Residency Retreat

The UPMC Eye Center has grown significantly over the last 5 years. The complement of clinical faculty has increased in number from about a dozen to nearly double that.  Patient care activities are no longer exclusively in Oakland. We now have increasingly busy practices at Mercy, Wexford, Bethel Park, St Margaret's and Monroeville.  There is no doubt that the Eye Center will continue to grow over the next five years.

As the Eye Center grows it is important to ensure that our residency and fellowship programs grow and change to make the best possible use of all of the educational resources available. 

It is with this in mind that I ask you to attend a half day retreat  to discuss the future of our residency program at at the Herberman conference center on the morning of January 10 from 8 am until noon.

 

Objectives Overview

The major focus of the retreat will be the creation of a five year plan for the program.

We will begin with a review of the state of the program at present. We will review the current rotations, conference schedules and other elements of the curriculum with an eye toward identifying opportunities to improve our ability to teach to our own goals and objectives as well as to the ACGME core competencies and outcome project.

Clinical Rotations

The "ACGME Program Requirements Document" for ophthalmology states that

"Each resident must have major technical and patient care responsibilities in order to provide an adequate base for a comprehensive ophthalmic practice."

To this end we will examine the experiences of our housestaff during each rotation and discuss the balance of time devoted to each of the subspecialty disciplines of ophthalmology. We will examine the current experiences within each rotation and discuss the balance of time devoted to surgical and clinical experiences as well as the time devoted to experiences at the Oakland campus, the Mercy campus and the community based practices.

The retreat attendees will divide into breakout groups to discuss individual clinical rotations. The break-out groups will report back to the group as a whole after these sessions.

Clinical Conferences

From the ACGME website:

"The ACGME Outcome Project is a long-term initiative by which the ACGME is increasing emphasis on educational outcome assessment in the accreditation process. Expectations for increased emphasis on outcome assessment are reflected in changes to Program and Institutional Requirements."

OKAP exam performance and performance on the ABO written and oral examinations are familiar examples of outcomes assessments that address the "medical knowledge" competency. The performance of our program on these assessments has been variable and in some years suboptimal. It is important that we explore the reasons for our past performance and identify possible means by which to improve future performance.

To this end we will examine and discuss the structure and content of the medical knowledge curriculum as represented by the current conference schedule. In addition we will discuss additional means by which the program may improve its performance on these important outcomes.

The retreat attendees will divide into breakout groups to discuss individual clinical conference schedules, formats and content. The break-out groups will report back to the group as a whole after these sessions.

Conclusions / Creation of a plan of action

The retreat attendees will review the conclusions and recommendations from the clinical rotation and clinical conference reports and create a list of action items for the residency committee and residency program director.

Topics for future retreats

As the residency program grows along with the department it is important that the program undergoes a continuous process of self-evaluation and improvement and that this improvement is driven by input from all stakeholders in the resident education process. We cannot hope to address every aspect of the training program during this first retreat. We will end the retreat by discussing our priorities and agenda for the coming year and future residency retreats.


           
Introduction

  • Welcome and Introduction
  • Goals and objectives of the residency program
    • Our stated goals and objectives
    • ACGME Core Competencies
    • Other ACGME requirements
  • Review of the program at present
    • Rotations
    • Conference Schedule
    • Surgical Lab
    • Scholarly Project
    • Journal Club
    • "Crash Course"
    • Ophed Website
  • Clinical rotation break-out groups
    • Is the appropriate amount of time given to clinical experiences in this rotation? Is the rotation designed to meet our goals and objectives? Is the rotation designed to make use of all available clinical instructors and sites? Is the rotation designed to properly balance clinical and surgical instruction?
      • For this session we will have information available to us on clinic volumes by service by site, and faculty by site.  We will also have data regarding current resident surgical volumes on each service at each location, as well as positive aspects of these rotations (e.g. great teaching) and areas for improvement (e.g. surgical cases not turned over to the resident).
      • Session one (5 groups)
        • Glaucoma
        • Retina
        • Neuro-ophthalmology
        • Cornea
        • Oculoplastics
      • Session two (4 groups)
        • Consult / ED
        • Comprehensive
        • VA
        • New Mexico
        • Pediatric Ophthalmology
      • Session three (4 groups)
        • Pathology
        • Low vision
        • Contact Lens
        • Uveitis
  • Clinical rotation break-out group reports
  • Clinical conference break-out groups (One session, 4 groups)
    • Schedules
      • Are all topics best taught across the year in one hour sessions? Are some topics best taught in concentrated daily short courses or multiple hour weekend or evening symposia?
    • Formats
      • The retention rate of knowledge from passive learning during slide lectures is reported to be poor. Resident case presentation formats tend to ensure that one resident has participated in "active learning" By what means can we ensure that all residents in attendance at a conference are "active learners?"
    • Content
      • Should our conference series be based on
        • the material covered in the BCSC?
        • The interests and expertise of our faculty?
        • Our goals and objectives document?
    • Additional means of addressing "Medical Knowledge" competency
      • quizzes
      • self-evaluation / learning portfolios / reading logs
      • online courses (REC, OphEd)
      • other
  • Clinical conference break-out group reports
  • Conclusions / Formation of a plan of action
  • Agenda for next retreat