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

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