2017 Spring: Remediation in Health Sciences Education

As a follow-up to the IAMSE fall 2016 web seminar series on assessment, the spring 2017 IAMSE web seminar series will continue with exciting, informative sessions focusing on remediation. The goal of remediation is to correct the course of students who have gone astray in their journey to become a health professional. However, because of the varying components in a professional health science curriculum including basic science knowledge, clinical skills, and professionalism coupled with ever changing curricular modifications; effective remediation in health science education has become a complex issue with many challenges. To explore some of these issues, the spring web seminar series will provide a series of presentations by speakers who will share their experiences and expertise in remediation. The fundamental groundwork for the understanding of the importance of successful remediation will be laid and examples of programs who have applied these principles to integrated basic science courses and clinical skills will be provided. A timely presentation on the approaches to remediation of the new paradigm in undergraduate medical education assessment: Entrustable Professional Activities (EPAs) will be included. Licensing exam failures are a major concern in health professions education and one session will be dedicated to a panel presentation of identification of students in jeopardy of not passing and/or remediation of these exams from the perspectives of allopathic (USMLE Step-1), osteopathic (COMLEX), and physician assistant (PANCE) medical programs. The series will also contain a session on the many issues (philosophical, educational, and legal) of “forward-feeding” assessment information on learners to faculty in subsequent courses. The audience will be invited to contribute to the series by sharing their experiences and insights using the phone line or our newly implemented back-channel communication.

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March 2, 2017 at 12:00 pm

Remediation of Basic Science in Integrated Blocks

Presenter: Giulia Bonaminio, PhD & Jeannette Guerrasio, MD

Dr. Bonaminio received her B.S. degree in Biology from Bowling Green State University and her M.S. and Ph.D. degrees in Molecular Genetics from The Ohio State University. She completed a postdoctoral fellowship in Medical Genetics at Stanford University and the Hedwig van Ameringen Executive Leadership in Academic Medicine (ELAM) Program for Women at Drexel University College of Medicine.

After completing her post-doctoral training, she served for five years as the Biomedical Curriculum Specialist at the University of Kentucky College of Medicine. In 1997 she joined the University of Kansas School of Medicine. Dr. Bonaminio is the Associate Dean for Medical Education, the Director of the Office of Medical Education, and a Professor in the Department of Family Medicine. She has responsibility for oversight of the undergraduate medical curriculum, the standardized patient program and clinical skills lab, the evaluation of courses and the curriculum, and medical education research.

Dr. Bonaminio has published and presented locally and nationally on topics including curriculum design and the use of active learning in medical education. She has been a member of the International Association of Medical Science Educators (IAMSE) since 1997 and has served as a Board Member, Vice President, President and Past President. She received the IAMSE Master Scholar Award in 2012 and the Association of American Medical College (AAMC) Central Group on Educational Affairs’ Laureate Award in 2016. She serves as a member of the AAMC’s Curriculum Inventory Advisory Board and the Student Surveys Advisory Committee.

Jeannette Guerrasio, MD is an Associate Professor of Medicine in the Department of General Internal Medicine, Hospitalist Section, at the University of Colorado and author of Remediation of the Struggling Medical Learner. She graduated from Albany Medical College and completed her residency at the University of Connecticut. As the Assistant Program Director of the Internal Medicine Residency, Dr. Guerrasio developed a pioneering approach to improve the educational experience of learners, by creating individualized learning plans for struggling residents and medical students. She was named Director of Remediation and Individualized Learning Plans, for the School of Medicine for both Undergraduate and Graduate Medical Education to further expand access to her program. Her research explores understanding and early identification of at risk learners and remediation methods and outcomes. In addition to resident and medical student education, she is committed to the clinical care of hospitalized patients, with a focus on inpatient geriatrics. She has contributed to several quality improvement projects at the University of Colorado Hospital to improve geriatric assessments and to decrease delirium, functional decline, and urinary tract infections in this vulnerable population.

The session will define remediation and describe the unique challenges of struggling medical students, including information to guide course directors and students through the process. Drs. Guerrasio and Bonaminio will highlight teaching tips to improve our learners’ studying and test taking skills. Examples of remediation programs will also be discussed.

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March 16, 2017 at 12:00 pm

Trust and Remediation: Entrustable Professional Activities and Trust Decisions

Presenter: Brian Martin, DO

Dr. Bryan Martin is the Immediate Past President of the American College of Allergy, Asthma and Immunology (ACAAI). He is currently an Emeritus Professor of Medicine at The Ohio State University where he previously served as the Associate Dean for Graduate Medical Education, the Designated Institutional Official, the Associate Medical Director of University Hospital and until 2015 as the Founding Director of the Allergy and Immunology Fellowship.

Dr. Martin did his Internal Medicine Residency at William Beaumont Army Medical Center in El Paso, TX, where he was selected to be the Chief Resident, and his Allergy Immunology Fellowship at Fitzsimmons Army Medical Center, in Denver, CO. He has served as the Chair of the Accreditation Council for Graduate Medical Education (ACGME) Allergy and Immunology Residency Review Committee, and has served the ACGME as a Volunteer CLER Site Visitor and as an ACGME-International Site Visitor.

A Distinguished Fellow of the ACAAI, Dr. Martin is the author of over 50 peer-reviewed publications and book chapters, and is the recipient of a number of awards, to include the ACGME Parker Palmer Courage to Teach Award, the Lewis Aspey Mologne Award for Military Academic Excellence, the Order of Military Medical Merit and the Legion of Merit. He is a Fellow of the American College of Physicians, the American College of Osteopathic Internists, and the American Academy of Allergy, Asthma and Immunology.

Dr. Martin retired from the United States Army in 2008 after a 28 year career. His last assignment was at Walter Reed Army Medical Center where he served in such capacities as the Chair of the Department of Allergy and Immunology, Director of the National Capital Consortium Allergy Immunology Fellowship, Specialty Consultant for Allergy, Immunology and Immunizations to the Army Surgeon General and Founding Associate Director of the National Vaccine Healthcare Centers Network.

Professionalism is difficult to define, and both professionalism and unprofessional activities are too often described in terms that resemble the old adage: “you will know it when you see it.” Activities that are difficult to define and quantitate are also difficult to remediate, and leave the educator with the difficult and frustrating task of accessing a remedial endpoint for an attribute that is difficult to define. This program will examine the important role of trust in the training of medical professionals. How do we develop, evaluate and remediate trust in the training of medical professionals? The new paradigm in undergraduate medical education assessment: Entrustable Professional Activities (EPAs), has made the incorporation of trust a vital part of medical education. Medical Educators and patients both want the same thing in student health care providers. The patient needs to trust that the team member who is in a learning role is knowledgeable, yet understands the limits of his/her knowledge, is compassionate, can communicate with them in a way they can understand, who will be there when needed; in a word, one they can trust. The preceptor also needs to know the learner has these attributes, and wants a student who is able to ask for, receive and react to, feedback. While it may seem obvious that trust underlies all educational and medical decision making, trust is difficult to access and even more difficult to remediate if it is lacking or lost. There is evidence that physician-learners are poor at accessing their own capabilities, making feedback a critical part of their education, and yet, honest, constructive feedback is both difficult to give and difficult to receive. EPAs may help educators give this feedback by breaking down Entrustable Professional Activities into individual competencies which can be evaluated and discussed. Using a series of case examples this webinar is designed to help the educator develop an emotional intelligence based strategy to help provide better communication and remediate trust based decision making.

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March 23, 2017 at 12:00 pm

Sharing Assessment Information: Why, How, and What to Consider

Presenter: Lynn Cleary, MD

Dr. Cleary is Professor of Medicine, SUNY Distinguished Teaching Professor, and Vice President for Academic Affairs at Upstate Medical University in Syracuse, NY. She is a former clerkship director, former associate dean for curriculum, and has collaborated with colleagues on presentations and literature on the topic of sharing assessment information.

Competencies in medical education are developed longitudinally, and competency is rarely achieved within one course, clinical rotation, or educational unit. Learners gain competency at differing paces, and some require more time or practice to achieve one or another competency. Sharing assessment information across traditional course boundaries may improve efficiency and support more personalized educational experiences. As a group, educators have some ambivalence about sharing assessment information, with the greatest concern that sharing assessments may introduce bias. This webinar will summarize existing literature on the subject, the case for and against sharing assessment information, and considerations in establishing a process for sharing assessment information.

Seminar Archive
March 30, 2017 at 12:00 pm

Remediation of Gaps in Clinical Skills–One Size Fits One

Presenter: Cate Nicholas, MS, PA, EdD & Camilla Curren, MD

Dr. Nicholas is the Director of Simulation Education and Operations for the University of Vermont (UVM) Clinical Simulation Laboratory (CSL) which serves the Colleges of Medicine, College of Nursing and Health Sciences, and the UVM Medical Center. The CSL is dually accredited by the Society for Simulation in Healthcare (SSH) and the American College of Surgeons. As simulation educational consultant, she works with faculty to integrate simulation based educational teaching and assessment activities into formal curriculum, programming and continuing healthcare education. Dr Nicholas is the Director of Clinical Skills Curriculum for the UVM Larner College of Medicine. She oversees all M1-M4 clinical skills curriculum and assessment including remediation process. She is an Assistant Professor in OB-GYN and Family Medicine and retired from her private practice after 35 years.

Dr. Nicholas is an Accreditation Site Reviewer for SSH as and the Vice Chair of Quality for the SSH Certification Committee. She is past chair of Research and Grants for the Association of Standardized Patient Educators (ASPE) and was named the ASPE Educator of the Year for 2011.

Dr Nicholas is interested in use of debriefing techniques in remediation, faculty development in feedback and debriefing skills, patient centered/relationship centered communication skills and the effect of gendered communication on interprofessional teams.

Dr. Camilla Curren is an Assistant Clinical Professor of Internal Medicine at OSU Medical Center and of Pediatrics at Columbus Children’s Hospital, and serves as Director of Longitudinal Groups for the newly integrated Lead.Serve.Inspire Curriculum at OSU College of Medicine in Columbus, Ohio. She is the recipient of numerous teaching awards from the OSU College of Medicine including the 2016 Master Teacher Award from Courage to Teach and the 2016 Distinguished Educator Award from the College of Medicine and the 2015 Alumni Faculty Teaching Award. Dr. Curren works with and mentors faculty in the remediation of students with clinical skills deficits in the first two years of medical school (Part One) during their earliest clinical experiences.

She is a graduate of The Ohio State University College of Medicine and of the OSU and Nationwide Children’s Hospitals Internal Medicine/Pediatrics program and is actively involved in the preclinical and clinical aspects of teaching medical students and residents.

Remediation of gaps in clinical skills requires an individualized approach to the learner, the problem, and the clinical setting in which the gaps are noted. Having the learner repeat a standardized patient skills encounter alone, for example, will likely not result in the desired demonstration of adequate skills which were absent on initial assessment. However, a methodical assessment of the learner’s cognitive or behavioral errors, followed by progressive coaching to an acceptable endpoint, is usually successful in achieving targeted skills acquisition. This session will discuss methods of analyzing clinical skills encounters for, and of remediating, common cognitive or behavioral learning issues in ways that are respectful of the learner and that contribute to durable improvement in clinical skills. We will specifically discuss teaching approaches that have been implemented successfully in clinical skills remediation situations. During this session the participant will learn to: 1. Analyze the learners cognitive or behavioral error 2. Create a individualized remediation plan 3. Assess the effectiveness of the plan

Seminar Archive
April 13, 2017 at 12:00 pm

Remediation of “High Stakes” Professional Exams

Presenter: Aubrey Knight, MD, Nicole Wadsworth DO, FACOEP, FACEP, & Pat Kenney-Moore EdD, PA-C

Dr. Aubrey Knight is Associate Dean for Student Affairs and Professor of Medicine and Family & Community Medicine at the Virginia Tech Carilion School of Medicine. Dr. Knight graduated from the University of Virginia School of Medicine and the family medicine residency at Carilion in Roanoke and a geriatric medicine fellowship at the University of Maryland. Dr. Knight is a board certified in Family Medicine, Geriatric Medicine, and Hospice and Palliative Medicine.

In his role as Associate Dean for Student Affairs, Dr. Knight spends much of his time with career and academic advising. He personally coaches students and helps guide them to resources aimed at improving their success in the classroom, at the bedside and in the testing environment.

Dr. Knight’s career has focused on medical education. He has been a family medicine residency director as well as the program director for a hospice and palliative medicine fellowship. He was the founding program director for the Carilion Geriatric Medicine fellowship program and, after a 10 year hiatus is once again, the program director of this fellowship. He has collaborated with the VT Center for Gerontology on research related to aging and caregiving.

He is a Fellow of the American Academy of Family Physicians, a Certified Medical Director with the Society for Post-Acute and Long-Term-Care Medicine, and a member of the American Geriatric Society. Dr. Knight is a geriatric provider at the Carilion Clinic Center for Healthy Aging for their Mild Cognitive Impairment and Memory Disorders Clinics and a physician with the inpatient palliative medicine team at Carilion Roanoke Memorial Hospital.

Dr. Knight has been recognized in the Roanoke magazine as one of Roanoke “Top Docs” and by Our Health Magazine for “Best Bedside Manner.” He is on the Medical Scientific Committee for the Alzheimer’s Association and the Advisory Board for the Gold Humanism Honor Society.

Dr. Nicole Wadsworth (D.O., FACOEP, FACEP) is an Associate Dean for Academic Affairs and Assistant Professor of Emergency Medicine. Her educational interest surrounds board preparation for medical students who struggle with academic success, inter-professional education, simulation in medical education and curriculum development.

She is currently the Co-Chair of the Curriculum Transformation Team at the Heritage College, leading faculty teams in review and revision of the current curriculum as well as assisted in the development of a pilot curricular program at the Heritage College’s Cleveland extension campus.

She has previously presented at American Association of Colleges of Osteopathic Medicine around the topic of Multicultural medical school curriculum, Committee on College Accreditation Training regarding standard six and Committee on College Accreditation Training regarding Compliance: Meeting and Exceeding the Standards.

Pat Kenney-Moore EdD, PA-C is an Associate Professor, Associate Director and Academic Coordinator in the Oregon Health & Science University School of Medicine, Division of Physician Assistant Education. She is responsible for the didactic phase of the OHSU PA program and is involved in teaching, learning, assessment and remediation of PA students.

She is a graduate of the Physician Assistant Program at the University of Southern California (USC), and subsequently completed a Master of Science degree in Postsecondary, Adult and Continuing Education and a Doctor of Education degree in Educational Leadership: Postsecondary Education from Portland State University. Pat’s clinical background includes family medicine and general internal medicine and she continues to maintain a part time clinical practice at a free clinic.

In addition to program responsibilities, Pat is a member of the Board of Trustees for the Oregon Medical Association and participates nationally with the National Commission on the Certification of Physician Assistants (NCCPA), and the Physician Assistant Education Association (PAEA).

She is a Distinguished Fellow of the American Academy of Physician Assistants and has received several honors including Oregon PA of the Year in 2005, OHSU School of Medicine Faculty Excellence in Education Award for 2004-2005, and several academic teaching awards. In 2016 she received the national Master Faculty award presented by the Physician Assistant Education Association.

(USMLE Step-1, COMLEX, PANCE) Aubrey Knight will discuss USMLE Step-1. Nicole Wadsworth will describe the multidisciplinary approach to identifying and supporting the students who are most at risk for failing Level 1 of the COMLEX exam. Pat Kenney-Moore Physician assistant education is a condensed and abbreviated version of allopathic medical education that occurs over an average of 27 months. The licensing examination for PAs (Physician Assistant National Certifying Examination or PANCE) is uniquely situated to occur after graduation, creating challenges in identifying at risk students early in order to ameliorate potentially negative outcomes after graduation. This portion of the webinar will highlight issues related to PA student remediation and the approach to graduates who are unsuccessful in passing the PANCE

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