From the Director
Interns are now officially 1/3 done with intern year! The ITE went smoothly – thanks to everyone for helping out by covering their colleagues so we could get the test scheduled. Pretzels were a hit for Doctoberfest – as Ragnar Palsson pointed out in his answer to “what is the salted pretzel sign” – one possible answer is the bump in noon conference attendance when pretzels are served.
As you will see with WDIRTW, noon conference attendance is a big topic for our program to discuss. We started at our GME leadership meeting and Chris and Armando were able to attend. Look for an email asking if you’d like to participate in our working group.
Other fun this week included western day on gen med 4. Nice boots team!
Kudos from Vaishali Patel to Bobby Aertker for gracefully picking up a busy consult service at the last minute, to Hany Elmariah and Phil Lehman for excellent presentations at VA Med-Surg conference, and to Mandar Aras for leadership as
VA day float
Kudos and pubmed from the program goes This week to our presenters at Clinical Science Day - Lindsay Anderson, Noah Kalman, John Stanifer, Hany Elmariah, Carling Ursem, Aaron Mitchell and Meredith Clement, Jen also was selected for an oral presentation. Nice work!
We’ve made great progress on our community donations. Check out the email for our paypal link if you’d still like to donate to help buy a wheelchair for the North Street Community. Also thanks for recognizing our nurses! Full list of those recognized to be announced at the end of Doctoberfest.
Have a great week
Congrats again to all of us for achieving 100% vaccination in 24 days and the Martin society, in particular, for being the first ones to hit 100%. Your trophy is coming . . .
QI Noon Conference
Our next QI conference will be on 10/30 in 2002, so plan on coming to hear the next in the High Value, Cost-Conscious Care series.
Hand Hygiene Update
Our current numbers through the end of September. . . be on the lookout for another update at the QI noon conference.
Actual Hand Washing Rate for September = 84.0%
Actual Hand Washing Rate Overall = 85.4%
Goal = 91%
What Did I Read This Week
Submitted by Aimee Zaas, MD
What did I read : three articles about conference attendance:
- Acad Med. 2003 Jan;78(1):84-9., Didactic teaching conferences for IM residents: who attends, and is attendance related to medical certifying examination scores?FitzGerald JD, Wenger NS.
- Mayo Clin Proc. 2008 Apr;83(4):449-53. doi: 10.4065/83.4.449, Associations of conference attendance with internal medicine in-training examination scores.
- Article review: Conference attendance ≠ better test scores, By Michelle Lin, MD|January 11th, 2010, Medical Education|0 Comments, McDonald FS, Zeger SL, Kolars JC.
Why did I read them: as a program, our attendance at conference is struggling. This is a nationwide issue per my conversations with other program directors, with “work compression” and duty hours cited as major reasons. Steve has taken the lead on analysis of this for our program and thank you to the 60 (!) residents that filled out the survey. We talked about this at our GME meeting on Friday as well.
What did the authors do? Two of the studies looked at single programs. The authors tried to correlate conference attendance and content (as well as lunch provided or not) and the other looked at conference attendance and ITE scores over a four year period.
What did they find – the weaker study (the one year study) found : Residents’ attendance at conferences was 34% overall or 54% excluding excused absences. Adjusting for the conferences’ and residents’ characteristics, attendance declined by one third as the year progressed. Providing lunch at noon conferences enhanced residents’ attendance (odds ratio [OR] 1.26 overall and OR 1.64 for residents on inpatient rotations). Higher attendance was not associated with improvement in standardized medical knowledge test scores.
The stronger study did find a correlation between core conference attendance and ITE scores.
Specifically, total conference attendance was significantly associated with increased IM-ITE scores, with cohort mean increase of 2.30% (95% confidence interval [CI], 1.24% to 3.36%; P<.001). Core curriculum conferences accounted for much more of this association than either medical grand rounds or morbidity and mortality, with cohort mean increases of 2.05% (95% CI, 0.13% to 3.90%; P=.04), 0.24% (95% CI, -0.56% to 1.03%; P=.61), and 0.03% (95% CI, -1.69% to 1.69%; P=.97), respectively.
The third was more of an opinion – read for yourself.
What is the take away ? Conference attendance is waning nationally (personal communication). In fact, likely because of the 16 hour rule, The ACGME no longer has a minimum requirement for attendance. We know that there are many rotations where it is not possible to attend (nights and ICU).
But, as a group, the residents and faculty value conference, especially our core lecture series. Lunch at conference is a way to recognize the busy-ness of the day and is the #1 line item in our budget. Most importantly, lifelong learning is an important part of our professionalism. So….please join our working group to enhance conference and to set reasonable expectations for content and attendance.
And thank you Randy for doing my pub med search! Above and beyond!!!
From the Chief Residents
|Oct. 25: Dr. Arati Rao||AML in the Elderly|
|10/21||The CDC’s Antibiotic Resistance Threats and Antimicrobial Stewardship||Richard Drew||12:00||Saladelia Sandwichs||2002|
|10/22||Common HIV Mgmt Issues||Chuck Hicks||12:00||Bullock’s BBQ||2002|
|10/23||Stead Society Conference||Stead Leaders||12:00||Jersey Mike’s||2002, 8262, 4275, 1120, 208|
|10/24||Chronic Opiod Management||Lynn Bowlby||12:00||Cosmic Cantina: Q||2001|
From the Residency Office
November 13th- Networking Event at Dr. Klotman’s!
Reminder to our current JAR’s – Upcoming opportunity for junior residents to enjoy some time to connect with Duke’s Division Chiefs and Fellowship Program Directors! This is a great way to have some face time with your future mentors!
Don’t forget to sign up so that we know who is coming.
DOCTOBERFEST IS HERE !
“Building Our Community” October 1-31, 2013
Thank you to everyone who has donated so far to our Doctoberfest Fundraiser for the North Street Community project. With the addition of the opportunity to contribute via PayPal, donations jumped over 400%!!! Clearly technology has a lot to do with success!!! Keep in coming, and the Sumo suits you see in this picture will soon be filled by Dr Zaas and Chief Residents. Our goal? $1,240, the amount needed to purchase a new portable wheelchair ramp for the community. Please donate using the link below – every penny counts!
Resident and Nurse “Wall of Fame”:
If you have not yet seen the “wall of fame” in the Med Res office, you have to stop by and see the awesome comments we have received regarging both nurses and residents. If you have someone you want to recognize, here is the link to do so.
Still remaining – more trivia, recognition of the flu shot campaign success, haloween party, trick or treat, and of course – the Sumo wrestling contest (we hope).
We look forward to celebrating with and honoring our incredible Duke Medicine community all month
Research Support – New Opportunities
The Office of Clinical Research has partnered with GME and the Internal Medicine Residency Program to offer a broad list of resources supporting resident research projects. A number of our residents have already taken advantage of the free consultation regarding their work, some leading to dedicated statistical analysis and support using the funds they received in their Resident Research Awards.
We are attaching two documents for reference: a power point slide set outlining the project, and a 2nd document that summarizes how this works/points of access.
A special thanks to Dr. Arcasoy for helping to coordinate this effort to expand access to research design support and statistical analysis for our residents.
Resident’s Thoughts Regarding Code Status
(Tufts Medical Center)
“How do residents ask patients about code status? Do they think this discussion is the responsibility of a resident or an attending? We ask these and other questions in a nation-wide survey of Internal Medicine residents on how they approach discussions of code status with patients with advanced cancer. This project has been reviewed by the Tufts Medical Center IRB. There is a lottery for prizes for participants, including $10 and $25 Amazon and iTunes gift certificates.”
David Einstein, MD (PGY-3, Internal Medicine, Tufts Medical Center) with Paul Mathew, MD
Upcoming Dates and Events
- October 28: Annual Recruitment Kickoff
- November 13: Networking Event at Dr. Klotman’s! (An opportunity for JAR’s, fellowship directors, and division chiefs to connect!)
- November 28: Annual “Turkey Bowl”
- December 4: “Voices in Medicine”
- Main Internal Medicine Residency website
- Main Curriculum website
- Ambulatory curriculum wiki
- Department of Medicine
- Confidential Comment Line Note: ALL submissions are strictly confidential unless you chose to complete the optional section requesting a response.