June 11, 1998

At our June 9 communications meeting, Franklin Medio, Ph.D., director of the Office of Graduate Medical Education, spoke to the management team concerning GME initiatives. Dr. Medio joined the College of Medicine in Sept. 1997. He has 20 years of experience in the health care field, has held faculty positions at three medical schools and one major teaching hospital and has worked as an independent consultant. Dr. Medio brings additional strength to the MUSC leadership team. GME is an integral function of our mission. Through improving our understanding of the GME program and priorities, employees throughout the Medical Center can be better prepared to support our mission. We are looking forward to working with Dr. Medio and we plan to continue communication of GME initiatives as we move forward.

W. Stuart Smith, Interim Vice President for Clinical Operations Interim CEO, MUSC Medical Center

Recognition: Relay for Life Award

• MUSC has been a participant and corporate sponsor of the American Cancer Society’s Relay for Life for several years. In Relay for Life, teams from many organizations throughout Charleston raise money through sponsorship, bake sales and other events, then gather for a 12-hour relay. This year, MUSC’s team raised more than $5,500 to fight cancer. At the June 9 communications meeting, Relay for Life chairman Jay Sorrels presented MUSC with an award in appreciation of its corporate sponsorship and the efforts of the team representing MUSC.

Announcement: MUSC Hurricane Symposium

• Physical Plant, Safety and EMSstaff members, nurses, physicians and any other interested Medical Center employees are invited to attend the MUSC Hurricane Symposium on Friday, June 19, from 8 a.m. to 4 p.m. at Baruch Auditorium. Speakers include: Ed Smolik, a nationally known facilities engineer; Karen Weaver, R.N., M.A., MUSC Medical Center director of Surgery and Women’s & Infants’ Services; Cathy Haynes, deputy director of the Charleston County Emergency Preparedness Department; and Rob Fowler, NBC Channel 2 meteorologist. This program on how to prepare for the 1998 storm season is free, but registration is required. Call 792-2409 to register.

Teaching Residents How to Teach

• Franklin Medio, Ph.D., director of the Office of Graduate Medical Education, spoke to the management team on the office’s development of the Core Curriculum program for residents. The Core Curriculum is part of MUSC’s strategic plan. It includes essential topics that cut across all medical and surgical specialities, such as teaching skills, medical infomatics, ethics and continuous quality improvement.
• The first element of the Core Curriculum, a special course designed to teach residents how to teach medical students and each other, has been in place since January. Medio said there is a growing recognition among medical schools of the importance of preparing residents to be effective teachers. He said even those residents who have no plans to enter academic life have teaching responsibilities during their residencies, and they can benefit from programs that help them develop skills to integrate their teaching and patient care responsibilities. To underscore the importance of the course, Medio begins by pointing out to residents that even when their actions are simply being watched by a medical student, they are teaching; they cannot avoid being role models. Medio has worked with seven departments so far and plans to reach all residency programs by the end of 1998.
• The teaching skills course addresses several key areas, including the following:
• Roles and responsibilities of residents. Medio said the “spoon feed me” habit some learners have must be broken, and residents can help in this process. The program also works to help residents become self-motivated, lifelong learners.
• The learning curve. Students who are proficient at learning information may not be immediately skillful at using medical instruments and putting what they learn into action. This section helps resident learn how to be effective at teaching these essential “psychomotor” skills.
• Principles of clinical learning. Here, residents learn how to find time to teach, taking advantage of the many teaching opportunities during a hectic day of patient care.
• The resident as team leader. Medio makes a point to remind residents when they don’t have the answer to a problem or question, it can be turned into a teaching opportunity by showing students how they go about finding answers.
• Socratic teaching method. This shows residents how to question students in a positive, dynamic way to help them learn rather than punish them for not having an answer.
• Evaluation of clinical performance. This section deals with who should evaluate whom and when that evaluation should take place. In other words, faculty need to evaluate residents, and residents need to evaluate their students, but students and residents also should have a chance to evaluate their teachers in order to improve the curriculum.
• Handling the “difficult” individual. This section covers the problem of what to do when an individual is not cooperative or motivated. For example, a student may feel he has the right to pick and choose his curriculum based on his particular interests and goals rather than satisfy the requirements established for all students.
• Medio said the program, which formally recognizes residents as educators, already has had an impact on the organization. Expectations of the residents’ roles are shifting and expanding, as is their authority. Medio said there also is a demand for similar training to be made available for interested faculty members, perhaps in the form of workshops on specific topics.
• The program also is reaching outside the walls of the university. Medio and George Arana, M.D., associate dean for Graduate Medical Education, presented MUSC’s Core Curriculum at the recent Association of Academic Medical Centers’ Group on Residency Affairs meeting in March, and Medio has been invited to participate in a special AAMC Graduate Medical Education and Group on Educational Affairs Core Curriculum Working Group meeting on June 24.
• Additional Core Curriculum elements:
• Managed care. Medio received a small grant from the Partnerships for Quality Education group of the Pew Charitable Trusts Foundation. He is working with Donald Fox, M.D., director of the Division of General Internal Medicine and Geriatrics residency program, and Peter Carek, M.D., director of the Department of Family Medicine residency program, to design a special clinical education program for primary care residents. This program will allow residents to spend time at offices of Palmetto Primary Care and Carolina Family Care physicians to get real-world experience.
• Medicare compliance and regulations. Another Core Curriculum program covers the real-world topic of recent changes in Medicare rules and regulations. Group lectures from Health Care Financing Administration officials give residents an update on the policies and procedures for complying with Medicare billing. Working with MUSC’s compliance staff, Medio plans to design computer-based, self-directed instructional materials so residents can keep up to date.
• Hospital communication. In the planning stages is a communication skills training program for residents on how to effectively navigate the myriad of information that is communicated throughout the hospital. It covers both computerized information systems and plain old talking, boosting such skills as how to best communicate with referring physicians. This program is a recommendation of the MUSC Hospital Executive Committee Communication Task Force.

Charting the Course - JCAHO Update

• Vivian Gettys, Joint Commission on Accreditation of Healthcare Organizations program manager, announced a JCAHO steering committee has formed to plan and put into place a course of action for maintaining the Medical Center’s performance in meeting JCAHO standards.
• The interdisciplinary steering committee of 52 members is responsible for ensuring the Medical Center fulfills JCAHO standards. Committee activities include:
• Ongoing evaluation of the Medical Center’s performance based on JCAHO standards will be integrated into day-to-day operations.

• Development of action plans with a focus on making a positive impact on patient care and services to improve patient outcomes.
• Ongoing review and revision of Medical Center policies and procedures.
• The committee is incorporated into MUSC’s Quality Network. It is composed of three teams that report to a core group.
• The patient-focused team will address standards in the areas of patient rights, assessment and care, patient education and continuum of care.
• The organizational-focused team will concentrate on the standards covering performance improvement, leadership processes, human resources, environment of care, information management and infection control.
• The leadership-focused team will work on standards dealing with governance, management, medical staff issues and nursing leadership.
• Gettys added that the Medical Center is midpoint in the survey period and could be chosen for a random, unannounced survey by the Joint Commission during the first quarter of 1999. Specific areas that have been most troublesome for accredited hospitals nationwide are targeted in this type of survey. She said this underscores our need to be prepared at all times. The steering committee will help us do that in an organized, planned way.