GME Leadership Development: Educating the Next Generation of GME Leaders
W Wiese-Rometsch & MD & H Kromrei, MA Detroit Medical Center
GME Conceptual Model: Performance Domains
Education
Accreditation
Communication
Management &
Improvement
Leadership
Evaluation
Clinical
Needs Assessment
ACGME & AOA Requirements
Citation Tracking Tool
Internal Review Results
Program Director Survey
GME Leadership Program Director Survey
Perceived importance
Perceived competence
25 items; 5- point Likert scale
Categories: Resident Leadership People Leadership Business Leadership
PD Survey: “Resident Leadership” Category “Resident” Leadership Importance * Competence*
Creating & Evaluating Competency Based Curricula
64% Very / Ext 18% Not /Some
Maintaining Compliance with ACGME / AOA Requirements
90% Very / Ext 5% Not /Some
Communicating with Residents 100% Very/Ext 0% Not /Some
Communicating with Former Residents
55% Very / Ext 13% Not /Some
Managing & Evaluating Resident Performance
94% Very / Ext 5% Not /Some
Managing Resident Conflicts & Problems
90% Very / Ext 7% Not /Some
Recruiting Resident Candidates 93% Very / Extra 9% Not /Some
PD Survey: “People” Leadership Category
“People” Leadership Importance * Competence* Selecting & Recruiting Program Faculty & Staff
91% Very / Extra 23% Not /Some
Managing Program Faculty & Staff
91% Very/Extra 16% Not /Some
Managing Program Faculty & Staff Conflicts/ Problems
85% Very / Extra 20% Not /Some
Retaining Program Faculty & Staff
88% Very / Extra 7% Not /Some
Promoting Program Faculty & Staff Professional Development
76% Very / Extra 18% Not /Some
PD Survey: “Business” Leadership Category
“Business” Leadership Importance * Competence* Maximizing Program Performance 89 % Very / Extra 17% Not /Some
Competing for Resources 75 % Very / Extra 23% Not /Some
Managing Resources 86 % Very / Extra 14% Not /Some
Creating & Managing Budgets 68% Very / Extra 25% Not /Some
Negotiating with Institutional Leadership
84% Very / Extra 23% Not /Some
Analyzing Program Performance 93% Very/Extra 5% Not /Some
Communicating / Relationship with Leadership Peers
77% Very / Extra 9% Not /Some
Summary of Needs Assessment Findings Goal: Triangulation of data 1. Macro Level: Accreditation Outcomes
2. Micro Level: Internal Review Results
3. Stakeholder Perceptions: Program Director Survey
Instructional Methods Baseline reflection
survey on “ideal program”
Pre-test / Post –test Mini-lectures “Hands on”
experiential learning activities
Round table
dialogues for all sessions Assignments
Large group
workshops (open to all PDs)
GME Leadership Academy Curriculum
Accreditation Cycle Core Competencies Developing Competency Based Curriculum and
Evaluations The Annual Program Review Communication and Technology Resource Planning Writing Your Program Information Form or Booklet Program Management Leadership Development
Session 1: Accreditation Goals / Objectives Tasks
Understand the ACGME / AOA Regulatory Cycle and Associated Protocols
Review ACGME or AOA Specific Program Requirements
Understand Institutional and Program Level Accreditation
Review new ACGME / AOA Common Program Requirements (Effective July 1, 2011)
Understand the Internal Review Protocol and Process
Participate in an Internal Review
Participate in self-assessment activity
Rate program performance in meeting accreditation compliance
Accreditation
Session 2: Core Competencies
Goals / Objectives Tasks
Understand the ACGME / AOA Core Competencies
Evaluate Your Program Information Form’s Learning Activities
Incorporate the Core Competencies into Your Program
Determine Program need for development of competency-based learning activities
Participate in Self-Assessment Activity
Rate program performance in implementing experiential learning activities for core competencies
Participate in Group Activity Develop / improve a learning activity for PBL or SBP
Education
Session 3: Developing Competency-Based Curriculum & Evaluations
Goals / Objectives Tasks
Understand how to write goals, objectives, and evaluations
Revise a sample curriculum for a core rotation in your program
Understand the requirement for aligning program curriculum (measurable goals / objectives) to evaluation and assessment tools
Align the existing evaluation to the curriculum
Participate in Self-Assessment Activity
Rate program performance in compliance with requirements for competency-based goals and objectives
Education &
Evaluation
Session 4: The Annual Program Review
Goals / Objectives Tasks
Understand the Annual Program Review Requirements
Review current annual review protocol Compare current review process to ACGME requirements Identify opportunities for improving your annual program review
Participate in Self-Assessment Activity
Describe program’s approach to Annual Review Determine compliance with requirements
Evaluation
Session 5: Communication & Technology Resource Planning
Goals / Objectives Tasks
Understand effective utilization of educational technology to improve resident / program performance
Participate in Office of Teaching and Learning Session
Apply educational technology to enhance communication and teaching
Import lecture to “Wimba” Review manuscript for plagiarism using “Safe-Assign” Develop resident exams on “Blackboard”
Participate in Self-Assessment Activity
Rate program performance in utilization of technology in communicating and teaching residents
Communication
Session 6:Writing Your PIF and Telling the Story of Your Program
Goals / Objectives Tasks
Understand importance of the PIF or Booklet
Develop PIF writing plan for your program
Determine PIF stakeholders
Delegate PIF responsibilities to program members
Identify effective PIF writing strategies
Review / revise PIF to increase compliance and effectiveness
Participate in Self-Assessment Activity
Rate your program’s PIF and describe your involvement with PIF
Accreditation & Communication
Session 7: Program Management
Goals / Objectives Tasks
Understand the process of program management
Understand “Performance Indicators” and their importance in program evaluation
Review program data (Annual Program Review Action Plan and Internal Review Action Plan) Track program performance (GME Score Card) Identify obstacles to program improvement
Participate in Self-Assessment Activity
Rate program’s current methods for evaluating program performance in specified domains
Management & Improvement
Session 8: Leadership Development
Goals / Objectives Tasks
Understand leadership competencies
Analyze personal values and align with leadership competencies
Develop short and long-term professional development plan
Review Current CV Develop action plan to meet identified goals
Identify negotiation strategy skills
Describe requirements for leadership in your current role
Participate in Self-Assessment Activity
Describe your current core values and long term goals
Leadership
Supplemental Curricular Elements
GME Faculty Development Series: Decreasing Evaluation Bias Effective Interviewing Skills Teaching Skills: The 1 Minute Preceptor The Problem Resident: Lessons Learned Legal Issues in GME
Outcomes: Knowledge Gain
Session Pre-Test Post-Test
1 79 % 96%
2 65% 74%
3 73% 87%
Table 1: Pre & Post-Test Average Scores
Outcomes: Course Evaluation
Table 2: Course Evaluation Results
Evaluation item Agree/Strongly Agree
Recommendsession to others
97 %
Interactive/Engaging
100%
Relevant to job 97%
Outcomes: Course Evaluation
Participant Comments “It was great! Really appreciated the pre-session survey and pace of content delivery.” “Should be completed by all PDs.” “Excellent initiative.”
Future Directions
Simple ID Process
ID Process Layer 2
ID Process Layer 1
ID Process Layer 3
ID Process Layer ’n’ Complex ID Process Quality
Limited Time & Resources
Ample Time & Resources
Tessmer and Wedman’s Layers-of-Necessity Model
Take Home Points
Conduct a Needs Assessment
Align with Accreditation
Requirements Adapt
Tailor Curriculum based on
Feedback
References
Wiese-Rometsch, W., Guerra-López, I., Kromrei, H., Developing Successful Leaders: A Model for Graduate Medical Education. Poster presented at the Association for Medical Education Europe, Malaga, Spain, 2009.
Kromrei H., Wiese-Rometsch W. (2010). Portfolio Assessment:
Relevant Evaluation Methods and Their Implication for Portfolio Design. In Guerra-Lopez, I (Ed) Social and Organizational Performance Review: Concepts and Research; 2010 2:2. pp119-134 Bloomington: Author House
Neher, J. O., Gordon, K. C., Meyer, B., & Stevens, N. (1992). A five-step "microskills" model of clinical teaching. Journal of the American Board of Family Practice, 5, 419-424.