Highlights of the Innovation Showcase

The Integration of Diversity, Equity, and Inclusion (DEI) into a Family Medicine Curriculum (J.H., T.K., Y.P.)

Before integrating health equity topics into our weekly didactic curriculum, our program’s training on cross-cultural patient care was limited to sessions in orientation and monthly lectures with minimal faculty inclusion. With our interventions, all faculty and residents are collectively enhancing their understanding of how to better respect our patients’ social and racial backgrounds in the context of patient care.

To achieve this, the DEI in Didactics subcommittee identified and sent 1 to 3 resources to speakers to help them incorporate DEI themes into their lectures on medical topics. Provided resources included articles, videos, and reflection questions to accommodate a variety of learning styles. During lectures, a resident would track which resources were presented and the type of disparity discussed. We curated a virtual library of these resources and made them accessible to other residency programs and our house staff for further self-reflection.

Upon surveying residents and faculty, we discovered that this project made them more likely to include information on DEI in future lectures and that they perceived our program to be more inclusive.

Our project created a structured workflow that encouraged more consistent teaching of health inequities and invited all house staff to engage in DEI work.

Using Milestone Data and Open-Source Software to Promote Program Improvement and Identify Bias in Milestone Ratings (C.G., M.M.)

The emergence of competency-based medical education has necessitated the adoption of ACGME milestones, prompting residency programs to submit biannual milestone ratings for all residents. Consequently, this transition has facilitated uniform data collection through the Accreditation Data System (ADS), administered by ACGME. This system allows residency programs to download their milestone ratings submitted over time, which can then be analyzed. Data analysis requires statistical software, which can be expensive. An immediate solution to this expense is the use of open-source and easy-to-use software such as jamovi.³ The use of data from ADS paired with jamovi enables programs to identify their program’s relative strengths, weaknesses, and potential bias in milestone ratings. The use of these tools in our residency program has (1) promoted critical program-level reflection and awareness of the potential for bias; (2) identified areas for faculty and Clinical Competency Committee development; (3) provided our curriculum committee with information about potential curriculum gaps; (4) promoted a program mission and vision informed by strengths and weaknesses; and (5) led to the broader application of analytics in our residency program.

10 Years of Required Resident Capstone Projects Within a 4-year Curriculum—What We’ve Learned Along the Way (J.S.)

In an effort to encourage residents to adapt a scholarly approach to their passions, all residents in our program are required to complete a capstone project. The core components of the capstone projects are that residents must have a question, perform a background literature review, propose a methodology to answer the question, provide a reflection of the project’s results, and disseminate the findings to an interested audience.

Residents work with a faculty mentor, as well as program support faculty, to complete their capstone projects. In addition, the formal residency curriculum has time carved out for resident capstone work. During the 4th year of their residency, residents present their findings to an audience that includes their peers, faculty, and invited members of the public. They also submit a final report, which includes a reflection about the process.

We utilized experience of faculty members, supplemented by information from resident reflections, to inform lessons learned from the first 10 years of resident capstone projects, which include:

• Identify markers of success early in the process

• Manage expectations early in the program’s development

• Appreciate the intrinsic value of project topics

• Develop tools and resources that are resident focused

• Expect that baseline experiences of residents vary

• Residency time is inconvenient

• Flexibility about project topics is paramount to resident buy-in