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Western Region Group on Educational Affairs Spring 2003 Report
I. 2003 Spring Meeting
A very successful 2003 spring meeting was hosted by the University of Nevada, School of Medicine March 28- March 30, 2003. Despite a difficult economy, a precarious world situation, and a somewhat difficult to reach venue, the meeting was quite well attended with 76 registered participants.
The meeting began with “pre-conference” meetings of the Computer Resources and Standardized Patient interest groups during the day on Friday. Each group and their own individual resource and discussions sessions first and then the two groups came together to discuss the topic of SP exercise related data collection, analysis and feedback.
The main conference kicked off Friday evening and continued through early Sunday afternoon. Building around a theme of “Educational Competencies and Evidence Based Medicine: How We Measure Up” the conference presented a series of three plenary sessions. Scott Fields addressed the topic of defining educational competencies. Scott emphasized the crucial differences between process-based and competency –based education and urged the audience consider characteristics of quality patient care—safe, effective, patient-centered, timely, efficient, equitable--- in any construct of medical education related competencies.
During the second plenary Carl Stevens and Phillip Goodman built on Scott’s discussion by exploring learning relating to two of the ACGME competencies. Carl tackled practice-based learning, and by virtue of his proposed educational approach, he also addressed systems-based practice. Specifically, Carl presented a very cogent argument that our learning environment and teaching strategies need to be transformed so education occurs in the context of team-based practice, incorporates patient outcome data as an integral element of the educational process, and maintains a primary focus on patients as its primary over-riding objective. The bottom line of all of our educational efforts should be to improve the quality of care that patients receive. Phillip Goodman addressed the medical knowledge competency and presented an example of using innovative adaptive technologies to improve physicians’ abilities to effectively apply evidence in a timely way to solving patient care problems.
In the final plenary Patricia O’Sullivan took on the issues of competency related assessment. After reflecting on some of the difficulties that an assessment drives curriculum approach engenders, Patricia outlined some of the gaps that exist in our currently utilized assessment methodologies. She then went on to explore journaling and self-reflection as two methods which might help address some of these gaps. Small breakout discussion groups focusing on the areas of professionalism, self-reflection, cultural competence, practice-based learning and systems-based practice, and technology, convened after both the curriculum and assessment related plenary sessions. As a unique innovation the hosts at the University of Nevada attempted to capture the intellectual work of both the plenary sessions and the breakout groups on a real-time basis and create a synthesis of this effort as a “paper” emanating from the conference.
In addition to the plenary and breakout sessions, two portions of the conference were dedicated to presented peer reviewed submissions of the membership. Eighteen poster submissions were featured on Friday evening, and nineteen oral abstract presentations, four workshops, and one symposium were presented during concurrent sessions held on Saturday afternoon. The outstanding poster award went to Nicole Antonio, Daniel Beistline, Todd Phillips, Kevin C. Facemyer PhD of the University of Nevada for a student poster “The implementation of first year computer and software requirements in a medical curriculum.” The outstanding oral abstract award was presented to Elizabeth Morrison MD, MSE of the University of California, Irvine for “Bringing education and service together (BEST): a pilot randomized controlled trial of a longitudinal residents-as-teachers curriculum.”
II. Highlights of the Members’ Business Meeting---GEA Discussion Items
Grand Initiative Proposal to Package Competency Related Resources and Offer “Train the Trainers” Workshop
Mike Prislin presented a brief overview of the evolution of proposed Grand Initiative related activities occurring at the national steering committee meetings during the past year and the recent proposal to develop focused resources and sponsor train the trainer workshops that could potentially occur in a number of different settings. Brownie Anderson indicated that Debra Da Rosa, Deborah Simpson, and Linda Perkowski are in fact preparing a workshop which will be offered at the upcoming AAMC annual meeting. Members expressed some interest in such a workshop depending on the specific nature of its content and training. Mike Prislin asked whether members had any interest in presenting such workshops at future regional meetings. Again members’ enthusiasm would be highly dependent on the specific content (competencies) being presented and the nature of the training being offered. There was some discussion of the potential audience which might be interested in participating in these workshops at the regional level. The consensus of the group was that while individual program directors might be invited to participate, the focus should be placed on providing training to individuals who can then function at the level of their own institution to provide training to individual program directors.
Proposal to Offer a National Spring GEA Meeting
Mike Prislin provided a summary of steering committee discussion pertaining to asking the regions to consider the desirability of having national GEA meetings at some to be determined frequency. The advantages of a National GEA meeting would include the opportunity to offer a much more substantial amount of programming than is currently feasible at the annual meeting, to relieve the regions of the administrative burden of planning for meetings, and to relieve the regions ( and the host institutions) of the financial risk associated with putting on a regional meeting. It was pointed out that at least one region has experienced a catastrophic financial loss associated with their spring meeting during recent years, and as a result the regional leadership is having great difficulty finding willing host institutions. It was also pointed out that many meetings including last year’s combined WGEA/WGSA meeting (which has in the past realized a small profit) experienced a deficit, and that this year’s regional will also have a small net loss. The membership expressed considerable ambivalence about having national meetings. Some felt that there would be some advantage in terms of the additional educational opportunities while others wondered whether it would be largely duplicative. Most felt that if national meetings are to be offered they should occur on a relatively infrequent basis much like what currently takes place with the periodic national GSA meetings. Many felt that meeting size, location and content would strongly influence whether or not they would attend. Deborah Danoff suggested that the membership be polled regarding their preferences in this regard. Mike Prislin said that he would put a discussion item to this effect on the WGEA listserv. There was a strong consensus among the membership that whatever occurs with respect to the development of a national meeting, annual regional meetings should continue to occur. Advantages of the regional meeting format that were cited included there relative low cost and convenience to attendees, their intimate and supportive environment which fosters a positive learning and networking environment for junior faculty, and the opportunities the regional meeting affords to try out innovative programming. Brownie Anderson indicated that there are a number of ways that the AAMC may be able to assist the regions in terms of the regional meetings. This includes preparation and transmission of calls for submissions, preparation of meeting programs and other related printed/graphic materials, and potentially with conference registration functions. Tracy Veach indicated that such assistance would be enormously helpful and substantially decrease meeting administrative expenses.III. Highlights of the Members’ Business Meeting and the Executive Committee Meeting---WGEA Leadership Transitions
Mike Prislin announced that the terms of the following positions will conclude at the time of the fall meeting:
Mike indicated that nominations should be forwarded to Ed Keenan who is the current nominations chair. Mike reminded the membership that they will receive a recommended slate of candidates at the upcoming fall meeting with option of submitting additional nominations from the floor at the time of the meeting also being available.
IV. Highlights of the Executive Committee Meeting--- Planning for the 2004 WGEA Spring Meeting
This will be a joint WGEA/WGSA conference held at Asilomar April 25- April 28, 2004. UCSF will be hosting the meeting and Carol Hodgson and Maxine Papadakis have already begun preliminary planning. The Executive Committee has proposed utilizing the concept of the reflective practitioner as one possible conference theme. In addition the Executive committee is exploring how to invigorate the participation of the GME and CME sections in the regional meeting. It is the sense of the committee that our efforts should be particularly focused toward GME deans and those individuals involved in GME who particularly aspire to leadership positions. It is also the sense of the committee that many resources are currently available to assist individual program directs via their specialty societies and board organizations. The committee feels that it would be wise to identify specific areas where we might be able to offer specific support. Residents as Teachers curriculum development and offering training to newly designated chief residents were identified as two such areas. The Executive committee also reviewed Ron Edelstein’s proposal that WGEA consider assuming a policy development role with respect to emerging CME issues. Mike Prislin reported that he has presented this concept to the national steering committee meeting and there is no objection so long as it is clear that any policies so developed are clearly identified as expressing the opinion of the WGEA, not the AAMC at large. Several members of the committee expressed enthusiasm for this idea. Possible topics for policy development that were mentioned include Industry Relations and the Support of CME, the recertification Process and Various Options for Assessment, and the Utilization of Technology in CME.
