Highlights from the Innovation Showcase (AFMRD)

Diversity OSCE (FD)

We developed an innovative way to introduce culturally responsive care and direct observations through a Diversity Objective Structured Clinical Examination (OSCE.) First-year residents see 3 standardized patients while being directly observed by a faculty member in the room. The residents learn to respect other’s cultural beliefs and to use interpreters effectively. Residents are given immediate feedback after the session.

The goals of our Diversity OSCE are:

1. Emphasize the importance of culturally responsive care

2. Set the expectation for direct observations and immediate feedback from faculty

3. Prepare the new residents to see real patients

Resident evaluations of this activity have been over whelmingly positive. Residents feel it is an effective way to ease back into patient care (some fourth-year medical students lack direct patient care for months before starting residency) and get one-on-one feedback.

To ensure your Diversity OSCE is successful:

1. Adequately prepare the mock patients (we use staff)

2. Explain the educational value of this activity to the residents in advance. Debrief with the entire group after the OSCE to discuss the importance of culturally responsive care

3. Do not evaluate the resident’s medical knowledge This activity is intended to help residents grow!

Arts and Humanities (AH)

Arts in Medicine has circulated in the literature and curricula for some time, but our innovation started in 2018. The initial session was impulsive—without prior analysis of needs assessments or return on investment spreadsheets. We made kindness rocks. Simply, Arts and Humanities is an attempt to bring creativity, beauty, thoughtfulness, and fellowship to our practice.

Studies indicate integrating an arts programs can have impact on stress reduction, whole person orientation, professionalism, empathy, higher level observational skills and teamwork/communication.²

Our voluntary 40-minute sessions occur on Fridays over lunch every 4 weeks in the group visit room with size ranging from 5-20 faculty, students, residents, medical assistants, nurses, nurse practitioners, and front office staff.

It is a low-stakes, low-pressure activity. Cost is minimal (could be free) depending on the activities chosen; typically, $30 for “craft-heavy” sessions. Hospital resources (eg, art and music therapists, mindfulness coach) and local contacts (elementary school art teachers) have been utilized, all donating their time. Outside facilitators relieve the need to coordinate supplies and teach, but many successful sessions have been run by internal staff (eg, administrator-led knitting workshop.) Food-based sessions (cupcake decorating) are best attended.

Final impact? Kindness Rocks are still found scattered around our practice!

Text-Based Friendly Competition to Increase Engagement in Evidence-Based Medicine (MRH)

Understanding evidence-based medicine concepts and staying up to date with the literature were struggles for our faculty and residents and were identified as areas for improvement department wide at our 4 Family and Community Medicine residency programs. We instituted an evidence-based weekly questions quiz (EBQ) to improve exposure to up-to-date evidence-based medicine topics from recent literature. Relevant topics of interest were identified from the literature, a faculty wrote a related question, and a question was sent weekly via text message to all faculty and learners, including students rotating on family medicine clerkship.

Participation was encouraged but voluntary and anonymous, with the correct answer and evidence summary released the next day at the beginning of faculty meeting and resident didactics to allow for brief discussion. Some programs set up friendly competitions between learners and faculty or between clinic teams for participation or percent correct answers.

Engagement was highest when questions were directly relevant to clinical practice, and 89% of those eligible participated at some time. Feedback has been overwhelmingly positive, especially from the residents. Distributing question-writing burden to multiple faculty has been helpful; we also take regular breaks during busy months such as June-August and over winter holidays.