FADYA EL RAYESS, MD, MPH GOWRI ANANDARAJAH, MD HELEN BRYAN, MA ROBERTA GOLDMAN, PHD DEPARTMENT OF FAMILY MEDICINE ALPERT MEDICAL SCHOOL OF BROWN UNIVERSITY Building a scholarly development curriculum: How do we make it practical & meaningful for residents? STFM Annual Conference May 2 nd, 2013

Learning Objectives Explore ‘scholarship’ within the family medicine residency curriculum Develop strategies to encourage residents to engage in meaningful scholarship Brainstorm ways to address such challenges as setting realistic expectations, achievable outcomes and providing protected “project time”

Small Group Question How do you define scholarship or scholarly work as it relates to residents in family medicine?

Theoretical Framework In 1990 Ernest Boyer proposed 4 types/ meanings of scholarship: Discovery Integration Application Teaching (See ACGME handout) Glassick, C.E. “Boyer’s Expanded Definitions of Scholarship, the Standards for Assessing Scholarship, and the Elusiveness of the Scholarship of Teaching.” Academic Medicine. 2000;75:877–880.

Theoretical Framework 1994 Carnegie Scholars standards to evaluate scholarship:  Clear goals  Adequate preparation  Appropriate methods  Significant results  Effective presentation  Reflective critique (Product is reviewed and judged to be meritorious and significant by a panel of the candidate’s peers) Glassick, C.E. “Boyer’s Expanded Definitions of Scholarship, the Standards for Assessing Scholarship, and the Elusiveness of the Scholarship of Teaching.” Academic Medicine. 2000;75:877–880.

DeHaven’s Characteristics of Family Medicine Residency Programs Successful in Research Program Director support Protected time Faculty involvement in research Research curriculum/journal club An easily accessible research professional Opportunities for residents to present their research Crawford, P. & Seehusen, D. Scholarly Activity in Family Medicine Residency Programs:: A National Survey. Family Medicine 2011; 43(5): DeHaven, M.J. et al. Creating a research culture: what we can learn from residencies that are successful in research. Fam Med 1998;30(7):501-7

Our Goals For residents to conduct a scholarly project during residency, and develop skills to conduct scholarly work in the future. Process is as important as product Passion is important to the process Evaluation and dissemination skills are also important (including our own curriculum evaluation) Roberta Goldman, PHD, Brown University and HSPH, 2012

Brown Family Medicine Residency’s Scholarly Program Progression Active shift towards scholarship 2 nd year scholarly block rotation added Every other month R3 methods seminar New requirements: evaluation component presentation at a research conference Active shift towards scholarship 2 nd year scholarly block rotation added Every other month R3 methods seminar New requirements: evaluation component presentation at a research conference HRSA grant awarded: funding for scholarly development faculty Residency faculty organized 1 st poster presentations at annual RIAFP conference New requirements: NIH or CITI course (protection of human subjects in research training) HRSA grant awarded: funding for scholarly development faculty Residency faculty organized 1 st poster presentations at annual RIAFP conference New requirements: NIH or CITI course (protection of human subjects in research training)

Brown Family Medicine Residency’s Scholarly Program Progression IRB exemption application streamlined Faculty development: How to be a mentor List of faculty interests New requirements: IRB application (even if exempt) Presentation at 1 local & 1 regional (or national) conference IRB exemption application streamlined Faculty development: How to be a mentor List of faculty interests New requirements: IRB application (even if exempt) Presentation at 1 local & 1 regional (or national) conference half-day sessions added to 1st year 3 R3 seminars added educational evaluation survey design qualitative methods Evaluation rubric developed for feedback on conference presentations Faculty development series Manuscript preparation half-day sessions added to 1st year 3 R3 seminars added educational evaluation survey design qualitative methods Evaluation rubric developed for feedback on conference presentations Faculty development series Manuscript preparation

Brown Family Medicine Residency’s Plans for Next Year R3 methods seminars will be moved to early R2 Educational evaluation Survey design Qualitative methods R2 self-directed learning coach to track progress 3 half days will be blocked for R3 project work To encourage more time spent on data analysis, poster/presentation preparation, etc. Faculty development series: Mentoring best practices Moving from project to publication R3 methods seminars will be moved to early R2 Educational evaluation Survey design Qualitative methods R2 self-directed learning coach to track progress 3 half days will be blocked for R3 project work To encourage more time spent on data analysis, poster/presentation preparation, etc. Faculty development series: Mentoring best practices Moving from project to publication

Project Design Tools: Developmentally-Staged Worksheets Designed to efficiently and thoughtfully guide residents from having many vague project topic ideas through stages of:  choosing one satisfying topic choice  picking a specific project idea within that topic  developing project components and planning for implementation, data gathering and analysis  creating a preliminary yet detailed timeline

Project Design Tools: Developmentally-Staged Worksheets Worksheet series:  Worksheet 1: Topic Planning – initial exploration of merits of no more than two good ideas  Worksheet 2: Topic Rating – a more blunt rating of the two ideas re: interest, importance, feasibility, skills, collaborators, potential mentors, and resources  Worksheet 3: Initial Steps for Project Planning  Worksheet 4: Detailed Project Planning  Worksheet 5: Project Timeline  End of PGY2 rotation Checklist

Current Scholarly Development Faculty Research Director 30%  1:1 meetings to focus topics; develop project design and evaluation  supervise year 2 rotation  shepherd residents through IRB application, project design, implementation, evaluation Research Coordinator 5%  survey design/ survey tools, data analysis  assistance with poster presentation FM Faculty Champion 10%  frequent informal check ins with residents and faculty  scholarly development curriculum design/evaluation Residency Director & Residency Coordinator  protected teaching and project time  scheduling

Scholarly Presentations Residents per Class Graduating Class IRB Application Hospital Research Conference Regional Conference (RIAFP) National Conference (1)

Our Experience: Qualities of Successful Projects Experienced faculty mentor  especially one motivated to publish Narrow research question Time spent planning project & evaluation tools Earlier start  more likely to succeed and present at national conference Joint project  2 residents allow rolling start to project, maintain momentum and allow division of labor Residents who are motived by possibility of a fellowship or academic position

Breakout Groups What are challenges that you have encountered in your own residencies and solutions you have tried? 1. Time 2. Faculty Mentorship 3. Resident Motivation and Persistence 4. Research Resources

Summary Successful scholarly development curricula have:  Resident engagement  Program director support  Protected project time  Faculty involvement in research  Research curriculum/journal club  Easily accessible research professionals  Opportunities for residents to present their research