2019 Winter: The Learning Environment in Health Sciences Education

The 2019 winter series of the IASME webinar program will focus on the role of the learning environment in health science education. The significance and importance of the learning environment is based on the assumption that a poor environment is associated with poor student performance, burn-out and stress. Numerous reports of students experiencing increased levels of unprofessional behavior and mistreatment on the part of faculty, residents, staff and other students have raised concerns about student wellbeing, professional development, and accreditation requirements. As a result, a major emphasis on the part of health science educators today is to evaluate the learning environment, identify areas of concern, and take measures to address these issues. The goal of this series is to raise awareness of the importance of ensuring a positive learning environment across health sciences education and to provide examples of systems and programs that have addressed this issue in an impactful manner. The introductory session will discuss the challenges in developing a conceptual framework for the learning environment, current limitations in measuring the learning environment, and initiatives designed to improve the learning environment. The remainder of the sessions will examine the current state of affairs in a variety of different health science settings. A panel will discuss these issues from the perspective of osteopathic, nursing and physician assistant educational programs. We will gain insight into the issues and research being conducted on the global learning environment from some selected schools outside of the United States. We will explore the learning environment in graduate medical education (ACGME) and will conclude with an in-depth practical approach of how one medical school created a robust system to monitor the learning environment which will include case studies. It is anticipated that at the end of the series the audience will be more in-tuned with the importance of maintaining a healthy learning environment and be better equipped with practical applications for their educational programs.

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January 10, 2019 at 1:00 am

Overview & Introduction of the Learning Environment

Presenter: Larry Gruppen

Dr. Gruppen is Professor in the Department of Learning Health Sciences, University of Michigan Medical School, where he directs the competency-based Master in Health Professions Education program. His research interests center around the development of expertise, knowledge and performance assessment, self-regulated learning, and scholarship development. He has over 160 peer-reviewed publications on a variety of topics in medical education and presents regularly at national and international professional meetings. He was recognized for career productivity by the AAMC’s Central Group for Educational Affairs’ Medical Education Laureate Award, the 2015 John P. Hubbard Award from the National Board of Medical Examiners, and the Merrel Flair Award from the AAMC Group on Educational Affairs.

The importance and visibility of the learning environment has grown in recent years as various regulatory agencies focus attention on possible deficiencies in the learning environment (LE). The LE has been associated with stress and burnout, quality improvement initiatives, and curriculum design. This session will discuss the challenges in developing a conceptual framework for the LE, current limitations in measuring the LE, and initiatives designed to improve the LE.

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January 17, 2019 at 1:00 am

The Learning Environment: An International Perspective

Presenter: Sean Tackett


Sean Tackett, MD, MPH is Assistant Professor of Medicine and International Medical Education Director, Division of General Internal Medicine, Johns Hopkins Bayview Medical Center and a Senior Medical Consultant for Johns Hopkins Medicine International. His career goal is to improve the quality of health professions education internationally.
His research on medical student learning environments has included collaborators from China, Taiwan, Malaysia, Israel, and Brazil, and he has published scholarship related to international medical school accreditation, educational technologies. He has also conducted curriculum development consultation and workshops for faculty working in Brazil, China, Malaysia, Oman, Saudi Arabia, United Arab Emirates, Vietnam, and Zambia. Clinically, he practices hospital medicine and attends on inpatient medical teaching services.

His session will review research related to learning environments, focusing on study designs and measurement methods, and will describe the growing interest in learning environments and their impact on professional development and well-being internationally.

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January 24, 2019 at 1:00 am

The Learning Environment During Residency

Presenter: John Co

John Patrick T. Co, MD, MPH, is the Director of Graduate Medical Education at Partners HealthCare, Designated Institutional Official (DIO) for Brigham and Women’s (BWH) and Massachusetts General Hospitals (MGH), and Director of Ambulatory Quality and Safety for the MassGeneral Hospital for Children, all in Boston, MA. He is a trained in health services research, and for 5 years served as associate program director for pediatric residency training at MGH. He is certified by the American Board of Pediatrics (ABP) in General Pediatrics, and focuses his academic work in areas that are at the intersection of medical education, quality improvement, and patient safety. Currently he serves as Co-Chair of the Accreditation Council for Graduate Medical Education (ACGME) Clinical Environment Review (CLER) Evaluation Committee and has served on several other national committees related to education and quality of care, including the ABP Foundation Board of Directors and as on the Editorial Board for Pediatrics.

The Accreditation Council for Graduate Medical Education (ACGME) established the Clinical Learning Environment Review (CLER) Program in 2012 to provide institutions that train residents and fellows with formative feedback to improve patient care while optimizing the clinical learning environment (CLE) in the 6 CLER Focus Areas (Patient safety, Health care quality (including health care disparities), Care transitions, Supervision, Fatigue management, mitigation, and duty hours, Professionalism).

In the Fall of 2018, the ACGME released its second CLER National Report of Findings, which details findings from the second set of visits to nearly 300 ACGME Sponsoring Institutions with 3 or more core residency programs. During the webinar, we will present findings from the report, as well discuss changes over time since the first cycle of CLER visits.

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February 7, 2019 at 1:00 am

System and Case Studies

Presenter: System and Case Studies

Dr. Harrington received a bachelor of science degree inPharmacy and his medical degreefrom West Virginia University.He wasone of the first residents in the country to complete a combined residency program in Internal Medicineand Psychiatryand is boarded in both specialties. Following completion of residency, Dr. Harrington began his academic career and remained on faculty at the University ofVirginia School of Medicineuntil 1990when he joined Carilion Health System to develop a psychiatry residency. Having mentored many psychiatry residents at Carilion Medical Center,Dr. Harrington has contributed to the careers of numerous psychiatrists,many of whom now work in southwest Virginia. He has greatly enjoyed his work with patients in the Roanoke Valley and was involved with establishment of the Mental Health Collaborative treating patients underserved in traditional health care settings. Dr. Harrington is a Distinguished LifeFellow of the American Psychiatric Association and is active in the Psychiatric Society of Virginia where he serves on the Ethics Committee. In 2007, Dr. Harrington was named VicePresident for Academic Affairs for Carilion Clinicwhere he supervised the expansion of graduate medical educationresulting in the establishment of numerous new residencies and fellowships, and the development of theresearch, simulation, and professional developmentdepartments at Carilion Medical Center. As part of the transformation of the Carilion Clinic, Dr. Harrington was instrumental in the early development of the Virginia Tech Carilion School of Medicine. At the Virginia Tech Carilion School of Medicine, Dr. Harrington is a tenured Professorof Psychiatryand is the Vice Dean for the medical school. In 2014, Dr. Harrington was the recipient of Carilion Clinic’s Robert L. Keeley, M.D. Healing Hands Award for physician leadership and exemplary service to patients.

The Liaison Committee on Medical Education has recognized the importance of a healthy learning environment for students to optimally learn, to promote well-being, and to develop professionalism. Since 1990 the LCME has used the Graduation Questionnaire (GQ) to survey graduating medical students about their experiences and perceptions of their school’s leaning environment. Many schools’ GQ survey results have shown that students were less likely to report unprofessionalism and mistreatment while in school suggesting students are fearful of reporting while they are students. As a result, the LCME focuses on the learning environment in the accreditation surveys of medical schools.

Following Virginia Tech Carilion School of Medicine’s (VTCSOM) 2013 LCME accreditation visit, the school established the Learning Environment Advocacy Committee (LEAC), a multidisciplinary committee that serves as the clearing house for learning environment concerns from students. The learning environment concerns are reviewed by the committee, recommendations are made to investigate the concerns, and the concerns are addressed in the departments where the unprofessionalism or mistreatment occurred. The LEAC raises awareness of the importance of a healthy learning environment for students, faculty, residents, nurses and staff at VTCSOM and its clinical affiliate. This seminar will review the process of developing the LEAC, the activity of the LEAC since the committee was established, and the results of an organizational wide learning environment survey.

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