UW Family Medicine Residency Network Webinar August 2015 Creating an effective orientation UW Family Medicine Residency Network Webinar August 2015 Creating an effective orientation a kickass ID: 921357
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Slide1
Creating an effective orientation
UW Family Medicine Residency Network WebinarAugust 2015
Slide2Creating an effective orientation
UW Family Medicine Residency Network Webinar
August 2015
Slide3Creating an effective orientation
a kick-ass
UW Family Medicine Residency Network Webinar
August 2015
Slide4Creating an outstanding orientation
UW Family Medicine Residency Network WebinarAugust 2015
Slide5Shannon U Waterman
Swedish Family Medicine Residency - Cherry HillSeattle, WA
“4 Sites: One Program”
(soon to be
5 urban, underserved sites + RTT)
Faculty
Former
Associate PD and Clerkship Site
Director
Slide6Questions to answerWhat are our program’s goals for orientation?
How much time can we carve out of our curriculum?Is there benefit to a protected block of time up front? Are there developmental reasons to present some content later in the year?
Slide7Would be helpful to know about your experiences:
Logistics POLL
Slide8Priorities POLL
Slide9Longitudinal POLL
Slide10Orientation ChallengesBarriers
Time
Faculty skills
Service demands
Geography – distant sites
Possible Solutions
PD/AD commitment to protected faculty time
Community resources
“Super R1”
Hospitalists
Start prior to first block
Dedicated clinic days
Slide11“What is lacking?” POLL
Slide12CHFM Orientation Goals
Administrative (paperwork, badging, EHR)Orientation to curriculumOrientation to the communities we serve
Skills development and reinforcement
Establish common knowledge base
Skills for high stakes situations
Slide13CHFM GoalsGet established in clinic
Cohesion and “bonding” of classsociograms (3 hr)
intern/faculty lunch (3
hr
)
yarn ceremony (45 min)
c
hief resident outreach/”buddy” systems
Professionalism
Future: Early assessment - OSCE
Slide14Cherry Hill Experience5 ½ weeks of orientation
Block 1 + week and a halfNo call. Mandatory participation. Predictable clinic days (Thurs PM/Fri all day)Dedicated faculty creates schedule, coordinates community resourcesCollaboration with residency administrator
Weekly evaluation (survey monkey)
No OSCE (understaffed)
Slide15Learner centered orientation
“Logical progression” of topics may not be helpful. Be willing to START by addressing where each intern will go the first day of their first rotation (senior “buddy” to talk to about the rotation, review the syllabus), where to put their lunch, etc.
Some topics are best presented over time.
Electronic medical record longitudinal orientation
Professionalism
Slide16Professionalism
Interviewing skillsScreening for substance useIntimate partner violenceMotivational interviewing/behavior change/BATHE“Saying No”
Self care and burnout prevention
Meditation and mindfulness practices modeled
Narrative medicine workshop
L
ongitudinal curriculum (
Balint
, R1 support group)
Perfectionism
“The Imperfection Option” workshop (3
hr
)
Slide17“The Imperfection Option”
Pre-work: Watch Brené Brown’s TED talk “The Power of Vulnerability”Perfectionism: a habit of mind, gap between reality and ideal
Alternative model: “Health Striving”
Slide18Hallmarks of Perfectionistic Mind
GrandiosityFocus on Product over Process Focus on External Rewards over Internal Ones Deprecation of the True Processes of Creativity and Career-Building
Overly moralistic self-evaluation
Labeling
Hyperbole and generalization
Dichotomous thinking
An overly active system of self-commands
Procrastination
Slide19“The Imperfection Option”
Explore 4 strategies for developing more helpful habits of mind. Direct inquiry Radio stations metaphor – 3 other strategies
KGAP or KFKD – the Perfectionistic Station
Alternative “stations” – KLUV, KLRN, KHUM
Writing, drawing, read commentary from artists/authors/scientists/spiritual thinkers
Exercises in self compassion
– impact on patients
Slide20Slide21Slide22Slide23Professionalism POLL
Slide24Questions to answerWhat are our program’s goals for orientation?
How much time can we carve out of our curriculum?Is there benefit to a protected block of time up front? Are there developmental reasons to put some content later in the year?
Slide25Shannon U Waterman
Swedish Family Medicine Residency - Cherry HillSeattle, WA
Questions or comments?
Please email me at:
Shannon.waterman@Swedish.org
Slide26Mindy Udell MD
OrientationUW Family medicine residencynetwork webinar2015
Slide27Part of Community Health of Central Washington10 – 10 – 10 Residency8 – 8 - 8 Yakima
2 – 2 – 2 EllensburgYakima Valley Memorial HospitalYakima Regional Cardiac CenterYakima Neighborhood Health (Obstetrics)
Memorial Pediatric Hospitalist Service
Central Washington Family Medicine
CHCW Ellensburg
Senior Residential
RCare
Central Washington Family Medicine Residency Program
Slide28Admin
Hospital Boot Camp
Clinic Boot Camp
Practic
al Experience
Slide29On your mark…
OrientationClinic TeamsLead RN’sOB Team/OB triage skillsGYN
Clinic Manager
Nurse Manager
EMR
systems
Regional Hospital
Memorial Hospital
Review
Hospital H&P
Admit orders
Presentations
SOAP
notes
Resources
Care Coordinators/Community ResourcesBehavioral Health ConsultsPAML labClinic PharmacyRN teamsEducationHospital billingClinic billingCore hospital disease lecturesIntro to hospital Pediatrics
Top calls on Clinic phone call (
peds
/adults)
EKG’s
Radiology
review
Slide30Bonding timeResident Rafting RetreatPassing of the batonSenior Advice (prior to FMS)
Day in the life of a residentCommunity service CWFM in review (skits from each class and department)Clinic Scavenger HuntHospital Scavenger Hunt
Self Care
Resident Fatigue
Self Management Skills
Patient Centered Communication
Dealing with difficult patients
Patient Centered Interviewing
Skills
Teaching
Residents as teachers
How to give SMART feedback
Get Set…
Slide31Getting ReadyShadow ClinicsOwn ClinicOB clinicFamily Medicine Service Team
Paired CallHospital ServiceOB service
Tests
NRP
ACLS
Hospital OSCE
Clinic OSCE
Physical Exam OSCE
GO!!!!
Slide32OSCES
Slide33Why are residents let go of a residency program?
Poll
Slide34Slide35Slide36Slide37Slide38Slide39POLLWhat keeps Residency Programs from building standardized exams?
Slide40Slide41POLLWhat does your residency program do with information gathered from orientation?
Slide42Slide43Slide44Slide45Slide46Slide47Slide48Slide49Scenario: resident was very rude to the standardized patient and no rapport was built
Slide50Slide51THANK YOU Questions?