CHAMP:Teaching on Today’s Wards

Overview and Methods

University of Chicago, Section of Geriatrics

Teaching on Today’s Wards was created and presented by:

Paula M. Podrazik, MD, Julie Johnson, PhD, ChadWhelan, MD

Supported by the Donald W. Reynolds Foundation

1. Teaching in the inpatient setting—Challenges and Importance:

The inpatient setting is the main training site for residents and medical students. The hospital, with potential iatrogenic events, challenging transitions, mortality risk, is likewise a crucial setting for older patients. Changes in residency work rules and new Accreditation Council for Graduate Medical Education (ACGME) core competencies have added to the challenge of teaching in this busy setting. Addressing these challenges and demands, the CHAMP faculty development program (FDP) merges the educational needs of faculty teachers, residents, and medical students around the goal of improving the care of hospitalized older adults.

2. How to Use the Materials:

Like the CHAMP FDP, Teaching on Today’s Wards has the potential for widespread portability to all teaching faculty who attend and teach adult medicine in the inpatient setting. Materials can be used in their entirety to recreate a similar FDP at your institution for General Internists, Hospitalists, Geriatricians, Family Practitioners and fellows, or they can be used in modular pieces as well, e.g., a workshop on teaching Practice Based Learning and Improvement (PBLI) or Systems Based Practice (SBP) competencies or just using the census audit tool to teach.

3. Teaching on Today’s Wards: Methods and Materials

CHAMP (Curriculum for the Hospitalized Aging Medical Patient) is a multi-tiered educational project with a faculty development program at its core. Hospitalists, general internists and family practitioners who teach residents and students are the targeted audience.

Strategies for strengthening inpatient teaching skills, addressing ACGME Core Competencies, while reinforcing geriatric knowledge, are presented in Teaching on Today’s Wards. Five two-hour sessions of Teaching on Today’s Wards follow the Stanford “Improving Clinical Teaching Skills” course, and culminate in a half-day OSTE (Observed Structured Teaching Exercises) to strengthen faculty learners’ inpatient teaching skills.

4. Teaching on Today’s Wards: Aims and Content Areas

Aims:

  • Assist the teaching faculty to improve their own individual process of teaching in the specific site of the inpatient wards.
  • Advance techniques and materials for teaching across all the ACGME competencies with an emphasis on teaching aspects of systems based practice (SBP) and practice based learning and improvement (PBLI) in “real” time during the course of ward rounds.
  • “Teaching on Today’s Wards” uses geriatric content as the basis for all discussions.

Sessions One and Two: Improving the Teaching Process

  • Use of process mapping to analyze and improve a faculty learner’s teaching process
  • Incorporating professionalism/communication into the bedside teaching agenda
  • Setting teaching goals
  • Two interactive card games that explores goal setting for the team of residents and medical students and how to expand a teaching agenda to include more teaching across the ACGME competencies using geriatric content.

Card Game #1: “I hope I get a good team.” explores the effects of the inpatient team dynamics on

the teaching process. The aim of this card game is to reflect on your teaching process with regard

to how you goal setting for the team and members of the team based on level of learner and

individual strengths and weaknesses.

Card game #2—“Missed teaching opportunities”— explores what you teach on a given call cycle,

How to develop a teaching agenda to include more of the aging related topics and

teach this geriatric content across the ACGME competencies.

Session Three: Systems Based Practice

  • Introduction to systems
  • Introduction to triggers for teaching about systems problems
  • Introduction to quality improvement using the Plan-Do-Study-Act (PDSA) model

Session Four: Practice-Based Learning and Improvement

  • Introduction to practice-based learning and improvement
  • Use of the case audit and census audit tools. See Figure # 1– sample census audit

Session Five: Life-Long Learning

  • When, what and how to formulate teaching questions

CHAMP (Curriculum for the Hospitalized Aging Medical Patient)

University of Chicago

Supported by a Donald W. Reynolds Foundation grant

Figure #1 Sample Census Audit

CENSUS AUDIT: FOLEY CATHETER USE*

By Chad Whelan, MD

Foley Catheter:YesNo

If Yes then:Where was it placed? ______

When was it placed? ______

Appropriate indication when placed? Yes No

Appropriate indication now?YesNo

If No, then DC

If Yes, Plan for DC Yes No

Patient Safety Issues/Systems Issues?

Summary

Proportion of Patients with Foley Catheter ______

Proportion of Patients with Catheters with indication when placed ____

Proportion of Patients with Catheters with indication now ______

Patient Safety Issues/Systems Issues Themes

______

______

Plan for Change: ______

______

Plan to Re-Measure: ______

CHAMP (Curriculum for the Hospitalized Aging Medical Patient)

University of Chicago

Supported by a Donald W. Reynolds Foundation grant