Medicine and Health Sciences Commons^™

Optimizing Psychological Safety: Using A Focus Group To Acquire Perspectives From Standardized Patients Who Identify As Lgbtq+, Brandy Brown, Rachel Kupferman, Bethany Rocheleau, Christine Mallar, Karissa Hannifan, Beth Gray, Victoria Hayes, Leah Mallory

Journal of Maine Medical Center

Introduction: Gender and sexual minority (lesbian, gay, bisexual, transgender, questioning; LGBTQ+) patients report poor health care experiences, partly because health care providers are not trained to meet their needs. Simulation can help learners practice competencies related to diversity, equity, and inclusion, but there are psychological safety considerations when recruiting standardized patients (SPs). Our objective was to incorporate the expertise of members of the LGBTQ+ community in our SP pool as we developed related curriculum.

Methods: All SPs were invited to participate in a focus group if they identified as LGBTQ+ and wanted to contribute. Content experts developed a focus group …

Improving Inclusive Communication: Pilot Results From A Simulation-Based Learning Opportunity To Practice Taking A Sexual Health History, Rachel Kupferman, Beth Gray, Bethany Rocheleau, Christine Mallar, Karissa Hannifan, Victoria Hayes, Leah Mallory, Brandy Brown

Journal of Maine Medical Center

Introduction: Sexual and gender minority (lesbian, gay, bisexual, transgender, questioning; LGBTQ+) patients experience health care inequities. Simulation using standardized patients (SPs) is an effective tool for communication-based training. To promote equitable practice, we created an experiential learning opportunity for residents to practice inclusive communication and improve their comfort in caring for LGBTQ+ patients while maintaining the psychological safety of SPs.

Methods: Our interdisciplinary team explored relevant simulation curricula, conducted a focus group with LGBTQ+ SPs, created a didactic presentation, and designed and implemented a simulated case. Family medicine residents participated in the training and completed pre- and post-training surveys rating …

Developing An Interprofessional Community Psychiatry Rotation Using An Assertive Community Treatment Team Model: A Preliminary Evaluation, Ruth Frydman

Journal of Maine Medical Center

Introduction: There is a shortage of psychiatric providers trained to work in community settings with people with serious mental illness (SMI) and associated comorbidities. We designed an innovative psychiatry rotation and curriculum for psychiatry residents and other learners.

Methods: The rotation incorporates working with our Assertive Community Treatment team and includes home visits, assertive outreach, and visits in other community settings. It was designed to improve learners’ confidence in their understanding and skill set for working with and treating people with SMI in the community on an interprofessional (IP) team. This pilot quality improvement project evaluated psychiatry resident responses to …

The Academy At Mite Report Of Activities 2022, Mmc Institute For Teaching Excellence

Journal of Maine Medical Center

No abstract provided.

Weekly Review Of An Academic Checklist To Operationalize Improvements To A Surgical Residency Program, Sean Francois, James Whiting, Kartikey Pandya, Jaswin Sawhney

Journal of Maine Medical Center

Introduction: We report on the use of a weekly academic checklist to monitor proposed improvements to a surgical residency program.

Methods: A single-center, retrospective analysis of residency improvements with an academic checklist of quality initiatives reviewed weekly at morbidity and mortality conferences. The positive response rate for each of the 11 items were reviewed. Trends of positive responses during the year were reviewed. The effectiveness of the checklist was also assessed with 2 internal surveys completed by faculty and residents.

Results: Over 15 months, the checklist was reviewed 46 times. The rate of a positive response for items varied from …

Geographic Preference In The Residency Match Before And After The Emergence Of The Covid-19 Pandemic, Andrew Beauchesne, Campbell Belisle Haley

Journal of Maine Medical Center

No abstract provided.

A Four-Year Longitudinal Curriculum To Improve Feedback-Seeking Behaviors For Medical Students, Vicki Hayes, Robert Bing-You, Tamara Palka, Marybeth D. Ford, Robert Trowbridge Jr

Journal of Maine Medical Center

Introduction: Feedback is essential for performance improvement and plays a pivotal role in competency-based medical education. Medical learners need training to acquire skills to effectively seek feedback for their unique situations.

Methods: We developed a 4-year longitudinal curriculum designed to encourage feedback-seeking by medical students. The 4.5-hour curriculum consisted of interactive lectures, feedback-seeking surveys, trigger videotapes, and peer-group discussions in small- and large-group formats.  A volunteer study cohort (n = 14/37, 38%) was interviewed in 4 separate waves in individual and focus-group formats to explore perceptions about feedback-seeking and effectiveness of the curriculum.

Results: Themes and student quotes related to …

Senior Academic Ranks In Us Anesthesiology Programs: Differences Between Women And Men And Examination Of Independent Factors For Success, Brenda Lee, Farhad Zahedi, Ina Zaimi, Roman Schumann

Journal of Maine Medical Center

Introduction: Gender equality among faculty is a challenge in academic medicine, including anesthesiology. We investigated the likelihood that several factors were associated with academic success in the United States (US), defined as having achieved a senior academic rank (SAR) in a US anesthesiology training program.

Methods: We collected data available on the Internet on 131 anesthesiology programs, including faculty academic rank, gender, number of faculty, graduate status from an American medical school, fellowship training status, number of residents, number of program fellowships, and geographic location. SAR was defined as either associate professor or professor. Data were analyzed with logistic regression. …

Desperately Seeking Feedback: A Phenomenographic Study Of Medical Students’ Experiences During A 4-Year Longitudinal Feedback Curriculum, Robert Bing-You, Victoria Hayes, Tamara Palka, Marybeth Ford, Robert Trowbridge

Journal of Maine Medical Center

Introduction: The focus of feedback in medical education recently shifted to a dialogic partnership between teachers and learners, co-creating effective feedback exchanges. We previously described a prototype, longitudinal 4-year curriculum for medical students to develop feedback-seeking behaviors. We explored the students’ experiences as participants in this novel program.

Methods: Beginning in academic year 2017-2018, we assessed the 4-year experiences of 14 medical students with a phenomenographic, qualitative approach. Three waves of semi-structured, individual interviews were conducted during the first 3 years. Focus groups were conducted in the final year of the program. Meaning units were identified, and categories were determined …

Inclusive Language Matters: Recommendations For Health Care Providers To Address Implicit Bias And Equitable Health Care, Crystal R. Herron

Journal of Maine Medical Center

Problem Statement: Stigmatizing language—written and verbal—can fuel implicit bias among health care professionals, leading to unintentional negative effects in how they care for patients. To provide equitable care, health care professionals and systems must become aware of the language they use and learn to replace biased language with inclusive language.

Background: The medical field strives to treat all patients equally, yet disparities in health care persist. These disparities are due, in part, to implicit bias that affects how health care professionals and systems care for patients. Although reports recommend developing education programs that address implicit bias, these programs fail to …

Focused Hospital Medicine Cme On Pulmonary Point-Of-Care Ultrasound Through Just-In-Time Training During The Covid-19 Pandemic, Matthew Buttarazzi, Kristen Bartlett, Katherine Stebbins, Monica Thim

Journal of Maine Medical Center

Introduction: We describe the use of focused CME with just-in-time training in pulmonary point-of-care ultrasound (POCUS) for hospitalists as part of our response to coronavirus disease 2019 (COVID-19). This training served as a pilot for developing a longitudinal training program for our inpatient adult medicine providers.

Methods: In mid-March 2020, ultrasound education and image review were deployed within hospital medicine at a large academic medical center. Faculty were provided (1) a small-group lecture focused on ultrasound findings in pneumonia, (2) weekly review of imaging, and (3) a monthly review conference of ultrasound imaging.

Results: Use of POCUS for pulmonary pathology …

Physician Shadowing: An Essential Practice In Fostering The Doctors Of Tomorrow, Anna M. Martens, Jo Linder, Janell Lewis

Journal of Maine Medical Center

Problem Statement: Maine Medical Center (MMC) lacks a robust shadowing program, and there is inequity in shadowing opportunities for students from underrepresented minorities and economically disadvantaged backgrounds. Physician shadowing is essential for college students interested in going to medical school as it helps students make career decisions and strengthens their medical school applications. As we continue to expand our undergraduate programs in medical education and seek to grow our physician workforce, we need to provide students with equal opportunities to observe careers in medicine in order to foster interest and passion for the health field.

Background: A robust body of …

2019 Mite Annual Report

Journal of Maine Medical Center

No abstract provided.

Lessons From An Evidence-Based Medicine Exploration: When Transparency And Sensitivity (Analyses) Can Change The Take-Home Message, Nadi N. Kaonga, Toby Fitzgerald

Journal of Maine Medical Center

No abstract provided.

Development Of A Certificate In Healthcare Improvement For Inter-Professional Teams, Kathleen M. Fairfield, Hannah R. Martin, Peter W. Bates, Erin M. Graydon-Baker, Mark G. Parker, Jordan S. Peck, Debra A. Rothenberg, Ghassan A. Saleh, Isaac Z. Stickney, John Tooker, Robert L. Trowbridge, John E. Wennberg

Journal of Maine Medical Center

Introduction

To address gaps in care team improvement-science education and connect geographically dispersed learners, we created a healthcare improvement certificate program, now completing the third program year, for inter-professional (IP) healthcare teams, including third year medical students.

Methods

This hybrid learning program consists of five modules: Learning Healthcare Systems, Improvement Science, Patient Safety and Diagnostic Error, Population Health and Health Equity and Leading Change. The curricular materials are comprised of focused readings, concise videos, faculty-moderated discussion boards, weekly synchronous calls of participants with faculty, and a longitudinal improvement project. The faculty are content experts, and worked with a curricular designer …

Building A Peer Reviewer Community Of Practice, Victoria Hayes Md, Robert Bing-You Md, Med, Mba, Wendy Craig Phd

Journal of Maine Medical Center

Introduction: Scholarly peer review is the cornerstone for maintaining quality and relevance in the medical literature. Few programs that support peer-reviewer training have been described.

Methods: We developed a 2-pronged approach to support peer-reviewer training at our institution. This approach included a formal online course that offered a certificate of completion and an informal group manuscript peer review (GMPR) meeting held monthly.

Results: A total of 13 participants completed the online course in the first 2 years (2017-2018). Nineteen enrolled in the third year. The GMPR met regularly over 3 years and reviewed 26 manuscripts. Typical attendance has been 8-10 …

“When I Let Go Of What I Am, I Become What I Might Be.” Lao Tzu, Robert Bing-You

Journal of Maine Medical Center

No abstract provided.

Tusm Faculty Appointments And Promotions 2019

Journal of Maine Medical Center

No abstract provided.

Reviewer Acknowledgement 2019

Journal of Maine Medical Center

No abstract provided.

Introducing An Adult Adhd Toolkit For Application In Collaborative Care, C. Jason Mallo

Journal of Maine Medical Center

Introduction: While providers in collaborative care have been challenged to respond to rising patient complaints about attention deficit hyperactivity disorder (ADHD) in adulthood, institutional guidance has been lacking or insufficient. To address this issue, an Adult ADHD Toolkit was created to be used by providers spanning primary care and psychiatry. This article reviews how the toolkit was developed, its contents, and future directions.

Methods: A workgroup of providers from different backgrounds devised materials for the toolkit by reviewing adult ADHD literature and clinical consensus.

Discussion: The toolkit addresses common dilemmas encountered in the evaluation and management of adult ADHD, and …

Changes In Hospital Utilization By Individuals Experiencing Homelessness After Engaging With Interdisciplinary, Low-Barrier Healthcare Services In Portland, Maine, Sarah Hemphill Ba, Adam Normandin Md, Ms, Debra Rothenberg Md, Phd

Journal of Maine Medical Center

Introduction: The Maine Medical Center Preble Street Learning Collaborative (PSLC) aims to couple medical education with addressing the unmet healthcare needs of those experiencing homelessness in Portland, Maine. The PSLC provides low-barrier medical, psychiatric, dental, and case management services to all-comers and is co-located near many of the city’s social services. The purpose of this study was to evaluate the impact of the PSLC in its first 19 months by describing demographic characteristics and patterns in hospital utilization of patients served by the PSLC.

Methods: We performed a retrospective chart review of 888 patients with one or more …

Virtual Coaching And Deliberate Practice To Enhance Medical Students' Clinical Reasoning During Oral Case Presentations, Nicole Akar-Ghibril Md, Cristina Carter Md, Gabrina Dixon Md, Med, Ellen Goldman Med, Mba, Mary C. Ottolini Md, Mph, Med

Journal of Maine Medical Center

ABSTRACT:

Introduction

Oral case presentations (OP) provide an opportunity for medical students to practice clinical reasoning and communication skills, and for faculty to provide assessment. Specific teaching strategies are needed to improve students’ OP skills.

Objective

To compare the effectiveness of Virtual Coaching (VC) to Small Group (SG) discussion or Traditional Feedback (TF/control) in improving clinical reasoning during OP, using a validated PBEAR (Problem Representation, Background Evidence, Analysis, Recommendation) tool.

Design/Methods

Students from two medical schools were randomly assigned to three groups during their inpatient pediatric clerkship. All completed an eLearning module about using illness scripts to promote clinical reasoning …

Time To Bring Curiosity Back Into The Practice Of Medicine, Robert Bing-You

Journal of Maine Medical Center

No abstract provided.

Faculty Entrustment Of Students In The Core Clerkships: A Comparison Between The Longitudinal Integrated Clerkship And The Block Clerkship, Robert L. Trowbridge, Marybeth D. Ford, Jenny L. Carwile, Eliza R. Bullis, Robert G. Bing-You

Journal of Maine Medical Center

INTRODUCTION: Entrustable Professional Activities (EPAs) have been proposed for use in undergraduate medical education. The ability of faculty to entrust students with EPAs may differ between Longitudinal Integrated Clerkships (LICs) and traditional block clerkships.

METHODS: Participants were core clerkship faculty, 64 in a LIC and 31 in a sequential block clerkship. We administered a web-based survey at the end of the core clerkship year to measure preceptors’ typical entrustment (on a scale of 0–10) in students for the 13 American Association of Medical Colleges Core EPAs. We compared entrustment between LIC and block faculty using a Mann-Whitney test.

RESULTS:LIC …

Maine Medical Center Quality And Safety Storyboards: Operational Excellence As Platform For Improvement

Journal of Maine Medical Center

Physician and other healthcare learners and clinicians must prepare to assume an active role in the design, implementation, and improvement of emerging models of health care delivery while concurrently improving quality, workflow efficiency and safety. While these expectations are building, few practicing clinicians have training or experience with these challenges. Maine Medical Center’s Operational Excellence Team builds on a framework of Lean Thinking, the Model for Improvement* and PDSA cycles** to advance improvement capacity among care teams across our organization. Interprofessional Teams are coached to use proven tools and techniques to identify and remove barriers to care and establish sustainable …

Tufts University School Of Medicine Mary Y Lee, Md, Medical Education Day Poster Abstracts

Journal of Maine Medical Center

The following abstracts represent posters of Tufts University School of Medicine (TUSM) research and innovation projects in medical education (in progress and completed).

The goal of this conference is to promote faculty educational research and provide faculty development with opportunities to engage in cutting-edge topics in medical education. Faculty have the opportunity to show their scholarly medical education work to TUSM's community through posters and oral presentations, and participate in educational workshops.

EDUCATIONAL OBJECTIVES

To have participants:

1) Share their work on medical education research with TUSM's community.

2) Analyze new trends in today's health professionals' education.

3) Select in …

Time-Out In Madrid: Considering The Role Of Time-Outs In Clinical Practice, Colin T. Phillips

Journal of Maine Medical Center

No abstract provided.

Rationale And Design Of An Endocrinology Education Program For Primary Care In Maine: Initiation Of Mainehealth Endo Echo Maine, Irwin Brodsky, Joan Ingram, Stacy O'Brien, Tho Ngo, Charles T. Winchell

Journal of Maine Medical Center

Introduction: Population health and quality of care initiatives for the management of common endocrine disorders often include algorithmic and protocol-driven workflows in primary care practices. Endo ECHO is a division of Project ECHO at University of New Mexico that engages primary care clinicians in didactic presentations and case discussions to augment conceptual (experiential, nuanced) rather than algorithmic (rote) learning.

Research Design and Methods: MaineHealth Endo ECHO was designed using the Project ECHO model. Project ECHO® is an interactive learning opportunity that uses video conferencing to connect specialty and primary care to share best practices for delivering care. Using …

Physician Gender Impact On Obesity Care In The Academic Ambulatory Setting, Peggy R. Cyr Md, Christina Holt Md, Msc, Amy Haskins Phd, Karyn King Md, Robert Post Md, Derjung M. Tarn, Arch Mainous Phd

Journal of Maine Medical Center

BACKGROUND & OBJECTIVE: The purpose of this study was to assess a nationally representative sample of academic family physicians to determine whether personal physician characteristics are associated with attitudes towards and care of overweight and/or obese patients.

METHODS: Questions pertaining to physician’s interactions with overweight and obese patients was administered as the 2012 Council of Academic Family Medicine Educational Research Alliance (CERA) survey to academic family physicians. We analyzed self-reported demographic responses physicians gave with the main outcome the association between self-reported likelihood of engaging in weight loss discussions with overweight or obese patients and physicians’ personal characteristics …

Changing The Surgical Residency: A Mixed-Methods Study Of Residents’ And Faculty Experiences One Year After Implementation, Sarah B. Cairo, Wendy Craig, Caitlin Gutheil, Paul K. J. Han, Kristiina Hyrkas, Lynda Macken, Jim Whiting

Journal of Maine Medical Center

Objective: To evaluate a reformed surgical residency curriculum aimed at addressing emerging practice models, enhancing residents’ educational experience, and improving the quality/continuity of patient care by reducing the service size and enhancing attending-resident interactions.

Methods: A mixed-methods study of the surgical training program following curriculum reform including: 1) focus group and individual qualitative interviews with residents, attendings, nurses, and advanced practice providers to explore stakeholder perspectives on curriculum reform, 2) time study of surgical resident activities, and 3) quantitative assessment of surgical case logs.

Results: Qualitative interviews demonstrated disparate knowledge and attitudes regarding the goals of the curriculum with emergence …