March 2012|Vol.5|no.1
From the Desk of the Associate Dean
The Latest on Graduate Medical Education at the School of Medicine
As March blows in, we have many things to celebrate as well as things to anxiously await (Match Day). In January the school co-hosted the Nevada Chapter of the American College of Physicians annual meeting at the Simulation Center in Las Vegas. The meeting was extremely successful and planned by internal medicine – Las Vegas program director Sandhya Wahi, MD, MPH. She reformatted the meeting to include small group breakout sessions and hands on learning activities. In addition, the resident competition was structured differently this year with the “winners” from Reno and Las Vegas regional sessions competing on site. The finalists from this competition for the first time presented to the conference attendees and overall winners were announced (see below). Also new this year was the introduction of a Doctors’ Dilemma competition. The winning team from the competition will compete at the national ACP meeting in May in New Orleans. Winners from the resident competitions include:
Clinical Vignettes
- First Place: Dinadelle B. Viola, MD – IM- Reno
- Second Place: Ranjit Maker, MD – IM-Las Vegas
- Third Place: Paul Hayward, MD – IM-Reno
Research
- First Place: Ramesh K. Gadam, MD – IM-Las Vegas
- Second Place: Shien Hu, MD – IM-Reno
- Third Place: Fuzhan Parhizgar, MD – IM-Las Vegas
Doctors’ Dilemma Team: Jitendra Adepu, MD; Sudheer Polisetty, MD; Ranjit Makar, MD – IM Las Vegas.
In January, the second Resident Teaching Honor Roll was posted. The honor roll is criterion based and the standards are very high. Residents have to achieve a score of 4.85 of 5 and have 5 evaluations submitted or the mean number for the group to be considered. All individuals meeting the established criteria are placed on the honor roll. This honor roll reflects students’ evaluations for the six month block from July through December. Thirty two residents made the list and of these residents, eight are listed for the second time.
February began with the first annual Philip Goodman, MD Award in Excellence in Resident Critical Appraisal competition. The event was held in Reno with pictel to Las Vegas. Residents representing 10 of the residency programs participated. During the competition, each resident presented his/her paper to the judges and audience and answered everyone’s questions. The judges included dean of the school of medicine Thomas Schwenk, MD and former dean of the school of medicine John McDonald, MD, PhD as well as William Evans, MD from the Children’s Heart Center, Robert Langer, MD, MPH, Director of the Jackson Hole Center for Preventive Medicine and Joshua Bardin, MD, Vascular Surgeon. Steven Zell, MD, professor of internal medicine – Reno served as the moderator.
This competition is sponsored in part by the Philip Goodman, MD endowment. Many thanks go to Nancy Goodman and her support of resident education. The winners of the competition were:
- First Place: Kathryn Kolonic, DO – Family Medicine Las Vegas
- Second Place: Matthew Larsen, MD – Psychiatry Reno
- Third Place: Faisal Siddiqui, MD – Internal Medicine Reno
The final February activity honoring residents was the announcement of the Arnold P. Gold Foundation Humanism and Excellence in Teaching Awards. This year, residents were selected based on their teaching evaluations from the third year students (class of 2013) i.e. presence on the teaching honor roll and the written comments from the students. The selection of the recipients was made by Dr. Peggy Dupey, the associate dean for admissions and student affairs, Dr. Gwen Shonkwiler, the assistant dean for assessment and me. The awards will be presented in Reno on April 11, 2012 at individual departmental didactic sessions and in Las Vegas on April 17, 2012 at the conclusion of the Education Interdisciplinary Grand Rounds. This year’s recipients of the Humanism and Excellence in Teaching Awards are:
- Walter Yuen, MD – Internal Medicine Reno
- Jayleen Chin, MD – Psychiatry Reno
- Mariangela Rivera, MD – Surgery
- Vickie Bailey, MD – Pediatrics
- Kanchan Kanel, MD – Internal Medicine Las Vegas
- Deepak Nandikanti, MD – Internal Medicine Las Vegas
Now we are in March and all rank lists have been submitted. We all have our fingers crossed that programs will fill and we don’t have to experience the SOAP for the first time. This year the match season has been really different and strange. Competition is up and maybe that is a good thing. On March 12 we will learn how we did by the numbers and later in the week by name. Good luck to everyone as we embark on this annual adventure.
The trees on West Charleston are blooming. Spring will be here soon.
Best,
m
Miriam Bar-on, M.D.
Associate Dean for Graduate Medical Education and Designated Institutional Official
From the ACGME
A systematic review of curricular interventions teaching transitional care to physicians-in-training and physicians
Buchanan, IM and Besdine, RW. Acad Med. 2011 May;86:628-639
Summary
The patient safety movement in this country has focused increased attention on problems in transitional care of patients. Transitional care can be defined as a set of actions designed to ensure the coordination and continuity of health care as patients transfer between locations or between different levels of care within the same location. Inadequate transitions definitely lead to significant medical errors and patient harm.
The authors of this paper conducted a systematic review of all available literature from 1973 to 2010 on topics consistent with the above definition of transitional care. The goal was to identify currently available interventions used to teach best practices in transitional care. A thorough literature search yielded 27 references, three-quarters of which were published in 2008 or later. A review of these references demonstrated 25 unique, eligible interventions, excluding duplicates.
The authors reviewed the 25 eligible interventions and discussed what learner characteristics, temporal characteristics, and content characteristics were emphasized in these interventions. The vast majority were designed for clinical learners and consisted of brief, self-limited educational measures. Classroom-based strategies were emphasized; mostly didactic sessions with use of small-group and large-group-based learning. Handouts and web-based curricula were also common, often provided as accompaniments to classroom-based didactic lectures. Only 42% of the materials reviewed provided evidence-based support for their content.
The paper went on to discuss the weaknesses and failings of the currently available interventions and what is needed to strengthen training in this area in the future. Clearly, inclusion of allied health care professionals in this training and designing curricular interventions for mixed audiences would be beneficial. Diverse trainees need to be educated together using curricula that promote communication and collaboration. Citing supporting literature should also be a top priority as evidence-based interventions are more likely to be embraced and implemented.
Comment
Transitional care represents a diverse array of actions and competencies that have demonstrated an important influence on the quality of patient care. In the last few years, the number of educational interventions developed to teach this complex topic has increased dramatically. The authors of this paper do a good job of assessing important factors that must be addressed in developing future curricula in this area. First, efforts to span the breadth of transitional care with specific interventions that are evidence-based should be made. econd, more rigorous, purposeful development and validation of novel curricular interventions will allow their publication in high quality peer-reviewed publications. Finally, integration of these new interventions must be incorporated into existing educational programs. The growing recognition of the importance of transitional care and the increased emphasis in medicine on coordinated interdisciplinary care should help further this agenda in the years ahead.
Summary and Comments by Steven R. Craig, MD, FACP
Best Practices
Resident Wellness – If They are Not Happy, Neither are You
Michael Epter, DO, Program Director, Emergency Medicine
It is important to create a wellness component in residency programs. Emergency medicine has a well developed program that is based on the CARE mneumonic. In addition, we have developed a sample mission statement and have a core competency based wellness curriculum. The curriculum with the competency based objectives is available upon request.
CARE
The CARE mneumonic details the main components to a successful initiation of a wellness
Culture – changing the culture from avoidance of burnout to vitality and resilience
Champion – appointment of a faculty and resident to champion wellness within your program
Committee – resident committee on wellness with predetermined, regularly scheduled meetings
Assessment – utilization of a validated burnout inventory (e.g., Maslach-Burnout Inventory)
Agenda – wellness item on monthly faculty meeting
Retreats – both formal (residency sponsored) and informal
Educate – didactic series on wellness topics (see link above)
The emergency medicine mission statement, which can be used as a model for other programs is:
The residents of the Department of Emergency Medicine at the University of Nevada strive to be proactive and preventative in the ongoing process of self evaluation and make conscious decisions that improve our own vitality and have a positive effect on the quality of our life with the overall goal of leading healthy, balanced lifestyles and fostering leadership.
Wellness is important for residents, program directors and faculty. A comprehensive program can be successfully implemented within a residency program. Please contact me for additional information.
In the Spotlight
Welcome Katina Shehie, coordinator for the internal medicine – Las Vegas program, to the School of Medicine. Katina comes to the School of Medicine from Loyola where she had years of experience in being a coordinator.
Congratulations to Jeremy Matuszak, MD, program director for psychiatry – Reno and his wife on the birth of their first child London Sophia, born on Valentine’s Day.
Congratulations to Michael Epter, DO, emergency medicine program director on being selected Program Director of the Year by the American Academy of Emergency Medicine. This award recognizes and EM program director who has made an outstanding contribution to AAEM. The winner of this award is chosen by the AAEM resident and student association.
Congratulations to Katie Kolonic, DO on her fellowship in geriatrics at Oregon Health Sciences University that will start in July 2012.
Congratulations to the internal medicine – Las Vegas residents who submitted to the national American Colleges of Physicians annual meeting this spring in New Orleans and had them accepted.
- Ramesh Keerthi Gadam, MD – Can It Wait Until The Morning? – A retrospective study of the clinical utility of blood culture gram stain reports provided between 10:00 pm and 6:00 am. This abstract was also selected as one of the 10 research winners at the 2010 National Associates Competition.
- Reza Vaghefi-Hosseini, MD – A case of proliferative glomerulonephritis with monoclonal IgG deposits.
- Jason Suszko, MD – Ascites in pregnancy: from erythema nodosum to peritoneal coccidioidomycosis.
Congratulations to the internal medicine – Las Vegas residents who submitted abstracts to Digestive Diseases Week 2012 and had their abstracts accepted.
- Ranjit Makar, MD – Inhibition of cortical response to non-painful somatic stimulus with simultaneous application of noxious visceral stimulis: A fMRI study in rat.
- Mahendran Jayaraj, MD – Seasonal and geographic variation in hospitalizations rates for ischemic colitis.
Congratulations to Cara Louise Fox, MD a second year family medicine – Reno resident who had her abstract Wireless video EMG can be used to study pelvic floor muscle response to movement accepted for presentation at the Society for Urodynamics and Female Urology meeting.
Congratulations to Elena Zenkin, MD, OB-GYN intern who had her abstract titled – Outpatient Misoprostol in the Management of Post-term Pregnancies accepted to the 60th annual ACOG meeting for May 2012.
Congratulations to Tamir Rogson, MD, first year family medicine intern who had his abstract titled – Pyelonephritis in Pregnancy: Organisms and Antimicrobial Resistance Trends in Southern Nevada accepted as a poster to the 60th annual ACOG meeting for May 2012.
Congratulations to the internal medicine – Las Vegas program leadership – Sandhya Wahi, MD, MPH, Cynthia Herrick, MD and Aditi Singh, MD and their interprofessional team for having their abstract The impact of interdisciplinary code simulation on perceptions of collaboration and team performance among internal medicine residents and nursing students accepted by the Society of General Internal Medicine for their annual meeting this spring in Orlando.
Congratulations to Ryan Hodnick, DO second year emergency medicine resident and core faculty Bryan Bledsoe, DO on the publication of their paper Low-fractional oxygen concentration continuous positive airway pressure is effective in the prehospital setting in Prehospital Emergency Care2012;Early Online:1-5.
Congratulations to Carol Scott, MD and Michael Milligan, MD on having matched both of their open positions for sports medicine fellows in Reno and Las Vegas respectively.
Congratulations to Erika Ryst, MD who filled her child psychiatry fellowship through the match.
The School of Medicine GME community will be well represented at the Western Group on Educational Affairs annual meeting in March. Multiple abstracts were submitted and accepted for presentation. The abstracts include the following:
- Documentation Bootcamp (poster) – Aditi Singh, Sandhya Wahi, Cynthia Herrick, Miriam Bar-on
- Milestone-Based Evaluation (poster) – Aditi Singh, Sandhya Wahi, Cynthia Herrick, Miriam Bar-on
- A New Ambulatory Curriculum to Meet Educational Needs (poster) – Aditi Singh, Sandhya Wahi, Miriam Bar-on
- Leading with a Carrot: A RATs Certification Program to Improve Residents’ Teaching Skills (poster) – Miriam Bar-on, Aditi Singh, Jennifer Hagen, Sandhya Wahi
- Curriculum Revision Utilizing Online Study Materials to Improve Pediatric Medical Knowledge in a Community Based Medical School (poster) – Kami Larsen
- Designing an Objective MMI Tool for New Resident Interviews (poster) – Kami Larsen, Miriam Bar-on, Jack Lazerson
In This Edition
From the Desk of the Associate Dean
From the ACGME
Best Practices
In the Spotlight
Past Four Issues
GMEmail is a service of the Office of Communication, University of Nevada School of Medicine. Miriam Bar-on, M.D., Editor, Office of Graduate Medical Education. Copyright 2011 University of Nevada School of Medicine.