creating a model program in the era of nas: a synthesis of best p ractices

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Graduate Medical Education Creating a Model Program in the Era of NAS: A synthesis of best practices Kim Walker, Ph.D. Education Specialist Graduate Medical Education Stanford Hospital and Clinics [email protected]

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Creating a Model Program in the Era of NAS: A synthesis of best p ractices. Kim Walker, Ph.D. Education Specialist Graduate Medical Education Stanford Hospital and Clinics [email protected]. Surgery Psychiatry Urology Pediatrics. Cardiology. - PowerPoint PPT Presentation

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Page 1: Creating a Model Program in the Era of NAS:  A synthesis of best  p ractices

Graduate Medical Education

Creating a Model Program in the Era of NAS: A synthesis of best practices

Kim Walker, Ph.D.Education SpecialistGraduate Medical EducationStanford Hospital and [email protected]

Page 2: Creating a Model Program in the Era of NAS:  A synthesis of best  p ractices

Graduate Medical Education

AnesthesiaInternal Medicine

Radiology Dermatology

Cardiology Sports Medicine Oncology Pathology

Surgery Psychiatry Urology Pediatrics

Page 3: Creating a Model Program in the Era of NAS:  A synthesis of best  p ractices

Graduate Medical Education

Program A Program B Program C Program D

A+ ?

Life in the silos…

Page 4: Creating a Model Program in the Era of NAS:  A synthesis of best  p ractices

Graduate Medical Education

Residents Program Directors

Faculty GME/DIOs

ACGME & RRCs

What are the best practices in GME (that allow everyone to smile)?

Page 5: Creating a Model Program in the Era of NAS:  A synthesis of best  p ractices

Graduate Medical Education

Purpose: Qualitative analysis of surveys and internal review reports on residencies and fellowships over a two-year period to identify program-level best practices. Process: Two coders thematically analyzed each document specifically for the questions on best practices or strengths about the program. Abductive coding started with codes determined a priori (ACGME core competencies). New codes were added when additional patterns in vivo emerged, derived from the responses themselves. This iterative coding process provided strong evidence for both a priori and emergent themes related to Best Practices in residencies and fellowship programs at Stanford University.

Research Design

Page 6: Creating a Model Program in the Era of NAS:  A synthesis of best  p ractices

Graduate Medical Education

Page 7: Creating a Model Program in the Era of NAS:  A synthesis of best  p ractices

Graduate Medical Education

Page 8: Creating a Model Program in the Era of NAS:  A synthesis of best  p ractices

Graduate Medical Education

DEDOOSE

Page 9: Creating a Model Program in the Era of NAS:  A synthesis of best  p ractices

Graduate Medical Education

Page 10: Creating a Model Program in the Era of NAS:  A synthesis of best  p ractices

Graduate Medical Education

Example for Quality Improvement

Excerpts Define Best Practice

Page 11: Creating a Model Program in the Era of NAS:  A synthesis of best  p ractices

Graduate Medical Education

Examples for Didactics

Excerpts Define Practice

Page 12: Creating a Model Program in the Era of NAS:  A synthesis of best  p ractices

Graduate Medical Education

Most # of coded categories

Code Category # of excerpts coded

Didactics sessions 128

Research Opportunities 154

Participating Sites 170

Patient Case Variety/Load 436

Program Personnel/Resources 407

Educational Atmosphere 147

Faculty (development, participation, qualifications) 717

Program Director (including leadership and responsiveness to residents)

420

Page 13: Creating a Model Program in the Era of NAS:  A synthesis of best  p ractices

Graduate Medical Education

Deciphering the codes: A model emerges

Page 14: Creating a Model Program in the Era of NAS:  A synthesis of best  p ractices

Graduate Medical Education

Best Practices and Sharing from Silos

Page 15: Creating a Model Program in the Era of NAS:  A synthesis of best  p ractices

Graduate Medical Education

Wiki Power

Web-based; easy access; easy content addition and evolution

Page 16: Creating a Model Program in the Era of NAS:  A synthesis of best  p ractices

Graduate Medical Education

THINK – PAIR – SHARE

THINK: What is one “best practice” that stands out in your mind from your institution or particular program? In what category of program administration, teaching or learning does it apply?

PAIR: Take turns sharing your best practice with someone sitting next to you, even if it means saying, “I can’t think of any!”

SHARE: If willing and interested, share your best practice with the greater GME community. Post to:

http://gmebestpractices.wikispaces.com/

Page 17: Creating a Model Program in the Era of NAS:  A synthesis of best  p ractices

Graduate Medical Education

REASONS TO BUILD COMMUNITY & RESOURCES

Page 18: Creating a Model Program in the Era of NAS:  A synthesis of best  p ractices

Graduate Medical Education

MORE REASONS…

Page 19: Creating a Model Program in the Era of NAS:  A synthesis of best  p ractices

Graduate Medical Education

MORE BEST PRACTICES…

DISCLOSURE: While numerous best practices emerged from this study, we definitely have our fair share of program weaknesses that counter-balance the strengths. But this study was focused on what is working…

Page 20: Creating a Model Program in the Era of NAS:  A synthesis of best  p ractices

Graduate Medical Education

TO TAKE DOWN THE SILOS!!

IT’S TIME….