Archives for June 2017

Update: Diversity Action Plans

As we approach the University’s 200th anniversary, it is good to remind ourselves of our history, so we can sometimes use it as a point of reference from which to move away. African-American undergraduate students were not allowed into our College of Arts and Sciences until the 1950s, and women were barred until the 1970s. Exclusion was common for three-quarters of this institution’s history. We are working continuously and actively to address this history so we may offer everyone — faculty, staff, and students — equal opportunity to succeed.

Last fall, during the Department Annual Reviews (DAR), each department was asked to think about how to improve diversity and inclusion for their areas. While the School of Medicine has had a diversity plan for several years, we wanted specific actions from the departments. In early 2017, we received thoughtful plans from every department. Upon reviewing these plans, Greg Townsend, MD, Associate Dean for Diversity and Medical Education, and I discovered common ideas and themes. These themes allowed Greg and me to develop guidelines for improving the plans and developing short-term and long-term goals.

These plans and goals provide a reference to one- and three-year strategic actions that departments will undertake. This way, we will all know the expectations for the coming year and by the end of 2020. This transparency provides an opportunity to collaborate, to share creative solutions, and to let our School’s greatest resource — our faculty and staff — be the source of the best ideas.

While we were working on diversity and inclusion action plans at the department level, the Provost’s office asked for a diversity plan from each of UVA’s schools. The School of Medicine’s plan is still under review, though we expect to receive feedback by the end of the summer. I will share it as soon as it is available.

Why be diverse?
Diversity is critical to becoming the kind of institution we think we should be — excellent, innovative, creative. Googling “why diversity matters” will give you abundant reasons why we should do this. Study upon study has been performed, and the data have been scrutinized and examined. In academic medicine, the data confirm that greater diversity is better for science, education, and patients.

Let us assume that you do not have time in your schedule to read the 3.8 billion Google returns for the search “why diversity matters” and you want a local example. Why does it matter for us? Here is an interesting chart showing the association between the school’s percentage of underrepresented in medicine students and the USMLE Step 1 and Step 2 scores.

(Click to enlarge.)

You can see the increased scores as we started making a conscious effort to increase student diversity. While it does not show causation, the correlation is powerful. What the scores do demonstrate is that our focus on diversity has not diminished the academic excellence of our student body.

Stayed tuned for more updates. We will be updating the Diversity website with best practices and will be sharing plans and guidelines in the coming months. Thank you to all of our faculty and staff who have put time and effort into these plans. Your efforts are noticed and appreciated.

Susan M. Pollart, MD, MS
Ruth E. Murdaugh Professor of Family Medicine
Senior Associate Dean for Faculty Affairs and Faculty Development

Highlights: June MAC Meeting

Connect to Purpose and Department Faculty Meetings (Dean David Wilkes)

  • Dean David Wilkes highlighted recent accolades and awards:
    • UVA Neurosurgery Residency Program was cited as the second most academically productive out of the 105 programs in the U.S.
    • Terry Bennett (Department Manager, Medical Education Programs) received the Leonard W. Sandridge Outstanding Contributor Award — the highest honor a UVA Health System team member can receive.
    • The Heart and Vascular Center received the 2017 Get With The Guidelines-Heart Failure Gold Plus Quality Achievement Award and was named to the Target: Heart Failure Honor Roll from the American Heart Association. They also received the 2017 Charles L. Brown Award for Patient Care Quality.
    • The Department of Orthopaedics received Premier Level certification from the International Geriatric Fracture Society CORE Certification Program for UVA’s Geriatric Fracture Care Program.
    • Iga Kucharska, PhD, received the inaugural Gordon Hammes Scholar Award, which honors young scientists responsible for the best papers published in Biochemistry.
    • Ariel Gomez, MD, received the University of Iowa Carver College of Medicine Distinguished Alumni Award.
    • UVA’s Board of Visitors recently approved $15.7M for the cross-disciplinary initiative called BRAIN, short for Bold Research Advancement in Neuroscience. Additionally, they approved an academic affiliation with Inova Health System Foundation that includes a research institute and a UVA School of Medicine regional campus in Northern Virginia.
  • By September, Dean Wilkes will be attending department meetings to have open conversations with faculty.

Office of Sponsored Programs (OSP) Update (Margaret Shupnik, PhD)

  • Dr. Margaret Shupnik shared that, while our research portfolio is growing, we have discovered some rate-limiting challenges. Dean Wilkes, Dr. Shupnik, and Stewart Craig have been speaking with faculty and chairs about getting received grants money in the hands of the investigators in a more expedited manner. Last week they met with the Office of Sponsored Programs and discussed ways to make the process better.
  • Next steps being instituted by OSP include:
    • Assigned specific staff to individual schools and departments
    • New hiring (4 new staff in June, ongoing recruitment)
    • Streamlining account creation
    • By 6/13, establish all signature-ready accounts with a 6/1 notice of award (NOA)
  • Goal: to establish new accounts within 5 days of NOA
  • Dr. Shupnik expressed gratitude to Dean Wilkes, Dr. Richard Shannon, and Pat Hogan for helping to improve this process.

National Institutes of Health (NIH) Update (Margaret Shupnik, PhD)

  • Next Generation of Researchers Initiative: The NIH has decided that there will be no Grant Support Index point system or limits on grants per PI.
  • The NIH is working on alternative methods to support younger investigators.
  • There will be institute-specific prioritization, but propose funding to 25th percentile:
    • 4 years — $210M/year from existing funds
    • tracking progress, metrics — assess at 2 years
  • If you wish to comment, visit the Open Mike Blog or email publicinput@od.nih.gov.

June BOV Update (Bobby Chhabra, MD)

  • Dr. Bobby Chhabra represents Medical Center faculty on the University of Virginia Health System Board and shared information from its recent meeting.
  • Dr. Chhabra reviewed
    • progress since 2016 on the Health System consolidated goals and strategies,
    • the FY17 balanced scorecard improvements;
    • financial data and Medical Center cash flow sources and uses;
    • FY18 budget, operating income, projections, capital budget, and major strategic initiatives and investments in the coming year, including Epic Phase 2, Ufirst, the new endoscopy procedure center, the strategic hiring initiative, the clinical translational science project, advancing strategic partnerships, and retention and recruitment; and
    • UVA Medical Center’s statistics, as compared to benchmarks at other academic medical centers.

UFirst Project Update (Jennifer Oliver, Sean Jackson, Kelley Stuck)

  • Ufirst will deliver a unified HR function across the organization that delivers a best-in-class HR service, enhancing UVA’s ability to recruit, hire, retain, and develop top talent. Key to enabling this transformation will be the implementation of a user-friendly HR technology called Workday.
  • Ufirst will benefit the 28,000+ faculty, staff, and team members at the Medical Center, School of Medicine, University Physicians Group, the 10 other UVA schools, administrative units, and UVA College at Wise.
  • Kelley Stuck discussed the future-state HR service delivery model, aligning processes and leveraging new technology to create an excellent employee experience. She noted that the new model is an evolution of OneHR, and the work invested in OneHR has helped clear the way for this transition. She also shared the timeframe and milestones from today until Workday goes live in July 2018.
  • Contacts:
  • Be on the lookout for opportunities to view Workday demonstrations and to engage in SMR sessions in the coming months.

How We Increased Inclusion Among Residents

Every March we’re excited about Match Day, to see where our students will complete their training. (You can see photos of this year’s event here.) The other side of that process is in seeing who matched with UVAHS and in welcoming new residents in July. We recently have seen a positive difference with regard to the number of underrepresented minorities (URM) in the incoming residents.

The AAMC defines URM as “those racial and ethnic populations that are underrepresented in the medical profession relative to their numbers in the general population.” In recent years, residents who are URM have made up 7 percent of residencies nationwide. UVA usually follows that trend, matching 7 or 8 percent. Last year, however, UVA matched 10 percent URM to our program; and this year 15 percent! Looking at data from the Department of Medicine, our biggest department, the numbers went from 3 percent historically to 15 percent this year. These are outstanding increases.

This change did not happen by accident.

Great Change … But How Did We Do It??
Undergraduate medical education (UME) tackled this problem more than a decade ago and made astounding advances. Because of efforts made in the School of Medicine, we are now proud to say we have one of the most diverse student populations in the country. We wanted to do the same for our residency trainees, but we also wanted to broaden the AAMC definition of URM to be more inclusive.

As a first step, we conducted meetings to hear how minorities fared at UVA and in Charlottesville. These meetings were with the School, the Diversity Consortium, and the Medical Center, and with leaders in the institution like Dean David Wilkes, Dr. Gregory Townsend, and Dr. Michael Williams. While we had good information about our medical students, we lacked a grasp on how our minority trainees felt. After listening and receiving input from many groups, the Graduate Medical Education Committee task force (co-chaired by Dr. Kristen Atkins and Dr. Gerald Donowitz), working closely with Dr. Susan Kirk, Associate Dean for Graduate Medical Education, realized that there was a real need for us to do better.

Every program director was interested in making a change, however there were no mechanisms in place to make a broad, cohesive, and intentional impact. The GMEC task force assisted in creating these mechanisms by bridging the many groups who were already working on this subject.

The program directors started talking openly with applicants about diversity and what it means (and how it feels) to be an underrepresented minority. We created Diversity Days wherein we announced that several of our interview days would be extended for applicants interested in talking about diversity. While these days were sponsored by the Department of Medicine, they were open to all applicants and departments. Our message to the applicants was that UVA wants every trainee at UVA to thrive. The feedback we received from the applicants was eye-opening. Many had never had interviewers discuss diversity with them before. They appreciated it and recognized we wanted a change and that they could be a part of that change. For some, it was the first time they realized how important it was to belong to a place that was interested in their success.

Additionally, the task force educated program directors at monthly GMEC meetings about what was learned from speaking with GME trainees and applicants. We learned (and taught!) how to talk about diversity to an applicant, how to broach the subject, and how to openly discuss where UVA was with regard to diversity, but also where we wanted it to be. We kept the topic on everyone’s radar.

We also decided we couldn’t wait for the applicants to come to us. Like reaching out to high-school students before applying to college, we are now contacting third- and fourth-year medical students and giving them information about UVA Health System. We are going to regional and national meetings such as the Student National Medical Association (SNMA), the largest student-run organization focused on supporting underrepresented minority medical students.

Great Success and Momentum
All of this work is so that we may best serve our patients. A diverse group of trainees who reflect the community we serve leads to better patient care. And we are working on creating the best, most diverse resident teams. The past year has just been a pilot. We are moving forward with plans to propose new programs, create brochures for all programs for outreach, include more representation at SNMA meetings, and work with faculty across Grounds who conduct research on microaggressions. (There is much training and awareness we need to work on in this area.) We are also going to continue to tap into the underrepresented minority trainees who are already here and continue to solicit their help in recruitment and culture change. We will continue to take the pulse of our current trainees and institute activities and sessions that foster a culture of inclusion among all trainees, regardless of race, ethnicity, religion, gender, or sexual orientation.

Other ideas coming down the road: We are proposing formal training for all faculty in handling microaggressions and providing better access to our UVA Ombuds, Brad Holland, with scheduled on-site office hours. New signage has been implemented at the entrance to the Claude Moore Medical Education Building and the hospital lobby to let trainees (and everyone!) know that UVA is a welcoming place.

What we are doing for graduate medical education is a small component of what the whole community is doing — here at the hospital, in Charlottesville, and in Albemarle County. But we want the community to know that this is an important issue. We have learned much this year, and many of the needed connections are now in place. It was a good year. But it is just the first step in a longer process.

The success of initiatives such as this relies upon the willingness of all to participate. We would like to thank Dean Wilkes, Dr. Susan Kirk, the program directors, the task force, and the GMEC for their efforts in making this happen.

R.J. Canterbury, MD, MS, DLFAPA
Wilford W. Spradlin Professor
Senior Associate Dean for Education

Susan M. Pollart, MD, MS
Ruth E. Murdaugh Professor of Family Medicine
Senior Associate Dean for Faculty Affairs and Faculty Development

Survey: Your Voice Was Heard

In November of 2015, faculty were invited to take part in the Faculty Forward Engagement Survey. And take part you did. The national average response rate for this survey is 65 percent; however, 74% of our school’s faculty engaged with this survey. Thank you!

Much has changed since the fall of 2015. For one thing, the survey is no longer called Faculty Forward. The Association of American Medical Colleges (AAMC) has changed the survey’s name to StandPoint. Going forward, we will be referring to it as such.

We received the results in early 2016 and, for the past year, have been working with chairs and departments on action plans. In total, we met with all department chairs to review results. Furthermore, we were invited to present in 15 departments and presented results directly to faculty, held focus groups, and had individual conversations — all with the purpose of tackling concerns and challenges. At the institutional level, an advisory task force met and reviewed the results, discussing how to improve three broad areas of concern: communication, governance, and explanation of finances. We lead focus groups with faculty around these topics, and began working at the school level to address them.

Some action plans are in direct response to the survey results while other initiatives that address areas of concern raised in the survey were taken independently. Regardless of their source, highlights at the school level, include providing opportunities for Dean Wilkes to directly engage and communicate with faculty and SOM leaders in decision making, implementing a new process for department chair annual review, providing additional channels of communication (like this blog), collecting diversity plans from all departments, establishing the SOM Financial Advisory Committee, and presenting SOM/UPG and Health System financials at the monthly administrators meeting.

At the department level, examples of action-plans include arranging formal mentorship agreements for new and junior faculty; developing a plan for the reporting of financial principles and performance, as the Basic Science Funding Model is revised and clarified; deconstructing research silos by actively encouraging interdisciplinary research programs; meeting with all junior and mid-level faculty every year or two to review professional development progress; fostering greater transparency in and commitment to sponsoring our faculty for professional development opportunities, award nominations, and honorary society memberships; integrating faculty more formally into education activities of the School of Medicine; forming a Shared Governance Program to allow faculty and staff to voice their issues in small focus groups; expanding and complementing scientific expertise of departments through junior and senior faculty hires; and integrating Be Safe programs into all corners of the department (not just clinical sites).

That’s just a sample of what we’re looking to accomplish. To see the full list of action-plan items — both at the school and the department level — click here. For more information on the survey, visit the StandPoint Engagement Survey page on the Faculty Affairs and Development website.

Thank you to the faculty for their engagement with the StandPoint survey and in working to develop robust action plans — 2017 is shaping up to be a year of extraordinary progress.

Susan M. Pollart, MD, MS
Ruth E. Murdaugh Professor of Family Medicine
Senior Associate Dean for Faculty Affairs and Faculty Development

Assessing Students Today to Be Ready for Tomorrow

How can we ensure our medical students are prepared properly for the United States Medical Licensing Examination (USMLE) and our graduate students are ready to earn their PhDs and become leaders in biomedical research?

The answer: novel ways of assessment.

UME: Predicting the Future
The School of Medicine has had an integrated curriculum for years. This means that our students no longer study subjects in isolation. Learning is organ system-based, and this is how our students progress through the curriculum. Within each system, we assess performance in multiple ways. The weekend formative and summative assessments are main contributors to a student’s grade.

For the past two years, we have been reviewing class performance and determining how it correlates with board scores. James Martindale, PhD, Assistant Professor and Director of Test Development, oversees all SOM testing and is focusing on how overall system grades and weekend formative and summative assessment results relate to Step 1 performance (the application of important concepts of the sciences basic to the practice of medicine). He has found strong correlations in the data and is building a model that can determine how much of the variation in assessment performance can be predictive. While we are not teaching to the test, we do need to know if we are preparing our students for their future careers in medicine — including licensure. Later, we will review Step 2 (clinical knowledge and clinical skills) and Step 3 (taken after medical school graduation) data, to see if similar models can be built.

The impetus for this work is the need to identify the few students who are predicted to perform poorly on Step 1 while they still have time to remediate and enhance their study skills. This will be one additional tool to support our students.

BIMS: Say it out loud!
Amy Bouton, PhD
, Associate Dean for Graduate and Medical Scientist Programs, and her colleagues who teach the first-year core course for PhD candidates in the Biomedical Sciences (BIMS) Graduate Program want our graduate students to speak up. In fact, it’s an expectation.

Every first-year student in the BIMS Graduate Program takes an oral examination as the culminating assessment tool for the core course. This exam marks the beginning of their transition from a focus on grades and formal classes to a focus on self-initiated study, research, and professional development.

The examiners ask questions that cover basic information to ascertain that students understand the outline approaches and the purposes and goals of assigned papers. Students must interpret the results to demonstrate that they can make connections between the paper and topics in the course that apply to research, and show that they can make higher order reasoning and intellectual jumps.

We have found this method to be an excellent way to assess our graduate students. It allows us to determine whether they have acquired the basic skills emphasized in the core course and evaluates their ability to problem solve. It gives students an experience similar to what they will face later in their training when they must pass their advancement to PhD candidacy exam. A student who performs poorly on the oral exam is encouraged to work with the mentor to develop a plan for addressing the identified deficiencies.

A tremendous amount of preparation goes into administering these exams, which take place over a period of between 1-2 days and involve nearly 30 faculty members. These assessments provide an important means for early intervention for those students who have not yet developed the skills and knowledge needed to become a strong researcher and scientist.

We realize that English is not the primary language for some of our students. Our data indicate that this has not been a barrier to success, yet we continuously are monitoring for any outlying performance indicators. Since we have been administering this oral exam for only two years, it is too early to determine outcomes with respect to the impact on students’ advancement to candidacy exams.

Thank You, Faculty!
When I see the dedication of our faculty in ensuring we are continuously improving ways in assessing our students — driven by mission and goals — I am in awe. Thank you to Jim, Amy, and all the faculty whose tireless effort goes into student assessment.

R.J. Canterbury, MD, MS, DLFAPA
Wilford W. Spradlin Professor
Senior Associate Dean for Education

Med Students Offer Unity, Community

In response to recent events in the community, our students in the UVA chapter of the Student National Medical Association (SNMA) organized “A Response of Unity to a Demonstration of Intolerance” in the Claude Moore Health Sciences Library — spearheaded by Marta Getachew, a 1st-year medical student.

Student volunteers held whiteboards that said, “Charlottesville is a place for _____, not hate.” Faculty, staff, and students were encouraged to fill in blank space with what the Charlottesville and UVA community means to them.

In a letter to the School of Medicine, Jewel Llamas, 4th-year medical student and the new president of UVA’s chapter of SNMA, wrote, “In such a time of discord and divergence among so many groups in our nation, we hope to bring peace of mind to the people who may need it by showing that the ideologies of the people involved in the Lee Park demonstration are believed by a minority of people within our community, not the majority.”

Thank you to our students for creating such memorable moments and an atmosphere of unity, respect, and understanding. I could not be prouder of them. It was a well-received event supported by leadership, staff, and faculty from across the Health System. Hundreds of photos were taken over three days. Below is a sampling of the wonderful messages shared and wonderful people who participated.

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

(Click photos to enlarge.)