1. RESEARCH IN THE RESIDENCY

2. ACGME Program Requirements for Graduate Medical Education EFFECTIVE 7/1/2007 Common Program Requirements (FOR ALL RESIDENCIES) Residents’ Scholarly Activities

3. ACGME Program Requirements for Graduate Medical Education Common Program Requirements Residents’ Scholarly Activities 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

4. ACGME Program Requirements for Graduate Medical Education R esidents’ Scholarly Activities Family Medicine Elaboration 2.Residents should participate in scholarly activity. Each program must provide supervised experiences for all residents in scholarly activities Research Presentations at professional meetings Presentation or publication of review articles and case presentations

5. ACGME Program Requirements for Graduate Medical Education Family Medicine Elaboration Residents’ Scholarly Activities 2.Residents should participate in scholarly activity. Formal instruction and practical experience must assure that each resident develops and demonstrates skills in locating sources of scientific data pertinent to the care of patients analyzing the appropriateness of research design and statistical methods

6. ACGME Program Requirements for Graduate Medical Education Family Medicine Elaboration Residents’ Scholarly Activities 2.Residents should participate in scholarly activity. Formal instruction and practical experience must assure that each resident develops and demonstrates skills in obtaining information about diagnostic and therapeutic effectiveness applying evidence from pertinent clinical studies to patient care

7. ACGME Program Requirements for Graduate Medical Education Family Medicine Elaboration Residents’ Scholarly Activities 2.Residents should participate in scholarly activity. The program must provide a supervised, ongoing forum in which residents explore and analyze emerging scientific evidence pertinent to the practice of family medicine

8. ACGME Program Requirements for Graduate Medical Education Family Medicine Elaboration Residents’ Scholarly Activities 2.Residents should participate in scholarly activity. All residents must actively participate in scientific inquiry by Direct participation in research Or Scholarly projects that make use of the scientific methods noted above

9. ACGME Program Requirements for Graduate Medical Education Family Medicine Elaboration Residents’ Scholarly Activities 2.Residents should participate in scholarly activity. Residents must also have guided experiences in the application of emerging clinical knowledge applicable to their own patient panels. The training environment must be in compliance with accepted evidence-based practices

10. Family Medicine Faculty Guidelines The faculty must establish and maintain an environment of inquiry and scholarship with an active research component. The faculty must regularly participate in organized clinical discussions, rounds, journal clubs, and conferences.

11. Family Medicine Faculty Some members of the faculty should also demonstrate scholarship by one or more of the following: (1) peer-reviewed funding; (2) publication of original research or review articles in peer-reviewed journals, or chapters in textbooks; (3) publication or presentation of case reports or clinical series at local, regional, or national professional and scientific society meetings; or, (4) participation in national committees or educational organizations.

12. Family Medicine Faculty Faculty should encourage and support residents in scholarly activities.

13. SO… If those are the requirements…. How can we get there from here? Where are we already there? What new things are on the horizon at Allina that may help us out? Miscellaneous musings intertwined

14. ACGME Program Requirements for Graduate Medical Education C ommon Program Requirements Residents’ Scholarly Activities 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. Consider adding sessions on –formulating a research question –picking a research methodology –partnering with a statistician/design person

15. ACGME Program Requirements for Graduate Medical Education C ommon Program Requirements Residents’ Scholarly Activities –M–MN state law as applies to chart consents for research –N–NIH Human subject protection training –I–Intro to the IRB (Institutional Review Board) –E–Explaining research/study consent to patients –I–Interpreting research results to patients for use in their care

16. Where can these sessions be incorporated? Family Medicine Month Noon conference Block sessions? COPC project planning

17. ACGME Program Requirements for Graduate Medical Education Family Medicine Elaboration Residents’ Scholarly Activities 2.Residents should participate in scholarly activity. Formal instruction and practical experience must assure that each resident develops and demonstrates skills in locating sources of scientific data pertinent to the care of patients (besides UTD..) Morning Report Precepting: learn from each other and from other programs (Mark Ebell at MSU) Allina Library Resources

18. ACGME Program Requirements for Graduate Medical Education Family Medicine Elaboration Residents’ Scholarly Activities Formal instruction and practical experience must assure that each resident develops and demonstrates skills in analyzing the appropriateness of research design and statistical methods obtaining information about diagnostic and therapeutic effectiveness applying evidence from pertinent clinical studies to patient care IN a supervised, ongoing forum

19. AKA JOURNAL CLUB reincorporate EBM curriculum Require all faculty and residents to prepare a journal club (with the assistance of RB) Tune-up morning report Formal “PRACTICE UPDATES”?

20. ACGME Program Requirements for Graduate Medical Education Residents’ Scholarly Activities PLAYING TO OUR STRENGTHS COPC: a vehicle for teaching research? WE ALREADY REQUIRE COPC PROJECTS How can we grow them into research?

21. ACGME Program Requirements for Graduate Medical Education Residents’ Scholarly Activities COPC: a vehicle for teaching research? Structured time with research oriented faculty as part of project design? –NAPCRG (North American Primary Care Research Group) document on principles of research in communities : participatory research –partner with other programs doing COPC –Ann McCauley’s Community diabetes project –Qualitative research in clinical practice

22. ACGME Program Requirements for Graduate Medical Education Residents’ Scholarly Activities PLAYING TO OUR STRENGTHS COPC: Should we be sharing our projects? STFM, AAFP poster sessions if revisited as research: MAFPRN research forum and NAPCRG

23. ACGME Program Requirements for Graduate Medical Education Family Medicine Elaboration Residents’ Scholarly Activities Residents should participate in scholarly activity. Research COPC projects Faculty generated studies: Vitamin D Participation in Network studies: MAFP Research Network (MAFPRN) Collaboration with other residencies

24. National Children’s Health Study Collaboration with other departments at United: Perinatal, hospitalized patients with common problems across groups Children’s community outreach AMC Residency grads

25. ACGME Program Requirements for Graduate Medical Education Residents’ Scholarly Activities Scholarly Activity The Academic alternative to Research Review of clinical questions FPIN as in JFP (training workshop at STFM) Question generation from resident clinics and service Should each resident, or designated teams of residents be responsible for producing an inquiry?

26. ACGME Program Requirements for Graduate Medical Education Residents’ Scholarly Activities Scholarly Activity CQI Activity Problem specific audits: OB: add evidence based topics serially? Hypertension, Diabetes, Asthma Formal process improvement? Hospital QI

27. ACGME Program Requirements for Graduate Medical Education Common Program Requirements Residents’ Scholarly Activities 3. The sponsoring institution and program should allocate adequate educational resources to facilitate resident involvement in scholarly activities How does Allina define this? UFMR, Abbott IM program Protected time

28. ACGME Program Requirements for Graduate Medical Education Common Program Requirements Residents’ Scholarly Activities 3. The sponsoring institution and program should allocate adequate educational resources to facilitate resident involvement in scholarly activities Institutional Resources United E and R Foundation interested in funding small projects

29. ACGME Program Requirements for Graduate Medical Education Common Program Requirements Residents’ Scholarly Activities 3. The sponsoring institution and program should allocate adequate educational resources to facilitate resident involvement in scholarly activities Institutional Resources Allina Research Support Unit

30. ACGME Program Requirements for Graduate Medical Education Common Program Requirements Residents’ Scholarly Activities Allina Research Support Unit Under reconstruction: Current proposal will include : Resource personnel for study design, biostatistics, data collection and analysis, and grant writing Larger funding Enhanced focus on community benefit

31. Family Medicine: Faculty Guidelines The faculty must establish and maintain an environment of inquiry and scholarship with an active research component. Required partnership with residents COPC- Journal Club- Morning Report-CQI -FPIN Faculty Portfolios? Own or collaborative research THIS IS A REAL CHALLENGE FOR COMMUNITY BASED RESIDENCIES: We need to learn how other programs, especially those with a COPC focus are managing this

32. Family Medicine Faculty Guidelines The faculty must regularly participate in organized clinical discussions, rounds, journal clubs, and conferences. See previous slide AND Set goal of becoming exporters of knowledge to our community: Grand Rounds, Hot Topic Outreach to Grads, AMC

33. Family Medicine: Faculty Guidelines Some members of the faculty should also demonstrate scholarship by one or more of the following: (1) peer-reviewed funding; (2) publication of original research or review articles in peer- reviewed journals, or chapters in textbooks; (3) publication or presentation of case reports or clinical series at local, regional, or national professional and scientific society meetings; or, (4) participation in national committees or educational organizations. PLEASE COMPLETE YOUR INVENTORIES AND RETURN TO JENNIFER OLSON: we gotta start somewhere! THANKYOU