Articles
New academic year brings renewed focus on faculty engagement
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The first in a new series of faculty engagement events kicked off September 13, with several physician faculty members in attendance. Physicians who work directly with resident physicians or serve in an advisory role for the program are invited to the monthly sessions as a way to stay up to date on program news and details of interest, receive helpful tips to enhance their role as an educator, and allow a forum for general discussion, questions and answers. In order to accommodate physicians’ busy schedules, the events will be offered at three different times each month in Magnolia Room 1 of the BMH-NM Medical Plaza One building.
The October sessions will be held on Tuesday, Oct. 11, from 7:00 – 8:00 a.m. and Wednesday, Oct. 12, from 12:00 – 1:00 p.m. or 5:00 – 6:00 p.m. Please be sure to mark your calendar for these valuable meetings! |
Helping Struggling Learners Succeed Through Resident Coaching
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Time and again, psychological studies show that one of the main differences between weak and strong students is metacognition (a student’s awareness of his or her level of understanding). Good students know when they have mastered material, but weaker students tend to be grossly overconfident. Among medical residents, this can certainly be a problem for those struggling to keep up with the pace of clinical duties, daily learning of knowledge and skills, and a myriad of other responsibilities. A new resident coaching model is emerging in residency programs to help these aspiring doctors improve quickly in their training. In the following Q&A with Roy Phitayakorn, MD, I explore the reasons why residents might be having problems and what the mentoring model can do to help. Dr. Roy Phitayakorn is a general and endocrine surgeon and the Director of Surgical Education Research at Massachusetts General Hospital and an Assistant Professor of Surgery at Harvard Medical School. He is also the Education R&D consultant to NEJM Group. Josette Akresh-Gonzales: In an article called “Why we overestimate our competence” on the American Psychological Association blog, Cornell University social psychologist David Dunning, PhD, reports that “the least competent performers inflate their abilities the most…[and] the reason for the overinflation seems to be ignorance, not arrogance.” Does this finding apply to resident physicians? If so, what are some ways that residents can become more aware of their need to improve?Roy Phitayakorn, MD: Resident physicians are under enormous competing pressures with little or no feedback on their actual performance. Sometimes the feedback they do receive is contradictory, so they are uncertain if they really need to improve in a certain cognitive/behavioral domain or not. Therefore, I think the best way for residents to improve is to look at their data as a whole and spend some time doing guided reflection with a coach or mentor on what the data show exactly and how or what they want to improve. JAG: What are some of the other factors that contribute to a resident failing an in-training or board certification exam, say, or not meeting expectations in clinical tasks?RP: One approach to classifying resident deficiencies is the KSA approach — Knowledge, Skills, and Attitude. Let’s take them one at a time: Residents’ performance deficits on knowledge-based assessments may be a result of their not prioritizing time to study, studying incorrect materials, or poor test-taking skills. Skill deficits, such as problems with doing certain clinical procedures, may require more effective practice time as well as expert feedback to accelerate learning of new skills. Attitude issues may stem from psychological well-being challenges such as burnout. In my opinion, attitude issues are the most difficult ones to address — and are so often the most ignored within a residency program until a critical issue gains the attention of the patient safety group or the hospital’s medicolegal team. Of course, medical problems such as hypothyroidism or attention-deficit disorder may also cause issues in any of these domains and should be ruled out early. JAG: Can you discuss the recent trend to assign mentors or coaches to struggling residents?RP: We recognize that all physicians, residents and attendings, benefit from mentorship and coaching. Unfortunately, the ones who need it most are often unsure about how to find a mentor or coach to help them. Therefore, many residency programs have started assigning all resident physicians a mentor and/or coach to help them navigate their development into caring, highly-skilled physicians. These programs often consist of regular meetings where the residents will review their evaluation data with their mentor/coach and create an action plan about what they would like to improve before their next meeting. NEJM Knowledge+ is a great way to receive objective data about how a resident’s cognitive knowledge is developing and could be used for remediation as well. JAG: Yes, in fact, program directors have access to numerous reports in NEJM Knowledge+ showing residents’ progress through the learning material and their performance in specific topic areas. Do you think a resident coach can also help to improve a learner’s self-awareness over time?RP: Metacognition is difficult to develop without both objective data, feedback, and a willingness on the resident’s part to change. I think emotional intelligence is a hidden piece to some of that willingness to accept feedback and change behaviors that do not reconcile with objective data. Regular assessment and development of emotional intelligence is standard practice in many industries except medicine. Hopefully we will catch up someday as more research is published in this area. JAG: Can you recommend good resources for coaching residents in general and coaching them on self-awareness in particular?RP: The first thing I’d suggest is to look to working resident coaching and mentoring programs as a model, such as the one at Massachusetts General Hospital (MGH): MGH Internal Medicine Professional Development Coaching Program. There, “Each trained volunteer faculty member coaches two to three residents and remains their coach for their entire residency. All residents are included in the coaching program. Interns and faculty meet quarterly, usually for an hour each quarter.” And at Stanford School of Medicine, the Stanford Pediatric Residency’s Coaching Initiative provides “longitudinal assessment and feedback to residents throughout their training, and to help residents develop skills of lifelong learning and self-reflection. Each resident is assigned a specific Faculty Coach who observes and guides that resident across multiple rotations, inpatient and outpatient settings, and training years. The Coach observes the resident in multiple clinical situations (rounds, clinic, initial H&P, handoffs, supervisory encounters, care conferences, and others) and provides specific and directed feedback aimed at strengthening clinical skills.” Another resource is this slide set provided by the Massachusetts Medical Society, entitled “Physician Coaching and Mentoring Programs: Surviving the Tsunami of Change,” Presented by Susan F. Reynolds, MD, PhD., President and CEO of The Institute for Medical Leadership, to the Massachusetts Medical Society’s Physician Leadership Institute, on February 1, 2012. It includes information on setting up a trusting relationship between coach and resident, and using goal setting and accurate data to drive ongoing conversations. Here’s a sample piece of advice from that presentation: Best Physician Coaching Strategies
- SOURCE: NEJM Knowledge Plus |
Planning underway to recruit third class of resident physicians
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Fall isn’t the only season that is ushered in when the leaves and temperatures start to drop. The residency recruitment time of year ramps into full swing in a few short weeks, and planning is underway to welcome the third class of resident physicians to Oxford, MS. The next group of 12 interns will bring the program up to its full complement of 36 positions when they begin their training in the summer of 2023. A notable difference this year will be the shift exclusively to in-person interviews during the recruitment period. Applicants will be able to experience Oxford, BMH-NM, and all the surrounding areas have to offer during these visits, which are scheduled for the following dates:
On the evening before these dates, a group of resident physicians will accompany the candidates to dinner in Oxford to get to know their potential co-residents in a casual setting. On interview days, the prospective resident physicians will spend the day in the hospital and in the Baptist Medical Group – Oxford Internal Medicine Clinic learning about day-to-day flow, curriculum, attending didactics, and interviewing with program faculty and leadership. After a welcome breakfast and Town Hall session, they will break into groups to progress through their schedule that rotates between interviews, hospital and clinic tours, and resident physician roundtables. To enhance the in-person experience, roundtable sessions with faculty and administration have been added this year. From 1:50 p.m. - 3:25 p.m. on each of the days above, applicants will be hosted in the Physicians’ Lounge for informal meet and greets and discussions with any physicians on the general medical staff and Baptist leaders who are available. We encourage you to mark your calendars and find time to meet them. After the visit and interview days conclude, programs and applicants will submit their rank order lists to the National Residency Match Program (NRMP) by March 1, 2023. Match Week begins Monday, March 13, culminating in Match Day on Friday, March 17. |
