Archives for January 2017

Degrees Changing by Degrees

As of June 1, 2017, UVA’S Biomedical Sciences (BIMS) and Public Health Science (PHS) graduate students will receive their degrees from the School of Medicine (SOM). The main reason for this move: It makes sense.

Our graduate students currently receive their degrees from the Graduate School of Arts and Sciences (GSAS); however, the BIMS program has been fully supported by the SOM since its inception, the majority of BIMS students perform their research under SOM mentors, and most of the PHS courses are taught by SOM faculty. Even though the School of Medicine provided the lion’s share of the education, these graduate students were not technically “ours.”

Once this move occurs, the SOM will be the home for all three of its major education programs (undergraduate medical education, biomedical sciences PhD programs, and PHS graduate programs). Moreover, governance will be made easier, as we will be able to provide direct oversight of our students and their wellbeing. An added benefit is that the School of Medicine’s philanthropic initiatives will now be able to focus on our BIMS and PHS alumni.

Like I said: It makes sense.

How does this affect faculty and staff?
The short answer is that it doesn’t. While there are some operational items to iron out with the registrar’s office, financial services, and student information services, the educational programs themselves will remain the same, as will the current leadership and management of each of the programs. So, for example, the PHS Master of Public Health Program and Master of Clinical Research Program will continue to be taught and led by Department of Public Health Sciences faculty, and the BIMS programs will continue largely as they have done in the past. One new change, however, is that an Executive Steering Committee for Education, comprised of the leaders of the three programs (UME, BIMS, PHS), has been established to address common features of all of the programs.

Change that does not feel like change is a rare event. This is a positive move, as it’s allowing us to get all of our students and programs together in the School of Medicine and provides us with the means to connect the undergraduate medical, BIMS, and PHS programs. I am now meeting bi-weekly with Ruth Gaare Bernheim, JD, MPH, the William Hobson Professor and chair of the Department of Public Health Sciences and director of the Master of Public Health Program, and Amy Bouton, PhD, Harrison Distinguished Teaching Professor in Microbiology, Immunology and Cancer, and Associate Dean for Graduate and Medical Scientist Programs, to coordinate educational issues and to ensure alignment within the School. One early activity that highlights the tremendous value of this educational realignment is an interprofessional values seminar that has brought together BIMS, medical education, and PHS students to discuss professional values via literature and film. We expect to launch more of these kinds of creative initiatives moving forward into the future.

It is important to note that our interactions with GSAS have been, and will continue to be, strong. Indeed, this move has been greatly facilitated with the help of GSAS leadership, for which I am very appreciative. These strong bonds will continue through our interdisciplinary programs in biophysics and neuroscience and through our numerous collaborations and educational initiatives. Meanwhile, I look forward finally to have all our students “officially” here!

Sincerely,
R.J. Canterbury, MD
Senior Associate Dean for Education

CQI’ing Before It Was Cool to CQI

QualityThe Liaison Committee on Medical Education (LCME) checks in on us every 8 years. To prepare properly for these accreditation site visits, like many schools, we start two years in advance. Gathering materials. Performing a self-study. Building a database. If you recall the last go-round, the preparation for the site visit can be intense. But this hurry-hurry two-year scurry is not in the spirit of what the LCME wants of schools.

To avoid this two-years on, six-years off cycle, the LCME recently added an element requiring schools to perform Continuous Quality Improvement (CQI). CQI provides schools the opportunity to do more than just meet the minimum standards. It requires processes to be put in place whereby schools continuously track how they’re doing on the accreditation standards and how they’re working toward improving the quality of their program.

The good news is that we’ve been performing CQI for years, though we have not called it CQI. Our faculty have always looked to find new ways to make UVA’s School of Medicine better than it was the day, week, month, or year before. The bad news is that we have not always documented it — so that is something we’ll need to work on.

How will this change things for you? The answer is evolving. Right now, we’re in the process of figuring out how to formalize our CQI process. What will it be? How will we implement it? These are questions we need to sort out. The LCME is not prescriptive in how we perform CQI, save that we have documentation of our processes that have measurable outcomes to improve programmatic quality and that we are monitoring them to meet accreditation standards.

Last summer we formed a steering committee and convened a few half-day retreats where we closely examined each LCME standard, looking for gaps and areas of improvement. We are now prioritizing them and determining the necessary resources to address them.

If you have any questions about CQI or the LCME standards, please contact Lesley Thomas, JD, Assistant Dean for Medical Education at llt6p@virginia.edu.

Stayed tuned for more on CQI in the months to come!

Sincerely,

R.J. Canterbury, MD
Senior Associate Dean for Education

Teaching Wisdom: Phronesis Project Expands

Close up of older woman and caretaker holding handsTwo years ago the School of Medicine piloted a program called the Phronesis Project — “phronesis” being the Greek word for “practical wisdom.” Spearheaded by Dr. Margaret Plews-Ogan, the pilot was designed to foster wisdom and empathy in our medical students.

I am pleased to announce that the project has been so successful that we are expanding it. The class entering UVA in August 2017 will double the size of the current project with the ultimate goal of having the entire incoming class in August 2018 gain “phronesis.”

What Does All of This Mean?
Our students will receive a longitudinal patient experience. Starting on their first day of school, they will be paired with patients whom they will follow, care for, and advocate for through all four years of medical school. Being paired with a patient with a chronic health condition early in medical school has an incredibly positive impact on both the student and the patient. Phronesis students receive insight into what a long-term doctor-patient relationship can be — a fulfilling aspect of primary care. Past Phronesis students have visited patients in the ICU and at home, helped patients sign up for benefits, and even dealt with their patient’s passing. These students come to understand early in their career the doctor-patient relationship and how to develop a professional identity.

Potential outcomes from Phronesis’ expansion include:

  • Students internalize characteristics, values, and norms of the profession through guided experience of a long-term relationship with a complex patient
  • Improved knowledge retention — concepts are retained better when seen in context of their own patient
  • Fewer professionalism concerns throughout training due to strong mentoring and role modeling from the beginning of medical school
  • Students see the trajectory of illness early in their training
  • Students have increased resilience and wisdom; reduced burnout, especially in the depersonalization domain; and improved tolerance of ambiguity
  • We graduate students with a deeper social commitment and understanding of the social determinants of health
  • Graduating students see themselves first and foremost as the patient’s advocate

It is important to note that the student isn’t the only beneficiary here. Phronesis is a two-way street. In this model, the patient is also a teacher. They benefit by having direct, personal access to a healthcare advocate and through their personal satisfaction of knowing they are contributing to the field of medical education. Relationships such as these have shown to have positive outcomes for the patients, who require less acute care because of these connections.

Faculty Gain a Champion, Too
In the coming years, clinicians are likely to see more of our students as they join patients at appointments on the patient-side of the exam table. Providers benefit from Phronesis as students are involved with patients by, for example, following up on scheduling tests, coaching patients on diets, and ensuring medical instruction is appropriately followed.

The expanded Phronesis Project will continue to promote interdisciplinary care, too. As the students learn and grow, they will be involved with the entire interdisciplinary care team. (This highlights one of our main Health System Goals: “To train heath care providers of the future to work in multi-disciplinary teams.”) We hope that, in the long run, we create doctors who have a high capacity for professionalism and who have the ability to nurture the doctor-patient relationship while avoiding burnout.

Thank you to Peggy Plews-Ogan for starting this program and Rachel Kon and Megan Bray for assisting in expanding Phronesis. Additional thanks to Natalie May, who has been instrumental from the beginning, and John Schorling, an original mentor who developed the reflective practice component which was further enhanced by Suzanna Williams. Pilot mentors include: John Schorling, Beth Jaeger-Landis, Ira Helenius, Mo Nadkarni, Carolyn Englehard, and Eve Bargman.

I look forward to seeing the fruits of their efforts for years to come, the effects of which will ripple positively across healthcare for decades.

Sincerely,
R.J. Canterbury, MD
Senior Associate Dean for Education

Highlights: January MAC Meeting

som-bldg_NEW_12122014Opening Comments from the Dean

  • Dean Wilkes announced the recruitment of Dr. José Oberholzer as Director of the Charles O Strickler Transplant Center. Dr. Oberholzer brings expertise in multiple organ and minimally invasive transplantations. He will start on March 1, 2017.
  • Dean Wilkes announced the appointment of Phillip Bourne, PhD, as Director of the Data Science Institute, effective May 1, 2017. A fellow of the American Academy of Arts and Sciences, Dr. Bourne was the first NIH Associate Director for Data Science, reporting directly to NIH Director Francis Collins.

Communication

  • Many of our plans to move us forward require operational To maximize efficiency and consistency of communication, Dean Wilkes recommended that the center and department business administrators be included in the MAC meetings going forward.

UVA-Inova Education and Research Partnership Retreat

  • Representatives from UVA (SOM, VPR, SEAS, Darden iLab) and Inova met last week for a 2-day retreat.
  • The first day was to establish common understandings, e.g., to preserve the best of each organization’s autonomy and to embrace the best of integration.
  • The second day focused on brainstorming the vision for the partnership’s Institute of Genomics and Applied Life Sciences. This included work in outlining the next steps, such as agreement on the vision statement, establishing oversight and working committees, appointing the founding director and Board of Directors, and finalizing the institute’s structure.
  • The partners in education also met on the second day and discussed logistics related to establishing a Northern Virginia regional campus to provide an alternate site for third- and fourth-year students.
  • Working committees, jointly led by UVA and Inova personnel, are being established with specific deliverables and timelines.