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Residency Readiness for Practice Challenge Grant Recipients

2018 Grant Recipients

Department of Medicine

Project Title: Point of Care Ultrasound: Training Internal Medicine Residents for 21st Century Bedside Medicine

Gigi Y. Liu, MD, MSc

Instructor, Medicine

Brian T. Garibaldi, MD

Associate Professor, Medicine
Associate Program Director, Osler Internal Medicine Residency Program
Co-President, Society of Bedside Medicine

Abstract of Project: Point of care ultrasound (POCUS) has revolutionized clinical practice by improving diagnostic capability, reducing the need for additional tests, enhancing physical exam skill, and bringing providers back to the bedside to engage in shared discovery with their patients. Training in POCUS is critical to preparing residents for 21st century clinical medicine. Over the last three years, the Osler Residency Program at JHH implemented the Advancing Bedside Cardiopulmonary Physical Exam Skills Program (ACE), a novel bedside education program that improves the clinical skills of graduate medical trainees.1 JHBMC has studied the use of hand-carried ultrasound to improve the cardiac examination skills of hospitalists,2,3 and has explored the rate at which residents can learn cardiac ultrasound.4 Through the execution of this multi-center proposal, the internal medicine (IM) residency programs at JHH and JHBMC will: 1. co-develop and implement a longitudinal POCUS curriculum for housestaff; 2. develop and validate innovative assessment tools for cognitive, psychomotor, and clinical integration POCUS skills; and 3. build a POCUS performance dashboard to aid in resident education and provide data to improve the curriculum. This program will help to define competency standards for IM POCUS training, a critical element that is currently lacking. The program will also be the first in the US to integrate POCUS training into an established clinical skills program, and will be a model for 21st century bedside clinical education.


Department of Otolaryngology - Head and Neck Surgery

Project Title: JHFIRE: Joint Huddles for Improving Resident Education

Lee M. Akst, MD

Director of the Johns Hopkins Voice Center
Assistant Professor, Otolaryngology - Head and Neck Surgery

Abstract of Project:
Background: Current methods for teaching residents in the operating room depends upon an unguided discovery model of education, in which residents ‘learn by doing’. This unguided discovery model is inefficient, and residents are increasingly reporting that they do not feel prepared for independent surgical practice.

Description of Problem: Improved quality and quantity of operative education is necessary to improve resident operative education, transforming operative education into a guided model of learning. Preliminary evidence suggests that this transformation can be aided by structured pre-operative briefings and post-operative debriefings, but routine use of these teaching tools has been limited.

Project Design: We propose to standardize use of pre-operative briefings and post-operative debriefings for all operative cases within the Department of Otolaryngology-Head and Neck Surgery which involve resident participation. Residents and attendings will be educated into how to perform these structured interactions in order to maximize their effectiveness.

Assessment: Assessment will involve several ‘layers’. Compliance in performance of the pre-operative and post-operative huddles will be measured; resident and attending attitudes on the quality of resident education performed within the Department will be measured; residents will be queried for their opinions on worth of the program; and resident operative performance will be measured as possible to judge impact of the huddles.

Generalizability: If successful, these Joint Huddles could be extrapolated to any procedural discipline within Johns Hopkins, and also beyond Johns Hopkins. Other surgical specialties would benefit from routine use of these educational huddles, and similar teaching could be incorporated around other procedures performed by other medical specialties such as lumbar punctures, central line placements, GI endoscopy, pulmonary bronchoscopy, and more.