W Wiese-Rometsch, MD & H Kromrei, PhDcPhDc
Detroit Medical CenterDetroit Medical Center
83 Residency Programs
> 1000 Trainees
Formal Leadership Training ?
GME Conceptual Model: Performance Domains
Evaluation
Clinical
GME Leadership Academy
Curriculum Development
Process
Needs Assessment
ACGME & AOA Requirements
Citation Tracking Tool
Internal Reviews
Program Director Survey
Internal Review Action Plan
GME Leadership Program Director Survey
Perceived importance
Perceived competence
25 items; 5- point Likert scale
Categories: Resident Leadership People Leadership Business Leadership
PD Survey: “Resident Leadership” Category
“Resident” Leadership Importance * Competence*
Creating & Evaluating Competency Based Curricula
64% Very / Extra
18% Not /Some
Maintaining Compliance with ACGME Requirements
90% Very / Extra
5% Not /Some
Communicating with Residents
100% Very/Extra
0% Not /Some
Communicating with Former Residents
55% Very / Extra
13% Not /Some
Managing & Evaluating Resident Performance
94% Very / Extra
5% Not /Some
Managing Resident Conflicts & Problems
90% Very / Extra
7% Not /Some
Recruiting Resident Candidates
93% Very / Extra
9% Not /Some
PD Survey: “People” Leadership Category “People” Leadership Importance *
Competence*
Selecting & Recruiting Program Faculty & Staff
91% Very / Extra
23% Not /Some
Managing Program Faculty & Staff
91% Very/Extra
16% Not /Some
Managing Program Faculty & Staff Conflicts/ Problems
85% Very / Extra
20% Not /Some
Retaining Program Faculty & Staff
88% Very / Extra
7% Not /Some
Promoting Program Faculty & Staff Professional Development
76% Very / Extra
18% Not /Some
PD Survey: “Business” Leadership Category
“Business” Leadership Importance * Competence*
Maximizing Program Performance
89 % Very / Extra
17% Not /Some
Competing for Resources 75 % Very / Extra
23% Not /Some
Managing Resources 86 % Very / Extra
14% Not /Some
Creating & Managing Budgets
68% Very / Extra
25% Not /Some
Negotiating with Institutional Leadership
84% Very / Extra
23% Not /Some
Analyzing Program Performance
93% Very/Extra
5% Not /Some
Communicating / Relationship with Leadership Peers
77% Very / Extra
9% Not /Some
Summary of Needs Assessment FindingsGoal: Triangulation of data
1. Macro Level: Accreditation Outcomes
2. Micro Level: Internal Review Results
3. Stakeholder Perceptions: Program Director Survey
GME Leadership Academy Aims
Instructional Methods
Baseline reflection survey on “ideal program”
Pre-test / Post –test
Mini-lectures
“Hands on” experiential learning activities
Round table dialogues for all sessions
Assignments
Large group workshops (open to all PDs)
GME Leadership Academy Curriculum
Accreditation Cycle Core Competencies Designing & Developing Competency Based
Curriculum / Evaluations The Annual Program Review Communication and Technology Resource
Planning Writing Your Program Information Form / Booklet Program Management Leadership Development
Session 1: AccreditationGoals / Objectives Tasks
Understand the ACGME & AOA Regulatory Cycle and Associated Protocols
Review ACGME & AOA Program Requirements
Understand Institutional and Program Level Accreditation
Review new ACGME or AOA Common Program Requirements (Effective July 1, 2011)
Understand the Internal Review Protocol and Process
Participate in an Internal Review
Participate in self-assessment activity
Rate program performance in meeting accreditation
Session 2: Core CompetenciesGoals / Objectives Tasks
Understand the ACGME / AOA Core Competencies
Evaluate Your Program Information Form’s Learning Activities
Incorporate the Core Competencies into Your Program Competency-Based JournalingMilestones ProjectResident Portfolio
Determine Program need for development of competency-based learning activities
Participate in Group Activity
Develop or improve a learning activity for Practice-Based Learning or Systems-Based Practice
Session 3: Developing Competency-Based Curriculum & Evaluations
Goals / Objectives Tasks
Understand how to write goals, objectives, and evaluations
Revise a sample curriculum for a core rotation in your program to meet ACGME requirements
Understand the requirement for aligning program curriculum (measurable goals / objectives) to evaluation and assessment tools
Align the existing evaluation to the curriculum
Participate in Self-Assessment Activity
Rate program performance in compliance for requirements of competency-based curricula and evaluations.
Session 4: The Annual Program Review
Goals / Objectives Tasks
Understand the ACGME Program Review Requirements
Review current annual review protocolCompare current review process to ACGME / AOA requirementsIdentify opportunities for improving your annual program review
Participate in Self-Assessment Activity
Describe program’s approach to Annual ReviewDetermine compliance with requirements
Session 5: Communication & Technology Resource Planning
Goals / Objectives Tasks
Understand essential elements of effective communication
Identify current strategies for communication with residents
Identify current technological resources utilization for communication
Determine opportunities for enhancing utilization of technology in communication planning
Participate in Self-Assessment Activity
Rate program performance in utilization of technology in communicating and teaching residents
Session 6: Writing Your PIF (Booklet) and
Telling the Story of Your ProgramGoals / Objectives Tasks
Understand the importance of the PIF or Booklet
Develop PIF writing plan for your program
Determine PIF stakeholders
Delegate PIF responsibilities to program members
Participate in Self-Assessment Activity
Rate your Program’s PIF and describe your involvement with PIF writing
Session 7: Program Management
Goals / Objectives Tasks
Understand the process of program management
Understand “Performance Indicators and their importance in program evaluation
Review program data (Annual Program Review Action Plan and Internal Review Action Plans)Track program performance (GME Score Card)Identify obstacles to program improvement
Participate in Self-Assessment Activity
Rate program’s current methods for evaluating program performance in specified domains
Session 8: Leadership DevelopmentGoals / Objectives Tasks
Understand leadership competencies
Analyze personal values and align with leadership competencies
Develop short and long-term professional development plan
Review current CV
Develop action plan to meet identified goals
Identify negotiation strategy skills
Describe requirements for leadership in your current role
Participate in Self-Assessment Activity
Describe your current core values and long term goals
Supplemental Curricular Elements
GME Faculty Development Series: Decreasing Evaluation Bias Effective Interviewing Skills Teaching Skills: The 1 Minute
Preceptor The Problem Resident: Lessons
Learned Legal Issues in GME
Outcomes: Knowledge Gain
Session Pre-Test Post-Test
1 79 % 96%
2 65% 74%
3 73% 87%
Table 1: Pre & Post-Test Average Scores
Outcomes: Course Evaluation
Table 2: Course Evaluation Results
Evaluation item Agree/Strongly Agree
Recommendsession to others
97 %
Interactive/Engaging
100%
Relevant to job 97%
Participant Comments
“It was great! Really appreciated the pre-session survey and pace of content delivery.”
“Should be completed by all PDs.”
“Excellent initiative.”
Lessons Learned
Future Directions
Simple ID Process
ID Process Layer 2
ID Process Layer 2
ID Process Layer 1
ID Process Layer 1
ID Process Layer 3
ID Process Layer ’n’Complex IDProcess Quality
Limited Time & Resources
Ample Time & Resources
Tessmer and Wedman’s Layers-of-Necessity Model
Take Home Points
Conduct a Needs Assessment
Align with Accreditation Requirements
Adapt
Tailor Curriculum based on Feedback
Questions ?
References
Wiese-Rometsch, W., Guerra-López, I., Kromrei, H., Developing Successful Leaders: A Model for Graduate Medical Education. Poster presented at the Association for Medical Education Europe, Malaga, Spain, 2009.
Kromrei H., Wiese-Rometsch W. (2010). Portfolio Assessment: Relevant Evaluation Methods and Their Implication for Portfolio Design. In Guerra-Lopez, I (Ed) Social and Organizational Performance Review: Concepts and Research; 2010 2:2. pp119-134 Bloomington: Author House
Neher, J. O., Gordon, K. C., Meyer, B., & Stevens, N. (1992). A five-step "microskills" model of clinical teaching. Journal of the American Board of Family Practice, 5, 419-424.