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

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

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