2011 - UCSF School of Medicine - University of California, San ...

Education Day2011Monday, April 25, 2011Millberry Union Conference Center

UCSF Education Day 2011The Haile T. Debas Academy of Medical Educatorsand the Office of Medical Education present:THE 10 th ANNUAL EDUCATION DAYMillberry Union Conference CenterMonday, April 25, 2011University of California, San FranciscoSchool of MedicineWelcome 1Schedule of Events 2Cooke Award Winners 4Keynote Address Information 5Abstracts for Oral Presentations 7Abstracts for Poster Presentations 13Workshop Descriptions 41Index by Author 42University of California, San Francisco • School of Medicinei

UCSF Education Day 2011ScholarshipWorking GroupJody Steinauer, MD, ChairLouise Aronson, MD, MFAAmin Azzam, MD, MADavid Daikh, MD, PhDMichelle Lin, MDTerrence Liu, MDPatricia O'Sullivan, EdDMaxine Papadakis, MDJason Satterfield, PhDJeffrey Tabas, MDArianne Teherani, PhDLeadership and StaffMolly Cooke, MDDirectorHarry Hollander, MDAssociate DirectorCynthia AsheManagerJames BeaudreauSr. Programs AnalystKathleen LandPrograms AnalystAcademy of Medical Educators4 Koret Way, LR-102, Box 0563San Francisco, CA 94143-0563(415) 514.2282 | (415) 514.9264 (Fax)www.medschool.ucsf.edu/academyMembersShelley Adler, PhDLouise Aronson, MD, MFAColette Auerswald, MD, MSMeg Autry, MDAmin Azzam, MD, MARobert Baron, MD, MSTimothy Berger, MDMartin Bogetz, MDRichard Breiman, 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 Elkin, MDAlicia Fernandez, MDTracy Fulton, PhDAlan Gelb, MDAndrew Goldberg, MD, MSCEElizabeth Harleman, MDMichael Harper, MDKaren Hauer, MDHarry Hollander, MDKatherine Hyland, PhDDavid Irby, PhDRebecca Jackson, MDSharad Jain, MDC. Bree Johnston, MDS. Andrew Josephson, MDKatherine Julian, MDTimothy Kelly, MDShieva Khayam-Bashi, MDMarieke Kruidering-Hall, PhDAnda Kuo, MDCindy Lai, MDHarry Lampiris, MDMichelle Lin, MDTerrence Liu, MDHelen Loeser, MD, MScDaniel Lowenstein, MDJohn Maa, MDKevin Mack, MD, MSAlma Martinez, MD, MPHSusan Masters, PhDMarcia McCowin, MDCarol Miller, MDIgor Mitrovic, MDJessica Muller, PhDAndrew Murr, MDMaxine Papadakis, MDManuel Pardo Jr., MDJ. Colin Partridge, MD, MPHMichael Peterson, MDAnn Poncelet, MDSusan Promes, MDMichael Rabow, MDPatricia Robertson, MDDana Rohde, PhDMark Rollins, MD, PhDGeorge Rutherford III, MDHenry Sanchez, MDJason Satterfield, PhDGeorge Sawaya, MDNiraj Sehgal, MD, MPHBradley Sharpe, MDWilliam Shore, MDWade Smith, MD, PhDJody Steinauer, MDJeffrey Tabas, MDLowell Tong, MDKimberly Topp, PT, PhDSandrijn van Schaik, MD, PhDMargo Vener, MD, MPHMaria Wamsley, MDElisabeth Wilson, MD, MPHLisa Winston, MDJohn Young, MD, MPPLeslie Zimmerman, MD© 2011, University of California RegentsiiThe Haile T. Debas Academy of Medical Educators

UCSF Education Day 2011Welcome to Education DayDear Friends,On behalf of The Haile T. Debas Academy of Medical Educators and the Office ofMedical Education, we are proud to present the tenth annual Education Day, an eventthat showcases the scholarly work of the UCSF School of Medicine’s faculty, residents,and students.The program covers a variety of important research questions and innovations in medicaleducation. Following a blinded peer review of all abstract submissions, the Academy’sScholarship Working Group, which plans Education Day, has selected 51 submissions tobe featured at Education Day. Six of these submissions have been selected as oralpresentations based upon their quality and collective relevance to the largest audience ofmedical educators.We are also pleased to offer a number of special programs. We welcome NorthwesternUniversity’s Diane B. Wayne, MD, as this year’s visiting professor, who will delivertoday’s keynote address, Use of Medical Education Research to Improve Patient CareQuality. And in recognition of the recent opening of UCSF’s new Teaching and LearningCenter, we have also developed several workshops that demonstrate the cutting-edgeeducational technologies that are available to the UCSF community.This will be our fifth year presenting the Academy’s Cooke Awards for the Scholarship ofTeaching and Learning. Please join us for the awards announcement at the conclusion oftoday’s plenary session.We extend a very special thank you to our community of medical educators forcontributing so generously to this year’s Education Day. This program provides just asmall glimpse of the creativity and excitement of their scholarly work here at UCSF. Wehope you enjoy the program.Jody Steinauer, MD, MASChair, Scholarship Working GroupMolly Cooke, MDDirector, Academy of Medical EducatorsUniversity of California, San Francisco • School of Medicine 1

UCSF Education Day 2011Schedule of EventsMorning Sessions8:00-9:30 am Meet the Visiting Professor:Interactive session featuring a moderated discussion aroundpre-selected themes between UCSF faculty and Diane B.Wayne, MD, this year's Education Day keynote speaker.Golden Gate RoomMillberry Union10:00 am-noon Oral Presentations:A Randomized Trial of Reflective Learning Guidelines andFeedback among Third Year Medical StudentsLouise Aronson, MD, MFAGolden Gate RoomMillberry UnionBlended Learning: The New Wave of Faculty DevelopmentKatherine Hyland, PhDCompetency-Based Curricula for the Health Professions in TanzaniaHelen Loeser, MD, MScLongitudinal Interprofessional Curriculum Well Received byFirst-Year Health Professions StudentsJennifer Staves, MS3What's Really So Different about Longitudinal IntegratedClerkships (LICs) and Block Clerkships? Findings from aMulti-Center Observational, Work Sampling StudyBridget O'Brien, PhDWriting for Change: Training Residents in Health PolicyAdvocacy through NarrativeLouise Aronson, MD, MFA2 The Haile T. Debas Academy of Medical Educators

UCSF Education Day 2011Afternoon Sessions12:15-12:45 pm Keynote Address:Use of Medical Education Research to Improve Patient Care QualityDiane B. Wayne, MD12:50-1:00 pm Cooke Award for the Scholarship of Teaching & Learning:Louise Aronson, MD, MFAHelen Loeser, MD, MScBridget O'Brien, PhDGolden Gate RoomMillberry UnionGolden Gate RoomMillberry Union1:00-2:30 pm Moderated Walkaround Poster Session City Lights RoomMillberry Union2:30-3:30 pm Unmoderated Poster Viewing City Lights RoomMillberry Union3:45-5:00 pm Concurrent Breakout Workshops (takes place on the second floor ofUCSF library in the Teaching and Learning Center):Leveraging Technology for EducationAmin Azzam, MD, MA; Ryan Brazell; Sean McClelland; ChristianBurke; Renee Courey, PhD; Louise Aronson, MD, MFAPoster Presentations and PrizesLouise Aronson, MD, MFA; Patricia O'Sullivan, EdDScholarship of SimulationDiane B. Wayne, MD; Sandrijn van Schaik, MD; Jody Steinauer, MDTeaching andLearning CenterCL-211/212CL-220CL-213/214University of California, San Francisco • School of Medicine 3

UCSF Education Day 2011Cooke Award for the Scholarshipof Teaching and LearningThe 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 Day. All submissions to Education Day were eligible forthese awards, which are accompanied by a certificate and honorarium. Top-scoring projects were nominated for theaward following a blinded peer review of all abstract submissions. Award winners were determined by a ballot in whichScholarship Working Group members ranked the blinded abstracts, excluding those in which they were involved.Please join us in congratulating the 2011 recipients:Louise Aronson, MD, MFAFor her submission as first author in Writing for Change:Training Residents in Health Policy Advocacy throughNarrativeHelen Loeser, MD, MScFor her submission as first author in Competency-BasedCurricula for the Health Professions in TanzaniaBridget O'Brien, PhDFor her submission as first author in What's Really SoDifferent about Longitudinal Integrated Clerkships (LICs)and Block Clerkships? Findings from a Multi-CenterObservational, Work Sampling Study4 The Haile T. Debas Academy of Medical Educators

UCSF Education Day 2011Keynote AddressUse of Medical Education Researchto Improve Patient Care QualityDiane B. Wayne, MDDr. Wayne is passionate about linking education toimproved quality of care. In this lecture she will discussspecific examples of medical education research astranslational science and features of highly successfuleducational research programs.Dr. Wayne is a clinician-educator at Northwestern University. She is the Vice Chair ofEducation in the Department of Medicine and an Associate Professor of Medicine. Shehas been the Internal Medicine Residency Program Director since 2001. During hertenure she has focused on enhancing the national reputation of Northwestern's internalmedicine training programs and developing medical education research programs in thedepartment. Her other commitment has been to promoting diversity. For the past twoyears, more than 20 percent of incoming interns in the Department of Medicine havebeen from groups traditionally underrepresented in medicine. Dr. Wayne's researchinterests include simulation-based education, standard setting and competencyassessment of students, residents and fellows.Dr. Wayne has received numerous awards, including the 2007 National Award forMedical Education Scholarship from the Society of General Internal Medicine and the2007 Thomas Hale Ham Award for New Investigators from the Research in MedicalEducation Committee (RIME) of the AAMC. She was a 2010 recipient of the ParkerPalmer "Courage to Teach" National Program Director Award from the AccreditationCouncil of Graduate Medical Education. She has been a Deputy Editor of the Journal ofGeneral Internal Medicine since 2006.University of California, San Francisco • School of Medicine 5

UCSF Education Day 20116 The Haile T. Debas Academy of Medical Educators

UCSF Education Day 2011A Randomized Trial of ReflectiveLearning Guidelines and FeedbackAmong Third Year Medical StudentsLouise Aronson, MD, MFA,aronsonl@medicine.ucsf.edu; Brian Niehaus MD,Brian.Niehaus@ucsf.edu; Laura Hill-Sakurai, MD,HillSakL@fcm.ucsf.edu; Cindy Lai, MD,CLai@medicine.ucsf.edu; Patricia O'Sullivan, EdD,patricia.osullivan@ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Competencies, Evaluation ofPrograms and Curricula, Feedback, ReflectionPurpose: To assess the impact of reflective learningguidelines and feedback, individually and together, onthe reflective ability demonstrated by medical students inwritten reflection exercises.Background: In response to national mandates,educators are increasingly incorporating reflection intotheir teaching. However, review of medical studentreflections from UCSF and elsewhere revealed that mostconsisted of anecdotes with few of the educationalcomponents described in the literature. We hypothesizethat learners do not reflect in an educationally useful waybecause we have not trained them to do so.Methods: We conducted a randomized, controlled trialof the impact of reflective learning guidelines and facultyfeedback on reflective skills. All third year medicalstudents wrote reflections on professionalism after their1st, 3rd and final clerkships. In a 2x2 design, half thestudents received reflective learning guidelines and halfdid not, and half in each of these groups receivedfeedback on both reflective skill and reflection contentand half received feedback on content alone. Reflectionswere scored by trained raters (r= 0.89) using apreviously validated 0 - 6 point rubric. We conducted ananalysis of covariance using 1st scores as the covariateand final scores as the dependent variable.Results: Mean reflection scores were 3.81 (sd=1.9)using guidelines and 2.22 (sd=.89) without guidelines(p

UCSF Education Day 2011TOP mentees will continue to evaluate their mentors'performance.Dissemination: We plan to publish this tool on Med EdPortal and present at national medical educationmeetings.Reflective critique: A team of eight AME membersprovided input. This project was presented at the TLCSopening, and valuable input was received. After welaunch the training module, adjustments will be madebased on feedback from users.Competency-Based Curricula for theHealth Professions in TanzaniaHelen Loeser, MD, MSc, UCSF School of Medicine,Helen.Loeser@ucsf.edu; Judy Martin-Holland, PhD,MPA, RN, CS, FNP UCSF School of Nursing,judy.martin-holland@nursing.ucsf.edu; SharonYoumans, PharmD, MPH, UCSF School of Pharmacy,youmanss@pharmacy.ucsf.edu; Peter Loomer, DDS,PhD, UCSF School of Dentistry, peter.loomer@ucsf.edu;Eligius Lyamuya, MD, Muhimbili University of Health andAllied Sciences, eligius_lyamuya@yahoo.com; PatriciaO’Sullivan, EdD, UCSF School of Medicine,OSullivanP@medsch.ucsf.eduAreas abstract covers: UME, GMEDomain(s) addressed: Competencies, CurricularInnovation, Global Health, Interprofessional EducationPurpose: A strategic Tanzania-U.S. universitypartnership, formed to optimize the impact of healthprofessions graduates on health outcomes in Tanzania,led to an interprofessional collaboration to developcompetency-based curricula.Background: Competency-based education was newlymandated inTanzania and Muhimbili University of Healthand Allied Sciences (MUHAS) embarked upon a reviewand revision of their Medicine, Dentistry, Nursing,Pharmacy, and Public Health curricula. MUHAS soughtexpertise in undertaking the revision and incorporatingcompetencies into their teaching and assessment. Aninterprofessional team from UCSF schools of dentistry,medicine, nursing and pharmacy provided consultation.Methods: Curriculum revision began in 2008 andincluded these key steps[1]: (1) extensive stakeholderconsultation; (2) determination of Tanzania's healthpriorities; (3) identification of competencies necessaryfor Tanzanian health professionals; (4) faculty training incompetency-based education; (5) individual courserevision by faculty and (6) demonstrations by UCSFcollaborators. Data and process that supported thesesteps included national surveys, focus groups,workshops and retreats.Evaluation Plan: By 2011, curricula in all MUHASschools will be revised to include competency-basedobjectives, new strategies for instruction and studentassessment. Opportunities will be introduced for activelearning, clinical experience and structured fieldwork.Stakeholder consultation and periodic assessment ofprogram outcomes by surveys of graduates andemployers are planned.Dissemination: MUHAS and UCSF faculty arepresenting this curriculum work and outcomes locally,regionally, and internationally. A website is inpreparation for sharing results, and supporting additionalregional and international collaborations.Reflective critique: There is ongoing exchange from allpartnership members evaluating progress to guidedecisions for next steps. MUHAS will pilot some aspectsof the curriculum to ease the transition to the newapproach. Interprofessional education collaborationshave been productive at MUHAS and UCSF.References:1. H. Loeser, P. O'Sullivan, D. Irby. Leadership Lessons fromCurricular Change at UCSF School of Medicine. Acad. Med. 82(4):324-330. April 2007Longitudinal InterprofessionalCurriculum Well Received by First-Year Health Professions StudentsJennifer Staves, MS3, UCSF School of Medicine;Alexandria Cerri, Sacred Heart Cathedral PreparatoryHigh School; Susan Hyde, DDS, MPH, PhD, UCSFSchool of Dentistry; Brian Alldredge, PharmD, UCSFSchool of Pharmacy; Sharon , PharmD, UCSF School ofPharmacy; Jeff Kilmer, MA, UCSF School of Nursing;Dorothy Perry, PhD, UCSF School of Dentistry; HelenLoeser, MD, MSc, UCSF School of Medicine; KimberlyTopp, PhD, PT, UCSF School of Medicine, Departmentof Physical Therapy; H. Carrie Chen, MD, MSEd, UCSFSchool of MedicineAreas abstract covers: UMEDomain(s) addressed: Communication, CurricularInnovation, Evaluation of Programs and Curricula,Interprofessional EducationPurpose: We describe the implementation andevaluation of a novel interprofessional curriculum forfirst-year dentistry, medicine, nursing, pharmacy, andphysical therapy students.Background: Promoting interprofessional education(IPE) early in the training of health professions studentscan help lay strong foundations for effective teamwork inUniversity of California, San Francisco • School of Medicine 9

UCSF Education Day 2011their future careers. We implemented a required yearlongcurriculum for all first-year health professionsstudents. The curriculum included 2 half-day events(“IPE Days 1 & 2”) during which students collaborated ininterprofessional teams of 9-10 students to addresshealthcare disparities and team communicationchallenges. Student teams also responded to four triggerquestions throughout the year using an online discussionforum.Methods: Students completed satisfaction surveys atthe end of each IPE Day and year using a 5-point Likertscale (1=strongly disagree, 5=strongly agree). Wedetermined utilization of the online forum by calculatingand categorizing student postings and identifying majorthemes.Results: 477 students participated in the curriculum.Students rated both IPE Days 1 and 2 as effective (Day1=4.06, Day 2=3.92) and relevant to their education(4.30, 4.06). 423 (88.9%) students participated in theonline forum generating 1205 postings. Studentresponse rate to the online questions decreased from83% to 26% over the year. Pharmacy students had thehighest online participation rate (92% responded at leastonce) and nursing the lowest (81%, p=0.02). Majordiscussion themes are presented.Discussion: We successfully implemented a novelinterprofessional curriculum which was well received byfirst-year health professions students. However, use ofthe online forums declined over time, suggesting theneed for further curricular refinements to sustainparticipation.Reflection: Input from faculty from all participatingschools was critical to the success of thisinterprofessional initiative. Student feedback wasgathered via online and paper surveys, and was used toinform the expansion and refinement of the curriculum.What's Really So Different aboutLongitudinal Integrated Clerkships(LICs) and Block Clerkships?Findings from a Multi-CenterObservational, Work Sampling StudyBridget O'Brien, PhD, UCSF, bridget.obrien@ucsf.edu;Ann Poncelet, MD, UCSF, ann.poncelet@ucsf.edu; LoriHansen, MD, University of South Dakota, SanfordSchool of Medicine, lori.hansen@usd.edu; David Hirsh,MD, Harvard Medical School, dhirsh@challiance.org;Barbara Ogur, MD, Cambridge Hospital, HarvardMedical School; Edward Krupat, PhD, Harvard MedicalSchool; Erik Alexander, MD, Harvard Medical School,ealexander@partners.org; Iris Ma, UCSF; Karen Hauer,MD, UCSF, khauer@medicine.ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Evaluation of Programs andCurricula, Longitudinal Educational ActivitiesPurpose: To compare direct and independent patientcare activities of longitudinal integrated clerkship (LIC)and block students at three medical schools.Background: Studies suggest that students in LICsmaintain more patient-centeredness throughout the yearcompared to students in block clerkships. Theexplanation may rest in students’ involvement in directpatient care activities.Methods: We conducted a yearlong, observational,work sampling study at 3 US medical schools with LICand block clerkships. Trained observers documentedstudents’ activities and level of participation every 10minutes for 4-hour periods in internal medicine andobstetrics-gynecology. In this analysis, we comparestudents’ participation in direct patient care activities inthe last three months of the clerkship year. Each studentwas observed 1-4 times. The observation session is theunit of analysis. Data analysis included calculatingmedian percentages of session time and Mann-WhitneyU-tests comparing percentage of session time that LICand block students’ engage in direct and independentpatient care activities.Results: We observed 44 students (28 LIC,16 block),resulting in 91 late year observations. Despite somedifferences among schools, LIC students overall spentsignificantly more time engaged in direct patient carecompared to block students (45%vs.35%,p=0.040) andmore time performing these direct patient care activitiesindependently than block students (25%vs.9%,p

UCSF Education Day 2011clerkships. This independence may be moredevelopmentally appropriate for late-year clerkshipstudents and warrants further investigation of therelationship to students’ patient-centeredness.Reflective Critique: We are conducting ongoingconsultations with research team members andconsultants and incorporating their feedback to improveour analysis.Writing for Change: TrainingResidents in Health Policy Advocacythrough NarrativeLouise Aronson, MD MFA, UCSF,aronsonl@medicine.ucsf.edu; Anda Kuo, MD,AKuo@sfghpeds.ucsf.edu; Sharad Jain, MD,Sharad.Jain@ucsf.edu; Vanessa Grubbs, MD,grubbsv@medsfgh.ucsf.edu; Jennifer Siegel, MD,jennifer.siegel@ucsf.edu; Alice HM Chen, MD,achen@medsfgh.ucsf.edufor quality, relevance and usefulness were 4.95, 4.925and 4.975, respectively. Qualitative comments wereequally positive and emphasized usefulness of prereading,in-class writing, hearing each other's storiesand reading aloud with peer/faculty feedback. Somewanted more time and a few needed support afterraising upsetting patient experiences. Residentspublished in New York Times (2), Health AffairsNarrative Matters, Huffington Post and Annals of InternalMedicine.Discussion: Narrative writing is a relevant and usefuladvocacy tool for pediatric and internal medicineresidents in advocacy tracks and was enthusiasticallyreceived by the learners. Trainees were able to developthe basics of publishable pieces within the framework ofa few structured seminars.Reflection: Presentations at WGEA, AGSAreas abstract covers: GMEDomain(s) addressed: Communication, Evaluation ofPrograms and Curricula, Health Policy, MedicalHumanitiesPurpose: To develop, implement and assess acurriculum to train residents in advocacy-based PublicMedical Writing.Background: Medical narratives are used to educate,change opinions and influence policy. From letters to theeditor or opinion columns in newspapers to essays inmedical or policy journals, physician's stories inspirechange and give voice to society's most vulnerable.Although law and business schools train learners inpersuasive communication, medicine has used narrativeprimarily to promote self-reflection and humanism.Methods: Faculty with expertise in narrative, policy andunderserved medicine collaborated to develop a 3-partworkshop for medicine and pediatrics residentsparticipating in advocacy educational tracks. Workshopswere 2 hours long and included: discussion of articlesfrom newspapers, medical and health policy journals;discussion of audience, venues, advocacy levels andnarrative craft; in-class (session 1) and at-home(sessions 2-3) writing; development of ledes (session 1)and in-progress articles (sessions 2-3). Faculty reviewedadditional drafts as needed. Participants scored sessionquality, relevance and usefulness on a 0-to-5 (worst-tobest)scale and provided qualitative feedback. Facultytracked resident publications.Results: All 19 residents completed evaluations. Mosthad little writing experience. Combined session ratingsUniversity of California, San Francisco • School of Medicine 11

UCSF Education Day 201112 The Haile T. Debas Academy of Medical Educators

UCSF Education Day 2011Poster PresentationsCurriculum Development PostersAdventures in Competency-Based Formative Assessment: Faculty Development toProvide Feedback on Critical Reflections ........................................................................................................................ 16Louise Aronson, MD, MFA; Susan Masters, PhD; Lowell Tong, MD; Kevin Mack; Carol A. Miller,MD; Heidi E. Kirsch, MD; Marieke Kruidering, PhDContinuous Improvement During Third-Year Clerkships .............................................................................................. 16Vanja Douglas, MD; Joseph Liu, BA; Heidi Kirsch, MD; Ann Poncelet, MD; Andy Josephson, MDCurriculum in Developmental Disabilities ........................................................................................................................ 17Clarissa Kripke, MD; Gerri Collins-Bride, RN, ANPDevelopment of a Longitudinal Reflective and Narrative Medical Writing Course for ThirdYear Medical Students........................................................................................................................................................ 17Emily Whichard, MS4; Margo Vener, MD, MPH; Louise Aronson, MDFour Primary Care Residency Training Programs Develop Leadership, Cultural Competence,and Community Advocacy and Partnership Curricula through Collaboration ............................................................ 18Sharad Jain, MD; Craig Keenan; Steve Roey; Kathleen HicksFrom Silos to Certainty: Combining Resources to Create an Interdisciplinary Website toImprove Trauma Education and Patient Care .................................................................................................................. 18Eric Lin, MD; Ben Houseman, MD, PhD; Esther Chen, MD; Rochelle Dicker, MD; David Duong,MD; Robert Mackersie, MD; Andre Campbell, MDLeveraging a Near-Peer Medical Student to Improve Orientation and Training on Portfoliosand Competency-Based Development ............................................................................................................................. 19Amanda Angelotti, MS2; Chandler MayfieldLOFT: Development of a Leadership Observation and Feedback Tool ........................................................................ 19Read Pierce, MD; Sandrijn van Schaik, MD, PhD; Sonny Tat, MD; Anda Kuo, MDPeer-Facilitated Small Groups to Encourage Cross-Competency Learning ................................................................ 20Laura Byrne; Matthew Schechter; Igor Mitrovic, MD; Tracy Fulton, PhDPreparing for Teaching Health Center Residency Programs: Migrant and Farm Worker 4 thYear Transition Elective ..................................................................................................................................................... 21Adriana Padilla, MDScreening, Brief Intervention, and Referral to Treatment (SBIRT) for Substance Use Disordersamong Resident Physicians: Curriculum Development and Preliminary Evaluation.................................................. 22Neda Ratanawongsa, MD, MPH; Jennifer Manuel, PhD; Daniel Ciccarone, MD, MPH; JenniferHettema, PhD; Brad Shapiro, MD; Sharad Jain, MDStudent Created Modules to Guide Portfolio Implementation ....................................................................................... 22Nicklaus Brandehoff, University of California, San Francisco, nicklaus.brandehoff@ucsf.eduTeaching Ultrasound Imaging Perception: “Weathermaps to Recognition”................................................................ 23Marcia McCowin, MD; Virginia Griswold, MD; Stefanie Weinstein, MD; Irene Turman, RVTUniversity of California, San Francisco • School of Medicine 13

UCSF Education Day 2011Team-Based Journal Club: A Longitudinal Approach to Evidence-Based Medicine (EBM)Training During Residency ................................................................................................................................................ 23Renee Kinman, MD, PhD; Serena Yang, MD, MPHCurriculum Evaluation/Educational Research Posters2007 - 2010 Match Data from Model SFGH on Underserved and Primary Care Residency Choice ........................... 25Margo Vener, MD, MPH; Elisabeth Wilson, MD, MPH; Anna Loeb, MS3; Nili Sommavilla, MS3;Julia Bruckner, MS3; Margaret Wheeler, MDA Randomized Trial of Hypothesis-Driven versus Screening Neurological Examination .......................................... 25Hooman Kamel, MD, UCSF; Gurpreet Dhaliwal, MD; Maulik Shah, MD; Amar Dhand, MD, DPhil;Babak Navi, MD; S. Andrew Josephson, MDA Review of Longitudinal Medical Educational Programs Relating to a PsychiatryResidency Clinical Curriculum Redesign......................................................................................................................... 26Colin E. Stewart, MD; Danielle Carlin, MD; John Q. Young, MD, MPP; Amin Azzam, MD, MAAnesthesia Journal Clubs: General Practices and Successful Features ..................................................................... 26Kathryn Price, MS; Marek Brzezinski, MD PhD; H Nicole Tran, MD; Kathy Schlecht, DO; AnnetteMizuguchi, MD, PhD; Stephen Kimatian, MD; Guneet Natt, MD; John Mitchell, MDCreating an Inter-Professional Teamwork Education Program for Health ProfessionsStudents in a District Setting in Tanzania ........................................................................................................................ 27Gary Koehler; Siriel Massawe; Helga Naburi; Sebalda LeshabariDiabetes, Hypertension and Asthma…Oh My! Can a Chronic Illness Cohort Help ImproveStudent and Patient Outcomes?........................................................................................................................................ 28Margo Vener, MD, MPH; Ben Howell, MS3; Nicole Gomez, MS3; Kate Chomsky-Higgins, MS3;Nili Sommavilla, MS3; Margaret Wheeler, MDDissemination and Implementation of an Evidence-Based, Tobacco-Treatment Curriculum.................................... 28Alan K Louie, MD; Sebastien C. Fromont, MD; Karen Suchanek Hudmon, DrPH, RPH; Sharon M.Hall, PhD; Judith J. Prochaska, PhD, MPHEvaluating a Novel Quality Improvement Curriculum for Third Year Medical Students ............................................. 29David Stern Levitt, BS; Somnath Mookherjee, MDFaculty and Resident Knowledge of Health Care Costs ................................................................................................. 29Amy Clouse; Adam Carlson, MD; Bradley Sharpe, MDFaculty Development to Support Competency Based Medical Education in Tanzania:A Situation Analysis ........................................................................................................................................................... 30Molly Fyfe, MA, MPH; Charles MKony; Kelli Barbour; Dorothy Perry; Patricia O’Sullivan, EdD;Sarah MacFarlaneFaculty-Narrated Web-Based Learning Modules Improve Students’ Communication Skillson a High-Stakes Clinical Skills Examination .................................................................................................................. 30Christina A. Lee, MD; Anna Chang, MD; Calvin L. Chou, MD, PhD; Christy Boscardin, PhD;Karen Hauer, MDFeasibility of a Supplemental Home-Based Curriculum for Basic Surgical Skills Acquisition .................................. 31Leslie C. Sheu, BA, UCSF School of Medicine, leslie.sheu@ucsf.edu; Hueylan Chern, MD;Patricia S. O'Sullivan, EdD; Ed Kim, MD14 The Haile T. Debas Academy of Medical Educators

UCSF Education Day 2011Geriward: An Interprofessional Team-Based Curriculum on Care of the Hospitalized Older Adult.......................... 32Stephanie Rennke, MD; Lynda Mackin, RN, PhD, ANP-BC, CNS; Bree Johnston, MD, MPH;Adam Moylan, PhD; Vicki Jue, PharmD; Cindy Lai, MDIdentifying Curricular Needs for Clinical Medical Education in Tanzania..................................................................... 32Reena Gupta, MD; Molly Fyfe, MPH MA; Charles Mkony, MD; Sarah Macfarlane, PhD MSc;Eligius Lyamuya, MD; Ephata Kaaya, MDImpact of Student-Run Clinics on Preclinical Students’ Sociocultural and InterprofessionalAttitudes: A Prospective Cohort Analysis........................................................................................................................ 33Leslie C. Sheu, BA; Cindy J. Lai, MD; Anabelle D. Coelho, MS; Lisa D. Lin, MS; Patricia Zheng,BS; Patricia Hom, BA; Vanessa Diaz, BS; Patricia S. O’Sullivan, EdDIntegrating Multiple Levels of Learners into an Interdisciplinary Team-Based Model ofAmbulatory Care ................................................................................................................................................................. 33Katherine Julian, MD; Bridget O'Brien, PhD; Maria Wamsley, MDLearners' Perspectives on Effective Mentorship............................................................................................................. 34Christy Boscardin, PhD; Renee Courey, PhD; Louise Aronson, MD, MFA; Allison Chen; MarkLovettLights, Camera, Action: Small Group Video Review Promotes Efficient, Effective Clinical Learning....................... 35Margo Vener, MD. MPH; Erika Schillinger, MDMeaningful Innovation or Rearranging Deck Chairs? Comparing Three Formats for aFamily Medicine Clerkship ................................................................................................................................................. 35Margo Vener, MD; Nili Sommavilla, Med 3; Julia Bruckner, MS3; Arianne Teherani, PhDMedical Student Perceptions of Anesthesiology............................................................................................................. 36Kathryn Price, MS; Guneet Natt, MD; Bridget O'Brien, PhD; Marek Brzezinski, MD, PhD; MartinBogetz, MDMedical Students’ Attention to Multiple Risk Behaviors: A Standardized Patient Examination ................................ 36Judith J. Prochaska, PhD, MPH; Kathleen Gali; Bernie Miller; Karen Hauer, MDPhysical Examination Teaching: A Systematic Review of the Literature ..................................................................... 37Somnath Mookherjee, MD; Lara Pheatt, MA; Calvin L. Chou, MD, PhDPilot of a Lifelong Professional Development Metric in a Scholarly Concentration Program.................................... 38Renee Courey, PhD; Carrie Chen, MD, MSEd; Louise Aronson, MD, MFA; Kristen Fitzhenry, MS;Josh Adler, MD; Additional Pathway to Discovery DirectorsProfessional Deformation: The Repression of Personal Values and Attributes in Medical Education..................... 38Michael W. Rabow, MD; Carrie N. Evans, MA; Rachel N. Remen, MDTeaching and Assessing Medical Students’ Skills in Counseling for Behavior Change:A Systematic Review .......................................................................................................................................................... 39Karen E. Hauer, MD; Patricia Carney, PhD; Anna Chang, MD; Jason Satterfield, PhDThe Educational Value of Overnight Call Amid Resident Duty Hours Restrictions..................................................... 39Oren K. Fix, MDThe UCSF Geriatric Community Resources Clinical Algorithm and Guide .................................................................. 40Christopher A. Bautista; Louise Aronson, MDUniversity of California, San Francisco • School of Medicine 15

UCSF Education Day 2011Curriculum Development PostersAdventures in Competency-BasedFormative Assessment: FacultyDevelopment to Provide Feedback onCritical ReflectionsLouise Aronson, MD, MFA, UCSF Department ofMedicine, Division of Geriatrics,aronsonl@medicine.ucsf.edu; Susan Masters, PhD,UCSF, Department of Cellular and MolecularPharmacology, masters@cmp.ucsf.edu; Lowell Tong,MD, USCF, Department of Psychiatry; Kevin Mack,UCSF, Department of Psychiatry; Carol A. Miller, UCSF,Department of Pediatrics; Heidi Kirsch, MD, UCSF,Department of Neurology; Marieke Kruidering, PhD,UCSF, Department of Cellular and MolecularPharmacology, Marieke.Kruidering@ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Faculty Development,Feedback, Portfolios, ReflectionPurpose: To develop and assess a volunteer effort toprovide feedback on reflective skills in medical studentcritical reflections.Background: Literature suggests that reflectionimproves professional behavior, teamwork, selfmonitoring,and clinical performance. Reflective skilldevelopment requires repeated practice with timelyfeedback. As medical schools increasingly incorporatereflection into their curricula, they must devise means ofproviding feedback to large numbers of learners onexercises that can be assessed for both reflective skilland reflective learning about a specified topic.Methods: A series of competency-based, formativeexercises were added across the first-year corecurriculum and linked to the MD Portfolio. We recruitedfaculty and staff to a feedback team via targeted emailsand announcements at curricular committee andAcademy meetings. A 1.5-hour-long training introducedvolunteer reviewers to critical reflection using theLEAP/SOAP model and related feedback guidelines andhad participants practice writing feedback on reflectiveskill development for several de-identified reflectionsamples. RESULTSThe initial call yielded 8 volunteers.A repeat call yielded 4 more. The feedback team of 9faculty from 8 departments and 3 educational staffprovided feedback on 456 reflections from September toDecember, 2010. To protect student privacy, reviewerscould not see previous reflections or feedback. Onaverage, faculty provided feedback on 3-5 reflections perweek, which delayed the feedback to students for up to4-6 weeks.Evaluation Plan: Reviewers will complete a surveyabout the experience and their feedback approach. Arater will score the quality of feedback in a random subsampleusing qualitative analysis and a feedback rubric.We will compare results from the first and thirdreflections and analyze relevant data from longitudinalstudent focus groups and course evaluations.Dissemination: ECC meetings; Education Day, WGEA,national meetings.Reflective critique: We will use the evaluationinformation to revise next year’s critical reflectioncurriculum.References:1. Sandars, John. The use of reflection in medical education: AMEEGuide No. 44, Medical Teacher, 31: 8, 685 -695, 2009.Continuous Improvement DuringThird-Year ClerkshipsVanja Douglas, MD, UCSF, vanja.douglas@ucsf.edu;Joseph Liu, BA, UCSF School of Medicine,joseph.liu@ucsf.edu; Heidi Kirsch, MD, UCSF,heidi.kirsch@ucsf.edu; Ann Poncelet, MD, UCSF,ann.poncelet@ucsf.edu; S. Andrew Josephson, MD,UCSF, ajosephson@memory.ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Curricular Innovation, FeedbackPurpose: To develop a web-based interface that allowsstudents and educators to evaluate each other dailyduring clinical rotations.Background: Feedback is an important yet oftenneglected part of the learning process. Quality toolsbased on the principles of Continuous Improvement (CI)provide a medium for effective and immediate feedback.Methods: We developed an online CI module in theCollaborative Learning Environment through whicheducators and students can provide each other dailyfeedback. Over one year, two instructors on an inpatientneurology clerkship were assigned to use the modulewith their third-year students (10 students) and the restattended as usual (7 students). Students completed asurvey about feedback after their rotation. Instructorsusing the module were interviewed. The Wilcoxon ranksumtest was used to compare Likert scales.16 The Haile T. Debas Academy of Medical Educators

UCSF Education Day 2011Evaluation Plan: The module was used an average oftwo times per week. Students using the module weremore satisfied with the amount (p=0.07) and quality(p=0.02) of their feedback. Those using the moduleagreed they received more (p=0.02) and higher quality(p=0.06) feedback compared to other rotations duringthird year. All stated the CI module should be adoptedon more clinical rotations. Educators found it timeintensivebut discovered it helped hone their skill atgiving quality feedback.Dissemination: The module will be expanded to otherinstructors in the neurology department in the comingyear.Reflective critique: The number of students andeducators using the module was small, but the receptionfrom students was very positive. Educators may still findtime a major hurdle in implementation.Curriculum in DevelopmentalDisabilitiesClarissa Kripke, MD, UCSF Department of Family andCommunity Medicine, kripkec@fcm.ucsf.edu; GerriCollins-Bride, RN, ANP, Community Health Systems,UCSF School of Nursing, gerri.collinsbride@nursing.ucsf.eduAreas abstract covers: UME, GME, CMEDomain(s) addressed: Curricular Innovation, Diversity,Interprofessional Education, Primary CarePurpose: The goal of this project is to increase thecompetence of health care professionals to meet thehealth care needs of adults with developmentaldisabilities.Background: In 2006 an interagency collaborative wasestablished to identify barriers to health care for adultswith developmental disabilities and to develop a pilot toaddress them.Methods: The Office of Developmental Primary Care(ODPC) was established in the UCSF Department ofFamily and Community Medicine to bring together aninterprofessional team of clinicians to develop training atthe predoctoral, residency and faculty developmentlevels. ODPC developed a curricular map, competenciesand an interprofessional student interest group. Theteam worked with community partners to develop acomprehensive website and set of curricular materialsincluding practice pearls, health maintenancerecommendations, information on accessing services,sample power point presentations, empathy exercises,chart forms, links, policy papers and sample referralletters. The team has presented the content in didacticpresentations to over 1300 trainees in different healthdisciplines.Evaluation Plan: The Office of Developmental PrimaryCare is tracking hits and downloads to its website (over3000 per month). We are collecting evaluations at everydidactic session.Dissemination: ODPC has integrated a problem basedlearning case into the predoctoral medical schoolcurriculum, developed an elective, integrated a healthadvocate from the Arc of San Francisco into the familymedicine residency training site and developed diadacticpresentations for over 1300 trainees in variousdisciplines, locally and nationally. Content has beensummarized in a guide to clinical care for all medicalstudents and in a book chapter for nursing students.Reflective critique: Revising and expanding the trainingand web materials is an ongoing, iterative process andwe continue to partner with people with disabilities andtheir advocates in all of our curriculum development.Development of a LongitudinalReflective and Narrative MedicalWriting Course for Third Year MedicalStudentsEmily Whichard, MS4, University of California at SanFrancisco, emily.whichard@ucsf.edu; Margo Vener, MD,MPH, University of California at San Francisco,mvener@fcm.ucsf.edu; Louise Aronson, MD, Universityof California at San Francisco,aronsonl@medicine.ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Curricular Innovation,Longitudinal Educational Activities, Medical Humanities,ReflectionPurpose: To design a longitudinal writing course forthird year medical students to reflect on their transition toclinical medicine and advance of their public writingskills.Background: The literature describes reflection as atool for self-regulated life-long learning and developmentof professional practice. The growing diversity of typesand venues for narrative medical writing presents anopportunity to help students translate reflective learninginto writings which effectively communicate their uniqueclinician experiences to colleagues and the public.Methods: Curriculum development consisted of: (1) aliterature review of public medical writing; (2) informalsurveys of course directors and medical students aboutreflection and writing interests and needs; (3) selectionUniversity of California, San Francisco • School of Medicine 17

UCSF Education Day 2011of exemplar readings of advocacy and narrative medicalwriting; (4) development of a series of structuredprompts; and (5) creation of a student syllabus andcompanion faculty teaching guide. We then piloted aseven-session course with Model SFGH volunteers in2010-2011 and solicited their feedback on coursemethods and goals. We obtained Academic Senateapproval and recruited faculty for a 4-session,longitudinal, third year medical student course entitled“Public Medical Writing” to start in the 2011-12 academicyear.Evaluation Plan: Evaluation will include tracking ofstudent enrollment and retention in year one andenrollment in subsequent years, student preparation forsessions, and student completion of one short, revised,publication quality narrative medical writing piece. At theend of the course, students will complete courseevaluations and a knowledge test of public medicalwriting types and venues. Finally we will analyze studentwritings for writing, storytelling and reflective traits usingpreviously validated rubrics.Dissemination: Health & Society Works-in-Progress;Pathways to Discovery symposium; WGEA.Reflective critique: The final course reflects feedbackfrom third year course directors, Model SFGH directors,course pilot participants and other pathways learners.Four Primary Care ResidencyTraining Programs DevelopLeadership, Cultural Competence,and Community Advocacy andPartnership Curricula throughCollaborationSharad Jain, MD, UCSF, Sharad.Jain@ucsf.edu; CraigKeenan, UC Davis, craig.keenan@ucdmc.ucdavis.edu;Steve Roey, Santa Clara Valley Medical Center,Steve.Roey@hhs.sccgov.org; Kathleen Hicks, AlamedaCounty Medical Center, khicks@acmedctr.orgValley Medical Center) that provide care to underservedpopulations and the development of a curriculum thataddresses topics on leadership, advocacy, communitypartnerships, and cultural competency.Methods: Program leadership worked together todevelop training models that can be implemented,evaluated, and ultimately disseminated to a broaderaudience of residency training programs. The process ofdeveloping a comprehensive curriculum for medicineresidents to learn these core topics requiredcollaboration to (1) perform an assessment of currentcurricula being delivered and compare these curriculawith the literature and national guidelines, (2) implementcurricular design to facilitate delivery at programs withwide variations in schedules and logistics, and (3)document the impact of these innovations on residentphysicians’ knowledge, skills, and attitudes.Evaluation Plan: The impact of the curriculum onresidents is currently being assessed using pre- andpost- surveys. Informal survey of faculty and residentsinvolved in the curricula demonstrated great satisfactionwith the process and ease of delivery with thecurriculum.Dissemination: Collaboration with specific curricularobjectives provides a valuable method for rapiddevelopment and delivery of curricula to addressdisparities among training physicians and proved aninvaluable technique that is both transferable and flexibleto fit individual programs’ needs. We also believe thatthis process had significant beneficial impact on facultydevelopment. We plan to disseminate our work throughpresentations at various meetings and to make ourcurriculum available to other programs.Reflective critique: We await learner feedback throughour surveys, as well as from our dissemination efforts.This feedback will help improve the curriculum.Areas abstract covers: GMEDomain(s) addressed: Community Medicine, CurricularInnovation, LeadershipPurpose: Physicians, especially those working in safetynet systems, must be trained to address disparitiesserving as "agents of change" to improve outcomes fortheir patients.Background: We describe a collaborative processamong four primary care medicine residency trainingprograms (UCSF/SFGH, Alameda County MedicalCenter, University of California, Davis, and Santa Clara18 The Haile T. Debas Academy of Medical Educators

UCSF Education Day 2011From Silos to Certainty: CombiningResources to Create anInterdisciplinary Website to ImproveTrauma Education and Patient CareEric Lin, MD, Department of Anesthesia, University ofCalifornia, San Francisco, lineric@anesthesia.ucsf.edu;Ben Houseman, MD, PhD, Department of Anesthesia,University of California, San Francisco,Houseman@anesthesia.ucsf.edu; Esther Chen, MD,Department of Emergency Medicine, University ofCalifornia, San Francisco,esther.chen@emergency.ucsf.edu; Rochelle Dicker, MD,Department of Surgery, University of California, SanFrancisco, DickerR@sfghsurg.ucsf.edu; David Duong,MD, Department of Emergency Medicine, University ofCalifornia, San Francisco,David.Duong@emergency.ucsf.edu; Robert Mackersie,MD, Department of Surgery, University of California, SanFrancisco, rmackersie@sfghsurg.ucsf.edu; AndreCampbell, MD, Department of Surgery, University ofCalifornia, San Francisco, acampbell@sfghsurg.ucsf.eduAreas abstract covers: UME, GMEDomain(s) addressed: Computers and Technology,Curricular Innovation, Longitudinal Educational Activities,Patient CarePurpose: To create an internet resource that enhancestrauma education at San Francisco General Hospital(SFGH) by: (1) consolidating educational material fromthe anesthesia, emergency medicine, and surgerydepartments; and (2) providing always-accessiblecontent for learners from any department, training level,or trauma-related rotation.Background: The literature on workplace learning hasshown that there are common organizational factors thataffect learning in any field. Sharing of resources is onesuch factor that facilitates learning, while negativefactors include role uncertainty and emphasis on isolatedwork. Medical education studies have furtherdemonstrated that both undergraduate and graduatelearners struggle with such learning barriers, particularlywhen entering a new role or hospital. Staggered shiftsand rotation-centered traditions also hamper the sharingof practices and resources. One solution isasynchronous education through an interdisciplinaryonline resource.Methods: We developed a website to function as astand-alone web portal (sfghtrauma.org), with public andpassword-protected areas accessible at all times. SFGHfaculty with prominent roles in trauma education for eachdepartment contributed the curricular materials used foreach trainee rotation. The authors consolidated, created,and agreed upon the final content. All learners receivedwritten and verbal instructions to utilize the website astheir primary information source.Evaluation Plan: Evaluation of this work will investigatechanges in faculty teaching perceived learning outcomesfrom students and faculty, and end-of-rotationevaluations of the website.Dissemination: This resource will be discoverable viainternet search engines and continually accessible toboth the public and UCSF community. We plan topublish our outcomes in a relevant educational journal.We will publish our creation process for shared, topicbasedresources on AAMC MedEdPortal.Reflective critique: We are soliciting both learner andfaculty feedback through written questionnaires andfocus groups. Learner and faculty feedback will be usedto continually improve this resource for future learners.Leveraging a Near-Peer MedicalStudent to Improve Orientation andTraining on Portfolios andCompetency-Based DevelopmentAmanda Angelotti, MS2, UCSF School of Medicine,amanda.angelotti@ucsf.edu; Chandler Mayfield, UCSFSchool of Medicine, chandler.mayfield@ucsf.eduAreas abstract covers: UME, GMEDomain(s) addressed: Communication, Competencies,Computers and Technology, PortfoliosPurpose: To develop near-peer orientation and trainingmaterials to address communications challenges whenpresenting portfolios and competency-baseddevelopment to medical students.Background: UCSF launched an electronic portfolio in2009 to support competency-based development. Afterits first year, students reported that they did notunderstand portfolio requirements, value, or purpose andthat technical resources were inadequate and confusing.Methods: A second year medical student developedand delivered a new student orientation session onportfolios and their relationship to competency-baseddevelopment to incoming first year medical students inthe fall of 2010. This session clarified how the portfoliosupports professional development from the perspectiveof a near peer, provided examples of portfolios createdby fellow students and residents, and discussedcompetencies in student-friendly and approachableterms. The student also redeveloped existing onlineresources to clarify the purpose and requirements of theportfolio and improve and highlight the technical helpsection.University of California, San Francisco • School of Medicine 19

UCSF Education Day 2011Evaluation Plan: Surveys will be disseminated tostudents to assess the updated training materials. Thesedata will be compared to data from the first year ofportfolio implementation.Dissemination: The orientation presentation wasdelivered to first year students in the fall of 2010 andmaterials have been shared with staff and facultyresponsible for future portfolio training. The updated MDPortfolio Handbook is accessible on iROCKET, theelectronic curriculum platform of the UCSF School ofMedicine. A poster abstract has been submitted for the2011 AAMC Western Regional Conference at StanfordUniversity.Reflective critique: Survey data from the first year ofportfolio implementation and support from CurricularAffairs and the Office of Education Technology wereused to develop the revised portfolio training curriculum.A Frequently Asked Questions section will be added tothe handbook based on recent student feedback, and aliterature search will be conducted to seek furthermethods for teaching new medical students about theuse of portfolios.LOFT: Development of a LeadershipObservation and Feedback ToolRead Pierce, MD, UCSF, Read.Pierce@ucsf.edu;Sandrijn van Schaik, MD PhD, UCSF,vanschaiks@peds.ucsf.edu; Sonny Tat, MD, UCSF,TatS@peds.ucsf.edu; Anda Kuo, MD, UCSF,AKuo@sfghpeds.ucsf.eduAreas abstract covers: GME, CMEDomain(s) addressed: Assessment and Testing,Communication, Feedback, LeadershipPurpose: To develop a pilot tool for assessment andfeedback of physician leadership skills.Background: Clinical environments provide numerousopportunities to work in multidisciplinary teams.Physicians are often expected to lead such teams, yetthere is a paucity of validated assessment tools forevaluating leadership behaviors in the healthprofessions. Existing tools largely focus on crisissituations such as resuscitations or surgicalemergencies. The Leadership Practice Inventory (LPI) isa validated and reliable leadership assessment toolwidely used in the business world to provide multisourcefeedback in varied settings. This tool, however,does not adequately address experiences on a clinicalteam.Methods: We performed an in-depth literature review onteamwork and team leadership in clinical workenvironments using PubMed and Business SourceComplete. We identified 5 assessment instruments forleadership in clinical crisis situations and modified theLPI tool to incorporate relevant concepts from theseinstruments. The resulting pilot Leadership Observationand Feedback Tool (LOFT) is a 5-domain instrumentwith 15 questions constructed to capture observedleadership behaviors and give suggestions forimprovement using open-ended text.Evaluation Plan: We have started a study amongpediatric and internal medicine residents and anticipatecollecting approximately 80 pilot LOFTs. We will conducta qualitative analysis of the LOFT responses untilsaturation has been reached to identify themes anddelineate a spectrum of physician behaviors in each ofthe 5 leadership practice domains. This will inform thecreation of behavioral anchors on a scale from novice toexpert that we can use to create a quantitative LOFT.Dissemination: We will summarize the qualitativefindings in a manuscript for peer reviewed publication.Reflective critique: Our project was reviewed byESCape prompting us to recognize the need to start witha qualitative LOFT in order to establish behavioralanchors for a quantitative tool.References:1. Posner, B. Leadership Practices Inventory Data Analysis. Retrievedon February 7, 2011 from:http://media.wiley.com/assets/2034/63/LPIAnalysisAug2009.pdf.Peer-Facilitated Small Groups toEncourage Cross-CompetencyLearningLaura Byrne, UCSF School of Medicine,laura.byrne@ucsf.edu; Matthew Schechter, UCSFSchool of Medicine, matthew.schechter@ucsf.edu; IgorMitrovic, MD, Department of Physiology, UCSF Schoolof Medicine, imitrov@phy.ucsf.edu; Tracy Fulton, PhD,Department of Biochemistry, UCSF School of Medicine,tracy.fulton@ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Basic Science Education,Competencies, Curricular InnovationPurpose: To design a series of basic science smallgroups with increased student responsibility forfacilitation and team dynamics.Background: Expert-facilitated small groups provide avenue for application of knowledge in UCSF’s20 The Haile T. Debas Academy of Medical Educators

UCSF Education Day 2011preclerkship curriculum. However, administrativeresource-intensivity and uneven facilitator quality impactthe overall effectiveness of the modality. Given theincorporation of ACGME competencies into UME, thereis a need for early, structured practice in the domains ofInterpersonal & Communication Skills, Practice-BasedLearning and Professionalism.Methods: We developed 3 peer-facilitated (PF) basicscience small group sessions. Content learning isfaculty-supported by electronic and in-person “roving” Q-and-A, and multiple choice questions with instantfeedback. An accompanying self-facilitation curriculumconsists of an introductory large group presentation,incorporating audience participation, and a selffacilitateddebriefing after the first group. These sessionswere designed to explicitly address non-medicalknowledge learning by encouraging analysis of groupprocess and personal goal-setting.Evaluation Plan: To address the efficacy of the PFgroups for medical knowledge acquisition and forpractice of specific skills in other competency domains,we have collected student responses to quantitative andopen-ended questions. We have also collected objectiveperformance data from course examination questions.This data will be discussed and compared to thatcollected from more traditional small groups.Dissemination: Curriculum details and preliminaryevaluation data have been shared with curriculumoversight committees, and implementation in othercourses has been discussed. We will considersubmission to MedEdPORTAL and outside conferencesor journals once program evaluation is complete.Reflective critique: Based on pilot-year feedback, thegroups have been modified with increased contentcomplexity, additional multiple-choice questions, and theimproved use of technology and the new Teaching andLearning Center for faculty “check-ins” with groups.Future evaluation and implementation will also beinformed by outcomes from implementation of Team-Based Learning in the Essential Core.Preparing for Teaching Health CenterResidency Programs: Migrant and FarmWorker 4th Year Transition ElectiveAdriana Padilla, MD, UCSF Fresno Family and CommunityMedicine, apadilla@fresno.ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Curricular Innovation, PrimaryCare, ReflectionPurpose: The Migrant and Farm worker elective engagesparticipants in a pathway highlighting primary health care incommunity health centers while learning about systemsbased practice. Such pathways will be critical to transition4th year students into teaching health centers.Background: Academic Medicine’s November 2010 journalhighlights the challenge of “Taking back Year 4.”1 Wallingand Merando further suggest that goals for the fourth yearshould be clarified.2 The Affordable Care Act will promoteteaching health centers (THC) which are expected todevelop in the Central Valley. This elective was designed tofacilitate a student’s transition to a rural THC and its uniquesystems based practice to encourage advance practiceskills.Methods: The elective includes clinical care responsibilities3 days a week and 2 days of field work activitieshighlighting systems based practice themes to allowdemonstration of an awareness of and responsiveness tothe larger context and system of health care. Fieldworkactivities include orientation to reflective learning and allowfor reflective analysis of student learning goals.Evaluation Plan: Participants are evaluated utilizingUCSF’s standard clinical evaluation form. Four reflectivesummaries are required from fieldwork learning goals.Qualitative methods will be used to explore the range ofparticipant learning themes. Themes will be analyzed toenhance future participant learning and facultydevelopment.Dissemination: Presentations at departmental researchmeetings are planned. Critical will be presentations toTHC’s as they develop. Submission to family medicinejournals and meetings will occur.Reflective critique: Review by a THC was helpful indesigning the elective. Student participant evaluations havepromoted modification. Qualitative analysis will occur withFresno’s family medicine research team.References:1. Stevens C. Commentary: Taking back Year 4: A call to action.AcadMed. 2010;85:1663-1664.2 Walling A, Merando A. The fourthyear of medical education: A literature review. AcadMed.2010;85:1698-1704.University of California, San Francisco • School of Medicine 21

UCSF Education Day 2011Screening, Brief Intervention, andReferral to Treatment (SBIRT) forSubstance Use Disorders amongResident Physicians: CurriculumDevelopment and PreliminaryEvaluationNeda Ratanawongsa, MD, MPH, UCSF, San Francisco,California, RatanawongsaN@medsfgh.ucsf.edu; JenniferManuel, PhD, UCSF, San Francisco, California,jennifer.manuel@ucsf.edu; Daniel Ciccarone, MD, MPH,UCSF, San Francisco, California,ciccaron@fcm.ucsf.edu; Jennifer Hettema, PhD,University of Virginia, Charlottesville, Virginia,JEH7DV@hscmail.mcc.virginia.edu; Brad Shapiro, MD,UCSF, San Francisco, California,Brad.Shapiro@ucsf.edu; Sharad Jain, MD, UCSF, SanFrancisco, California, sharad.jain@ucsf.eduAreas abstract covers: UME, GME, CMEDomain(s) addressed: Clinical Instruction andPerformance, Evaluation of Programs and CurriculaPurpose: A residency curriculum was developed toenhance residents’ confidence and skills with usingSBIRT (Screening, Brief Intervention and Referral toTreatment)Background: SBIRT conducted in medical settings iseffective in reducing risky alcohol and drug use. Selfreporteddiscomfort and lack of experience dealing withalcohol and drug problems are associated with lowerconfidence in SBIRT skills among UCSF internalmedicine resident physicians. Moreover, half of clinicpatients surveyed anonymously at the teaching countyhospital reported lack of counseling about safe drinkinglimits by their providers.Methods: We implemented a 7-week, 32-hourlongitudinal SBIRT curriculum for internal medicineresidents (n=32) at the teaching county hospital. Thecurriculum included SBIRT didactics, small groupdiscussions, skills practice role-plays, and site visits tolocal substance use treatment and referral programs.Written narrative reflections, clinical case discussions,and clinical observation checklists were used to evaluateresidents.Evaluation Plan: Qualitative analysis of residents’narrative reflections showed an increase in confidenceusing SBIRT skills with their patients. Residents citedlack of time, competing work responsibilities, lack ofpreceptor support, and patient resistance as barriers tocontinued use of SBIRT. Analysis of qualitative checklistdata revealed that residents screened skillfully forsubstance use disorders and employed patient-centeredlistening skills, while struggling with “rolling withresistance” and formulation of specific action plans.Dissemination: Dissemination plans include presentingSBIRT curriculum development through posterpresentations and publications in scientific journals. Weare currently working on website development andpossibly a video of the SBIRT approach.Reflective critique: Feedback from the residents andtraining staff has been solicited ongoing in order tomodify the training and feedback portions of thecurriculum.Student Created Modules to GuidePortfolio ImplementationNicklaus Brandehoff, University of California, SanFrancisco, nicklaus.brandehoff@ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Competencies, CurricularInnovation, Longitudinal Educational Activities, PortfoliosPurpose: To describe a student-created step-by-stepguide to help student set up and become familiar withthe MD Portfolio at UCSF.Background: In 2009 UCSF SOM launched MDPortfolio for students to provide evidence of achievementof competencies expected by graduates. The systemincluded opportunities for uploading evidence, criticalreflection and obtaining feedback. However, introductionof the portfolio required orientation to its purpose andguidance on how to use the electronic platform. Themodules created provided this introduction andguidance.Methods: Faculty advisors in education and technologywere consulted to determine their vision of the MDPortfolio and to identify key items to help studentsbecome familiar with the portfolio concept. Six pilotonline competency examples using the Mahara platformand one online introduction module using ArticulateEngage software were created and posted to the E-Portfolio September 2009.Evaluation Plan: During development a group of 5students and 2 faculty tested the modules for clarity,design and ease of use. Before final release, a group of18 students evaluated modules for accessibility, design,ease of use, and overall incorporation into the E-Portfoliosystem.Dissemination: Presentations were done at theCurriculum Ambassador Showcase 2009, Class of 201322 The Haile T. Debas Academy of Medical Educators

UCSF Education Day 2011Orientation, and UCSF SOM 3rd Annual FacultyDevelopment Day 2010.Reflective critique: This work provided a foundation forstudents to create a standard portfolio profile and learnthe mechanisms of the online platform. Due to theevolution of the MD portfolio on both a platform andeducational level, many of the examples are nowobsolete, but these examples provided the groundworkfor newer, more robust examples for students to use.Teaching Ultrasound ImagingPerception: “Weathermaps toRecognition”Marcia McCowin, MD, UCSF, SFVA,marcia.mccowin@ucsf.edu; Virginia Griswold, MD,UCSF, SFVA, virginia.griswold@va.gov; StefanieWeinstein, MD, UCSF, SFVA,stefanie.weinstein@va.gov; Irene Turman, RVT, SFVA,irene.turman@va.govAreas abstract covers: UME, GMEDomain(s) addressed: Clinical Instruction andPerformance, Curricular Innovation, SimulationPurpose: To give students of ultrasound imaging theskills to recognize normal anatomic structures.Background: One of the most challenging aspects ofteaching medical ultrasound to novice learners isenabling the learner to perceive normal anatomicalstructures; “It all looks like weather-maps to me” is acommon comment. The inability to reliably recognizenormal structures significantly delays the goal of startingto learn the spectrum of normal variation and pathology.When learners attempt the methods (studying atlasesand asking the expert to point out structures) which workwell for CT and MR which have visually obviousreference anatomy, they discover that ultrasound imageshave few visually obvious reference anatomic structuresand using these learning techniques often results infrustration and failure.Methods: A self-learning powerpoint series wasdeveloped to teach the detailed anatomy required to findvisual reference for abdominal (the abdomen waschosen for ample reference anatomy) ultrasound.Normal contiguous CT images were reconstructed in thecommon planes used for ultrasound and displayed bothunlabeled and then labeled with the required anatomy ina fashion designed to reinforce the relationships of thereference anatomy. An explanation of the differentappearance of the reference anatomy on ultrasoundcompared to CT is followed by ultrasound images,unlabeled and labeled so that the learner can self-test.The series is designed so that the learner can work attheir own pace and retrace steps.Evaluation Plan: Various learners including residentphysicians, medical students, and ultrasound technologystudents will be surveyed as to usefulness of the series.Dissemination: We plan to share our experience withour colleagues at the Association of UniversityRadiologists Annual Meeting.Reflective critique: Ultrasound experts includingphysicians and technologists will be surveyed regardingthe change in perceptive abilities of the learners.Team-Based Journal Club: ALongitudinal Approach to Evidence-Based Medicine (EBM) TrainingDuring ResidencyRenee Kinman, MD, PhD, Children’s Hospital CentralCalifornia, UCSF Fresno Medical Education Program,rkinman@childrenscentralcal.org; Serena Yang, MD,MPH, UCSF Fresno Medical Education Program,syang@fresno.ucsf.eduAreas abstract covers: GMEDomain(s) addressed: Curricular Innovation,Longitudinal Educational Activities, ResidencyPurpose: To demonstrate the feasibility of a teambased,longitudinal journal club at UCSF FresnoPediatric Residency ProgramBackground: Physicians must keep abreast of evolvingevidence while monitoring and improving upon theirpractices. Supported by ACGME as an activity that“promotes a spirit of inquiry and scholarship,” journalclubs (JC) are utilized by many programs in a variety offormats.Methods: In 2009, we began piloting an innovativeteam-based JC format grounded in team-based learningand social & cognitive congruence theories. Residents(PL-1,2,3) are distributed in teams that stay togetherthroughout training. JCs are moderated by a residentwith close faculty support. Prior to each JC, teams areassigned article sections to appraise using standardizedworksheets designed to elicit critical thinking. At the startof each JC, teams briefly meet to discuss assignedsections. The moderator then facilitates a large groupdiscussion with each team presenting their section, andfinishes with a discussion of “how the article affects mypractice”.Evaluation Plan: Residents are surveyed before JCexposure and annually thereafter to assess confidenceUniversity of California, San Francisco • School of Medicine 23

UCSF Education Day 2011ratings in critical appraisal of medical literature. Pre-postintervention data will be analyzed using paired Wilcoxonsigned-rank test. Resident/faculty evaluation of JCcurriculum occurs annually. Future plans will assess:residents’ critical appraisal skills using validated tools,resident practice of EBM during clinical rotations,resident moderator performance, and faculty perceptionof JC impact on resident education.Dissemination: We will share our curriculum with otherresidency programs at UCSF; present at regional andnational conferences; and submit our findings to MedEdPortal.Reflective critique: We plan to refine our curriculumbased on feedback from our faculty and learners, andmedical education forums such as ESCape.24 The Haile T. Debas Academy of Medical Educators

UCSF Education Day 2011Curriculum Evaluation & Educational Research Posters2007 - 2010 Match Data from ModelSFGH on Underserved and PrimaryCare Residency ChoiceMargo Vener, MD, MPH, UCSF, mvener@fcm.ucsf.edu;Elisabeth Wilson, MD, MPH, UCSF,ewilson@fcm.ucsf.edu; Anna Loeb, MS3, UCSF,anna.loeb@ucsf.edu; Nili Sommavilla, MS3, UCSF,nili.sommavilla@ucsf.edu; Julia Bruckner, MS 3, UCSF,julia.bruckner@ucsf.edu; Margaret Wheeler, MD, UCSF,mwheeler@medsfgh.ucsf.eduAreas abstract covers: UME, GMEDomain(s) addressed: Career Choice, CurricularInnovation, Primary CarePurpose: To evaluate whether Model SFGH increasesthe number students matching into primary care and/orunderserved residenciesBackground: The US faces a primary care physicianshortage, especially in underserved communities (1).Students trained in underserved programs have morepositive attitudes toward underserved patients (2) andhigher intentions of practicing in underservedcommunities (3). Model SFGH is an innovative 6-monthtrack for third-year students interested in urban health.Students complete three semi-integrated clerkships inunderserved settings, follow continuity patients, andwork in community health.Methods: Using match data from 2007-10, wecompared specialty and program choice of graduatingstudents who completed Model SFGH (59) to graduatingstudents who had not participated (600). We alsoevaluated match results from 2004-6, before ModelSFGH.Results: Compared to non-participants, Model SFGHstudents have higher rates of matching into primary careresidencies (66% vs. 38%), and/or programs inunderserved communities (37% vs. 18%). Compared tothe three years before implementation of Model SFGH,this represents an increase in the rate of matching intoprimary care for the total graduating class (40% vs 30%)but not an increase in underserved programs (19% vs20%).Discussion: Model SFGH students match morefrequently into primary care and/or underservedresidencies than non-participants. This increase issignificant in training new primary care physicians; sinceModel SFGH began, the total rate of UCSF graduatesmatching into primary care has increased. Furtherresearch should clarify what curricular factors(peer/faculty support, patient continuity) most profoundlyimpact students’ decisions.Reflective critique: We presented this work at STFMfor feedback. Further research will track students whowanted to do Model SFGH but were not selected in thelottery.References:1. Center for Workforce Studies, AAMC, 2007.2. Godkin et al, Teach Learn Med. 2006.3. Ko, et al Academic Medicine, 2005.A Randomized Trial of Hypothesis-Driven versus ScreeningNeurological ExaminationHooman Kamel, MD, UCSF, hooman.kamel@ucsf.edu;Gurpreet Dhaliwal, MD, UCSF; Maulik Shah, MD, UCSF;Amar Dhand, MD, DPhil, UCSF; Babak Navi, MD,UCSF; S. Andrew Josephson, MD, UCSFAreas abstract covers: GMEDomain(s) addressed: Clinical Instruction andPerformancePurpose: We hypothesized that trainees would performbetter using a hypothesis-driven approach to theneurological examination, rather than the traditionalscreening examination.Background: The neurological examination is importantbut complex and difficult to master.Methods: We randomly assigned 16 medical students toperform screening examinations of all major aspects ofneurological function or hypothesis-driven examinationsfocused on aspects suggested by the history. Eachstudent examined 4 patients, two of whom had focaldeficits. Outcomes of interest were the correctidentification of patients with focal deficits, number ofspecific deficits detected, and examination duration.Outcomes were assessed by an investigator blinded togroup assignments. McNemar’s test was used tocompare the sensitivity and specificity of the twoexamination methods.Results: Sensitivity was higher with hypothesis-drivenexaminations than screening examinations (78% versus56%; p = 0.046), although specificity was lower (71%versus 100%; p = 0.046). The hypothesis-driven groupidentified 61% of specific examination abnormalities,while the screening group identified 53% (p = 0.008).University of California, San Francisco • School of Medicine 25

UCSF Education Day 2011Median examination duration was 1 minute shorter in thehypothesis-driven group (7.0 minutes versus 8.0minutes; p = 0.13).Discussion: In this randomized trial comparing twomethods of neurological examination, a hypothesisdrivenapproach resulted in greater sensitivity and atrend towards faster examinations, at the cost of lowerspecificity, compared to the traditional screeningapproach. Our findings suggest that while a screeningexamination may be preferable when a focal deficit isunlikely, a hypothesis-driven approach may be superiorwhen the history is concerning for an acute focalneurological process.Reflective critique: We are working with our colleaguesin Emergency Medicine to further test this curriculum.A Review of Longitudinal MedicalEducational Programs Relating to aPsychiatry Residency ClinicalCurriculum RedesignColin E. Stewart, MD, UCSF, Department of Psychiatry,Colin.Stewart@ucsf.edu; Danielle Carlin, MD, UCSF,Department of Psychiatry, Danielle.Carlin@ucsf.edu;John Q. Young, MD, MPP, UCSF, Department ofPsychiatry, JQYoung@lppi.ucsf.edu; Amin Azzam, MD,MA, UCSF, Department of Psychiatry,Amin.Azzam@ucsf.eduAreas abstract covers: UME, GMEDomain(s) addressed: Clinical Instruction andPerformance, Curricular Innovation, LongitudinalEducational Activities, ResidencyPurpose: We sought to review the literature onlongitudinal educational programs, search for bestpractices and innovations, and relate findings to ourclinical curriculum redesign.Background: UCSF’s general adult psychiatryresidency is redesigning its clinical curriculum. Based onour knowledge of adult and workplace learning, weintend to include longitudinal educational programs inthe curriculum.Methods: Two authors did independent PubMedliterature searches on longitudinal curricula using MeSHterms from seminal articles in the field. Almost 1,000articles were retrieved. After scanning all titles andreading pertinent abstracts, relevant articles werereviewed. Findings were recorded in a template andcommon themes identified.Results: Factors that significantly impact residentsatisfaction and learning include: 1) Clear goals andobjectives, 2) preceptor and patient care continuity, 3)protection from inpatient responsibilities, and 4)adequate ancillary support. Clinic objectives are oftenbased on needs assessments completed via residentsurvey. Other longitudinal experiences such ascommunity projects and problem-based learning (PBL)cases can easily be integrated into clinics to complementlearning in clinical settings. As residents advance, theyneed less direct observation, more guidance in practicemanagement, and more opportunities for self-directedquality improvement projects.Discussion: An ideal longitudinal educational programin a psychiatry residency might involve a weeklyexperience in a general psychiatry continuity clinicspanning all four years that involves lasting relationshipswith preceptors and gradually decreasing direct clinicalsupervision complemented by increasing involvement inpractice management decisions and projects. Anadaptation of this abstract was submitted to the WGEA.Reflective critique: A psychiatry residency clinicalcurriculum committee (CCC) comprised of educatorsfrom multiple UCSF training sites meets regularly toreview findings and discuss their implications for ourcurriculum redesign. Resident feedback is also beinggathered from a pilot continuity clinic at our VA trainingsite and will be reviewed by the CCC prior toimplementing further pilot programs.Anesthesia Journal Clubs: GeneralPractices and Successful FeaturesKathryn Price, MS, University of California SanFrancisco, School of Medicine, kathryn.price@ucsf.edu;Marek Brzezinski, MD PhD, University of California SanFrancisco, Department of Anesthesia and PerioperativeCare, BrzezinM@anesthesia.ucsf.edu; H. Nicole Tran,MD, Kaiser Permanente: Oakland Medical Center,,hiennicole@gmail.com; Kathy Schlecht, DO, SouthOakland Anesthesia Associates P.C.,2kschlecht@comcast.net; Annette Mizuguchi, MD PhD,Brigham and Women’s Hospital,AMIZUGUCHI@partners.org; Stephen Kimatian, MD,Cleveland Clinic, kimatis@ccf.org; Guneet Natt, MD,San Francisco VA Medical Center,guneet_nat@yahoo.com; John Mitchell, MD, HarvardMedical School, Beth Israel Deaconess Medical Center,jdmitche@bidmc.harvard.eduAreas abstract covers: GMEDomain(s) addressed: Evaluation of Programs andCurricula, Quality Improvement, ResidencyPurpose: To identify general characteristics of journalclub and features associated with higher residentattendance and longevity.26 The Haile T. Debas Academy of Medical Educators

UCSF Education Day 2011Background: Journal clubs(JC) are frequent additionsto anesthesia residency curriculum offering multiplebenefits to medical education. Despite this, faculty oftenfield complaints and struggle to maintain attendance andparticipation at JC. Features associated with greaterthan 50% attendance and existence greater than 2 yearswere previously investigated in internal medicine-basedJCs. Successful internal medicine JCs were associatedwith mandatory attendance, larger residencies, andincreased resident leadership. However, little is knownabout general features of anesthesia-based JCs.Furthermore, features associated with success have yetto be identified.Methods: Nationwide, 117 anesthesiology programdirectors received an e-mailed survey assessing JCfeatures. Successful JCs were defined as existing morethan four years with an average attendance rate over50%. Data were assessed using chi-square and t-testanalysis.Results: Eighty programs responded (response rate,68%). Seventy-seven (96%) conduct JC. Typically, JCsmeet monthly for 1 hour. Faculty(without residentinvolvement) are highly involved in organizing,moderating, and selecting articles. Attendance is oftenmandatory (69%) and recorded (89%). Though practicebasedlearning was the ACGME competency mostemphasized, it also required the most improvement inteaching. Formal JC evaluation was rare (60%).Successful JCs had increased faculty attendance(p

UCSF Education Day 2011Reflective critique: This program may serve as a modelthat informs broader integration of multidisciplinaryclinical experience at UCSF.Diabetes, Hypertension andAsthma…Oh My! Can a ChronicIllness Cohort Help Improve Studentand Patient Outcomes?Margo Vener, MD, MPH, UCSF, mvener@fcm.ucsf.edu;Ben Howell, MS 3, UCSF, ben.howell@ucsf.edu; NicoleGomez, MS 3, UCSF, nicole.gomez@ucsf.edu; KateChomsky-Higgins, MS 3, UCSF,Kate.chomskyhiggins@ucsf.edu; Nili Sommavilla, MS 3,UCSF, nili.sommavilla@ucsf.edu; Margaret Wheeler,MD, UCSF, mwheeler@medsfgh.ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Communication, LongitudinalEducational Activities, Patient Care, Primary CarePurpose: To evaluate whether our 3rd-year chronicillness curriculum improved: 1) students’ understandingof chronic illness and management and/or 2) clinicaloutcomes for chronically ill patientsBackground: To care for an aging population, futurephysicians need skills to optimize chronic illnessmanagement (1,2). We designed an innovativecurriculum to improve 3rd-year students’ ability toprovide chronic illness care. Students developed theirown panel of chronically ill patients. They performedstructured visits emphasizing understanding the patient’sgoals, self-management, education, and prevention.Methods: Twenty-five students each followed at leastpatients for six months. Using student reports, wetracked patient metrics (blood pressure, glucose, etc)and behavior changes (starting exercise, etc). We alsofollowed patient educational outcomes. We assessed theeducational impact to medical students through Likkertsurveys and focus groups.Results: While the average patient did not showsignificant change in blood pressure, etc, selectedpatients demonstrated very impressive changes (eg: 20lb intentional weight loss). Both students and patientsfound these changes highly inspirational. Students alsoreported greater appreciation of: 1) the ups and downsof chronic illness management; 2) the importance ofcontinuity: 3) the value and challenge of patienteducation and prevention 4) the need not to stereotypepatients 5) the importance of follow up outside officevisits 6) the importance of hope.Discussion: Although chronic care was not optimizedfor all participating patients, helping even one patient intheir panel make substantial health gains had markedimpact on students’ understanding of chronic illness andtheir belief that they could improve health outcomes theirpatients.Reflective critique: We plan to present this at WGEAfor feedback. Future efforts will focus on how to extendthis curriculum to third-year students in other longitudinaland block rotations.References:1. Pols, Chronic Illness, 2009.2. Holman, JAMA, 2004.Dissemination and Implementation ofan Evidence-Based, Tobacco-Treatment CurriculumAlan K. Louie, MD, UCSF, alanlouie@lppi.ucsf.edu;Sebastien C. Fromont, MD, UCSF,SCFromont@hotmail.com; Karen Suchanek Hudmon,DrPH, RPH, UCSF, hudmonk@pharmacy.ucsf.edu;Sharon M. Hall, PhD, UCSF, Sharon.Hall@ucsf.edu;Judith Prochaska, PhD, MPH, UCSF,JProchaska@ucsf.eduAreas abstract covers: UME, GMEDomain(s) addressed: Evaluation of Programs andCurricula, Faculty Development, InterprofessionalEducation, ResidencyPurpose: The goal of the current study was to improvecompetency in tobacco-treatment by psychiatrictrainees. The objective was to evaluate thedissemination and implementation phase of PsychiatryRx for Change, a 4-hour, tobacco-treatment curriculumfor psychiatric residencies and graduate psychiatricnursing programs.Background: Nearly half of cigarettes sold in the U.S.are smoked by people with mental illness and substanceuse disorders. Yet, surveys suggest psychiatrists rarelytreat tobacco use and only half of psychiatric residencyprograms provide didactics on such treatment, with amedian length of 1 hour (Prochaska et al., 2006). Wedeveloped the Psychiatry Rx for Change curriculum toaddress this gap and demonstrated positive educationaloutcomes sustained at 3-months follow-up with 55psychiatric residents (Prochaska et al, 2008). Diffusionof Innovations theory (Roger 1995) and the RE-AIMframework (Glasgow & Emmons, 2007) guideddissemination and implementation.Methods: Faculty from psychiatric residencies (n=28)and graduate psychiatric nursing programs (n=15) fromthe Western U.S. attended a one-day Psychiatry Rx for28 The Haile T. Debas Academy of Medical Educators

UCSF Education Day 2011Change training. Pre/post-training and follow-up surveyswere administered.Results: Participants’ rating of their overall ability toteach tobacco treatment increased from pre- to posttraining(p

UCSF Education Day 201117 commonly ordered diagnostic tests. A percent (%)error was calculated for each diagnostic test as [(meanestimated – actual)/actual] x 100. Participants alsoresponded to eight attitudinal questions using a 5-pointLikert scale.Results: Thirty-six attendings and 92 residentscompleted the survey, representing a response rate of75% and 82% respectively. All participants regardless oftheir level of training grossly under-estimated hospitalcharges (mean error -41.4%), and over-estimatedMedicare reimbursement (mean error +152%).Participants rated their own knowledge of costs as poor(2 out of 5) and their interest in receiving educationabout costs as high (4.2 out of 5).Discussion: At a single academic medical center,internal medicine residents and faculty demonstratedpoor knowledge of hospital charges for diagnostic tests.Given this finding and participants’ interest in receivingeducation about medical costs, curricular interventionsaimed at improving physician knowledge of healthcarefinances would be appropriate.Reflective critique: Based on these results, acurriculum on costs of care is being developed for theresidency program. Additionally, a table outlininghospital charges and Medicare reimbursement forcommonly ordered diagnostic tests will be published inthe next edition of the Hospitalist Handbook.Faculty Development to SupportCompetency Based MedicalEducation in Tanzania- A SituationAnalysisMolly Fyfe, MA, MPH, UCSF Global Health Sciences,mollyfyfe@yahoo.com; Charles MKony, MuhimbiliUniversity of Health and Allied Sciences,charles_mkony@yahoo.com; Kelli Barbour, UCSFGlobal Health Sciences, kelli.barbour@ucsf.edu;Dorothy Perry, UCSF School of Dentistry,PerryD@dentistry.ucsf.edu; Patricia O’Sullivan, UCSFSchool of Medicine, OSullivanP@medsch.ucsf.edu;Sarah MacFarlane, UCSF Global Health Sciences,macfarlane@globalhealth.ucsf.eduAreas abstract covers: Faculty DevelopmentDomain(s) addressed: Faculty Development, GlobalHealthPurpose: To use data from graduates, students andfaculty to identify needs in faculty development.Background: Tanzania faces a severe shortage ofhealth professionals. Muhimbili University of Health andAllied Sciences (MUHAS) is the largest public healthprofessions university in Tanzania. With the goal ofenhancing the quality of health care graduates, a jointMUHAS and UCSF team assessed the facultydevelopment needs at MUHAS.Methods: In 2009, 147 recent MUHAS graduates andtheir supervisors (n=48) were surveyed on theirperceptions of how well MUHAS prepared them forprofessional practice. Students (n=41) in 6 focus groupsprovided their perceptions of the learning environment.Three faculty focus groups (n=32) revealed needs forfurther professional development.Results: MUHAS students, alumni and supervisorsrecognized a need for teaching beyond professionalknowledge. Students acknowledge that the lectures areeffective, but they have limited exposure to otherpedagogical methods, identifying needs for activelearning, early and strong clinical experience and facultymentoring. The faculty identified the need to employtechnology, and improve their own teaching mentoringskills.Discussion: MUHAS needs to improve the teaching andlearning process in competencies other thanprofessional knowledge. Both teachers and studentswould benefit from improved mentoring as a key startingpoint. Based on this situation analysis, facultydevelopment will target educational strategies for activelearning in large and small group settings, clinicalteaching skills, and mentoring.Reflective critique: This information has beenpresented by colleagues from MUHAS and based onfeedback we believe would be of interest at UCSF.Faculty-Narrated Web-BasedLearning Modules Improve Students’Communication Skills on a High-Stakes Clinical Skills ExaminationChristina A. Lee, MD, UCSF,christinaaudreylee@gmail.com; Anna Chang, MD, SanFrancisco Veteran Affairs Medical Center,anna.chang2@va.gov; Calvin L. Chou, MD, PhD, SanFrancisco Veteran Affairs Medical Center,calvin.chou@ucsf.edu; Christy Boscardin, PhD, UCSF,BoscardinCK@medsch.ucsf.edu; Karen Hauer, MD,UCSF, khauer@medicine.ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Clinical Instruction andPerformance, Communication, Curricular Innovation,Standardized PatientsPurpose: To determine whether a web-based SPmodule with detailed SP and faculty commentary used30 The Haile T. Debas Academy of Medical Educators

UCSF Education Day 2011immediately prior to a clinical skills examination leads toimproved communication skills.Background: Web-based standardized patient (SP)modules have been associated with improvement inmedical students’ history taking and physicalexamination skills on clinical performance examinations(CPX). However, the use of such modules has not yetcorrelated with improvement in students’ communicationskills.Methods: This was a prospective observational studyinvolving fourth year medical students in academic year2008-2009. A 90 minute web-based module consistingof three simulated clinical encounters between a medicalstudent and SP was narrated by an expert clinician andSP to explain expected clinical skills behaviors. All 147students were notified one month prior to the CPX andencouraged to review the learning module prior to theexamination. The outcome measure was CPX scores.Results: 106 students (72%) viewed the web-basedmodule prior to the CPX and logged into the module fora mean of 86.4 minutes. There was no difference inUSMLE Step 1 or clerkship summary scores betweenstudents who chose to use the module and those whodid not. Students who watched the module performedsignificantly higher on the CPX communication score(+2.61%, p

UCSF Education Day 2011Reflective critique: This curriculum was designed andevaluated with feedback from surgical faculty andmedical educators, and presented at ESCape. Feedbackfrom residents has prompted the design of a manual andtake-home videos, to be integrated into the curriculumnext year.Geriward: An Interprofessional Team-Based Curriculum on Care of theHospitalized Older AdultStephanie Rennke, MD, UCSF,srennke@medicine.ucsf.edu; Lynda Mackin, RN, PhD,ANP-BC, CNS, University of California, San Francisco,lynda.mackin@ucsf.edu; Bree Johnston, MD, MPH,University of California, San Francisco, VA MedicalCenter; Adam Moylan, PhD, University of California, SanFrancisco, amoylan@ucsf.edu; Vicki Jue, PharmD,University of California, San Francisco,vicki.jue@ucsfmedctr.org; Cindy Lai, MD, University ofCalifornia, San Francisco, clai@medicine.ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Competencies, InterprofessionalEducation, Patient CarePurpose: To develop and implement aninterprofessional team-based curriculum on care of thehospitalized older adult. Student objectives were to 1)identify geriatric competencies pertaining to the hospitalsetting; 2) engage in team-based learning to complete abedside exercise and 3) present a patient caseemphasizing systems-based practice.Background: Interprofessional team care is required foreffective management of complex patients such as olderhospitalized adults. Health professions students benefitfrom learning experiences that mirror current health caremodels. Team-based learning(TBL) is an effectivestrategy to teach students knowledge and skills inpatient care.Methods: GeriWard, offered four times, included 26third year medical students, 12 fourth year pharmacystudents and 13 nursing students during 6 months of a12-month pilot. GeriWard included: (1) a two-hourworkshop, teams interviewed and examined an olderpatient focusing on one of three geriatric AAMCcompetencies: bladder catheters, restraints and skinassessment/pressure ulcer staging; and (2) medicalstudents presented their findings to the inpatient team.Students completed pre- and post-workshop surveys onattitudes towards interprofessional education (IPE) andself-efficacy around the competencies. Hospital-basedfaculty rated the student presentations on content andapplication to systems-based practice.Results: Students showed improvement in attitudestoward IPE pre and post-curriculum (p= 0.001). Studentsrated self-efficacy on the competencies higher afterparticipating in the curriculum. Hospitalist faculty ratedthe student presentations highly, citing the students’ability to identify opportunities for quality improvementinterventions.Discussion: A curriculum combining team-basedlearning and bedside care increased students’ attitudestowards IPE and self-assessed ability to identify geriatriccompetencies and systems-based practice. Findings willbe presented at the Society of Hospital Medicinemeeting and a manuscript will be developed forpublication.Reflective critique: Backed on feedback from studentsGeriWard will include physical therapy students andexpand to the SFVAMC and SFGH.Identifying Curricular Needs forClinical Medical Education inTanzaniaReena Gupta, MD, UCSF, reena.gupta@ucsf.edu; MollyFyfe, MPH MA, UCSF, mollyfyfe@yahoo.com; CharlesMkony, MD, Muhimbili University of Health and AlliedSciences, Tanzania, charles_mkony@yahoo.com; SarahMacFarlane, PhD MSc, UCSF,Macfarlane@globalhealth.ucsf.edu; Eligius Lyamuya,MD, Muhimbili University of Health and Allied Sciences,Tanzania, eligius_lyamuya@yahoo.com; Ephata Kaaya,MD, Muhimbili University of Health and Allied Sciences,Tanzania, ephata.kaaya@yahoo.comAreas abstract covers: UMEDomain(s) addressed: Clinical Instruction andPerformance, Competencies, Evaluation of Programsand Curricula, Global HealthPurpose: To identify curricular needs for clinicalteaching at the Muhimbili University of Health and AlliedSciences (MUHAS) School of Medicine in Tanzania.Background: Tanzania faces a severe shortage ofphysicians. High student-faculty ratios and limited clinicalteaching facilities challenge medical education atMUHAS. We examined clinical training at MUHAS toinform curricular revision and improve clinical teaching toensure the preparation of competent physiciangraduates.Methods: This situation analysis of clinical teaching atMUHAS draws on data from three sources. The 2009Tracer Study surveyed recent MUHAS medicalgraduates (n=147) and their supervisors (n=48) on theirperceptions of how well MUHAS prepared them for32 The Haile T. Debas Academy of Medical Educators

UCSF Education Day 2011professional practice. Student focus groups (n=41)investigated student perceptions of medical educationand the learning environment at MUHAS.Results: MUHAS medical students and recentgraduates identified strengths of the curriculum inconferring medical knowledge. However, they identifiedsignificant gaps in their medical education with respectto practical clinical training. Surgical skills andambulatory outpatient care were highlighted as specificdeficiencies in clinical training. Both students and facultyfeel that clinical teaching is impeded by the large numberof students in clinical sessions, limited facilities toconduct clinical teaching, and limited faculty to supervisestudents.Discussion: Increased practical clinical skill training isneeded to improve graduates’ clinical competency,especially in the areas of surgical skills and outpatientambulatory care. Informed by student, graduate, andstakeholder perspectives, MUHAS is currentlyundergoing major curriculum revisions focused oncompetency-based medical education and improvingclinical training.Reflective critique: In partnership with UCSF, MUHASis implementing efforts to increase clinical exposure,surgical skills simulation training, ambulatory careprecepting, and faculty development about clinicalteaching methodologies to improve medical educationand the preparation of graduates who are betterequipped to address health needs in Tanzania.Impact of Student-Run Clinics onPreclinical Students’ Socioculturaland Interprofessional Attitudes: AProspective Cohort AnalysisLeslie C. Sheu, BA, UCSF, leslie.sheu@ucsf.edu; CindyLai, MD, UCSF, clai@medicine.ucsf.edu; Anabelle D.Coelho, MS, UCSF, anabelle.coelho@ucsf.edu; Lisa D.Lin, MS, UCSF, lisa.lin@ucsf.edu; Patricia Zheng, BS,UCSF, patricia.zheng@ucsf.edu; Patricia Hom, BA,UCSF, patricia.hom@ucsf.edu; Vanessa Diaz, BS,UCSF, Vanessa.diaz@ucsf.edu; Patricia S. O’Sullivan,UCSF, osullivanp@medsch.ucsf.eduBackground: Descriptive studies suggest that studentrunclinics (SRCs) positively impact participatingstudents. However, studies rarely include students frommultiple professions, validated instruments, and a controlgroup. At our health professions campus, first-yearstudents can participate in SRCs focusing on specificunderserved populations: Latino(a), Asian/PacificIslander, and urban homeless communities. In thisstudy, we used validated measures to explore the impactof these SRCs on preclinical students’ sociocultural andinterprofessional attitudes.Methods: Using a pre-post control group design, weconducted a prospective cohort study of first-yearmedical, nursing, and pharmacy students whoparticipated in SRCs and those who did not. At thebeginning and end of the year, they completed surveysconsisting of demographics, validated measures onsociocultural awareness (SAMI) and readiness forinterprofessional learning (RIPLS), and open-endedquestions.Results: Of all participating students, 77% (274 of 358)completed the post-survey, with 68% (n=182) havingmatching pre-post surveys. Students held positiveattitudes in sociocultural and interprofessional domains.After adjusting for baseline scores, attitudes did not differsignificantly between those who participated in SRCsand those who did not. In the qualitative analysis, 99%reported reinforced or increased commitment to workingwith the underserved. Forty percent reported that theirexperiences made a positive impact on theirinterprofessional attitudes.Discussion: In this study, we found no quantifiableeffect of SRC participation on sociocultural orinterprofessional attitudes. However, students perceivedbenefits in both domains, suggesting that the SAMI andRIPLS may not be sensitive enough for measuring theeffects of SRCs. Further studies are needed to assessthe long-term impact of preclinical SRCs.Reflective critique: We have incorporated extensivefeedback from advisors and ESCape, and havesubmitted the abstract to an education meeting.Areas abstract covers: UMEDomain(s) addressed: Cultural Competence, Diversity,Evaluation of Programs and Curricula, InterprofessionalEducationPurpose: To evaluate the impact of student-run clinics(SRCs) on sociocultural and interprofessional attitudesacross health professions.University of California, San Francisco • School of Medicine 33

UCSF Education Day 2011Integrating Multiple Levels ofLearners into an InterdisciplinaryTeam-Based Model ofAmbulatory CareKatherine Julian, MD, UCSF, kathy.julian@ucsf.edu;Bridget O'Brien, Ph.D., UCSF,ObrienB@medsch.ucsf.edu; Maria Wamsley, MD,UCSF, maria.wamsley@ucsf.eduAreas abstract covers: UME, GMEDomain(s) addressed: Evaluation of Programs andCurricula, Health Systems, Interprofessional Education,Primary CarePurpose: Near-peer teaching may be more effectivethan expert teaching. This project describes theintegration of interns/PISCES students into internalmedicine (IM) resident continuity clinic teams to promotenear-peer teaching among multi-level learners.Background: One limitation of the PISCES clerkship isthe relative lack of interaction with residents. IMresidents and interns have little interaction in clinic dueto separate continuity clinic days. Increasing teachinginteractions among residents, interns, and medicalstudents is desirable to promote near-peer teaching.Methods: In 2008, IM PGY2/PGY3 continuity clinics atParnassus/Zion were reorganized to create a teambasedmodel of care. In 2009, we integrated 14 PISCESstudents and 26 interns into the teams. Each teamconsisted of one attending, 2-6 PGY2/3 residents, 2-3interns, one LVN and one administrative assistant. 9 of10 teams included PISCES students.Results: Interns/PGY2/PGY3 residents were surveyedregarding their satisfaction with the team model. PISCESstudents participated in focus groups. 36 of 70 residentsresponded. 51% reported improved informal peermentoring; 38% reported improved educationalenvironment; 70% reported seeking advice from residentpeers in clinic and 59% reported receiving qualityteaching from resident peers. 87% of residentrespondents supported student presence on the teamsbut only 29% felt that students were effectivelyintegrated into the team structure. Although PISCESstudents reported positive learning experiences in IMclinic and appreciated resident interactions, they didn’tstrongly identify as members of their clinic team.Discussion: Integrating interns/residents in continuityclinic improved informal peer mentoring, near-peerteaching, collegiality and the clinic educationalenvironment. Residents overwhelmingly supported thepresence of students on their clinic teams. However,most residents and students did not feel that studentswere effectively integrated into the team structure.Reflective critique: More work must be done to betterintegrate students into clinic teams and increase theinteraction with interns and residents.Learners' Perspectives onEffective MentorshipChristy Boscardin, PhD, UCSF,christy.boscardin@ucsf.edu; Renee Courey, PhD,UCSF, CoureyR@medsch.ucsf.edu; Louise Aronson,MD MFA, UCSF, aronsonl@medicine.ucsf.edu; AllisonChen, UCSF, ChenAM@medsch.ucsf.edu; Mark Lovett,UCSF, LovettM@medsch.ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Evaluation of Programs andCurricula, MentoringPurpose: The purpose of the study was to identifycharacteristics of mentors that students considerimportant for effective mentorship in the Pathwaysprogram.Background: Mentorship can significantly influencepersonal development, career choice, and researchproductivity. The UCSF Pathways to Discovery programprovides in depth training for careers beyond the routinepractice of medicine. Program success depends oneffective mentoring currently delivered by a team ofproject mentors and program directors. Learnerscurrently identify project mentors based on contentexpertise and project interest.Methods: 10 randomly selected medical studentsparticipated in a focus group. The learners were asked aseries of structured, open-ended questions to describetheir experience working with project mentors. 35students also completed a survey item (4 point-scale)rating their overall experience with mentorship.Results: 30 (86%) students rated mentorship quality asvery good or excellent (3 to 4). Learners described aneffective mentor as someone who provided contentexpertise but was also a “good advocate” and offeredinsight into the student’s career interests.Discussion: Although learners select mentors based oncontent expertise, learners expect each mentor toprovide scholarly, career development, and psychosocialsupport. While many faculty met their role as projectmentors, learner expectations match program-widegoals rather than narrower project mentor roles. Tobetter align learner expectations and availablementoring, we are 1) creating materials that explain the34 The Haile T. Debas Academy of Medical Educators

UCSF Education Day 2011function of mentorship teams; 2) producing a mentordevelopment module to expand mentor roles to meet thebroader needs of students.Reflective critique: The results from the survey and thefocus group were shared with the Pathways programdirectors for feedback and input.Lights, Camera, Action: Small GroupVideo Review Promotes Efficient,Effective Clinical LearningMargo Vener, MD. MPH, UCSF, mvener@fcm.ucsf.edu;Erika Schillinger, MD, Stanford University,erikas@stanford.eduAreas abstract covers: UMEDomain(s) addressed: Communication, Patient Care,Reflection, Standardized PatientsPurpose: To evaluate two models for faculty-facilitatedsmall group review of video-recorded student clinicalencountersBackground: Feedback on video-recorded clinicalencounters helps enhance professionalism,interpersonal and communication skills among medicalstudents (1, 2, 3). Unfortunately, video review withindividual students is time-consuming for faculty; thismay limit video usage (4).Methods: During 2010, we reviewed data for 40 thirdyearstudents in group video reviews at a public andprivate medical school. In one model, students wererecorded with standardized patients, faculty selectedpositive moments, and video clips were reviewed insmall groups. In the other model, students wererecorded with actual patients, students selectedchallenging moments, and video clips were reviewed insmall groups. Both small groups included five studentsand one preceptor. Sessions focused onprofessionalism, communication, and relationship skills.Focus groups and open-ended surveys were used forqualitative theme analysis.Results: Students in both groups found video reviewvaluable. Students cited improved communicationstrategies and agenda-setting as particular strengths.Students reported benefit from watching their peers.Preceptors found group debriefing effective and efficient,noting that respect and confidentiality were essential.Preceptors valued gaining insight into students’professionalism and self-reflection. All foundtechnological hurdles frustrating.Discussion: Many schools struggle with how to bestteach professionalism in a meaningful, time-efficientmanner. Our study suggests group video reviewprovides an effective format for modeling professionalskills, providing feedback, and discussingcommunication issues.Reflective critique: We presented this work at STFMfor feedback. Future studies should evaluate whetherlongitudinal video review sessions could add benefit forlearning.References:1. Mann, Adv Health Sci Educ Theory Pract 2007.2. Hodges, Med Educ. 2009.3. Plack, Allied Health. 2005.4. Mathers,Med Educ. 1999.Meaningful Innovation orRearranging Deck Chairs?Comparing Three Formats for aFamily Medicine ClerkshipMargo Vener, MD, MPH, UCSF, mvener@fcm.ucsf.edu;Nili Sommavilla, Med 3, UCSF,nili.sommavilla@ucsf.edu; Julia Bruckner, MS 3, UCSF,julia.bruckner@ucsf.edu; Arianne Teherani, PhD, UCSF,teherani@medsch.ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Curricular Innovation,Evaluation of Programs and Curricula, LongitudinalEducational Activities, Primary CarePurpose: To determine which rotation model providedthe most optimal Family Medicine learning experienceBackground: Continuity has value as an organizingprinciple in medical education (1); however, blockrotations inherently limit continuity. In longitudinaloutpatient rotations, students value continuity withpatients and preceptors (2,3). To explore innovative 3rdyearmodels, UCSF offers the required Family Medicineclerkship in three formats — a 6-week block rotation, 6-month longitudinal rotation (Model SFGH), or 12-monthlongitudinal-integrated experience (PISCES).Methods: We assessed course evaluations, writtenexams, clinical practice exam (CPX) scores, andresidency match results for 2008-2010. We alsoevaluated student responses to open-ended surveys.Results: On course evaluations (1=poor; 5=excellent),PISCES students reported the highest teaching quality(block=4.25; 6-month=4.21; 12-month=4.46). Longerclerkship length correlated with students reporting betterfeedback on clinical skills (block=3.77; MSFGH=3.90;PISCES=4.29). Overall clerkship ratings increased inlonger models (block=4.11; MSFGH=4.24;University of California, San Francisco • School of Medicine 35

UCSF Education Day 2011PISCES=4.32). Students in either longitudinal modelwere more likely to describe continuity relationships withpatients and preceptors/role models as strong positiveinfluences on their medical education. For 2008-2010,Model SFGH matched into Family Medicine at a higherrate than other students (18%vs6%).Discussion: Both the 6 month longitudinal and the 12-month longitudinal integrated model seem to offer betterfeedback, positive continuity experiences, and morehighly-rated clerkship experiences than the traditionalmodel. However, longitudinal models are also moreresource-intensive. Any discussion of which model isoptimal should include consideration of outcomes as wellas resource use.Reflective critique: This work was discussed at STFM.Future research will focus on how to extend optimalaspects of the longitudinal models to students in all FMclerkship models.References:1. Hirsh, NEJM 2007.2. Irby, Academic Medicine 1995.3. Prislin, Academic Medicine 1998.Medical Student Perceptions ofAnesthesiologyKathryn Price, MS, University of California SanFrancisco, School of Medicine, kathryn.price@ucsf.edu;Guneet Natt, MD, San Francisco VA Medical Center,guneet_nat@yahoo.com; Bridget O'Brien, PhD,University of California San Francisco, Office of MedicalEducation, ObrienB@medsch.ucsf.edu; MarekBrzezinski, MD PhD, University of California SanFrancisco, Department of Anesthesia and PerioperativeCare, BrzezinM@anesthesia.ucsf.edu; Martin Bogetz,MD, University of California San Francisco, Departmentof Anesthesia and Perioperative Care,BogetzM@anesthesia.ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Professionalism, ReflectionPurpose: To describe students’ perceptions ofanesthesiology prior to their clinical clerkship.Background: Perceptions of another's field of practicecan impact interprofessional collaborations. The hiddencurriculum may influence students' perceptions of a fieldand these perceptions may persist because studentslack opportunities to challenge them early in training.Inaccurate or negative perceptions may interfere withstudents’ openness to learning and interaction withpatients and team members.Methods: Medical students were asked to "describe onepreconceived notion about the specialty of anesthesia"at the start of their required UCSF anesthesiologyclerkship. Responses were collected from 1,009students from 2003 - 2009. A general inductive approachwas used to analyze students' written preconceptions.Preconceptions were coded with consensus by twoauthors for both theme and tone.Results: Five themes emerged: task responsibilities,patient interaction, lifestyle, reputation, and future of thefield. Task responsibilities were discussed mostfrequently(53%), often with negative tone(56%).Students felt "unclear" about the non-procedural taskresponsibilities of anesthesiologists. Patientinteraction(19%) was also perceived negatively(88%),with emphasis on lack of longitudinal relationships andlimited time spent with patients. Lifestyle-focusedpreconceptions(10%) were more positive(87%),centering on enviable hours and compensation. Higherlevels of substance abuse and difficulty interacting withsurgeons contributed to negative impressions(46%) ofprofessional reputation(16%). The future ofanesthesiology(2%) was often viewed positively(60%),noted for job security and residency competitiveness.Discussion: Negative perceptions can adversely impactinterprofessional respect, communication andcollaboration. Patient care and safety may suffer.Curricular interventions can facilitate more accurate,typically less critical perceptions of specialties. Earlierexposure through shadowing, preceptorships andinterest groups, especially during preclinical years, maydispel stereotypes, improving attitudes andunderstanding of anesthesiologyReflective critique: Presented and modified accordingto ESCape feedback.Medical Students’ Attention toMultiple Risk Behaviors: AStandardized Patient ExaminationJudith J. Prochaska, PhD, MPH, UCSF Department ofPsychiatry, jprochaska@ucsf.edu; Kathleen Gali, UCSFDepartment of Psychiatry, Kathleen.Gali@ucsf.edu;Bernie Miller, UCSF Teaching and Learning Center,MillerB@medsch.ucsf.edu; Karen Hauer, MD, UCSFDepartment of Medicine, khauer@medicine.ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Evaluation of Programs andCurricula, Research, Standardized Patients, Healthbehavior changePurpose: This study examined medical students’assessment and treatment of multiple risk behaviors in a36 The Haile T. Debas Academy of Medical Educators

UCSF Education Day 2011standardized patient examination.Background: Risk behaviors tend to cluster andsmokers in particular are likely to engage in multiplerisks. Treating multiple risk behaviors improves patienthealth outcomes and reduces health care costs.Methods: Using a randomized experimental design,medical students’ counseling interactions wereevaluated with a standardized patient presenting withsexual health concerns and current tobacco use withvaried problematic drinking status (alcohol-positive oralcohol-negative). Participants were 156 third yearmedical students at the University of California, SanFrancisco. Checklists completed by standardizedpatients evaluated students’ clinical performance. Afterthe encounter, students completed surveys of theirknowledge and attitudes for treating smokers withalcohol problems.Results: Overall, most students assessed tobacco use(85%); fewer assessed alcohol use (54%). Relative tothe alcohol-negative case, students seeing the alcoholpositivecase were less likely to assess STD history(80% vs. 91%, χ2(1)=4.15, p=.042) or patients’readiness to quit smoking (41% vs. 60%, χ2(1)=5.01,p=.025) and endorsed greater attitudinal barriers totobacco treatment, F(1,155)=4.79, p=.030. Patientsatisfaction, expressed as willingness to continuemedical treatment with the student doctor, wassignificantly lower for the alcohol-positive than thealcohol-negative case, χ2(1)=5.18, p=.023. Clinicalperformance ratings moderated the relationship betweenpatient case version and patient satisfaction.Discussion: When presented with a case of multiplerisk behaviors (sexual health, tobacco and alcohol),medical students performed less effectively and receivedlower patient satisfaction ratings than with a caseinvolving fewer behavioral risks. Findings weremoderated by ratings of students’ overall clinicalperformance.Reflective critique: The findings support the need forparadigm shifts in medical education that emphasizeassessment of multiple risks, new models ofconceptualizing behavior change as a generalizedprocess, and treatment of the whole patient foroptimizing health outcomes.Physical Examination Teaching: ASystematic Review of the LiteratureSomnath Mookherjee, MD, UCSF, Department ofMedicine, Division of Hospital Medicine,SMookherjee@medicine.ucsf.edu; Lara Pheatt, MA,UCSF School of Medicine, Office of Medical Education,PheattL@medsch.ucsf.edu; Calvin L. Chou, MD, PhD,UCSF and VA Department of Medicine, Division ofGeneral Internal Medicine, calvin.chou@ucsf.eduAreas abstract covers: UME, GME, CMEDomain(s) addressed: Clinical Instruction andPerformance, Evaluation of Programs and Curricula,Patient CarePurpose: To review physical examination (PE) teachingmethods studied in the literature, summarize findings,and recommend best practices.Background: Physicians must be competent in the“synthesis” of PE data to make optimal patient caredecisions. Recent reports have bemoaned theinadequacy of physicians' PE skills; however, mostschools teach a comprehensive PE without links topatient care. Therefore, PE education needsimprovement, but the most effective teaching methodsare unknown.Methods: We included all publications of PE teachingpublished from 1951-2011 that studied the effects of acurricular intervention and reported on teaching efficacy.Data extracted included organ system targeted, studydesign, types of curricula, measurements of efficacy,and domains of PE learning (psychomotor skills,knowledge, communication, and “synthesis” of data intoclinical application).Results: Of 3665 papers retrieved, 121 met inclusioncriteria. The most represented organ systems werecardiovascular, musculoskeletal, gynecological, andgeneral (multiple organ systems or comprehensive PE).Sixty-six (55%) studies included control groups. Majorcategories of educational interventions includedsimulation with standardized patients (SPs), simulationof aspects of PE (such as recordings of heart sounds),bedside teaching, and peer examination or tutoring.Common assessment methods included checklists withobserved structured clinical examinations, written tests,and surveys of learner satisfaction and self-assessedcompetence. Psychomotor skills and knowledgeacquisition were the most common competenciestargeted; seventeen papers (14%) were judged to teachPE in the “synthesis” realm.Discussion: Despite heightened awareness of theimportance of PE skills in guiding patient care, we foundfew curricula that taught PE “synthesis.” Heterogeneity inUniversity of California, San Francisco • School of Medicine 37

UCSF Education Day 2011interventions and outcome measurements impedesidentification of the most effective teaching methods.Higher quality studies of PE teaching, particularly in therealm of synthesis, will allow for better identification ofbest practices in this area.Reflective critique: Based on recommendations fromESCape, we will add statistical expertise to the project toassess effect sizes.Pilot of a Lifelong ProfessionalDevelopment Metric in a ScholarlyConcentration ProgramRenee Courey, PhD, UCSF, renee.courey@ucsf.edu;Carrie Chen, MD, MSEd, UCSF,chenhc@peds.ucsf.edu; Louise Aronson, MD, MA,UCSF, aronsonl@medicine.ucsf.edu; Kristen Fitzhenry,MS, UCSF, FitzhenryK@medsch.ucsf.edu; Josh Adler,MD, UCSF, aadlerj@ucsfmedcenter.org; AdditionalPathway to Discovery Directors, UCSFAreas abstract covers: UME, GME, IPHEDomain(s) addressed: Competencies, Evaluation ofPrograms and Curricula, Longitudinal EducationalActivities, MentoringPurpose: To design and pilot an assessment tool thatdescribes progress in skills acquisition for scholarshipand leadership careers.Background: The UCSF Pathways to Discoveryprogram prepares interprofessional UME and GMEtrainees in discovery and leadership. Learners completeformal curricula and faculty-mentored projects in areasranging from the molecular to the global. Traditionally,assessment measured only course participation, projectquality, presentations, publications, and learnersatisfaction. Because the program aims to launchcareers in innovation, academia and leadership, ameans of charting steps along the continuum ofprofessional development was also required.Methods: We adapted the Dreyfus scale of skillacquisition from novice to expert to measure progress inthree competency areas, “Research and Scholarship,”Leadership and Advocacy,” and “Professional IdentityDevelopment.” The scale was sent to 52 faculty mentorsand did not allow selection of expert.Results: 33/52 faculty mentors responded. For the threecompetency areas, 52%, 64%, and 67%, respectively,placed their mentees at proficient, the highest availablelevel, describing competency usually achieved at theassistant professor stage.Discussion: The number of mentors selecting thehighest level of achievement greatly exceededexpectations. Program leaders anticipated that mostUME learners would move from novice or beginner tobeginner or competent. The failure to capture accuratedata on the stage of learners’ professional developmentmay be due to the culture of grading. Mentor educationand explicit distinction of formative career progressionassessment from summative performance assessmentmay improve appropriate scale use by mentors.Reflective critique: The results of the pilot evaluationhave been presented to the Committee on Curriculumand Educational Policy (CCEP). The Pathways toDiscovery Directors have also reviewed this data.Professional Deformation: TheRepression of Personal Values andAttributes in Medical EducationMichael W. Rabow, MD, UCSF,mrabow@medicine.ucsf.edu; Carrie N. Evans, MA,UCSF, Carrie.Evans@ucsf.edu; Rachel N. Remen, MD,UCSF, drrachel@commonweal.orgAreas abstract covers: UMEDomain(s) addressed: Medical Humanities,Professionalism, Reflection, ResearchPurpose: To understand what personal qualities orvalues students believe they might lose or be forced tosurrender during the course of their medical education.Background: The process of developing character andcommitment to the highest values of medicine has beencalled “professional formation" (1). However, medicalstudents are at risk for “deformation” as well. Asstudents progress through medical school, they gainprofessional competence but may also be at risk forharm. Prior research has documented the developmentof depression and the loss of empathy during medicaltraining. Little research has examined students’ ownexperience of such changes.Methods: In 2007-08, Healer’s Art elective studentsinternationally submitted words that described a part ofthemselves that they were wary about showing oractually did not let show in school. These words wereanalyzed using qualitative and quantitative techniques.Results: Words from 673 medical students from 31medical schools were analyzed. Eleven themes wereidentified. The most common themes were Spirituality,Emotional Engagement, Identity/Self-expression,Freedom/Spontaneity, and Relationships. The mostcommon individual words used were “Creativity,”“Family,” “Balance,” “Freedom,” “Love,” and “Peace.”38 The Haile T. Debas Academy of Medical Educators

UCSF Education Day 2011There were only rare differences in distributions ofthemes across gender, year in school, size of school, orschool nationality.Discussion: Healer’s Art medical students identify coreissues and values that they may repress or feel unableto sustain in medical training. According to the dataanalyzed here, medical training involves not onlyprofessional formation, but personal deformation as well.Medical educators must attend to both gains inprofessional competence and the personal qualities andvalues that are at risk as students progress throughmedical training.Reflective critique: Judith Wrubel, PhD, anaccomplished qualitative researcher, helped design thestudy and analytic methods.References:1. Rabow MW, Remen RN, Parmelee DX, Inui TS. Professionalformation: extending medicine's lineage of service into the nextcentury. Acad Med. 2010;85:310-17.Teaching and Assessing MedicalStudents’ Skills in Counseling forBehavior Change: A SystematicReviewKaren E. Hauer, MD, UCSF, karen.hauer@ucsf.edu;Patricia Carney, PhD, Oregon Health SciencesUniversity, carneyp@ohsu.edu; Anna Chang, MD,UCSF, anna.chang2@med.va.gov; Jason Satterfield,PhD, UCSF, jsatter@medicine.ucsf.eduAreas abstract covers: UME, GMEDomain(s) addressed: Clinical Instruction andPerformance, Evaluation of Programs and Curricula,Patient CarePurpose: To characterize published curricularinterventions to teach medical trainees to counselpatients for behavior change and identify curricularformats that enhance patient outcomes.Background: Unhealthy lifestyle behaviors contribute toapproximately half of United States (US) deaths.However, physicians infrequently address importantbehavioral science topics during clinical visits and lacksufficient skill in counseling patients to implementbehavior change.Methods: We conducted a systematic literature searchof studies published 1965-2010 evaluating curricula oncounseling for behavior change for medial trainees.Included studies described: (1) behavior changecounseling, (2) a teaching intervention for medicaltrainees, and (3) assessment of the intervention. Weextracted eligible articles and rated impact on learnersand patients using Kirkpatrick’s hierarchy.Results: Of 2,758 initial citations, 106 met inclusioncriteria. 75 studies described interventions for medicalstudents, and 88 for residents/fellows. Most studiesoccurred in the US (94) at single institutions (91). Themajority (77) occurred in primary care disciplines:internal medicine (36), family medicine (30) andpediatrics (13). The most prevalent study design waspre-post comparison; only 22 studies used a randomizedcontrolled design.The most commonly addressedcurricular topic for counseling for behavior change wassmoking (65 studies) followed by nutrition (27),alcohol/drug use (26), and exercise (20). Theoreticalframeworks uncommonly justified curricularinterventions, although 28 studies used thetranstheoretical model of change. 58 studies involved 8or fewer hours of curricular time, and 48 spanned 4 orfewer weeks. Outcome measures related to learnerattitudes, knowledge or skills were common; only 8studies showed benefit to patients or organizationalpractice.Discussion: Multi-institutional research on methods ofteaching trainees counseling for behavior change thatinfluence patients’ health outcomes are urgently neededto ensure trainees’ clinical competence and improvedpatient care.Reflective critique: We will present our manuscript draftat ESCape 3/1/11 for feedback.The Educational Value of OvernightCall Amid Resident Duty HoursRestrictionsOren K. Fix, MD, MSc, UCSF Medical Center,oren.fix@ucsf.eduAreas abstract covers: GMEDomain(s) addressed: Competencies, Health Systems,Patient Care, Quality ImprovementPurpose: To compare faculty perception of theeducational value of a rotation with overnight call to onewithout overnight call.Background: The implementation of new ACGME dutyhours regulations in July 2011 will place new restrictionson post-graduate year (PGY)-1 trainees, primarily byrestricting consecutive duty hours to 16. Theseregulations limit PGY-1 residents from staying overnightfollowing a normal workday. Residency programs mustconsider the relative educational value of overnight callversus alternative duties that provide a similar learningexperience.University of California, San Francisco • School of Medicine 39

UCSF Education Day 2011Methods: An anonymous, 5-item Web-based surveywas e-mailed to clinical faculty of a liver transplantrotation. Items solicited opinions about the educationalvalue of overnight call, adequacy of supervision and thevalue of a rotation without overnight call. Answer choiceswere yes/no or multiple choice and includedopportunities for comment. Analyses were descriptiveand qualitative.Results: 10/15 (67%) faculty completed the survey. Allrespondents answered that overnight call waseducationally important for the PGY-1 resident and allfelt that adequate supervision was available. In a rotationwithout overnight call, 90% of respondents answeredthat weekend coverage remained educationallyimportant but most felt this did not replace theeducational value of overnight call. Respondentsidentified the following competencies learned fromovernight call: development of independence,confidence, responsibility, decision-making, prioritizationand communication; cross-covering; and the opportunityto work-up new admissions.Discussion: Despite the scheduling difficulties imposedby new duty hours regulations, overnight call maintains aunique learning experience that should be preservedwhere possible in the training of PGY-1 residents.Reflective critique: Survey results were reported to theInternal Medicine Residency Program with a proposal tomaintain overnight call if possible, with weekend day asan educationally important, although qualitatively inferior,alternative.References:1. Nasca TJ, Day SH, Amis ES. The new recommendations on dutyhours from the ACGME task force. N Engl J Med 2010;363(2):e3.The UCSF Geriatric CommunityResources Clinical Algorithm andGuideChristopher A. Bautista, Christopher.Bautista@ucsf.edu;Louise Aronson, MD, aronsonl@medicine.ucsf.eduBackground: Roughly half of current physician visits inmany specialties are from patients >65 years old, andthe population aged >60 is expected to double by 2050.As states increasingly cut services keeping elderlypatients healthy and independent, healthcare providersmust be aware of, refer to, and lobby for these vitalgeriatric community resources.Methods: Following a literature review, internetsearches and interprofessional expert focus groups, wedeveloped an algorithm and related guide detailingservices, eligibility, coverage and cost, provider role andlocal contacts. Validity was established through surveysof students, residents, faculty and local communityproviders as well as feedback from over 30interprofessional national leaders in Geriatrics. Casebasedpre/post-tests with medical students and residentswere used to evaluate the educational utility of the toolsafter a brief introduction.Results: 58% (37/64) of survey respondents said thatthey were “somewhat likely” or “very likely” to use thesetools in their clinical practice and teaching. 63% (26/41)of learners “agreed” or “strongly agreed” that the toolsmade them more comfortable referring elderly patients tocommunity resources. 64% (9/14) of medical studentsand 90% (4/5) of residents who completed the pre/posttestscored higher after brief training with the tools.Discussion: The Geriatric Community ResourcesClinical Algorithm and Guide providers a validated andeducationally effective framework to help cliniciansappropriately refer elderly patients to vital communityservices. The tool alone does not help all trainees, someof whom may require a dedicated educational sessionon the purpose and uses of certain resources.Reflective critique: Presentations at ESCAPE,Geriatrics WIP and dissemination to local and nationalgeriatrics leaders for review led to additional resourcesand refined structure.Areas abstract covers: UME, GME, CME, IPHEDomain(s) addressed: Community Medicine,Evaluation of Programs and Curricula, Patient Care,Primary CarePurpose: To develop a tool that gives providers apractical conceptual framework for approaching themyriad resources necessary to keep elderly patientshealthy and independent in the community.40 The Haile T. Debas Academy of Medical Educators

UCSF Education Day 2011Workshop DescriptionsLeveraging Technology for EducationAmin Azzam, MD, MA; Ryan Brazell; Sean McClelland;Christian Burke; Renee Courey, PhD; Louise Aronson,MD, MFAIn this workshop, participants will learn how to produceonline, interactive, digitally-enhanced learning tools. Thisworkshop will showcase equipment and softwareavailable to educators, and include presentations fromlibrary staff about best practices for creating enhancedlearning tools. Panelists will offer tips for sharing onlinelearning tools with learners and for integrating thesetools into existing courses. Facilitators will demonstratethe process by modifying an existing static educationaltool (e.g., powerpoint lecture slides) into three differentlevels of enhancement: 1) web-based slides; 2) audionarration, and 3) an interactive learning module.Learning Objectives:1. Understand techniques for developing online,interactive, digitally-enhanced learning tools.2. Review resources available, including software andequipment, available to educators at UCSF forproducing learning tools.3. Learn about best practices for sharing online learningtools with learners and opportunities for integratingonline learning into existing courses.Poster Presentations and PrizesLouise Aronson, MD, MFA; Patricia O'Sullivan, EdDIn this workshop, panelists will learn aboutcharacteristics of good and bad posters, and learn aboutprinciples of poster design to both evaluate and producehigh-quality posters. In an interactive exercise,participants will actively review a range of digital postersof varying quality using a rubric, with a discussion tofollow about how ratings were established. A follow-updiscussion will focus on best practices in poster visualdesign and graphical presentation of information that willhelp participants create and recognize high-qualityposters that are worthy of awards when presented atmedical conferences.2. Learn how to better evaluate and review posters, andhow to provide constructive feedback to posterauthors.3. Describe how reviewers typically establish ratingswhen evaluating posters, and how rubrics and otherrating tools can assist the process of evaluatingposters.Scholarship of SimulationDiane B. Wayne, MD; Sandrijn van Schaik, MD; JodySteinauer, MDIn this workshop, experts will discuss the scholarship ofsimulation as an educational strategy. Panelists willdescribe their own experiences designing simulationresearch projects, and how these activities have affectedtheir own career development. Interactive exercises willhelp participants better understand best practicesassociated with simulation research. Panelists willinspire educators to use simulation for teaching and toimprove the quality and evaluation of simulation training.There will be ample opportunity to discuss educators’questions and practical aspects of designing simulationresearch.Learning Objectives:1. Describe best practices for incorporating simulationbasededucation into health professions education.2. Define strategies for effective simulation-basededucational research.3. Review research gaps and unanswered questions insimulation-based education.Learning Objectives:1. List best practices in poster design in poster visualdesign and graphical presentation of information.University of California, San Francisco • School of Medicine 41

UCSF Education Day 2011Index by AuthorAdam, Carlson..................................29Adler, Josh .......................................38Adriana, Padilla ................................21Alexander, Erik .................................10Alldredge, Brian..................................9Angelotti, Amanda ............................19Aronson, Louise ....4, 8, 11, 16, 17, 34,38, 40, 41Azzam, Amin ..............................26, 41Barbour, Kelli....................................30Bautista, Christopher........................40Bogetz, Martin ..................................36Boscardin, Christy ......................30, 34Brandehoff, Nicklaus ........................22Brazell, Ryan ....................................41Bruckner, Julia............................25, 35Brzezinski, Marek .......................26, 36Burke, Christian............................8, 41Byrne, Laura.....................................20Campbell, Andre...............................19Carlin, Danielle .................................26Carney, Patricia................................39Chang, Anna ..............................30, 39Chen, Alice HM ................................11Chen, Allison ....................................34Chen, Carrie .....................................38Chen, Esther ....................................19Chen, H. Carrie ..................................9Chern, Hueylan ................................31Chomsky-Higgins, Kate....................28Chou, Calvin...............................30, 37Ciccarone, Daniel .............................22Clouse, Amy.....................................29Coelho, Anabelle D. .........................33Collins-Bride, Gerri ...........................17Courey, Renee ...........................34, 38Courey, Renee .................................41Dhaliwal, Gurpreet............................25Dhand, Amar ....................................25Diaz, Vanessa ..................................33Dicker, Rochelle ...............................19Douglas, Vanja .................................16Duong, David....................................19Evans, Carrie....................................38Fitzhenry, Kristen .............................38Fix, Oren...........................................39Fromont, Sebastien C. .....................28Fulton, Tracy ....................................20Fyfe, Molly..................................30, 32Gali, Kathleen...................................36Gomez, Nicole..................................28Griswold, Virginia .............................23Grubbs, Vanessa..............................11Gupta, Reena ...................................32Hall, Sharon M..................................28Hansen, Lori.....................................10Hauer, Karen..................10, 30, 36, 39Hettema, Jennifer.............................22Hicks, Kathleen ................................18Hill-Sakurai, Laura..............................8Hirsh, David......................................10Houseman, Ben ...............................19Howell, Ben ......................................28Hudmon, Karen Suchanek ...............28Hyde, Susan.......................................9Hyland, Katherine...............................8Jain, Sharad .........................11, 18, 22Johnston, Bree .................................32Josephson, S. Andrew ...............16, 25Jue, Vicki..........................................32Julian, Katherine ..............................34Kaaya, Ephata..................................32Kamel, Hooman ...............................25Kathy, Schlecht ................................26Keenan, Craig ..................................18Kilmer, Jeff .........................................9Kim, Ed.............................................31Kimatian, Stephen............................26Kinman, Renee ................................23Kirsch, Heidi .....................................16Koehler, Gary ...................................27Kripke, Clarissa ................................17Kruidering, Marieke ..........................16Kuo, Anda ..................................11, 20Lai, Cindy ...............................8, 32, 33Land, Kathleen ...................................8Lee, Christina A................................30Leshabari, Sebalda ..........................27Levitt, David Stern............................29Lin, Eric ............................................19Lin, Lisa............................................33Liu, Joseph.......................................16Loeb, Anna.......................................25Loeser, Helen.................................4, 9Loomer, Peter ....................................9Louie, Alan K....................................28Lovett, Mark .....................................34Lyamuya, Eligius ..........................9, 32MacFarlane, Sarah.....................30, 32Mack, Kevin......................................16Mackersie, Robert ............................19Mackin, Lynda ..................................32Manuel, Jennifer...............................22Martin-Holland, Judy ..........................9Massawe, Siriel ................................27Masters, Susan ................................16Mayfield, Chandler ...........................19McClelland, Sean .............................41McCowin, Marcia..............................23Miller, Bernie ....................................36Miller, Carol A. .................................16Mitchell, John ...................................26Mitrovic, Igor ....................................20Mizuguchi, Annette ..........................26Mkony, Charles .......................... 30, 32Mookherjee, Somnath................ 29, 37Moylan, Adam ..................................32Naburi, Helga ...................................27Natt, Guneet............................... 26, 36Navi, Babak......................................25Niehaus, Brian ...................................8O'Brien, Bridget................ 4, 10, 34, 36O'Sullivan, Patricia . 8, 9, 30, 31, 33, 41Patricia, Hom ...................................33Perry, Dorothy.............................. 9, 30Pheatt, Lara .....................................37Pierce, Read ....................................20Poncelet, Ann............................. 10, 16Price, Kathryn ............................ 26, 36Prochaska, Judith ...................... 28, 36Rabow, Michael ...............................38Ratanawongsa, Neda ......................22Remen, Rachel ................................38Rennke, Stephanie ..........................32Roey, Steve .....................................18Satterfield, Jason .............................39Schechter, Matthew .........................20Schillinger, Erika ..............................35Shah, Maulik ....................................25Shapiro, Brad ...................................22Sharpe, Bradley ...............................29Sheu, Leslie C............................ 31, 33Siegel, Jennifer ................................11Sommavilla, Nili ................... 25, 28, 35Staves, Jennifer .................................9Steinauer, Jody ................................41Stewart, Colin E. ..............................26Tat, Sonny........................................20Teherani, Arianne ............................35Tong, Lowell.....................................16Topp, Kimberly...................................9Tran, H. Nicole .................................26Turman, Irene ..................................23van Schaik, Sandrijn .................. 20, 41Vener, Margo ................. 17, 25, 28, 35Wamsley, Maria ...............................34Wayne, Diane B. .......................... 5, 41Weinstein, Stefanie ..........................23Wheeler, Margaret ..................... 25, 28Whichard, Emily ...............................17Wilson, Elisabeth .............................25Yang, Serena ...................................23Youmans, Sharon ..............................9Young, John Q. ................................26Zheng, Patricia.................................3342 The Haile T. Debas Academy of Medical Educators