2014 CLIME FUNDED PROJECTS

2014-2015 CLIME Funded Proposals

  • Suffering where thou art? Exploring Medical Student Perception of Medication Education Regarding Suffering 
  • An Interactive Learning Module to Improve Communication in Crucial Conversations
  • Microsurgical Technical Skills Simulation Curriculum
  • Medical Student Perceptions of Giving Feedback to FAculty During Third Year Clerkships
  • Peer Observation and Feedback of Bedside Teaching
  • Examining Pedagogy in a Clinical Conditions Course: Strengthening Curricular Alignment and Interprofessional Education (IPE) 
  • Impact of a Structured Just-in Time Intervention on Trainee Laceration Repair Performance 

Suffering Where Thou Art? Exploring Medical Student Perception of Medication Education Regarding Suffering

Thomas R. Egnew, EdD, LICSW

Co-Investigators:

William R. Phillips, MD, MPH

Theodore J. Phillips Endowed Professor, Family Medicine

Peter R. Lewis, MD, Professor; Kimberly Myers, Pennsylvania State UCOM

Grant Amount: $2,130

Abstract: An ancient goal of medicine is the relief of suffering, yet little is known about how medical students are prepared to accomplish this. The UWSOM is currently undergoing a curriculum renewal process which incorporates the enduring values that “patient welfare comes first” and that students are protected “from harm and negative experiences” while being provided “meaningful and positive learning experiences.”  Inadequate preparation to therapeutically engage suffering risks compromising patient welfare while at the same time engendering harmful and negative student experiences which mitigate meaningful and positive learning. This qualitative study involving student focus groups builds on an earlier pilot study surveying UWSOM students’ perceptions of their medical education about suffering. By further exploring student perceptions of their experience of their education about suffering, we propose to gather information that supports the fulfillment of the values espoused in the UWSOM’s curriculum renewal efforts.

An Interactive Learning Module to Improve Communication in Crucial Conversations

Caroline Jeanette Hurd, MD, Clinical Assistant Professor, Department of Medicine

Co-Investigator:

Anthony Back, MD, Professor, Department of Medicine

Grant Amount: $4,900

Abstract: Communication with patients and families facing serious illness is one of the most important skills physicians learn in training. Until recently, these skills were primarily taught by traditional paradigms in medical education such as lectures and observation. As our understanding improves about how learners learn best, this paradigm is evolving to incorporate more active participation and self-assessment that use innovative technology platforms. With a grant from the Cambia Health Foundation, I have salary support for two years to design and implement an innovative curriculum for crucial communications into the Internal Medicine and Pediatric residencies with a focus on delivering serious news and conducting family conferences. The curriculum will include self-directed modules, simulated patient practice sessions and multi-media just-in-time learning tools. As the Cambia grant only provides salary support, the CLIME grant would help fund the development of an interactive online module, as part of this curriculum, for emotional cue identification. This is a central skill for excellent patient-centered care and the module will provide practice for residents using a validated tool and then apply these new skills to a patient encounter and see how they impact patient-provider relationships.

Microsurgical Technical Skills Simulation Curriculum

Kari Keys, MD, Assitant Professor, Plastic Surgery

Co-Investigators:

Jeffrey Friedrich, Plastic Surgery

Isaac Bohannon, Assistant Professor, Otolaryngology

Jason Ko, Plastic Surgery

Grant Amount: $3,000

Abstract: Background: Microsurgical skills are currently taught largely in the arena of the operating theater.  These skills are highly technical and require the acquisition of new fine motor movements and the adaptation to a two-dimensional field of view.   Technical skills such as this are particularly suited for iterative learning in a lab environment rather than the intermittent and sporadic environment of the operating room.

Methods: A novel simulation curriculum will be developed and implemented for trainees who will be performing microsurgery. The curriculum will involve didactic modules, expert video, structured and graduated hands-on practice, and assessment.

Outcomes: The curriculum will be evaluated through trainee self-assessment and expert assessment using the Global Rating Scale for the discrete multistep task of microsurgical vessel anastomosis.

Medical Student Perceptions of Giving Feedback to Faculty During Third Year Clerkships

Amanda Kost, MD, Assistant Professor, Family Medicine

Co-Investigators:

Heidi Combs, Associate Professor, MD, Psychiatry

Eileen Klein, MD, Professor, Pediatrics

Lynne Robins, PhD, Professor, Medical Education

Patricia Kritek, MD, EDM, Associate Professor, Medicine

Grant Amount: $4,000 

Abstract: Although feedback from teacher to student is a critical component of medical education, very little is known about the experience of students giving feedback to teachers. Limited existing literature and UWSOM focus groups done with fourth year students suggests it is a negative experience. We seek to understand medical student perceptions of giving feedback to teachers through a qualitative analysis of structured interviews. This research is meant to be a companion study to a project previously funded by CLIME that is investigating the perceptions of third year clerkship faculty on receiving feedback from students. Results from both studies will help guide the creation of surveys to better understand the student and teacher experience of student generated feedback. Results can also suggest faculty development activities aimed at improving this experience for both students and teachers.

Peer Observation and Feedback of Bedside Teaching

Somnath Mookherjee, MD, Assistant Professor, Medicine

Collaborators:

Daniel Cabrera, MD, MPH, Clinical Instructor, Medicine

Christy McKinney, PhD, MPH, Clinical Assistant Professor, Medicine

Grant Amount: $4,000

Abstract: Teaching during bedside rounds is an important part of the education of students and house staff.  There are many reasons to commend bedside rounding, foremost among them: patients prefer it and teachers and learners realize that it is a valuable means of learning clinical skills. However, it is challenging to teach effectively at the bedside, and there is little formal training in this skill. Our previous work has shown that peer observation and feedback of formal “conference-room” small-group teaching increases faculty confidence in several domains that are essential for optimizing teaching. In this pilot, we will evaluate a program of peer observation and feedback during bedside rounding, a setting which presents unique challenges in comparison to teaching in a structured environment away from patients. We will use a literature-based framework to train hospital medicine faculty in systematic observation and feedback of their peers’ bedside teaching behaviors.  We hypothesize that peer observation and feedback will increase faculty confidence in bedside teaching and increase faculty self-reported use of key bedside teaching skills. Findings from this program will be disseminated through peer-reviewed publication and workshops to faculty in other Departments who teach bedside learners.

Examining Pedagogy in a Clinical Conditions Course: Strengthening Curricular Alignment and Interprofessional Education (IPE)

Jennifer S Pitonyak, PhD, Assistant Professor, Rehabilitation Medicine

Grant Amount: $4,000

Abstract: Background: Lecture-based instruction is the primary pedagogical approach used in the interprofessional course REHAB 533: Disease and Diagnosis in Rehabilitation and student, faculty, and program feedback indicates a possible need to revise the current course methods. Course revision is strengthened when a structured process of program evaluation is used to examine how the delivered and experienced curriculum differs from the planned curriculum, and to assess course alignment with program curricular objectives.

Purpose: This project conducts a systematic evaluation of student, faculty, and program perceptions of current pedagogy used in REHAB 533, examines alignment of course content with program objectives, and identifies opportunities and innovations for IPE.

Methods: The project uses qualitative and quantitative program evaluation methods of interview, focus groups, survey, and curriculum mapping to synthesize findings. Implications: Course evaluation is necessary prior to revising instructional methods, as changes need to align with the curricula of all involved programs. This project addresses CLIME cores of instructional design, interprofessional collaboration & training, and educator development and informs innovative education research in these areas. 

Impact of a Structured Just In Time Intervention on Trainee Laceration Repair Performance

Neil Uspal, MD, Assistant Professor, Deparment of Pediatrics

Co-Investigators:

Jennifer Reid, MD, Assistant Professor

Anita Thomas, MD, Fellow, Department of Pediatrics

Grant Amount: $3,000

Abstract: Just-in-time (JIT) training is an educational modality in which procedural skills are taught to and reviewed with trainees immediately before the performance of a procedure. Seattle Children’s Hospital opened a new emergency department (ED) on April 23, 2013 containing a dedicated JIT training space. We plan to utilize this space to perform a research study to evaluate whether a structured, JIT intervention prior to a laceration repair procedure improves the technical performance of the procedure. In the standard teaching study phase, residents will receive usual training, ranging from no preparation to informal teaching in the JIT room, prior to a laceration repair. The supervising physician will then complete a mastery checklist after the procedure to determine how adherent the resident was to proper suturing technique. In the JIT training phase, residents rotating through the ED at this time will be provided a short, structured JIT training intervention by an ED supervising physician prior to suturing. The resident will then perform the laceration repair supervised by a second supervising physician. The supervising physician will once again complete a mastery checklist. We hypothesize that residents receiving the structured JIT intervention will be more adherent to correct suturing technique.