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Nancy Mesiha, David Disbrow, Ali Shakir
Part 1 Assignment: Needs
Definition of Need: A lack of requisite knowledge, attitude and skills that is required to achieve success/goals.
Need :
Improve communication skills of cardiology fellows with patient and patient families
Needs Assessment: Gap Analysis and discrepancies between
1. Patient evaluations regarding communication skills of cardiology fellows
2. Self Reflection Essay
3. Standardized patient case with videotaping for future review
Learning Plan
4. Role playing of effective communication between health care team and family
1. Didactic lectures regarding effective communication techniques
2. Review of standardized patient video with assessment
3. Self Reflection on evaluations of patient surveys
Learner Assessment:
1. Standardized patient case with observer and actors to assess communication skills of cardiology fellows
(Likert scale on effectiveness of communication skills)
2. Repeat Patient evaluations regarding communication skills of cardiology fellows
3. Provide feedback with results of final patient evaluations and standardized patient evaluations
Part 2: Change
Implementation of outpatient clinic for electrophysiology for cardiovascular fellows
Electrophysiology rotation is a required component of cardiovascular fellowship training. Fellows are required to obtain competency in basic electrophysiology during their two month rotation in evaluating arrhythmia patients in in-patient and outpatient settings. Currently, outpatient clinic is not part of the curriculum.
1. Establish a sense of urgency:
a. Required by ACGME
b. Fellows lack of exposure and continuity of care to outpatient arrhythmia management
Perceived lack of exposure by fellows to outpatient arrhythmia management
2. Develop a sense of vision and strategy
a. Add electrophysiology clinic to the existing EP rotation which currently exists
b. Description of achieved goals the fellows will need to complete by the end of the rotation
3. Communicate the change of vision
a. Communicate to fellows/attendings at regular staff meetings regarding change in curriculum/changes
b. Gain support from program director, EP attendings, and clinic staff regarding addition of fellows to clinic
4. Empower broad-based action
a. Receive feedback from fellows/ attendings, clinic staff regarding to be discussed at competency meetings
5. Generating Short Term Wins
a. Survey fellows learning gains and obtain feedback from attending the clinic
b. Survey attendings regarding clinic flow and patient care affected by fellows’ presence in the clinic
6. Consolidating Gains
a. Recognition of achieved goals of fellows after attending the clinic
b. Improvement in Board Scores/Practice Habits with presence of EP clinic
7. Anchor new approach in culture
a. Fellows appreciation of EP clinic and increased interest in outpatient arrhythmia care
b. Solidifies fellows training in arrhythmia care
c. Improvement in overall patient care regarding cardiac arrhythmias
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Comments (1)
Bev Wood said
at 3:21 pm on Sep 18, 2011
Very thoughtful posting.
The Needs are addressed effectively using the schema presented. You are definitelly presenting your learners with a number of possible activities to ensure they make an application in their daily life of ways to increase their learning and effectiveness.
Change represents a carefully organized approach to engaging the fellows in a patient management straategy that will be helpful to them and should result in improved patient care and appreciation of management as learned in patient encounters.
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