Inaugural Chief Resident Orientation Focuses on Skills for Success
Chief residents play many roles — leader, administrator, educator, mentor and counselor — but changes in graduate medical education are making them busier than ever before. In an effort to provide some guidance, the Miller School and Jackson Memorial Hospital recently held the first orientation specifically for new chief residents. The one-day program brought 55 of them together, representing every department in the school.
The orientation program was a collaborative effort involving Michael K. Butler, M.D., M.H.A., executive vice president and chief medical officer of Jackson Health System; S. Barry Issenberg, M.D., Director of the Miller School’s Gordon Center for Research in Medical Education; Richard K. Parrish, II, M.D., professor of ophthalmology and Associate Dean for Graduate Medical Education; Joan St. Onge, M.D., associate professor of clinical medicine and Associate Dean for Graduate Medical Education; and Hector Fabio Rivera, M.D., Assistant Director of Curriculum and Technology Development at the Gordon Center.
“The most significant change in the role of chief residents is a greater focus on direct observation of our learners,” said St. Onge. “They are in a unique position to assist in the assessment that determines where interns and residents are in terms of certain milestones in their training.
“To do this, they use a variety of different evaluation tools, while providing feedback to their learners. They also will have to document their assessments in a much more rigorous fashion than in the past. Their reports, as well as those of other faculty members, are then reviewed by the Clinical Competency Committee. This committee assists the program director in determining a resident’s readiness for private practice.”
Direct observation, however, was only part of the extensive orientation program, which was split into two four-hour sessions that took place at the Gordon Center on June 2. The new chief residents were divided into eight subgroups, each with a mix of medical specialties designed to build contacts and collaboration during the coming year.
One of the sessions focused on instructional development.
“We began by conducting a survey of current chief residents, asking them to suggest topics they would have found most useful when they were starting out,” said Rivera. “Based on the responses, we focused on three areas — team concepts, teaching in clinical settings, and assessment and debriefing.”
These topics were covered in didactic and interactive lecture settings, small group sessions, team training exercises and simulated scenarios using high-fidelity simulators.
“They gave us a lot of tools — especially for learning how to be a liaison between faculty and residents,” said Cecilia Perez, M.D., an incoming chief resident in OB-GYN. “It also was very interesting to hear from others about the different ways in which they educate and collaborate. The most useful material, for me personally, was how to give feedback, to critique performance and do it in a helpful way.”
The second session dealt with resident integration into hospital operations. Topics ranged from hospital-acquired conditions, patient safety goals and quality metrics to scheduling patient utilization, incident reporting and conflict resolution.
Conflict resolution, in fact, was the hot topic for most of the attendees, including Gustavo Westin, M.D., a new chief resident in internal medicine. “That, plus mentorship and feedback sessions are some of the tougher challenges chief residents face,” he said. “It would also be helpful to have a session with the former chief residents so they could share their experiences.”
The lunch break gave new and former chief residents a networking opportunity, but Westin suggested something far more extensive, including an overlap during which the two groups would work together for as much as a month.
This type of feedback is exactly what St. Onge was looking for when she surveyed the group after the program was completed. Based on the results, additional training sessions are planned.
“Our goal was not only to focus on the skills needed for chief residents to function as leaders and educators, but also to give them an overall view of their important place in the system and who they will be interacting with on a daily basis,” she said. “The orientation was only one day, and based upon the feedback, we now plan to also hold quarterly workshops throughout the year. We will also continue to hold the orientation each spring.”