2013 - UCSF School of Medicine - University of California, San ...

UCSF Education Symposium 2013The Haile T. Debas Academy of Medical Educators presents:THE 12 th ANNUALEDUCATION SYMPOSIUMApril 22-23, 2013University of California, San FranciscoSchool of MedicineWelcome 1Schedule of Events 2Cooke Award Winners 4Keynote Address Information 5Abstracts for Oral Presentations 6Abstracts for Poster Presentations 11Submitted Abstracts 36Index by Author 51University of California, San Francisco • School of Medicinei

UCSF Education Symposium 2013ScholarshipWorking GroupAmin Azzam, MD, MA, ChairLouise Aronson, MD, MFAColette Auerswald, MD, MSDan Ciccarone, MD, MPHDavid Daikh, MD, PhDAlicia Fernandez, MDEllen Haller, MDPatricia O'Sullivan, EdDAnn Poncelet, MDGeorge Rutherford III, MDJason Satterfield, PhDJody Steinauer, MDJeffrey Tabas, MDArianne Teherani, PhDEmily Webb, MDLeadership and StaffHelen Loeser, MD, MScDirectorCynthia AsheManagerKathleen LandSr. Programs AnalystKaren BrentPrograms AnalystAcademy of Medical Educators4 Koret Way, LR-102, Box 0563San Francisco, CA 94143-0563(415) 514.2282 | (415) 514.9264 (Fax)www.medschool2.ucsf.edu/academyMembersShelley Adler, PhDLouise Aronson, MD, MFAColette Auerswald, MD, MSMeg Autry, MDAmin Azzam, MD, MAKenny Vinh Banh, MDRobert Baron, MD, MSTimothy Berger, MDMartin Bogetz, MDMarek Brzezinski, MD, PhDAndre Campbell, MDAnna Chang, MDHuiju Carrie Chen, MD, MSEdLee-may Chen, MDRachel Chin, MDPeter Chin-Hong, MD, MASCalvin Chou, MD, PhDDaniel Ciccarone, MD, MPHMolly Cooke, MDDavid Daikh, MD, PhDRobert Daroff, MDGurpreet Dhaliwal, MDMohammad Diab, MDDavid Duong, MD, MSDavid Elkin, MDAlicia Fernandez, MDTracy Fulton, PhDAlan Gelb, MDAndrew Goldberg, MD, MSCEEllen Haller, MDElizabeth Harleman, MDMichael Harper, MDKaren Hauer, MDGregory Hendey, MDHarry Hollander, MDKatherine Hyland, PhDDavid Irby, PhDRebecca Jackson, MDSharad Jain, MDS. Andrew Josephson, MDKatherine Julian, MDTimothy Kelly, MDShieva Khayam-Bashi, MDRenee Kinman, MD, PhDMarieke Kruidering-Hall, PhDAnda Kuo, MDCindy Lai, MDHarry Lampiris, MDLorriana Leard, MDMichelle Lin, MDTerrence Liu, MDHelen Loeser, MD, MScDaniel Lowenstein, MDJohn Maa, MDAlma Martinez, MD, MPHSusan Masters, PhDLindsay Mazotti, MDMarcia McCowin, MDMeg McNamara, MDCarol Miller, MDIgor Mitrovic, MDJessica Muller, PhDAndrew Murr, MDHeather Nye, MD, PhDMaxine Papadakis, MDManuel Pardo Jr., MDJ Colin Partridge, MD, MPHMichael Peterson, MDAnn Poncelet, MDSusan Promes, MDMichael Rabow, MDPatricia Robertson, MDDana Rohde, PhDMark Rollins, MD, PhDGlenn Rosenbluth, MDGeorge Rutherford III, MDHenry Sanchez, MDJason Satterfield, PhDGeorge Sawaya, MDBrian Schwartz, MDNiraj Sehgal, MD, MPHBradley Sharpe, MDKanade Shinkai, MD, PhDWilliam Shore, MDWade Smith, MD, PhDJody Steinauer, MDJeffrey Tabas, MDLowell Tong, MDKimberly Topp, PT, PhDSandrijn van Schaik, MD, PhDMargo Vener, MD, MPHMaria Wamsley, MDEmily Webb, MDDaniel West, MDElisabeth Wilson, MD, MPHLisa Winston, MDSerena Yang, MD, MPHJohn Young, MD, MPPLeslie Zimmerman, MD© 2013, University of California RegentsiiThe Haile T. Debas Academy of Medical Educators

UCSF Education Symposium 2013Schedule of EventsMonday, April 22Morning Sessions8:30-10:30 am Oral Presentations:Lange RoomKey Principles of High-Quality Interprofessional Team Communication: A Web-Based Interactive CurriculumDarren Fiore, MD; Annette Carley, RN, MS, NNP, PNP; Mary Lynch, RN, PNP-BC, MS, MPH, FAAN; Sherilyn VanOsdol, PharmD, BCPSTeaching Basic Surgical Skills in The Skills Lab Vs. Computer-Based VideoTraining (CBVT): A Randomized Controlled TrialEmily Huang, MD; Hueylan Chern, MD; Patricia O'Sullivan, EdD; Edward Kim,MDDeveloping a Rubric to Evaluate Feedback: The Feedback on FeedbackApproach to Teaching Critical ReflectionMarieke Kruidering, PhD; Patricia O'Sullivan, EdD; Louise Aronson, MD, MFAPrior Peer-learning Relationships Enhance Student Delivery of CommunicationSkills FeedbackDylan Masters, BA; Anna Chang, MD; Marieke Kruidering-Hall, PhD; KarenHauer, MD; Calvin Chou, MD, PhDDevelopment of a Clinical Team Leadership Observation and Feedback Tool(LOFT)Sandra Oza, MD; Edna Miao, BA; Read Pierce, MD; Anda Kuo, MD; SandrijnM van Schaik, MD, PhDInterprofessional Teamwork in Different Clinical Settings: A QualitativeAnalysisSandrijn M van Schaik, MD, PhD; Bridget O'Brien, PhD; Sandra A Almeida,MD, MPH; Shelley R Adler, PhD10:45-11:30 am Keynote Address:Lange RoomMentoring for Educational ScholarshipJanet P. Hafler, EdD11:30-11:45 am Cooke Award for the Scholarship of Teaching & LearningLange RoomKey Principles of High-Quality Interprofessional Team Communication: A Web-Based Interactive CurriculumDarren Fiore, MD, Annette Carley, RN, MS, NNP, PNP, Mary Lynch, RN, PNP-BC, MS, MPH, FAAN, Sherilyn VanOsdol, PharmD, BCPSPrior Peer-learning Relationships Enhance Student Delivery of CommunicationSkills FeedbackDylan Masters, BA, Anna Chang, MD, Marieke Kruidering-Hall, PhD, KarenHauer, MD and Calvin Chou, MD, PhD2 The Haile T. Debas Academy of Medical Educators

UCSF Education Symposium 2013Monday, April 22Afternoon SessionsPlease see inside back cover for poster session tour guide roadmap12:15-1:00 pm1:00-2:00 pm2:15-3:00 pm3:00-4:00 pmModerated Poster Session IUnstructured Poster ViewingModerated Poster Session IIUnstructured Poster ViewingTechnologyLearning CenterCL 220 & 223,CL 221 & 222Tuesday, April 23Workshops9:00-11:00 amTeaching Faculty to Decode the Hidden Curriculum (of Faculty Life)Presenter: Janet Hafler, EdDWithin the medical education literature, the concept of a hidden curriculummost often has been applied to the case of medical students and residentswith the socialization of faculty remaining relatively underexplored. Morerecently, Hafferty and Castellani and Hafler et al. suggest that there is a needto understand the tacit/hidden curriculum as applied to the socialization offaculty within their roles in academic medicine. Specifically, Hafler et al. raisethe question of whether faculty development programs can be designed toassist faculty in decoding the hidden curriculum.TechnologyLearning CenterCL 2209:00-11:00 amModerated Poster Session II Engaging your "Digital Native" Learners:Strategies for EducatorsPresenters: Sandrijn Van Schaik, MD, PhD; Michelle Lin, MD; BradleyMonash, MD; Gail Persily, MLIS; Evans Whitaker, MD, MLISAre you worried that your approach to teaching is seen as old-fashioned byyour millennial students, and unsure how to get them engaged? Have youheard about Twitter, but aren't sure why it is considered the new "digital watercooler" in medical education? Would you like to try Audience ResponseSystems, but are you afraid that will just be too complicated? Do you need apassport to the digital world, because you feel more like an immigrant than anative? Come to this fun, interactive workshop in which you will learn (andpractice!) how easy it can be to use technology in an effective way to enhanceyour teaching and learner engagement.TechnologyLearning CenterCL 223University of California, San Francisco • School of Medicine 3

Cooke Award for the Scholarship ofTeaching and LearningUCSF Education Symposium 2013The Academy is pleased to continue the Cooke Award for the Scholarship of Teaching and Learning, established in 2007to recognize outstanding scholarly works presented at Education Symposium. All submissions to Education Symposiumwere eligible for these awards, which are accompanied by a certificate and honorarium. Top-scoring projects werenominated for the award following a blinded peer review of all abstract submissions. Award winners were determined by aballot in which Scholarship Working Group members ranked the blinded abstracts, excluding those in which they wereinvolved.Please join us in congratulating the 2013 recipients:Darren Fiore, MD; Annette Carley, RN, MS, NNP, PNP; Mary Lynch, RN,PNP-BC, MS, MPH, FAAN and Sherilyn Van Osdol, PharmD, BCPS fortheir work: Key Principles of High-Quality Interprofessional TeamCommunication: A Web-Based Interactive Curriculum, accepted for EducationSymposium as an oral presentation.Dylan Masters, BA; Anna Chang, MD; Marieke Kruidering-Hall, PhD;Karen Hauer, MD and Calvin Chou, MD, PhD for their work: Prior PeerlearningRelationships Enhance Student Delivery of Communication SkillsFeedback, accepted for Education Symposium as an oral presentation.4 The Haile T. Debas Academy of Medical Educators

UCSF Education Symposium 2013Keynote AddressMentoring for EducationalScholarshipJanet P. Hafler, EdDYale School of MedicineDr. Janet Hafler, Professor of Pediatrics, and Assistant Dean for Educational Scholarshipreceived her master’s in education specializing in maternal and child health fromColumbia University and her doctorate from Harvard University in Education. As theleader for educator development at the Yale School of Medicine Teaching and LearningCenter her responsibilities include the creation and implementation of medical educationprograms for teaching faculty, students and residents. Over her career she has nurtureda climate in teaching and learning where faculty, residents and students have beenexposed to cutting edge literature and ideas in medical education. She has focused onassisting faculty to explore innovative ways to effectively promote learning in both theclassroom and clinical settings.Dr. Hafler runs an active research program applying qualitative research methods inmedical education. She collaborates with and mentors clinicians and faculty on theelements of qualitative research in the field of medical education and medical care. Inturn, mentored faculty members have learned to develop and demonstrate the toolsnecessary to effectively teach and lead others. Dr. Hafler has published over 100 bookchapters, curriculum materials and original articles in medical education and clinicaljournals. She has served as visiting professor internationally and is invited to presentregularly at regional and national professional meetings.In her Keynote Address on Monday, Dr. Hafler will discuss the role of a mentor ineducational scholarship. On Tuesday, she will present the workshop, “Teaching Facultyto Decode the Hidden Curriculum (of Faculty Life).”University of California, San Francisco • School of Medicine 5

UCSF Education Symposium 2013Oral PresentationsKey Principles of High-Quality Interprofessional Team Communication: A Web-BasedInteractive Curriculum .......................................................................................................................................................... 7Darren Fiore, MD; Annette Carley, RN, MS, NNP, PNP; Mary Lynch, RN, PNP-BC, MS, MPH,FAAN; Sherilyn Van Osdol, PharmD, BCPSTeaching Basic Surgical Skills in The Skills Lab vs. Computer-Based Video Training(CBVT): A Randomized Controlled Trial ............................................................................................................................. 7Emily Huang, MD; Hueylan Chern, MD; Patricia O'Sullivan, EdD; Edward Kim, MDDeveloping a Rubric to Evaluate Feedback: The Feedback on Feedback Approach toTeaching Critical Reflection ................................................................................................................................................. 8Marieke Kruidering-Hall, PhD; Patricia O'Sullivan, EdD; Louise Aronson, MD, MFAPrior Peer-learning Relationships Enhance Student Delivery of Communication SkillsFeedback ................................................................................................................................................................................ 9Dylan Masters, BA; Anna Chang, MD; Marieke Kruidering-Hall, PhD; Karen Hauer, MD; CalvinChou, MD, PhDDevelopment of a Clinical Team Leadership Observation and Feedback Tool (LOFT) ................................................. 9Sandra Oza, MD; Edna Miao, BA; Read Pierce, MD; Anda Kuo, MD; Sandrijn van Schaik, MD,PhDInterprofessional Teamwork in Different Clinical Settings: A Qualitative Analysis ..................................................... 10Sandrijn van Schaik, MD, PhD; Bridget O'Brien, PhD; Sandra A Almeida, MD, MPH; Shelley R Adler, PhD6 The Haile T. Debas Academy of Medical Educators

UCSF Education Symposium 2013Oral PresentationsKey Principles of High-QualityInterprofessional TeamCommunication: A Web-BasedInteractive CurriculumDarren Fiore, MD, UCSF School of Medicine,fiored@peds.ucsf.edu; Annette Carley, RN, MS, NNP,PNP, UCSF School of Nursing,Annette.Carley@nursing.ucsf.edu; Mary Lynch, RN,PNP-BC, MS, MPH, FAAN, UCSF School of Nursing,mary.lynch@nursing.ucsf.edu; Sherilyn Van Osdol,PharmD, BCPS, UCSF School of PharmacyVanosdolS@pharmacy.ucsf.eduAreas abstract covers: UME, GMEDomain(s) addressed: Clinical Instruction andPerformance, Communication, Curricular Innovation,Interprofessional EducationPurpose: To develop a succinct, evidence-based, onlinecurriculum highlighting principles of communication withthe primary goal of fostering high-quality and effectivecommunication within the interprofessional team.Background: Meaningful communication betweenmembers of an interprofessional team is the cornerstoneof quality patient care, yet at UCSF there is no teamcommunication curriculum. Our curriculum is informedby Lave and Wenger’s concept of communities ofpractice which is a network of individuals who developan overlapping knowledge base and set of valuesfocused on common goals. A web-based curriculumallows the community of practice to engage in discussiononline and subsequently during team-based exercises.Blended learning theory argues for integration of face-tofaceand online learning.Methods: An interprofessional cadre of educatorsreviewed best practices for team communication,drawing on evidence to create 6 short, web-basedmodules highlighting communication principles. Thepilot learners are nurse, physician and pharmacisttrainees participating in mock pediatric resuscitations.The curriculum focuses on vetted communicationprinciples such as closed-loop communication and roledelineation. Modules contain text, narration, video, andactivities to reinforce learning. The curriculum will behoused on the UCSF CLE, which enables sharing of thecurriculum. The authors will write a succinct ‘teacher’smanual’ to offer guidance on how interested educatorsmight incorporate the interprofessional team trainingmodules into their own curricula.Evaluation Plan: To evaluate learners: pre/post-modulequizzes to evaluate knowledge, skills, attitudes. Toevaluate curriculum's impact: use a validated teamperformance tool to compare data on teamwork andcommunication before and after curriculumimplementation.Dissemination: Poster presented at CINHC's Magic inTeaching Conference. Plan to submit abstract to WGEAconference. We aim to submit the curriculum forpublication in AAMC’s peer-reviewed MedEdPortal. /Reflective Critique: We will seek peer review throughESCAPE (educational scholarship conference) andKanbar Simulation and Scholarship Group. Learnerfeedback in the pilot will help shape the final product.Teaching Basic Surgical Skills in TheSkills Lab vs. Computer-Based VideoTraining (CBVT): A RandomizedControlled TrialEmily Huang, MD, UCSF,emily.huang2@ucsfmedctr.org; Hueylan Chern, MD,UCSF, hueylan.chern@ucsfmedctr.org; PatriciaO'Sullivan, EdD, UCSF, osullivanp@medsch.ucsf.edu;Edward Kim, MD, UCSF, edward.kim@ucsfmedctr.orgDomain(s) addressed: Clinical Instruction andPerformance, Computers and Technology, CurricularInnovation, SimulationPurpose: We implemented a computer-based videotraining (CBVT) curriculum for surgical interns at ourinstitution and examined its effects on performance.Background: Technological advances make teachingbasic surgical skills via CBVT an attractive option. Whilenovice medical students have been shown to improveperformance on basic surgical skills with CBVT, itseffectiveness for residents, who must achieve greaterproficiency, is less clear.Methods: This prospective randomized controlled trialincluded 22 PGY-1 surgical residents at UCSF. Theinterns were randomized to a CBVT curriculum (n=11) orUniversity of California, San Francisco • School of Medicine 7

UCSF Education Symposium 2013instructional sessions at the Surgical Skills Center(n=11). Pre- and post-intervention videotapes of eachintern performing basic surgical skills (knot tying andsubcutaneous suturing) were deidentified and scored bythree expert raters using a global rating scale.Additionally, post-intervention, all interns werevideotaped performing an integrated task which wasscored using a modified objective structured assessmentof technical skills (OSATS), generating tissue handling(4 items) and technical skill (4 items) scores. Weconducted an analysis of covariance for the fiveoutcomes, and calculated effect size (es) of theintervention (necessary due to small sample size).Results: Our measures showed acceptable inter-raterreliability: one- (.77) and two-handed (.63) knot tying,subcutaneous suturing (.73), tissue handling (.73), andtechnical skill (.85) scores. Adjusting for pre-interventionscore, we found no difference in performance betweenthe two groups for basic surgical skills: one-handed knottying (p=.21, es= .076), two-handed knot tying (p=.48,es=.028), suturing (p=.11, es=.14) or for integrated skills:tissue handling (p=.77; es=.005), and technical skill(p=.60, es=.014).Discussion: CBVT is an effective option for teachingbasic surgical skills to surgical residents, and does notsubsequently limit performance on complex skills. Thiseasily implemented strategy frees skills lab facilities foradvanced topics, while enabling programs without askills lab to provide effective teaching.Reflective Critique: We solicited anonymous feedbackfrom residents on the curriculum implementation.Developing a Rubric to EvaluateFeedback: The Feedback onFeedback Approach to TeachingCritical ReflectionMarieke Kruidering-Hall, PhD, Department of Cellularand Molecular Pharmacology, UCSF,Marieke.Kruidering@ucsf.edu; Patricia O'Sullivan, EdD,Department of Medicine, patricia.osullivan@ucsf.edu;Louise Aronson, MD, MFA, Department of Geriatrics,louise.aronson@ucsf.eduPurpose: To develop and validate a feedback rubric toassess feedback to learners’ on written criticalreflections.Background: Critical reflection promotes self-directedlife-long learning and is widely incorporated into medicaltraining. To develop learners’ reflective abilities, facultymust be able to provide feedback that builds thelearners’ reflective skill. No tools exist to evaluatereflection feedback or help faculty provide reflectionfeedback.Methods: We developed a 6-item rubric with 2 items onreflection content feedback, 2 items on reflective skillfeedback, and one item each on communication clarityand tone, the scale ranging from problematic (0) to good(3). Doctoring course faculty (n=16) participating in areflection faculty development workshop provided preandpost- workshop feedback to two standardizedreflections. Trained raters scored the feedback. Wecalculated inter-rater correlation coefficients, averagedthe raters’ scores and used paired T-tests to determine ifthe total rubric score as well as each individual item ofthe rubric was sensitive to the effect of instruction.Results: The inter-rater correlation coefficients rangedfrom 0.64 to 0.86. The raters could not reliably scorecommunication clarity (.39 (pre); 0 (post)). Total rubricscores increased significantly pre- to post-workshop (8.1v. 12.2; p.05).Discussion: We have demonstrated evidence of validitybased on content, reliability and sensitivity to anintervention. Further work is required to decide the valueof the communication clarity item. Medical educators canuse this rubric as training tool in workshops, to evaluatewritten feedback about reflection to learners and helplearners provide feedback to peers.Reflective Critique: We revised the rubric based oninput from four feedback experts and faculty at threeworkshops nationwide. We have submitted to WGEAand RIME for review.Areas abstract covers: UME, GMEDomain(s) addressed: Faculty Development,Feedback, ReflectionOral presentations continued next page8 The Haile T. Debas Academy of Medical Educators

UCSF Education Symposium 2013Prior Peer-learning RelationshipsEnhance Student Delivery ofCommunication Skills FeedbackDylan Masters, BA, University of California, SanFrancisco, dylan.masters@ucsf.edu; Anna Chang, MD,University of California, San Francisco,ChangAn1@medsch.ucsf.edu; Marieke Kruidering-Hall,PhD, University of California, San Francisco,Marieke.Kruidering@ucsf.edu; Karen Hauer, MD,University of California, San Franciscokhauer@medicine.ucsf.edu; Calvin Chou, MD, PhD,University of California, San Francisco,calvin.chou@ucsf.educalvin.chou@ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Communication, Competencies,Feedback, SimulationPurpose: To study the effect of prior peer-learningrelationships among medical students on their delivery ofpeer feedback after simulated clinical encounters.Background: Effective feedback must be specific,nonjudgmental, and intended to improve performance. Acontext of trust facilitates delivery and reception offeedback. Feedback delivery in “non-cognitive” domainssuch as interpersonal communications can be morechallenging to deliver. Students can also be lesscomfortable providing corrective feedback as opposed toreinforcing feedback to peers.Methods: During a clinical skills evaluation, we divided46 third-year medical student feedback pairs into twosubgroups: those formed by students who shared asmall group in a longitudinal pre-clerkship clinical skillscourse (prior peer-learning relationship) and byclassmates who had no prior shared small groupexperiences. Students in both subgroups observed theirpartners in a simulated clinical case and then providedfeedback, which we videotaped, transcribed, and codedfor type (general or specific, and reinforcing orcorrective) and content (task or communication). Tworesearchers coded each transcript, and the groupreconciled codes via discussion.Results: Students with a prior peer-learning relationshipprovided increased specific corrective feedback aboutcommunication skills than students with no prior sharedlearning experience (p=0.014). We found no significantdifference between subgroups in corrective feedbackabout tasks, or in reinforcing feedback about eithercommunication skills or tasks.Discussion: Prior peer-learning relationships inlongitudinal clinical skills courses increase and enrichprovision of specific corrective feedback aboutcommunication skills. Opportunities for feedbackbetween students with prior peer-learning relationshipsrepresent a potentially underused method of helpingstudents improve skills in sensitive clinical skills domainssuch as interpersonal communication.Reflective Critique: ESCape members reviewed a draftof the manuscript, and we incorporated their feedback.The RAPtr Review Committee evaluated an abstract andan oral presentation of this study. We have submitted amanuscript describing this study to Medical Education.Development of a Clinical TeamLeadership Observation andFeedback Tool (LOFT)Sandra Oza, MD, Department of Medicine, University ofCalifornia, San Francisco School of Medicine,sandra.oza@ucsfmedctr.org; Edna Miao, BA,Department of Neurology, University of California, SanFrancisco School of Medicine, ednamiao@gmail.com;Read Pierce, MD, Department of Medicine, University ofColorado School of Medicine, read.pierce@gmail.com;Anda Kuo, MD, Department of Pediatrics, University ofCalifornia, San Francisco School of MedicineAKuo@sfghpeds.ucsf.edu; Sandrijn van Schaik, MD,PhD, Department of Pediatrics, University of California,San Francisco School of Medicine,VanSchaikS@peds.ucsf.eduAreas abstract covers: GMEDomain(s) addressed: Feedback, LeadershipPurpose: Identify appropriate terminology and skillsassociated with clinical team leadership based on theLeadership Practice Inventory (LPI)1, and create abehaviorally-anchored assessment tool for residents.Background: Competency in team leadership is arequired outcome of residency training, but assessmenttools for leadership skills outside of high-acuity settingsare lacking. The LPI is a validated tool used in variousnon-clinical contexts. While LPI terminology has limitedapplicability to clinical settings, we postulated itsconstructs are applicable to clinical team leadership.Methods: We modified the LPI based on clinicalleadership literature to create an open-ended instrument.Residents leading interprofessional inpatient pediatricand internal medicine teams identified 5 team membersUniversity of California, San Francisco • School of Medicine 9

UCSF Education Symposium 2013to provide feedback using our instrument. Throughiterative qualitative analysis we coded this feedback,identified major themes and extracted leadershipbehaviors. Next, we used modified Delphi methodologywith a panel of healthcare leadership experts to rate: firstthe importance of behaviors, and second the traininglevel at which these behaviors can be expected. Weanalyzed between-experts agreement using ContentValidity Index (CVI).Results: Seventy-five team members providedfeedback. Qualitative analysis revealed ten domains ofclinical leadership, and 30 associated behaviors. The 10domains focused on appreciation and motivation,balancing autonomy and supervision, accessibility andinvolvement, seeking input, workload management,feedback, facing challenges, team learning, modelingprofessionalism, and establishing expectations. In thefirst Delphi round, CVI estimates were all ≥0.80. Thesecond round provided the expected training level for allbehaviors. Using these data, we developed abehaviorally-anchored, developmentally-oriented 10-itemtool.Discussion: Our study identified essential leadershipbehaviors to include in a behaviorally-anchored anddevelopmentally-oriented clinical leadershipassessment. We anticipate this tool will fill a gap incompetency assessment.Reflective Critique: We are piloting this tool withresidents to determine its validity and reliability. We willrefine the tool using pilot data prior to dissemination.References: Posner B.http://media.wiley.com/assets/2034/63/LPIAnalysisAug2009.pdfInterprofessional Teamwork inDifferent Clinical Settings: AQualitative AnalysisSandrijn M Van Schaik, MD, PhD, University ofCalifornia, San Francisco, vanschaiks@peds.ucsf.edu;Bridget O'Brien, PhD, UCSF,ObrienB@medsch.ucsf.edu; Sandra A Almeida, MD,MPH, Sandra A. Almeida, MD, LLC, HealthcareConsulting, salmeida@cox.net; Shelley R Adler, PhD,UCSF AdlerSh@oicm.ucsf.eduAreas abstract covers: GME, CMEDomain(s) addressed: Assessment and Testing,Communication, Interprofessional Education, LeadershipPurpose: To explore the constructs underlyinginterprofessional teamwork in low-acuity clinical settingsand team members’ perspectives of essential teamworkattributes.Background: Working effectively in interprofessionalteams is a core competency for all healthcareprofessionals, yet there is a paucity of instruments toassess the associated skills. Published teamwork skillsassessment tools focus primarily on high-acuity contexts(e.g., operating rooms), and may not generalize to nonhigh-acuityenvironments (e.g., outpatient clinics). Thedevelopment of a teamwork skill assessment toolapplicable to low-acuity clinical settings requiresunderstanding of the construct of interprofessionalteamwork and associated skills in those contexts.Methods: We studied 4 interprofessional teams in twodifferent low-acuity settings at our institution: Women’sHIV clinics and inpatient pediatric wards. Over a periodof 17 months, we collected qualitative data throughdirect observations, focus groups, and interviews. Weanalyzed the data using qualitative thematic analysis,reconciling differences in interpretation through refineddefinitions and recoding, and triangulating data fromdifferent sources.Results: We conducted 7 focus groups and 27individual interviews with a total of 36 team membersrepresenting 8 professions. The teams in our studyemphasized shared leadership and collaborativedecision-making, mutual respect, recognizing one’s ownand others’ limitations and strengths, and the need tonurture relationships. They also discussed tensionsaround hierarchy and questioned whether physicianleadership is appropriate for interprofessional teams.Discussion: Our findings indicate that thecharacteristics of teamwork in low-acuity settings differfrom those of teamwork in high-acuity settings, andprovide insights about potential barriers for effectiveteamwork. This work lays the foundation for subsequentresearch aimed at delineating specific skills to informdevelopment of an assessment tool.Reflective Critique: Preliminary data from this studywere presented at the 2012 WGEA conference and amanuscript with the complete results is currently underreview for presentation at the 2013 RIME conference.10 The Haile T. Debas Academy of Medical Educators

UCSF Education Symposium 2013Poster PresentationsCurriculum Development PostersThe UCSF Enrichment Program for ELAM Students ....................................................................................................... 14Christopher Benitez, MD; Carol Miller, MD, MPH; Elisabeth Wilson, MD; Sharad Jain, MDTeaching SBIRT to Pediatric Residents: A Design-Based Research Approach .......................................................... 14Sara Buckelew, MD; Amy Whittle, MD; Jason Satterfield, PhD; Paula Lum, MD, MPH; Patricia O'Sullivan, PhDFlipping the Classroom: Designing a Constructivist Curriculum for a Hybrid SeminarCourse .................................................................................................................................................................................. 15Laurence Clement, PhD; Laurence Clement, PhD; Sarah Goodwin, PhD; Ron Vale, PhD; Jonathan Scholey, PhDTeaching Outpatient Quality & Safety Principles through Ambulatory Morbidity & MortalityConference ........................................................................................................................................................................... 15Aparna Goel, MD; Reena Gupta, MD; William Huen, MD, MPH; Urmimala Sarkar, MD, MPH; Krishan Soni, MD, MBA;Claire Horton, MD, MPHTraining Students As Health Coaches: Aligning Service and Education ..................................................................... 16Kathy Hamlin, Med 4; Isabel Edge, Med 4; Margo Vener, MD, MPHDevelopment of a “Longitudinal Management of Patients and Populations” Curriculum forLongitudinal Integrated Clerkship Students .................................................................................................................... 16Laura Hill-Sakurai, MD; Amiesha Panchal, MDTeaching Knot Tying Via the Kinesthetic Method ........................................................................................................... 17Emily Huang, MD; Edward Kim, MD; Hueylan Chern, MD; Patricia O'Sullivan, EdD; Barnard Palmer, MD; Brian Cook, ;Erik McDonaldOut With the Old, In With the New: Exploring New Online Learning Platforms asAlternatives to the Traditional Course Syllabus .............................................................................................................. 17Katherine Hyland, PhD; Christian Burke, BA; Christy Boscardin, PhD; Chandler Mayfield, BARemedy at UCSF: A Sustainable Student-Run Initiative ................................................................................................. 18Lily Muldoon, UCSF MS 3; Jessica Gould; Jacob Mirsky; Meggie Woods; Sharad Jain, MD; Hemal Kanzaria, MDA Home Visit Curriculum to Foster Interprofessional Collaboration and Improve CareCoordination for High-Risk Patients in Trainee Primary Care Continuity Clinics ........................................................ 19Shalini Patel, MD; Melissa Bachhuber, MD; Bridget O'Brien, PhDA Primary Care Inter-Professional Case Conference: Promoting Interdisciplinary Learningand Addressing Challenges. .............................................................................................................................................. 19Shalini Patel, MD; Christina Kim, ANP; Bridget O'Brien, PhD; Erick Hung, MDDevelopment and Evaluation of an Interprofessional Collaborative Case Conference Series .................................. 20Meg Pearson, MD; Bridget O'Brien, PhD; Rebecca Shunk, MDUniversity of California, San Francisco • School of Medicine 11

UCSF Education Symposium 2013Emergency Medicine Training for Haitian Senior Medical Students ............................................................................. 20Kenny Pettersen, BS; Sarah Ashley, BS; Mathieu Edris, MD; Marc Johnson, MD; Margaret Salmon, MD, MPH; JacobMiss, MDPRIME-US - SFHIP: A Community Engagement Service Learning Project ................................................................... 21Aisha Queen-Johnson, MSW; James Rouse Iniguez, MA; Elisabeth Wilson, MD, MPH; Paula Fleisher, MA; RobertoVargas, MPH; Randy Quezada, MPPA Crisis Management Curriculum for Medical Students using Critical Event Simulation .......................................... 21Nicholas Riegels, MD; Nardine Saad Riegels, MD; Lindsay Mazotti, MDPost Graduate Training in Global Health Delivery ........................................................................................................... 22Sriram Shamasunder, MD; Phuoc Le, MD, MPH, DTM&H; Madhavi Dandu, MD, MPH; Marwa Shoeb, MDMaking Disease Modeling Education Infectious: A Teacher-Researcher Partnership toBring Computational Modeling Into the High School Classroom Using the Multi-ParadigmModeling Platform NOVA ................................................................................................................................................... 23Nicolas Sippl-Swezey, BA; Richard Salter, PhD; Travais Porco, PhD, MPH; Wayne Getz, PhD; Jeanne Appelget, MSEvaluating Discharge Summary as Entrustable Professional Activity (EPA) in InternalMedicine Residency: A Hospitalist-Intern Collaboration ................................................................................................ 23Heather Whelan, MD; Abbi Eastburn, MD; Denise Connor, MD; Jeff Kohlwes, MDCurriculum Evaluation/Educational Research PostersDeveloping an Interprofessional Team-based Observed Structured Clinical Examination(ITOSCE) to Evaluate Patient-Centeredness .................................................................................................................... 25Alice Ainsworth, BS; Charlie DeVries, MPH; Bridget O'Brien, PhD; Calvin Chou, MD, PhDWhat Really Happens During Ward Rounds?: A Multisite, Observational Study of PatientCare, Teaching, and Bedside Behaviors .......................................................................................................................... 25Alyssa Bogetz, MSW; Sylvia Bereknyei, DrPH; Bradley Monash, MD; Stephanie Rennke, MD; Sara Buckelew, MD;Clarence Braddock, MD; Jason Satterfield, PhDHelp Me Help Myself: Student Attitudes About Self-Directed Learning Tools in CoreClerkships ............................................................................................................................................................................ 26Laura Cantino, MSIV; H. Carrie Chen, MD, MSEd; Julie Lindow, MA; Patricia Robertson, MD; Arianne Teherani, PhD;Robert Daroff, MD; Vanja Douglas, MD; Karen Hauer, MDLearning the Ropes Together: “Workplace Learning Communities” in the Third Year ofMedical School .................................................................................................................................................................... 27Calvin Chou, MD, PhD; Arianne Teherani, PhD; Dylan Masters, BA; Margo Vener, MD; Maria Wamsley, MD; AnnPoncelet, MDTwo Years of Experience Embedding “Becoming the Patient” into the “Foundations ofPatient Care” course at UCSF............................................................................................................................................ 27Adan Garcia-Mecinas; Joe Mendez, MD; Heather Bennett, MD; Amin Azzam, MD, MAThe Effect of Resident Duty-hours Restrictions on Internal Medicine ClerkshipExperiences: A Survey of Clerkship Directors ................................................................................................................ 28Karen Hauer, MD; Christy Boscardin, PhD; Dario Torre, MD, MPH, PhD; Jennifer Kogan, MD12 The Haile T. Debas Academy of Medical Educators

UCSF Education Symposium 2013Cost Analysis of Virtual Reality Phacoemulsification Simulation in Ophthalmology TrainingPrograms .............................................................................................................................................................................. 29Eugene Lowry, BA; Ayman Naseri, MDHow Do We Evaluate Our Learners’ Reflective Ability? A Comparison of Two ReflectionRubrics ................................................................................................................................................................................. 30Rebecca Miller, BS; Patricia S. O'Sullivan, EdD; Louise Aronson, MD, MFAResidents as Teachers: How Do They Compare to Attendings? ................................................................................... 31David M. Naeger, MD; Chad Wilcox, MA; Andrew Phelps, MD; Karen Ordovas, MD; Emily M. Webb, MDStudents Teaching Students: Do Students Benefit from “Near-Peer” Teaching? ....................................................... 31David M. Naeger, MD; Miles Conrad, MD; Janet Nguyen, MS; Maureen Kohi, MD; Emily M. Webb, MDVisions of the Ideal Medical Student: Impressions From Longitudinal Integrated and BlockClerkship Experiences ........................................................................................................................................................ 32Bridget O'Brien, PhD; David Hirsh, MD; Ed Krupat, PhD; Joanne Batt, BA; Lori Hansen, MD; Ann Poncelet, MD; KarenHauer, MDDevelopment and Implementation of an Interprofessional Standardized PatientAssessment ......................................................................................................................................................................... 32Sandra Oza, MD; Christy Boscardin, PhD; Maria Wamsley, MD; Aimee Sznewajs, RN, NP, MD; Karen Hauer, MDThe Surgical Clerkship and Medical Student Performance in a Standardized Patient Casewith Acute Cholecystitis ..................................................................................................................................................... 33Robert Tessler, BM; Karen E. Hauer, MD; Andrew Leavitt, MD; Bernie Miller, BA; John Maa, MDImpact of a Workshop and Individualized Coaching on Pediatric Provider Skillfulness inMotivational Interviewing ................................................................................................................................................... 34Amy Whittle, MD; Jennifer Hettema, PhD; Jennifer Manuel, PhD; Eileen McCormick, BA; Carrie Cangelosi, MSW; SarahDe La Cerda, MSW; Matt Tierney, PNP; Paula Lum, MD, MPHUniversity of California, San Francisco • School of Medicine 13

UCSF Education Symposium 2013Curriculum Development PostersThe UCSF Enrichment Program forELAM StudentsChristopher Benitez, MD, UCSF,Christopher.Benitez@ucsf.edu; Carol Miller, MD, MPH,UCSF, MillerC@peds.ucsf.edu; Elisabeth Wilson, MD,UCSF, ewilson@fcm.ucsf.edu; Sharad Jain, MD, UCSFSharad.Jain@ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Community Medicine, CulturalCompetence, Global Health, MentoringPurpose: From 2008-2012, UCSF faculty partnered withUS students from La Escuela Latinoamerica de Medicina(ELAM) to support their transition from the medicalschool run by the Cuban government to residencies inthe United States. The goal was to establish a course tosupport those students intending to return to the US forresidency training.Background: ELAM provides a six year medicaleducation for about ten thousand international (non-Cuban) students, including 120 American students.Preference is given to students who come from the mostunder-resourced communities. UCSF faculty interestedin healthcare for underserved communities embarked onthe pilot of the UCSF Enrichment Program for ELAMStudents.Methods: UCSF faculty traveled to ELAM to conduct aninformal needs assessment with US-ELAM students.Over two years, 20 US-ELAM students participated in astructured curriculum in San Francisco. In 2012, UCSFfaculty returned to Cuba and met with a 40 students,continuing several aspects of the earlier curriculum andbeginning others. The US-based curriculum wasdeveloped to focus on culturally relevant clinicalinterviewing, US-specific clinical training experiences,and mentoring by US medical faculty. The Cuba-basedcurriculum targeted clinical skills and reasoning,documentation, integrating global health practice intoone’s career, and post-graduate training.Evaluation Plan: Anonymous program evaluationsurveys were completed by participants at the end of thefirst session in San Francisco and combined withinformal feedback offered by the participants. Allstudents rated the program as outstanding and learnedconcrete skills that would be useful in residency training.Dissemination: The preliminary results of the projectwere presented at the UC Global Health Day in 2010.We hope to disseminate this project via presentations atnational conferences.Teaching SBIRT to PediatricResidents: A Design-Based ResearchApproachSara Buckelew, MD, UCSF, buckelews@peds.ucsf.edu;Amy Whittle, MD, UCSF, whittlea@peds.ucsf.edu; JasonSatterfield, PhD, UCSF, jsatter@medicine.ucsf.edu;Paula Lum, MD, MPH, UCSF plum@php.ucsf.edu;Patricia O'Sullivan, PhD, UCSF,osullivanp@medsch.ucsf.eduAreas abstract covers: GMEDomain(s) addressed: Communication, CurricularInnovation, Patient CarePurpose: We piloted a curriculum to teach SBIRT(screening, referral and brief intervention) for adolescentsubstance use to pediatric residents.Background: We used a design based research (DBR)approach, which examines educational interventions thatare based off a dominant theory, assesses theirperformance in the learning environment, and thengenerates new frameworks for conceptualizing learning.Methods: We implemented a curriculum that included 1)five web-based SBIRT modules, 2) a two-hour in-personseminar to practice motivational interviewing (MI), and 3)two direct observations of residents with patients.Supervising physicians used an observation checklist torecord a) how the residents screened for substance use,b) their use of MI techniques, and c) strengths/ areas toimprove.Evaluation Plan: After four months, 13 residentscompleted the rotation. Ten residents viewed at least4/5 online training modules, and most (87%) residentsrated they were “very satisfied” with the seminars.Implementing the observation form was more difficult,given the intensive faculty time required for directobservation, the complexity of the checklist items, andthat not all observed visits uncovered a substance useproblem. Out of a total of 26 observation forms, 77%were either incompletely or incorrectly filled out (n=14) or14 The Haile T. Debas Academy of Medical Educators

UCSF Education Symposium 2013were not done (n=6). Part b) of the observation formhad the most errors.Dissemination: We plan to submit the curriculum toMedEd Portal.Flipping the Classroom: Designing aConstructivist Curriculum for aHybrid Seminar CourseLaurence Clement, PhD, UCSF, ASCB,lclement@ascb.org; Sarah Goodwin, PhD, UCSF,ASCB, sgoodwin@ascb.org; Ron Vale, PhD, UCSFvale@cmp.ucsf.edu; Jonathan Scholey, PhD, UC Davis,jmscholey@ucdavis.eduAreas abstract covers: UME, GME, CME: FacultyDevelopmentDomain(s) addressed: Basic Science Education,Computers and Technology, InterprofessionalEducation, ResearchPurpose: To design, pilot and evaluate a hybrid PBLbiomedical curriculum for senior undergraduate,graduate and continuing education students, with thepotential of making it a fully-online course.Background: UCSF is currently developing numerousonline learning initiatives. iBioSeminars, a joint project ofUCSF and ASCB, offers high-level online seminars oncutting-edge biomedical research in various fields,including human health, microbiology and cell biology.Internationally, over half the users who access the site’seducational tools are graduate students in the biologicalor health sciences.Methods: Starting in March 2013, we will pilot a 10-week, senior-level, flipped course at UC Davis in whichstudents watch iBioSeminars lectures as homework. Thecurriculum will follow the 5E constructivist learning cyclemodel. Each week, students will be presented with aresearch question (Engage), watch the online seminar(Explore) and take an online quiz (Explain). At thebeginning of the semester, each student will be assigneda scientific paper relating to the research problem forwhich they will lead a peer-discussion in class(Elaborate). After each class, all students will turn in areflection on the research problem discussed that week.The final assignment will be a 2-page research paperrelating to the facilitated lesson (Evaluate).Evaluation Plan: We will evaluate learning gains foriBioSeminars lectures through pre-post knowledge tests,and assess critical thinking skills at three points in eachlesson (pre/post-video, post-discussion reflections).Analytical and critical thinking skills will be furtherassessed through the research paper.Dissemination: Course materials will be openlyaccessible on the iBioSeminars site, and the evaluationresults will be presented at the ASMCUE conference.Teaching Outpatient Quality & SafetyPrinciples through AmbulatoryMorbidity & Mortality ConferenceAparna Goel, MD, University of California, SanFrancisco, aparna.goel@ucsf.edu; Reena Gupta, MD,San Francisco General Hospital, University of California,San Francisco, reena.gupta@ucsf.edu; William Huen,MD, MPH, San Francisco General Hospital, University ofCalifornia, San Francisco, william.huen@ucsf.edu;Urmimala Sarkar, MD, MPH, San Francisco GeneralHospital, University of California, San Franciscourmimala.sarkar@ucsf.edu; Krishan Soni, MD, MBA,University of California, San Francisco,krishan.soni@ucsf.edu; Claire Horton, MD, MPH, SanFrancisco General Hospital, University of California, SanFrancisco, claire.horton@ucsf.eduAreas abstract covers: GMEDomain(s) addressed: Competencies, CurricularInnovation, Quality Improvement, ResidencyPurpose: Implement an ambulatory M&M caseconference series to: 1) discuss outpatient medicalerrors and adverse events using a non-judgmentalapproach, 2) identify opportunities for inter-professionalcommunication, practice-based learning, and systemsimprovement, and 3) foster a culture of ambulatoryquality and safety.Background: Although outpatient adverse events are amajor source of morbidity and mortality, morbidity andmortality (M&M) conferences have not been traditionallyconducted in ambulatory settings.Methods: Clinic directors of General Medicine Clinic atSan Francisco General Hospital and the Quality & Safetychief resident are identifying a case for discussion.Internal medicine residents, faculty, medical students,and multidisciplinary staff are invited to the M&Mconference. A novel tool, the SFGH M&M Matrix, is usedas a framework for analyzing adverse events andmedical errors through the ACGME core competencies.University of California, San Francisco • School of Medicine 15

UCSF Education Symposium 2013Evaluation Plan: Survey of conference attendees isbeing used to evaluate the overall quality of theconference, educational utility in analyzing medicalerrors and adverse events, and ability to identifystrategies to improve patient safety. The impact of M&Mconferences on clinic policy and system redesign willalso be measured. At this time, 95.2% of participantsreported high satisfaction with ambulatory M&M. 85.0%of conference participants reported they were very likelyto or definitely would improve their practice based on theconference.Dissemination: The concept of ambulatory M&M, theSFGH matrix and the experiences at GMC will be sharedat poster presentations and ultimately publication in ahigh-impact educational journal.Training Students As HealthCoaches: Aligning Service andEducationKathy Hamlin, Med 4, UCSF, kathy.hamlin@ucsf.edu;Isabel Edge, Med 4, UCSF, isabel.edge@ucsf.edu;Margo Vener, MD, MPH, UCSF, mvener@fcm.ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Communication, Patient Care,Primary CarePurpose: We trained students as health coaches toexplore a new model for engaging medical students inearly, meaningful clinical experiences andsimultaneously playing a useful role that adds value tothe outpatient team.Background: Health coaching helps patients bettermanage their health and improves care outcomes.Active workplace learning enhances confidence,competence, motivation and professional identityformation. We sought to immerse early students inprimary care teams to achieve workplace learningbenefits while also providing a valuable patient service.By working as health coaches, students gain skill inpatient interaction, communication, and teamparticipation; they also potentially help improve patientcare.Methods: We trained seven first-year students as healthcoaches. Training included communication strategiessuch as ask-teach-ask, closing the loop, action planning,agenda setting, medication reconciliation, and chronicillness education. Students served as coaches atSFGH's Family Health Center. While patients awaitedtheir doctor, students reconciled medications, providedhealth education, and asked about patients’ visitagendas. With patients’ consent, students observed thephysician visit; afterwards students and patients closedthe loop.Evaluation Plan: A Likkert-scale survey wasadministered before and after the elective. Early resultsshow significant (p

UCSF Education Symposium 2013Primary care organizations have embraced theseprinciples, but the formal objectives and evaluationcriteria of the Family & Community Medicine componentof PISCES do not explicitly include them.Methods: The “Longitudinal Management of Patientsand Populations” curriculum is being piloted to thestudents in the PISCES program for the 2012-2013academic year. The students complete: 1) Panelmanagement prevention exercise, 2) a checklist of tasksfor longitudinal management of an individual patient(creating a problem list, reviewing tests and specialists’assessments, communicating with patients via email andtelephone, etc.), and 3) self-audit of chronic diseasemanagement performance. In addition, studentsdocument use of motivational interviewing longitudinallyand practice eco-maps and genograms in order to buildclinician-patient relationships. Four 90 minute seminarsreinforce these activities.Evaluation Plan: Pre and post-course surveys of bothstudents and faculty.Dissemination: We have discussed expanding thisprogram to other clerkships within PISCES. “Inprogress” presentation at Society for Teachers of FamilyMedicine 1/2013Teaching Knot Tying Via theKinesthetic MethodEmily Huang, MD, UCSF,emily.huang2@ucsfmedctr.org; Edward Kim, MD, UCSF,edward.kim@ucsfmedctr.org; Hueylan Chern, MD,UCSF, hueylan.chern@ucsfmedctr.org; PatriciaO'Sullivan, EdD, UCSF osullivanp@medsch.ucsf.edu;Barnard Palmer, MD, UCSF East Bay,bpalmer@acmedctr.org; Brian Cook, UCSF,brian.cook@ucsf.edu; Erik McDonald, UCSF,erik.mcdonald@ucsf.eduAreas abstract covers: GMEDomain(s) addressed: Curricular Innovation,ResidencyPurpose: We developed a kinesthetic, process-orientedcurriculum for teaching surgical knot tying to novices.Background: Knot tying, arguably the most essential ofsurgical skills, has traditionally been taught with anemphasis on spatial configuration rather than kinesthetichandling of the sutures, and most available teachingmaterials reflect this orientation. Based on cognitive taskanalyses of novice performance and skills acquisitionprinciples, we postulated that teaching suture handlingmaneuvers (gathering, sliding, and locking) andemphasizing process over outcome would significantlyimprove novice learning. This principle has wideapplication to surgical education, and we anticipate thatit extends beyond the acquisition of basic skills.Methods: We developed a novel pedagogical methodthat focuses on kinesthetic maneuvers involved in theprocess of knot tying, and produced materials (manual,video) for dissemination. Keys to the method are: explicitdefinitions of maneuvers and knot components, order ofteaching different types of knots, and emphasis onphysical setup.Evaluation Plan: We designed a randomized controlledtrial to determine effects of our curriculum on noviceperformance compared to a standard teaching method.We recruited 74 first year medical students at UCSF andrandomized them to a two-hour knot tying session usingeither the traditional or kinesthetic method. Postinterventionvideos were collected and will be scoredusing a previously validated visual analog scale (VAS).We controlled for practice by collecting practice knots toassess for confounding, and will compare the two groupsusing analysis of covariance with practices knots as acovariate and the VAS score as the dependent variable.Dissemination: An instructor’s manual and video havebeen disseminated via MedEdPORTAL. We continue touse this pedagogical method in the Skills Center atUCSF. We plan to submit results of the randomized trialfor peer review.Out With the Old, In With the New:Exploring New Online LearningPlatforms as Alternatives to theTraditional Course SyllabusKatherine Hyland, PhD, Department of Biochemistry andBiophysics, katherine.hyland@ucsf.edu; Christian Burke,BA, Technology Enhanced Learning,christian.burke@ucsf.edu; Christy Boscardin, PhD,RADMe, Boscardin, BoscardinCK@medsch.ucsf.edu;Chandler Mayfield, BA, Technology Enhanced LearningMayfield@medsch.ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Basic Science Education,Communication, Curricular Innovation, LongitudinalEducational ActivitiesUniversity of California, San Francisco • School of Medicine 17

UCSF Education Symposium 2013Purpose: 1) To pilot a new interactive, inquiry-based,online learning platform developed by Odigia as analternative to traditional syllabi; 2) develop efficient waysfor faculty to collaboratively author learning content; and3) solicit feedback from students on essentialfunctionality of an inquiry-based online learning platform.Background: The Essential Core curriculum is highlyintegrated, with longitudinal themes and disciplines. Amajor challenge is organizing and presenting a widerange of content in a highly structured, yet learner-drivenand engaging format. Emerging educationaltechnologies offer new opportunities to address thischallenge by transforming traditional course syllabi intoan interactive format that students can use throughouttheir medical education.Methods: We are partnering with Odigia on thedevelopment of a web-based learning platform. Weperformed an initial pilot using medical genetics andmolecular biology content in M3 with nine 2nd yearmedical students. A larger pilot is planned utilizingcurriculum ambassadors and EC faculty representinglongitudinal disciplines.Evaluation Plan: We used a 12-question survey with 9students to solicit feedback on perceived benefits of theOdigia platform compared to paper, PDF or other webbasedformats. Students reported benefits from:embedded self-assessments, integrated multimedia,hyperlinked words to definitions, modular organization ofcontent, progress tracking. Students requestedubiquitous accessibility, better annotation capabilities,entire glossary view, and the ability to create flashcards.In the next phase, we will use focus groups and a writtenevaluation tool to evaluate ease of editing capabilitiesand interactive features to determine whether thisplatform can effectively replace course syllabi.Dissemination: Project plans will be shared withcollaborating faculty and at EC curriculum committeemeetings and presented at national education meetings.Curriculum ambassadors will present at the showcase.Remedy at UCSF: A SustainableStudent-Run InitiativeLily Muldoon, UCSF MS 3, UCSF School of Medicine,lily.muldoon@ucsf.edu; Jessica Gould, UCSF School ofMedicine, JGould@ucsf.edu; Jacob Mirsky, UCSFSchool of Medicine, jacob.mirsky@gmail.com; MeggieWoods, UCSF School of Medicine,Meggie.Woods@ucsf.edu; Sharad Jain, MD, UCSFSchool of Medicine, Sharad.Jain@ucsf.edu; HemalKanzaria, MD, UCLA, hemal.kanzaria@gmail.comAreas abstract covers: UMEDomain(s) addressed: Community Medicine, GlobalHealth, Interprofessional EducationPurpose: Remedy at UCSF (R@UCSF), a servicelearningprogram, reduces medical waste and healthdisparities through socially responsible supplyredistribution.Background: The US healthcare system discards 33pounds of medical waste per patient per day. Manyhealth professional students are unaware of themagnitude of this waste and extent of worldwideinequities in health resource distribution.Methods: R@UCSF partners student volunteers fromhealth professional schools with nurses and physiciansworking in under-resourced communities internationally.In collaboration with these communities and UCSFhospital staff, students identify reusable supplies that areoften discarded due to federal regulations or proceduralexcess. Students train staff to place these reusablemedical supplies in 17 collection bins strategicallylocated throughout the hospital. R@UCSF recruitsnursing, medicine, dentistry, and pharmacy studentswho collect, transport, and sort supplies. Students thencoordinate supply redistribution with UCSF staff travelingto in-need clinics, including students on internationalrotations. The hands-on experience exposes students tothe magnitude of medical waste and the potential forinternational redistribution of supplies.Evaluation Plan: Volunteers record the volume andtype of collected supplies. In the past four years,R@UCSF has donated over 26,000 pounds of supplies.From 2010-2012, the organization directly suppliedprojects in over 20 countries.Dissemination: The R@UCSF model can be expandedto other schools and hospitals to recover their unusedsupplies and reduce waste worldwide. To disseminatethis model, we published articles in the Lancet, theDiplomatic Courier and recruited students from otherschools.18 The Haile T. Debas Academy of Medical Educators

UCSF Education Symposium 2013A Home Visit Curriculum to FosterInterprofessional Collaboration andImprove Care Coordination for High-Risk Patients in Trainee Primary CareContinuity ClinicsShalini Patel, MD, SFVA/UCSF, shalini.patel@ucsf.edu;Melissa Bachhuber, MD, SFVA/UCSF,melissa.bachhuber@ucsf.edu; Bridget O'Brien, PhD,UCSF/SFVA, ObrienB@medsch.ucsf.eduAreas abstract covers: GMEDomain(s) addressed: Curricular Innovation,Interprofessional Education, Primary Care, ReflectionPurpose: We developed a home visit curriculum toengage medical and nursing trainees in a shared homevisit experience through which they identify and reflectupon patient safety issues, recognize the importance ofcare coordination and interprofessional communication,and see the impact of home visits on clinical practice.Background: Home visits are an important componentof healthcare delivery to high-risk patients, yet mosttrainees have little experience in home visits on theirprimary care patients.Methods: At the SFVA Primary Care Clinics, tworesident trainees are paired with an NP student practicepartner. Our home visit curriculum extended thiscollaboration by having practice partners conduct jointhome visits. The home visit curriculum included anintroductory home visit session addressing functionalassessment skills and home safety evaluations.Resident and NP student pairs, along with a supervisingpreceptor from medicine or nursing, visited two patientsduring a half-day session. Trainees developedmultidisciplinary care plans for their patients. A groupdebrief session following the home visits provided anopportunity for trainees to reflect upon and discuss carecoordination and patient safety issues.Evaluation Plan: Twenty-one trainees and 9 facultypreceptors participated in the home visit curriculum. Themean rating for overall quality was 4.0 out of 5(n=11);likelihood of changing clinical practice as a result of thesession was 4.5 out of 5(n=10). Analysis of trainees’written reflections (n=15) on lessons learned during thedebrief session highlighted three themes: improvedinsight into patients’ functional status, medication errors,and home safety assessment.Dissemination: We presented the curriculum at SGIMCalifornia (2013) and submitted it to national SGIM. Thecurriculum will be featured in the InterprofessionalEducation Center newsletter.A Primary Care Inter-ProfessionalCase Conference: PromotingInterdisciplinary Learning andAddressing Challenges.Shalini Patel, MD, SFVA, shalini.patel@ucsf.edu;Christina Kim, ANP, SFVA, ; Bridget O'Brien, PhD,UCSF/SFVA, ObrienB@medsch.ucsf.edu; Erick Hung,MD, UCSF EHung@lppi.ucsf.eduAreas abstract covers: GMEDomain(s) addressed: Community Medicine, CurricularInnovation, Interprofessional Education, LongitudinalEducational ActivitiesPurpose: Describe the advantages and challenges ofteaching in an inter-professional educational setting.Discuss how to engage learners at variousdevelopmental levels and in other medical disciplinesand health professions.Background: Internal medicine trainees often train inthe same outpatient clinics as mental health trainees andstudents from other professions (nursing, pharmacy, andsocial work). This abstract presents a model for anambulatory case conference that brings interprofessionaltrainees together to promote crossdisciplinary teaching and learning in a community basedVA clinic that focuses on caring for homelesspopulations.Methods: The model uses a format in which a learnergenerates a question for consultation and presents anoutline of a clinical case. The inter-professional groupthen generates questions for further inquiry and thefacilitator assigns learners to use an evidenced-basedapproach to find answers for each of the questions. Atthe next session, the group reviews the case andquestions and learners present their findings on theirassigned questions. Educators involved in the caseconference facilitate the discussion and provide contextwhen needed.Evaluation Plan: The mean rating on whether traineessaw greater value in discussing patient care plans aspart of an interdisciplinary group as a result of theconference was 5.3 out of 6 (n=12). Trainee commentsUniversity of California, San Francisco • School of Medicine 19

UCSF Education Symposium 2013on evaluations valued the chance to collaborate andinteract with a diverse group about complicated issues.Dissemination: Workshop, SGIM California regionalmeeting, 2/2/13. Submitted to national SGIM meeting.Featured in Interprofessional Education Centernewsletter (in press).Development and Evaluation of anInterprofessional Collaborative CaseConference SeriesMeg Pearson, MD, UCSF, meg.pearson@ucsf.edu;Bridget O'Brien, PhD, UCSF,ObrienB@medsch.ucsf.edu; Rebecca Shunk, MD,UCSF, rebecca.shunk@va.govAreas abstract covers: GMEDomain(s) addressed: Curricular Innovation,Interprofessional Education, Patient Care, Primary CarePurpose: We developed a Collaborative CaseConference (CCC) series to reinforce a culture ofinterprofessional collaboration in primary care throughinteractive, multidisciplinary trainee-led conferences.Background: Interprofessional collaboration (IPC) iswidely recognized as an important part of quality primarycare, but many clinics provide inadequate opportunitiesfor trainees to develop the knowledge, skills, andattitudes needed for IPC. To address this gap, wecreated a series of monthly conferences (CCC) in whichtrainees from multiple health professions participate inan interprofessional discussion about medically andpsychosocially complex patients with the goal ofdeveloping an improved care plan for the patient.Methods: CCC is housed in the SFVAMC Center ofExcellence in Primary Care Education, which trains NPstudents and internal medicine residents to work as partof a Patient Aligned Care Team with professionals andtrainees from nursing, psychology, pharmacy, socialwork and dietetics--all of whom participate in CCC.Each CCC is an hour-long case-based conference.Trainees work closely with a faculty mentor to prepare,including selecting an appropriate patient, creating casewrite-ups and discussion questions, inviting relevantdiscussants, selecting two pertinent articles from theliterature, and creating a facilitation plan to encouragecollaboration among participants. The trainee writes apost-conference care plan detailing innovations thatarose during CCC and completes a 3-month progressupdate.Evaluation Plan: Evaluation of CCC includesobservation of participants’ collaborative behaviors;participants’ ratings of satisfaction with facilitation,educational value, and collaborative nature of theconference; and self-assessments of knowledge, skillsand attitudes related to IPC.Dissemination: Our submission to SGIM is underreview and we plan to submit to Med Ed Portal. We planto scale up CCC to other sites, including SFGH andGlide Memorial clinic.Emergency Medicine Training forHaitian Senior Medical StudentsKenny Pettersen, BS, University of California, SanFrancisco, kenny.pettersen@ucsf.edu; Sarah Ashley,BS, University of California, Davis,seashley@ucdavis.edu; Mathieu Edris, MD, l’Universitéd’Etat d’Haiti, mathieu.edris@yahoo.fr; Marc Johnson,MD, l’Université d’Etat d’Haiti drmcjohnson@yahoo.fr;Margaret Salmon, MD, MPH, University of California,San Francisco, margaret.salmon@ucsf.edu; Jacob Miss,MD, Highland General Hospital, jakemiss@gmail.comAreas abstract covers: UMEDomain(s) addressed: Clinical Instruction andPerformance, Curricular Innovation, Evaluation ofPrograms, Global Health,Purpose: In Haiti, trauma from roadside collisions andnatural disasters is a quickly growing cause of morbidityand mortality. At l’Hopital de l’Université d’Etat d’Haiti(HUEH), Haiti's largest public teaching hospital, medicalstudents in their sixth and final year of training are oftenthe first providers to manage patients as they enter theemergency department in the “critical window” of care.HUEH is a partner with the UC system via the UC HaitiInitiative on several efforts, including the goal ofestablishing a more focused training on emergencymedicine for these front-line Haitian providers.Background: Though little is written on short or longtermemergency medicine training in low-incomecountries, studies of trainings for healthcareprofessionals suggest that focusing on skill-sets andprocedures is most efficacious.Methods: In December, 2012, a five-day pilot workshopwas conducted for twenty-four senior Haitian medical20 The Haile T. Debas Academy of Medical Educators

UCSF Education Symposium 2013students at HUEH. Lectures and skill sessions coveredkey aspects of the primary and secondary traumasurvey. Notable sessions addressed basic airwaymanagement, FAST exam, and suturing skills. Eachstudent received a book and flash drive of coursematerials. Lectures and materials were in French, withhelp from translators when needed. Emergencymedicine physicians from UCSF and Highland GeneralHospital and surgeons from HUEH designed and led thetrainings. Students from HUEH, UCSF, and UCDorganized course logistics.Evaluation Plan: Mean scores for the pre and post-testimproved from 35% to 61% (paired t-test p < 0.0001).Previously validated survey questions on self-perceivedclinical and procedural competency demonstratedsignificant improvement in each subject area andprocedure taught.Dissemination: Social media, uchaiti.org, journals.PRIME-US - SFHIP: A CommunityEngagement Service LearningProjectAisha Queen-Johnson, MSW, UCSF, queenjohnsona@fcm.ucsf.edu;James Rouse-Iniguez, MA,UCSF, rousej@fcm.ucsf.edu; Elisabeth Wilson, MD,MPH, UCSF, ewilson@fcm.ucsf.edu; Paula Fleisher,MA, UCSF pfleisher@fcm.ucsf.edu; Roberto Vargas,MPH, UCSF, rvargas@fcm.ucsf.edu; Randy Quezada,MPP, UCSF, randy.quezada@ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Curricular Innovation,Longitudinal Educational Activities, Research, Other:Community EngagementPurpose: The PRIME-US curriculum has traditionallyincluded one-time community engagement activities.This year, we designed a service-learning course for ourfirst years, partnering with San Francisco HealthImprovement Partnerships (SFHIP). SFHIP is aninnovative program through UCSF’s Clinical andTranslational Science Institute (CTSI) that convenesuniversity, civic, and community based partners tocollaborate on addressing health disparities in SanFrancisco. This course provides students with theopportunity to learn about best practices in communityengagement and to participate in longitudinalcommunity-based activities and partnerships.Background: Service learning is known to reinforcestudent interest in working with underservedcommunities. Longitudinal curricular activities have alsobeen shown to increase student satisfaction and relatedskill sets. By creating a longitudinal service-learningcourse, we hope to create a more robust and meaningfulexperience for our students and community partners. Inaddition, the PRIME-SFHIP partnership reflects theprinciples developed by Community CampusPartnerships for Health (CCPH), a non-profitorganization promoting health equity and social justice.Methods: The course includes both didactic and servicesessions developed jointly with SFHIP. Students aredivided into four working groups, paired with SFHIPnavigators to address specific health disparities.Didactic sessions cover principals of campus-communitypartnership, community assessment, and communitybasedresearch. Service sessions include interviewingstakeholders, aggregating data, conducting literaturereviews, and developing logic models.Evaluation Plan: The course is being evaluated usingpre-post surveys and focus groups for the students.Mid-point focus groups revealed high satisfaction with aneed for increased clarity of course objectives. SFHIPnavigators and community partners will also besurveyed.Dissemination: We plan to submit abstracts to theFamily Community Medicine Colloquium and theCommunity Campus Partnership for Health nationalconference.A Crisis Management Curriculum forMedical Students using Critical EventSimulationNicholas Riegels, MD, Kaiser Oakland,riegelsn@gmail.com; Nardine Saad Riegels, MD, KaiserOakland, nardine.saad@gmail.com; Lindsay Mazotti,MD, Kaiser Oakland, lindsay.a.mazotti@kp.orgAreas abstract covers: UMEDomain(s) addressed: Curricular Innovation,Mentoring, Patient Care, RemediationPurpose: We have launched an individualized, handsonclinical elective for first- and second-year medicalstudents targeting patient care, interpersonal andcommunication skills through one-on-one facultymentorship. Our learner-centered curriculum expandsopportunities in Foundations in Patient Care (FPC) andUniversity of California, San Francisco • School of Medicine 21

UCSF Education Symposium 2013Transitional Clerkship (TC) for self-selected students,and students referred for remediation to develop clinicalskills.Background: While FPC and TC build patient care andcommunication competencies, many pre-clerkshipstudents need additional practice. Students’ learningneeds vary, with some mastering first- and second-yearmilestones early, seeking to expand expertise, andothers requiring more experience to achieve them.Through an individualized tutorial we aim to improvepreparedness for and reduce stress in clerkships, andbuild professional identity for students both at and belowexpected competencies. Our model draws upon “Callfor Reform of Medical School and Residency” (Cooke,Irby & O’Brien, 2010) by individualizing learning,integrating knowledge with clinical experience, andcultivating professional identity.Methods: The elective is open to second-year medicalstudents and spring semester first years. Most studentsself-select; a subset is referred by FPC to remediateclinical competencies. Students create IndividualizedLearning Plans (ILPs). Students spend 4-6 half-daysessions one-on-one with attendings in SFVA’s FacultyHospitalist Group engaged in clinical encountersaddressing their learning goals. After each session,faculty annotate ILPs, providing a dynamic educationalsign-out documenting progress and setting future goals.At course end, students contemplate progress andidentify take-home points.Evaluation Plan: • Faculty annotated ILPs trackprogress on learning goals and identify activities used inskill building. Surveys of enrolled and waitlisted studentsadministered in clerkships will assess differences inpreparedness, professional identity formation, and stressDissemination: We will submit abstracts to SGIM, SHMand AAMC.References: Cooke, M., Irby, D., & O’Brien, B. (2010). Educatingphysicians: A call for reform of medical school and residency. SanFrancisco: Jossey-Bass.Post Graduate Training in GlobalHealth DeliverySriram Shamasunder, MD, UCSF,sshamasund@medicine.ucsf.edu; Phuoc Le, MD, MPH,DTM&H, UCSF, pvl@medicine.ucsf.edu; MadhaviDandu, MD, MPH, UCSFMadhavi.Dandu@ucsfmedctr.org; Marwa Shoeb, MD,UCSF, MShoeb@medicine.ucsf.eduAreas abstract covers: GME, CMEDomain(s) addressed: Global Health, QualityImprovementPurpose: The curriculum based at UCSF and in the fieldaims to: 1) build capacity of American healthprofessionals to be effective in resource poor settings. 2)Improve the capacity of low income countries(LIC) healthsystems and strengthen it through longitudinalinstitutional relationships and quality improvementprojects and 3) Deepen the capacity of local healthprofessionals to care for their population.Background: The authors all have extensive experienceworking in the field in Rwanda, Haiti and India amongmany other countries. Following residency, no formaltraining existed for any of the authors. As medicaleducators familiar with the ACGME competencies forresidency programs, we aimed to adapt thesecompetencies for the global health practitioner. Wewere informed by Association of the Schools of PublicHealth (ASPH), and the Global Health EducationConsortium (GHEC) and the who have all put outcompetency guidelines for Global Health education.Methods: We set out several competencies and areusing both in the field mentorship and classroomdiscussions, as well as small group sessions to help thelearners gain proficiency in these domains. The ACGMEcorrelated competency appears in parenthesis. Thecompetencies include Patient Care in Low ResourceSettings(patient care) Diseases of Poverty inAdults(medical knowledge), CapacityStrengthening(system-based practice) among 8 total.Evaluation Plan: We will have 360 degree evaluationsof our fellows, including an evaluation by colleagues inthe field. / Pre and post fellowship written exam. Essayreflections from the field, monthly. Independentassessment of field QI projectDissemination: Publication of essays from thefield.(One has already been published by a fellow) / Aviewpoint piece describing the need for this training andour fellowship experience(submitted, publicationpending). UC Global Health Day 2013- Workshop onEvaluation22 The Haile T. Debas Academy of Medical Educators

UCSF Education Symposium 2013Making Disease Modeling EducationInfectious: A Teacher-ResearcherPartnership to Bring ComputationalModeling Into the High SchoolClassroom Using the Multi-ParadigmModeling Platform NOVANicolas Sippl-Swezey, BA, UCSF Proctor Foundation,nicolas.sippl-swezey@ucsf.edu; Richard Salter, PhD,UC Berkeley, rmsalter@berkeley.edu; Travais Porco,PhD, MPH, UC San Francisco, Travis.Porco@ucsf.edu;Wayne Getz, PhD, UC Berkeley wgetz@berkeley.edu;Jeanne Appelget, MS, Castilleja School,jappellget@castilleja.orgAreas abstract covers: UME: HS Pre-MedicalDomain(s) addressed: Computers and Technology,Curricular Innovation, Global Health, SimulationPurpose: a) Pilot a self-contained 3-day moduleintroducing principles of infectious disease modeling inhigh school human biology. b) Engage studentsintuitively in a rapid-cycle scientific process to assessglobal infectious disease hypothesis using computationalsimulation data.Background: Two new voluntary national United StatesK12 science education standards, A Framework for K12Science Education and the Next Generation ScienceStandards specify computational modeling as an integralcrosscutting concept, and part of the future vision forAmerican science education. The module was designedcombining two pedagogical architectures for scienceeducation: Understanding By Design and The BiologicalSciences Curriculum Student Five-Es framework.Education specialists and computational modelingexperts at the NIH Office of Science Education and theNIH Modeling of Infectious Disease Agent Study(MIDAS) group supported development.Methods: We designed and piloted a 3-day modulewhere students explored live simulations of in-classepidemics. They then independently researched globalinfectious disease characteristics for tuberculosis,measles, chronic diarrhea, HIV and influenza. In groups,students applied background research to computationalepidemic models. They formulated hypothesis regardingthe affect of disease characteristics such as incubationtime, vaccination rates and transmission probabilities onepidemic frequency, rate and size. They rapidlygenerated large volumes of simulation data andarticulated how their data supported or refuted theirhypothesis.Evaluation Plan: Students provide pilot feedback inwritten evaluations of learning. An online post-lessoncontent retention survey will be developed andadministered.Dissemination: The simulation models used in thelesson are accessible online. The module documents willbe published publicly. Results will be presented at theCalifornia Association of Independent Schools Annualnorthern region conference.Evaluating Discharge Summary asEntrustable Professional Activity(EPA) in Internal Medicine Residency:A Hospitalist-Intern CollaborationHeather Whelan, MD, UCSF/SFVA,hwhelan@medicine.ucsf.edu; Abbi Eastburn, MD,UCSF/SFVA, abigail.eastburn@ucsf.edu; DeniseConnor, MD, UCSF/SFVA, denise.connor@ucsf.edu;Jeff Kohlwes, MD, UCSF/SFVA, jeffrey.kohlwes@va.govAreas abstract covers: GMEDomain(s) addressed: Competencies, CurricularInnovation, Feedback, ReflectionPurpose: Goals: To improve intern abilities in safehospital discharge. Objectives: demonstrate writtenelements of a discharge summary; understand roles ofkey members of the interdisciplinary care team; reviewand accurately reconcile medication list; demonstrateproficiency in navigating the VA health care system toprovide needed services at discharge.Background: Hospital discharge is a high-risk time forpatient safety and requires competency in multipledomains. Interns have generally been expected tocomplete hospital discharges with little formal instructionor feedback. EPA's offer a way to evaluate directlyobserved competence in clinical practice. Creating anEPA requires defining the essential activities of practiceand the expected roles of learners as they develop andgain experience. UCSF’s internal medicine residencyprogram has implemented a discharge summary EPA toexamine intern practice with VA hospitalist supervision.Methods: Each VA ward month, medicine interns meetwith both a hospitalist attending and pharmacist to reflectupon their discharge summary. Feedback focuses onUniversity of California, San Francisco • School of Medicine 23

UCSF Education Symposium 2013provider communication, systems barriers, intern selfefficacyand medical issues that pose challenges to asafe discharge. Comments and learning goals areentered into a standardized template in the intern’sportfolio. The sequential nature of these meetingsallows an assessment of progress towards being“entrustable” in completing hospital discharges.Evaluation Plan: Outcomes will include interns’ selfreportedconfidence in completing safe discharges;knowledge of recommended elements of a dischargesummary, key participants, and critical steps in safehospital discharge.Dissemination: Abstracts will be submitted to SGIM,SHM and APDIM.24 The Haile T. Debas Academy of Medical Educators

UCSF Education Symposium 2013Curriculum Evaluation & Educational Research PostersDeveloping an InterprofessionalTeam-based Observed StructuredClinical Examination (ITOSCE) toEvaluate Patient-CenterednessAlice Ainsworth, BS, Medical Student, UCSF,alice.ainsworth@ucsf.edu; Charlie DeVries, MPH,Medical Sociology, UCSF, charlie.devries@ucsf.edu;Bridget O'Brien, PhD, Assistant Professor, Departmentof Medicine and Office of Research and Development inMedical Education, UCSF, obrienb@medsch.ucsf.edu;Calvin Chou, MD PhD, Professor of Clinical Medicine,UCSF and VAMC SF calvin.chou@ucsf.eduAreas abstract covers: GMEDomain(s) addressed: Assessment and Testing,Communication, Curricular Innovation, StandardizedPatientsPurpose: Our objectives were to (1) design an ITOSCEto evaluate patient-centeredness during providerinteractions with both patients and interprofessionalcolleagues, (2) generate high fidelity standardizedpatient (SP) and standardized interprofessionalcolleague (SI) cases, and (3) compile feedback fromtrainees on the ITOSCE experience.Background: Team-based patient-centered care iscentral to primary care reform. Although healthprofessionals must develop skills in interprofessionalism,we lack methods to evaluate patient-centeredness ininterprofessional encounters.Methods: We modeled 2 SP cases on actual patientswith chronic medical and complex psychosocial issues.One portrayed a homeless veteran with uncontrolleddiabetes; the other was an elderly man with cognitivedysfunction and at-risk alcohol use. We also developed4 SIs (representing nursing, pharmacy, psychology, andsocial work) with whom trainees discussed the SP caseswith SIs. To ensure SI case fidelity, we interviewedrepresentatives from each profession on their scope ofpractice, incorporated interview responses into SItraining, and used trainees from each profession as SIs.As an added challenge, we coached SIs to exhibitsuboptimal patient-centered behaviors. During theITOSCE, 2 nurse practitioner fellows and 4 internalmedicine residents rotated through both SP cases, eachfollowed by case discussions with 3 SIs. After theITOSCE, trainees discussed the experience in focusgroups.Results: Trainees described SP and SI cases asauthentic but found SIs more difficult than typicalinterprofessional interactions. They felt ITOSCE wasadvantageous to practicing patient-centered skillsincluding motivational interviewing and agenda setting.Discussion: We designed an ITOSCE with reasonableface validity. The ITOSCE holds promise as a method toassess trainees’ interactions with patients andinterprofessional colleagues. Next steps include codingboth types of interactions for patient-centered behaviors.We are disseminating at conferences and preparing amanuscript.Reflective Critique: We will modify SP and SI casesbased on focus group feedback.What Really Happens During WardRounds?: A Multisite, ObservationalStudy of Patient Care, Teaching, andBedside BehaviorsAlyssa Bogetz, MSW, University of California, SanFrancisco, alyssa.bogetz@ucsf.edu; Sylvia Bereknyei,DrPH, Stanford University, sylviab@stanford.edu;Bradley Monash, MD, University of California, SanFrancisco, bmonash@medicine.ucsf.edu; StephanieRennke, MD, University of California, San Franciscosrennke@medicine.ucsf.edu; Sara Buckelew, MD,University of California, San Francisco,buckelews@peds.ucsf.edu; Clarence Braddock, MD,Stanford University, cbrad@stanford.edu; JasonSatterfield, PhD, University of California, San Francisco,jsatter@medicine.ucsf.eduAreas abstract covers: UME, GMEDomain(s) addressed: Clinical Instruction andPerformance, Communication, Cultural Competence,Patient CarePurpose: This project measured patient-centeredness,leaner-centeredness, and social and behavioral topicsthat emerged during ward rounds to establish aperformance baseline, capture best practices, andidentify pressing educational needs.University of California, San Francisco • School of Medicine 25

UCSF Education Symposium 2013Background: Hospital rounds are the cornerstone ofclinical teaching and professional identity development,however, learner burnout and patient recidivism aresubstantial. Opportunities to optimize the experience oflearners and patients may be constrained by clinicaldemands, patient census, and a perception that thesocial and behavioral sciences (SBS) are too timeconsuming for inpatient medicine. Little is currentlyknown about the process or content of ward rounds.Methods: N=80 ward teams (40 Med, 40 Peds: 40UCSF, 40 Stanford) were observed during clinicalrounds by a pair of observers. Observers used astructured codesheet to assess patient and learnercenteredness, overall quality, SBS issues that emerged,and best practices/missed opportunities. The codesheetwas based on previously validated tools, expert opinion,and iterative field testing.Results: Rounding teams on average saw 7.8 patientsover 2.1 hours. Learner-centered scores ranged from2.7/5 (discussed goals) to 3.6 (learning climate).Patient-centered scores ranged from 1.9 (elicitingdecision making preferences) to 3.9 (showing respect).Global ratings ranged from 3.6/5(responsiveness) to 3.8(listening). Faculty-led rounds had higher qualityteaching than resident-led rounds. At least one SBStopics emerged in 51.3% of bedside patient encounterswith health behaviors being the most common. Qualitysuffered with larger team size and patient census.Discussion: We used structured observations to assesscurrent teaching and patient care practices on wardrounds. Findings from this study will shape newinpatient curricula to improve learner/patientcenteredness and SBS coverage.Reflective Critique: Feedback was received from theAssociation American of Medical Colleges, Society forGeneral Internal Medicine, American PsychologicalAssociation and local faculty development workshops.Results have been discussed with the medicine andpediatrics departments.Help Me Help Myself: StudentAttitudes About Self-DirectedLearning Tools in Core ClerkshipsLaura Cantino, MSIV, UCSF School of Medicine,laura.cantino@ucsf.edu; H. Carrie Chen, MD, MSEd,UCSF Department of Pediatrics,ChenHC@peds.ucsf.edu; Julie Lindow, MA, UCSFDepartment of Obstetrics, Gynecology and ReproductiveSciences, LindowJ@obgyn.ucsf.edu; Patricia Robertson,MD, UCSF Department of Obstetrics, Gynecology andReproductive Sciences robertsonp@obgyn.ucsf.edu;Arianne Teherani, PhD, UCSF Department of Medicine,Teherani@medsch.ucsf.edu; Robert Daroff, MD, UCSFDepartment of Psychiatry, Robert.Daroff@va.gov; VanjaDouglas, MD, UCSF Department of Neurology,Vanja.Douglas@ucsf.edu; Karen Hauer, MD, UCSFDepartment of Medicine, khauer@medicine.ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Clinical Instruction andPerformance, Feedback, Longitudinal EducationalActivitiesPurpose: To evaluate student attitudes about andengagement with self-directed learning tools in coreclerkships.Background: Self-directed learning is a necessary skillfor trainees and practicing physicians to reflect on theirperformance, incorporate feedback and set improvementgoals. In 2011-12, the Medicine, Pediatrics, Ob/Gyn,Psychiatry and Neurology core block clerkshipsintroduced individualized learning plans (ILPs) andfeedback from faculty or residents using the BriefStructured Clinical Observation (BSCO) tool.Methods: Participating students received an end-of-year33-item paper survey. Primary outcomes were attitudesabout the ILP and BSCO tools and engagement asmeasured by timing of ILP completion. Investigatorscoded survey comments using content analysis.Results: The survey response rate was 76% (152/200),representing 119 students. Students completing the ILPat the beginning of the clerkship, as instructed, reportedgreater value for their learning (26% of students,mean=3.32, SD=0.98 on 5-point Likert scale) than thosewho completed it at the middle of the clerkship (25%,2.72/1.10) or at the end (46%, 2.05/1.08), p

UCSF Education Symposium 2013satisfaction. However, comments reveal complexstudent attitudes about self-directed learning tools anddesire for meaningful integration into the curriculum.Reflective Critique: Cross-disciplinary collaborationenhanced the project. Conversion of the survey fromelectronic to paper format improved response rate. Weplan to present a manuscript draft at Escape.Learning the Ropes Together:“Workplace Learning Communities”in the Third Year of Medical SchoolCalvin Chou, MD, PhD, UCSF, VAMC SF,calvin.chou@ucsf.edu; Arianne Teherani, PhD, UCSF,Office of Medical Education, teherani@medsch.ucsf.edu;Dylan Masters, BA, UCSF, School of Medicine,dylan.masters@ucsf.edu; Margo Vener, MD, UCSF,SFGH mvener@fcm.ucsf.edu; Maria Wamsley, MD,UCSF, Maria.Wamsley@ucsf.edu; Ann Poncelet, MD,UCSF, ann.poncelet@ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Clinical Instruction andPerformance, Curricular Innovation, LongitudinalEducational ActivitiesPurpose: We sought to determine how studentsdescribed their peer groups as communities thatencompassed characteristics of both workplace learningand learning communities, and to explore how theirexperiences in different clerkship models characterizedtheir learning.Background: When students move from the classroominto clinical practice environments, their roles andlearning challenges shift dramatically. Learningcommunities that students inhabit in their first two yearsdissipate in favor of immediate workplace learning thatoccurs in clinical settings. We have constructed severaldifferent clerkship program models with continuity(CMCs) to help medical students transition to anddevelop throughout the clerkship year.Methods: We randomly assigned students in traditionalblock clerkships and CMCs to complete a survey ofopen-ended questions based on one of two frameworks:workplace learning or learning communities. Weconducted qualitative content analysis to characterizestudents’ experiences and match overlapping themes.Results: Students in all programs highlightedoverlapping characteristics of both workplace learningand learning communities. Students in CMCs morefrequently mentioned themes about regular meetings,teamwork, confiding in each other, comparingthemselves with their peers in the workplace, methods ofenabling patient continuity, and means of obtainingimportant clinical experiences and improving efficiency.Discussion: Students learn the ropes of the clerkshipsthrough important peer-to-peer social learning networks,which we term workplace learning communities. Inthese communities, peers provide accessible, real-time,and relevant resources to help each other navigatetransitions, clarify roles and tasks, manage interpersonalchallenges, and decrease isolation. Medical schools cansupport the formation and functioning of these clinicallybasedlearning communities through the structure of theclerkship year by incorporating continuity with peers.Reflective Critique: We have submitted this work forconsideration at both AERA and at AAMC-RIME; wehave incorporated feedback from the AERA submissionprocess into the abstract.Two Years of Experience Embedding“Becoming the Patient” into the“Foundations of Patient Care” courseat UCSFAdan Garcia-Mecinas, University of California, Berkeley,adan.garciamecinas@yahoo.com; Joe Mendez, MD,Barnes-Jewish Hospital; Heather Bennett, MD,University of California, San Francisco; Amin Azzam,MD, MA, University of California, San Francisco Schoolof Medicine, Amin.Azzam@ucsf.eduAreas abstract covers: GME, CMEDomain(s) addressed: Communication, Competencies,Professionalism, Quality ImprovementPurpose: We created the “Becoming the Patient”curricular module to promote professionalism andawareness around medical illness and disability amonghealth professionals. The module includes: 1)introduction, 2) personal reflection exercise, 3) videointerviews of UCSF-affiliated medicalstudents/physicians discussing their personal illness ordisability journeys, and 4) discussion of the interviewthemes.Background: Medical illness and disability are prevalentin the medical provider community, yet significant stigmasurrounding physicians as patients remains. In 2011, weUniversity of California, San Francisco • School of Medicine 27

UCSF Education Symposium 2013piloted a facilitated 2-hour MS-1 “Becoming the Patient”small group session at UCSF. In 2012, scheduleconflicts necessitated splitting the content across twodifferent split-half sessions (e.g. the two hours wereseparately presented in one hour segments abutting twoother one-hour curricular elements). We assessed theimpact of “Becoming the Patient,” both as a single andtwo-part session.Methods: Students completed paper-based evaluationsimmediately after the session(s). Both the 2011 and2012 surveys included twelve Likert items to assessmodule effectiveness; the 2012 survey added threeopen-ended questions evaluating the impact of the splithalftwo-part structure. There were 135 respondents in2011 and 100 in 2012.Results: Most students agreed or strongly agreed thatthe curricular module enhanced their appreciation for“the presence of medical illness and disability within themedical community” (88% in 2011 vs. 80% in 2012).However, we were less successful in teaching medicalstudents how to “locate articles and resources availablefor professionals with illness or disability” (48% stronglydisagreed/disagreed in 2011 vs. 31% in 2012).Discussion: In two consecutive years, medical studentsdo not feel competent in their abilities to “locate articlesand resources available for professionals with illness ordisability.” Therefore, we intend to modify the module tobetter emphasize this aspect of the intended objectives.Reflective Critique: “Becoming the Patient” is aneffective curricular module in promoting professionalismand awareness around medical illness and disabilityamong health professionals, but can be improved tobetter assist students’ abilities locating articles andresources available for professionals with illness ordisability.The Effect of Resident Duty-hoursRestrictions on Internal MedicineClerkship Experiences: A Survey ofClerkship DirectorsKaren Hauer, MD, University of California SanFrancisco, khauer@medicine.ucsf.edu; ChristyBoscardin, PhD, University of California San Francisco,BoscardinCK@medsch.ucsf.edu; Dario Torre, MD, MPH,PhD, Drexel University College of Medicine,Dario.Torre@DrexelMed.edu; Jennifer Kogan, MD,Perelman School of Medicine at the University ofPennsylvania, Jennifer.Kogan@uphs.upenn.eduAreas abstract covers: GMEDomain(s) addressed: Patient Care, ResidencyPurpose: To examine internal medicine clerkshipdirectors’ perceptions of the effects of current residentduty-hours regulations on students’ experiences withteaching, feedback and evaluation, and patient care.Background: Medical students receive much of theirclerkship teaching from residents. The 2011Accreditation Council for Graduate Medical Education(ACGME) duty-hours restrictions for residents changethe inpatient team structure and represent a majorchange to the learning environment for medical students.Methods: The Clerkship Directors in Internal Medicine(CDIM) annual survey queried members about 2011duty-hours regulations just before (2011) and after(2012) implementation. Twenty-four survey itemsaddressed perceptions of the effect of resident dutyhoursregulations on students (1-5 Likert scale, where5=strongly agree that this item is greater with newregulations). We calculated descriptive statistics andconducted factor analysis to identify the effects of dutyhoursrestrictions on students. We compared 2011 and2012 results using paired sample t-tests.Results: The 2011 survey response rate was 73%(85/113 institutions); in 2012 it was 82% (99/121).Respondents perceived negative effects of duty-hoursregulations on students in both years related to teachingand feedback, students’ experience of continuity,transfers of patient care, teaching enthusiasm, andhousestaff time for teaching (all means < 3.0). In 2012,respondents more strongly perceived that duty-hoursregulations made evaluating students’ clinical skills moredifficult (p=.004) and encroached on students’ patientcare experiences more than had been anticipated in2011 (p=

UCSF Education Symposium 2013(http://www.acgme.org/acgmeweb/GraduateMedicalEducation/DutyHours.aspx). Accessed January 29, 2013. 2. Nasca TJ, Day SH, AmisES Jr; ACGME Duty-hours Task Force. The new recommendations onduty-hours from the ACGME Task Force. N Engl J Med. 2010;363:e3.3. Kogan JR, Pinto-Powell R, Brown LA, Hemmer P, Bellini LM, PeltierD. The impact of resident duty-hours reform on the internal medicinecore clerkship: Results from the Clerkship Directors in InternalMedicine survey. Acad Med. 2006;81:1038-1044. 4. White CB, HaftelHM, Purkiss JA, Schigelone AS, Hammoud MM. Multidimensionaleffects of the 80-hour work week at the University of Michigan MedicalSchool. Acad Med. 2006;81:57-62. 5. Mazotti LA, Vidyarthi AR,Wachter RM, Auerbach AD, Katz PP. Impact of duty-hour restriction onresident inpatient teaching. J Hosp Med. 2009;4:476-480. 6. Brasher,AE, Chowdhry, S, Hauge, LS, and Prinz, RA. Medical students’perceptions of resident teaching. Have duty hours regulations had animpact? Ann Surg. 2005;242:548-555. 7. Jagsi R, Shapiro J,Weinstein DF. Perceived impact of resident work hour limitations onmedical student clerkships: a survey study. Acad Med. 2005;80:752-757. 8. Nixon LJ, Benson BJ, Rogers TB, Sick BT, Miller WJ. Effectsof Accreditation Council for Graduate Medical Education work hourrestrictions on medical student experience. J Gen Intern Med.2007;22:937-941. 9. Jagsi R, Shapiro J, Weissman JS, Dorer DJ,Weinstein DF. The educational impact of ACGME limits on residentand fellow duty-hours: a pre-post survey study. Acad Med. 2006;81:1059-1068. 10. Kashner TM, Henley SS, Golden RM, Byrne JM,Keitz SA, Cannon GW, Chang BK, Holland GJ, Aron DC, MuchmoreEA, Wicker A, White H. Studying the effects of ACGME duty-hourslimits on resident satisfaction: results from VA learners’ perceptionssurvey. Acad Med. 2010;85:1130-1139. 11. Dornan T, Boshuizen H,King N, Scherpbier A. Experience-based learning: a model linking theprocesses and outcomes of medical students' workplace learning. MedEduc. 2007;41:84-91. 12. Hirsh D, Ogur B, Thibault G, Cox M."Continuity" as an organizing principle for clinical education reform. NEngl J Med. 2007;356:858-866. 13. Hauer KE, Hirsh D, Ma I, HansenL, Ogur B, Poncelet AN, Alexander EK, O'Brien BC. The role of role:learning in longitudinal integrated and traditional block clerkships. MedEduc. 2012;46:698-710. 14. Fletcher KE, Saint S, Mangrulkar RS.Balancing continuity of care with residents' limited work hours: definingthe implications. Acad Med. 2005;80:39-43. 15. Reed DA, Levine RB,Miller RG, Ashar BH, Bass EB, Rice T, Cofrancesco J Jr. Impact ofduty hour regulations on medical students' education: views of keyclinical faculty. J Gen Intern Med. 2008;23:1084-1089.16. Schumacher DJ, Slovin SR, Riebschleger MP, Englander R, HicksPJ, Carraccio C. Perspective: beyond counting hours: the importanceof supervision, professionalism, transitions of care, and workload inresidency training. Acad Med. 2012;87:883-888. 17. Shea JA, WillettLL, Borman KR, et al. Anticipated consequences of the 2011 dutyhours standards: views of internal medicine and surgery programdirectors. Acad Med. 2012;87:895-903. 18. IBM SPSS Statistics forWindows, Version 21.0. IBM Corp. Released 2012. Armonk, NY: IBMCorp. 19. Kogan JR, Bellini LM, Shea JA. The impact of resident dutyhour reform in a medicine core clerkship. Acad Med. 2004;79:S58-61.20. Wang KE, Fitzpatrick C, George D, Lane L. Attitudes of affiliatefaculty members toward medical student summative evaluation forclinical clerkships: a qualitative analysis. Teach Learn Med. 2012;24:8-17. 21. Howley LD, Wilson WG. Direct observation of students duringclerkship rotations: a multiyear descriptive study. Acad Med.2004;79:276-280. 22. Harrison R, Allen E. Teaching internal medicineresidents in the new era. Inpatient attending with duty-hour regulations.J Gen Intern Med. 2006;21:447-452. 23. Walters L, Greenhill J,Richards J, Ward H, Campbell N, Ash J, Schuwirth LW. Outcomes oflongitudinal integrated clinical placements for students, clinicians andsociety. Med Educ. 2012;46:1028-1041. 24. Kogan JR, Holmboe ES,Hauer KE. Tools for direct observation and assessment of clinical skillsof medical trainees: a systematic review. JAMA. 2009;302:1316-1326.25. Hemmer PA, Pangaro LP. The effectiveness of formal evaluationsessions during clinical clerkships in better identifying student withmarginal funds of knowledge. Acad Med. 1997;72:641-643. 26. LangVJ, Mooney CJ, O'Connor AB, Bordley DR, Lurie SJ. Associationbetween hand-off patients and subject exam performance in medicineclerkship students. J Gen Intern Med. 2009;24:1018-22. 27. YardleyS, Brosnan C, Richardson J. The consequences of authentic earlyexperience for medical students: creation of mētis. Med Educ.2013;47:109-119. 28. Piderit SK. Rethinking resistance andrecognizing ambivalence: A multidimensional view of attitudes towardan organizational change. Acad Manage Rev. 2000;25;783-794.29. Auger KA, Landrigan CP, Gonzalez del Rey JA, Sieplinga KR,Sucharew HJ, Simmons JM. Better rested, but more stressed?Evidence of the effects of resident work hour restrictions. Acad Pediatr.2012;12:335-343. 30. Pellegrini VD Jr. Perspective: ten thousandhours to patient safety, sooner or later. Acad Med. 2012;87:164-167.31. Ratanawongsa N, Bolen S, Howell EE, Kern DE, Sisson SD,Larriviere D. Residents' perceptions of professionalism in training andpractice: barriers, promoters, and duty hour requirements. J Gen InternMed. 2006;21:758-763. 32. Kotter JP. Leading Change. Boston, Mass:Harvard Business School Press; 1996. 33. Friedell ML, Farley D,Brothers T, Nadzam G, Jarman BT. Strategies for the 2011 duty-hoursrestrictions. J Surg Educ. 2011;68:502-512.Cost Analysis of Virtual RealityPhacoemulsification Simulation inOphthalmology Training ProgramsEugene Lowry, BA, University of California, SanFrancisco, gene.lowry@ucsf.edu; Ayman Naseri, MD,University of California, San Francisco,ayman.naseri@va.govAreas abstract covers: GMEDomain(s) addressed: Computers and Technology,Curricular Innovation, Residency, SimulationPurpose: To investigate the cost-savings generated bythe Eyesi ophthalmic surgical simulator (manufacturedby VRMagic, Mannheim, Germany) in operating room(OR) time-savings and determine the savings-adjustedprice of the simulator.Background: Increasing numbers of US ophthalmologyresidencies are adopting virtual reality simulation as partof their surgical training curricula. This technology isbecoming sufficiently popular that the national VHASimLEARN project is investigating its potential bestuses. The current literature is inconclusive on the safetyeffects of this simulator but has found a significantreduction in OR case length (1-3). These time savingshave not previously been quantified to determine theadjusted cost of simulation technology.Methods: We perform a cost analysis modeling ahypothetical residency program with 2-9 residents over 5to 10 years of simulator use life. Savings were deductedfrom the purchase price of the Eyesi unit to determinethe effective cost, and a sensitivity analysis wasconducted varying uncertain input variables by 50%.University of California, San Francisco • School of Medicine 29

UCSF Education Symposium 2013Results: Number of residents in a training program hasthe largest potential impact on cost-savings associatedwith Eyesi simulation technology. OR time-savings arelikely to reduce the price of a simulator for an averageresidency by $10,674 to $19,882 at 5 and 10 years ofuse. For the largest residencies, simulation maygenerate $103,763 in OR time-savings leading to anadjusted machine cost of just under $50,000.Discussion: OR time-savings associated with virtualreality simulation may significantly reduce purchaseprice, especially for large residencies. Smallerresidencies may benefit from Eyesi simulator sharing toachieve economies of scale. Further investigation intoimproved safety and qualitative effects may quantifyadditional value of this simulator.Reflective Critique: We received feedback on theimportance of potential reductions in vitreous loss rateswith virtual reality simulation. We do not include it in theanalysis here due to lack of supporting evidence, butwould like to investigate changes in complication rates atUCSF after adoption of this technology to add to theeffectiveness literature.References: 1) Belyea DA, Brown SE, Rajjoub LZ. Influence of surgerysimulator training on ophthalmology resident phacoemulsificationperformance. J Cataract Refract Surg. 2011;37(10):1756-1761. 2) Pokroy R,Du E, Alzaga A, et al. Impact of simulator training on resident cataractsurgery. Graefes Arch Clin Exp Ophthalmol. 2012. 3) Watts C, Oetting TA.Surgical simulator improves early resident learning curve for cataract surgery.Association of University Professors of Ophthalmology, Annual Meeting[Miami, FL]. Jan 25, 2012.How Do We Evaluate Our Learners’Reflective Ability? A Comparison ofTwo Reflection RubricsRebecca Miller, BS, UCSF, rebecca.miller@ucsf.edu;Patricia S. O'Sullivan, EdD, UCSF,OSullivanP@medsch.ucsf.edu; Louise Aronson, MD,MFA, UCSF, aronsonl@medicine.ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Assessment and Testing,Reflection, ResearchPurpose: To compare the performance and practicalusage of two major rubrics reflection rubrics to informresearchers and educators.best practices for evaluating learners’ reflective ability.Two medical education research groups have developedrubrics, distinct in structure and approach. Reflection-on-Action is holistic, assigning a single level, and basedsolely in reflection theory. REFLECT is analytic, withfive items, and draws from both reflection and narrativemedicineliteratures. Our study compared theperformance and practical usage of these rubrics tomake recommendations to researchers and educators.Methods: 149 3rd-year UCSF medical students wrotereflections in response to identical prompts. Halfreceived structured guidelines on reflection. Trainedraters scored 56 reflections, 28 from each group.Training on Reflection-on-Action took two hours; tworaters attained an interrater-reliability=0.91. REFLECTrequired six hours; three raters achieved an interraterreliability=0.84.We used Pearson correlation coefficientsto associate overall rubric scores and for subsections ofREFLECT, and t-tests to compare structured andunstructured reflections.Results: Reflection-on-action scores ranged from 0-6(possible range 0-6, mean=3.15, SD=1.23). REFLECTaverage scores ranged from 1.47-3.77 (possible range1-4, mean=2.71, SD=0.47). Overall correlation of the tworubrics was 0.53. Correlation of the holistic Reflectionon-Actionscore to individual REFLECT items rangedfrom 0.64 (presence) to 0.85 (emotion). Students givenstructured guidelines scored significantly higher (p

UCSF Education Symposium 2013Residents as Teachers: How Do TheyCompare to Attendings?David M. Naeger, MD, UCSF Dept of Radiology andBiomedical Imaging, David.Naeger@ucsf.edu; ChadWilcox, MA, UCSF Dept of Radiology and BiomedicalImaging, cwilcox1@mix.wvu.edu; Andrew Phelps, MD,UCSF Dept of Radiology and Biomedical Imaging,Andrew.Phelps@ucsf.edu; Karen Ordovas, MD, UCSFDept of Radiology and Biomedical ImagingKaren.Ordovas@ucsf.edu; Emily M. Webb, MD, UCSFDept of Radiology and Biomedical Imaging,Emily.Webb@ucsf.eduAreas abstract covers: UME, GMEDomain(s) addressed: Evaluation of Programs,Mentoring, ResidencyPurpose: In the setting of a fourth year radiologyelective, to retrospectively compare medical studentevaluations of radiology resident lectures compared tolectures of radiology faculty.Background: Educating medical students is a coremission of academic radiology departments. In someprograms, residents participate in student teaching. Thispractice is often driven by eager residents, the desire toteach residents how to teach, and in some departmentsacross the country, the need to fill teaching gapsresulting from limited faculty teaching time. It is unclearhow resident lectures are perceived compared tolectures from attending faculty.Methods: Numerical evaluations of lectures given byfaculty, fellows, and residents were collected over a oneyear period as part of routine course evaluations for afourth year medical student radiology elective. Thelecture scores were compared, overall with an ANOVAtest and pair-wise with a student t-test. A pre-defined lowp-value threshold was used for the t-tests to account forthe multiple comparisons. To account for the inherentclustering of the data due to repeat lecturers, the datawere re-analyzed on a “per lecturer” basis.Results: 307 individual lecture scores were collected.There was no statistical difference between the lecturescores received by attending faculty (mean 9.10 on ascale of 10) and residents (8.99/10), p = 0.08. Fellows,however, scored statistically significantly lower (8.45/10)than attendings and residents (p

UCSF Education Symposium 2013Results: 94% and 95% of 4th and 1st year studentsreported they “enjoyed” or “really enjoyed” the near-peerteaching experience. 82% of 4th years perceivedimprovement in their teaching skills and an increase intheir knowledge of the subject matter. Only 47% of the4th years thought they were “helpful” or “very helpful,”though 89% of the 1st years thought their 4th year coinstructorsas “helpful” or “very helpful.”Discussion: A novel “near-peer” program of 4th yearmedical students co-instructing 1st year students waspiloted. All participants enjoyed the experience, andfourth years thought the session was educational forthem as well. Although most 4th years did not judgethemselves as overly helpful, most 1st year studentsoverwhelming considered them helpful.Reflective Critique: This project was designed in ahighly collaborative manner. We hope to discuss theproject further during the Educational Symposium, andaim to submit this to a peer-reviewed journal.Visions of the Ideal Medical Student:Impressions From LongitudinalIntegrated and Block ClerkshipExperiencesBridget O'Brien, PhD, UCSF, bridget.obrien@ucsf.edu;David Hirsh, MD, Harvard Medical School,dhirsh@challiance.org; Ed Krupat, PhD, HarvardMedical School, ed_krupat@hms.harvard.edu; JoanneBatt, BA, UCSF jbatt@medicine.ucsf.edu; Lori Hansen,MD, University of South Dakota Sanford School ofMedicine, lhansen@yanktonmedicalclinic.com; AnnPoncelet, MD, UCSF, ann.poncelet@ucsf.edu; KarenHauer, MD, UCSF, khauer@medicine.ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Clinical Instruction andPerformance, Longitudinal Educational ActivitiesPurpose: This study examines students’ andsupervisors’ perceptions of the ideal student in block(BC) or longitudinal integrated clerkships (LIC) as a wayof exploring the messages students glean from theirclerkship experiences and supervisors’ contributions tothese messages.Background: Sociocultural influences during the coreclerkship year shape students’ self-perceptions, valuesand potentially professional identity. Experiences in BCsand LICs may encourage and reinforce different valuesand behaviors.Methods: In this qualitative study, research assistantsinterviewed 48 third-year students from three UnitedStates medical schools. Half the students participated inBCs, the other half in LICs. Students completedinterviews in which they described the ideal student intheir clerkship. Using phenomenographic techniques, theauthors identified five profiles of the ideal student andcoded each student’s description for alignment withthese profiles. Students’ clinical supervisors (9 block, 17LIC) also provided descriptions of the ideal student,which were coded and compared to students’descriptions.Results: The majority of students in both modelsdescribed an ideal student who fit the learner profile(pro-active, self-directed, improvement-oriented).Differences between models appeared early and lateyearas more block students described an ideal studentas a team player (working well with others) andperformer (appearing knowledgeable and competent)while more LIC students described an ideal student as acaregiver (caring for, engaging with, and advocating forpatients). Although supervisors’ descriptions of the idealshowed patterns similar to students in their respectiveclerkship models, they less commonly emphasizedcaregiving.Discussion: Students’ descriptions of the ideal studentin block and LIC models revealed differences consistentwith experiences that have been reported for eachmodel. These findings suggest implications for students’motivations and emerging professional identities.Reflective Critique: We presented the study at ESCapeand received invaluable feedback which we havealready incorporated into our manuscript.Development and Implementation ofan Interprofessional StandardizedPatient AssessmentSandra Oza, MD, Department of Medicine, University ofCalifornia, San Francisco School of Medicine,sandra.oza@ucsfmedctr.org; Christy Boscardin, PhD,Department of Medicine, University of California, SanFrancisco School of Medicine,BoscardinCK@medsch.ucsf.edu; Maria Wamsley, MD,Department of Medicine, University of California, SanFrancisco School of Medicine,maria.wamsley@ucsf.edu; Aimee Sznewajs, RN, NP,32 The Haile T. Debas Academy of Medical Educators

UCSF Education Symposium 2013MD, Department of Pediatrics, University of California,San Francisco School of MedicineAimee.Sznewajs@ucsf.edu; Karen Hauer, MD,Department of Medicine, UCSF School of Medicine,khauer@medicine.ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Assessment and Testing,Interprofessional Education,Purpose: Develop and implement an interprofessionalstandardized patient (SP) assessment for medicalstudents.Background: The World Health Organization (WHO)identifies interprofessional collaborative practice as ameans to improve the quality of patient care inincreasingly complex care systems (1). Interprofessionallearning assessments can determine readiness forinterprofessional interactions and simultaneouslyhighlight the importance of interprofessional practice tostudents.Methods: Four authors representing medicine andnursing developed an interprofessional SP case, “VL,”for four schools during the 2012 California ClinicalPerformance Examination. An interprofessional teamparticipated during all stages of case development andactor training. The student is tasked with collaboratingwith a standardized nurse (SN) to gather information andinitiate a diagnostic and management plan. Studentassessment is based on two checklists: a 29-item SPchecklist (2) and an 11-item SN checklist targetinginterprofessional practice competencies (3). Studentsurveys of interprofessional self-efficacy andexperiences were also collected.Results: Eighty-eight percent (464/530) of studentstaking the exam consented to study inclusion. Of apossible 100%, the mean overall performance scores(SD) across all sites was 74.65(9.31) on the SPchecklist, and 79.57(14.12) on the SN checklist.Analyses exploring relationships between performancescores, interprofessional curricula across sites, studentself-efficacy and interprofessional experiences areongoing.Discussion: Our interprofessional SP case was feasiblein a high-stakes clinical skills exam, and demonstratedthat SP assessments can be adapted to evaluateinterprofessional competency. Ongoing analyses offactors associated with interprofessional performancecan inform future curriculum development in IPE.Reflective Critique: Nursing feedback during actortraining highlighted an unrealistic aspect of the nursingrole that has been revised to more accurately capturetheir professional practice. Informal student feedbackcollected after the exam prompted modifications toensure smoother implementation during future exams.References: 1. World Health Organization (2010).http://whqlibdoc.who.int/hq/2010/WHO_HRH_HPN_10.3_eng.pdf. 2.Makoul G. Patient Educ Couns 2001; 45:23. 3. Interprofessional EducationCollaborative Expert Panel (2011). http://www.aacn.nche.edu/educationresources/ipecreport.pdf.The Surgical Clerkship and MedicalStudent Performance in aStandardized Patient Case with AcuteCholecystitisRobert Tessler, BM, UCSF School of Medicine,robert.tessler@ucsf.edu; Karen E. Hauer, MD, USCFDepartment of Medicine, khauer@medicine.ucsf.edu;Andrew Leavitt, MD, UCSF Departments of Pathologyand Laboratory Medicine, LeavittA@labmed2.ucsf.edu;Bernie Miller, BA, UCSF School of Medicine ClinicalSkills MillerB@medsch.ucsf.edu; John Maa, MD, UCSFDepartment of Surgery, John.Maa@ucsfmedctr.orgAreas abstract covers: UMEDomain(s) addressed: Clinical Instruction andPerformance, Standardized PatientsPurpose: To determine third-year medical students’skills in assessing a patient with acute abdominal pain,including performance of key data gathering andinformation sharing tasks.Background: The third year surgical clerkship is theprinciple opportunity for medical students to learn aboutsurgical disease and treatment during medical school. Atthe University of California, San Francisco School ofMedicine in 2012, the mini-Clinical Performance Exam(mini-CPX) included a case of surgical disease to assessstudents’ performance of key steps in evaluation andmanagement of the acute abdomen.Methods: In October 2012, 173 third-year UCSFmedical students participated in the mini-CPX. A surgicalcase involved a man with acute abdominal pain due tocholecystitis secondary to sickle cell disease. A keyobjective of the mini-CPX exercise was for students torecognize the severity of illness in this patient, asreflected in his elevated white blood cell count, fever andMurphy’s sign, and recommend admission to theUniversity of California, San Francisco • School of Medicine 33

UCSF Education Symposium 2013hospital. Standardized patients used checklists to ratestudent performance of expected history taking, physicalexam, information sharing and communication. Studentsalso answered questions in an inter-station exercise toprobe their thought process and analysis of pertinentfindings and differential diagnosis.Results: Overall, 55.5% failed to recommend admission,58.4% did not explain the relation of hemolytic diseaseto acute cholecystitis to the patient, and 88.7% did notask to perform a rectal exam.Discussion: Over half of the students did not performkey physical exam and counseling items for a patientwith an acute abdomen. Students’ performance in themini-CPX revealed specific areas for improvement inmedical student evaluation of the patient with acuteabdominal pain. Further data analysis will determinewhether completion of Surgery 110 has a favorableimpact on the mini-CPX as demonstrated by improvedperformance in the standardized patient checklist. Wewill also evaluate responses on the interstation exerciseto understand students’ approaches and clinicalreasoning in evaluating the patient with acute abdominalpain.Reflective Critique: As educators, we hope to useinformation from this study to enhance the curriculum forstudents, thereby better preparing them to evaluate,diagnose, and manage patients with acute surgicaldisease.Impact of a Workshop andIndividualized Coaching on PediatricProvider Skillfulness in MotivationalInterviewingAmy Whittle, MD, UCSF, Whittlea@peds.ucsf.edu;Jennifer Hettema, PhD, University of Virginia,JEH7DV@hscmail.mcc.virginia.edu; Jennifer Manuel,PhD, UCSF, jennifer.manuel@ucsf.edu; EileenMcCormick, BA, UCSF mccormicke@php.ucsf.edu;Carrie Cangelosi, MSW, SFGH,carrie.cangelosi@sfdph.org; Sarah De La Cerda, MSW,SFGH, sarah.delacerda@sfdph.org; Matt Tierney, PNP,UCSF, mtierney@ucsf.edu; Paula Lum, MD, MPH,UCSF, plum@php.ucsf.eduAreas abstract covers: CMEDiscussion: A single half-day training plus a coachingcall can change and maintain provider fidelity to MI. Theresults of the study were presented at the AcademicDomain(s) addressed: Communication, FacultyDevelopment, Standardized PatientsPurpose: We investigated whether an MI workshop plusa single individualized coaching call could improveproviders’ MI performance in standardized patient (SP)interviews.Background: Motivational interviewing (MI) is anevidence-based method for promoting behavior changein adult and pediatric populations. MI uses a guidingstyle to address ambivalence and draw out a person’sown arguments for change. MI is a complex skill thattakes practice and feedback to develop. Individualcoaching is one technique that could enhance MItraining.Methods: Pediatric providers completing a 4-hour MItraining as part of a departmental retreat were invited toparticipate in a curriculum evaluation. Providerscompleted baseline assessments with a telephonebasedSP, attended the training, received a 1-weekfollow-up SP call (FU1), participated in an optionalcoaching call to receive feedback on FU1, andcompleted a 2-month FU2. Interviews were coded usingthe Motivational Interviewing Treatment Integrity scale3.1.1. Paired samples t-tests were used to investigatethe significance of changes from baseline to each followuppoint. In addition, because of concerns regarding lowpower from small sample size, unbiased estimators ofeffect size, d, were calculated.Results: 11/22 (50%) of invited providers completed thebaseline SP call and attended the training. All wereretained at FU1, 8/11 (73%) completed a coaching call,and 7/11 (64%) completed FU2. At baseline, fidelity toMI was highly variable. Mean MI Spirit ranged from 2-4.66 (M=3.39, SD=.95), with 7/11 providers meeting orexceeding beginning proficiency standards (average of3.5). Providers tended to use few reflections comparedwith questions (M=0.13:1, SD=0.9:1). At FU1, all MITIglobal scores, behavior counts, and summary scoresimproved, however only MI Adherent behaviors andSimple Reflections reached statistical significance. Mostchanges had small to moderate effect sizes.Improvements were maintained at FU2, but coaching didnot further increase SP performance. Mean summaryscores met or approached beginning proficiency levelsfor most outcomes, with the exception of reflection toquestion ratio, which was still low (0.28:1) at FU2.Pediatric Association region IX and X meeting inconjuction with a training on motivational interviewing.The findings will also be shared at the national Pediatric34 The Haile T. Debas Academy of Medical Educators

UCSF Education Symposium 2013Academic Societies meeting in May 2013. We arecurrently considering how to leverage the standardizedpatient cases created for this study to use in futuretrainings.Reflective Critique: Feedback at the APA regionalmeeting focused on whether there could be anassessment of the learner before trainings to better tailorfuture motivational interviewing workshops. Informalfeedback from the faculty involved in the study waspositive and focused on the need for more practice andreinforcement.University of California, San Francisco • School of Medicine 35

UCSF Education Symposium 2013Submitted AbstractsCurriculum Development AbstractsAn Interactive Mobile Curriculum for Teaching the Hypothesis-Driven NeurologicalExamination ......................................................................................................................................................................... 39Dylan Alegria, MS, UCSF, dylan.alegria@ucsf.edu; Chandler Mayfield, UCSF, Mayfield@medsch.ucsf.edu; ChristyBoscardin, PhD, UCSF, BoscardinCK@medsch.ucsf.edu; Scott Andrew Josephson, MD, UCSFajosephson@memory.ucsf.edu; Daniel Lowenstein, MD, UCSF, Lowenstein@medsch.ucsf.edu; Vanja Douglas, MD,UCSF, Vanja.Douglas@ucsf.edu; Susannah Cornes, MD, UCSF, Susannah.Cornes@ucsf.edu“Hospital-Based Medicine: A Clinical Skills Tutorial:” an Elective for Pre-Clerkship MedicalStudents ............................................................................................................................................................................... 39Denise Connor, MD, SF VAMC, UCSF, denise.connor@ucsf.edu; Heather Whelan, MD, SF VAMC, UCSF,HWhelan@medicine.ucsf.eduIncorporation of a Patient Education Component on Colorectal Cancer Prevention intoSecond Year Medical Students’ Objective Structured Clinical Exam............................................................................ 40Jenny Crawford, MA, MPH, UCSF SOM, crawfordj2@medsch.ucsf.edu; Allison Ishizaki, MPH, UCSF SOM,ishizakia@medsch.ucsf.edu; Ann Homan, MA, UCSF Kanbar Center, homana@medsch.ucsf.edu; Anna Chang, MD,UCSF SOM, changan1@medsch.ucsf.eduCreating a Professionalism Learning Community to Promote Skills Development of FacultyThrough Case-Based Workshops ..................................................................................................................................... 41Tess Lang, MD, University of California San Francisco School of Medicine, tess.lang@ucsf.edu; Tess Lang, MD,University of California San Francisco School of Medicine, tess.lang@ucsf.edu; Maria Wamsley, MD, University ofCalifornia San Francisco School of Medicine, maria.wamsley@ucsf.edu; Arianne Teherani, PhD, University of CaliforniaSan Francisco School of Medicine Teherani@medsch.ucsf.edu; Mary H. McGrath, MD, MPH, University of California SanFrancisco Plastic & Reconstructive Surgery, Mary.McGrath@ucsfmedctr.org; Louise Aronson, MD, MFA, University ofCalifornia San Francisco, aronsonl@medicine.ucsf.edu; Rachael Lucatorto, MD, University of California San Francisco,Rachael.Lucatorto@ucsf.edu; Sandrijn van Schaik, MD, University of California San Francisco,VanSchaikS@peds.ucsf.edu; Christian Burke, University of California, San Francisco School of Medicine,BurkeCh@medsch.ucsf.edu; Maxine Papadakis, MD, University of California, San Francisco School of Medicine,PapadakM@medsch.ucsf.edu; Patricia O'Sullivan, MS, EdD, University of California, San Francisco School of Medicine,PapadakM@medsch.ucsf.edu; Catherine Lucey, MD, University of California, San Francisco School of Medicine,LuceyC@medsch.ucsf.eduPRIME Capstone Group Project: Optimizing Patient Experience at Chinatown Public HealthCenter ................................................................................................................................................................................... 41Yee-Bun Lui, MD, MPH, UCSF, luiy@fcm.ucsf.edu; Unity Nguyen, MPH, UCSF, unity.n@gmail.com; Anna Loeb, MPH,UCSF, Anna.Loeb@ucsf.edu; Janis Sethness, MPH, UCSF Janis.Sethness@ucsf.edu; John Trinidad, MPH, UCSF,John.Trinidad@ucsf.edu; Aisha Queen-Johnson, MSW, UCSF, Queen-JohnsonA@fcm.ucsf.edu; Elisabeth Wilson, MD,MPH, UCSF, ewilson@fcm.ucsf.eduTwittering Toxicology: Use of Micro-Blog for Asynchronous Teaching of Toxicology toEmergency Medicine Residents ........................................................................................................................................ 42Derrick Lung, MD MPH, UCSF, derrick.lung@emergency.ucsf.edu; Patil Armenian, MD, UCSF,parmenian@fresno.ucsf.edu; Rais Vohra, MD, UCSF, rvohra@fresno.ucsf.edu; Michelle Lin, MD, UCSFmichelle.lin@emergency.ucsf.edu36 The Haile T. Debas Academy of Medical Educators

UCSF Education Symposium 2013A Longitudinal Training Program in Family-centered HIV Care for Residents at SanFrancisco General Hospital (SFGH) .................................................................................................................................. 43Mina Matin, MD, UCSF, mmatin@nccc.ucsf.edu; Amanda Newstetter, MSW, UCSF, amanda.newstetter@ucsf.edu; LydiaLeung, MD, UCSF, ; Nicole Bores, MD, UCSF Nicole.Bores@ucsf.edu; Kirsten Balano, PharmD, UCSF,balanok@pharmacy.ucsf.edu; Hali Hammer, MD, UCSF, hhammer@fcm.ucsf.eduPiloting Social Emotional Intelligence Training for 1st Year Medical Students ........................................................... 43Oli Mittermaier, M.S., EXLI, LLC, oli@exli.org; Teo Nissen, MD, EXLI, LLC, teo@exli.org; Raj Gill, CPCC, EXLI, LLC,raj@exli.org; Beth Wilson, MD, UCSF ewilson@fcm.ucsf.eduHospital Medicine Lecture Series ...................................................................................................................................... 44Sima Pendharkar, MD, UCSF-SFGH, PendharkarS@medsfgh.ucsf.edu; Cecily Gallup, MD, MPH, UCSF-SFGH,GallupC@medsfgh.ucsf.eduA Longitudinal Quality Improvement Curriculum for Third Year KLIC Medical Students ........................................... 44Nardine Saad Riegels, MD, Kaiser Oakland, nardine.saad@gmail.com; Nicholas Riegels, MD, Kaiser Oakland,nicholas.x.riegels@kp.org; John Young, MD, Kaiser Oakland, john.q.young@kp.org; Lindsay Mazotti, MD, Kaiser Oaklandlindsay.a.mazotti@kp.orgDeveloping Roles and Expectations for Residency Advisors and Advisees ............................................................... 45Margaret Stafford, MD, UCSF, mstafford@fcm.ucsf.edu; Elisabeth Wilson, MD, UCSF, ewilson@fcm.ucsf.edu; GeorgeSaba, PhD, UCSF, gsaba@fcm.ucsf.eduA Primary Care Leadership Academy at UCSF ................................................................................................................ 46Margo Vener, MD, MPH, UCSF, mvener@fcm.ucsf.edu; Elisabeth Wilson, MD, MPH, UCSF,ewilson@fcm.ucsf.eduCurriculum Evaluation and Educational Research AbstractsUsing iPads to Support Self-directed Learning in a Longitudinal Integrated Clerkship ............................................. 47Dylan Alegria, MS, UCSF, dylan.alegria@ucsf.edu; Patricia Nason, MBA, UCSF, NasonP@medsch.ucsf.edu; AnnPoncelet, MD, UCSF, Ann.Poncelet@ucsf.edu; Chandler Mayfield, UCSF Mayfield@medsch.ucsf.edu; Christy Boscardin,PhD, UCSF, BoscardinCK@medsch.ucsf.edu; Maria Wamsley, MD, UCSF, Maria.Wamsley@ucsf.eduResults of the AANS Membership Survey of Adult Spinal Deformity Knowledge: Impact ofTraining, Practice Experience and Assessment of Potential Areas for Improved Education .................................... 47Aaron Clark, MD, PhD, UCSF Neurosurgery, clarkaar@neurosurg.ucsf.edu; Tyler Koski, MD, Northwestern UniversityFeinberg School of Medicine, tyler.koski@nmff.org; Justin Smith, MD, PhD, University of Virginia,JSS7F@hscmail.mcc.virginia.edu; Michael Rosner, MD, Neurosurgery Service, Walter Reed National Military MedicalCenter MICHAEL.ROSNER@US.ARMY.MIL; Christopher Shaffrey, MD, University of Virginia,CIS8Z@hscmail.mcc.virginia.edu; Paul McCormick, MD, Columbia University College of Physicians and Surgeons,pcm6@columbia.edu; Christopher Ames, MD, UCSF Neurosurgery, amesc@neurosurg.ucsf.eduProfessional Identity Development in Health Professions Students with Disabilities ................................................ 48Charlie DeVries, MPH, UCSF, charlie.devries@ucsf.eduOff to the Right Start: A Continuity Clinic Immersion Curriculum for Primary Care InternalMedicine Interns .................................................................................................................................................................. 49Ryan Laponis, MD, MSci, UCSF, ryan.laponis@ucsf.edu; Radhika Ramanan, MD, MPH, UCSF,rramanan@medicine.ucsf.edu; Katherine Julian, MD, UCSF, kathy.julian@ucsf.eduUniversity of California, San Francisco • School of Medicine 37

UCSF Education Symposium 2013Peer-to-peer Handoffs on Clinical Clerkships: Tips Students Tell Each Other ............................................................ 49Dylan Masters, BA, University of California, San Francisco, dylan.masters@ucsf.edu; Bridget O'Brien, PhD, University ofCalifornia, San Francisco, ObrienB@medsch.ucsf.edu; Calvin Chou, MD, PhD, University of California, San Francisco,calvin.chou@ucsf.eduHow to Identify “Success Cases” of Faculty Teaching Critical Reflection ................................................................... 50Amy Shaw, BA, UCSF, amy.shaw@ucsf.edu; Marieke Kruidering, PhD, UCSF, marieke.kruidering@ucsf.edu; PatriciaO'Sullivan, PhD, UCSF, osullivanp@medsch.ucsf.edu; Louise Aronson, MD, MFA, UCSF aronsonl@medicine.ucsf.edu38 The Haile T. Debas Academy of Medical Educators

UCSF Education Symposium 2013Curriculum Development AbstractsAn Interactive Mobile Curriculum forTeaching the Hypothesis-DrivenNeurological ExaminationDylan Alegria, MS, UCSF, dylan.alegria@ucsf.edu;Chandler Mayfield, UCSF, Mayfield@medsch.ucsf.edu;Christy Boscardin, PhD, UCSF,BoscardinCK@medsch.ucsf.edu; Scott AndrewJosephson, MD, UCSF ajosephson@memory.ucsf.edu;Daniel Lowenstein, MD, UCSF,Lowenstein@medsch.ucsf.eduLowenstein@medsch.ucsf.edu; Vanja Douglas, MD, UCSF,Vanja.Douglas@ucsf.edu; Susannah Cornes, MD,UCSF, Susannah.Cornes@ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Clinical Instruction andPerformance, Computers and Technology, CurricularInnovation, Longitudinal Educational ActivitiesPurpose: Reduce student discomfort with neurologicalexam skills by developing a mobile, longitudinal, learnerdrivencurriculum that fosters progression from acomprehensive to a hypothesis-driven approach duringundergraduate medical training.Background: Medical students express discomfort withtheir neurologic exam skills. This “neurophobia” stemsfrom the challenge of putting the exam into clinicalpractice. A targeted neurological exam engages clinicalreasoning skills and is more efficient and sensitive thana comprehensive exam. A longitudinal curriculuminitiated early in medical school that builds to a targetedapproach may help overcome neurophobia. Delivery ofthis curriculum via tablet computer encourages studentengagement, allows individualized exploration andfacilitates links to clinical experiences.Methods: Following a review of the literature and aformal needs assessment a consensus set ofexamination maneuvers for the essential screening,comprehensive screening, and common symptomtargetedneurologic exams were developed. Video clipsand descriptions of each exam maneuver were createdusing patient volunteers. Interactive cases with video,game-like elements and expert answers wereconstructed around the common symptom sets. A tabletbasedcurriculum was chosen to allow for use at thepoint of care.Evaluation Plan: A pretest and post-test of exammaneuver selection and clinical reasoning during theMS3 neurology clerkship will be used to comparestudents with and without access to symptom targetedexams against historical controls. Measures of selfregulationand metacognition will also be assessed.Dissemination: The curriculum will be deployed as aniPad-based application, NeuroExam Tutor, in the firsthalf of the first year and revisited in later courses. Theapplication will be free for UCSF students and madeavailable for purchase globally.Reflective Critique: Input during ESCape Conferenceand from leadership in Foundations of Patient Care,Brain Mind and Behavior, and the Neurology clerkshipassisted in refining the curriculum and evaluation.Ongoing refinements are expected followingimplementation.“Hospital-Based Medicine: A ClinicalSkills Tutorial:” an Elective for Pre-Clerkship Medical StudentsDenise Connor, MD, SF VAMC, UCSF,denise.connor@ucsf.edu; Heather Whelan, MD, SFVAMC, UCSF, HWhelan@medicine.ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Curricular Innovation,Mentoring, Patient Care, RemediationPurpose: We have launched an individualized, handsonclinical elective for first- and second-year medicalstudents targeting patient care, interpersonal andcommunication skills through one-on-one facultymentorship. Our learner-centered curriculum expandsopportunities in Foundations in Patient Care (FPC) andTransitional Clerkship (TC) for self-selected students,and students referred for remediation to develop clinicalskills.Background: While FPC and TC build patient care andcommunication competencies, many pre-clerkshipstudents need additional practice. Students’ learningneeds vary, with some mastering first- and second-yearmilestones early, seeking to expand expertise, andothers requiring more experience to achieve them.Through an individualized tutorial we aim to improveUniversity of California, San Francisco • School of Medicine 39

UCSF Education Symposium 2013preparedness for and reduce stress in clerkships, andbuild professional identity for students both at and belowexpected competencies. Our model draws upon “Callfor Reform of Medical School and Residency” (Cooke,Irby & O’Brien, 2010) by individualizing learning,integrating knowledge with clinical experience, andcultivating professional identity.Methods: • The elective is open to second-year medicalstudents and spring semester first years. Most studentsself-select; a subset is referred by FPC to remediateclinical competencies / • Students create IndividualizedLearning Plans (ILPs) / • Students spend 4-6 half-daysessions one-on-one with attendings in SFVA’s FacultyHospitalist Group engaged in clinical encountersaddressing their learning goals / • After each session,faculty annotate ILPs, providing a dynamic educationalsign-out documenting progress and setting future goals /• At course end, students contemplate progress andidentify take-home pointsEvaluation Plan: • Faculty annotated ILPs trackprogress on learning goals and identify activities used inskill building / • Surveys of enrolled and waitlistedstudents administered in clerkships will assessdifferences in preparedness, professional identityformation, and stressDissemination: We will submit abstracts to SGIM, SHMand AAMC.Reflective Critique: Students complete anonymousevaluations for course improvement.References: Cooke, M., Irby, D., & O’Brien, B. (2010). Educatingphysicians: A call for reform of medical school and residency. San Francisco:Jossey-Bass.Incorporation of a Patient EducationComponent on Colorectal CancerPrevention into Second Year MedicalStudents’ Objective StructuredClinical ExamJenny Crawford, MA, MPH, UCSF SOM,crawfordj2@medsch.ucsf.edu; Allison Ishizaki, MPH,UCSF SOM, ishizakia@medsch.ucsf.edu; Ann Homan,MA, UCSF Kanbar Center, homana@medsch.ucsf.edu;Anna Chang, MD, UCSF SOMchangan1@medsch.ucsf.eduDomain(s) addressed: Communication, CurricularInnovation, Patient Care, Quality ImprovementPurpose: We developed and implemented an activity toassess second year medical students’ ability to sharemedical information with patients in an understandableand non-technical way.Background: Research suggests that clinician-deliveredhealth education during routine clinical care can increasepatient comprehension and adherence to clinicianrecommendations. Students learn colorectal cancerscreening guidelines during their second year.Understanding complex guidelines and one’s ownpersonal risk factors are integral components forprevention and early screening for colon cancer.Methods: We determined what students learned aboutcolorectal cancer screening guidelines and thendeveloped a Standardized Patient based case to useduring the Objective Structured Clinical Exam (OSCE).Our case depicts a 54 year old patient who has not seena doctor in three years with a family history of coloncancer and blood in his stool. During a preventativehealth care visit, the student is asked to take a focusedhistory and provide patient education as necessary. Thestudent must also address the patient’s fears to increasethe patient’s screening compliance. In addition toproviding verbal education, the students create anunderstandable and non-technical patient educationdocument that includes recommendations for lifestylemodifications, risk factors for colorectal cancer, and nextsteps.Evaluation Plan: The students will evaluate this caseusing a paper based qualitative feedback and Likertscaleevaluation.Dissemination: This case will continue to be part of theOSCE and will be submitted to MedEd Portal.Reflective Critique: These students received coursecontent on colorectal screening guidelines and patientcommunication. Next years’ students will have alsocompleted an eight-hour Health Coaching Workshop.We will assess the differences in the students’perception of their preparation as well as theirperformance on this case from this year to next.References: Ferreira, M et al. (2005). Health Care Provider- DirectedIntervention to Increase Colorectal Cancer Screening Among Veterans.Journal of Clinical Oncology, 25 (7).Areas abstract covers: UME40 The Haile T. Debas Academy of Medical Educators

UCSF Education Symposium 2013Creating a Professionalism LearningCommunity to Promote SkillsDevelopment of Faculty ThroughCase-Based WorkshopsTess Lang, MD, University of California San FranciscoSchool of Medicine, tess.lang@ucsf.edu; Tess Lang,MD, University of California San Francisco School ofMedicine, tess.lang@ucsf.edu; Maria Wamsley, MD,University of California San Francisco School ofMedicine, maria.wamsley@ucsf.edu; Arianne Teherani,PhD, University of California San Francisco School ofMedicine Teherani@medsch.ucsf.edu; Mary H.McGrath, MD, MPH, University of California SanFrancisco Plastic & Reconstructive Surgery,Mary.McGrath@ucsfmedctr.org; Louise Aronson, MD,MFA, University of California San Francisco,aronsonl@medicine.ucsf.edu; Rachael Lucatorto, MD,University of California San Francisco,Rachael.Lucatorto@ucsf.edu; Sandrijn van Schaik, MD,University of California San Francisco,VanSchaikS@peds.ucsf.edu; Christian Burke, Universityof California, San Francisco School of Medicine,BurkeCh@medsch.ucsf.edu; Maxine Papadakis, MD,University of California, San Francisco School ofMedicine, PapadakM@medsch.ucsf.edu; PatriciaO'Sullivan, MS, EdD, University of California, SanFrancisco School of Medicine,PapadakM@medsch.ucsf.edu; Catherine Lucey, MD,University of California, San Francisco School ofMedicine, LuceyC@medsch.ucsf.eduAreas abstract covers: CMEDomain(s) addressed: Communication, FacultyDevelopment, Feedback, ProfessionalismPurpose: Formation of a professionalism learningcommunity (PLC) and to create a case basededucational program that helps physicians develop andcontinuously reinforce the skills needed to sustainprofessionalism in today’s complex and dynamic healthcare environment.Background: Professionalism encompasses a set ofvalues that guide the physicians’ daily work. Manybelieve that professionalism is a virtue and that thosewho behave unprofessionally lack that virtue. As aconsequence, our approach to professionalism lapseshas focused on discipline. An alternate view is thatprofessionalism is a complex competency and thatlapses should be approached with an educationalintervention.Methods: The PLC is designing case-based workshopsthat will demonstrate commonly encounteredprofessional dilemmas and provide opportunities topractice self-regulation skills in three domains for thephysician: 1) as an individual, 2) as a member of aprofessional peer group, and 3) as a leader within thesystem. Cases are being developed from a literaturereview, AAMC Graduation Questionnaire results, andUCSF clinical teaching evaluations. Short video clips ofStandardized Colleague trigger scenes are beingdeveloped for Grand Rounds presentations. The PLCwill recruit new members at each workshop to grow thenumber of individuals committed to advancingprofessionalism in the clinical environment.Evaluation Plan: We will examine faculty attitudestowards a skill-based approach to professionalism andassess faculty skills using a checklist completed by anexperienced observer that has received priorprofessionalism skills training. Professional lapses andchallenges within each clinical discipline will be analyzedto develop additional workshops.Dissemination: Case-based workshops will bedisseminated at departmental Grand Rounds.Ultimately, we plan to extend the workshops to includeother UCSF health professions schools.Reflective Critique: We are soliciting feedback from allparticipating faculty in the Professionalism LearningCommunity in addition to expertise locally and nationallyand departmental feedback.PRIME Capstone Group Project:Optimizing Patient Experience atChinatown Public Health CenterYee-Bun Lui, MD, MPH, UCSF, luiy@fcm.ucsf.edu;Unity Nguyen, MPH, UCSF, unity.n@gmail.com; AnnaLoeb, MPH, UCSF, Anna.Loeb@ucsf.edu; JanisSethness, MPH, UCSF Janis.Sethness@ucsf.edu; JohnTrinidad, MPH, UCSF, John.Trinidad@ucsf.edu; AishaQueen-Johnson, MSW, UCSF, Queen-JohnsonA@fcm.ucsf.edu; Elisabeth Wilson, MD, MPH,UCSF, ewilson@fcm.ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Competencies, CurricularInnovation, Leadership, Primary CarePurpose: The PRIME-US Capstone course aims toprovide opportunities for senior medical students toimprove their professional competencies. Last fall, fourUniversity of California, San Francisco • School of Medicine 41

UCSF Education Symposium 2013Capstone students served as a consultant team forChinatown Public Health Center (CPHC), a safety netclinic in the San Francisco DPH system. In partnershipwith CPHC, this month-long group project was designedwith the explicit purpose of helping students advancetheir leadership and health care managementcompetencies.Background: Group projects have known efficacy inhelping students develop professional competencies. Bycollaborating with our community partner on the designof a group project with the explicit goals of advancingleadership and health care management competencies,we were able to create a hands-on and meaningfulexperience for our students and community partner. Inthe process, the students provided services of addedvalue to the health center and gained valuableadvancement in their competencies.Methods: The consultant team was given the projectobjective to “improve the patient care experience atCPHC from the moment they walk through the door tothe moment they leave.” They began by meeting withclinic leadership who pledged full support and necessaryresources for their project. Under the guidance of theCPHC Associate Medical Director, the studentsconducted work flow/cycle time analysis from theperspective of patients, shadowed registration staff,interviewed clinic management, conducted focus groupsand surveys with CPHC staff, completed point of care(POC) surveys with patients, and presented theirfindings and recommendations at an all CPHC staffmeeting.Evaluation Plan: Weekly check-in was held with thestudents. End of project feedback session wasconducted. Students also completed a formal projectevaluation survey.Dissemination: We will submit abstracts to the FamilyCommunity Medicine Colloquium and the WGEAConference.Reflective Critique: Group reflection session withstudents generates feedback for PRIME leadership,resulting in ideas for group project improvement.Twittering Toxicology: Use of Micro-Blog for Asynchronous Teaching ofToxicology to Emergency MedicineResidentsDerrick Lung, MD MPH, UCSF,derrick.lung@emergency.ucsf.edu; Patil Armenian, MD,UCSF, parmenian@fresno.ucsf.edu; Rais Vohra, MD,UCSF, rvohra@fresno.ucsf.edu; Michelle Lin, MD, UCSFmichelle.lin@emergency.ucsf.eduAreas abstract covers: GMEDomain(s) addressed: Curricular Innovation,Mentoring, ResidencyPurpose: EM-Toxicologists and emergency medicineresidents with a concentration in toxicology will use thesocial media tool Twitter as an educational adjunct. Wewill survey residents before and after a year of use toqualitatively assess the tool's impact on their education.We will also qualitatively describe the postings on Twitterduring this time.Background: Learning toxicology is an inherentlyasynchronous process. While poisoning cases arefrequent, it is well known that the clinically severe ornovel toxicities are infrequent. The expected breadth ofknowledge in toxicology for emergency medicineresidents is much larger than what is typicallyexperienced during a residency. In addition, medicaltoxicologists are rarely accessible in residencyeducation. Usually, a residency program has no medicaltoxicologists on staff. Even when medical toxicologistsare available faculty, they are not always physicallypresent or available to reinforce salient learning points ofall educationally important toxicologic casesencountered by residents. / / We seek to use socialmedia, specifically Twitter, to make broaden the reachand accessibility of toxicology education amongemergency medicine residents. There have been fewpublished studies using social media for residencyeducation. Publications regarding social media inhealthcare education are predominantly opinion piecesregarding methods and principles of social media use ineducation. Our study is unique in that we will attempt tomeasure the effectiveness of social media as a teachingtool.Methods: This is an observational study, usingqualitative descriptions of teaching content and methods.We aim to describe the effectiveness of our teaching toolby the quantity and type of educator-learner interactions.Evaluation Plan: We are primarily evaluating the extentof active resident participation to judge the effectivenessof our teaching tool.Dissemination: Publication of results and discussion ofchallenges of the use of social media.42 The Haile T. Debas Academy of Medical Educators

UCSF Education Symposium 2013Reflective Critique: Directly solicited feedback fromparticipating attendings and residents every month sincethe beginning of the study in January 2013. Our nextpotential modification of our curriculum project maycome in June 2013.A Longitudinal Training Program inFamily-centered HIV Care forResidents at San Francisco GeneralHospital (SFGH)Mina Matin, MD, UCSF, mmatin@nccc.ucsf.edu;Amanda Newstetter, MSW, UCSF,amanda.newstetter@ucsf.edu; Lydia Leung, MD, UCSF;Nicole Bores, MD, UCSF Nicole.Bores@ucsf.edu;Kirsten Balano, PharmD, UCSF,balanok@pharmacy.ucsf.edu; Hali Hammer, MD, UCSF,hhammer@fcm.ucsf.eduAreas abstract covers: GMEDomain(s) addressed: n/aPurpose: To develop a curriculum that promotesproficiency in and inspires postgraduate careers in familyHIV care.Background: Although the American Academy ofFamily Physicians now recommends training residents inHIV [1], we are unaware of existing training programs incaring for HIV-affected families. The UCSF Departmentof Family and Community Medicine has multipleprograms to support an innovative residency-leveltraining program at SFGH’s Family Health Center,including the Family HIV Clinic (FHIVC), the PacificAIDS Education and Training Center (PAETC), and theNational HIV/AIDS Clinicians’ Consultation Center. TheFHIVC cares for HIV-positive patients and their families,including partners and HIV-exposed infants.Methods: We developed a two-year longitudinalprogram for four residents. Our model includes smallgroupdidactics and workshops, online modules [2], andcontinuity clinical experience incorporating interprofessionaltraining with physicians, pharmacists,nurses, and social workers. The diversity of patients,scope of care, and inherent focus on relationships offersbroad education in screening, preventive care, pre- andpost-exposure prophylaxis, diagnostic dilemmas, andantiretroviral treatment. Beyond the FHIVC, residentswork with our inpatient service at SFGH and the BayArea Perinatal AIDS Center.Evaluation Plan: Residents are monitored for progresson curricular milestones, allowing for bidirectionalfeedback. Additionally, continuous supervision of patientpanels ensures exposure to a diversity of clinicalexperience. As part of our evaluation mechanism, preandpost-training tests are administered. For futuredirections, a core-competencies evaluation tool is alsobeing developed with the Northwest AETC.Dissemination: We plan to submit our work to peerreviewedconferences and journals. We will also conductsite-visits with extramural faculty for further feedbackand exchange of ideas.Reflective Critique: We will follow the career paths ofour graduates, as well as evaluate the feasibility ofachieving specialist certification upon graduation via theAmerican Academy of HIV Medicine.References: 1. Recommended Curriculum Guidelines for FM Residentshttp://www.aafp.org/online/etc/medialib/aafp_org/documents/about/rap/curriculum/hiv.Par.0001.File.tmp/Reprint273.pdf. 2. HIV Web Studyhttp://depts.washington.edu/hivaids/Piloting Social Emotional IntelligenceTraining for 1st Year MedicalStudentsOli Mittermaier, M.S., EXLI, LLC, oli@exli.org; TeoNissen, MD, EXLI, LLC, teo@exli.org; Raj Gill, CPCC,EXLI, LLC, raj@exli.org; Elisabeth Wilson, MD, UCSFewilson@fcm.ucsf.eduAreas abstract covers: GMEDomain(s) addressed: Assessment and Testing,Curricular Innovation, Leadership, ReflectionPurpose: To pilot an experiential Social EmotionalIntelligence (EI) training program for first-year medicalstudents. Specific focus was on skill building in thedomains of “Professionalism” and “Interpersonal &Communication Skills” Core Competencies.Background: Amongst the 6 ACGME CoreCompetencies, approximately 60% of these skills can beclassified as “hard” or “technical” skills, while 40% are“soft” or “social emotional” competencies. Over the past15 years EI has been proven to be a vital ingredient to“excellence” and “professionalism” in the businesscommunity. However, in the medical community(especially in medical schools), practical training of EIskills continues to lag behind. Unlike technical/scientificknowledge, EI skills have traditionally been difficult toUniversity of California, San Francisco • School of Medicine 43

UCSF Education Symposium 2013measure, let alone teach. With the advent ofassessment instruments such as the Multi HealthSystem’s Emotional Quotient Inventory (EQ-i), accuratedata is available to aid in the development of emotionalintelligence competences. This assessment identifies anindividual’s EI strengths/weaknesses and gives concretestrategies to develop the EI skills with the support of acoach or mentor.Methods: Over an 11-week period during the 1st 6months of medical school, EXLI provided EI training for16 1st year medical students and 7 faculty mentors. Thestudents and faculty completed the EQ-i selfassessmentfrom which a personal report wasgenerated. Students participated in 2 didactic trainingsessions, online journaling, and weekly check-ins withmentors to track progress on their self-generated EIgoals.Evaluation Plan: Students and faculty submitted a prepilotquestionnaire exploring their understanding ofspecific EI concepts and terms. The same questionnairewas completed at the conclusion of the 11-week pilotand the responses were compared. Throughout the pilotstudents and faculty mentors met for weekly check-ins.Although the results were mixed, several key themesemerged as strengths and areas of improvement forfuture years.Dissemination: We intend to present a poster at UCSFEducation Day, 2013 and distribute the findings to keyfaculty at the UCSF Medical School Curricular Office.Reflective Critique: EXLI solicited input from studentsand select faculty at the end of the pilot via two, inpersongroup debriefs. We intend to use this evaluationdata to improve the structure, timing, and content of theEmotional Intelligence curricular content.Hospital Medicine Lecture SeriesSima Pendharkar, MD, UCSF-SFGH,PendharkarS@medsfgh.ucsf.edu; Cecily Gallup, MD,MPH, UCSF-SFGH, GallupC@medsfgh.ucsf.eduAreas abstract covers: GMEDomain(s) addressed: Competencies, Health Systems,Patient Care, Quality ImprovementPurpose: The “Hospital Medicine Lecture Series,” basedon the core competencies in hospital medicineestablished by the Society of Hospital Medicine (SHM),will be launched at San Francisco General Hospital(SFGH) to expand clinical and health systemsknowledge. Hospitalists will present to trainees andfaculty, emphasizing local resources and updates oninitiatives specific to SFGH and the population it serves.The objective is to improve the quality of care providedto patients from admission to discharge, and during caretransitions.Background: The role of the hospitalist has expandedto include involvement in patient care, hospital-widequality improvement (QI), and education. Studiesdemonstrate that reduced resident work hours havelimited teaching time. Hospitalists may fill this gap. TheSHM core competencies of a hospital medicinecurriculum are divided into three areas: “ClinicalConditions”, “Health Care Systems”, and “Procedures”.Methods: Hospitalists will present clinical and healthsystems topics, within and outside of the Department ofMedicine. Presentations will include a case, literaturereview, management guidelines, and local solutions,resources and updates on QI initiatives specific to SFGHand the population it serves. The presentations will beperiodically reviewed to ensure that guidelines arecurrent.Evaluation Plan: Lecture attendees will answerquestions related to the establishment of clear goals bythe presenter, adequate preparation, effectivepresentation, how their practice will change as a result ofthe information presented, identification of concepts theywill take away from the lecture, and remaining gaps intheir understanding of the subject. The evaluations willbe compiled and reviewed to assess the effectiveness ofthe lecture series.Dissemination: Presentations will be accessible on asecure website. Evaluation results will be disseminatedthrough conferences within and outside of theDepartment of Medicine.Reflective Critique: An evaluation form will bedistributed to lecture attendees. Results will be reviewedusing Qualtrics, feedback provided to presenters, andmodifications made thereafter.A Longitudinal Quality ImprovementCurriculum for Third Year KLICMedical StudentsNardine Saad Riegels, MD, Kaiser Oakland,nardine.saad@gmail.com; Nicholas Riegels, MD, KaiserOakland, nicholas.x.riegels@kp.org; John Young, MD,44 The Haile T. Debas Academy of Medical Educators

UCSF Education Symposium 2013Kaiser Oakland, john.q.young@kp.org; Lindsay Mazotti,MD, Kaiser Oakland lindsay.a.mazotti@kp.orgAreas abstract covers: UMEDomain(s) addressed: Curricular Innovation, HealthSystems, Longitudinal Educational Activities, QualityImprovementPurpose: To implement a longitudinal qualityimprovement (QI) curriculum for third-year medicalstudents in the Kaiser Longitudinal Integrated Clerkship(KLIC), using didactic instruction and experientiallearning.Background: Medical school QI curricula often invokeknowledge rather than skills-based learning, and seldomallow for direct student participation in a QI project (1).Methods: A quality improvement course was designedand implemented as part of our Policy, Leadership andSystems Engineering (PuLSE) curriculum. Studentsembarked on a QI initiative involving risk-stratification inthe pre-operative clinic. Complementary didacticinstruction accompanied each stage of the project.Students reviewed adverse events and observed clinicoperations, constructed a fishbone diagram, developedprocess maps and a failure modes analysis, generatedrecommended patient safety interventions, andsummarized their findings in a written report.Evaluation Plan: Students assigned an average scoreof 4.6/5.0 to the didactic elements of the course,exceeding the mean for the didactic components ofKLIC, and suggesting acceptability. Evaluation of QIskills will include: pre/post performance on the QIKnowledge Assessment Test (2) and a QI self-efficacysurvey; self-assessment and a critical reflection exerciseusing a leadership assessment tool developed by theprogram; and feedback on their QI proposal from KLICcourse directors and hospital leaders in April 2013 usingthe QI Proposal Assessment Tool (3).Dissemination: The PuLSE curriculum was presentedat the CLIC Rendezvous meeting and the AAMCMedEdPORTAL Poster Session in 2012. Students willpresent their work at the Kaiser Perioperative MedicineConference in May 2013.Reflective Critique: Student feedback has informed QIproject scope and curriculum changes. Input fromhospital leaders will guide development of future QIprojects to maximize meaningful student participation.References: Wong BM et al. Acad Med. 2010;85:1425-39. / Ogrinc G et al.J Gen Intern Med. 2004;19:496-500. / Leenstra JL et al. J Gen Intern Med.2007;22:1330-4.Developing Roles and Expectationsfor Residency Advisors and AdviseesMargaret Stafford, MD, UCSF, mstafford@fcm.ucsf.edu;Elisabeth Wilson, MD, UCSF, ewilson@fcm.ucsf.edu;George Saba, PhD, UCSF, gsaba@fcm.ucsf.eduAreas abstract covers: GMEDomain(s) addressed: Communication, FacultyDevelopment, ResidencyPurpose: To enhance the family medicine residencyadvising program by providing more structure andguidelines for participants.Background: In 2011-2012, we conducted anassessment of the UCSF/SFGH Family and CommunityMedicine Residency Program advisory system with inputfrom both residents and faculty. A common theme thatemerged was the need for a more robust and structuredresident advisory system. We therefore worked tocreate defined roles and expectations for advisors andadvisees. We based our document on the ResidentAdvising Toolkit from Duke (Burgess, Heflin and Woods;Woods et al., 2010).Methods: We created a document that outlines rolesand expectations for both advisors and advisees andprovides suggestions for the content of the requiredadvisor meetings each year. Supporting documentsinclude templates for each required meeting which canbe used to document the meetings. We have solicitedfeedback on the documents from faculty and residents,and are currently in the process of creating the finaldraft. We plan to introduce the guidelines for use startingin July 2013.Evaluation Plan: We plan to survey residents andfaculty before and after the implementation of theguidelines about their advisory program experience. Wewill use this to assess our effectiveness in facilitating theadvising process and to make any necessary changes.Dissemination: Medical Education Symposium,departmental Colloquium.Reflective Critique: We will survey residents andfaculty to assess for effectiveness and plan forimprovements.University of California, San Francisco • School of Medicine 45

UCSF Education Symposium 2013References: Burgess, L., Heflin, M., Woods, S. Resident Advising Toolkit.MedEdPORTAL; Available from: www.mededportal.org ID 7800. / / Woods,S. Burgess, L., Kaminetzky, C., McNeill, D., Pinheiro, S., & Heflin, M.(2010). Defining the Roles of Advisors and Mentors in Postgraduate MedicalEducation: Faculty Perceptions, Roles, Responsibilities, and Resource Needs.Journal of Graduate Medical Education, 2, 195-200. /A Primary Care Leadership Academyat UCSFMargo Vener, MD, MPH, UCSF, mvener@fcm.ucsf.edu;Elisabeth Wilson, MD, MPH, UCSF,ewilson@fcm.ucsf.edualso track how many PCLA participants match intoprimary care.Dissemination: When meeting with California medicaleducation leaders through the CAPCI project, we willdiscuss the PCLA model. After evaluation of the PCLA,we will disseminate our work at national educationconferences.Reflective Critique: Based on resident and studentfeedback, we will increase our use of electronic mediaand develop greater coordination with national effortsincluding Primary Care Progress.Areas abstract covers: UME, GMEDomain(s) addressed: Career Choice, Mentoring,Primary CarePurpose: We formed a Primary Care LeadershipAcademy to promote learner engagement in primarycare innovations; support career interests in primarycare; and enhance primary care education, mentoringand advocacy.Background: The US faces a shortage of primary carephysicians. Most students make career choices basedon medical school experiences, and traditionally eachdiscipline engages students independently. The PCLApromotes coordination and synergy between differentprimary care fields and includes faculty and learners atall levels. When united, this group effort may have alarger impact on promoting primary care.Methods: After creating a working group, we launchedthe PCLA in September 2012. Over 40 students, 15residents, 2 fellows and 8 faculty from Family Medicine,Pediatrics and Internal Medicine have participated.PCLA members have mentored students; led educationsessions at the UCSF Primary Care Summit; helpedgain approval for an Ambulatory Care Sub-Internship;and developed a student-led first-year elective. TheCalifornia Advanced Primary Care Institute (CAPCI)contracted with PCLA to produce a report on primarycare innovation and education. PCLA members willinterview faculty and students at California’s ten medicalschools and make recommendations to help CAPCIdevelop a strategic plan for promoting primary careinnovation and education in California. /Evaluation Plan: We will conduct focus groups toassess the impact of PCLA participation on students’interest in primary care as well as the impact ofcollaboration across multiple levels of learners. We will46 The Haile T. Debas Academy of Medical Educators

UCSF Education Symposium 2013Curriculum Evaluation and Educational ResearchAbstractsUsing iPads to Support Self-directedLearning in a Longitudinal IntegratedClerkshipDylan Alegria, MS, UCSF, dylan.alegria@ucsf.edu;Patricia Nason, MBA, UCSF,NasonP@medsch.ucsf.edu; Ann Poncelet, MD, UCSF,Ann.Poncelet@ucsf.edu; Chandler Mayfield, UCSFMayfield@medsch.ucsf.edu; Christy Boscardin, PhD,UCSF, BoscardinCK@medsch.ucsf.edu; MariaWamsley, MD, UCSF, Maria.Wamsley@ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Computers and Technology,Curricular Innovation, Longitudinal Educational Activities,PortfoliosPurpose: Develop and implement iPad-based mobilelearning during the Parnassus Integrated StructuredClinical Experiences (PISCES) to increase studentengagement with evidence-based literature duringclinical experiences and foster development of skills ofself-regulation and metacognition.Background: There is limited data on how studentsutilize mobile resources during their clinical training.Mobile technologies can provide opportunities to linklearning to patient care, with resources and toolsaccessible at the bedside. Third-year medical students inthe PISCES clerkship move between clinical settings,sites, and specialties while creating learning issuesbased upon their self-identified clinical learning needs.PISCES learners may be ideally suited to leveragemobile technology to support self-directed clinicallearning.Methods: We provided 15 PISCES students with AppleiPads with access to the EMR to track their patientcohort and Evernote, an electronic notebook, fordocumentation and retrieval of self-identified clinicallearning issues. Students received a workshop on theiPad and Evernote. Evaluation of the program includes:focus groups with the students, student and preceptorsurveys, and evaluation of learning issues from PISCESstudents and a control group of students in a parallellongitudinal integrated clerkship (n=8) and a historicalcontrol group (n=16).Results: Data from early focus groups suggest variationin iPad usage by students. In initial surveys with itemson a five-point scale (1=strongly disagree, 5=stronglyagree), students reported the iPad was useful[mean=4.3(SD=0.9)), used to capture learning issues[mean=3.2(SD=1.7)], and to reference point of careresources [mean=4.6(SD=1.5)]. Portability and facultyperceptions were not reported as barriers to use.Discussion: Mobile devices are ideal platforms forsupporting learning during the clinical years. Early datasuggests high student satisfaction and usage patternswere individual.Reflective Critique: Based on preliminary data, thisproject will focus on improved access to learningmaterials and better methods for tracking learning goingforward.Results of the AANS MembershipSurvey of Adult Spinal DeformityKnowledge: Impact of Training,Practice Experience and Assessmentof Potential Areas for ImprovedEducationAaron Clark, MD, PhD, UCSF Neurosurgery,clarkaar@neurosurg.ucsf.edu; Tyler Koski, MD,Northwestern University Feinberg School of Medicine,tyler.koski@nmff.org; Justin Smith, MD, PhD, Universityof Virginia, JSS7F@hscmail.mcc.virginia.edu; MichaelRosner, MD, Neurosurgery Service, Walter ReedNational Military Medical CenterMICHAEL.ROSNER@US.ARMY.MIL; ChristopherShaffrey, MD, University of Virginia,CIS8Z@hscmail.mcc.virginia.edu; Paul McCormick, MD,Columbia University College of Physicians andSurgeons, pcm6@columbia.edu; Christopher Ames, MD,UCSF Neurosurgery, amesc@neurosurg.ucsf.eduAreas abstract covers: Neurosurgical educationUniversity of California, San Francisco • School of Medicine 47

UCSF Education Symposium 2013Domain(s) addressed: Assessment and Testing, BasicScience Education, Curricular Innovation, Evaluation ofProgramsPurpose: To assess deformity knowledge base andimpact of current training, education and practiceexperience to identify opportunities for improvededucation.Background: Adult spinal deformity(ASD) surgery isincreasing in the spinal neurosurgeon’s practice.Methods: A survey of neurosurgeon AmericanAssociation of Neurological Surgeons(AANS)membership was comprised of 11 questions developedand agreed upon by experienced spinal deformitysurgeons tested ASD knowledge and were subgroupedinto categories; (1)radiology/spinal pelvic alignment,(2)health related quality of life(HRQOL), (3)surgicalindications, (4)operative technique, and (5)clinicalevaluation. Chi-square compared differences based onparticipant demographics (years of practice, spinalsurgery fellowship training, percentage of practicecomprised by spinal surgery).Results: 1456 neurosurgeons responded. 57% hadpracticed 75% of their practice to spine. Overallcorrect answer percentage was 42%. Radiology/spinalpelvic alignment questions had lowest percentagecorrect(38%) while clinical evaluation and surgicalindications questions had highest(44%). >10 years inpractice, spine fellowship, and >75% spine practice wereassociated with overall percentage correct(p10 years in practice was significantly associated withincreased percent correct answers in 4/5 categories.Spine fellowship and >75% spine practice weresignificantly associated with percent correct in all.Interestingly, the highest error was seen in risk forpostoperative coronal imbalance with very low correctresponses(15%) and not better withfellowship(p=0.08,18%).Discussion: This suggests that ASD knowledge couldbe improved in neurosurgery. Knowledge may beaugmented with neurosurgical experience, spinalsurgery fellowships, and spinal specialization.Reflective Critique: Neurosurgical education shouldparticularly focus on radiology/spinal pelvic alignmentespecially pelvic obliquity and coronal imbalance andoperative techniques for ASD.Professional Identity Development inHealth Professions Students withDisabilitiesCharlie DeVries, MPH, UCSF, charlie.devries@ucsf.eduAreas abstract covers: UME: This study covers allhealth professions students at UCSFDomain(s) addressed: Diversity, InterprofessionalEducation, Professionalism, ResearchPurpose: This research will begin to close the criticalgaps in understanding how students with disabilitiesnavigate the topography of undergraduate healthprofessions education. Theoretical frameworks will bedeveloped for understanding the specific ways thatdisability affects the understanding and process ofprofessional identity development processes for healthprofessions students. /Background: Although the Americans with DisabilitiesAct (ADA) passed in 1990 and amended in 2008guarantees accommodations that ‘level the playing field’for students with disabilities (Hafferty & Gibson 2001),and although reports of health professions students withdisabilities have significantly increased in recent years(Arndt 2003; Dupler et al 2012; Sowers & Smith 2004),there remain many challenges to adequate inclusion andsupport of students with disabilities in health professionseducation (Carroll 2004; Little 2003; Smith & Allen2011). These continuing challenges lead to the questionposed by Marks in 2005: “When will people withdisabilities have a place in the [health professions]?”(70). / / Generally speaking, students with disabilitiesface daily negotiations around physical environment,disabled identities, and non-disabled identities in highereducation (Low 1996). Health professions students facevery specific professional identity developmentprocesses of their own over the course of their education(Slotnick 2001), and students with disabilities mustsimultaneously negotiate these personal-professionalidentity development processes through the frameworksof both their disabled identities and non-disabledidentities (Hafferty & Gibson 2003; Maheady 1999). /Methods: We plan to use a constructivist groundedtheory approach.Results: In progress.Discussion: Once data analysis is completed, theresulting findings will be disseminated as possiblethrough presentation and publication.48 The Haile T. Debas Academy of Medical Educators

UCSF Education Symposium 2013References: Americans with Disabilities Act, 42 USC §12102(1), 1990. / /Arndt, M.E. (2000). “Educating nursing students with disabilities : One nurseeducator’s journey from questions to clarity.” Journal of Nursing Education,204-206. / / Carroll, S.M. (2004). “Inclusion of people with physicaldisabilities in nursing education.” The Journal of Nursing Education,43(5):207-12. / / Dupler, A.E., Allen, C., Maheady, D.C., Fleming, S.E., &Allen, M. (2008). “Leveling the playing field for nursing students withdisabilities: Implications of the amendments to the Americans WithDisabilities Act.” Journal of Nursing Education, 51(3):140-4. / / Hafferty,F.W. & Gibson, G.G. (2001). “Learning disabilities and the meaning ofmedical education.” Academic Medicine: Journal of the Association ofAmerican Medical Colleges, 76(10): 1027-31. / / Hafferty, F.W. & Gibson,G.G. (2003). “Learning disabilities, professionalism, and the practice ofmedical education.” Academic Medicine: Journal of the Association ofAmerican Medical Colleges, 78(2): 189-201. / / Little, D. (2003). “Learningdifferences, medical students, and the law.” Academic Medicine: Journal ofthe Association of American Medical Colleges, 78(2): 187-8. / / Low, J.(1996). “Negotiating identities, negotiating environments: An interpretation ofthe experiences of students with disabilities.” Disability & Society, 11(2):235-248. / / Maheady, D.C. (1999). “Jumping through hoops, walking on eggshells: The experiences of nursing students with disabilities.” The Journal ofNursing Education, 38(4): 162-70. / / Marks, B. (2007). “Culturalcompetence revisited: Nursing students with disabilities.” The Journal ofNursing Education, 46(2): 70-4. / / / Smith, W.T. & Allen, W.L. (2011).“Implications of the 2008 amendments to the Americans with Disabilities Actfor medical education.” Academic Medicine: Journal of the Association ofAmerican Medical Colleges, 86(6): 768-72. / / Sowers, J. & Smith, M.R.(2004). “Nursing faculty members’ perceptions, knowledge, and concernsabout students with disabilities.” The Journal of Nursing Education, 43(5):213-8. /Off to the Right Start: A ContinuityClinic Immersion Curriculum forPrimary Care Internal MedicineInternsRyan Laponis, MD, MSci, UCSF,ryan.laponis@ucsf.edu; Radhika Ramanan, MD, MPH,UCSf, rramanan@medicine.ucsf.edu; Katherine Julian,MD, UCSF, kathy.julian@ucsf.eduAreas abstract covers: GMEDomain(s) addressed: Career Choice, Primary Care,ResidencyPurpose: To improve intern primary care medicalknowledge and systems-based care knowledge andskills while enhancing satisfaction with the continuityclinic experience.Background: It is increasingly difficult to teach internshow to effectively provide primary care. Barriers includelimited time in practice, patient complexity and complexsystems of care. In an effort to improve this, wedeveloped, implemented and evaluated a one-monthdidactic and experiential curriculum for primary careinterns focused on medical knowledge and systemsbasedcare.Methods: Participants were interns in the UC PrimaryCare Internal Medicine residency. They completed apre-curriculum survey with 23 closed-ended items(1=disagree, 4=agree) in the following domains:systems-based care, team-based care and use of theelectronic medical record. They also completed a postcurriculumsurvey that included the same 23 items aswell as items on perceived impact of the curriculum.Results: All interns (N=10) participated in the curriculumand all completed the pre and post curriculum survey.When comparing the averaged pre-survey results to thepost-survey results, there was an increase in knowledgein all 23 items with an average increase of 1.6 (p

UCSF Education Symposium 2013Background: As third-year medical students rotatebetween clerkships, they experience multiple transitionsacross workplace cultures and shifting learningexpectations. Most of the current literature focuses onthe pre-clerkship to clerkship adjustment, and programsdeveloped to ease this transition. However, students onclerkships undergo transitions constantly, and transitionpoints between rotations are less well characterized.Methods: Students from three VA-based clerkshiprotations participated in a peer-to-peer handoff sessionwhere they described tips for optimizing performance tostudents starting the clerkship they had just completed.We transcribed student comments from four handoffsessions and used qualitative content analysis to identifyand compare advice across clerkships.Results: Students shared advice about workplaceculture, content learning, logistics, and work-life balance.Common themes included expectations of the rotation,workplace norms, specific tasks, learning opportunitiesand learning strategies. Comments about patient careand work-life balance were rare. Students emphasizeddifferent themes for each clerkship; for example, forsome clerkships, students commented heavily on tasksand content learning, while in another students focusedon workplace culture and exam preparation.Discussion: These findings characterize some of thewidely diverse transitions that third-year studentsundergo as they rotate into new clinical trainingenvironments. Students emphasized different aspects ofeach clerkship in the advice they passed to their peers,and their comments often describe informal norms oropportunities that official clerkship orientations may notaddress. Peer-to-peer handoffs may help easetransitions between clerkships with dissimilar culturesand expectations.Reflective Critique: VALOR clerkship review with theClerkship Studies Steering Committee highlighted thesepeer-peer sessions as highly valuable and worthdisseminating to other programs. We submitted amanuscript describing this study to RIME.How to Identify “Success Cases” ofFaculty Teaching Critical ReflectionAmy Shaw, BA, UCSF, amy.shaw@ucsf.edu; MariekeKruidering-Hall, PhD, UCSF,marieke.kruidering@ucsf.edu; Patricia O'Sullivan, PhD,UCSF, osullivanp@medsch.ucsf.edu; Louise Aronson,MD, MFA, UCSF aronsonl@medicine.ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Evaluation of Programs, FacultyDevelopment, Feedback, ReflectionPurpose: We wanted to identify successful teachers of acritical reflection curriculum.Background: While curricula often are assessed vialearner feedback and evaluation, little has been writtenabout how to identify teachers’ success at adopting newteaching strategies.Methods: First-year medical students take a weekly,faculty-led doctoring course. Faculty and studentsreceived training in critical reflection, and facultyreceived feedback training. Students completed onecritical reflection and received online faculty feedback.On a scale from strongly disagree (1) to strongly agree(5), faculty rated their success in applying workshopteaching strategies. Students answered whether thefeedback used these strategies and rated feedback fromnot useful (1) to very useful (5). We combined eachfaculty member’s responses into a composite score. Wedefined successful faculty as those with a self-ratinggreater than 3 out of 5 and who, according to at leastone student, used all 4 feedback strategies and gave“very useful” feedback. All data were de-identified.Results: Twenty-two out of 40 faculty (55%) and 52 outof 155 students (34%) completed the survey. Compositefaculty self-ratings were >3 for 17/22 (77%) and

UCSF Education Symposium 2013Index by AuthorAdler, Shelley R .............................10Ainsworth, Alice .............................25Alegria, Dylan........................... 39, 47Almeida, Sandra A ........................10Ames, Christopher ........................47Appelget, Jeanne ..........................23Armenian, Patil ..............................42Aronson, Louise ............. 8, 30, 41, 50Ashley, Sarah.................................20Azzam, Amin ..................................27Bachhuber, Melissa ......................19Balano, Kirsten ..............................43Batt, Joanne ...................................32Benitez, Christopher .....................14Bennett, Heather ...........................27Bereknyei, Sylvia ...........................25Bogetz, Alyssa ...............................25Bores, Nicole ..................................43Boscardin, Christy . 17, 28, 32, 39, 47Braddock, Clarence ......................25Buckelew, Sara ........................ 14, 25Burke, Christian ....................... 17, 41Cangelosi, Carrie ...........................34Cantino, Laura ...............................26Carley, Annette ............................ 4, 7Chang, Anna .......................... 4, 9, 40Chen, H. Carrie ..............................26Chern, Hueylan .......................... 7, 17Chou, Calvin............... 4, 9, 25, 27, 49Clark, Aaron ...................................47Clement, Laurence ........................15Connor, Denise ........................ 23, 39Conrad, Miles .................................31Cook, Brian.....................................17Cornes, Susannah ........................39Crawford, Jenny ............................40Dandu, Madhavi ............................22Daroff, Robert ................................26De La Cerda, Sarah ......................34DeVries, Charlie ...................... 25, 48Douglas, Vanja ........................ 26, 39Eastburn, Abbi ...............................23Edge, Isabel ...................................16Edris, Mathieu ................................20Fiore, Darren ................................ 4, 7Fleisher, Paula ............................... 21Gallup, Cecily ................................. 44Garcia-Mecinas, Adan .................. 27Getz, Wayne .................................. 23Gill, Raj ........................................... 43Goel, Aparna .................................. 15Goodwin, Sarah ............................. 15Gould, Jessica ............................... 18Gupta, Reena ................................ 15Hafler, Janet P. ................................ 5Hamlin, Kathy ................................ 16Hammer, Hali ................................. 43Hansen, Lori................................... 32Hauer, Karen ....... 4, 9, 26, 28, 32, 33Hettema, Jennifer .......................... 34Hill-Sakurai, Laura ........................ 16Hirsh, David ................................... 32Homan, Ann ................................... 40Horton, Claire ................................. 15Huang, Emily ............................. 7, 17Huen, William ................................. 15Hung, Erick..................................... 19Hyland, Katherine.......................... 17Ishizaki, Allison .............................. 40Jain, Sharad ............................. 14, 18Johnson, Marc ............................... 20Josephson, Scott Andrew ............ 39Julian, Katherine ........................... 49Kanzaria, Hemal ............................ 18Kim, Christina ................................ 19Kim, Edward ............................... 7, 17Kogan, Jennifer ............................. 28Kohi, Maureen ............................... 31Kohlwes, Jeff ................................. 23Koski, Tyler .................................... 47Kruidering-Hall, Marieke .. 4, 8, 9, 50Krupat, Ed ...................................... 32Kuo, Anda......................................... 9Lang, Tess ..................................... 41Laponis, Ryan ................................ 49Le, Phuoc ....................................... 22Leavitt, Andrew .............................. 33Leung, Lydia .................................. 43Lin, Michelle ................................... 42Lindow, Julie .................................. 26Loeb, Anna ..................................... 41Lowenstein, Daniel ....................... 39Lowry, Eugene .............................. 29Lucatorto, Rachael........................ 41Lucey, Catherine ........................... 41Lui, Yee-Bun .................................. 41Lum, Paula ............................... 14, 34Lung, Derrick ................................. 42Lynch, Mary ................................. 4, 7Maa, John ...................................... 33Manuel, Jennifer............................ 34Masters, Dylan ................ 4, 9, 27, 49Matin, Mina .................................... 43Mayfield, Chandler ............ 17, 39, 47Mazotti, Lindsay ...................... 21, 45McCormick, Eileen ........................ 34McCormick, Paul ........................... 47McDonald, Erik .............................. 17McGrath, Mary H........................... 41Mendez, Joe .................................. 27Miao, Edna ....................................... 9Miller, Bernie .................................. 33Miller, Carol .................................... 14Miller, Rebecca.............................. 30Mirsky, Jacob ................................. 18Miss, Jacob .................................... 20Mittermaier, Oli .............................. 43Monash, Bradley ........................... 25Muldoon, Lily ................................. 18Naeger, David ............................... 31Naeger, David M. .......................... 31Naseri, Ayman ............................... 29Nason, Patricia .............................. 47Newstetter, Amanda ..................... 43Nguyen, Janet ............................... 31Nguyen, Unity ................................ 41Nissen, Teo .................................... 43O'Brien, Bridget ... .10, 19, 20, 25, 32,49Ordovas, Karen ............................. 31O'Sullivan, Patricia ... 7, 8, 14, 17, 30,41, 50Oza, Sandra ............................... 9, 32University of California, San Francisco • School of Medicine 51

UCSF Education Symposium 2013Palmer, Barnard ............................17Panchal, Amiesha .........................16Papadakis, Maxine ........................41Patel, Shalini ..................................19Pearson, Meg.................................20Pendharkar, Sima .........................44Pettersen, Kenny ...........................20Phelps, Andrew .............................31Pierce, Read ....................................9Poncelet, Ann..................... 27, 32, 47Porco, Travais ................................23Queen-Johnson, Aisha ........... 21, 41Quezada, Randy ...........................21Ramanan, Radhika .......................49Rennke, Stephanie .......................25Riegels, Nardine Saad............ 21, 44Riegels, Nicholas ..................... 21, 44Robertson, Patricia .......................26Rosner, Michael .............................47Rouse-Iniguez, James ..................21Saba, George ................................ 45Salmon, Margaret.......................... 20Salter, Richard ............................... 23Sarkar, Urmimala .......................... 15Satterfield, Jason .................... 14, 25Scholey, Jonathan ........................ 15Sethness, Janis ............................. 41Shaffrey, Christopher .................... 47Shamasunder, Sriram .................. 22Shaw, Amy ..................................... 50Shoeb, Marwa ............................... 22Shunk, Rebecca ............................ 20Sippl-Swezey, Nicolas .................. 23Smith, Justin .................................. 47Soni, Krishan ................................. 15Stafford, Margaret ......................... 45Sznewajs, Aimee ........................... 32Teherani, Arianne.............. 26, 27, 41Tessler, Robert .............................. 33Tierney, Matt .................................. 34Torre, Dario .................................... 28Trinidad, John ................................ 41Vale, Ron ....................................... 15Van Osdol, Sherilyn .................... 4, 7van Schaik, Sandrijn ........... 9, 10, 41Vargas, Roberto ............................ 21Vener, Margo ..................... 16, 27, 46Vohra, Rais .................................... 42Wamsley, Maria .......... 27, 32, 41, 47Webb, Emily ................................... 31Whelan, Heather ..................... 23, 39Whittle, Amy ............................. 14, 34Wilcox, Chad ................................. 31Wilson, Elisabeth . 14, 21, 41, 43, 45,46Woods, Meggie ............................. 18Young, John ................................... 4452 The Haile T. Debas Academy of Medical Educators