Academy of Distinguished Medical Educators - Pritzker School of ...

Academy of Distinguished 

Medical Educators 

Medical education day 

Thursday, November 17, 2011 

Proceedings

the acadeMy of distinguished Medical educators 

Medical education day 

thursday, noveMber 17, 2011 

The Academy of Distinguished Medical Educators was founded in 2006 to support and promote research, 

innovation, and scholarship in medical education at the University of Chicago. The Academy is led by 

Halina Brukner, MD, Professor of Medicine and Associate Dean of Medical School Education. 

In addition to hosting Medical Education Day, the Academy sponsors faculty development workshops 

throughout the year and funds scholarship in medical education. 

Keynote Speaker 

Lisa Coplit, MD 

Associate Dean for Assessment and Faculty Development 

Associate Professor of Medicine 

Quinnipiac University School of Medicine 

Clerkship and Program Directors’ Education Workshop 

Gordon Center for Integrative Science, Room W301-303 8:00-11:30 am 

Residents ARE Teachers 

Halina Brukner, MD; H. Barrett Fromme, MD, MHPE; and the Residents Are Teachers 

Steering Committee 

Keynote Address 

UCMC P-117 12:00-1:00 pm 

The Value, Rewards, and Evidence for Residents as Teachers 


Poster Session 

DCAM 4 th Floor Atrium 2:00-4:00 pm 

Innovations and Research in Medical Education at the University of Chicago 

Plenary Poster Presentations: Three Oral Abstracts 


• Geriatrics and Aging through Transitional Environments (GATE) MS1 Curriculum: Obtaining a 

Functional History 

• The Use of an Educational Simulation to Improve Neurology Resident Knowledge of and Experience 

with Thrombolytic Therapy 

• Characterizing Physician Listening Behavior During Hospitalist Handoffs using the HEAR 

Checklist 

Awards Ceremony & Reception 


Induction of new Masters and Fellows of the Academy of Distinguished Medical Educators 

Presentation of the LDH Wood Teaching Scholar Award 

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Table of Contents 

Keynote Speaker .......................................................................................................................................................1 

LDH Wood Teaching Scholar Award....................................................................................................................2 

Founding Members of the Academy ......................................................................................................................3 

Masters of the Academy .........................................................................................................................................4 

New Masters of the Academy ................................................................................................................................5 

Fellows of the Academy .........................................................................................................................................6 

New Fellows of the Academy .................................................................................................................................8 

Poster Listings 

Medical Education and Innovation 

1. Learner Perceptions of an Ad-Hoc versus Modular Didactic Curriculum in Emergency 

Medicine Residency ....................................................................................................................................12 

Lindsay Jin, MD; James Ahn, MD; Christine Babcock, MD, MSc 

2. Entrustment, Supervision and Autonomy of Housestaff During Inpatient Medicine 

Rotations: A Qualitative Study ................................................................................................................13 

Kevin Choo, MS3; Vineet Arora, MD, MAPP; Paul Barach, MD, MPH; 

Jeanne Farnan, MD, MHPE 

3. Survey of Problem Based Learning for Medical Student Pain Curricula .........................................14 

Dalia Elmofty, MD; Magdalena Anitescu, MD, PhD; Ashley Agerson, MD 

4. Teaching Self-Directed Learning: Can This Be Done? ..........................................................................15 

Susan Glick, MD; Jennifer Glick, ; Maureen Willcox, MS4; Patrick O’Connor; 

Michael O’Connor, MD 

5. Use of Problem Based Learning Discussions To Allow Medical Student Cognitive Autonomy .....16 

Michael Hernandez, MD; Igor Tkachenko, MD, PhD; Catherine Bachman, MD 

6. Visual Art and Medicine: A New Elective for 1st, 2nd and 4th Year Students at Pritzker ............17 

Nicole Baltrushes, MS4; Celine Goetz, MD; Laura Hodges, MS4; Joel Schwab, MD 

7. Clinical Simulation Initiative in Psychiatry for Medical Students: Development of a 

Free National Database .............................................................................................................................18 

Michael Marcangelo, MD; Angela Blood, MPH, MBA; Laura Hodges, MS4 

8. Geriatrics and Aging through Transitional Environments (GATE) MS1 Curriculum: 

Obtaining a Functional History ..............................................................................................................19 

Seema Limaye, MD; Shellie Williams, MD; Sandy Smith, PhD; Aliza Baron, MA 

9. Responding to Student-Identified Learning Needs: A Mixed Method Survey to Guide 

the Family Medicine Curriculum .............................................................................................................20 

Kohar Jones, MD; Mari Egan, MD, MHPE; Irma Dahlquist 

10. Medical Students as Hospice Volunteers: Influence of an Early Experiential Training 

Program in End-of-Life Care Education .................................................................................................21 

Melissa Mott, PhD, MS3; Stacie Levine, MD; Rita Gorawara-Bhat, PhD 

11. Improving Student-Run Free Clinic Care Through Pre-Clinical Student Didactic 

Intervention: A Pilot Feasibility Study ...................................................................................................22 

Andrew W. Phillips, MEd, MS4; Kristine Bordenave, MD; Rita Rossi-Foulkes, MD, MS 

12. Integration of the Virtual Human Embryo into the First Year Anatomy Curriculum ....................23 

Callum Ross, PhD; James O’Reilly, PhD; Quinn Dombrowski; Sam Quinan 

Research funded by the Academy of Distinguished Medical 

Educators’ Grants for Medical Student Education 

Research funded by the Graduate Medical Education Executive 

Committee’s Grants for Resident/Fellow Education 

Poster chosen for the 2011 Plenary Poster Presentation Medical Education Research, Innovation, Teaching and Scholarship 

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Scholarship & Discovery


13. Qualitative Analysis of First Year Medical School Orientation ........................................................24 

Sean Swearingen, MS2; H. Barrett Fromme, MD, MHPE; Shalini Reddy, MD 

14. Graduate Medical Education in Frailty: The SAFE Clinic ...................................................................25 

Katherine Thompson, MD; Megan Huisingh-Scheetz, MD, MPH; Lisa Mailliard, APN, MSN; 

Patricia Rush, MD, MBA 

15. Geriatrics and Aging through Transitional Environments (GATE) MS2 Curriculum: 

Introduction to Geriatric Assessments ..................................................................................................26 

Shellie Williams, MD; Seema Limaye, MD; Sandy Smith, PhD; Aliza Baron, MA 

16. The Hand-off CEX: Instrument Development and Validation .............................................................27 

Saba Berhie, MS2; Vineet Arora, MD, MAPP; Paul Staisiunas; Jeanne Farnan, MD, MHPE 

Patient Safety and Quality Improvement 

17. Improving Post-Hospital Follow-up for Resident Clinic Patients Through a New 

Discharge Clinic ........................................................................................................................................28 

Katrina Booth, MD; Amber Pincavage, MD; Lisa Vinci, MD; Beth White, PharmD 

18. Characterizing Physician Listening Behavior During Hospitalist Handoffs using the 

HEAR Checklist .........................................................................................................................................29 

Elizabeth Greenstein, MS3; Vineet Arora, MD, MAPP; Paul Staisiunas; 


19. Risk of Resident Clinic Handoffs: Showing up is Half the Battle .....................................................30 

Amber Pincavage, MD; Megan Prochaska, MD; Julie Oyler, MD; Vineet Arora, MD, MAPP 

20. Medical Education Curricula: Integrating Healthcare Quality and Patient Safety ......................31 

Elizabeth Rodriguez, MBA, MS; Kevin Weiss, MD, MPH 

Technology and Simulation 

21. Role of Social Media in Graduate Medical Education: A Blogger’s Perspective .............................32 

Wilma Chan, MD; James Ahn, MD; Alisa McQueen, MD; Christine Babcock, MD, MSc 

22. Exploring Opportunities and Challenges Posed by Technology Integration: 

A Simulation Workshop for First Year Medical Students ...................................................................33 

Vikrant Jagadeesan, MS2; Angela Blood, MPH, MBA; Stephen Small, MD; Saeed Richardson 

23. ABCs in the Sandbox: Interdisciplinary Trauma Team Training ........................................................34 

Alisa McQueen, MD; Michele Harris-Rosado, RN, BSN; Grace Mak, MD; Mindy Statter, MD 

24. Participant Satisfaction with Simulation of Minimally Invasive Spine Surgery Using 

Virtual Reality and Haptics .....................................................................................................................35 

Ben Roitberg, MD; Pat Banerjee, PhD 

25. Incorporating Ultrasound Education into Anesthesia Resident Training: 

A Two Year Study ........................................................................................................................................36 

Matthew Satterly, MD; Angela Blood, MPH, MBA; Jeffrey Katz, MD 

26. Pilot Curriculum for Teaching Residents Single Incision Laparoscopic Surgery (SILS): 

A Patient Safety Initiative .........................................................................................................................37 

Nancy Schindler, MD; Michael Ujiki, MD; Vivek Prachand, MD; Jose Velasco, MD 






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27. Publishing Evidence-based Medicine Writing Projects with Students ..............................................38 

Umang Sharma, MD; Mari Egan, MD, MHPE; Adam Mikolajczyk, MD 

28. Simulation-based Ultrasound Guidance and Procedure Training in Hospital Medicine: 

A Faculty Development Pilot Project .....................................................................................................39 

Nilam Soni, MD; Angela Blood, MPH, MBA; Stephen Small, MD 

29. The TIME (Technology in Medical Education) Project 2011: An Update– The Past, 

Present and Future ....................................................................................................................................40 

Scott Stern, MD; Brian Paterson 

30. The Use of an Educational Simulation to Improve Neurology Resident Knowledge of 

and Experience with Thrombolytic Therapy ..........................................................................................41 

Rachel Stork, MS3; Jeffrey Frank, MD; Morris Kharasch, MD; Ernest Wang, MD 

31. Wait Till Your Father Sees This! Simulation Training for Residents During their 

Pediatric Anesthesia Rotation .................................................................................................................42 

Faculty 

Igor Tkachenko, MD; Michael Hernandez, MD; Stephen Small, MD 

32. Doctoring Without a Script: The Improvising Physician .....................................................................43 

Daniel Brauner, MD; Gretchen Case, PhD 

33. Migration Analysis of Physicians Practicing in Hawaii from 2009-2011 ............................................44 

Laura Dilly, MS4; Kelley Withy, MD, PhD; Goutham Rao, MD 

34. The Impact of Faculty Characteristics on Internal Medicine Residency Candidates 

Interview Scores .........................................................................................................................................45 

Julie Oyler, MD; Jim Woodruff, MD; Jeff Charbeneau; Vineet Arora, MD, MAPP 

35. Relationship Between Inpatient Attending Physician Workload and Teaching Before 

and After Duty Hours: . A Seven Year Study ..........................................................................................46 

Lisa Roshetsky, MD; David Meltzer, MD, PhD; Holly Humphrey, MD; 

Vineet Arora, MD, MAPP 

Global Health 

36. Developing a Community-Based Family Medicine Clerkship in Wuhan, China ..................................47 

Nicole Baltrushes, MS4; Mari Egan, MD, MHPE; Sarah-Anne Schumann, MD; 

Renslow Sherer, MD 

37. Pre-hospital Disaster Management Education in Emergency Settings: Results of a 

Five-month Community-based Program in Rural Haiti.........................................................................48 

Corey Bills, MD, MPH; Christine Babcock, MD, MSc, MSc; Luke Davies; 

Christian Theodosis, MD, MPH 

38. A Community-based Cholera Surveillance and Education Program in Eastern Haiti .....................49 

Corey Bills, MD, MPH; Christine Babcock, MD, MSc; Luke Davies; Christian 

Theodosis, MD, MPH 

39. Assessment of Clinical Reasoning Skills of the Fifth Year Medical Students at 

Wuhan University .......................................................................................................................................50 

Aaron Cohn, MD; Nancy Luo, MD; Kate Lemler, MS4; Renslow Sherer, MD; Scott Stern, MD 






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40. Development of a Communication Skills Curriculum at Wuhan University Medical 

School: Implementing a Peer Role-playing Workshop ..........................................................................51 

Wei Wei Lee, MD, MPH; Renslow Sherer, MD 

41. Attitudes Toward Neurology in Medical Students in Wuhan, China ................................................52 

Rimas Lukas, MD; Brian Cooper; Ivy Morgan; Renslow Sherer, MD 

42. Planning for The Start of Internship - Survey and Focused Interviews at a Chinese 

Medical School ..........................................................................................................................................53 

Yang Shen, MD; Hong Lei, MD; James Woodruff, MD; Renslow Sherer, MD 

43. Evaluation of Student Attitudes and Training towards Geriatrics and Palliative Care 

in Wuhan, China ..........................................................................................................................................54 

Sandra Shi, MS2; Renslow Sherer, MD; Ivy Morgan; Hongmei Dong 

44. Observational Study of Hand Hygiene Compliance Rates in Intensive Care Units in 

Wuhan, China ..............................................................................................................................................55 

Lisa Sun, MS2; Wenjing Zong, MS2; Renslow Sherer, MD 

Community and Patient Health 

45. A Qualitative Analysis of Interviews with Participants of the Literature & Medicine 

Program at Select Veterans Administration Medical Centers ...........................................................56 

Abigail Cutler, MS3; Gabrielle Schaefer, MS3; H. Barrett Fromme, MD, MHPE 

46. Communication and Utilization of Healthcare Services Amongst Adolescents ..............................57 

Sarah Horvath, MS4; Kavitha Selvaraj, MS4; Sophie Shay, MS4; 

H. Barrett Fromme, MD, MHPE 

47. Development of a Website for Transition Care for Providers, Patients, and their 

Families ........................................................................................................................................................58 

Amy Lo, MD; Jennifer McDonnell, MD; Kruti Acharya, MD; Rita Rossi-Foulkes, MD 

48. Development of an Educational Intervention for Resident Education Regarding 

Transition Care of Youth with Special Health Care Needs.................................................................59 

Jennifer McDonnell, MD; Amy Lo, MD; Sara Platte, MD; Rita Rossi-Foulkes, MD 

49. Using Health Information Technology to Develop an Academic Medical Home: 

Effective Patient Education for Success in High School ....................................................................60 

Margaret Naunheim, MS3; Yingshan Shi, MD, MS; Janis Mendelsohn, MD; Michael Msall, MD 

50. Patient Perception of a Point-of-Care Tablet Computer (iPad) Being Used for 

Patient Education .......................................................................................................................................61 

Andrew Nickels, MD; Vesselin Dimov, MD; Valerie Press, MD; Raoul Wolf, MD 

51. Challenges in Transition: Barriers to Subspecialty Care for Adults with Developmental 

Disabilities .................................................................................................................................................62 

Joanna Perdomo, MS1; Alex Garnett, MS1; Richard Schroeder, MS1; Kamala Cotts, MD 

52. Predictors of Third Year Medical Students’ Intentions to Practice in Underserved 

Areas: A National Survey ...........................................................................................................................63 

Krishna Ravella; John Yoon, MD; Kenneth Rasinski, PhD; Farr Curlin, MD 

Academy Funded Research ........................................................... .......... ................................................. ...............69 

Request for Applications: Medical Education Research .............................................................................................70 






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Keynote Speaker 


Associate Dean for Assessment and Faculty Development 


Quinnipiac University School of Medicine 

Lisa Coplit, MD recently joined the Quinnipiac School of Medicine as an Associate Professor of Medicine and 

the Associate Dean for Assessment and Faculty Development. She completed her medical school, residency, 

and chief resident training at the Boston University School of Medicine. Dr. Coplit is an alumna of both the 

Harvard-Macy Program for Physician Educators and the Stanford Faculty Development Program in Clinical 

Teaching Skills. 

Prior to joining the faculty at Quinnipiac, Dr. Coplit was the Director of the Institute for Medical Education 

(IME) at the Mount Sinai School of Medicine (MSSM) in New York. As the Director of the IME, she worked 

with other medical educators to create and implement faculty development and professional development 

programs for educational leaders, basic science faculty, clinical faculty, residents, and medical students. 

Dr. Coplit served as the Co-Developer and Director of the Resident Teaching Development Program, a 

multi-specialty teaching skills curriculum for all residents at Mount Sinai Hospital and its twelve affiliates. 

She developed the “Teach the Teacher” curriculum which trained Mount Sinai and affiliate faculty to instruct 

teaching skills courses for the faculty and residents in their respective departments. Additionally, Dr. Coplit 

directed MSSM’s annual Educational Leadership Conference, similar to the University of Chicago’s Medical 

Education Day. She also co-directed Medical Education Grand Rounds, a fourth year medical student elective 

called “Becoming a Medical Teacher,” and helped to launch Training Tomorrow’s Teachers Today for medical 

students from around the country. Dr. Coplit was a member of the Curriculum Reform Team and Chair of 

the subcommittee to develop medical school competencies and teaching formats at MSSM. She served as Co- 

Director of the MSSM Curriculum Content Reform Task Force, whose role is to ensure a comprehensive review 

of the undergraduate medical education curriculum at MSSM. 

Dr. Coplit has published extensively on issues of medical education, particularly in the development and 

support of both medical students and residents in their teaching roles. Her work has appeared in Academic 

Medicine, Medical Education, and the Journal of General Internal Medicine. 

Dr. Coplit is active in both regional and national medical education organizations, and for the past two years 

has led the Academies Collaborative, a national organization of over thirty medical school Academies of Medical 

Educators. Currently, she is designing the programmatic assessments and the faculty development curriculum at 

Quinnipiac University School of Medicine. 

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LDH Wood Teaching Scholar Award 

Wylie Leighton McNabb, EdD 

Associate Faculty Dean of Medical Education Emeritus 

Emeritus Director, Center for Research in Medical Education and Health Care 

Dr. Wylie McNabb served as the Director of the Center for Research in Medical 

Education and Health Care at the University of Chicago for more than fifteen 

years, and as Associate Faculty Dean of Medical Education at the University 

from 1986 through 2002. During his years of valued service to the University 

of Chicago and the Department of Medicine, Dr. McNabb was the Principal 

Investigator for more than a dozen grants and published several groundbreaking 

works in the areas of health professions education, behavioral medicine, faculty and student evaluation, 

minority health, and lifestyle management issues in pulmonary, endocrine, and cardiovascular diseases. 

Dr. McNabb was the Principal Investigator of the Chicago Diabetes Demonstration and Education Cores, 

ushering in advancements in our knowledge of diabetes education. He served as the Co-Director of the Chicago 

Diabetes Research & Training Center with Drs. Arthur Rubenstein and Kenneth Polonsky. He was appointed 

as the University of Chicago’s Clerkship Director for the new Family Medicine Clerkship at MacNeal Hospital. 

His efforts in this endeavor led to the garnering of a $5 million grant award from the MacNeal Education 

Foundation to establish a permanent Department of Family Medicine at the University of Chicago Medical 

Center. 

Dr. McNabb has been a pioneer in introducing new pedagogic practices and innovative evaluation 

methodologies into medical education programs at the University of Chicago. In 1986, he introduced the use 

of standardized patients to assess and enhance the clinical skills of medical students, residents, and fellows. In 

cooperation with Dr. Eugene Geppert, he developed and established the “head to toe” physical examination 

using standardized patients as a requirement for passing the Physical Diagnosis course. Dr. McNabb oversaw 

the design and implementation of the first Clinical Performance Center on the University of Chicago campus. 

Another contribution was Dr. McNabb’s implementation of a comprehensive and standardized approach 

to student evaluation, requiring faculty observation of medical student performance of history and physical 

examination at both the beginning and the end of the Family Medicine clerkship. He instituted the use of 

patient and procedure encounter forms for students to identify the types of patients seen and types of medical 

procedures performed. These strategies and instruments for student evaluation were ultimately adopted by all 

clinical clerkships in the medical school. Finally, Dr. McNabb also made a major contribution to the system 

of faculty evaluation by developing a standardized unified approach for the evaluation of faculty teaching by 

students, which is still being utilized today. 

Now retired, Dr. McNabb continues to contribute to the Pritzker School of Medicine as a Senior Evaluation 

Consultant for the Pritzker Initiative. 

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Founding Members of the Academy 

The core missions of the Academy are to: 

• Promote excellence in teaching at the Pritzker School of Medicine. 

• Support scholarship among medical educators. 

• Enhance the Pritzker School of Medicine curriculum by supporting, recognizing, and rewarding its outstanding teachers. 

• Build community among medical educators at the Pritzker School of Medicine. 

• Facilitate the creation of an environment that enhances the status of medical educators at the University of Chicago. 

Halina Brukner, MD 

Professor of Medicine 

Associate Dean for Medical Education 

Eric Lombard, PhD 

Professor of Organismal Biology and 

Anatomy (Emeritus) 

Scott Stern, MD 


Assistant Dean for Technology and 

Innovation in Medical Education 

Bruce Gewertz, MD 

Former Professor 

and Chairman of Surgery 

(1981-2006) 

Stephen C. Meredith, MD, PhD 

Professor of Pathology and 

Biochemistry and Molecular Biology 

Ting-Wa Wong, MD, PhD 

Associate Professor of Pathology 

3 

Holly J. Humphrey, MD 


Dean for Medical Education 

Mark Siegler, MD 

Lindy Bergman Professor of 

Medicine and Surgery 

Lawrence D.H. Wood, MD, PhD 

Professor of Medicine (Emeritus) 

Former Dean for Medical 

Education (1996-2003)

Masters of the Academy 

Masters are faculty members who were inducted into the Academy of Distinguished Medical Educators because 

of their long-standing participation in medical education and their demonstration of the following: 

• Sustained excellence in teaching in the medical school. 

• Evidence of institutional impact of educational contributions. 

• Evidence of educational scholarship and/or innovation. 

• Serve as role models who inspire others with joy of teaching. 

Diane Altkorn, MD 


Godfrey Getz, MD, PhD 

Donald N. Pritzker 

Professor of Pathology (Emeritus) 

Eugene B. Chang, MD 

Martin Boyer Professor of Medicine 

Patricia Kurtz, MD 


Philip C. Hoffman, MD 


Joel Schwab, MD 

Associate Professor of Pediatrics 

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Adam Cifu, MD 


Aliya N. Husain, MD 

Professor of Pathology 

Mindy A. Schwartz, MD 


Linda Druelinger, MD 


Jerome Klafta, MD 

Professor of Anesthesia 

and Critical Care

Newly Elected Masters of the Academy 

Vineet Arora, MD, MAPP 

Associate Professor of 

Medicine; Section of 

General Internal Medicine 

Dr. Vineet Arora holds 

multiple leadership positions 

at all stages of medical 

education at the University 

of Chicago. She is the Assistant Dean for Scholarship 

and Discovery, Co-Director of the NIH funded Summer 

Research Program at the Pritzker School of Medicine, 

Associate Program Director for the Internal Medicine 

Residency Program, and Program Director of the 

MERITS Fellowship in Medical Education. Dr. Arora 

also contributes to pipeline programs into medical school 

through her leadership of the NIH-funded TEACH 

(Training Early Achievers for Careers in Health) 

Research Program, which aims to prepare and inspire 

Chicago Public School minority students to enter healthrelated 

research careers through a unique team structure 

of mentorship and realistic experiences. Dr. Arora has 

elevated medical education scholarship at the University 

of Chicago through her development, implementation, 

and leadership of the monthly Research and Innovation 

in Medical Education (RIME) conference, in which 

faculty and trainees from throughout the medical school 

can present their works in progress and exchange ideas 

about curriculum development and evaluation. 

Dr. Arora has spearheaded major institutional 

educational interventions at the University of Chicago, 

ranging from pharmaceutical industry interactions, 

sleep deprivation among housestaff, professionalism, 

and hand-off communications for medical students 

and residents. Her work has appeared in numerous 

journals, including the Journal of the American Medical 

Association, Annals of Internal Medicine, Archives of 

Internal Medicine, and Academic Medicine, and has 

received coverage from the New York Times, CNN, 

and US News & World Report. She has testified to the 

Institute of Medicine on resident duty hours and to the 

U.S. Congress about the increasing medical student 

debt and the primary care crisis. She is the recipient 

of numerous awards for her research and educational 

leadership, among them the 2011 Society of General 

Internal Medicine Mid-career Mentoring Award. 

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Callum Ross, PhD 


Organismal Biology and 

Anatomy 

Dr. Callum Ross serves as 

the Course Director for The 

Human Body, one of the 

centerpieces of the first year 

medical school curriculum. Dr. Ross gives the majority 

of lectures and attends all other lectures and labs, 

representing a significant commitment of time over the 

ten week experience. He works closely with his associate 

course directors and teaching assistants to ensure an 

outstanding educational experience. 

The Human Body is the most highly rated first year 

course at the Pritzker School of Medicine. Dr. Ross’ 

commitment to this course is reflected in his ongoing 

commitment to integrate new technologies, enhance 

quality and access to course material, and to support 

related educational initiatives. Under his leadership 

Radiology and Surgery have become integrated into 

the Human Body course in innovative ways. Dr. Ross 

has been chosen as one of the favorite faculty of the 

graduating Pritzker classes for many years. 

Dr. Ross also serves in a leadership capacity in the 

overall curriculum, as a member of the Pritzker Initiative 

Steering Committee, the Preclinical Curriculum Review 

Committee, and the Academic Progress Committee for 

Year 1. He has supported the expansion of the University 

of Chicago’s global health and medical education 

presence through his work on the Wuhan University 

Medical Education Reform (WUMER) Project Steering 

Committee. 

Additionally, Dr. Ross oversees an active research 

program in evolutionary morphology focusing on the 

biomechanics of the head, with special emphasis on 

the feeding apparatus. His research has resulted in the 

authoring and publication of over 45 peer-reviewed 

journal articles and book chapters. Dr. Ross is President 

of the Anatomical Gift Association of Illinois.

Fellows of the Academy 

Catherine Bachman, MD 

Assistant Professor of Anesthesia and 

Critical Care 


Assistant Professor of Pediatrics 

Karen A. Kim, MD 


James Brorson, MD 

Associate Professor of Neurology 

Javad Hekmat-Panah, MD 

Professor of Neurosurgery 

Neurology and Cancer Research 

Stacie Levine, MD 

Assistant Professor of Medicine 

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Assistant Professor of Medicine 

Nora Jaskowiak, MD 

Associate Professor of Surgery 

Karl Matlin, PhD 

Professor of Surgery

Fellows of the Academy 

Michael O’Connor, MD 

Professor of Anesthesia and 

Critical Care 

David Rubin, MD 


Monica Vela, MD 


Shalini Reddy, MD 


Sarah Stein, MD 


Darrel J. Waggoner, MD 


Human Genetics and Pediatrics 

7 

Kevin Roggin, MD 

Associate Professor of Surgery 

Sandra Valaitis, MD 

Associate Professor of Obstetrics 

and Gynecology 

James N. Woodruff, MD 

Associate Professor of Medicine

Newly Elected Fellows of the Academy 

Fellows are faculty members who were inducted into the Academy of Distinguished Medical Educators because 

of their demonstration of the following: 

• Recognized and well-documented excellence in teaching in the medical school. 

• Significant contributions to medical school courses or clerkships, including serving as course or clerkship 

director. 

• Potential for continued contributions and leadership in medical education. 

Keme Carter, MD 

Assistant Professor of Medicine; Section of Emergency Medicine 

Dr. Keme Carter is the Co-Clerkship Director for the Emergency Medicine Clerkship at the 

University of Chicago Medical Center. In this role, Dr. Carter has worked to ensure a very 

high standard of educational experience, which is borne out by the consistently outstanding 

evaluation scores provided by medical students. Under Dr. Carter’s leadership, Emergency 

Medicine became the first clerkship to introduce high fidelity simulation as a course 

requirement. Dr. Carter’s teaching is highly rated by students and in 2011, the graduating 

students selected her as one of the Faculty Favorite. In addition to her leadership role in this required clerkship, 

Dr. Carter is the course director for Introduction to Emergency Medicine, which provides an early exposure to 

clinical medicine for first and second year students. Dr. Carter serves as a faculty instructor for Physical Diagnosis 

and as a faculty sponsor for the Emergency Medicine Interest Group. Dr. Carter contributes to the Emergency 

Medicine residency through her work supporting residents as teachers, including material on effective teaching of 

medical students, giving feedback, and incorporation of the medical student into the ED team. She contributes to 

the leadership of the Pritzker School of Medicine through her participation on the Clinical Clerkship Curriculum 

Committee and the Academic Progress Committee for Years 3 and 4. On a national level, Dr. Carter is an active 

member of the Clerkship Directors in Emergency Medicine, and was recently elected to an advisor position in the 

Academy of Women in Academic Emergency Medicine. 

Heather A. Fagan, MD, MS 

Assistant Professor of Pediatrics 

Dr. Heather Fagan is the Program Director of the Pediatric Residency Training Program at the 

University of Chicago. In addition to her oversight of the core residency program, Dr. Fagan is 

also responsible for the nine subspecialty fellowships offered in the Department of Pediatrics as 

well as the Child Neurology fellowship. Dr. Fagan has introduced multiple initiatives to ensure 

the highest possible standard of training of residents and fellows, including two mandatory 

fellow retreats per year to address such topics as professionalism, problem based learning and 

systems based practice. In addition, Dr. Fagan has introduced an innovative and unique set of scholarship tracks to 

support the development of future leaders in pediatric medicine. Each track allows a resident to pursue a four-year 

residency training program which includes attaining a Master’s Degree in Medical Education, Public Policy, Health 

Economics, or Human Genomics. Other contributions to the Pediatric Residency include her work developing and 

facilitating the highly regarded monthly Morbidity and Mortality conference and a monthly “mock code” for Pediatric 

Residents. Dr. Fagan also facilitates the yearly “Intern Survival Series” lectures at the outset of the PGY-1 year. Dr. 

Fagan offers a formal Pediatric Sedation and Procedure elective which is a required experience for multiple training 

programs. In addition to her role in graduate medical education, Dr. Fagan is the Course Director for the Pritzker 

School of Medicine’s senior elective, Pediatric Sedation and Procedure Service. 

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Sabrina Holmquist, MD, MPH 

Assistant Professor of Obstetrics and Gynecology 

Dr. Sabrina Holmquist serves as the Clerkship Director for the Obstetrics-Gynecology 

Clerkship. She also holds leadership positions as Associate Fellowship Director for Family 

Planning and Director of Education for the Ryan Center Training Program in the Department 

of Obstetrics-Gynecology. Dr. Holmquist has made a major impact on the Obstetrics- 

Gynecology clerkship through her work to ensure a high standard of educational experience. 

Under her leadership the Obstetrics and Gynecology clerkship has enjoyed significant 

improvement in ratings from students. Dr. Holmquist has also contributed to the education of medical students by 

overseeing the fourth year sub-internship in Obstetrics-Gynecology, as well as through her significant contribution 

to the required second year course Clinical Pathophysiology and Therapeutics. Dr. Holmquist has served as an 

educational leader in the Obstetrics-Gynecology residency program as director of the rotation in family planning. In 

this capacity, she has introduced a newly designed lecture series, an online case study system, a question database, and 

a preceptor program for residents. On the national level, Dr. Holmquist participates in the Association of Professors of 

Gynecology and Obstetrics Solvay Scholars Program. She is pursuing a Masters in Health Professions Education at the 

University of Illinois-Chicago. 

John McConville, MD 

Assistant Professor of Medicine; Section of Pulmonary and Critical Care 

Dr. John McConville is the Internal Medicine Residency Program Director at the University 

of Chicago Medical Center. Before assuming this role in fall 2011, Dr. McConville served 

as the Pulmonary and Critical Care Fellowship Director. In this role, he made significant 

improvements to the structure and curriculum of the fellowship program, which included 

creating post-graduate-year specific goals and objectives for each clinical rotation, restructuring 

the curriculum of the weekly didactic conference, creating and organizing a two-week 

fellowship orientation program, designing a more comprehensive evaluation system of the clinical fellows; and 

designing and implementing an annual fellowship program evaluation system for both fellows and faculty. He created 

a four-hour class to teach chest tube insertion for in-house fellows as well as for other fellows in other universities in 

Chicago. Dr. McConville is currently creating a teaching curriculum that will incorporate web-based questionnaires, 

didactic lectures, and a simulation-based “hands-on” learning experience to standardize central line insertion practices 

throughout the Biological Sciences Division (BSD). Dr. McConville was the Department of Medicine’s 2010 

recipient of the Postgraduate Teaching Award and the inaugural winner of the BSD’s Distinguished Leader in Program 

Innovation Award. He has lectured at the American College of Chest Physicians Board Review course and at several 

international conferences and is a contributor to Harrison’s Principles of Internal Medicine. 

Babak Mokhlesi, MD, MSc 

Associate Professor of Medicine; Section of Pulmonary and Critical Care Medicine 

Dr. Babak Mokhlesi is the Director of the Sleep Disorders Center and the Director of the 

Sleep Fellowship Program at the University of Chicago Medical Center. In 2007, he developed 

the first ACGME-approved Sleep Medicine fellowship training program at the University of 

Chicago, a program that is now the largest in the state of Illinois. Dr. Mokhlesi developed all 

aspects of the program, including curriculum, clinical training, and evaluation processes. He 

provides 15 core lectures for the sleep fellowship as well as many lectures in the critical care 

didactic series. In addition to his work in the fellowship, Dr. Mokhlesi has an active involvement in the education 

of internal medicine residents and medical students in the Medical Intensive Care Unit, Morning Report, and the 

Procedure Service. His teaching evaluations are consistently outstanding. Furthermore, his teaching efforts have 

extended to educational sessions for sleep technologists and respiratory therapists in national meetings and continuing 

medical education conferences. Dr. Mokhlesi co-founded the Society of Anesthesia and Sleep Medicine (SASM) 

and is Co-Chairing the first SASM conference in Chicago: “OSA, Anesthesia and Sleep: The Common Ground.” 

In addition, he has been elected by other Sleep Medicine fellowship program directors to be a member of the Sleep 

Medicine Fellowship Directors’ Council of the American Academy of Sleep Medicine. 

9


Julie Oyler, MD 

Assistant Professor of Medicine; Section of General Internal Medicine 

Dr. Julie Oyler is the Associate Program Director for the Internal Medicine Residency Program 

at the University of Chicago Medical Center, and the Assistant Director of the Primary Care 

Group. Additionally, she is a key leader in the Scholarship and Discovery Program at the 

Pritzker School of Medicine, serving as the Track Leader for the Quality and Safety Track 

and also serving as the course director for an elective in this area. She receives consistently 

outstanding teaching evaluations from students and faculty. Formerly the Internship Selection 

Chair of the Internal Medicine Residency Program, Dr. Oyler has become the Ambulatory Associate Program 

Director, overseeing the Resident Continuity Clinic and Ambulatory Education. Dr. Oyler has received support 

from the Academy of Distinguished Medical Educators and Graduate Medical Education Committee to support her 

development and implementation of a 2-year longitudinal required curriculum for all Internal Medicine Residents 

using ABIM Practice Improvement Modules. She has published this work in the Journal of General Internal Medicine 

and Quality and Safety in Health Care. More recently, Dr. Oyler received support to develop a Quality Improvement 

curriculum for faculty, fellows, pharmacy students and medical students. Through her Quality Assessment and 

Improvement Curriculum for faculty, Dr. Oyler has helped faculty receive Maintenance of Certification Credit for 

ABIM Practice Assessment points in conjunction with the curriculum for internal medicine residents. 

Rita Rossi-Foulkes, MD, FAAP, MS, FACP 

Associate Professor of Medicine and Pediatrics; Section of General Internal Medicine 

Dr. Rossi-Foulkes serves as the Residency Program Director for the Internal Medicine- 

Pediatrics residency program at the University of Chicago Medical Center. Dr. Rossi-Foulkes is 

the founder and director of a UCMC-wide Transition Care Steering Committee aimed toward 

improving education of medical students, residents, faculty and other members of the health 

care team regarding care of youth and young adults with special health care needs. Dr. Rossi- 

Foulkes has contributed extensively to the residency program through the development and 

implementation of a revised Med-Peds Ambulatory Curriculum. Dr. Rossi-Foulkes’ contributions to medical education 

were recognized in 2007 with her receipt of the Department of Medicine Excellence in Clinical Care and Education 

Award. Her teaching evaluations from students and residents are outstanding. Dr. Rossi-Foulkes has served as Chair of 

the Medicine Pediatrics Executive Committee as a member of the Graduate Medical Education Committee, Medicine 

Curriculum Committee, and Medicine Pediatrics Ambulatory Task Force, among numerous other positions. On a 

national level, Dr. Rossi-Foulkes served on the American Academy of Pediatrics (ICAAP) Transition Care Workgroup 

which developed materials and organized a pre-course given at Midwest SGIM in September, 2011 on Transition Care. 

The workgroup continues to develop educational materials that will go onto ICAAP’s Transition Care website and will 

be used for providers desiring CME credits and Maintenance of Certification points. 

Nancy Schindler, MD 

Clinical Associate Professor of Surgery, NorthShore University HealthSystem 

Dr. Nancy Schindler is the Vice-Chairman of Education for the NorthShore University 

HealthSystem’s Department of Surgery and a member of the NorthShore University Health 

System Medical Group Board of Directors. She is the University of Chicago Department of 

Surgery Associate Program Director for the General Surgery Residency, the NorthShore Site 

Director, and the University of Chicago Associate Director of Surgical Education. She leads the 

Residents as Teachers and Leaders course in the Department of Surgery, as well as the Teaching 

Effectiveness Faculty Development course. Dr. Schindler is a leader in developing and leading numerous faculty 

development courses at both the University of Chicago and at NorthShore. She has taught many medical education 

topics at workshops at the Association for Surgical Education national meetings. In the past, she served for eight years 

as the Northwestern University Feinberg School of Medicine Surgery Clerkship Director. Currently, at the University 

of Chicago, Dr. Schindler is a MERITS Medical Education Fellowship Course Director and co-leads the workshop on 

Curriculum Development and Evaluation. She is also actively involved and a member of the Residents Are Teachers 

Steering Committee, Graduate Medical Education Committee, and the Surgical Education Committee. Dr. Schindler 

has received numerous awards for her excellence in teaching from the Feinberg School of Medicine and NorthShore 

University HealthSystem. She is currently pursuing her Masters in Health Professions Education at the University of 

Illinois-Chicago. 

10


Sonali M. Smith, MD 

Associate Professor of Medicine; Section of Hematology/Oncology 

Dr. Sonali Smith is the Director of the Lymphoma Program in the Section of Hematology/ 

Oncology at the University of Chicago Medical Center and is a key contributor to the 

University of Chicago Hematology/Oncology Fellowship. Dr. Smith’s contributions to teaching 

fellows were recognized with her receipt of the inaugural Section of Hematology/Oncology 

Teaching Award in 2011, as well as the Department of Medicine’s Graduate Medical Education 

Award for Best Teaching Attending the same year. Dr. Smith is also an active teacher of medical 

students, serving as a preceptor for the second year Physical Diagnosis course and as a beloved attending physician 

on the Oncology inpatient service. Dr. Smith lectures in the Topics in Internal Medicine series, participates in the 

Internal Medicine Journal Club, and teaches Hematology/Oncology fellows in a monthly Lymphoma Educational 

Conference. On a national level, Dr. Smith serves on the Education and Communication Committees of both the 

American Society of Hematology and the American Society of Clinical Oncology. This year, Dr. Smith was selected 

to be coordinating lecturer for Highlights of ASH (lymphoma). She also organizes and chairs the annual International 

Chicago Lymphoma Symposium. The ICLS began as a tribute to Dr. John Ultmann, a University of Chicago master 

teacher and clinician, and has grown into an annual symposium on lymphoma for community physicians. 

Avery Tung, MD 

Professor, Department of Anesthesia & Critical Care 

Dr. Avery Tung participates extensively in medical education and has, for many years, been a 

lecturer and group facilitator of the Advanced Clinical Pharmacology Therapeutics, Clinical 

Pathophysiology and Therapeutics, and other courses in the Pritzker School of Medicine. Dr. 

Tung has contributed extensively to the Introduction to the Clinical Biennium experience at 

the Pritzker School of Medicine to support the transition of medical students to the third year. 

Dr. Tung is an active participant in the Perioperative Medicine and Pain Therapy Clerkship 

rotation at the University of Chicago Medical Center, serving as both a clinical and didactic teacher of junior and 

senior medical students. Dr. Tung has made significant contributions to the preclinical Pritzker School of Medicine 

curriculum, and for his extensive efforts in medical education, Dr. Tung was asked to deliver the keynote address for 

the Pritzker second year student retreat in 2005. Additionally, he is a teacher and mentor for residents and fellows 

alike, instructing in Anesthesia and Critical Care Medicine, among other topics. He regularly participates in resident 

didactic sessions, and his efforts have consistently been reflected by top evaluations of his teaching. Furthermore, Dr. 

Tung has been a leader in his department in Quality Care, participating on the Continuing Quality Improvement 

(CQI) Committee and conducting bi-weekly CQI Morbidity & Mortality conferences. Beyond this, Dr. Tung serves 

as the co-director of two annual conferences. He regularly teaches at the American Society of Anesthesiologists Annual 

Meeting, lectures at several national meetings of subspecialty societies on cardiothoracic Anesthesia, Critical Care, and 

Pulmonary Medicine, and instructs at multiple regional and national CME courses. 

11

1. Learner Perceptions of an Ad-Hoc versus Modular 

Didactic Curriculum in Emergency Medicine Residency 

Lindsay Jin, MD; James Ahn, MD; Christine Babcock, MD, MSc 

Statement of Problem, Question, or Issue Addressed: Prior to initiation of this study, our emergency medicine 

residency operated with an ad-hoc curriculum. Multiple studies demonstrate a modular curriculum is a 

successful educational model. Studies in the medical school setting found that with initiation of a modular 

curriculum students score well on core competency testing and prefer learning in this model. Supporting 

evidence from obstetrics and gynecology and surgery literature corroborates this study. 

Objectives of Program/Intervention: The purpose of our study was to compare a modular didactic curriculum 

versus an ad-hoc curriculum in the setting of an emergency medicine (EM) residency. 

Description of Program/Intervention: During 2009-2010 a modular curriculum was implemented into a 

three-year EM residency program in a large urban tertiary care medical center. Our program shifted didactic 

conferences away from an ad-hoc format to a topic-based modules format. An identical survey was distributed 

to all residents during the 08-09 and 09-10 academic years querying the learners’ perceptions on didactic 

conferences. An unpaired T test was used to compare the results from 08-09 (prior to initiation of the modular 

curriculum) to 09-10 (after initiation of the modular curriculum) with statistical significance determined at 

p≤ 0.05. 

Results/Findings to Date: Responses were collected from 63% of the residency. 56.7% of residents thought that 

didactic conferences were organized under the modular curriculum vs. 17.2% under the ad-hoc curriculum (p 

< .0001). 69.0% of residents agreed that didactic conferences with the modular curriculum improved in-service 

examination performance vs. 39.2% in the ad-hoc curriculum (p = .0113). 86.6% of residents agreed that 

modular conferences improved clinical performance vs. 69.0% that ad-hoc curriculum improved performance 

(p < .0001). 60.0% of trainees had a positive educational experience in modular conferences vs 31.0% in the 

ad-hoc curriculum (p = .0006). 79.3% of learners observed that there was higher resident attendance after the 

modular curriculum was implemented. 27.6% of learners felt resident attendance was adequate under the adhoc 

curriculum (p < .0001). 

Key Lessons Learned/Conclusions: We found that EM residents at our institution preferred didactic conferences 

in a modular curriculum compared to an ad-hoc curriculum. Learners found the modular model more 

organized and more likely to improve both their in-training exam and clinical performance. Residents report 

a more positive educational experience when they attend modular didactic conferences. Lastly, resident 

attendance is higher in a modular vs. ad-hoc conferences, which argues that the modular curriculum is seen as 

more valuable to EM residents. Globally, the EM residents valued and preferred this curriculum style and it will 

be the permanent model in which our EM residency operates. 

12

2. Entrustment, Supervision and Autonomy of Housestaff 

During Inpatient Medicine Rotations: A Qualitative Study 

Scholarship 

& Discovery 

Kevin Choo, MS3; Vineet Arora, MD, MAPP; Paul Barach, MD, MPH; Jeanne Farnan, MD, MHPE 

Statement of Problem, Question, or Issue Addressed: Attending physicians are regularly challenged in their 

decision when to allow their trainees autonomy in procedural tasks and clinical decision-making. Medical 

educators have struggled to find ways to evaluate trainees and assist faculty in determining when trainees are 

prepared to perform tasks independently. 

Objectives of Program/Intervention: The aim of this study is to create a conceptual framework that elucidates 

the factors determining both the attending and resident perceptions of trust as they pertain to clinical decisionmaking 

and patient care. 

Description of Program/Intervention: Internal medicine residents and attending physicians at a single academic 

medical center were interviewed between January and November 2006, within one week of their final call 

night on an Internal Medicine rotation. Participants were asked, using Critical Incident Technique, to describe 

important entrustment decisions made during the rotation and their last call night. The interviews lasted 45 

minutes on average and were audio-taped for transcription. All patient and personal data were de-identified 

during transcription. The interview transcripts were reviewed and analyzed to identify sentences and phrases 

that described the factors that promoted, undermined, or otherwise described trust, which were then coded into 

discrete subthemes. Two investigators (JMF and KJC) independently reviewed representative portions of the 

transcript until consensus was achieved. Inter-rater reliability was calculated using a generalized kappa-statistic 

(κ). The coding scheme was then applied to the entire set of transcripts. 

Results/Findings to Date: 42/50 (84%) of residents and 40/50 (80%) of attending physicians were interviewed. 

The analysis yielded 535 discrete mentions of trusting factors, which were coded into 35 subthemes. The interrater 

Kappa for coding was 0.84 between the two raters. Four major domains of trust were described, each with 

specific sub-themes: trainee factors (confidence, accountability and dedication, recognition of limitations, area 

of specialty/career plans); supervisor factors (approachability, area of clinical expertise, perception of clinical 

obligations); task factors (urgency/severity of illness, transitions, level of difficulty, situational characteristics); 

and, system factors (workload, duty hours and efficiency pressures, training philosophy). Supervisors frequently 

describe basing their trusting decisions on direct observation of trainee performance. In addition, relational 

factors such as personality characteristics and prior work experience were frequently mentioned. 

Key Lessons Learned/Conclusions: The development of trust is multi-factorial and comprises factors driven by 

the supervisor, trainee, task and environmental characteristics. Trust is often driven by subjective conclusions 

drawn from direct trainee observation. Supervising attending physicians base their decisions on personal 

characteristics of their trainees, including honesty, disposition, and self-confidence which may be at odds with 

the trainee’s competency. The criteria for entrustment need to be better understood to develop reliable and 

measurable standards to evaluate the readiness of residents to treat patients unsupervised. 

13

3. Survey of Problem Based Learning for Medical Student 

Pain Curricula 

Dalia Elmofty, MD; Magdalena Anitescu, MD, PhD; Ashley Agerson, MD 

Statement of Problem, Question, or Issue Addressed: Chronic pain is one of the most prevalent conditions 

encountered in clinical practice. Chronic pain can burden patients in multiple domains: socioeconomic, 

psychological and quality of life. In 2010, the Department of Health and Human Services enlisted the Institute 

of Medicine to examine pain as a public health problem. The committee reported that chronic pain affects 

at least 116 million adults in the US; more than those affected by heart disease, cancer and diabetes (1). In 

1988, The International Association for the Study of Pain (IASP) published a pain curriculum for medical 

schools and estimated that it would require a minimum of 74h (2). For a majority of medical schools, pain 

education encompass about 10 hr maximum during a 4 year time period. Pain education must be an integral 

part of medical student education at all levels in order to improve chronic pain management. It is essential for 

medical students to have adequate exposure in order to develop knowledgeable and skilled future healthcare 

professionals. While progress is taking place, many gaps still exist. 

Objectives of Program/Intervention: To promote pain education in PBLD format, allowing students to develop 

authority, competency, skills and attitudes that enhance the learning process. 

Description of Program/Intervention: At the University of Chicago, third year medical students complete a two 

week rotation as part of their surgical clerkship in Anesthesia and Critical Care. During these two weeks, they 

spend 5 hours in the Acute Pain Service (APS) and 8 hours in the Pain Clinic. The neurophysiology, etiology, 

ethical issues and management of acute and chronic pain are reviewed. More recently, in spring of 2011, we 

introduced a Problem Based Learning Discussion (PBLD) on the management of Chronic Low Back Pain 

to promote pain education. Low back pain is one of the most common complaints in our society. We chose 

PBL type discussion as it allows students to develop authority, competency, skills and attitudes that enhance 

the learning process. Each PBL session consisted of approximately 5-6 medical students and was 60 minutes 

in length. A case discussion was emailed to the students at least 24 hr before the scheduled session to allow 

adequate preparation time. As well, the Pain PBLD was performed during the second week of their rotation to 

ensure that all students had completed their APS and Pain Clinic rotation. An online survey of a series of seven 

questions using a Likert-type scale was then conducted regarding their experience during the Pain PBLD. 

Results/Findings to Date: We achieved a 100% response rate. Of the 18 medical students that attended the 

Pain PBLD, all responded to the survey. The majority of students were favorable towards this mode of learning. 

All but 1 student responding to the survey strongly agreed that their educational background knowledge was 

increased with this modality of learning. 

Key Lessons Learned/Conclusions: Implementing a pain assessment and management program for medical 

students can provide a solid foundation upon which students can continue to build as their career develops. A 

European survey conducted in 2007 highlighted the anxiety of final year medical students in managing chronic 

pain (3). Our survey showed that the most favorable response was “The case scenario enriched my background 

knowledge for the rotation.” The students felt very comfortable in stating their opinions within the group. This 

emphasizes that the fundamental knowledge to improve chronic pain management can be introduced in PBLD 

format rather than the standard lecture format. PBL allows students to work as a team and engage in group 

discussion. 

14

4. Teaching Self-Directed Learning: Can This Be Done? 

Academy 

Grant 

Susan Glick, MD; Jennifer Glick; Maureen Willcox, MS4; Patrick O’Connor; Michael O’Connor, MD 

Statement of Problem, Question, or Issue Addressed: Self-directed learning is a requisite for lifelong learning. 

Third-year students are expected to be self-directed learners, selecting which content to study and the 

appropriate resources. Unfortunately, their educational experience in both college and medical school is 

overwhelmingly teacher-directed, hence our students are ill prepared for the transition to self-directed learning. 

How best to prepare medical students to become self-directed learners is unknown. 

Objectives of Program/Intervention: The Foundations in Clinical Medicine (FICM) course is an immersive, 

7-day classroom-based experience intended to prepare rising third-year students for the clinical years. One aim 

of the course is to develop students’ self-directed learning skills in preparation for the third-year clerkships and 

beyond. 

Description of Program/Intervention: The FICM course consists of 7 distinct content areas, 3 focused on 

self-directed learning. For two of these content areas (Data Interpretation and Hypothesis-Driven History and 

Physical Examination), we created a series of structured paper and pencil exercises that required self-directed 

learning. Students worked in groups of 4 to complete the exercises. They were provided with relevant print and 

on-line resources (textbooks, original articles, Up-to-Date) and were encouraged to seek others. Faculty were 

present to answer questions, but they were instructed not to initiate or lead discussion. For the other content 

area (FICM Laboratory), we created an unstructured setting for students to work individually or in groups to 

revisit content they had not yet mastered, and to extend their understanding. Faculty responded to students’ 

questions, but did not initiate or lead discussion. 

Results/Findings to Date: In order to determine the effectiveness of our teaching methodology, self-directed 

learning was assessed on the first day of the course and again at its conclusion using a single instrument that 

combined two validated measures of self-directed learning: Garrison’s Model of Self-Directed Learning and Lee’s 

Self-Assessed SDL Ability. The response rate was 100% (n=47). 

Responses were stripped of identifiers and entered into a database. After obtaining IRB exemption from review, 

we analyzed the data. 

Scores were calculated by assigning a point value to each answer (5 = strongly agree to 1 = strongly disagree), 

and then dividing the total number of points by the total number of questions answered. Use of the mean score 

instead of total score was necessary to correct for unanswered items. 

Since histograms for each subscale and for the total scores were roughly unimodal and symmetric, a paired t-test 

using Student’s t-test was utilized to compare the change in self-management, motivation, self-monitoring and 

the total score (Garrison’s Model of Self-Directed Learning) as well as the total score (Lee’s Self-Assessed SDL 

Ability) before and after the course. 

There was statistically significant improvement in the score for each subscale and for both total scores following 

the course. For Garrison’s Model of Self-Directed Learning, scored on a 4-point Likert scale, the mean 

improvement was 0.127 (95% CI 0.0631-0.190, p=0.00022). For Lee’s Self-Assessed SDL Ability, scored on a 

5-point Likert scale, the mean improvement was 0.486 (95% CI 0.305 - 0.667, p = 0.00000115). 

Key Lessons Learned/Conclusions: We cultivated self-directed learning in our students by immersing them in 

time-pressured problem-solving situations, providing them access to the appropriate resource materials, and to 

faculty to keep them on-track. Self-directed learning can be taught to medical students. 

15

5. Use of Problem Based Learning Discussions To Allow 

Medical Student Cognitive Autonomy 

Michael Hernandez, MD; Igor Tkachenko, MD, PhD; Catherine Bachman, MD 

Statement of Problem, Question, or Issue Addressed: Third year medical students spend two weeks on the 

perioperative and pain medicine rotation during their surgery rotation block. During this two weeks, they are 

integrated into the anesthesia team and take part in the perioperative care of surgical patients. For most, this 

provides a first glimpse into the practice of an anesthesiologist. The operating room is a fast paced learning 

environment. Time is limited due to the need to maintain efficiency of practice, but also by the need to rapidly 

adjust to the patient’s physiological perturbations iatrogenic or otherwise. As a consequence, student’s questions 

have to be answered or recalled after a complex flurry of actions. The inability to pause and consider the 

rationale for actions is detrimental to the student’s understanding of the discipline. 

Objectives of Program/Intervention: 

1. Provide a forum for student cognitive autonomy free from the time/situational pressures of an actual 

operative case. 

2. Provide an opportunity for participants to engage in dialogue regarding the medical plan, in a peer setting 

where points and counterpoints can be entertained by the group. 

3. Allow an opportunity to fill knowledge gaps that would otherwise remain despite good clinical experience. 

Description of Program/Intervention: Students on rotation are scheduled for a 1-2 hour problem based learning 

discussion with one of 2 faculty members experienced in facilitating the sessions. A case vignette is given to the 

students prior to the session. Students are told that the faculty member is there to facilitate, but not dominate 

the discussion. When there is no consensus, or a knowledge gap, the faculty facilitator provides input to resume 

the discussion. 

Results/Findings to Date: 

Scale: 1=strongly disagree to 5=strongly agree, 63 responses 

1. The problem based learning educational style is a good way to learn. Average Score: 4.79 

2. The PBL session adds something that is otherwise missing from the Anesthesia rotation. Average Score: 

4.56 

3. The faculty member “running” the PBLD gave us enough slack to allow discussion and did not just 

lecture. Average Score: 4.89 

Key Lessons Learned/Conclusions: 

1. The PBLD format may be a useful tool in settings where patient acuity or the fast pace of care would 

otherwise rob the student of opportunity for cognitive autonomy or a timely answer to their questions. 

2. The PBLD format allows students to consider the “art” of medical decision making in a novel fashion. 

Students are encouraged to consider the “pros and cons” of their plans, and to justify their decisions to their 

peers. This peer to peer debate fosters the student’s ability to communicate effectively to colleagues, 

to make decisions based on sound reasoning, and to consider alternatives when presented with opposing 

viewpoints. These skills are imperative for successful practice as a physician regardless of specialty. 

16

6. Visual Art and Medicine: A New Elective for 1st, 2nd and 

4th Year Students at Pritzker 

Nicole Baltrushes, MS4; Celine Goetz, MD; Laura Hodges, MS4; Joel Schwab, MD 

Statement of Problem, Question, or Issue Addressed: The Visual Art and Medicine class was developed in 

partnership with the University of Chicago Smart Museum as an elective class designed to enhance medical 

students’ communication and visual observation skills, as well as a venue for students to discuss values and 

experiences in becoming a doctor. Art-based classes at other medical schools have been shown to enhance 

student observational skills, and the Visual Art and Medicine curriculum was designed to expand upon this 

model by guiding students in the exploration of meaning and values-based aspects of art as a way to reflect 

upon the medical school experience. 

Objectives of Program/Intervention: The objectives of the class were to hone students’ observational skills, as 

well as to build communication skills through observation, description, and analysis of art. Additionally, the 

class aimed to use artwork as a tool both to build empathy, and to create a safe space to discuss values and 

experiences in medicine. 

Description of Program/Intervention: Visual Art and Medicine: Using Art to Explore the Practice of Medicine 

was an eight session course held in April 2011 and offered to twenty 1st, 2nd and 4th year medical students at 

Pritzker. The elective curriculum was developed based on a review of other art and medicine curricula offered to 

medical students and residents. The course consisted of five sessions at the Smart Museum and three art-related 

excursions. The first half of each Smart Museum session consisted of art observation exercises, and the second 

half consisted of discussion sessions with guest faculty, which were facilitated by 4th year teaching assistants. 

Students were asked to bring in artwork pertaining to one of four topics: the body, illness and pathology, 

empathy, and becoming a doctor. Discussions were based on themes addressed by these works of art. 

Results/Findings to Date: A survey was created to assess the performance of the Visual Art and Medicine elective 

across key objectives. Seventy-five percent of students said the class enhanced their understanding of medical 

practice and/or the art of being a physician and 91.7% of students said they would sign up for the course 

again. Student comments were also very helpful. One student commented that the class created “an open space 

where there was no hierarchy and where everyone felt comfortable sharing thoughts, even ones that were very 

personal.” Other comments included that the class served as “a reminder of how I initially felt about medicine 

and becoming a physician” and that it “made me more aware of the things I am seeing in general.” 

Key Lessons Learned/Conclusions: Medical students value the opportunity to participate in an arts-based class 

that offers a safe space for discussion among students at various points in their medical education. The Visual 

Art and Medicine class offers students a humanistic way to approach their experiences in medical education. 

17

7. Clinical Simulation Initiative in Psychiatry for Medical 

Students: Development of a Free National Database 


Grant 

Michael Marcangelo, MD; Angela Blood, MPH, MBA; Laura Hodges, MS4 

Statement of Problem, Question, or Issue Addressed: There is a growing movement in medical education 

emphasizing the importance of learner-centered strategies, while still valuing the integrity of traditional 

patient-centered instruction. In the last decade, medical educators have created national databanks of online, 

interactive teaching cases for clerkship students as a reflection of the learner-centered approach. For example, 

there are currently 32 online interactive pediatric cases known as the CLIPP cases (Computer-Assisted Learning 

in Pediatrics Program), 36 internal medicine SIMPLE cases (Simulated Internal Medicine Patient Learning 

Experience), 15 surgery WISE-MD cases (Web Initiative for Surgical Education), and 29 family medicine 

fmCASES (Family Medicine Computer-Assisted Simulations for Educating Students) that are widely used by 

clerkship directors. However, there is currently no equivalent collection in psychiatry. 

Objectives of Program/Intervention: We aim to create a free national database of Self-Learning Modules to 

provide alternative medical experiences for third year medical students who do not encounter certain required 

clinical conditions during their core Psychiatry clerkships. We will assess the modules by collecting data from 

online surveys to be completed by students. 

Description of Program/Intervention: A Clinical Skills Initiative (CSI) Task Force has been formed within 

ADMSEP (Association of the Directors of Medical Student Education in Psychiatry) and charged with 

developing new Self-Learning Modules for medical students during their core Psychiatry clerkships. These 

Self-Learning Modules will be based on the 14 common DSM-IV-TR diagnostic categories, as defined by 

the ADMSEP Psychiatry Learning Objectives Taskforce, which should be taught to clerkship students. The 

modules consist of filmed clinical scenarios with standardized patients, general patient care info relevant to the 

condition, and periodic quiz questions. The modules are not meant to replace actual clinical experiences with 

patients, but are meant to supplement student education when direct clinical exposure is not possible for a 

particular learning objective. 

Results/Findings to Date: To date, a total of five modules have been created, including patient cases depicting 

somatization disorder, adjustment disorder, and adolescent depression. In addition, pilot data from students 

examining the acceptability and utility of the modules has been gathered and will be presented. 

Key Lessons Learned/Conclusions: Going forward, our plan is to develop a significant library of cases and 

distribute them widely, for free, to medical schools through online resources such as MedEdPORTAL. 

18

8. Geriatrics and Aging through Transitional Environments 

(GATE) MS1 Curriculum: Obtaining a Functional History 

Plenary 


Grant 

Seema Limaye, MD; Shellie Williams, MD; Sandy Smith, PhD; Aliza Baron, MA 

Statement of Problem, Question, or Issue Addressed: The GATE curriculum teaches geriatrics across the 

spectrum of care settings, from home to independent living to hospital and nursing home. This MS-1 

experience is a home visit in an independent senior building that provides first year medical students the 

opportunity to take a functional history in a geriatric “trained patient” and conduct a brief home safety 

assessment. 


1. To develop geriatric assessment skills for Pritzker medical students in specific competencies, in particular: 

2. Assess and describe baseline and current functional abilities in an older adult 

3. Identify and assess safety risks in the home environment. 

4. To record and reflect on their trained patient encounter. 

Description of Program/Intervention: Prior to curriculum implementation, we hosted a 2.5 hours training 

session for over 30 independent seniors at Montgomery Place Retirement Community to recruit “trained 

patients”. The curriculum consists of a 1.5 hour lecture, followed by a home visit to an independent senior 

building. The lecture focused on geriatric history-taking skills and components of a geriatric functional history. 

During the last 30 minutes of the lecture, an independent active older adult visited the class and took questions 

about her life story. Over the next 6 weeks, students (in pairs) were assigned to visit “trained patient” living in 

at Montgomery Place Retirement Community, and conduct a functional history-taking interview and a home 

safety assessment. Clinical interviewing skills are assessed by “trained patients”, who deliver verbal feedback to 

the students and complete structured written assessment. Students wrote a 250 word reflective essay about the 

encounter. 

Results/Findings to Date: Eighty nine students completed the interview experience. A random sample of 27 

reflective essays (30%) were evaluated using a grounded theory qualitative analysis. The following themes were 

identified: 

• Patient independence; 

• Fascination with the patient’s life story; 

• Comfort with the geriatric patient; 

• Discomfort with interview content; 

• Importance of history-taking skills; and 

• Learning from patients. 

Trained patients evaluated each student on their interviewing skills and provided excellent ratings of student 

skills. Open-ended comments were positive, with some comments providing congruence with the categories 

derived from the student essays. 

Key Lessons Learned/Conclusions: This curriculum afforded students the unusual opportunity to enter the 

home of an older adult “trained patient” to take a geriatric functional history and a home safety evaluation. 

Students’ self-reflections on the experience indicate significant value in the experience. For instance, students 

reported numerous positive aspects of this interview experience but also recognized the challenge of taking a 

functional history and of asking sensitive questions. Feedback from the trained patients indicated their delight 

in participation and their ability to contribute to the students’ education. 

19

9. Responding to Student-Identified Learning Needs: A Mixed 

Method Survey to Guide the Family Medicine Curriculum 

Kohar Jones, MD; Mari Egan, MD, MHPE; Irma Dahlquist 

Statement of Problem, Question, or Issue Addressed: Medical students struggle to master an informal curriculum 

on each of their clinical rotations. Medical educators must identify these concerns to successfully address 

student learning needs. A qualitative analysis of student reflective writing from the family medicine clerkship 

revealed frequently recurring themes and subthemes, including learning concerns that suggested the potential 

for curricular reform. 

Objectives of Program/Intervention: We surveyed fourth year medical students to understand which of the 

identified potential learning needs students wanted to obtain formal training in on their family medicine 

rotation. 

Description of Program/Intervention: We conducted a mixed methods survey of fourth year medical students 

who had already completed the family medicine rotation. Students were asked to rank in order which of the 

identified potential unmet learning needs they would like to learn more about during their family medicine 

clerkship. These included: health care reform, handing time constraints, developing into a doctor, building 

relationships, cross cultural awareness, and pharmaceutical industry relationships. 

Results/Findings to Date: 59 out of 83 medical students responded, a 71% response rate. Students identified 

“health care reform” as the topic they most wanted to see in future curriculum, closely followed by “handling 

time constraints.” “Pharmaceutical industry relationships” was the topic they least wanted to see. 

Key Lessons Learned/Conclusions: Reflective writings provide a rich source of data to assess medical student 

concerns. Our qualitative/quantitative analysis identified unmet learning needs for medical students on the 

third year family medicine clerkship. “Health care reform” and “time constraints” were themes that most 

concerned our sample of medical students. The family medicine curriculum has been modified to incorporate 

these student-identified learning needs. 

20

10. Medical Students as Hospice Volunteers: Influence of an 

Early Experiential Training Program in End-of-Life Care 

Education 

Melissa Mott, PhD, MS3; Stacie Levine, MD; Rita Gorawara-Bhat, PhD 

Statement of Problem, Question, or Issue Addressed: During pre-clinical training, medical students are rarely 

exposed to palliative medicine and end-of-life (EOL) care. 

Objectives of Program/Intervention: To provide first-year medical students opportunities to experience pertinent 

issues in EOL by serving as hospice volunteers. 

Description of Program/Intervention: Patients and Families First (PFF)-a training program in EOL care 

education-was piloted on two cohorts of MS-1s (2009-2011). Students received 3 hours of volunteer 

training, and were required to conduct at least two consecutive hospice visits in pairs to obtain course credit. 

Students’ pre and post-volunteering attitudes were evaluated through Bugen’s Coping with Death Scale (0- 

210); Reflective essays were analyzed using qualitative methodology; salient themes were extracted by two 

investigators independently and then collaboratively. 

Results/Findings to Date: PFF participants (N=42) demonstrated a trend in improvement in baseline and 

post attitudes towards dying compared to student controls (pre all students=129; SD=14.3), (post: PFF=144; 

SD=14.9), (controls=130; SD=15.5). Qualitative analyses yielded three major themes including students’: 

1. Reactions - initial discomfort and vulnerability, amazement in normalcy of dying at home, devotion of 

caregivers, limitations in altering outcomes for patients at EOL, and personal reward through vicarious 

learning from elders; 

2. Perceptions of patients’ unanticipated needs including relief of non-physical suffering and support of 

caregivers; 

3. Reflections on own future death and value of volunteering in helping future physicians cope with death/ 

dying. 

Female and male student essays differed: females addressed socio-emotional aspects of patient and family care 

compared to males focusing on instrumental issues. 

Key Lessons Learned/Conclusions: Hospice volunteering during pre-clinical years provides valuable experiential 

training for students in caring for seriously ill patients and their families by fostering personal reflection and 

building of empathic skills. 

21

11. Improving Student-Run Free Clinic Care Through Pre- 

Clinical Student Didactic Intervention: A Pilot Feasibility 

Study 

Andrew W. Phillips, MEd, MS4; Kristine Bordenave, MD; Rita Rossi-Foulkes, MD, MS 

Statement of Problem, Question, or Issue Addressed: Student-run free clinics that are overseen by faculty are 

increasingly common throughout the country. Since their inception, concerns over maintaining high quality 

care provided by medical students, especially pre-clinical students, have been raised. 

Objectives of Program/Intervention: Determine the subjective feasibility of a vertically integrated, informal 

course for pre-clinical students to improve patient care at a student-run free clinic as measured by student 

perception of the intervention. 

Description of Program/Intervention: First year medical students voluntarily participated in a 15 minute smallgroup 

didactic session at the Community Health Clinic (CHC) each month before their shifts from January 

through April 2011 and one session at the University of Chicago in May 2011. Topics included diabetes 

mellitus, renal and nervous system components of hypertension, mood disorders, and low back pain and 

outpatient analgesia. Each session was divided into basic science and clinical perspectives with an emphasis on 

general management of patients with respect to integrating physiology, pathophysiology, and therapeutics. 

A proof of concept study was created using pre-obtained quality assurance and course data. Surveys composed 

of 7-point Likert scale questions and free response questions were analyzed with descriptive statistics. 

Results/Findings to Date: 14 of 26 students (54%) responded. All but one participant (92.9%) reported that 

the intervention presented unique material compared to required coursework to date. Free response sections 

described the intervention as a clinically relevant and clinically applicable elaboration of similar course topics. 

All students found the intervention to offer more information about standards of practice than their current 

courses with 78.8% of students strongly or very strongly agreeing. 

A cumulative total of 85.7% found the intervention helpful in understanding their patients’ disease processes 

and therapies. Moreover, 50% agreed that the intervention allowed them to provide improved patient care, and 

14.3% very strongly agreed, while 35% neither agreed nor disagreed. Free response answers most often cited 

greater understanding of the management decisions made by the attending and a perceived inability of first year 

medical students to change patient outcomes. Students overwhelmingly agreed (92.9% agreed, strongly agreed, 

or very strongly agreed) that the intervention improved their understanding of the rationales behind standard of 

care practices. Moreover, students reported a higher likelihood of using standards of practice care as a result of 

the intervention; 57.1% agreed and 21.4% strongly agreed, while 21.4% neither agreed nor disagreed. Students 

reported using information from the didactic sessions for patient care a median of 2.5 times over approximately 

5 clinic days, and all respondents reported at least one direct use. 

Key Lessons Learned/Conclusions: Pre-clinical students found the didactic intervention to contribute unique 

and helpful clinical pathophysiological and therapeutic information. They further reported an improved 

understanding of patient management and higher likelihood of employing standard of care practices. Our 

findings support the conceptual plausibility of a vertically integrated course for pre-clinical students to improve 

patient care in the student-run free clinic setting. Follow-up studies comparing objectively measurable patient 

outcomes are warranted. 

22

12. Integration of the Virtual Human Embryo into the First 

Year Anatomy Curriculum 

GME 

Grant 

Callum Ross, PhD; James O’Reilly, PhD; Quinn Dombrowski; Sam Quinan 

Statement of Problem, Question, or Issue Addressed: Historically, the Human Anatomy courses at the University 

of Chicago used serially sectioned chicken embryos and light microscopes to demonstrate the early stages of 

human development. This curriculum content was received with much skepticism by the medical students 

(“why am I looking at a chicken?”) and required them to reconstruct 3D relationships from sections that were 

arranged in lateral rows on microscope slides. 

Objectives of Program/Intervention: In order to make embryology more accessible and more relevant to medical 

student education, we decided to integrate online human embryological material in the course. 

Description of Program/Intervention: In 2007, we transitioned to utilizing the Virtual Human Embryo images 

produced by the Louisiana State University Health Sciences Center. These are digital images produced from 

serially sectioned human embryos from the Carnegie Collection. The sections are presented in the same 

fashion as serial CT or MRI images, allowing students to grasp 3D relationships more easily. In 2009, the 

original images from LSU were integrated with the Virtual Microscope interface that was also being introduced 

for Histology and Pathology in the first and second year curriculum to replace light microscopes. Unlike the 

original interface produced by LSU, the Virtual Microscope allows students to both zoom in from the entire 

image to specific areas of the section, and to follow that region from section to section. At the start of this 

project, specimens representing only the first 5 weeks of development (up to Carnegie Stage 14) were available. 

As later stages became available, they were integrated into the course. 

Results/Findings to Date: The introduction of the Virtual Embryo into the curriculum and its integration 

with the Virtual Microscope has substantially reduced skepticism regarding the importance of embryology, 

has dramatically improved the efficiency of teaching important 3D relationships during development, and has 

allowed the addition of laboratories addressing organogenesis to the first year curriculum. 

Key Lessons Learned/Conclusions: Our future efforts should include completing the integration of the latest 

stages made available from LSU, representing weeks 6 through 8 of development (Carnegie Stages 18 through 

23), improving the current annotation interface to make it more informative and user friendly, and adding 

functionality enabling us to link directly to specific sections of specific stages from text of our laboratory 

handouts. 

23

13. Qualitative Analysis of First Year Medical School 

Orientation 

Sean Swearingen, MS2; H. Barrett Fromme, MD, MHPE; Shalini Reddy, MD 

Statement of Problem, Question, or Issue Addressed: How can medical school orientation be changed to improve 

the transition into medical school for the incoming first year class? 

Objectives of Program/Intervention: Find significant trends in the qualitative survey analysis, and then use these 

trends to improve the orientation process for the next incoming class. 

Description of Program/Intervention: A week before orientation, incoming first year medical students were 

asked to fill out a survey (online using Survey Monkey) that asked them about their concerns about coming 

into medical school, and what their expectations were for orientation. They were then sent a reminder email 3 

days before orientation started if they had not yet filled out the survey. Immediately following orientation, the 

new first year students were asked to fill out another survey which focused on what they thought of specific 

things in the orientation process that have the potential to be changed. Those that did not fill out the survey 

immediately were reminded to a few days later. 

Results/Findings to Date: Although the results will not be done being fully analyzed for another week or so, 

from the analysis so far we have found that overwhelmingly, the main concern students have when starting 

medical school is being able to balance the time commitment for school with having a life outside of medical 

school. Additionally, the thing they hope to gain the most from orientation is making social connections with 

their classmates. As far as things that were found to need improvement from the post orientation survey, the 

major points include facilitating group interaction, and changing up the timing of when certain events took 

place. 

Key Lessons Learned/Conclusions: We are still working on getting a definitive conclusion, but it seems at this 

point that there needs to be an effort to improve scheduling to benefit the incoming students, and to improve 

facilitation of social activities by the second year medical students involved in orientation. 

24

14. Graduate Medical Education in Frailty: The SAFE Clinic 

MERITS 

Katherine Thompson, MD; Megan Huisingh-Scheetz, MD, MPH; Lisa Mailliard, APN, MSN; 

Patricia Rush, MD, MBA 

Statement of Problem, Question, or Issue Addressed: Frailty is a geriatric syndrome, characterized by: low energy 

or exhaustion, weakness, weight loss, slow walking speed, and low physical activity. As the number of adults in 

the U.S. grows every year, it will be increasingly important for physicians to identify and manage frail patients. 

Data suggests that the ability to identify frailty can enhance patient care through improved prognostication as 

well as more accurate preventive screening and treatment decision-making. No didactic or clinical education on 

frailty currently exists in University of Chicago’s Internal medicine (IM) resident curriculum. In addition, there 

is limited opportunity for IM residents to learn to work with interdisciplinary teams, which is an important 

aspect in the care of frail patients. 

Objectives of Program/Intervention: After participation in the SAFE Clinic frailty curriculum, IM residents will 

be able to: 

1. Define frailty and identify frail patients. 

2. Perform and interpret functional and cognitive assessment. 

3. Appreciate the importance of interdisciplinary care for frail patients. 

4. Appreciate the relevance of geriatric assessment to their future practice. 

Description of Program/Intervention: IM Residents will rotate through the Successful Aging and Frailty 

Evaluation (SAFE) Clinic, housed within the South Shore Senior Center geriatrics clinic, during their monthlong 

geriatrics rotation. Residents will join the SAFE Clinic team for one day on two consecutive weeks. Week 

one will consist of a pre-test assessing frailty knowledge and attitudes. Residents will then have a 30 minute 

didactic lecture on frailty, given by a geriatrician, and then observe a frailty assessment and learn how to 

administer cognitive and functional tests. On week two, residents will return and perform a frailty assessment 

on a new patient while a practitioner (MD or APN) observes and gives feedback. The resident will then 

participate in an interdisciplinary team meeting with an MD, APN, and social worker for patient care planning 

based on frailty status. Week two concludes with a post-test. 

Results/Findings to Date: Six residents have completed the SAFE Clinic frailty curriculum to date. Initial 

resident satisfaction survey results have been very positive. Representative quotes include: “One week ago, I 

had never heard of frailty. Now I not only know what frailty is, I have completed a frailty evaluation with an 

82-year-old man,” and “I really enjoyed participating in the interdisciplinary team meeting. I felt like I learned 

about a lot of options for patients that I never knew existed.” 

Key Lessons Learned/Conclusions: The SAFE Clinic provides an innovative forum for residents to learn about 

frailty and practice interdisciplinary care. Early feedback suggests that resident satisfaction with this educational 

experience is high. Future work will quantify improvements in resident knowledge, skills, and attitudes. In 

the future, this experience will also be expanded to other learners including medical, APN, and social work 

students. 

25

15. Geriatrics and Aging through Transitional Environments 

(GATE) MS2 Curriculum: Introduction to Geriatric 


Grant 

Assessments 

Shellie Williams, MD; Seema Limaye, MD; Sandy Smith, PhD; Aliza Baron, MA 

Statement of Problem, Question, or Issue Addressed: Competency-based assessment tools indicate whether 

students have mastered required skills. A 360 degree competency-based evaluation tool was developed for 

simulated patient cases focusing on geriatric assessment skills. A comparison of student self-evaluations with 

simulated patient and preceptor evaluations was conducted. 


1. To enhance geriatric assessment skills linked to AAMC Core Competencies. 

2. To develop evaluation tools and methods based on the AAMC Core Competencies. 

Description of Program/Intervention: Lecture and Workshop: “Introduction to Geriatric Assessments” began 

with a lecture highlighting strategies for: communicating with elderly patients and their caregivers; conducting 

advance directive discussions and; administering common geriatric screening tests for pain, gait, falls, 

depression, functioning, and cognition. The lecture was followed by a practice workshop facilitated by geriatric 

team members for students to role play introducing and administering geriatric screening tools. 

Simulated Patient (SP) Experience: The 2-hour simulated patient encounters are a required course component. 

87 Pritzker MS2 students conducted an SP interview in 1 of 6 geriatric cases. Each case was observed by a 

preceptor and verbal feedback was provided immediately after the encounter by the preceptor and simulated 

patient. 

Evaluation: Each student, their SP and preceptor completed a competency-based evaluation of the student’s 

performance. In addition, students assessed their current and prior confidence in taking a functional history 

and performing geriatric exams and screening tests. 


1. Self-confidence in taking a functional history and performing geriatric assessment. Students felt more 

confident after the intervention in 1) taking a functional history and 2) conducting a physical exam and 

conducting screening tests (t(86) = -16.08, p

16. The Hand-off CEX: Instrument Development and 

Validation 

Saba Berhie, MS2; Vineet Arora, MD, MAPP; Paul Staisiunas; Jeanne Farnan, MD, MHPE 

Statement of Problem, Question, or Issue Addressed: The most recent iteration of the Accreditation Council for 

Graduate Medical Education (ACGME) duty hour regulations, released in July 2011, has further limited 

PGY-1 shift duration to 16 hours. Explicit language in these regulations also mandates handoff education for 

trainees and for residency training programs to assess handoff quality. However, there is a lack of validated tools 

for the assessment of handoff quality and to utilize for trainee education. 

Objectives of Program/Intervention: The specific aims of this project were to create video-based examples of 

varying levels of handoff performance for education, adapting the approach in this publication, and to validate 

an assessment instrument, the Hand-off CES. 

Description of Program/Intervention: Six video-based scenarios were developed which highlight varying levels 

of performance in the domains of communication skills, professionalism and setting. Each video permuted 

one domain of performance while holding the others constant. Scripts were based upon real-time clinical 

observations. Videos ranged in length from 3-5 minutes. Videos were shown and debrief occurred immediately 

after to identify barriers and facilitators to the displayed behaviors. 

Faculty were recruited via email to participate in a workshop on handoff education and evaluation to both pilot 

test the videos for instrument validation. 

Videos were shown in a random order and faculty were instructed to use the Hand-off CEX to rate the 

performance. Briefly, the Handoff CEX was developed in prior work by Arora et al as a paper-based instrument 

in which individuals are rated in six domains on a nine point scale (unsatisfactory[1] to superior[9]) with 

qualitative anchors defining each level of performance. 

Descriptive statistics and two tests of reliability, Cronbach’s alpha and Kendall’s coefficient of concordance, were 

performed. Two tests of validity were performed: a test of trend across ordered groups and a two-way ANOVA 

to examine for rater bias. 

Results/Findings to Date: Fourteen faculty from 2 departments participated. 73 of a possible 90 (82%) handoff 

observations were captured. Reliability testing revealed a Cronbach’s alpha of 0.81 (0.8=optimal) and Kendall’s 

coefficient of concordance of 0.59 (>0.6=high reliability). Faculty were able to reliably distinguish the different 

levels of performance in each domain (e.g. communication skills, professionalism and setting) in a statistically 

significant fashion. Two-way ANOVA revealed no evidence of rater bias. 

Faculty participants commented on face validity of video scenarios, specifically those portraying setting and 

communication skills. In addition, robust discussion resulted in identifying the barriers and facilitators to the 

behaviors demonstrated in the video. 

Key Lessons Learned/Conclusions: Video-based scenarios, utilized to highlight differing levels of performance, 

with focused debrief are an effective way to observe specific domains and behaviors in handoff communication. 

In addition, the Hand-off CEX is a reliable and valid tool to assess varying levels of videos depicting handoff 

performance. 

27

17. Improving Post-Hospital Follow-up for Resident Clinic 

Patients Through a New Discharge Clinic 

Katrina Booth, MD; Amber Pincavage, MD; Lisa Vinci, MD; Beth White, PharmD 

Statement of Problem, Question, or Issue Addressed: University of Chicago internal medicine residents have 

consistently expressed difficulty in balancing inpatient responsibilities with outpatient continuity clinic patient 

care. This balance can be particularly challenging when trying to provide outpatient care for a medically 

complex clinic patient recently discharged from the hospital. Residents frequently cite limited appointment 

slots as a barrier to providing timely post-hospitalization follow-up care. Delayed time to follow-up in primary 

care also has implications for patients. Several studies have demonstrated that patients discharged from the 

hospital who are not seen in primary care clinic soon after discharge are at higher risk for readmission. 

Objectives of Program/Intervention: To improve both patient care and resident satisfaction, we have created a 

new weekly discharge clinic for resident continuity clinic patients who need early post-hospital follow-up. 

Description of Program/Intervention: The discharge clinic is a weekly half-day clinic which provides timely 

(1-2 weeks) post-hospital follow-up for resident continuity clinic patients who are unable to see their resident 

primary care physician due to lack of appointment openings. The clinic is staffed by a senior resident on an 

ambulatory rotation, a clinical pharmacist, and a general medicine attending preceptor. Visits are 1 hour in 

length, and each clinic can accommodate up to 4 hospital follow-up visits. The discharging teams are able to 

make appointments for patients via email and are asked to provide communication about the patients’ clinical 

needs prior to the visit. 

Results/Findings to Date: We plan to study the impact of the discharge clinic on time to follow-up in primary 

care after hospitalization, frequency of emergency room visits after hospitalization, and re-hospitalization 

rates. In addition, we hope to improve resident satisfaction with the balance of inpatient and outpatient 

responsibilities and provide education to residents about transitions of care after discharge. 

Key Lessons Learned/Conclusions: To date, residents have a positive experience with the clinic and anticipate it 

will improve care of their patients. Having a multi-disciplinary team is crucial to the quality of care provided. 

Key to the transition of care from inpatient to outpatient is communication between the inpatient team and the 

outpatient physician. Maintaining a high level of communication for these vulnerable patients has proven the 

most challenging aspect of this clinic to date. 

28

18. Characterizing Physician Listening Behavior During 

Hospitalist Handoffs using the HEAR Checklist 

Plenary 

Scholarship 

& Discovery 

Elizabeth Greenstein, MS3; Vineet Arora, MD, MAPP; Paul Staisiunas; Jeanne Farnan, MD, MHPE 

Statement of Problem, Question, or Issue Addressed: With the increasing use of hospitalists, handoffs have 

become more ubiquitous. Despite the increasing focus on handoffs by numerous physician groups, current 

recommendations and studies focus on the role of the person giving information in the handoff, or the sender. 

Given the importance of dialogue and two-way communication, we aim to observe and characterize listening 

behaviors of handoff receivers on an academic non-teaching hospitalist service. 


1. Displays of understanding, quantifying passive listening behaviors such as nodding, 

2. Processing information, focusing on active listening behaviors such as note-taking and questioning 

3. Interruption frequency and source 

Description of Program/Intervention: Handoffs were directly observed by a trained third party observer at 

a single academic medical center using the paper-based HEAR (Handoff Evaluation Assessing Receivers) 

checklist. The HEAR checklist was developed following a review of relevant literature and expert review. 

The checklist was piloted on the hospitalist service from June-November 2010. Descriptive statistics were 

performed and, where appropriate, two-sided t-tests, to compare passive and active listening behaviors. Pairwise 

correlations were calculated with the Handoff CEX instrument, developed to measure overall handoff quality. 

Results/Findings to Date: In the 48 handoffs observed, receivers displayed active listening behaviors significantly 

less frequently than passive listening behaviors (0.89 vs 1.65 (on a 0-3 scale) per handoff p

19. Risk of Resident Clinic Handoffs: Showing up is Half the 

Battle 

MERITS 

Amber Pincavage, MD; Megan Prochaska, MD; Julie Oyler, MD; Vineet Arora, MD, MAPP 

Statement of Problem, Question, or Issue Addressed: Many patients nationwide change their PCP when 

departing Internal Medicine residents graduate. No studies have examined this handoff. 

Objectives of Program/Intervention: Our study aims to assess patient outcomes of these care transitions. 

Description of Program/Intervention: In June 2010, graduating residents listed “high risk” patients on a signout 

with reasoning, target follow-up, and pending studies. Residents then discussed the patients during a designated 

handoff meeting. Chart audits examined when high risk patients were seen and by whom, acute care visits in 3 

months after the transition and if there were any associations between the clinic handoff process and outcomes 

(ED visits, hospitalizations and study follow-up). Residents assuming care were surveyed regarding their 

perceptions. 

Results/Findings to Date: Thirty graduating residents identified 258 high risk patients. Mean age was 61, 63% 

were female, and on average patients were transitioning to their 3rd PCP in 5 years. These patients had more 

co-morbidities (2.6 vs. 1.7, p

20. Medical Education Curricula: Integrating Healthcare 

Quality and Patient Safety 

Elizabeth Rodriguez, MBA, MS; Kevin Weiss, MD, MPH 

Statement of Problem, Question, or Issue Addressed: Medical schools are trying to incorporate patient safety 

into both the formal and informal curriculum through development of education programs for faculty, staff, 

and trainees. But most medical schools have not incorporated any content on patient safety or quality. Even 

though, some safety and quality elements have been incorporated into organizational core competencies, the 

competencies that comprise patient safety remain unclear. 

Objectives of Program/Intervention: In order to demonstrate that medical schools must model excellence in 

their curriculum by integrating healthcare quality and patient safety (“HQS”), I concentrated on the new 

Northwestern Feinberg School of Medicine Physician Assistant Program (“Program”) as a pilot area in order 

to provide some guidance in integrating HQS curriculum. The Program is part of the school of medicine and 

started its first class in June 2010. It is an accredited, two year program that uses lecture, small group discussion, 

clinical experiences, team-based learning and problem-based learning. However, it does not have formal 

curriculum on HQS. Nonetheless, for the first time, HQS is required to be part of its curriculum. Thus, I 

developed and delivered a curriculum providing an overview of topics in HQS and assessed Physician Assistant 

(“PA”) student learning through the application of three assessments. 

Description of Program/Intervention: My intervention consisted of a short three hour seminar provided to all 

30 current students and first cohort of the Program. I coordinated the sessions, materials and logistics as well 

as three assessments. The PA student learning objectives were: (1) PA students will implement and measure 

improvements in their own practice setting and (2) improve their communication skills as they relate to 

the discussion of medical mistakes. The learning objectives were broken into detailed elements. These were 

then linked to the assessment that included the measure of key content taught at the seminar. Moreover, 

the seminar’s curriculum was also directly linked to the learning objectives, but also to the Program’s core 

competencies and curriculum requirements. 

Results/Findings to Date: While I could not assess improvement in patient care directly, I measured how 

knowledge in HQS was improved. There was a pre-quiz, post-quiz 1 (conducted the same day as the seminar) 

and a post-quiz 2 (completed one month after the seminar). Overall, the seminar intervention was a success 

because it resulted in higher scores in both post-quiz 1 and post-quiz 2. In the pre-quiz, all students scored 

under 60% (correct); in post-quiz 1, students scored mostly between 61-80%; and during post-quiz 2, 

most students scored between 51%-80%. However, post-quiz 1 scores are higher than post-quiz 2, which 

demonstrate deterioration of knowledge over time (proving that PA students will benefit from another seminar 

during their year 2 for reinforcement). 

Key Lessons Learned/Conclusions: PA students were able to attain a snippet of HQS curriculum. However, the 

results demonstrate that there is still much room for improvement, since the scores are not high enough to 

prove mastery in HQS. In fact, besides annually providing this type of seminar for all first year PA students, 

another seminar in the PA students’ second year with reinforcement elements and curriculum that was not 

covered during this first seminar may be a potential future investment. It is our duty as teachers and educators 

to ensure that patient care is directly improved through the training and resources that we provide new students 

and even current practitioners. In addition to this return on investment, these types of seminars will drive future 

Program rankings. However, it is important to consider a fully developed course with detailed HQS curriculum 

that should be embedded in the Program’s core curriculum, which will yield a maximum return on investment. 

31

21. Role of Social Media in Graduate Medical Education: A 

Blogger’s Perspective 

Wilma Chan, MD; James Ahn, MD; Alisa McQueen, MD; Christine Babcock, MD, MSc 

Statement of Problem, Question, or Issue Addressed: Emergency Medicine Residents (EM/EMR) are 

overwhelmed with busy, irregular work hours and keeping up with medical literature becomes infrequent. Adult 

learners acquire information more readily if materials are provided in a variety of formats. Learning materials 

presented through interactive Social Media (SM) may increase the accessibility and frequency of EMRs selflearning. 

Objectives of Program/Intervention: A daily EM blog will increase the frequency of residents self-learning by 

providing accessibility to educational materials. 

Description of Program/Intervention: “Mitchell Cases,” an online weblog (“blog”) presents board-style questions 

with high-yield explanations detailing evaluations, diagnostics, treatments, and dispositions. Case questions 

posted at the beginning of the week encourage discussion of the clinical problem through the comments 

section. Participants submit answers anonymously and a case summary is posted at the end of the week. Topics 

highlight the core content of EMR curricula--the esoteric as well as high risk cases, including cardiac arrest, 

toxicology, environmental exposure, and endocrine emergencies. Additional blog entries feature EM faculty 

reviews of current literature, lecture summaries, EMR study tools, and career guidance. All posts and patient 

information are protected with private access only for EMR and faculty. Daily blog posts are scheduled Monday 

through Friday and Google Analytics gathers anonymous data such as: user traffic, time of day, frequency, and 

visit duration. 

Results/Findings to Date: Sixty-four invited visitors have access to the blog. Between August 26-September 25 

2011, Google Analytics data show 47 distinct visitors who follow the daily blog with a total of 234 visits and 

598 distinct pages viewed. Ninety-two percent of the 47 visitors return to the blog between that same period. 

On average, there are twice as may visits on Mondays and Tuesdays, independently, compared to other days of 

the week. Average time spent on the blog is 3min 49sec and visitors consumed between 1 to 6 distinct pages at 

each visit to the blog (average 2.56 pages). 

Key Lessons Learned/Conclusions: The educational blog is an interactive SM tool in graduate medical education 

(GME) that is accepted among EMR--data indicate its consistent use among returning visitors. Although SM 

has not gained complete acceptance in medical education settings, use of SM in GME may eventually replace 

more traditional learning methods. It is imperative for EM faculty and GME programs to be comfortable using 

SM tools for disseminating formal/ informal educational materials. It is unclear whether this format improves 

EMR clinical knowledge/ practice or standardized test scores--variations in individual study skills, experience, 

and small sample size do not allow us to make this conclusion. Future directions would include larger surveys 

and studies of EMR performance in clinical and test settings. 

32

22. Exploring Opportunities and Challenges Posed by 

Technology Integration: A Simulation Workshop for First 

Year Medical Students 

Vikrant Jagadeesan, MS2; Angela Blood, MPH, MBA; Stephen Small, MD; Saeed Richardson 

Statement of Problem, Question, or Issue Addressed: The University of Chicago Simulation Center (UC Sim) 

was approached by a student-led organization, Students for the Advancement of Technology in Medicine, 

to create an event for first year medical students (MS1) for several reasons. First, there was limited awareness 

among pre-clinical medical students about simulation technology and resources. Second, the multi-station 

approach would allow students to observe technology integration in various clinical settings. Third, many MS1 

elective events are lecture-based, while a workshop would allow for active learning. 

Objectives of Program/Intervention: One of the challenges in creating a workshop for MS1 students was to 

ensure that the content would be specifically tailored to the learner’s level of experience and ability. While first 

year medical students did not have extensive clinical experience, they did have background in specific training, 

such as CPR, that could be applied. In order to address the purpose of the project while considering the 

learner’s abilities, the educational goals were to: 

1. Expose first year medical students to simulation and technology at the University of Chicago. 

2. Gauge the students’ understanding of the opportunities and challenges posed by technology in medicine. 

3. Provide a conceptual framework for considering technological integration as it relates to patient safety and 

clinical outcomes. 

Description of Program/Intervention: A pilot workshop for 11 medical students began with a short didactic to 

introduce a conceptual framework. Content included examples of technology integration with both positive 

and negative consequences for patients, and a discussion of the changing job environments and training needs. 

Students then were separated into groups of three, and participated in five stations of 20 minutes each. 

Station I: Robotic Surgical Skills, Dr. Konstantin Umanskiy 

Station II: Laparoscopy Surgical Skills, Dr. Vivek Prachand 

Station III: Use of Ultrasound in Guiding Central Line Placement, Dr. Sean Smith and Dr. Nilam Soni 

Station IV: Interprofessional Team Training, Cynthia LaFond, R.N., Dr. Heather Fagan, Dr. Lisa McQueen 

Station V: Clinical Care Vignettes, Dr. Stephen Small 

Faculty leaders were recruited from Surgery, Hospital Medicine, Nursing, Pediatrics, and Anesthesia, 

emphasizing UC Sim as an institutional core facility. 

Results/Findings to Date: A course evaluation was included, collecting both quantitative and qualitative data. 

The student comments were overwhelmingly positive (M = 4.81 on a scale of 1-5), repeatedly requesting 

further workshop sessions. The qualitative data was especially informative, and will be showcased in the poster. 

Key Lessons Learned/Conclusions: Future sessions are planned for Fall 2011 to introduce UC Sim to the 

new MS1 class and current MS2 students. We will investigate the utility of integrating simulation into the 

existing pre-clinical curriculum. In addition, 100% of the students responded favorably to the prospect of a 

novel fourth-year elective course. Finally, student reflection during the debriefing session revealed that early 

simulation exposure and training could be a valuable preparatory exercise for the clinical years of medical 

education. 

33

23. ABCs in the Sandbox: Interdisciplinary Trauma Team 

Training 

MERITS 

Alisa McQueen, MD; Michele Harris-Rosado, RN, BSN; Grace Mak, MD; Mindy Statter, MD 

Statement of Problem, Question, or Issue Addressed: Comer Children’s Hospital at the University of Chicago 

hosts the only Level I Trauma Center on the south side of Chicago, caring for over 400 injured children 

meeting “level 1” trauma criteria annually. While providing this important clinical service, the pediatric 

trauma and pediatric emergency medicine teams provide clinical education to over 200 residents each year. 

The critically injured child deserves the very best performance from all of us, requiring both institutional 

preparedness and personal preparedness. Our teams of physicians, nurses, technicians, and ancillary staff change 

frequently, and the critically injured child can arrive to the emergency department with little to no advance 

warning, so maintaining that institutional preparedness and personal preparedness is challenging. One strategy 

is through medical simulation. 


1. Practice the cognitive, motor, and communication skills required to resuscitate a critically injured child in a 

multidisciplinary team setting. 

2. Critically evaluate one’s own performance and the team performance and deliver effective feedback during 

structured debriefing sessions. 

3. Identify individual gaps in performance in order to form the foundation for deliberate practice of skills 

needed to resuscitate the critically ill child. 

Description of Program/Intervention: In the summer of 2010, we established monthly trauma resuscitation 

simulation exercises with support from the UC Simulation Center. Participants include surgical residents, 

emergency medicine residents, and emergency nurses who work as a team to resuscitate the “patient.” Scenarios 

simulate an actual trauma resuscitation using a computerized child mannequin, actual medications, and 

actual equipment. The recent addition of a procedure simulator allows trainees to perform invasive procedures 

including cricothyroidotomy, tube thoracostomy, and pericardiocentesis. Scenarios are videotaped and reviewed 

with all participants after each scenario, facilitated by faculty in a non-threatening debriefing session. Scenarios 

originate from prior challenging situations, and are designed both to train participants in a safe setting as well as 

to explore potential gaps in knowledge and performance. 

Results/Findings to Date: Participants report high levels of satisfaction with pediatric trauma simulation 

training. Features that contribute to a successful exercise include: 

1. The opportunity to demonstrate improvement in a second simulation. 

2. Conducting the exercises “in situ” in our trauma bay. 

3. Interdisciplinary representation (nursing, surgery, emergency medicine). 

4. The addition of a task trainer in which actual procedures are performed on the simulator. 

Key Lessons Learned/Conclusions: Simulation training provides important team training for our residents 

and nursing staff. We are currently working to broaden staff participation to include radiology technicians, 

respiratory therapists, and ancillary staff who are critical participants in the resuscitation of the critically injured 

trauma patient. The next step is to identify ways in which simulation training impacts on actual patient care. 

Performance measurement tools are in development to begin to answer this question. 

34

24. Participant Satisfaction with Simulation of Minimally 

Invasive Spine Surgery Using Virtual Reality and Haptics 

Ben Roitberg, MD; Pat Banerjee, PhD 

Statement of Problem, Question, or Issue Addressed: In the era of duty hour restrictions and emphasis on patient 

safety neurosurgery and other surgical specialties face an increasing need to enhance surgical training with 

simulation of key surgical tasks. 

Objectives of Program/Intervention: The purpose of this study was to evaluate participant satisfaction 

while performing a percutaneous spinal procedure on a head- and hand-tracked high-resolution and highperformance 

virtual reality and haptic technology workstation. We also aim to collect data on performance and 

accuracy. 

Description of Program/Intervention: 134 neurosurgery fellows and residents trained on an ImmersiveTouch 

system (63 on Thoracic 9,10 and 11 and 71 on Lumbar 2,3 and 4 virtual models). A virtual Jamshidi needle 

was percutaneously inserted into a virtual patient’s pedicle derived from a computed tomography data set. 

An entry point on bone surface and a target point within bone were predetermined by a spine neurosurgeon. 

Participants were allowed up to five minutes of practice attempts. They were then asked to repeat what they 

practiced. Accuracy (average Euclidean distance from predefined entry and target points) was measured for each 

insertion. Every participant was requested to fill an anonymous form asking whether they were satisfied with 

the realism of the simulation, and if not explain why. 

Results/Findings to Date: 108/134 participants filled the feedback form, 105 were satisfied and 3 were 

dissatisfied with the realism of the simulation experience. Those dissatisfied cited inability to see the image in 

3D. There were 268 measured attempts to insert the virtual needle, 248 successful, and 20 breached bone; 9 

out of 126 ( 7.14%) failed in the thoracic group, and 11/142 (7.5%) failed in the lumbar group (NS). Mean 

accuracy score of successful attempts was 13.83 mm (SD 6.74 mm). 

Key Lessons Learned/Conclusions: Satisfaction with the realism of the simulation is high. We plan a more 

detailed questionnaire in future studies. The accuracy of pedicle needle placement achieved by participants 

using the simulator is comparable to that reported in recent literature, further evidence of simulation realism. 

35

25. Incorporating Ultrasound Education into Anesthesia 

Resident Training: A Two Year Study 

Matthew Satterly, MD; Angela Blood, MPH, MBA; Jeffrey Katz, MD 

Statement of Problem, Question, or Issue Addressed: Ultrasound technology is increasingly utilized in patient 

care and is recommended by regulatory bodies to enhance patient safety. In anesthesiology, ultrasound 

guidance is frequently employed to secure vascular access or place peripheral nerve blocks. While residents have 

opportunities in clinical settings to use ultrasound, it can be a rushed experience and finer nuances for optimal 

utilization may not be appreciated. 

Objectives of Program/Intervention: To create an educational program including topics from basic function to 

identification of anatomical structures necessary to safely perform various procedures, the programmatic goals 

were to: 

1. Assess current understanding of ultrasound technology, 

2. Assess knowledge of anatomical relationships used for vascular access/peripheral nerve blocks, 

3. Educate in a concentrated fashion in these areas with multiple methods, 

4. Assess knowledge growth by using a pre- and post-test after an Ultrasound Workshop. 

Description of Program/Intervention: During the week of September 12-17, 2011, residents attended morning 

lectures on various issues related to the use of ultrasound in patient care. Lecture topics included: the physics of 

ultrasound and use of the equipment (‘knobology’), specific peripheral nerve blocks, and a live demonstration 

of ultrasound and anatomy. The week culminated with a workshop during which participants were split into 5 

groups which rotated amongst 5 faculty-led stations, including: the ultrasound machine, vascular access (both 

arterial and venous), upper extremity peripheral nerve blocks, popliteal/posterior sciatic nerve blocks, and 

femoral/anterior sciatic nerve blocks. Residents also had the opportunity to practice using ultrasound on gelatin 

molds in order to practice manipulation of the ultrasound probe and needle placement. The standardized 

patient-based stations allowed the residents to make direct comparisons of various physical anatomies within the 

context of procedure planning. 

To establish a baseline of the residents understanding of the use of ultrasound as it relates to patient care in 

anesthesiology prior to the educational intervention, all participants were administered a pre-test written 

by faculty who led the workshop and didactic series. At the conclusion of the workshop a post-test was 

administered to assess knowledge growth 

Results/Findings to Date: Using data collected over two years (2010, 2011), we found that the course 

evaluations submitted by the participants were uniformly positive. Residents stated they felt more facile with 

the equipment, were better at identifying key anatomical structures, and gained a better appreciation for 

ultrasound. Performance on a knowledge test pre and post intervention found a significant improvement in test 

scores after the intervention. 

Key Lessons Learned/Conclusions: Subjectively, residents feel much more confident about their skills utilizing 

ultrasound technology in patient care if they have the opportunity to take part in a simulation exercise with 

ultrasound on standardized patients. The ability to gain hands-on experience in a low stress environment by 

scanning live anatomy was deemed to be of great benefit. This program can also be readily adapted to train 

other UCMC personnel (students, residents, nurses, faculty, etc). 

36

26. Pilot Curriculum for Teaching Residents Single Incision 

Laparoscopic Surgery (SILS): A Patient Safety Initiative 

GME 

Grant 

Nancy Schindler, MD; Michael Ujiki, MD; Vivek Prachand, MD; Jose Velasco, MD 

Statement of Problem, Question, or Issue Addressed: Emerging technology and new surgical procedures are 

difficult to incorporate into surgical training. 

Objectives of Program/Intervention: This pilot curriculum was designed to investigate the feasibility and 

effectiveness of a multistage model of teaching new surgical procedures. 

Description of Program/Intervention: The Single Incision Laparoscopic Surgery (SILS) curriculum includes 

four stages: 

Stage 1: An electronically delivered, interactive module designed to equip residents with the required knowledge 

about indications, contraindications, risks, benefits and rationale for this new procedure. 

Stage 2: A box trainer simulation module designed to teach residents the required technical skills to participate 

successfully in a live animal SILS procedure. 

Stage 3: A swine animal lab designed to provide a safe learning environment for residents to perform their first 

SILS procedures and to improve their technique in a high fidelity environment. 

Stage 4: A live patient experience. Only after successfully demonstrating the required knowledge and skills, a 

resident will participate in an appropriately supervised live patient SILS operation. 

Results/Findings to Date: Stage 1: Residents participated in the electronically delivered curriculum and were 

successful in demonstrating significant gains in knowledge. Resident scores improved from 38% correct on a 

pretest to 92% on the post test. All residents met the required 85% correct to be eligible for the Stage 2 lab. 

Stage 2: Residents participated in a box trainer lab followed by both in lab and at home practice. Residents were 

assessed using a modified FLS (Fundamentals of Laparoscopic Surgery) scoring rubric. Upon completing the 

lab and providing practice time, only 30% of residents achieved a passing score. With additional opportunities 

for practice and re-testing, an additional 25% (total of 55%) achieved a passing score for the lab. The remaining 

residents did not pass and were not able to move on to Stage 3. 

Stage 3: Eleven residents were eligible for the Stage 3 animal lab and five attended the first Stage 3 lab. The 

first part of the lab was an opportunity for residents to practice their skills and to receive feedback on the live 

animal model. After completing either a SILS appendectomy or cholecystectomy in the first part of the lab, 

the residents were assessed on a new SILS procedure: a small bowel repair. Residents were scored using two 

checklists. Four out of five of the residents were successful in achieving a passing score on this task and will be 

eligible to proceed to the live patient experience. One resident will need to repeat the lab and be retested. 

Resident evaluation of the curriculum has been very positive, however, resident self-assessment of knowledge 

and confidence in SILS has not demonstrated significant improvement. 

Key Lessons Learned/Conclusions: Although SILS requires similar skills to traditional laparoscopic surgery, 

we found that residents required more than the anticipated amount of training and practice to ascertain the 

required skill level. This suggests that we may over-estimate our learners’ readiness to perform procedures and 

that appropriate supervision and guidance in the OR is important for patient safety. More study is needed to 

identify if box trainer practice alone will improve these skills or if the animal lab might be able to expedite 

achievement of the required skill level. 

37

27. Publishing Evidence-based Medicine Writing Projects with 

Students 

Umang Sharma, MD; Mari Egan, MD, MHPE; Adam Mikolajczyk, MD 

Statement of Problem, Question, or Issue Addressed: There are studies describing publication of evidence-based 

medicine (EBM) writing projects with residents, but to our knowledge, there have been no reports about 

publishing such projects with medical students. 

Objectives of Program/Intervention: EBM writing projects provide an opportunity to teach EBM skills, hone 

student writing, enhance faculty editing skills, introduce students to the publication process, and provide 

publication for both students and faculty. 

Description of Program/Intervention: After reviewing the rationale for undertaking these projects, we will 

describe how we have been using an EBM writing project with fourth year students on their family medicine 

clerkship. 

Results/Findings to Date: We will review accomplishments and challenges we have had in implementing the 

program. A former student author will be present to discuss his view of the experience. 

Key Lessons Learned/Conclusions: We will review tactics to promote student success. 

38

28. Simulation-based Ultrasound Guidance and Procedure 

Training in Hospital Medicine: A Faculty Development 

Pilot Project 

Nilam Soni, MD; Angela Blood, MPH, MBA; Stephen Small, MD 

Statement of Problem, Question, or Issue Addressed: The incorporation of technological innovations into the 

practice of medicine continues to evolve healthcare at a rapid pace. The use of portable ultrasound for guidance 

of bedside procedures is evolving into the standard of patient care. Patient safety may be compromised when 

newer techniques are not integrated into routine practice in a timely manner. A needs assessment revealed that 

a minority of physicians feel comfortable with the use of ultrasound technology or portable ultrasound to guide 

procedures. Achieving a mastery understanding of ultrasound technology is a necessary building block for 

performing ultrasound-guided procedures. 

Objectives of Program/Intervention: The educational objectives of the program were to: 

1. Create a continuing medical education (CME) curriculum for understanding the fundamental principles 

of ultrasound and ultrasound-guided bedside procedures (central line placement, thoracentesis, 

paracentesis, lumbar puncture). 

2. Provide opportunities for practice and demonstration of ultrasound-guided procedure skills with 

simulation task trainers and real-time feedback. 

3. Develop assessment tools for the use of ultrasound in various procedures. 

Description of Program/Intervention: For both new and seasoned practitioners, the curriculum offered through 

The University of Chicago Simulation Center (UC Sim) included: 

1. Understanding of ultrasound and procedural equipment 

2. Awareness of indications and potential complications 

3. Methods to perform the procedures 

4. Practice of manual dexterity 

The content for each of the five modules included: 

1. Pre-test 

2. Didactic session 

3. Video of procedure 

4. Review of the procedural kit contents 

5. Hands-on practice with simulation task-trainers 

6. Scanning of patients 

7. Post-test 

8. Course evaluation 

From January through May 2011, the curriculum was delivered to a total of 25 hospital medicine providers. All 

participants attended the ultrasound and paracentesis modules. Participation in the remaining three modules 

(thoracentesis, CVC, and LP) was left to the discretion of the individual, as some hospital medicine providers 

perform only certain procedures in practice. 

Results/Findings to Date: A preliminary analysis of the pre-test and post-test data revealed that there was 

statistically significant knowledge growth for the participants who took part in the use of ultrasound module. 

Further analysis will be conducted to assess the significance of knowledge growth in the remaining learning 

modules. This preliminary finding is encouraging as it appears that the brief, simulation-based curriculum was 

effective in increasing the participants understanding and correct application of ultrasound technology. 

Key Lessons Learned/Conclusions: Based on the success of this pilot project, we appreciate that concise, 

simulation-based training sessions designed for busy clinicians can be effective at teaching basic ultrasound 

skills, and possibly other new technologies. The data are limited from this pilot program, but it does suggest 

that a brief training session for ultrasound-guided paracentesis may also increase knowledge of the procedure. 

Finally, the rate of skill extinguishment should be studied to determine how often training sessions must be 

held, or how many procedures must be completed, to maintain clinical expertise. 

39

29. The TIME (Technology in Medical Education) Project 

2011: An Update– The Past, Present and Future 

Scott Stern, MD; Brian Paterson 

Statement of Problem, Question, or Issue Addressed: Current and developing technologies provide an almost 

endless array of possibilities to augment medical education, limited more by the imagination than inherent 

limitations in technology. The TIME project continues to develop new technologies and create meaningful 

partnerships that are allowing us to create new, innovative, and cutting edge tools that create a dynamic, 

interactive, competency based medical curriculum. 

Objectives of Program/Intervention: The TIME project has 4 objectives. First, to enhance vertical integration 

within the curriculum. Second, to facilitate the use of technology tools within and beyond the classroom. 

Third, to create dynamic, interactive, case based simulations to teach clinical reasoning and an array of topics 

in the medical school curriculum. Fourth, such tools could also be harnessed to develop a competency based 

curriculum. 

Description of Program/Intervention: First, to achieve vertical integration, a new content management system 

(TIME-Space) was developed which captures lectures and other electronic curricular materials, stores and 

indexes these materials and makes them discoverable and reusable by students throughout the curriculum. 

Second, to augment the use of electronic teaching tools, TIME-Teach, a web based teaching resource, is being 

developed. Third, two interactive software projects are under development that will teach clinical reasoning 

and other basic science content. The first software tool provides a step by step diagnostic aid to students and 

residents as they evaluate patients with common internal medicine problems. The aid prompts students for 

key information from the history and physical exam and systematically limits the differential diagnosis as data 

is entered. This web based program will run on Smart phones, i-Pads and computers. An additional software 

project is being developed in conjunction with i-Human by Summit Performance. This interactive simulation 

will provide hundreds of interactive patient cases that will be linked to interactive learning exercises that can 

help to reinforce topics throughout the basic science and clinical curriculum. Ideally, such a program could 

ensure exposure to key diseases and document competency and mastery of key topics. 


1. TIME-Space has been widely used by the students who download thousands of documents each month. 

2. TIME-Teach will continue being developed this year with the recent addition of Elissa Johnson to the 

TIME team. 

3. The diagnostic app is under active development with the expected release of a beta version by January 1, 

2012. Already decision tress for more than half of the key symptoms in internal medicine have been 

created and are being converted to programming code. Finally, active discussions have begun with 

core faculty from the basic science curriculum who have begun work on the simulation project as we 

evaluate funding opportunities to spur development. 

Key Lessons Learned/Conclusions: Support from the Pritzker School of Medicine and BSD has been critical in 

the development of electronic tools to facilitate medical education. These tools augment vertical integration and 

will continue to push the envelope as they teach clinical reasoning, basic science content, provide interactive 

learning modules and provide a tool for ensuring broad exposure, assessing competency and mastery of 

material. 

40

30. The Use of an Educational Simulation to Improve 

Neurology Resident Knowledge of and Experience with 

Thrombolytic Therapy 

Plenary 

Scholarship 

& Discovery 

Rachel Stork, MS3; Jeffrey Frank, MD; Morris Kharasch, MD; Ernest Wang, MD 

Statement of Problem, Question, or Issue Addressed: Intravenous thrombolytic therapy (rt-PA) is the only FDA 

approved treatment for restoring brain blood flow in properly selected acute ischemic stroke patients, however 

many neurology residents will graduate with little or no experience with rt-PA use. rt-PA is underutilized in 

acute stroke patients and the inappropriate use of rt-PA leads to a higher risk of complications. Studies have 

linked underutilization and inappropriate use to lack of physician experience and training. Physician experience 

with rt-PA during training will be further limited by duty hour restrictions. 

Objectives of Program/Intervention: To assess if a simulated learning experience could improve Neurology 

resident knowledge, skill and experience with management of acute ischemic strokes. 

Description of Program/Intervention: Simulation is an educational modality well suited to increasing physician 

experience and training with the management of acute stroke patients with thrombolytic therapy, without 

risk to patients.In order to direct the design of the simulation curriculum, a short structured interview was 

conducted with 23 neurology residents, emergency medicine residents and neurology attendings to identify 

learning objectives for the simulation. Case data from the literature and from patients seen at University of 

Chicago were used to write case discussions and standardized patient/high fidelity patient simulator scenarios, 

which exemplified these objectives. These were encorporated into a half day educational simulation. 

Results/Findings to Date: The simulation was initially piloted with 4 medical professionals from the University 

of Chicago. Feedback from the pilot was used to improve the curriculum, which was then implemented with 

8 Neurology and Emergency Medicine resident volunteers from University of Chicago. All participants ranked 

their confidence in overall ability to manage acute stroke with thrombolytics higher after completing the 

simulation. The majority of participants (63%, n=8) went from incorrectly identifying the reversal agent to 

correctly identifying the reversal agent. In the exit survey, a majority of participants (88%, n=8) strongly agreed 

with the statement “I feel that I learned more in the simulation than I would have learned in a lecture covering 

the same material”. 

Key Lessons Learned/Conclusions: Simulation is an efficient and effective modality for improving knowledge of 

experience of Neurology residents with thrombolytic therapy. 

41

31. Wait Till Your Father Sees This! Simulation Training for 

Residents During their Pediatric Anesthesia Rotation 

Igor Tkachenko, MD; Michael Hernandez, MD; Stephen Small, MD 

Statement of Problem, Question, or Issue Addressed: During the Pediatric Anesthesia rotation anesthesia 

residents are exposed to variety of clinical cases. The goal of this rotation is to provide anesthesia residents 

with the most diverse clinical experience. One of the challenges in Pediatric Anesthesia is a skill of managing 

anxiety in parents as well as children. Parent present induction (PPI) is a common modality of stress-reduction 

in children undergoing induction of general anesthesia, where parents are present as the child goes off to sleep. 

The anesthesiologist is not only responsible for a safe anesthetic induction in the child, but also must manage a 

concerned parent. Dealing with complications and managing the patient’s airway in the presence of the parent 

can be difficult. Some parents become extremely anxious and can refuse to leave the OR. Often, residents never 

experience this clinical scenario during their training. 


1. Provide exposure to a rare but challenging pediatric anesthesia situation in a controlled environment. 

2. Provide residents with the opportunity to manage this clinical scenario independently. 

3. Provide the resident with the opportunity to watch the video recording of the case, discuss it, and receive 

feedback. 

Description of Program/Intervention: Anesthesia residents are offered an opportunity to participate in 

simulation training. Residents are given an introductory orientation to the simulation environment. A pediatric 

manikin is used with a team member playing the role of the “parent”. During mask induction the “child” 

develops airway complications, and the “parent” becomes extremely agitated and refuses to leave the OR. 

Residents are called upon to manage the patients complications as well as psychological aspect of dealing with 

an emotional parental response. 

Results/Findings to Date: Residents are asked to submit formal evaluations as well as informal feedback of the 

simulation case. Eighteen residents participated in the Simulation Training up-to-date and 18 responses were 

received. The residents were asked to rank the case on the scale from 1 to 5, with 1 representing “not at all” and 

5 representing “very much”. The question “Did the scenario seem realistic”, 17% ranked it 3, 11% - 3.5, 61% - 

4, and 11% - 5. The question “ Would you want to do more simulation training of this kind”, was answered as 

following: 15% - 3; 28% - 4, and 67%-5. 


1. Simulation training is a valuable tool for providing exposure to rare clinical circumstances that residents 

may not otherwise get to experience. 

2. Using a simulation allows the resident to function autonomously in a crisis, in contrast to a true clinical 

scenario in which an attending would likely intervene. 

3. Video review of performance is helpful to allow residents insight into their rapport with the patient’s 

family. 

42

32. Doctoring Without a Script: The Improvising Physician 

Daniel Brauner, MD; Gretchen Case, PhD 

Statement of Problem, Question, or Issue Addressed: Teaching students and physicians how to interact with 

patients in a compassionate and empathetic manner while still attending to the more factual and scientific 

aspects of this communication is a crucial agenda item for both undergraduate and postgraduate medical 

curricula. Previously we called for a more conscious appreciation of the physician as a performer and posited 

that empathetic imagination can be used as a tool for encouraging deeper doctor-patient interactions. In this 

project we look more closely at an aspect of this performance that can help to deepen this interaction further 

and is also an essential component of developing an empathic imagination, improvisation. Although the clinical 

encounter is highly structured this does not mean that it need necessarily be scripted, a potential pitfall of many 

curricular aimed at improving communication. 

Objectives of Program/Intervention: The objective of this program is to explore how improvisation as a method 

of rehearsal in the theater can be applied as a model for doctors, both in training and in practice for interacting 

with patients. 

In order for doctors to really engage with patients it is important to identify areas where physicians rely on 

scripted responses to sets of clinical issues. 

Doctors and those in training will learn how to incorporate the core concepts of improvisation when 

communicating with standardized and then actual patients. 

Description of Program/Intervention: By incorporating the underlying principle of improvisation, the “Yes, 

and...concept,” doctors can begin to learn to interact with their patients in an a real and empathic manner that 

honors the unique aspect of each patient in a way that more scripted discourse cannot. 

Results/Findings to Date: This is a theoretical construction to date but examples from programs that have begun 

using improvisation will be explored. 

Key Lessons Learned/Conclusions: Methods from improvisation can be applied to teaching about 

communication with patients as well as actually communicating with patients. 

43

33. Migration Analysis of Physicians Practicing in Hawaii from 

2009-2011 

Laura Dilly, MS4; Kelley Withy, MD, PhD; Goutham Rao, MD 

Statement of Problem, Question, or Issue Addressed: Hawaii currently suffers a 20% shortage of physicians. A 

growing and aging population, coupled with the fifth-oldest physician pool in the United States, make Hawaii’s 

physician shortfall poised to worsen. The state’s unique cultural, geographic, and practice settings make 

physician recruitment challenging. This study was undertaken to examine physician migration patterns into and 

out of Hawaii to better inform physician recruitment and retention techniques. 

Objectives of Program/Intervention: To determine patterns of physician movement into and out of Hawaii. 

Description of Program/Intervention: This study used 2009-2011 practice location data on all non-military, 

practicing physicians in Hawaii, a secure resource maintained by the University of Hawaii John A Burns School 

of Medicine - Area Health Education Center (AHEC). Medical school attended was electronically extracted 

from an AMA Masterfile list for allopathic physicians and from the Internet and colleagues for osteopathic 

physicians. Internet searches and telephone calls to clinician’s offices were employed to ascertain practice 

location as of September 2011. 

Results/Findings to Date: There are currently 3,187 actively practicing physicians in Hawaii. Of these, 2,707 

(84.9%) trained at US medical schools (136 medical schools represented), 2615 (96.5%) attended an allopathic 

institution, and 92 (3.4%) attended an osteopathic institution. Nearly half of all US-trained physicians 

attended medical school in Hawaii, California, New York, Illinois, or Pennsylvania. International medical 

graduates represented 191 medical schools from 67 distinct countries, primarily in the Philippines or the 

Caribbean (23.1% and 14.0% of the 480 international medical graduates, respectively). 

Between 2009 and 2011, a total of 238 physicians listed on the AHEC database retired from medicine or 

transitioned to non-clinical activities, and 329 physicians left Hawaii to practice in other locations. California 

received the largest portion of Hawaii’s former physicians (26.7%). No other state received more than 5% of 

the physicians who left Hawaii. Only 15.5% of physicians returned to the state where they attended medical 

school, and graduates from California represented 45% of this subset. 

Key Lessons Learned/Conclusions: As Hawaii’s physician shortage is poised to worsen, optimizing physician 

recruitment and retention has become a critical priority. Aside from the strong representation from John A. 

Burns School of Medicine, medical schools with some of the most alumni practicing in Hawaii (e.g., Creighton, 

UCLA, UCSF, Georgetown) all have active Hawaii student clubs. This may indicate larger populations of 

students from Hawaii or a greater interest in the state. Therefore, this research recommends targeting medical 

schools with Hawaii clubs for recruitment efforts. Furthermore, examining residency training location in 

relation to practice in Hawaii would be beneficial. 

Few trends are apparent when considering the physicians who left Hawaii to practice elsewhere. Other 

than California, which gained over a quarter of the physicians departing Hawaii, no region or alma mater 

demonstrates notable associations with physician emigration. Future study recommendations include examining 

residency location and conducting exit surveys of physicians leaving Hawaii to identify primary reasons for 

leaving. 

44

34. The Impact of Faculty Characteristics on Internal 

Medicine Residency Candidates Interview Scores 

Julie Oyler, MD; Jim Woodruff, MD; Jeff Charbeneau; Vineet Arora, MD, MAPP 

Statement of Problem, Question, or Issue Addressed: Research on the intern selection process has focused 

primarily on the impact of interview techniques and candidates characteristics on the effectiveness of resident 

selection. Few studies have examined interviewer characteristics on the candidate ratings. 

Objectives of Program/Intervention: Our goal was to determine whether faculty characterisitics lead to variation 

in residency candidate interview scores. 

Description of Program/Intervention: One time retrospective evaluation of previously existing interview data 

from applicants interviewed at the University of Chicago Internal Medicine Program from September 2004 

to March 2009. Faculty interviewers were assigned randomly according to their availability. Each interviewer 

received an electronic copy of the candidate’s Electronic Residency Application Service (ERAS) application 

prior to interview. Following the interview, faculty were asked to electronically rate applicants on a 1(worst) to 

10 (best) scale. Faculty characteristics were obtained from the Department website. Mulitvariate analysis was 

used to identify associations between faculty/candidate characteristics and interview score. IRB approval was 

obtained and data was deidentified before analysis. 

Results/Findings to Date: 1921 applicants were interviewed by 314 faculty for a total of 3813 discreet in-person 

interviews. Candidate characteristics which positively influenced overall score were PhD ( 0.48, p

35. Relationship Between Inpatient Attending Physician 

Workload and Teaching Before and After Duty Hours: 

A Seven Year Study 

MERITS 

Lisa Roshetsky, MD; David Meltzer, MD, PhD; Holly Humphrey, MD; Vineet Arora, MD, MAPP 

Statement of Problem, Question, or Issue Addressed: As attending workload increases with shorter resident duty 

hours, inpatient teaching may suffer. Although prior studies of resident workload demonstrate negative effects 

on resident education, health and patient care, no studies examine attending inpatient workload and outcomes. 

Objectives of Program/Intervention: We aim to investigate the association between inpatient attending workload 

and teaching. 

Description of Program/Intervention: From 2001-2008, all inpatient medicine attendings at a single teaching 

hospital were administered an end of rotation survey with Likert type-items regarding workload and teaching. 

Workload was measured using a conceptual framework initially developed by NASA and later adapted for 

physicians. A workload score (range 6-30) was generated from 6 items (effort, performance, frustration, and 

mental, physical and temporal demand). Time for teaching was measured using open-ended responses for 

hours per week didactic teaching, and a response of agree or strongly agree to “I had enough time for teaching.” 

Multivariable analyses, controlling for 2003 resident duty hour restrictions, season, and clustered by attending, 

were used to test the association between workload scores and teaching outcomes. We also investigated whether 

interactions between workload, season, and duty hours were significant. 

Results/Findings to Date: Response rate was 64% (458/719 attending blocks), representing 115 distinct 

attendings. Attendings reported a median of 3 hours/week (IQR 2-4) of didactic teaching and 42% reported 

enough time for teaching. Workload scores were normally distributed (mean=16, SD 2.7) with a weak positive 

correlation with actual patient volume (r=0.24, p

36. Developing a Community-Based Family Medicine Clerkship 

in Wuhan, China 

Nicole Baltrushes, MS4; Mari Egan, MD, MHPE; Sarah-Anne Schumann, MD; Renslow Sherer, MD 

Statement of Problem, Question, or Issue Addressed: China’s health care and medical education systems have 

changed significantly over the past sixty years. Currently both are focused on highly specialized training 

with few educational experiences in outpatient primary care. However, in light of their aging population, a 

resurgence in infectious disease, and rising healthcare costs among other concerns, China’s Ministry of Health 

recently declared that Family Medicine will be the key to providing quality and cost effective care to its growing 

population. Medical education now needs to be created and implemented to educate and train these future 

Family Medicine physicians. 

Objectives of Program/Intervention: As part of the Wuhan University Medical Education Reform (WUMER) 

project, University of Chicago Pritzker School of Medicine (PSOM) faculty are helping Wuhan University 

(WU) faculty start a Department of Family and Community Medicine and develop the first reported required 

community-based family medicine clerkship. This clerkship will ideally help to raise students’ awareness of 

family medicine as a career, inspire students to work in a community setting, as well as introduce the merits of 

outpatient training. 

Description of Program/Intervention: Almost three years after the partnership began there have been visits both 

to Chicago and China in order for both faculty to work together to create a family medicine curriculum which 

is based in community health centers (CHCs). The curriculum in Wuhan emphasizes the teaching of outpatient 

clinical skills and includes home visits, traditional Chinese medicine, and physical rehabilitation. PSOM faculty 

have provided faculty development in outpatient clinical teaching. Evaluation assessments have been conducted 

to identify characteristics and faculty development needs of the CHC preceptors as well as evaluate both the 

students’ and preceptors’ feedback after the first pilot clerkship. Clerkship development is ongoing, with the 

most recent PSOM faculty visit for a faculty development Teaching Symposium in September 2011. 

Results/Findings to Date: The Family Medicine Clerkship was piloted in autumn 2010 in the Qing Shan 

Community Health Center in Wuhan and the feedback received in the clerkship evaluations was encouraging 

and informative. Students enjoyed the exposure to the CHC setting, the unique doctor patient relationships, 

home visits, small group discussions, and the Traditional Chinese Medicine. Wuhan University Students, 

faculty, and CHC Preceptors alike requested ongoing faculty development. 

Key Lessons Learned/Conclusions: The Wuhan University faculty, administration, and CHC preceptors are 

motivated to continue developing and implementing the Family Medicine Clerkship. The pilot clerkship was 

well received and adjustments to the program to address the feedback received are being implemented. The 

second pilot of the clerkship is being implemented November 2011 and evaluation is ongoing. PSOM faculty 

and students are excited about the unique challenges and rewards this educational partnership offers. The need 

for primary care is becoming increasingly apparent in China, and around the world, and this new clerkship is 

an important and exciting step in the primary care direction. 

47

37. Pre-hospital Disaster Management Education in Emergency 

Settings: Results of a Five-month Community-based 

Program in Rural Haiti 

Corey Bills, MD, MPH; Christine Babcock, MD, MSc; Luke Davies; Christian Theodosis, MD, MPH 

Statement of Problem, Question, or Issue Addressed: The January 12, 2010 Haitian earthquake resulted in 

massive destruction of Haiti’s infrastructure with a large number of Haitians seeking refuge in 1 of 1300 

displaced camps. Continued monitoring of these camps is essential and highlights the need for trained 

professionals in disaster management in order to respond to future calamity. 

Objectives of Program/Intervention: The aim of this study is to determine the effectiveness of a unique training 

program for Haitian national ‘Health Agents’ in disaster management and health surveillance. 

Description of Program/Intervention: A five-month training program was undertaken from September 1, 

2010 to January 31, 2011 based at a displaced persons camp in Fond Parisien, Haiti. Instruction in disaster 

management was multifaceted and included lectures, didactic sessions and fieldwork. Comprehension of 

material was based on pre and post-test analysis and assessment of field-based casework in comparison to 

objective norms. 

Results/Findings to Date: All eight Haitian staff members were hired and successfully completed the five-month 

course. Overall comprehension of lecture material was impressive with increased average pre- to post-test scores 

of 44.8% (28.8% and 73.6%, respectively; p

38. A Community-based Cholera Surveillance and Education 

Program in Eastern Haiti 

Corey Bills, MD, MPH; Christine Babcock, MD, MSc; Luke Davies; Christian Theodosis, MD, MPH 

Statement of Problem, Question, or Issue Addressed: On October 21, 2010 a cholera outbreak was confirmed 

by the Haitian National Public Health Laboratory. Within one month cholera had spread to each of ten 

departments of Haiti. 

Objectives of Program/Intervention: The aim of this study is to analyze whether a Haitian national health agentled 

cholera surveillance program combined with basic public health messaging can provide insight into cholera 

outcomes. 

Description of Program/Intervention: A health agent-led team assessed villages in the primary municipality of 

Fond Parisien in Ouest Department from November 2010 to January 2011. Data was gathered via in-depth 

and key informant interviews. A purposive sampling of presumed high-risk villages throughout the region 

with a cross-sectional sample of households within selected villages was completed. Individual households 

were questioned regarding cholera symptoms and provided with simple public health education. This data was 

compared to clinical and demographic data at the region’s primary cholera treatment center (CTC) for analysis. 

Results/Findings to Date: Continuous data collection in the form of household surveys and rapid assessment 

procedures monitored high-risk populations in several hard to reach villages in the region. Health agents noted 

multiple deaths secondary to cholera-like symptoms in communities not reported to clinical or public health 

authorities. A total of 2416 clinical cases of cholera presented to the CTC over the study period. The clinical 

fatality rate was 0.745%. 

Key Lessons Learned/Conclusions: The use of health agents trained in disaster management and mitigation was 

successful and contributed to public acceptance of the primary CTC and control of cholera deaths within the 

region. 

49

39. Assessment of Clinical Reasoning Skills of the Fifth Year 

Medical Students at Wuhan University 

Aaron Cohn, MD; Nancy Luo, MD; Kate Lemler, MS4; Renslow Sherer, MD; Scott Stern, MD 

Statement of Problem, Question, or Issue Addressed: The Pritzker Initiative, a clinically focused curriculum, was 

iniated at the University of Chicago medical school in 2009. Wuhan University and Pritzker have colloborated 

to bring a similar curriculum to Wuhan. Courses in basic science, clinical reasoning, physical diagnosis and 

history-taking, ethics and professionalism are being adapted and scaled for use in Wuhan, starting with the 

students enrolled in the fall of 2009. 

Objectives of Program/Intervention: The objective of this study was to assess the clinical reasoning skills of the 

graduating class of the five-year medical education program, and to establish a baseline for future comparison to 

students in the reform curriculum. 

Description of Program/Intervention: We developed twenty clinical cases from the textbook “Symptom to 

Diagnosis” with stepwise clinical reasoning and questions addressing the following core competencies: data 

collection, differential diagnoses,evaluation to generate final diagnosis, management and overall performance on 

reasoning. The scoring algorithm was tailored to the emphasis of medical education at the undergraduate level, 

stressing the importance of developing a full spectrum of differential diagnosis and diagnostic evaluation for the 

final diagnosis. 

Results/Findings to Date: Senior medical students in Wuhan demonstrated a wide range in performance on a 

clinical reasoning exercise, with one third showing a substantial need for further skills development. Specific 

areas in which improvement was needed were ‘differential diagnosis’ and ‘history taking/data collection’. 

Reforms of curriculum in clinical years, as well as preclinical years, are needed in order to improve clinical 

reasoning skills to help students become competent physicians upon graduation. 

Key Lessons Learned/Conclusions: There is still significant room for improvement in clinical reasoning and 

development of a differential diagnosis for a given symptom, in both the Pritzker Initiative-inspired “reform 

curriculum” and the existing “tradional curriculum”. Continued comparison of the reform and traditional 

curriculums at Wuhan University medical school will help decipher what strategies work best for this cohort of 

medical students. 

50

40. Development of a Communication Skills Curriculum at 

Wuhan University Medical School: Implementing a Peer 

Role-playing Workshop 

Wei Wei Lee, MD, MPH; Renslow Sherer, MD 

Statement of Problem, Question, or Issue Addressed: Several studies show that a physician’s communication 

skills correlate with improved health outcomes and health care quality. Guidelines from the Institute for 

International Medical Education (IIME) and the American Association of Medical Colleges (AAMC) highlight 

the importance of teaching communication skills in the medical school curriculum and there is evidence that 

good communication skills can be taught and learned. 

Medical education in China has been characterized by passive, lecture driven curricula and limited 

opportunities for small group learning. Wuhan University (WU) invited the University of Chicago (UC) to 

assist in their medical education reform effort and in 2009, 50 first year students at WU participated in a 

reform curriculum. As reform students enter into their third year, WU is developing an “early patient contact” 

curriculum modeled on the Pritzker Clinical Skills course. The new curriculum aims to teach communication, 

professionalism and allows for early exposure to clinical medicine. Limited resources precluded implementation 

of a standardized patient program and UC faculty were asked to assist in developing peer-role playing 

workshops to teach communication skills 


1. Work with WU faculty to develop a communication skills curriculum. 

2. Pilot a peer role-playing workshop to teach patient-centered communication and allow students to practice 

and assess communication skills. 

Description of Program/Intervention: Presented lecture to WU reform students and faculty focused on patientcentered 

communication and delivering bad news. We developed 2 peer role-playing scenarios on lung cancer 

and chlamydia. The participants were divided into groups of five students and one faculty member. The 

students rotated to role-play “patient” and “physician.” On-looking students and faculty rated “physician’s” 

communication skills on a 5-point Likert scale. Fifteen minutes were allotted each for role play and feedback. 

The large group then reassembled to debrief and gave oral and written feedback on exercise. 

Results/Findings to Date: Feedback on peer role-playing exercise were grouped into strengths and weaknesses. 

The following comments reflected the strengths: a)“small groups promoted active participation and learning” 

b)“allowed us to experience emotions of both doctors and patient” c)“immediate feedback allowed us to see 

specific things we can improve” d) “realistic reflection of real life problems in doctor patient interactions” e) 

“relaxed, practical, very effective” The following comments reflected the weaknesses: a) “our first time doing 

a role play exercise, took too much time” b) “students lacked sufficient medical knowledge about diseases 

discussed” c) “not ‘real enough’ to simulate real life experience” 


1. Peer role-playing workshops are a low cost, easily implemented and effective way to teach communication 

skills. 

2. Students and faculty valued a formal communication curriculum and requested future collaboration to 

develop additional role-play cases for curriculum. 

51

41. Attitudes Toward Neurology in Medical Students in 

Wuhan, China 

Rimas Lukas, MD; Brian Cooper; Ivy Morgan; Renslow Sherer, MD 

Statement of Problem, Question, or Issue Addressed: ‘Neurophobia’ refers to medical students’ dislike of 

Neurology based on the perception that it is overly complex. To date, little is known regarding neurophobia in 

China. 

Objectives of Program/Intervention: Neuroscience education for medical students at Wuhan University in 

Wuhan, Hubei province, China is undergoing significant reform as part of a collaborative undertaking with the 

University of Chicago via the Wuhan University Medical Education Reform (WUMER) project. Prior to the 

implementation of the revised Neuroscience curriculum in autumn 2011 a 5 question survey was administered 

to 41 5th, 6th, and 7th year students (analogous to 3rd and 4th year US medical students). 

Description of Program/Intervention: Modeled on previously reported surveys used in other countries, 

the surveys addressed students’ self-assessments of their knowledge of subspecialties, confidence in clinical 

neurology and career intentions, and their perception of teaching methods, with responses from 1-5 on a Likert 

scale. 

Results/Findings to Date: Of 41 surveys, 21 were from students at the Renmin Hospital site and 20 from the 

Zhongnan Hospital site, evenly divided among years. 

Of student knowledge in 8 medical specialties, Neurology received a mean score of 2.78, ranking it 6th lowest. 

Paired-samples test found neurology was significantly lower than the top 3 specialties. There was no significant 

difference between neurology and the other four specialties. In turn students self-perceived knowledge may be 

in the midrange amongst other specialties. 

Students with low confidence in diagnosing and managing neurological patients trended toward a lower 

likelihood of specializing in neurology (mean score 2.67) compared to students with high confidence in both 

(mean score 3.80). Students with low likelihood of specializing in Neurology (≤2) were less likely to report 

confidence in both diagnosing (≥4) and managing neurological patients (mean cumulative score of 2.64). 

Students rated bedside teaching (4.03, CI 3.69-4.37, SD 1.00) followed by small group teaching (3.78, CI 

3.42-4.14, SD 1.072) as having the greatest value in learning neurology. Learning derived from peers was rated 

as the lowest valued (3.30, CI 2.98-3.63, SD 0.951) method of learning neurology. 

Key Lessons Learned/Conclusions: In this exploratory study, students self perceived knowledge of Neurology 

was low, but not lowest, when compared to other specialties. These findings differ from data reported from 

institutions in North America/Caribbean, Europe, and Africa. Students with greater clinical confidence in 

diagnosing and managing neurological illness reported a higher likelihood of pursuing a career in neurology, 

and, conversely, students who reported a higher likelihood of pursuing a career in neurology also reported a 

higher degree of confidence in their clinical neurology skills. Traditional bedside teaching was viewed as having 

the greatest value for teaching neurology, although small group sessions were also rated highly. Internet based 

learning, textbooks, and learning from ones peers were all viewed as fairly equivalent. A complementary multimodality 

approach may have the greatest benefit in teaching neurology. 

52

42. Planning for The Start of Internship - Survey and Focused 

Interviews at a Chinese Medical School 

Yang Shen, MD; Hong Lei, MD; James Woodruff, MD; Renslow Sherer, MD 

Statement of Problem, Question, or Issue Addressed: In 2008, the Wuhan University Health Sciences Center 

in Wuhan, China invited the University of Chicago to serve as Technical Advisors to their medical education 

reform effort. Among the issues to be addressed were a largely lecture-driven curriculum, poorly integrated 

basic and clinical sciences, limited opportunities for small group, case-based, and independent learning, lack 

of formative evaluation, lack of a Department of Community and Family Medicine linked to public health 

and infectious disease care and prevention, and outdated teaching methods and materials. In the past three 

years, under the leadership of the Wuhan University Medical Education Reform (WUMER) project team, a 

new curriculum (see below) has been implemented. The new curriculum has emphasized the integratation of 

basic and clinical sciences and innovative teaching methods. In the surveys conducted in 2010, the students 

enrolled in the reform class have achieved higher scores in questions in terms of critical thinking and knowledge 

retention compared to their counterparts. 

Objectives of Program/Intervention: In order to design a course that helps the fifth year undergraduate medical 

student to better prepare for the incoming internship, we performed a study to investigate the needs of the 

students as well as the expectations of clinical faculty across various specialties. 

Description of Program/Intervention: A survey investigating the needs of the students regarding procedure 

skills, clinical reasoning, and clinical knowledge base was to be completed on a voluntary basis by at least fifty 

undergraduate students who are in their final year of study and who have completed job interviews. Both 

multiple-choice questions and short-answer questions were used in the survey. 

Interviews and small group discussion were to be conducted with ten faculty members in the departments 

of internal medicine, surgery, pediatrics and obstetrics/gynecology. The faculties were to be asked about 

the criterion of resident selection, expectation they have for the future residents and areas of improvement 

considering their experiences with current students and residents. 

Results/Findings to Date: A total of sixty undergraduate students voluntarily participated in the survey. All of 

the them had completed all required medical school coursework and had finished their job interview process. 

Among them, 68% were female, 32% were males. Except for one student who was pursuing graduate training 

in a field of basic science, fifty-nine students were planning to pursue further training in clinical medicine 

(83%) or directly enter practice (17%). Twenty-six students (43%) were planing to enter internal medicine and 

its associated sub-specialties, twenty-one students (35%) were to enter a surgical specialty, three students (5%) 

were to be pediatricians and three students (5%) were to enter the field of ob/gyn. 

Key Lessons Learned/Conclusions: The conventional medical education curriculum is characterized by a 

rigid curriculum that is based on lectures and a disease-driven pedagogy. These weakness are the focus of 

the curriculum reform which is underway (WUMER project). A move to require residency is also planned. 

A training course that helps students bridge to residency training is needed. Following discussion with 

the leadership of the WUMER, an elective course will be offered next Spring. This course utilizes clinical 

vignettes to help students practice clinical diagnostic reasoning and clinical management protocols of common 

complaints. Problem-based learning and small-group discussion are the main format of this new course. 

53

43. Evaluation of Student Attitudes and Training towards 

Geriatrics and Palliative Care in Wuhan, China 

Sandra Shi, MS2; Renslow Sherer, MD; Ivy Morgan; Hongmei Dong 

Statement of Problem, Question, or Issue Addressed: Geriatrics is an emerging field in China, with no national 

certification or formal specialty training at present, and radical social reform in China has led to a growing 

geriatric population. At the same time in the past decade, China has prioritized shifting the delivery of primary 

care for urban populations to community health centers (CHCs) rather than larger public hospitals. The ease of 

access, closer proximity, and lower out-of-pocket costs make CHC care a more favorable alternative over subspecialty 

care in tertiary hospitals for many elderly. 

Objectives of Program/Intervention: We evaluated faculty and student attitudes towards Geriatrics, and 

investigated whether the new CHC Clerkship experience at Wuhan University had any influence on student 

opinions. Finally we sought to explore the delivery of health care, particularly to the elderly, in local community 

settings. 

Description of Program/Intervention: As a part of the Wuhan University Medical Education Reform 

(WUMER) project, a new Community Health Family Medicine clerkship was created and piloted with 30 fifth 

year students at a local QingShan Health clinic in the fall of 2010. 

We surveyed students and faculty at Wuhan University Medical School, and elder care givers at the QingShan 

Community Health Center. A total of 18 CHC clerkship students (‘CHC students’) were surveyed, with 

questions regarding their perceptions of geriatrics as well as judgment on current exposure to geriatrics during 

clinical and preclinical training. Parallel surveys were administered to 41 fourth year medical students in the 

standard medical curriculum. ‘Elderly patients’ were defined as age over 60 years. 

Results/Findings to Date: Overall, CHC students reported working with a higher proportion of older patients 

during their CHC clerkship experience. The disparity found between CHC and Standard curriculum responses 

was found to be statistically significant (t stat= -3.94, p=0.0002). Though 80% of Standard Curriculum 

students agreed that they are willing to treat older patients only 41% felt they confident in treating older 

patients (n=41). Faculty generally supported greater inclusion of training specific for older patients. 

In general, more CHC students reported that their medical school training, both courses and clinical, was 

adequate in preparing them for work with the elderly. Also, more CHC students reported that their rotations 

had allowed for adequate contact with older patients (88% vs 66%) - see Table 1. None of these differences 

were statistically significant (Mann-Whitney test, no P values

44. Observational Study of Hand Hygiene Compliance Rates in 

Intensive Care Units in Wuhan, China 

Lisa Sun, MS2; Wenjing Zong, MS2; Renslow Sherer, MD 

Statement of Problem, Question, or Issue Addressed: Health care associated infection (HCAI) is a major cause 

of patient disability, excess patient death, longer hospital stay and increased health care costs in China. Hand 

hygiene is the most important measure to prevent HCAIs, however limited data on hand hygiene compliance in 

China are available. 

Objectives of Program/Intervention: Hand hygiene compliance was evaluated among health care workers 

(HCWs) in ICUs in 2 hospitals (RH and ZH) in Wuhan, China. 

Description of Program/Intervention: An observational study of hand hygiene compliance among HCWs was 

conducted for each of the five WHO Moments for Hand Hygiene, i.e. 1) before patient contact; 2) before 

performing a clean/aseptic procedure; 3) after body fluid exposure risk; 4) after patient contact; and 5) after 

contact with patient surroundings. 

Results/Findings to Date: The overall hand hygiene compliance rate for ICU health care workers was 28% 

(N=3222). RH HCWs had a significantly higher hand hygiene compliance rate compared to ZH HCWS 

(P

45. A Qualitative Analysis of Interviews with Participants of 

the Literature & Medicine Program at Select Veterans 

Scholarship 

& Discovery 

Administration Medical Centers 

Abigail Cutler, MS3; Gabrielle Schaefer, MS3; H. Barrett Fromme, MD, MHPE 

Statement of Problem, Question, or Issue Addressed: Background: Founded in 1997, Literature & Medicine: 

Humanities at the Heart of Health Care is a hospital-based reading and discussion group for staff at 

community and academic medical centers. Once a month, physicians, nurses, administrators and support staff 

gather with a trained facilitator to discuss what they have read and reflect on what it means to them - as people 

and as healthcare professionals. Last year, 14 VA hospitals across the country took up the program, offering 

participants the opportunity to read and discuss literature relating directly to the experiences of their veteran 

patients and the challenges faced in caring for them. 

Problem: Healthcare providers cannot rely simply on their own experiences to understand their patients, who 

are often of a different religious, socio-economic or cultural background. This is especially true at a VAMC, 

where a large gulf exists between the patients (who although present heterogenous medical problems all share 

the experience of having served in the military) and their healthcare providers who for the most part are nonveterans. 

Literature offers these providers the opportunity to vicariously experience war, illness, death and 

human relationships among all peoples. Literature & Medicine is part of a larger movement to incorporate 

the humanities into medical practice and medical education, but it is unique as the only program of its kind 

that links hospitals on a statewide and national basis and involves a diverse mix of healthcare professionals. No 

previous study examined the impact of the Literature & Medicine on participating VAMCs or explored why 

such a program might be especially beneficial at an institution with such a unique patient population. 


1. Identify what attracts participants to the Literature & Medicine program; 

2. Distinguish the important elements of a successful reading and discussion group; 

3. Determine impact on provider job satisfaction, perceptions of work environment and patient care; 

4. Examine the Literature & Medicine program’s particular value to a VAMC. 

Description of Program/Intervention: To evaluate the program’s success at 14 VAMCs, I solicited via email 

the cooperation of participants who were interested in talking about their experience. I ultimately conducted 

interviews with individual program participants (n=13), one facilitator (n=1) and focus groups from two 

participating hospitals (n= 7 and n= 5). IRB exemption status was obtained and qualitative data from the 

transcripts was analyzed using constant comparative method. 

Results/Findings to Date: In interviews, participants of the Literature & Medicine program at VAMCs reported 

outcomes similar to those demonstrated previously reported by participants at non-VAMCs: increases were 

seen in colleague camaraderie and openness, empathy and compassion toward patients, appreciation and 

understanding of different perspectives, general morale and satisfaction with one’s work, and motivation to 

do better at one’s job. Interestingly, the program also demonstrated far-reaching effects: interviewees described 

sharing their thoughts and readings with non-participating staff hospital members and even patients. An 

overwhelming 100 percent of participants endorsed the program and expressed interest in both expansion and 

future participation. 

Key Lessons Learned/Conclusions: In order to understand and best serve their patients, healthcare professionals 

cannot rely solely on their own academic knowledge and life experiences. Patients not only present with their 

complaints and indications; they bring to the clinic their cultural backgrounds, religious and spiritual beliefs, 

and personal histories of the medical and non-medical kind. 

The Literature & Medicine program has proven to meet a deeply felt need in the hospital setting, by providing 

an opportunity for healthcare professionals to share insights with colleagues- an act that alone has made a 

significant impact on the way participants understand their work and their relationships with both patients and 

each other. It is also an innovative and cost-effective way to improve patient care, and it does so by increasing 

empathy for patients, interpersonal and communication skills, cultural awareness, and overall job satisfaction 

among providers. 

56

46. Communication and Utilization of Healthcare Services 

Amongst Adolescents 

Sarah Horvath, MS4; Kavitha Selvaraj, MS4; Sophie Shay, MS4; H. Barrett Fromme, MD, MHPE 

Statement of Problem, Question, or Issue Addressed: Many teens are unwilling to utilize medical care, even when 

it is free and accessible in settings like the Washington Park Free Youth Clinic. Barriers to utilizing medical 

care include adolescents’ perceptions of physicians, physicians’ perceptions of adolescents, trust of the health 

care system, and concerns regarding confidentiality. Additionally, lack of identification with the physician 

population acts as an obstacle in adolescent communication with clinicians. 

Chicago Youth Program (CYP) and Children Teaching Children (CTC) are two existing community programs 

which provide educational support to south side Chicago youth. CYP, which is housed in the same building 

as the Washington Park Clinic, is particularly concerned about rates of medical care uptake among its teen 

participants. We propose to work in conjunction with CYP and CTC to develop a novel program to address the 

issue of adolescent access of medical care. 

Objectives of Program/Intervention: The goals of the project are to 1) investigate the barriers to uptake of 

medical care and effective communication between medical professionals and their adolescent patients, from 

the adolescent point of view and 2) educate current and future physicians on ways to minimize them. We 

will empower the teens to create a workshop for medical students, residents and attending physicians which 

addresses barriers and adolescent health care issues they find most important. The workshop will then be 

presented to those who regularly staff the Washington Park Clinic. An evaluation of the intervention will 

be created in the form of a survey to be given both before and after the workshop in order to quantify the 

effectiveness of the program. This, too, will be directed by the teen participants. 

Description of Program/Intervention: We will design and implement a curriculum for eight teenagers giving 

them the skills, freedom and working environment necessary to create a 30-60 minute workshop for medical 

students, residents and attending physicians which addresses the barriers they find most important. The 

workshop will then be presented to those who regularly staff the Washington Park Clinic. An evaluation of the 

intervention will be created in the form of a survey to be given both before and after the workshop in order to 

quantify the effectiveness of the program. This, too, will be directed by the teen participants. The teens should 

feel empowered in their own medical decisions and serve as not only liaisons to the medical community, but 

also role models and peer educators to other teens. Ideally, this group will then participate in recruiting the next 

year’s new members. Each year, with the support of CYP, CTC and the SERVE class, the group will revise the 

workshop to keep it current and relevant. 

We will then integrate this teen-led workshop into Washington Park clinic’s annual board activities. Over time, 

it will expand the focus to present to boards and staff of other free clinics and groups of medical professionals at 

University of Chicago and around the city. 

Results/Findings to Date: We intend to qualify and quantify our results so that the program can be recreated 

in other settings where it may be useful. To do this, we will use a teen-created survey to evaluate med student/ 

resident/doctor attitudes pre- and post- intervention (participation in the workshop). 

Key Lessons Learned/Conclusions: Our program seeks to provide education at many levels. As a communitybased 

intervention, this study aims to involve adolescents directly in the creation of the workshop, empowering 

them to identify both barriers and solutions, while teaching them the skills necessary for implementing their 

vision effectively. They will then educate medical students, residents and attending physicians on how best to 

approach an adolescent patient. The curriculum will grow directly from the health care issues that are important 

to our teenage population. We hope to see a discernible difference in physician attitudes toward the treatment 

of teens and increased teen uptake of medical care as a result. 

57

47. Development of a Website for Transition Care for 

Providers, Patients, and their Families 

Amy Lo, MD; Jennifer McDonnell, MD; Kruti Acharya, MD; Rita Rossi-Foulkes, MD 

Statement of Problem, Question, or Issue Addressed: Young adults with chronic disease and disabilities are 

surviving well into adulthood; in 2006, it was estimated that 15% of North American youth suffered from 

chronic physical or mental health conditions. As these patients reach adulthood, their medical care is often 

fragmented, interrupted or inadequate to meet their needs. 

Internal Medicine, Pediatrics and Med-Peds faculty and residents were surveyed regarding knowledge, attitudes, 

and barriers to transition care. Results demonstrated that few physicians were familiar or comfortable with 

issues regarding transition care, but a majority expressed willingness to care for this population and felt 

transition education was important. Barriers in caring for this population cited by the physicians included lack 

of ancillary services, time, and reimbursement. 

Objectives of Program/Intervention: To address some of these barriers regarding transition care, we created a 

website designed to be a toolkit that providers, patients and families can use to learn about issues surrounding 

transition care. 

Description of Program/Intervention: This website provides general information about transition care as well as 

more specific information about various types of insurance available to pediatric and adult populations, SSI and 

SSDI, education planning, patient autonomy, and local, statewide, and national resources for youth and young 

adults with special health care needs The website also contains handouts and forms that providers can download 

and give to patients and patients and families can access themselves. By providing this transition care toolkit 

to providers, patients and families, we believe that providers will become more knowledgeable about transition 

care and feel more comfortable caring for this population. 

Results/Findings to Date: Our website is now available to the UCMC community. We are currently 

introducing the website to clinicians for their use. We plan to update the website based on feedback from our 

provider community. We will re-survey faculty and resident physicians after full implementation of the website 

to determine if the website has improved provider comfort with transition care and addressed some of the 

barriers that providers cited in caring for this population. 

Key Lessons Learned/Conclusions: UCMC providers expressed barriers to comfort with and knowledge about 

transition care. We created a website to provide information about transition care to providers, patients, and 

families. The website includes information regarding topics that frequently need to be addressed in caring for 

this population. The website also provides a tool kit of documents and forms related to transition care for use 

by providers, patients and families. 

Our goal is to increase provider familiarity and comfort with transition care as well as provide a quick resource 

for frequently encountered topics that are addressed during the transition of care for youth with special health 

care needs. 

58

48. Development of an Educational Intervention for Resident 

Education Regarding Transition Care of Youth with 

Special Health Care Needs 

Jennifer McDonnell, MD; Amy Lo, MD; Sara Platte, MD; Rita Rossi-Foulkes, MD 

Statement of Problem, Question, or Issue Addressed: Young adults with medical illnesses and developmental 

disabilities are surviving well into adulthood; in 2006, it was estimated that 15% of North American youth 

suffered from chronic physical or mental health conditions3. As these patients reach adulthood, their medical 

care is often fragmented, interrupted or inadequate to meet their needs. 

The University of Chicago is a tertiary care center that provides care to children and adults with complex 

chronic medical conditions. However, many adolescents with chronic medical diseases have difficulty navigating 

into the adult-oriented medical arena and are often lost to follow up. 

Objectives of Program/Intervention: We studied resident physician’s perceived barriers to transition with the 

goal of creating educational tools to address these. Surveys were mailed via interoffice mail to residents in the 

departments of medicine, pediatrics, and medicine/pediatrics and collected over a 3 month period. Residents 

identified lack of knowledge, lack of exposure, and lack of communication between adult and pediatric 

providers as barriers to transition care. 

Description of Program/Intervention: Based on the results of this data, a 1 hour educational lecture was 

developed addressing some of the frequent barriers encountered with transitioning youth with special health 

care needs from pediatric to adult care. Topics of this lecture included a definition of transition care, a proposed 

timeline for transition of patients, information about insurance gaps and insurance options, promoting and 

developing patient autonomy, information about guardianship and Chicago area resources for youth with 

special health care needs. 

Results/Findings to Date: The lecture was given to medicine/pediatrics residents at a monthly meeting and 

to pediatric residents at a noon conference. Evaluation of pediatric residents following the noon conference 

indicated that 17% of residents rated the overall presentation as “good” while 83% rated the lecture as 

“excellent.” In the future we hope to adjust the curriculum to be given in small groups at pediatrics pre-clinic 

conference as well as tailor the lecture for medicine residents. 

Key Lessons Learned/Conclusions: The educational curriculum was designed to increase resident exposure to the 

topic of transition care for youth with special health care needs and to address certain core knowledge topics 

that are encountered in the transition from pediatric to adult care. Plans for the future include adjusting the 

lecture to include internal medicine residents, creating an ambulatory curriculum, and creation of a transition 

care elective for UCMC residents and medical students. After these interventions, residents will again be 

surveyed regarding their knowledge and attitudes towards transition care. 

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49. Using Health Information Technology to Develop an 

Academic Medical Home: Effective Patient Education for 

Scholarship 

& Discovery 

Success in High School 

Margaret Naunheim, MS3; Yingshan Shi, MD, MS; Janis Mendelsohn, MD; Michael Msall, MD 

Statement of Problem, Question, or Issue Addressed: The medical home is the model for twenty-firstcentury 

primary care, which addresses family-centered and community-integrated health promotion. Health 

information technology can provide effective patient education and enhance communication among healthcare 

providers, patients, and their families. 

While information about success in high school exists online, little of this information comes from informed 

medical care providers. Success in high school often predicts success in future endeavors, and primary care 

physicians can affect positive change in their patients’ lives by addressing this issue. 


1. Explore how to engage school-aged children and their parents and effectively address the issue of “How to 

Succeed in High School and Beyond”. 

2. Explore potential interventions for community outreach from collaboration between families and 

providers. 

Description of Program/Intervention: A cross-sectional clinical survey was conducted in the Comer pediatric 

clinic (between 6/6/11-7/25/11) to find parents’ preferred sources and health topics for school-aged children. 

With collaboration from pediatricians, medical students led three high school students from UC Laboratory 

Schools, Hinsdale Central High School, and Walter Payton College Prep. These focused groups examined 

information currently provided to high school students about success including online resources, literature 

searches and pamphlets from the students’ current high schools. The web pages will synthesize and organize the 

information already accessible, while also supplementing it with information less readily available to emphasize 

physical, behavioral and mental health goals. 

Results/Findings to Date: Parents’ preference for sources of health information and topics 507 (86% response 

rate) parents responded to the survey and 487 questionnaires met inclusion criteria. For parents, the top 

sources of health information are their child’s physician (100%), online resources (93.2%), other healthcare 

professionals (82.1%), and their child’s school (56.0%). The top health topics parents preferred are the school 

physical exam (97.9%), vaccines (97.7%), lifestyle choices (95.8%), and school achievement (94.6%). 

Web page contents http://www.funandeducation.org/School_Health.htm 

The survey displays online education as a ubiquitous tool to connect school-aged children and their parents to 

health providers. Parents expressed a strong preference for school performance related topics. The web pages 

regarding “How to Succeed in High School” were designed for all students in high school to support their 

academic success and career orientation. The topic themes include physical, behavioral, and mental health; 

success in high school; college and alternatives to college; future challengers and career pathway options. 

Community outreach: In the survey, teen patients come from 77 high schools in the area. Involving these 

schools in the website is the first step to incorporate the academic medical home with the community. 

Key Lessons Learned/Conclusions: The school health online resources center provides online resources for 

teen patients and their families as part of continuing, comprehensive care; this can also facilitate community 

outreach efforts and the development of specific collaborations to improve health outcomes and reduce risky 

behaviors. 

60

50. Patient Perception of a Point-of-Care Tablet Computer 

(iPad) Being Used for Patient Education 

Andrew Nickels, MD; Vesselin Dimov, MD; Valerie Press, MD; Raoul Wolf, MD 

Statement of Problem, Question, or Issue Addressed: During the fall of 2010, the Internal Medicine/Pediatrics 

program at University of Chicago introduced Point-of-Care Tablet Computers (iPad) for clinical use. iPads 

are intended to improve access to EMR, work flow, resident and patient education, and access to electronic 

clinical tools. The graphic display and ease of interface makes the iPad a potentially powerful tool to achieve 

these goals. 

Objectives of Program/Intervention: This study is designed to gauge the initial patient perception of the iPad 

when used for patient education. 

Description of Program/Intervention: This survey is a physician administered, 8 question patient survey 

administered to Allergy Immunology patients or their parents. Preloaded iPads with education materials 

(“mind map” diagrams, clinical pictures) into the photo software were used to clinically education the patients. 

Simple percentages and Fisher’s exact non-parametric test were used for statistical analysis. 

Results/Findings to Date: 20 patients surveyed (11 resident/9 attending). For those survey items without 100% 

agreement, there was no statistically significant difference in responses based on level of training (p≥0.45). 

100% [0.861, 1] of participants liked the iPad use to help explain their children’s condition, 95% [0.783, 

0.997] of participants did not find it distracting. 100% [0.8601, 1] found it helpful. 100% [0.861, 1] would 

like to be used again to help explain medical information. 95% [0.784, 0.9974386] thought the iPad was 

helpful for coming to understanding of their condition. Limitations of this study include a convenient sample, 

physician-administered survey, and observer bias. 

Key Lessons Learned/Conclusions: Patient perception was very positive toward the use of a point-of-care tablet 

computer (iPad) in a clinical setting. While limited to only two operators, level of training did not have an 

effect on patient perception. Confirmation of the results may be required before wider implementation. 

61

51. Challenges in Transition: Barriers to Subspecialty Care for 

Adults with Developmental Disabilities 

Joanna Perdomo, MS1; Alex Garnett, MS1; Richard Schroeder, MS1; Kamala Cotts, MD 

Statement of Problem, Question, or Issue Addressed: The transition from pediatric to adult care occurs at age 18. 

This transition marks an important time in the health care trajectory of any individual, but holds significant 

gravity for individuals with intellectual and developmental disabilities (IDD). Individuals with IDD require 

lifelong interdisciplinary care from multiple health professionals, including primary care providers, neurologists, 

psychiatrists, orthopedic surgeons, and physical and occupational therapists. Due to the complexity of their 

medical needs, the transition period is especially challenging for individuals with IDD, as they must find adult 

replacements for each of their many pediatric health care providers. This task is made more difficult by the fact 

that there is a paucity of adult physicians who have intimate knowledge of IDD and feel comfortable caring for 

patients with IDD. Furthermore, the challenge of finding suitable adult physicians, particularly subspecialists, 

is heightened because many adults with IDD rely on Medicaid for insurance coverage; however, many hospitals, 

clinics, and individual physicians do not accept Medicaid at all or only accept Medicaid for pediatric patients. 

Unfortunately, there are few resources to facilitate the transition process, and many adults with IDD lack the 

subspecialty care they need. 

Objectives of Program/Intervention: This investigation began as a project in the first-year Health Care 

Disparities course. We sought to simulate the process an adult with an IDD, who is on Medicaid, would have to 

undergo in order to find an adult subspecialist in the fields of neurology, psychiatry, and orthopedics- the three 

main subspecialties that individuals with IDD must continue accessing throughout their lifetime. Specifically 

this study looked for suitable providers located in the South Side of Chicago. We aimed to document the 

difficulties of navigating the healthcare system and to compile a list of subspecialty providers that would provide 

care to adults with IDD on Medicaid. 

Description of Program/Intervention: Twelve federally qualified health centers (FQHCs) in the South Side were 

interviewed to determine if they accepted Medicaid, provided care for adult patients with IDD, and provided 

subspecialty services in neurology, psychiatry, and orthopedics. Based on their responses, further interviews 

were conducted with hospitals, clinics, and individual physicians to whom they refer patients for subspecialty 

services. These referral sites were asked the same set of questions. 

Results/Findings to Date: Out of twenty-two clinics contacted, two clinics were found to offer psychiatry 

services to IDD adults on Medicaid, while only one provides orthopedic services to this population. Finally, one 

clinic offered neurological services, but currently has a three month wait for a new patient appointment. 

Key Lessons Learned/Conclusions: Findings demonstrate a major shortage of subspecialty care clinics accepting 

adult patients with Medicaid on the South side of Chicago. This is especially problematic for adults with 

developmental disabilities, who often require extensive medical care from multiple medical specialists. However, 

the list of resources compiled in this study will serve as a useful tool for this population to access the care they 

require. 

62

52. Predictors of Third Year Medical Students’ Intentions to 

Practice in Underserved Areas: A National Survey 

Krishna Ravella; John Yoon, MD; Kenneth Rasinski, PhD; Farr Curlin, MD 

Statement of Problem, Question, or Issue Addressed: Demographic trends in medical education suggest increased 

difficulty in recruiting students into medically underserved areas. Though many different characteristics of 

students’ personal backgrounds are associated with intentions to practice among the underserved, it is unknown 

whether admiration of a physician role model is specifically associated with intentions to practice among the 

underserved. Admiration may be an important factor influencing medical students’ decisions during the process 

of medical education. 

Objectives of Program/Intervention: We examine the various factors associated with medical students’ intentions 

to practice in a medically underserved area and to test the hypothesis that students’ admiration of role models 

are positively associated with comparable pro-social behavior. 

Description of Program/Intervention: From Jan-June 2011, we surveyed a nationally representative sample of 

960 third-year medical students. We used a two-stage clustered sample design, selecting 24 of the 133 allopathic 

(MD) medical schools with probability proportional to size and then randomly selecting 40 students within 

each of the 24 schools. The primary criterion variable was medical students’ self-reported intention to locate 

their practice in a medically underserved area. Primary predictors included students’ reported desire to follow in 

the footsteps of a physician they admire. Other control variables included gender, region, social mission score 

ranking, race, whether parent/grandparent is a physician, whether they grew up or ever worked in a medically 

underserved setting, and whether sense of calling or income considerations influence specialty choice. 

Results/Findings to Date: 563 out of 960 3rd year medical students responded (59%). 30% of U.S. medical 

students reported intentions to practice in an underserved area. Male students were less likely than female 

students to report intentions to practice among the underserved (23% vs. 40% female, multivariate OR 0.6 

[0.4-0.9]). Black students and students who grew up or previously worked in an underserved setting were also 

more likely to report intentions to work for the underserved. Students who also reported not having a physician 

parent/grandparent were more likely to report intentions to practice among the underserved (35% vs. 14% 

with physician parent/grandparent, 2.5 [1.3-4.6]). Finally, students who reported a desire to follow in the 

footsteps of a physician they admire were more likely to report the intention to practice among the underserved 

(multivariate OR 2.2[1.3-3.7]). 

Key Lessons Learned/Conclusions: In our nationally representative study of U.S. third year medical students, we 

found that female students, black students, students with previous exposure to medically underserved settings, 

and students who did not have a physician parent or grandparent were more likely to report intentions to 

practice among the underserved. We also found that admiration of a role model physician was also associated 

with medical students’ intention to locate his or her future practice in a medically underserved area. The 

emotional experience of admiration during medical education may play an important role in shaping students’ 

attitudes toward practicing among the underserved. 

63

Current Academy Funded Research 

grants for Medical student education 

2010-2012 

Geriatrics and Aging Through Transitional Environments (GATE): Integrated, Longitudinal Geriatrics 

Curricula through the Pritzker Initiative 

Seema Limaye, MD; Shellie Williams, MD; Sandy Smith, PhD 

2011-2013 

Foundations in Clinical Medicine 

Susan Glick, MD; Michael O’Connor, MD 

Developing a Free National Databank of Online Psychiatry Teaching Cases 

Michael Marcangelo, MD 

grants for graduate Medical education 

2010-2012 

Pilot Curriculum for Teaching Residents Single Incision Laparoscopic Surgery (SILS): A Patient Safety Initiative 

Nancy Schindler, MD; Michael Ujiki, MD; Jose Velasco, MD; Vivek Prachand, MD 

2011-2013 

Resident Perceptions of Teaching on Night Floats 


For further information about previously funded medical education grants, please refer to our website: 

http://pritzker.uchicago.edu/about/rfa.shtml 

64

Request for Applications: Medical Education Research 

Sponsored by: 

The University of Chicago Pritzker School of Medicine’s Academy of Distinguished Medical Educators and the 

Graduate Medical Education Committee 

Deadline: Friday, January 20, 2012 

In order to foster a learning environment for students and residents that is characterized by creativity, 

originality, and rigor, the University of Chicago Pritzker School of Medicine’s Academy of Distinguished 

Medical Educators and the University of Chicago Medical Center are making research funding available to 

support a maximum of two proposals for projects in medical student education and two proposals for projects 

in resident/fellow education. 

The proposals pertaining to medical student education will be peer-reviewed through the Academy of 

Distinguished Medical Educators and those pertaining to resident/fellow education will be peer-reviewed 

through the Graduate Medical Education Committee (GMEC). 

We are especially interested in receiving proposals related to the following themes but welcome proposals in 

other areas as well: 

• Integration of clinical medicine and basic science 

• Fostering scholarship in medical school and/or residency training 

• Innovative programs in Quality Improvement or Systems-Based Practice for students and/or residents 

• Residents as Teachers 

If you are interested, please request an application form by emailing the University of Chicago Pritzker 

School of Medicine’s Dean for Medical Education (dean-for-meded@bsd.uchicago.edu). This email should 

include information as to whether the planned proposal pertains to medical student education, resident/fellow 

education, or both. 

Proposals are due on January 20, 2012. Total funding for projects should not exceed $25,000 per year for up 

to two years, equally shared between the grantee’s department and the Dean for Medical Education (up to 

$12,500 per year from each source, with documentation of anticipated support from department chairman). 

Awards will be announced by March 9, 2012 with funding to commence on July 1, 2012. 

This RFA is the sixth cycle of research support available for medical education at the University of Chicago 

and is one element of an ongoing series of initiatives to foster research, innovation, and scholarship in medical 

education and to promote and sustain a strong culture of teaching at the University of Chicago and the 

NorthShore University HealthSystem. 

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