March 27, 2019

Presentations and Awards at the 2019 STFM Annual Meeting

The annual meeting of the Society of Teachers of Family Medicine (STFM) will be held in Toronto this Spring. The U-M Department of Family Medicine will be well represented, with poster and educational sessions, as well as several professional leadership recognition awards.

Jenna Greenberg and Anna Laurie stand on either side of a poster titled Leaders in Family Medicine: Creating a Longitudinal Quality Improvement Curriculum for Family Medicine Residents
U-M Family Medicine faculty members Jenna Greenberg, M.D., assistant professor, and Anna Laurie M.D., assistant professor, at last year's STFM conference in Washington D.C., 2018 

Members of the University of Michigan Department of Family Medicine, including faculty, residents, and staff, will attend the 2019 Society of Teachers of Family Medicine (STFM) national conference, held in Toronto, Ontario from April 27 to May 1, 2019. Please check out out the wide range of U-M Family Medicine-led presentations, discussions, and workshops at STFM. For the most up-to-date times and locations, please consult the STFM conference page.  A special thank you to all the faculty research mentors and family medicine staff for their support of resident-led research this year! Follow the University of Michigan Family Medicine Twitter account @umfamilymed for live updates and photos from #STFM19.

 

PR06: Learning Faculty Development Skills in Mentorship, Coaching, Scholarly Activity, and Wellness: A Toolkit for New Faculty in Family Medicine

Abstract

New faculty face unique challenges navigating the multifaceted domains of medical student education, clinical care, residency training, and research. Family medicine departments often struggle to provide a comprehensive orientation for new faculty or a sustainable model for continuous faculty development. Presenters will provide a toolkit for new faculty, providing guidance on faculty development, mentorship, coaching, seeking feedback, scholarly activity, research development, advocacy, wellness and resilience. Presenters will facilitate discussions on common challenges and fundamental resources. A faculty panel will present leadership development activities, mentorship and coaching styles for seeking adequate support, take questions and offer advice, including guidance on seeking and giving feedback, establishing an academic or advocacy learning plan and agenda, research development, and creating an educator portfolio. A balanced approach to faculty life is becoming increasingly important with an increased administrative burden. Presenters will review strategies for maintaining wellness and building resilience as new family medicine faculty.

Upon completion of this session, participants should be able to:

  1. Describe the most common personal, clinical, administrative, and academic challenges identified by new faculty in family medicine, learn about family medicine advocacy, and identify national resources to support family medicine faculty;

  2. Identify effective mentoring and coaching concepts and styles, identify accessible opportunities for building mentoring and coaching relationships, and describe strategies for maintaining and modeling work-life balance;

  3. Develop relationships with other new faculty attendees through shared experiences, seek mentorship and coaching opportunities in home and outside institutions; draft an educator portfolio, and propose a faculty development plan.

Angela Kuznia, MD, MPH; Jamie Hill-Daniel, MD; Julie Graves, MD, MPH, PhD; Elise Morris, MD; Rahmat Na'Allah, MD, MPH; Michelle Roett, MD, MPH, FAAFP, CPE

4/27/2019

1:00 pm - 5:00 pm

Room: Churchill

DP031: Use of a Daily Prompt System to Encourage Feedback

Abstract

The University of Michigan Family Medicine residency is improving our feedback system for residents. Resident satisfaction with the feedback they receive is relatively low, as are faculty rates of completing requested feedback forms. The objective of the project is to increase the quality and quantity of verbal and written feedback given by faculty to residents, focusing on experiences in family medicine continuity clinic. Under our former system, we requested written feedback from outpatient preceptors when they met a minimum number of clinical interactions with each resident, making most written evaluations lengthy and tailored to specific experiences or skills. These forms were organized by competency area, with each question linked directly to an ACGME milestone. We instituted a system to encourage faculty to give residents feedback during every outpatient precepting session. A feedback prompt system triggers faculty to fill out a short, competency-linked feedback form which prioritizes narrative feedback over numeric scales. We are measuring the effect this intervention has on the quality and quantity of feedback to Family Medicine house officers, as well as resident and faculty satisfaction with the system.

Upon completion of this session, participants should be able to:

  1. Describe and create a simple prompt system for encouraging faculty to submit daily feedback to resident learners,

  2. Describe the advantages of simplified, competency-linked feedback forms,

  3. Describe the results of a project aimed at improving the quality and quantity of feedback given to resident learners.

Jean Wong, MD; Margaret Dobson, MD; Jenna Greenberg, MD; Mikel Llanes, MD; Anna McEvoy, MD; Leigh Morrison, MD; Stephen Warnick, MD

4/28/2019

1:15 pm - 2:15 pm

Room: Osgoode Ballroom

DP025: Developing a Multidisciplinary Post-Hospital Discharge Continuity Clinic in a Family Medicine Residency

Abstract

The time when patients transition from hospital to home is one of increased complexity and risk. The University of Michigan Family Medicine Residency has implemented a new Transitions of Care curriculum to focus on training residents to care for patients during this vulnerable time. A component of this curriculum is a multidisciplinary post-hospitalization discharge clinic. Prior to the implantation of this clinic, residents would rotate on our inpatient service, and separately care for patients in their outpatient clinic, with hospital discharge follow-up visits unlinked to continuity. It should benefit both the resident and patient to improve continuity after discharge, so we intentionally developed a clinic where the inpatient resident would see our discharged patients in follow-up. To improve the common gaps in care after hospital discharge, we sought to gather a mixed group of health care team members who could enhance the care provided for patients post-hospitalization. The resident will gain experience in leading a multidisciplinary outpatient team, including PharmD, nurse care navigator, and social worker. The purpose of this project is to evaluate the impact of this educational intervention on the residency curriculum.

Upon completion of this session, participants should be able to:

  1. Define the components of a multidisciplinary post-hospitalization discharge clinic,

  2. Explain the importance of a multidisciplinary team-based approach to caring for patients as they transition out of the hospital,

  3. Understand the educational value of resident continuity in caring for the same patient both in and out of the hospital.

Anna McEvoy, MD; Margaret Dobson, MD

4/28/2019

1:15 pm - 2:15 pm

Room: Osgoode Ballroom

Abstract

Purpose: Poor diet and obesity significantly impacts the health and wellbeing of Americans, particularly low-income and minority youth. Policies that mandate nutritional labeling on menus are increasingly being adopted across cities and municipalities in efforts to influence consumer diet behaviors. The purpose of this large-scale mixed method study is to understand the perceptions and behaviors related to the impact of menu labeling among a diverse national sample of youth. Methods: MyVoice is a large-scale longitudinal mixed method text message poll of youth age 14-24 years. Youth are recruited through targeted Facebook and Instagram advertisements to match national benchmarks based on weighted samples from the 2016 American Community Survey, including age, gender, race/ethnicity, educational level, family income, and region of the country. Open-ended probes were used to assess youth’s attitudes towards the usefulness of menu labeling, what information youth notice on menu labels, and what nutritional information they would like to see on menus. Qualitative data was analyzed by two investigators using a modified grounded theory approach and stratified by demographics as appropriate. Quantitative data was described using descriptive statistics. Results: Among the 385 respondents (RR=70%), a majority found menu labeling to be useful when making ordering decisions (58%; “yes! some things are surprising and it changes my mind about eating it”), while 36% of youth sampled thought menu labeling was not useful or they ignored the information (“Not really because I'm young so I can eat what I want”). Calories were most commonly noticed amongst our sample (87%). In regards to what youth would like to see on menus, 38% mentioned macronutrients such as carbohydrates, protein, and fats, 29% wanted to see the sugar content of foods, 16% stated ingredients, and 8% said no change. Conclusion: The majority of youth in our sample are exposed to nutritional information on menus and find it useful. Our findings suggest that youth are aware and interested in the nutritional content of the food they order when eating outside the home, and an emphasis on nutritional education may be a promising area for healthcare providers and educators to improve the diet of youth.

Ivana Khreizat, with mentor Tammy Chang

4/28/19

1:15 pm - 2:15 pm

Room: Osgoode Ballroom

W01: Quality Improvement Projects as Research: A Building Research Capacity (BRC) How-To Workshop

Abstract

Per ACGME Residency Review Committee guidelines, some faculty at all residency programs are required to demonstrate scholarship. For many programs, meeting this requirement is difficult. Many do this through quality improvement projects. According to the STFM Research Committee, approximately half of the research submissions to STFM’s Annual Conference are based on quality improvement, and the quality of these submissions is extremely variable. This workshop is designed to provide family medicine educators with specific hands-on experience in designing high-quality quality improvement projects that will result in outcomes that are meaningful, would make more competitive conference submissions, and are potentially publishable.

Upon completion of this session, participants should be able to:

  1. Understand the distinction between quality improvement and research, and the general standards for good research, evaluation, and other kinds of scholarship,

  2. Know the components of a rigorous QI project that would potentially result in high-quality outcomes,

  3. Design quality improvement projects that would result in scholarship products leading to successful conference submissions or publications.

David Schneider, MD, MSPH; Peter Carek, MD, MS; Tara Kiran, MD; C.J. Peek, PhD; Lynn Meadows, PhD; Tammy Chang, MD, MPH, MS; Dana King, MD, MS; Bernard Ewigman, MD, MSPH, FAAFP; Hazel Tapp, PhD

4/28/2019

4:00 pm - 5:30 pm

Room: Civic Ballroom North

STFM Awards and Recognition Program

Presentation of the 2019  Curtis G. Hames Research Award to Caroline Richardson, M.D., the Dr. Max and Buena Lichter Research Professor of Family Medicine

4/29/2019

8:30-10 am

DP057: Independent Learning Curriculum With Video Capture of Suturing Skills for Family Medicine Residents

Abstract

BACKGROUND AND OBJECTIVES: Interns begin residency with a wide range of clinical skills, and suturing ability is no exception. In our program, there is a review of suturing skills during the first month of residency, but most residents require significant additional instruction during their experiences with perineal and skin closure. We propose that clinical simulation would permit residents to practice on their own and receive asynchronous faculty feedback, which can improve suture skills without risk of harm to patients. 1-3 METHODS: We developed an online learning curriculum that includes essential suture information and a video demonstration. After reviewing materials, residents practice independently and record their own performance to be evaluated and receive feedback from a local expert in laceration repair technique.4 RESULTS: The program will be evaluated with pre- and post-learning survey, as well as pre- and post- learning knowledge test. CONCLUSIONS: We have designed a novel suturing curriculum for family medicine residents employing clinical simulation, video capture, and asynchronous faculty feedback. Improvements in resident knowledge and skill will be recorded and reported in the future.

Upon completion of this session, participants should be able to:

  1. discuss advantages and disadvantages of a curriculum for suturing simulation.

  2. describe the use of video capture to maximize feedback on suturing technique.

  3. modify this suturing curriculum for use at their home institutions.

Sahoko Little, MD; Scott Kelley, MD; Deborah Rooney, PhD

4/29/2019

10:00 am - 11:00 am

Room: Osgoode Ballroom 

FP56: Evaluating the Implementation and Effects of a Novel Curriculum for Residency Sick Call

Abstract

Purpose: Educational and clinical opportunities are lost when residents are called out of their assigned rotations to cover for co-residents in need of sick call. The decision to call for coverage, even when appropriate, can adversely affect resident wellness. The objective of our study is to evaluate the implementation and effects of a novel curriculum for residency sick call. Methods: The Flex Teacher Curriculum was implemented in August 2018 as a novel approach to providing sick call for family medicine residents training at the University of Michigan. During this two-week rotation, residents have no assigned clinical duties, and are on call to cover inpatient services if needed. When sick call is not utilized, the on-call resident has time for administrative duties and required scholarly work, which was limited prior to the implementation of the curriculum. The on-call resident is expected to prepare and lead educational sessions for their peers as part of the rotation. Six months after implementation of this novel curriculum, a post-intervention survey will be given to family medicine residents to measure the impact of the curriculum with regard to clinical experiences, educational experiences, and wellness. Additionally, quantitative changes in clinical and education time, as well as teaching experience feedback will be assessed. Results: This study is ongoing. We will show the design of the Flex Teacher Curriculum. Initial data for STFM will include post-intervention survey results of residents’ perceptions of the curriculum, as well as an analysis of changes to clinical and educational time, effects on wellness, and teaching experiences with the implementation of the curriculum.. Conclusions: Pending study completion. We anticipate that residents will gain both clinical and education time through the implementation of the Flex Teacher Curriculum, in addition to formalization of a “resident as teacher” curriculum through required peer-teaching experiences. We anticipate that the Flex Teacher Curriculum will improve resident wellness in two ways: first, by making it easier to call for coverage, as the on-call resident will no longer be pulled from clinical rotations; and second, by meeting the request of residents in our program to increase educational administrative time.

Leigh Morrison, MD; Anna McEvoy, MD

4/29/2019

10:00 am - 11:00 am

Room: Osgoode Ballroom

Abstract

Our clinics are filled with patients of all ages and ethnicities who are struggling to manage their weight and associated obesity related chronic diseases. Many patients who have tried for years to follow the standard advice to exercise regularly, eat a healthy diet, and lose weight feel frustrated and hopeless. There is confusion about what works and what does not work, and large-scale epidemiologic trials give conflicting results. Together, these problems have led to a lack of trust in medical advice around weight loss. There is a need for a new science of behavioral weight loss and new strategies for implementation and dissemination.

Consumer facing eHealth tools such as smart watches, lifestyle apps and physical activity sensors have helped some people to change their behavior and successfully lose weight, but clinical trials of such interventions are often disappointing. Just handing someone a pedometer does not work. Many patients who start out highly motivated get discouraged by the objective feedback from technology. But objective behavioral feedback in the right context and when paired with the right level of behavioral support can be remarkably effective. Patients empowered by technology can use objective data to learn what works for them.

After briefly reviewing lessons learned from two decades of consumer facing eHealth technology research supporting lifestyle change, Dr. Richardson will present preliminary results leveraging new low cost and user-friendly continuous glucose monitoring technology to help people with pre-diabetes and diabetes adopt a lower carbohydrate diet. Effective strategies include using technology not just to prescribe but also to give opportunities for those struggling with obesity to become the experts and to support others. Effective design emphasizes a positive user experience and information delivery that is easy to understand and learn from. Personalized algorithms coach users by starting from an objectively assesses baseline and personally tailored gradually incrementing goals. Effective motivational strategies help users make connections between behavior change and improvements in more immediate patient centered outcomes such as energy and focus. In summary, technology is more effective when we bring the focus back to the patient.

Caroline Richardson, MD

4/29/19

11:15 am - 12:15 pm

Room: 

Sheraton Hall A

PD7: The Clinic First Transition—Fact or Fiction

Abstract

Many programs nationally are adopting a Clinic First model; changing educational priorities, resident schedules and rotational elements to allow balanced inpatient and outpatient time. Bodenheimer’s 10+3 model combines the Building Blocks of High Performing Primary Care with components unique to teaching clinics; resident scheduling, engagement, and work-life balance. The model recognizes the importance of the FMC as the cornerstone of training for future practice. This panel will offer insight into how three programs have transitioned to Clinic First, as well an overview of national trends. The session will review the following benefits: improved continuity, increased regularity of residents in clinic, resident perception of clinic as a home, fewer transitions, improved resident wellbeing, and less fragmented learning. We will discuss risks involved in Clinic First transformations as well as the successes, in addition to sharing unexpected repercussions, both positive and negative. We will outline how these initiatives have affected resident and faculty wellness. Participants will gain insight into transformation and formulate a their own needs assessment, develop a plan and become familiar with BBPCA assessment tool.

Upon completion of this session, participants should be able to:

  1. On Completion of this session participants will understand the concept of Clinic First scheduling and the benefits that have been realized for several teaching clinics.

  2. In completion of this session the participants will be able to identify necessary steps towards Clinic First scheduling, with real life examples from the panelists.

  3. On completion of this session participants will be able to identify potential implications and difficulties of a Clinic First implementation in the context of one's own program.

Alexandra Verdieck, MD; Roger Garvin, MD; Holly Hofkamp, MD; Marianna Kong, MD; Jean Wong, MD; Barbara Miller, MD

4/29/2019

3:00 pm - 4:00 pm

Room: Churchill

L57A: From Anecdotes to Systems-Based Changes: Redesigning the Morbidity and Mortality 

Abstract

Morbidity and Mortality Conference (MMC) has been a long standing tradition in medical education with the goal to learn from adverse outcomes and improve patient safety. Unfortunately, despite significant time and resources routinely committed to this forum, the educational and clinical impact of MMC in our department has been generally limited. Additionally, despite the majority of our family medicine practice being outpatient-based, MMC’s still mostly focus on inpatient care. At our academic-based residency program, we recently redesigned MMC and piloted a theme-based Quality Improvement Conference (QC) with a shifted focus towards identifying systems-based errors and actionable changes utilizing cases across patient care settings that better reflect our general practice.

Upon completion of this session, participants should be able to:

  1. Define an ideal state for Morbidity and Mortality Conference that suits the educational and quality improvement needs of their local institution.

  2. Identify key stakeholders that would need to be involved with the process of redesigning Morbidity and Mortality Conference at their local institution.

  3. Identify potential sources for case solicitation/selection, presentation, and avenues for follow up at their local institution.

Christina Chiang, MD; Jenna Greenberg, MD; Caroline Richardson, MD

4/30/2019

3:30 pm - 4:00 pm

Room: Davenport

W10: Pursuing Scholarship: Creating Effective Conference Submissions

Abstract

Participants will generate a submission framework for a presentation proposal during this session, utilizing peers and facilitators’ for feedback. This submission was developed through the efforts of the STFM Collaborative on Faculty Development and the Annual Conference Program Committee. Academic faculty have expectations to engage in educational scholarship in order to advance their careers. However, many are unclear about how to write a high-quality proposal for a presentation at a national meeting, or about the reasons why a previous submission was not accepted. As competition increases for limited presentation spots, the importance of understanding the submission and evaluation process, as well as how to deliver a quality presentation is increasing. Participants in this session will benefit from a discussion of the submission categories and evaluation criteria for proposals for STFM meetings, and best practices in advancing scholarship and writing SMART objectives for designing a quality presentation submission in order to improve the likelihood of acceptance at national conferences. Additionally participants will develop a proposal utilizing STFM’s presentation template, utilizing feedback from facilitators and peers.

Upon completion of this session, participants should be able to:

  1. Match learning objectives of a submission to the MOST appropriate STFM submission category/presentation opportunity.

  2. Identify common mistakes seen in submissions for presentation proposals, as well as strategies to improve presentation proposals for conference submissions.

  3. Prepare a conference submission proposal utilizing tools and best practices to improve the presentation quality and increase the likelihood of acceptance.

Joanna Drowos, DO, MPH, MBA; Tammy Chang, MD, MPH, MS; Nathan Culmer, PhD; Jennifer Hartmark-Hill, MD, FAAFP; Monica Demasi, MD; Linda Hogan, PhD; Edgar Figueroa, MD, MPH; Tina Kenyon, MSW; John Malaty, MD, FAAFP; Amy Odom, DO; Andrea Pfeifle, EdD; David Schneider, MD, MSPH; Katie Westerfield, DO, IBCLC

4/30/2019

3:30 pm - 5:00 pm

Room: Sheraton Hall C