Notes+7.22.09

** July 22, 2009  ** ** MINUTES  ** ** PRESENT: ** Jenny Pisculli, Chair, Chris Lutrzykowski, Harry Colt, Nancy Weingarten, Chris Ross, Andy Rice, Karen Gershman, Jenifer Van Deusen (notes). Chair Jenny Pisculli welcomed everyone to this the debut meeting of this group, and reviewed the intended outcomes for the meeting, which were: “As a result of this meeting, members will: ¶  Agree on the purpose of this Committee; ¶  Know what it hopes to accomplish; ¶  Know about proposed Committee process; ¶  Be able to describe a basic protocol for resident evaluation; and ¶  Express enthusiasm about the process and the work.” Jenny presented the idea that since this could be a fairly controversial group, it might help us to have some agreed upon norms about how we work together. She proposed these, with some explanation of each:  1. Start and end on time.  2. Be here now.  3. Say what need to be said; ask what needs to be asked.  4. Things get done here. Members agreed these sounded good and all said they could live with them for this meeting. Check In/ Norms/ Team Roles Jenny, as Chair, facilitates; Jenifer takes notes. Chris Ross graciously volunteered to monitor how we do with our intended outcomes and norms. Why we are here What we hope to accomplish Jenny referred members to the draft overview Jenifer prepared. Discussion ensued. Ideas on our purpose ranged from: perform evaluations of residents to assist them to be successful by understanding their strengths (so they can build on them) and overcoming their weaknesses; make an Individualized Learning Plan for all residents, not just those in trouble; change how we’ve done things for 30 years since the residency has changed but this process hasn’t; have this be a vehicle for making the giving and receiving of good and timely feedback part of what we ALL do every day; having the learner present for the evaluation is a huge advantage, respectful, great way to give just in time direct feedback; continue to build our culture of learning thru consistency of evaluation for everyone, with transparent expectations and process. Ideally this group will take the resident’s self-identified weakness and help her/him plan how to address that over the next period of time, with specific strategies and indicators that we can look at the next time. Summative evaluation processes using the Dreyfus format will be revised by the Competency-Based Education Committee in concert with the Advancement Committee. (We will need to review Dreyfus with the full faculty). How we will do the work The question here was, “How do we take advantage of the enormous amount of information we collect?” Discussion included: ¶  Give advisors a set of instructions on how to do this job to prepare them for their new role (a “fellowship!”) ¶  Ensure that advisors know how to prepare the resident to be in this setting ¶  Teach faculty how to do chunks of the work at a time – first, get to know your advisee, then work thru the chunks of the task ¶  Have the Advancement Committee take over the role of “checking boxes,” freeing up the advisor to take over the more important tasks of assisting the resident with self-assessment, goal setting, how to survive residency, how to be a good doctor Our plan is to evaluate each resident twice a year, which will be a scheduling challenge as we want both the resident and the advisor present at whichever site is more convenient for them. // Jenifer will work with schedulers. //   The folders we have are great but raise the question, “Instead of trying to decide where what we gather fits, shouldn’t we decide what we want to evaluate and then decide what is the best evidence of that?” We could define each competency for ourselves as a group, then put all of our forms on the table and decide what works for which competency, and if we need them all, and begin looking at new artifacts to collect. The portfolio comes from the art world, so we could ask residents to select authentic examples of their own work that show how they do, with the Advancement Committee as “art critic.” Ideally the portfolio will be electronic, enabling ease of collection of data/ artifacts and transmissibility (?) to residents upon graduation, as the ACGME plans to do in 2011. Other issues included: ¶  Look at building systems that enable us to give just in time feedback to minimize surprises ¶  Ensure we monitor cultural issues (esp. of IMGs) as we work ¶  Change the culture so we “catch people doing good” Katje Musgrave Jenny presented a prepared case, using Katje as an example. She showed a draft from we have created and then another type of form in the SOAP note format. Both are posted on the “wiki” Jenifer created. // She will invite all so they can view and edit. // Since Katje was unable to be with us today due to rotation, we decided to mock-review her again so we can experience what the process will really be like, perhaps using an amalgam of our form and the SOAP note. // Jenny will prepare the presentation and alert Katje. //    Outcome Check Norms Check <span style="font-size: 11pt; font-family: Wingdings; mso-fareast-font-family: Wingdings; mso-bidi-font-family: Wingdings; msofareastfontfamily: Wingdings; msobidifontfamily: Wingdings; msolist: Ignore;">¶  Jenny noted that we touched on all of our intended outcomes, which we will continue to work on at the next meeting. 1) Agreeing on the purpose of the Committee is a bit of a moving target but we came to some agreement, as is 2) knowing what it hopes to accomplish and 3) proposed Committee process; we began to examine 4) a basic protocol for resident evaluation; and felt some energy if not 5) enthusiasm about the process and the work.   Chris R. reported that we did pretty well on our norms: we started and ended more or less on time (altho some difficulties with arrival), everyone seemed to say what they needed to, we were mostly present and got some stuff done. Chris L. suggested that we add these to the norms for next meeting: Recognize the other site and Limit interruptions.   <span style="font-size: 11pt; font-family: Wingdings; mso-fareast-font-family: Wingdings; mso-bidi-font-family: Wingdings; msofareastfontfamily: Wingdings; msobidifontfamily: Wingdings; msolist: Ignore;">¶   Jenifer will ensure that there is a speakerphone for Monday meetings. At next meeting: <span style="font-size: 11pt; font-family: Wingdings; mso-fareast-font-family: Wingdings; mso-bidi-font-family: Wingdings; msofareastfontfamily: Wingdings; msobidifontfamily: Wingdings; msolist: Ignore;">¶  Do mock review with Katje present <span style="font-size: 11pt; font-family: Wingdings; mso-fareast-font-family: Wingdings; mso-bidi-font-family: Wingdings; msofareastfontfamily: Wingdings; msobidifontfamily: Wingdings; msolist: Ignore;">¶  Determine preliminary review format <span style="font-size: 11pt; font-family: Wingdings; mso-fareast-font-family: Wingdings; mso-bidi-font-family: Wingdings; msofareastfontfamily: Wingdings; msobidifontfamily: Wingdings; msolist: Ignore;">¶  Review where we are in the evaluation schedule <span style="font-size: 11pt; font-family: Wingdings; mso-fareast-font-family: Wingdings; mso-bidi-font-family: Wingdings; msofareastfontfamily: Wingdings; msobidifontfamily: Wingdings; msolist: Ignore;">¶  Review preliminary proposed schedule.
 * MDFMR Advancement Committee **
 * 1)  Welcome/ Outcomes/ Overview
 * 1)  Committee/ Team Process:
 * 1)  Purpose of the Committee:
 * 1)  Schedule & Logistics
 * 1)  Mock Resident Review/ Evaluation
 * 1)  Check Out:
 * 1)  Next Steps/ Next Meeting August 3rd