ACCREDITATION AND GENERAL INFORMATION Original Accreditation Date: March 8, 1956

Residency in Anatomic & Clinical PathologyMontefiore Medical CenterAlbert Einstein College of Medicine of Yeshiva Univ, Bronx, NY

ACCREDITATION AND GENERAL INFORMATION Original Accreditation Date: March 8, 1956Accreditation Status: Continued Full AccreditationLooking Forward to Fifty Years of Continuous FULL Accreditation

Montefiore Pathology Residency

Who are we?


Introduction

Theme & goal: kind, nurturing, competent yet visionary residencyThe major duty of the resident is to learnOne of largest pathology residencies in USACGME/RRC Fully & Continuously Approved: Pathology, Neuropathology, Hematopathology, Cytopathology; also GYN, Renal/GU, & Surgical Pathology (non-RRC)Forward looking competencies included in residency and evaluations


The Moodle Revolution


ELEARNING PROGRAM (http MOODLE://moodle.org/) http://pathology-ed.aecom.yu.edu.

Moodle is our course management system - a software package designed to help educators create quality online courses. Such e-learning systems are sometimes also called Learning Management Systems or Virtual Learning Environments. One of the main advantages of Moodle over other systems is a strong grounding in social constructionist pedagogy. Moodle is Open Source software.


MOODLE Philosophy (http://moodle.org/doc/?frame=philosophy.html):The design and development of Moodle is guided by a particular philosophy of learning, a way of thinking that you may see referred to in shorthand as a "social constructionist pedagogy".


MOODLE 1. Constructivism:This point of view maintains that people actively construct new knowledge as they interact with their environment.


MOODLE 2. Constructionism:Constructionism asserts that learning is particularly effective when constructing something for others to experience.


MOODLE 3. Social Constructivism:This extends the above ideas into a social group constructing things for one another, collaboratively creating a small culture of shared artifacts with shared meanings. When one is immersed within a culture like this, one is learning all the time about how to be a part of that culture, on many levels.


MOODLE 4. Connected and Separate:Separate behavior is when someone tries to remain 'objective' and 'factual'. In general, a healthy amount of connected behavior within a learning community is a very powerful stimulant for learning, not only bringing people closer together but promoting deeper reflection and re-examination of their existing beliefs.


MOODLE 5. Teacher: A 'teacher' can change from being 'the source of knowledge' to being an influencer and role model of class culture, connecting with students in a personal way that addresses their own learning needs, and moderating discussions and activities in a way that collectively leads students towards the learning goals of the class.


MOODLE 6. eLearningWe have made dramatic strides in our eLearning, and web based self-assessment (MOODLE MONTEFIORE), which will allow both residents and faculty to be more consistently and strongly involved in this type of communal education.


MOODLE 7. Curricula, Goals & eTestResidents are also supplied with Curricula, Goals & eTest (optimally before & after rotation) on MOODLE MONTEFIORE More robust information, e.g., ADDENDA

NB and EVALUATIONS!


MOODLE 8. Evaluations: 1. EXAMPLE OF MOODLE REMINDER FOR EVALUATION:2. CUMULATIVE EMAIL WEEKLY UPDATE OF OUTSTANDING EVALUATIONS3. Template End of Rotation COMPETENCY Evaluation of Residents4. Professionalism Self-Assessment5. Communication Skills and Professionalism 360 EVALUATION6. FINAL ASSESSMENT


MOODLE 9. Calendar - Weekly conferences:Calendar: You will find a listing of the weekly conferences that occur on the East and West campuses when we review our MOODLE SITE.Email reminder of conferences DAILY required & suggested to each resident & faculty member.


MOODLE MONTEFIORE & Community of Information:MOODLE MONTEFIORE & Community of Information: The Residency maintains active bulletin boards on jobs, meetings, and issues in pathology and medicine. This coupled with numerous mailings on issues like competency creates the connectivity glue that a thriving residency and faculty wants, benefit from and maintain spirit. The numerous events as the residents research night, the pathology annual retreat, the winter gala, the farewell and awards dinner, and the incoming breakfasts maintains this sense of community.


MOODLE & Governance:The broad based input by residents and faculty, and checks & balances in the governance of the residency are a great strength. Formal meetings on the residency occur every two weeks with the Residency Advisory Committee and then with the Chair and Chief Residents with Program Director in attendance. Decisions are typically communal, with the right to appeal and in most cases go directly to the representative RAC, which includes all the chief residents.


MOODLE MONTEFIORE our Virtual Community of Learning :Over the past two year we have actively met monthly, met as a group and had a retreat to institute construction, fielding, implementation, usage, and analysis of our Competency evaluations, goals & curricula, and self-assessment/eTests. This is all via our MOODLE Site. This has been highly successful as a way of expanding our goals via the Competencies, and impacting resident & faculty education. This modality has richly enhanced all aspects of our educational initiative and could be a Best Practice opportunity for all programs (we have shared this information with programs across North America & exhibited this at ACGME via poster & individual sessions with Drs. Leach, Nestler & the ACGME MIS group).


Moodle eTesting & Course DevelopmentCourse Management System (CMS)Web-based eTestingWeb-based updatingAutomated record-keeping of testing & surveysE-TestsCourse contentLessonsDiscussions


Moodle Faculty Training


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The Dubler Residency Ethics Curriculum: First in Pathology

Chapter I: Ethical Foundations of Clinical Practice A brief history of ethics in the clinical setting The role of ethics in clinical medicine Clinical ethics consultation Bioethics committees Fundamental ethical principles Respecting patient autonomy Beneficence Nonmaleficence Justice Principlism and alternative approaches Conflicting obligations and ethical dilemmas


The Moodle eTest


Moodle-Dublers eTest in Ethics


Moodle - ContentImagesPDFsLessonsPowerPointWord documentsDiscussions


The Moodle Site: pathology-ed.aecom.yu.eduhttp:// pathology-ed.aecom.yu.edu/moodle


Leaders in National Pathology Recruitment Module for USA Medical Schools Career Opportunities in PATHOLOGY The Intersociety Committee on Pathology Information.


National Leadership in GME & Competency Few in Pathology


ORGANIZING for COMPETENCY - Managing the Web of Governance and Institutional CultureFaculty, Residency & Associates of theDepartment of Pathology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY

Competency is an exercise in departmental partnership & collaboration. To that end, the Faculty, Residency & Associates of Pathology at AECOM/MMC (600 staff with 84 faculty, 23 residents & fellows), a mid-sized organization, began on the road to competency two years ago. Initial stimuli stemmed from the GME Committee, relaying information from ACGME generically & by specific involvement in ACGME committees. The ACGME itself broadcast & unfurled its competency banner high. National meetings (APC/PRODS) held ACGME competency seminars. The Greater New York Hospital Association (GNYHA) supplied critical high profile seminars & hardcopy competency information that were invaluable. This information was summarily hardcopy circulated to all faculty with economy, & residency responsible faculty in detail & repetitively. Email competency information was communicated with all parties in a similar mode. Competency reports & news were verbally presented by the chair (a key supporter & catalyst), program director & resident representative at four layers of faculty/residency meetings: general faculty meetings, departmental executive sessions, divisional faculty meetings, residency advisory & oversight meetings, i.e., residency board of trustees. Small goal oriented working groups are narrowly tasked to develop specific divisional toolboxes for competency application, management & measurement. Computer based learning & self-assessment devices (Etests) are being developed. Divisional faculties are now reaching out to discipline specific colleagues to share & develop tools. Lastly, faculty/residents are involved in citywide, regional, national organization committees overseeing & instituting competency. In sum:competency development & implementation is a reflection (Rorschach) of faculty/residents self-study, sense of community, & broader national influences. Implementation can be enhanced by understating that a complicated social structure exists defining an academic & clinical faculty. Recognition of this complex reality is a determinant of competency success.

OBJECTIVE STANDARDS

CLINICALLY CORRELATED CASES AND ENTITIES APPROPRIATE FOR LEVEL OF TRAINING

COMPUTER BASED LEARNING TOOLS AND SELF-ASSESSMENT

CUTTING ROOM PROTOCOLS AND PROCEDURES (CRPP)

REDESIGNED DIDACTIC LECTURE SERIES

NUMEROUS SPECIALTY CONFERENCES

RESIDENT-FELLOW LED CONFERENCES

ABSTRACT

SKILLS

KNOWLEDGE

PROFESSIONALISM

CONCLUSIONS

SURGICAL PATHOLOGY

HEMATOLOGY

AUTOPSY MEDICINE

MICROBIOLOGY

CYTOLOGY

PATIENT CARE MEDICAL KNOWLEDGE PRACTICE-BASED LEARNING AND IMPROVEMENT PROFESSIONALISM INTERPERSONAL AND COMMUNCATION SKILLS SYSTEMS-BASED PRACTICE

ACGME GENERAL COMPETENCIES

SKILL

Needs Remediation

Competent

Outstanding

Demonstrates ability to adequately describe gross specimen and obtain appropriate tissue sections

Demonstrates technical ability, timeliness, and appropriate communication when performing frozen sections

Is organized and prepared for slide sign-out, including acquisition of previous pathology material

Demonstrates the ability to communicate effectively with clinicians and other members of the health care environment

SKILL

Needs Remediation

Competent

Outstanding

Interprets peripheral smears

Performs manual differential

Interprets CBC cytograms

Demonstrates understanding of principles of hemostasis

Interprets coagulation profiles

Interprets hemoglobin electrophoresis

Interprets SPEPs, UPEPs, and IFEs

Demonstrates understanding of principles of QC

SKILL

Needs Remediation

Competent

Outstanding

Evaluates consent form thoroughly prior to proceeding

Contacts and discusses case with clinician prior to and following the autopsy

Uses proper method(s) of identification of patient prior to commencing

Submits and examines routine and pathologic sections

Completes PAD within 48-72 hours post-autopsy

Presents each adult autopsy at weekly Morgue conference

SKILL

Needs Remediation

Competent

Outstanding

Performs and interprets Gram stains

Performs and interprets Acid Fast stains

Demonstrates understanding of and can advise clinicians as to specimen collection and processing

Can identify fungi in vitro and in vivo

Demonstrates understanding of immune response to various pathogens

Demonstrates understanding of antimicrobial resistance and susceptibilities

SKILL

Needs Remediation

Competent

Outstanding

Demonstrates ability to determine specimen adequacy on a slide

Demonstrates ability in FNA palpation, aspiration and smear techniques

Demonstrates understanding of when and how to use Diff-quick vs Pap stain

Shows ability to investigate cases utilizing texts, journal articles and internet

Demonstrates ability to suggest/order appropriate, and interpret results of special and immunohisto-chemical stains

CHARACTERISTIC

Needs Remediation

Competent

Outstanding

Demonstrates commitment to ethical principles (e.g. patient confidentiality, informed consent, provision of care)

Demonstrates accountability to patients, society and profession

Demonstrates commitment to professional development and excellence

Demonstrates sensitivity to patient diversity (e.g. age, culture, gender, disability)

Competency: The Resident PerspectivePatient CareInterpersonal & Communication SkillsSystems Based PracticeProfessionalismPractice-Based Learning & ImprovementMedical Knowledge


Competency: Where we are.Competency Working GroupEvaluations, eTests, Curriculum Opportunities for Resident InputResidency Town Hall MeetingsCP Town Hall MeetingResident SurveysOpportunities to provide feedback Mid-year reviewChief Residents Meetings End-of-rotation evaluation of rotation and faculty


National Resident Perspective: Our ParticipationAAMC Organization of Resident RepresentativesUSCAP, ASCP future directionsCAP Residents ForumRetreats with residents involved in revising/modifying goals & objectivesAddition of Ethics, Professionalism, and Health Care Delivery & Management to Didactic Lecture SeriesRe-structuring of Departmental Conferences


Future Directions (1)Patient Care (Related Activities)Practicum-based evaluationsConferences that document Learning Curve Medical KnowledgeDETAILED COREFull cadre of Etests Practice Based Learning & ImprovementResident PortfoliosQuality Assurance/Improvement Studies


Future Directions (2)Interpersonal & Communication Skills and Professionalism360 evaluations support staff, techs, supervisors, lab managers, clinicians from other services, as well as supervising Pathology attending(s)Simulated professional interactionsEthicsSystems-Based PracticeExpanded Laboratory Management Component with emphasis on Pathologys role in health care deliveryMore inclusive Didactic Lecture Series


Competency Leadership: Why us?In a few short years residents and fellows will be Attending Pathologists at institutions with residency training programs and will be (to some extent) responsible for that program remaining accredited on the basis of their ability to produce COMPETENT pathologists.

If we are part of the process now, we will understand and control what we need to do later!!


Thanks for Presentation Help.Dr. Tylis Chang Moodle PresentationDr. Samson Fine Competency PresentationMs. Betty Edwards Residency Information


Half-a-Century of Educational Excellence: Past, Present & Future


The espirit


Leadership in National GME & Competency Few in PathologyCompetency: The Resident Perspective

ACCREDITATION AND GENERAL INFORMATION Original Accreditation Date: March 8, 1956

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Transcript of ACCREDITATION AND GENERAL INFORMATION Original Accreditation Date: March 8, 1956