Archive for: orientation
Training modules for computer systems prepare residents for patient care
Congratulations to Anne O’Hearn C-TAGME from Albert Einstein Medical Center, in Philadelphia, PA. She won free registration to the 4th Annual Residency Program Management Workshop!
The following describes how e-learning modules have shortened her resident orientation and better prepares trainees for their first day of patient care duties.
Bring spouses/signficiant others into the loop on residency program events
I took my dog to the veterinarian this morning, and the vet happens to be the wife of one of my interns. (It’s not a big town here)
While examining my dog, she said, “Hey, isn’t there some sort of intern dinner next week? I think so, but I’m not sure because my husband NEVER TELLS ME ANYTHING!”
Now, while I completely sympathized with her (because my husband never tells me anything either) it occurred to me that I could start an e-mail list for spouses and significant others. This would allow me to communicate with them about major program dates and events. I think bringing them into the loop will not only help their family, but it will help ensure that my residents are as successful as possible at making it to program functions.
How do you communicate with your residents’ spouses/significant others? Anyone have any experiences to share in this area? Leave a comment in the box below.
Fellowship Forum: From Match to orientation
According to the NRMP General Schedule of Dates, it looks like fellowship programs Match at all different times of the year:
- Allergy & immunology in May
- Internal medicine and radiology in June
- OB/GYN and anesthesiology in October
- Ophthalmology in December
- Pediatric and surgery fellowships in any month you can name
So what happens during all the time between Match Day and when the new fellows actually arrive for orientation?
We used to keep in vague touch with the incoming fellows, but these folks kept contacting us to be sure they were expected. And we’d wonder if they were still coming. Although the NRMP makes matching a legal issue, it’s still a “long time – no see” situation.
To settle our nerves about this communication gap, we now send a letter of confirmation” immediately following the Match Day. Here’s what’s in it:
- A personal welcome for the fellow, to the institution, department, and program.
- The official training dates expected for the coming year.
- The date they must arrive for GME orientation, if earlier than the department orientation.
- The post graduate year (PGY) they will be upon entering.
- Notice of when they can expect to receive the GMEC Contract or Agreement of Appointment, which will include proposed salary, perks, credentialing process, and other information.
- Contact information for the program director and coordinator.
- Signature of the program director.
- Request that they sign the letter and return a copy to you.
This form of correspondence provides an extra secure feeling, so we coordinators can breathe easier until the next July first, and the beginning of the new academic year.
p.s. Good luck with your Match this year, whenever it is!
How do you keep in touch with your fellows and avoid the long-time-no-see problem? Leave a comment in the box below.
Learn your new interns’ names and faces
Does everyone hand out a face sheet, or something similar, of their new interns or fellows each year? If not, it’s a very useful resource and service!
OSCE activities for residents
In the April issue of Residency Program alert, I profiled Charleston Area Medical Center (CAMC) and the institution’s use of an OSCE during orientation to gauge new resident’s skills.
During the OSCE, residents must:
- Perform a H&P using a standardized patient
- Perform a clinical procedure using a standardized patient, partial task trainer, or hybrid combination
- Write orders for tests, labs, etc., based on their assessment
- Interpret test or lab results
- Present findings to an attending physician
- Complete a team-based ACLS activity as part of the patient cases
As you can imagine, it takes CAMC quite awhile to do all of these activities with all of their incoming residents and not everyone can be working with the standardized patients at the same time. CAMC rotates residents in groups through the OSCE as well as two other activities to ensure everyone is busy.
The first activity is a test using questions from the USMLE Step III practice exams, says Gordon Green, MD medical education consultant at CAMC. This gives program directors and faculty members a heads up on who may have trouble passing the real exam, and they can work with these residents to better prepare them for the exam.
The second activity also has to do with passing exams. Residents attend an exam preparation course to find out whether or not they have difficulty with exams from a skill perspective, anxiety, or deficits in knowledge. “We provide them with advice on how to improve their standardized exam taking ability,” Green says.
For those of you who do OSCEs in your institution/program, what do you have residents do while they wait to go through the various stations?
Residency observer release
A couple of people commented about the release form Diane referred to in an earlier post describing how her program lets incoming residents shadow for a day before orientation.
In her institution, observers must sign a release before shadowing. Because the interns are not employees yet, they have to abide by the observer policy.
Download the hospital observer policy.
From Savannah: Day 2 at AHME
The conference really kicked in to high gear this morning, so I decided to whip up a quick post before we go back to more sessions after the afternoon break.
I attended a very informative and helpful session on institutional orientation this morning, presented by Carrie Eckart, MBA, director of GME at Albany Medical Center. Here are a few tidbits I picked up:
- As you know, both programs and institutions send new residents an overwhelming amount of paperwork prior to orientation. In addition to including a checklist of documents residents must return to them, Eckart’s institution also posts a spreadsheet online that tracks what documents the GME office has received. Residents can log on and see the spreadsheet too. She said this has cut back on the number of phone calls the GME office receives from residents wondering if their materials made it to them.
- Create a master orientation schedule for each specialty and include it in the orientation packets for residents. The GME office collaborates with each specialty and creates a calendar specific to each program that shows when orientation is and other related activities. This makes it easier for residents as they only have to refer to one sheet of paper to find out where they need to be.
- Invite spouses to hear the talk on benefits information. The spouses are the other stakeholder when it comes to choosing benefit plans, so it’s not a bad idea to invite them to hear your HR person explain the plans.
- Enlist the new chief residents to be Incoming Resident Advisors, and ask them to be available to new residings via e-mail during April, May, and June.
- Don’t distribute an agenda; otherwise, attendees may just look for the sessions they think are interesting/most relevant and skip out on the rest. Eckart also saves benefits information as the last program of the day because that’s something most feel they need to stick around for.
That’s a summary of the tips Eckart gave. . . What tips do you have for ensuring residents don’t leave or skip out on important sessions during orientation? Leave them in the comment box below!
Also of note: I heard an excellent presentation this morning by the ACGME’s Timothy Brigham, MDiv, PhD comparing the challenges graduate medical educators face in teaching residents and dealing with faculty and hospital administration to the book Beowulf. Now, remembering Beowulf from my high school English class, I was skeptical this was going to be any good, but it was wonderful, and I recommend that if Brigham is speaking at a conference you’re attending to definitely sit in on his session.
Shadowing opportunity for new residents
While we’re on the topic of orientation. . .
We offer a morning of optional “shadowing” for all of our incoming residents. I think a lot of places may do this, but it’s new for us in the last few years.
They are generally quite nervous before they start, and they get really antsy during orientation because all they can think is “what is it going to be like?”
We let them come in one morning and round with an inpatient team. Because they are just observers, they aren’t affecting the teacher/learner ratio. We have them fill out the requisite releases ahead of time, and then they just hover and watch. They can also stay for lunch if they want to.
I find those who take advantage of this opportunity focus better during the actual orientation as it creates a mental context. It also helps them to feel more comfortable, and it generates some questions that they would not otherwise have had.
About 30% take advantage of this opportunity.
Do you offer something similar in your programs? Tell us about it in the comment box below.
Sample pre-orientation e-newsletters
Ask and you shall receive!
As the first post indicated, Diane sends these e-newsletters out about once a week between Match and orientation. Being the good sport that she is, Diane shared two sample issues: The first is the introduction newsletter she wrote for this year’s new residents. The second is an example of an issue she sends out later in the summer, introducing current residents and some of the new ones.
One warning: Diane says don’t panic when you see how long the intros are for each resident in the second sample newsletter. She loves to write and goes all out. You certainly don’t need to.
Special note for RPA subscribers: I wrote an article about Diane’s e-newsletter in the May 2008 issue of RPA. You can read more about what Diane includes in each issue, why, and get an outline of what each issue includes. Access the archives by visiting HCPro’s Web site. You will have to log in to see past issues. Just click on Archives, then 2008, and then under May, look for the article entitled, Give new residents a head start on orientation. (I know, I used the same title for the blog post–I can only be so creative!)
Time saving strategy: Give residents a head start on orientation
Editor’s Note: You can now find sample issues of the e-newsletter by clicking here.
The period of time between Match Day and orientation is a flurry of activity for residency program coordinators. Not only are you credentialing newly matched trainees, you’re organizing orientation, re-credentialing your current housestaff, planning for their rising year orientation, overseeing exit procedures for graduates, and arranging all end-of-the-year evaluations. Oh, and did I mention you’re also orienting a new batch of chief residents?
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