Children’s Research Institute | Academic Annual Report 2017-2018

Innovation Through Collaboration

Institutes, Centers, & Offices

Medical Education Report to the Children’s National Medical Staff

Vision: Children’s National Health System faculty educational programs continually develop and use innovative strategies to prepare the pediatric experts of tomorrow, while providing the highest quality family-centered care for patients today.

Children’s National remains fully accredited in the Next Accreditation System (NAS). The NAS requires increased accountability from academic medicine leaders. As a component of NAS, the ACGME created a Clinical Learning Environment Review (CLER) program to assess the learning environment of GME programs at sponsoring institutions. It focuses on six focus areas: patient safety; health care quality; care transitions; supervision; well-being; and professionalism.

In July 2016, Children’s National Health System was awarded a four-year ACGME grant: “Pursuing Excellence in the Clinical Learning Environment.” Each of the eight awardee institutions is charged with designing and piloting innovative and interprofessional programs to improve the clinical learning environment to optimize the development of all health care professionals and the safety and quality of care for all patients. Children’s National was the only children’s hospital to receive one of these grants. Throughout the grant term, the eight institutions collaborate on their institution’s program progress with the end goal of deploying a combination of the most effective programs to the 800 ACGME-accredited institutions nationwide.

For the past year and half, the Office of Medical Education has partnered with nursing education, simulation, quality and safety, strategy and other internal stakeholder groups to develop and pilot the first arm of its educational programing.The programs are aimed at improving front-line providers’ quality improvement and safety competency, as well as increasing cases of interprofessional teamwork and communication.

  • Simulation: In fall 2016, Children’s implemented an interprofessional simulation program across the organization, engaging 1,400 clinician participants.
  • QI Education (QuILT and IQI): In spring 2017, the team launched a Quality Improvement for Leaders Training (QuILT) program for ACGME fellowship program directors. As an expansion of an existing nursing QI fellowship, nursing fellows will be paired with physicians to pilot the Interprofessional QI (IQI) program.This is a deliberate effort to engage various disciplines in order to learn and conduct QI projects in an interprofessional manner.
  • QI Academy: Modeled after the CAPE medical education program, a Quality and Safety Academy will be established in 2018 to develop an interprofessional cohort who will work on quality and safety programs to improve care and develop generalizable QI knowledge.
  • Quality and Safety Online Portal/Modules: An interactive "Patient Safety Passport" online portal was created in 2017 to provide foundational safety knowledge in an interactive electronic environment. The portal collects, integrates, and aggregates data from the participating residents, nurses, ancillary staff and faculty to determine the effectiveness of the e-module educational interventions.

Organizational quality, safety and culture measures will be correlated with the data obtained through the simulations, QI trainings and online portal. These measures will help Children’s National better understand the workforce’s knowledge and capacity in patient safety and quality methods as well as identify subsequent areas of focus for improvement.

Leadership

Mary C. Ottolini, M.D., MPH, Vice Chair, Medical Education and Designated Institutional Official; Chair, Graduate Medical Education Committee

Medical Education Programs

Graduate Medical Education Committee (GMEC) Activities

The Graduate Medical Education Committee (GMEC) is charged by the ACGME with overseeing the residency and fellowship programs to ensure the quality of the clinical education, conferences, and blended learning resources so that all trainees meet or exceed competency expectations. In addition to clinical excellence, the GMEC also promotes scholarly inquiry by trainees to investigate new approaches to diagnose and treat disease, with the goal of improving the health of children in the region, across the country and around the world.

Over the course of the year, the GMEC approves new programs and program directors, shares best practices in documentation and evaluation, solicits areas for improvement from residents and fellows, reviews onboarding procedures, resident supervision, resident responsibilities, resident evaluation, compliance with duty-hour standards, and resident participation in patient safety and quality of care education. During the 2016-2017 academic year Children’s National approved a GMEC SCORECARD to track compliance with ACGME requirements and program quality.

Children’s National sponsors 23 ACGME-accredited fellowship training programs, including Medical Genetics and Hospice & Palliative Care, which recently applied for endorsement and received “initial accreditation,” the highest status granted to new programs. Pulmonary medicine is partnering with George Washington University (GW) to start a pediatric sleep medicine track this year. Surgical critical care is also in the processing of submitting a proposal to start a new fellowship program sponsored by Children’s National. All other programs continue to function with “continued accreditation.”

As most GMEC programs will not undergo an ACGME site visit until 2021, the GMEC developed and approved a special program review protocol, designed to identify underperforming programs.

Pediatric Residency Program

Recruitment

In June 2017, the Pediatric Residency Program welcomed 40 new interns with impressive and diverse backgrounds in research, advocacy, global health and medical education from medical schools across the country and around the globe. Receiving over 2,400 applications, the Children’s National program remains one of the most competitive in the nation, with submissions from two-thirds of all fourth-year U.S. medical students applying in pediatrics. The overall quality of matched candidates keeps improving, with approximately 40 percent being inductees into the prestigious Alpha Omega Alpha honorary medical society and 20 percent self-identifying as under-represented minorities in medicine.

The Children’s National pediatric residency program trains a total of 117 residents. The program has five tracks that candidates match into through the National Resident Matching Program (NRMP): Categorical, Community Health, Primary Care, Child Neurology, and Medical Genetics. Program graduates go on to be leaders in community pediatrics, public health and subspecialty care. The graduates go on to top fellowships at Children’s National and other elite institutions across the country.

Scholarly Productivity

At Children’s National, pediatric residents may apply for protected time (one-half day per week during their second and third years) to work on a mentored, longitudinal research project through an innovative program called REACH (Research, Education and Advocacy in Child Healthcare). During academic year 2017, pediatric residents authored 29 publications, presented 28 projects at major national or international research conferences and were awarded two prestigious national awards (the American Medical Women’s Association Susan L. Ivey Courage to Lead Award and the inaugural President Bill Clinton Innovation Award for Health Care Provider Training & Education).

Educational Innovation

By providing world-class education and training to pediatric residents in a nurturing environment, the pediatric residency program works to improve child health at local, regional, national and global levels through clinical care, education, advocacy and research. Children’s National residency program provides extensive training in pediatric subspecialty care, as well as a superb foundation in general pediatrics. Despite the size and diversity of the program, Children’s National remains focused on the growth and development of each resident.

As part of an individualized approach to training, the residency program is proud to announce the development of six optional pathways: Global Health, Child Health Advocacy and Public Policy, Hospital-based Careers, Primary Care Careers, Medical Education, and Intensive Research. With focused mentorship and a variety of pathway-specific opportunities, residents can structure their elective time in a deliberate, longitudinal manner based on personal and professional interests. Upon graduation, residents who have completed pathway requirements are eligible for a certificate of completion.

Medical Student Education

Children’s National continues to have over 180 GW medical students annually completing their third-year pediatric core clerkship for inpatient and outpatient rotations, with Holy Cross Hospital also providing opportunities for inpatient rotations. Under the leadership of Craig DeWolfe, M.D., the pediatrics clerkship continues to be the highest-rated clerkship at GW, with ratings on the graduation questionnaire far above the national average for a pediatric clerkship. Children’s National earned these ratings through its outstanding educational curriculum and its diverse and highly skilled faculty, fellow and resident educators. The clerkship includes family-centered rounds, clinical reasoning, active learning, simulations, and employs active feedback and observation techniques along with reflection and the incorporation of the humanities.

Children’s National offers more than 30 senior pediatric electives and hosted more than 200 fourth-year medical students, with a near even split among GW, national and international medical schools. Jeremy Kern, M.D., in his second year as the electives director, leads a month-long capstone course which provides graduating medical students with innovative experiential learning through simulated and hands-on activities, allowing students to practice and consolidate learned knowledge to proceed with confidence as interns providing care to patients.

Under the leadership of Gabrina Dixon, M.D., leadership, all 120 medical students from Howard University (HU) now rotate for three weeks at Children’s National during the inpatient portion of their pediatrics clerkship. Students are taught and supervised by faculty members leading the four Hospitalist Academic Team Services, as well as the Pulmonary/Adolescent Medicine Service. The HU are afforded all the same learning opportunities as the GW students.

In addition, third-year GW medical students rotate on the Neurology, Neurosurgery, Psychiatry, and Surgery Services. Overall, Children’s National trains more than 500 medical students each year.

eLearning Center

In 2017, Children’s National continues to transform online medical education throughout the world by creating immersive clinician-centered training products and learning platforms across disciplines and medical genres. Children’s National has developed education portals for residents, fellows, hospitalists, nurses, geneticists, military, clinical researchers, patients and their families.

Continuing Professional Development

Each week over 200 pediatric health care professionals and researchers attend grand rounds in person or virtually through Webex to interact with experts from Children’s National as well as other internationally renowned child health leaders. The highly rated grand rounds cover the latest developments in clinical care, educational innovation, clinical and translational research. The department offers over 350 additional continuing medical education sessions for various divisions throughout Children’s National.

In addition, the department offers an annual, week-long Pediatric Board Review Course with many in-person and online course materials for those taking certifying exams for the first time and those maintaining American Board of Pediatrics Certification. There were a total of 49 respondents in 2017 (roughly 50 percent of attendees), of which, 94 percent had a very positive opinion of the course. The same number of participants shared that the course increased their confidence in preparing for the ABPN exam and 75 percent of respondents felt their test-taking skills improved because of the course. Additionally, 92 percent of respondents thought the educational content was excellent and 94 percent thought the design and organization were excellent and would highly recommend the course to their colleagues.

The Board of Visitors Simulation Program

Mary Patterson M.D., M.Ed., the associate vice chair medical education research, co-leads the inter-disciplinary program with Simmy Randhawa DNP, MS, MBA, RN-BC, NE-BC. Dr. Patterson was the principal investigator for the ACGME Innovators grant. She currently leads the simulation component of this initiative, to train all physicians and nurses in principles of patient safety.

Over 1,400 nurses and physicians were trained in the initial wave. The Simulation Program is in the process of beginning part II of the ACGME simulation program. Modules focusing on ACAs and RCAs with accompanying interprofessional in situ simulations will begin in the first quarter of calendar year 2018. The program is also continuing to expand the interprofessional academic in situ simulations with the academic teams.

CAPE: Children’s Academy of Pediatric Educators

Twenty-six of the most talented and dedicated clinician educators at Children’s National are members of CAPE. The academy is directed by Dr. Patterson, with educational consultant Ellen Goldman, Ed.D. To join CAPE, a faculty member must have a solid background in adult learning theory and educational research methods, based on completing a year- long Master Teacher Leadership Development Certificate Program offered by the Graduate School of Education at GW or a similarly rigorous program. In addition, to be selected as an academy member, faculty must be engaged in conducting an educational research project that will enhance patient care quality and safety. CAPE projects utilize a blended learning approach, combining eLearning with simulation to provide doctors and nurses with shared background knowledge and opportunities for team-based deliberate practice.

Institutes, Centers, & Offices

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