GME Leadership Development: Educating the Next Generation of GME Leaders

W Wiese-Rometsch & MD & H Kromrei, MA Detroit Medical Center

83 Residency Programs > 1000 Trainees

FORMAL LEADERSHIP TRAINING?

GME Conceptual Model: Performance Domains

Education

Accreditation

Communication

Management &

Improvement

Leadership

Evaluation

Clinical

GME Leadership Academy

Curriculum

Development Process

Needs Assessment

ACGME & AOA Requirements

Citation Tracking Tool

Internal Review Results

Program Director Survey

Internal Review Action Plan

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

GME Leadership Academy Aims

GME Leadership Academy Aims

GME Leadership Academy Aims

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.”

Lessons Learned

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

Future Directions

Take Home Points

Conduct a Needs Assessment

Align with Accreditation

Requirements Adapt

Tailor Curriculum based on

Feedback

Questions ?

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.