GME Leadership Development:GME Leadership Development:Educating the Next Generation of Educating the Next Generation of

GME LeadersGME Leaders

W Wiese-Rometsch, MD & H Kromrei, W Wiese-Rometsch, MD & H Kromrei, PhDcPhDc

Detroit Medical CenterDetroit Medical Center

83 Residency Programs

> 1000 Trainees

Formal Leadership Training ?

GME Conceptual Model: Performance Domains

Evaluation

Clinical

GME Leadership Academy

Curriculum Development

Process

Needs Assessment

ACGME & AOA Requirements

Citation Tracking Tool

Internal Reviews

Program Director Survey

Internal Review Action Plan

GME Leadership Program Director Survey

Perceived importance

Perceived competence

25 items; 5- point Likert scale

Categories: Resident Leadership People Leadership Business Leadership

PD Survey: “Resident Leadership” Category

“Resident” Leadership Importance * Competence*

Creating & Evaluating Competency Based Curricula

64% Very / Extra

18% Not /Some

Maintaining Compliance with ACGME Requirements

90% Very / Extra

5% Not /Some

Communicating with Residents

100% Very/Extra

0% Not /Some

Communicating with Former Residents

55% Very / Extra

13% Not /Some

Managing & Evaluating Resident Performance

94% Very / Extra

5% Not /Some

Managing Resident Conflicts & Problems

90% Very / Extra

7% Not /Some

Recruiting Resident Candidates

93% Very / Extra

9% Not /Some

PD Survey: “People” Leadership Category “People” Leadership Importance *

Competence*

Selecting & Recruiting Program Faculty & Staff

91% Very / Extra

23% Not /Some

Managing Program Faculty & Staff

91% Very/Extra

16% Not /Some

Managing Program Faculty & Staff Conflicts/ Problems

85% Very / Extra

20% Not /Some

Retaining Program Faculty & Staff

88% Very / Extra

7% Not /Some

Promoting Program Faculty & Staff Professional Development

76% Very / Extra

18% Not /Some

PD Survey: “Business” Leadership Category

“Business” Leadership Importance * Competence*

Maximizing Program Performance

89 % Very / Extra

17% Not /Some

Competing for Resources 75 % Very / Extra

23% Not /Some

Managing Resources 86 % Very / Extra

14% Not /Some

Creating & Managing Budgets

68% Very / Extra

25% Not /Some

Negotiating with Institutional Leadership

84% Very / Extra

23% Not /Some

Analyzing Program Performance

93% Very/Extra

5% Not /Some

Communicating / Relationship with Leadership Peers

77% Very / Extra

9% Not /Some

Summary of Needs Assessment FindingsGoal: Triangulation of data

1. Macro Level: Accreditation Outcomes

2. Micro Level: Internal Review Results

3. Stakeholder Perceptions: Program Director Survey

GME Leadership Academy Aims

Instructional Methods

Baseline reflection survey on “ideal program”

Pre-test / Post –test

Mini-lectures

“Hands on” experiential learning activities

Round table dialogues for all sessions

Assignments

Large group workshops (open to all PDs)

GME Leadership Academy Curriculum

Accreditation Cycle Core Competencies Designing & Developing Competency Based

Curriculum / Evaluations The Annual Program Review Communication and Technology Resource

Planning Writing Your Program Information Form / Booklet Program Management Leadership Development

Session 1: AccreditationGoals / Objectives Tasks

Understand the ACGME & AOA Regulatory Cycle and Associated Protocols

Review ACGME & AOA Program Requirements

Understand Institutional and Program Level Accreditation

Review new ACGME or AOA Common Program Requirements (Effective July 1, 2011)

Understand the Internal Review Protocol and Process

Participate in an Internal Review

Participate in self-assessment activity

Rate program performance in meeting accreditation

Session 2: Core CompetenciesGoals / Objectives Tasks

Understand the ACGME / AOA Core Competencies

Evaluate Your Program Information Form’s Learning Activities

Incorporate the Core Competencies into Your Program Competency-Based JournalingMilestones ProjectResident Portfolio

Determine Program need for development of competency-based learning activities

Participate in Group Activity

Develop or improve a learning activity for Practice-Based Learning or Systems-Based Practice

Session 3: Developing Competency-Based Curriculum & Evaluations

Goals / Objectives Tasks

Understand how to write goals, objectives, and evaluations

Revise a sample curriculum for a core rotation in your program to meet ACGME requirements

Understand the requirement for aligning program curriculum (measurable goals / objectives) to evaluation and assessment tools

Align the existing evaluation to the curriculum

Participate in Self-Assessment Activity

Rate program performance in compliance for requirements of competency-based curricula and evaluations.

Session 4: The Annual Program Review

Goals / Objectives Tasks

Understand the ACGME Program Review Requirements

Review current annual review protocolCompare current review process to ACGME / AOA requirementsIdentify opportunities for improving your annual program review

Participate in Self-Assessment Activity

Describe program’s approach to Annual ReviewDetermine compliance with requirements

Session 5: Communication & Technology Resource Planning

Goals / Objectives Tasks

Understand essential elements of effective communication

Identify current strategies for communication with residents

Identify current technological resources utilization for communication

Determine opportunities for enhancing utilization of technology in communication planning

Participate in Self-Assessment Activity

Rate program performance in utilization of technology in communicating and teaching residents

Session 6: Writing Your PIF (Booklet) and

Telling the Story of Your ProgramGoals / Objectives Tasks

Understand the importance of the PIF or Booklet

Develop PIF writing plan for your program

Determine PIF stakeholders

Delegate PIF responsibilities to program members

Participate in Self-Assessment Activity

Rate your Program’s PIF and describe your involvement with PIF writing

Session 7: Program Management

Goals / Objectives Tasks

Understand the process of program management

Understand “Performance Indicators and their importance in program evaluation

Review program data (Annual Program Review Action Plan and Internal Review Action Plans)Track program performance (GME Score Card)Identify obstacles to program improvement

Participate in Self-Assessment Activity

Rate program’s current methods for evaluating program performance in specified domains

Session 8: Leadership DevelopmentGoals / Objectives Tasks

Understand leadership competencies

Analyze personal values and align with leadership competencies

Develop short and long-term professional development plan

Review current CV

Develop action plan to meet identified goals

Identify negotiation strategy skills

Describe requirements for leadership in your current role

Participate in Self-Assessment Activity

Describe your current core values and long term goals

Supplemental Curricular Elements

GME Faculty Development Series: Decreasing Evaluation Bias Effective Interviewing Skills Teaching Skills: The 1 Minute

Preceptor The Problem Resident: Lessons

Learned Legal Issues in GME

Outcomes: Knowledge Gain

Session Pre-Test Post-Test

1 79 % 96%

2 65% 74%

3 73% 87%

Table 1: Pre & Post-Test Average Scores

Outcomes: Course Evaluation

Table 2: Course Evaluation Results

Evaluation item Agree/Strongly Agree

Recommendsession to others

97 %

Interactive/Engaging

100%

Relevant to job 97%

Participant Comments

“It was great! Really appreciated the pre-session survey and pace of content delivery.”

“Should be completed by all PDs.”

“Excellent initiative.”

Lessons Learned

Future Directions

Simple ID Process

ID Process Layer 2

ID Process Layer 2

ID Process Layer 1

ID Process Layer 1

ID Process Layer 3

ID Process Layer ’n’Complex IDProcess Quality

Limited Time & Resources

Ample Time & Resources

Tessmer and Wedman’s Layers-of-Necessity Model

Take Home Points

Conduct a Needs Assessment

Align with Accreditation Requirements

Adapt

Tailor Curriculum based on Feedback

Questions ?

References

Wiese-Rometsch, W., Guerra-López, I., Kromrei, H., Developing Successful Leaders: A Model for Graduate Medical Education. Poster presented at the Association for Medical Education Europe, Malaga, Spain, 2009.

Kromrei H., Wiese-Rometsch W. (2010). Portfolio Assessment: Relevant Evaluation Methods and Their Implication for Portfolio Design. In Guerra-Lopez, I (Ed) Social and Organizational Performance Review: Concepts and Research; 2010 2:2. pp119-134 Bloomington: Author House

Neher, J. O., Gordon, K. C., Meyer, B., & Stevens, N. (1992). A five-step "microskills" model of clinical teaching. Journal of the American Board of Family Practice, 5, 419-424.