Didactics

Resident education is our top priority. We not only provide a wide array of didactic activities, but also protect residents’ time such that they are not being pulled for patient care duties while attending educational sessions. Below is a snapshot of some of the educational activities we offer:

Morning report

Residents on the inpatient teams get to work with 2-3 faculty members each day to do a variety of activities including dissecting an interesting case, analyzing diagnostic testing, reviewing board-style questions related to topics discussed during the block, and giving short presentations on relevant inpatient topics. A medical librarian is involved to help incorporate the latest evidence into the discussions and medical decision-making.

Academic half-day

Based on resident feedback, we recently created academic half-day (AHD), which is a weekly 3-hour session that covers core IM topics. Residents are excused from clinical duties during this time, so they can devote their full attention to didactics. AHD starts with lectures/cases from subspecialty faculty, and follows with a rotating base of activities such as journal club, M+M, small group cases, great debates, resident research presentations, medical trivia competitions, MKSAP board question reviews and wellness check-ins. 

Morbidity and Mortality (M+M) conference

In an effort to continuously improve, we dissect cases as a group where a poor outcome occurred. We do this in a judgement-free way that allows identification of knowledge gaps or systems issues that led to suboptimal care. Often issues are identified that drive resident QI projects to help improve future care. 

Journal club

Subspecialists select important articles in their field relevant to the topic discussed at AHD. With faculty, residents review the article and discuss the methods and impact of the study as a group. This both exposes residents to key evidence from which to base their medical decisions and teaches how to critically appraise the literature. 

The Great Debates

This is a resident-led interactive session in which two resident teams choose a controversial topic in medicine. Each group formally debates the merits of each side of the topic. Faculty advisers work with each team to help sharpen their skills in analyzing the literature, but the key learning is understanding both sides of an issue and using the available evidence to help guide shared decision-making with patients. Some examples of prior debates include:  

• Steroids in community-acquired pneumonia
• Surgery vs. antibiotics for acute uncomplicated appendicitis
• Albumin vs. crystalloid for fluid resuscitation
• Vaping vs. cigarette smoking in patients not ready to quit
• Testosterone supplementation in age-related hypogonadism 

Ambulatory Curriculum

The ambulatory curriculum is comprised of several components including quality improvement projects, learning modules (John’s Hopkins PEAC modules), resident-led presentations during weekly ambulatory didactics and population health management. All components are longitudinal, and residents participate throughout the year. Additionally, during the weekly ambulatory didactics, there is integration of board-style question review and journal articles.

Integrated Board Review

All residents are given the funds to purchase MKSAP, the ACP board review curriculum. We integrate board review into all of our conferences, to make sure we understand the key concepts we are learning. We focus not only on the topic at hand, but also test-taking strategies. We also have a separate board review course for senior residents with longitudinal subject-specific examinations, followed by review sessions.

Knowledge games

Ever walk out of a lecture thinking you were super engaged, and then try to recall something about that lecture weeks later and you can’t do it? This happens all the time – if we don’t do anything active with material presented to us, we will not retain it long term. Our program director, Dr. Sall, has a master’s degree in education and has been able to integrate adult learning theory principles into our curriculum. One example of this is the “Knowledge Games”, where residents engage in retrieval practice and spaced repetition by answering daily questions about topics they have learned throughout the year. To make it fun, at the end of each month the resident with the most points wins a prize.

Point-of-Care Ultrasound (POCUS)

We have recently acquired the handheld Butterfly Ultrasound probes, and are building a POCUS curriculum. This will involve didactics, multidisciplinary precepted scanning and case-based image reviews. 

Simulation

As part of morning report, we hold monthly simulations to review rapid response and code scenarios at our simulation center here at TPK. We also conduct standardized patient simulations periodically to review communication skills. This year, we will also engage with the military partnership simulation center at our Osborn location for additional hi-fidelity simulations.

Medical Grand Rounds

The monthly Grand Round lectures bring local and national faculty to HonorHealth to provide education to a multidisciplinary audience on topics relevant to the IM boards and patient care.

Retreats

In addition to group wellness retreats and activities, we offer specific career development retreats, including:

• Year 1 -  Transition to Leader and Teacher Retreat
  For interns near the end of their PGY-1 year in anticipation of transitioning to a senior leadership role
• Year 2 -  Career Guidance Retreat
  For senior residents to help prepare for future career paths in primary care, hospital medicine or fellowship.