The 36th Forum for Behavioral Science in Family Medicine Sponsored by The Medical College of Wisconsin Title: How to Promote Scholarly Activity in a Busy Family Medicine Residency Program Maureen Grissom, PhD Tochi Iroku-Malize, MD, MPH

The 36th Forum for Behavioral Science in Family Medicine Sponsored by The Medical College of Wisconsin Disclosure Dr. Grissom andDr. Iroku-Malize have no conflicts of interest to report

Goals & Objectives Become familiar with the ACGME definition of Scholarly Activity and the ACGME/RRC Requirements Learn about ONE WAY that these can be accomplished using: – Who, What, When, Where, Why & How? Leave this session with a WRITTEN PLAN to start from when you return home

What’s your role in your program? – Program Director, Associate PD – Physician Faculty – Behavioral Science Faculty – Program Coordinator – Resident – Student – Other

Which best describes your program? – Associated with a medical school – Associated with a hospital – Associated with a clinic

1.“The curriculum must advance residents’ knowledge of the basic principles of research, including how research is conducted, evaluated, explained to patients, and applied to patient care.” 2.“Residents should participate in scholarly activity.” 3.“The sponsoring institution and program should allocate adequate educational resources to facilitate resident involvement in scholarly activities.” Scholarly_Activity_Resident-Fellow.pdf ACGME Core Definition of Scholarly Activity

ACGME Family Medicine RRC Guidelines ACGME 2012

ACGME FM Faculty Scholarly Activity Requirements specific%20Requirement%20Topics/DIO-Scholarly_Activity_Faculty.pdf Updated June 2015

ACGME FM Resident Scholarly Activity Requirements specific%20Requirement%20Topics/DIO-Scholarly_Activity_Resident-Fellow.pdf specific%20Requirement%20Topics/DIO-Scholarly_Activity_Resident-Fellow.pdf Updated June 2015

It’s likely that you’re doing a lot more than you think— The most important thing to remember is to DOCUMENT what you’re doing!

Boyer’s Four Components of Scholarship From Grady et al. Defining scholarly activity in graduate medical education. JGME,

How does your program currently meet the ACGME scholarly activity requirement? (#1 & 2 on your handout)

What We Do at Our FM Residency Program Who, What, When, Where, Why & How?

– 27 residents (9-9-9) – One group project per year for all residents – 9 groups-Comprised of PGY 1, PGY2, PGY3 – Faculty mentors – One individual project per residency – Completed during second year Community Medicine rotation – Additional individual opportunities – Get to know your IRB contact and people who can help with methodology and statistics WHO: Working Within Your Program’s Boundaries

Combination of Individual and Group-based QI Projects Benefits of QI Projects – Quicker—chart reviews – Relevant—more interest on part of residents and on part of hospital or clinic administration Benefits of Group Projects – More than one resident is achieving their scholarly activity goal simultaneously WHAT: Types of Projects

1.Mobile Medical Apps for Diagnosis Part II 2.Duty Hours Part II 3.Early Intervention in Acute Kidney Injury 4.Examining the Relationship between Maternal Pre- Pregnancy BMI and C-section Rate 5.Effects of SBIRT Implementation 6.Barometric Pressure and Spontaneous Rupture of Membranes 7.Implementation of a Bilirubin Ordering Flow Sheet 8.Meaningful Use 9.Training in Colposcopy 10.HbA1c and Inpatient Management of Diabetes Last Year’s Group Projects NSLIJ-SSH FMRP

1.Diabetes and Annual Ophthalmology Check ups 2.Immunization Compliance in Diabetic Patients 3.Diabetes and Smoking: A Deadly Combination 4.Correlation of Clinical Diagnosis and Histopathological Confirmation for Dermatological Conditions 5.Are We Managing our Depression Patients Well with Appropriate Documentation, Laboratory Test, Referrals and History? 6.Reduction in Anxiety with Music During Minor Dermatological Procedures 7.Teenage Mothers and Contraception 8.Compliance with Diabetes Flow Sheet 9.Asthma Management Plan Compliance in Asthmatic Patients 10.Polypharmacy in Elderly Population 11.Correlation between Abnormal PAP Smears and Colposcopy 12.Threat of Global Infectious Diseases Transmitted by Travelers in US Multiethnic Cities 13.Correlation of HBA1C levels and Diabetes Complications in Hispanic and Non-Hispanic populations 14.MCHAT Screening for Autism: How Well are We Doing ? Individual CMProjects NSLIJ-SSH FMRP

Background Literature Review, Hypotheses Methods Variables, Data Template, Sample Size Results Descriptive Statistics, Data Analysis Conclusions/Discussion Limitations & Implications for Residency, Hospital, Field of Medicine WHAT Makes a Scholarly Project?

WHEN: Working Within Your Program Timeline July AugSeptOctNovDecJanFebMarAprilMayJun ITE AAFP FMX Submit to STFM STFM Annual Conf Board Exam Submit to FMX Exam Prep

WHEN: Working Within Your Program, Timeline July AugSeptOctNovDecJanFebMarAprilMayJun ITE AAFP FMX Submit to STFM Conf Board Exam Submit to FMX TOPIC HOW TO DO RESRCH LIT REV H 0 H A ID VAR’s DATA TEMP IRB APP BEGIN DATA COLL PRESENT TO FACULTY & ADMIN IDEAS FOR PROJECTS… COMPLETE DATA COLLECTION, CONCLUSION IDEAS FOR PROJECTS… Exam Prep

Set due dates and hold short PowerPoint presentation for each section of project Allows for consultation and adjustment throughout Once group has a plan for project, can submit as “work in progress” to conferences Culmination of project Final presentation to program faculty and hospital administration PowerPoint presentation easily adapted to poster WHEN: Scheduling Projects

Where do you submit these projects? Identify conferences that fit your program’s type of projects and schedule your projects with submission dates in mind Many have poster sessions specific to medical students, residents, and fellows AAFP FMX, Global Health, National Conf STFM Annual, Practice Improvement NAPCRG THE FORUM! WHERE?

Conducting your own research: Makes you a better consumer of research Can help you address issues at the patient, physician, team, and organizational level Provides opportunity for collaboration with other departments and specialties Helps you realize there are many kinds of research National posters, presentations and publications set you apart from other physicians WHY Should Research Be Part of Medical Education?

Not just an ACGME requirement… Keep a list across time of posters, talks, publications Recognize those who work hard WHY: Generating Excitement about Research

Ideas to Offer – Always on the lookout for projects Willingness to Take Requests – Residents can choose an existing topic or pose one of their own HOW: To Make This Work

Resources & Support – Faculty Coordinator(s)/Research Champions – Faculty Mentors – Health system level research support – ACGME Level Support Organization Breaking projects into manageable pieces with accountability for team members HOW To Make This Work

A Few Things We’ve Learned… Make roles and expectations as CLEAR as possible! Big ideas are good but the project needs to be manageable. Start with a schedule of dates but remain flexible.

Clear Objectives and Expectations

Be Clear About Authorship and the Duties of Group Members

History Helps – Successful projects  posters, publications – Knowing where to present your research – Get residents/fellow (and faculty) excited Don’t forget to DOCUMENT Do it again the next year, and the next… HOW To Make This Work

Now to YOUR Program and Your…. Who? What? When? Where? Why? How?

Thanks for listening and participating We welcome any feedback or ideas!