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GEA/GSA Small Group Discussion Sessions

Sunday, November 8
8:30 - 10:00a	GEA/GSA Small Group Discussion Session Globalization: What Makes International Exchanges Worthwhile? Moderator: John J. Norcini, Ph.D. President and CEO Foundation for Advancement of International Medical Education and Research (FAIMER) Discussants: Ricardo Ronco, M.D. Director of Medical Education Associate Professor of Pediatrics Universidad Del Desarollo Santiago, Chile Javeed Sukhera, M.D. PGY3, Department of Psychiatry University of Rochester Medical Center Mary Y. Lee, M.D., M.A, M.S. Associate Provost Professor of Medicine Tufts University School of Medicine Description of Topic and Rationale: Medical student, resident, and medical school faculty interest in cross-cultural and global health experiences is increasing and the variety and scope of international exchange opportunites has grown to address the increased demand. Because medical education crosses political, religious, and ideological boundries; the issues faced by medical school faculty and administration in creating educational programs to prepare physicians to practice medicine are universal. Global dialogue around these issues creates the opportunity for countries and medical professionals to learn from one another. One of the goals of FAIMER is to improve the health of populations through improvement in health professions education. FAIMER has developed approaches to faculty development that offer opportunites for exchange and for others to learn from experiences of resource challenged sites and successful " train the trainer" model. The session provides a unique opportunity to learn from U.S. and international faculty about their experiences, to consider the lessons learned from those experiences, and how some of the lessons may be applied. The session will feature U.S. medical school faculty in discussion with international faculty and session participants. Questions for Discussion: What are the enabling and constraining factors to the development of international exchange programs for institutions and for students and faculty? What are the advantages and disadvantages to establishing an international exchange program at your institution? How does one establish an international exchange program? Intended Audience: The session is intended for anyone interested in globalization and its impact on medical education.	Hynes Convention Center Room 101
Monday, November 9
2:30 - 4:00p	GEA/GSA Small Group Discussion Session Student Learning Portfolios and Professionalism Moderator: Chris Osmond, Ph.D Assistant Professor of Social Medicine University of North Carolina at Chapel Hill School of Medicine Discussants: Rita Charon, M.D., Ph.D. Professor of Clinical Medicine Director of the Program in Narrative Medicine Columbia University, College of Physicians and Surgeons Debra Litzelman, M.D., M.A. Professor of Medicine Associate Dean for Medical Education and Curriculum Affairs Indiana University School of Medicine Louise Aronson, M.D., M.F.A Associate Professor of Medicine Co-Director of the Medical Humanities Initiative University of California San Francisco School of Medicine Description of Topic and Rationale:The call for increased attention to professionalism education has been accompanied by a rise in student learning portfolio requirements in undergraduate medical curricula. Such portfolios usually have several explicit purposes: to assess student attainment of professionalism objectives, to provide qualitative data on student performance that might support summative assessments, and to document student growth as an outcome of work with faculty mentors. However, student learning portfolios are also underdeveloped opportunities to meet social and behavioral science curriculum objectives - domains of medical training that have been well-articulated but irregularly addressed - including the maintenance of physician well-being, the development of social responsibility, and the cultivation of effective communication skills though the fostering of reflective and metacognitive habits of mind. Student learning portfolios also open medical education to the possibilities and challenges of including qualitative, narrative, and aesthetic responses to medical training as valid evidence of educational attainment, elements that both enrich and complicate the evaluative function of the work that results. Questions for Discussion: How can student learning portfolios reveal and impact a school's informal curriculum? What is the impact of the informal curriculum on the teaching of professionalism? What are the limits and affordances of digital portfolio technologies? Which administrative challenges can be anticipated, and how might they be addressed? How can existing faculty mentorship structures be supported by portfolio work? What opportunities do portfolios engender for collaboration between Student Affairs, other departments and offices, and curriculum leaders? What are the evaluation challenges of student learning portfolios? Intended Audience: This session will be useful for preclinical and clinical teaching faculty, Course Directors, Curriculum Committee members, Student Affairs personnel, and all those interested in using student learning portfolios in UME.	Hynes Convention Center Room 108
2:30 - 4:00p	GEA/GSA Small Group Discussion Session Role of the AAMC Graduation Questionnaire as Both Institutional Assessment and LCME Self-Study Data Moderator: Robert Eaglen, Ph.D. Scholar in Residence Northeastern Ohio Universities Colleges of Medicine and Pharmacy Discussants: Margarita Kokinova, Ph.D. Assistant Dean for Assessment and institutional Effectiveness Northeastern Ohio Universities Colleges of Medicine and Pharmacy Isaac K. "Ike" Wood, M.D., FAACAP Senior Associate Dean for Medical Education and Student Affairs Virginia Commonwealth University School of Medicine Nicole Borges, Ph.D. Wright State University Description of Topic and Rationale: One of the more important indicators of the institutional effectiveness of a medical school is the satisfaction of its graduates with the educational program, the support services offered to students and the entire learning environment. The responses to the AAMC Graduation Questionnaire (GQ) are generally accepted as a reliable measure of graduates' satisfaction with their medical school experiences. Careful analysis of GQ reports can help identify areas of strength and weakness of the institution. The findings of such analysis become increasingly important when an institution is starting a self-study in preparation for an LCME site visit. The structure and content of the GQ, however, pose several challenges for institutional assessment. One of the key challenges is the validation or corroboration of GQ data from other sources. Identifying institutional assessment data that can confirm the GQ results is not always an easy task. Medical schools usually do not have survey instruments that correlate directly with many of the elements of the comprehensive GQ. Local program assessment data are collected at different time points through instruments that often focus on school-specific issues, which makes the validation of GQ results difficult. Schools may use a different vocabulary to inquire about the same kinds of student satisfaction data that are captured on the GQ, which can cause confusion when students complete the Graduation Questionnaire. Many items on the GQ ask respondents to provide an assessment of events or activities that took place several years earlier, without a mechanism for determining whether student perceptions have changed over time or were unduly influenced by their later experiences. Another challenge is ensuring that students understand the importance of the GQ and its potential impact on the institution, both for routine program assessment and for the special circumstances of an LCME review. A lack of guidance about the uses and value of the GQ can lead to diminished response rates and may affect the quality of the responses submitted. The open-ended narrative responses in the GQ's Strengths and Weaknesses Report can be particularly challenging as a tool for program assessment, given the variability and idiosyncrasy of responses. Increasing student awareness of these issues should help to foster carefully thought out feedback that will benefit succeeding classes of students. This small-group discussion will address the above questions by sharing the experiences of three schools which routinely use GQ data for institutional assessment. Two of the schools recently competed LCME reviews and the third is just embarking on its LCME self-study process. The session will provide an opportunity for participants to discuss the strengths and limitations of GQ data as a tool for quality improvement, and to share their experience with using GQ data specifically in preparation for an LCME visit. Questions for Discussion: How do schools link GQ data with data collected at the school level? How do schools disseminate and use GQ results within their institution? What thresholds or benchmarks do institutions use to evaluate the significance of GQ findings? How much emphasis do schools put on GQ data in preparation for an LCME site visit? What procedures do schools use to ensure that their senior students understand the importance of the GQ and its potential impact on the institution? How do schools ensure an acceptable response rate? Intended Audience: Faculty and administrators from Academic Affairs and Student Affairs offices	Hynes Convention Center Room 308
2:30 - 4:00p	GEA/GSA Small Group Discussion Session Reflections on the Mistreatment of Medical Students Moderator: Michael D. Prislin M.D. Associate Dean Student Affairs University of California Irvine, School of Medicine Discussants: Donna Elliott M.D., M.S.Ed, Ed.D. Associate Dean Student Affairs University of Southern California, Keck School of Medicine Joyce Fried Assistant Dean and Chair Gender and Power Abuse Committee David Geffen School of Medicine at UCLA Neil Parker M.D. Senior Associate Dean for Student and Resident Affairs David Geffen School of Medicine at UCLA Description of Topic and Rationale: The mistreatment of medical students received considerable attention during the 1990s. Despite this attention, the issue continues to be a source of concern in medical education. Indeed the Liaison Committee on Medical Education has added an accreditation standard to address this issue (MS-32. Each medical school must define and publicize the standards of conduct for the teacher-learner relationship, and develop written policies for addressing violations of those standards). Yet existing data suggests that little improvement has occurred. In fact, mistreatment of students appears to be derived to a great degree from the culture of medicine and perpetuated by the transmission of that culture during the educational process. This session will engage the audience in a broad discussion of student mistreatment. Topics covered will include: defining what constitutes mistreatment; identifying the prevalence of mistreatment; examining the development of institutional policies to address mistreatment; identifying common barriers to effectively addressing mistreatment; and, describing best practices in responding to and preventing the occurrence of mistreatment. Questions for Discussion: What constitutes medical student mistreatment? What are common myths and stereotypes pertaining to medical student mistreatment? What is the current prevalence of medical student mistreatment? What are the current standards of national accrediting bodies pertaining to mistreatment? What are some "best practices" pertaining to institutional policy development and responses to student mistreatment? What are common barriers hindering effective responses to medical student mistreatment?	Hynes Convention Center Room 209
2:30 - 4:00p	GEA/GSA Small Group Discussion Session Technical Standards, Reasonable Accomodations and Beyond Moderator: Joel A. DeLisa, M.D., M.S. Professor and Chairman of Physical Medicine and Rehabilitation UMDNJ-New Jersey Medical School Discussants: Amy Long, M.S.III Wake Forest University School of Medicine Bliss Temple, M.S.III Duke University School of Medicine Nathaniel Myall, M.S.II Stanford University School of Medicine Description of Topic and Rationale: Diversity within the medical workforce is helping to expand culturally competent care for our nation's and our world's most vulnerable, underserved minorities. However, for people with disabilities a significant gap still exists. Disabled Americans are less likely than their nondisabled counterparts to receive primary and preventive care, more likely to be uninsured, and are at higher risk for substance abuse, mental health problems, and obesity and its comorbidities in their lifetimes. They make up at least 10% of the global population and about 20% of the US population, yet disabled physicians make up less than 1% of medical school graduates. There has been significant discourse within the AAMC and the medical literature over the last thirty years about the admission of prospective students with disabilities. Questions abound: What are the minimal physical, sensory, psychological, and cognitive requirements for a physician? How do we reasonably accommodate physical limitations in the physically demanding world of medical training? Is it ever appropriate to use an intermediary while providing medical care? Where is the balance between undifferentiated students versus an undifferentiated curriculum? What role do students with disabilities have in increasing the ability of the medical profession to serve diverse patients? And, perhaps most importantly, how does the training of disabled students work for educators and students at a practical level? These questions are challenging, and the responses can be controversial. However, it is imperative that they be addressed in light of the great need for culturally competent care for disabled Americans as well as the moral and legal imperatives for medical schools to provide a level playing field for all applicants and matriculants. While there are several examples in the literature concerning the controversies around admitting and accommodating students with disabilities, there is a shortage of successful models. Thus there is a need for disabled students and physicians to share their experiences. Questions for Discussion: What are the barriers to admitting and accommodating students with disabilities? What are ways these barriers have been addressed? What were the pitfalls in these situations? How can these situations be translated into models for future students? What other questions do attendees have for the discussion panel concerning the objectives?	Hynes Convention Center Room 205
2:30 - 4:00p	GEA/GSA Small Group Discussion Session Jefferson University and Albert Einstein University Yeshiva College of Medicine: Case Comparing Clinical Skill Center Planning and Design Moderator: Fletcher MacNeill, M.ARCH Burt Hill Discussants: Felise Milan, M.D. Director Introduction to Clinical Medicine Albert Einstein College of Medicine at Yeshiva University Katherine Berg, M.D. Associate Professor of Medicine Co-Director, University Clinical Skills and Simulation Center Thomas Jefferson University Dale Berg, M.D. Professor of Medicine Co-Director, University Clinical Skills and Simulation Center Thomas Jefferson University Description of Topic and Rationale: The use of simulation in medical education has dramatically increased over the recent past. Almost every medical school has built or is in the process of considering the development of a clinical skills center. Due to ever evolving and ever more sophisticated technological tools, along with innovations in teaching models, achieving the best facility design solution is a challenge. Moreover, every medical school has a unique identity, its own set of objectives and teaching methods, yet all must conform to a demanding set of standards overseen by the LCME. In this Small Group Discussion our panel will address the kinds of challenges that are commonly faced in planning and designing clinical skills and simulation teaching facilities, how they addressed them and lessons learned. Questions for Discussion: How will the school use simulation in the curriculum, and how does the center function as a venue to integrate the simulation and skills aspect into the pre-existing curriculum? What did you learn from the planning process that would prompt you to change the approach if you were planning a facility today? Have you had to make adjustments with your facility, such as renovations or installation of new equipment due to changes taking place in teaching methods or technology? If so, what kinds of adjustments have you made? Based on the experience of each of the institutions represented (one being a renovation with minimal gutting, the other being a free-standing new building designed specifically for allied health/medical education) what configuration, or layout, for clinical skills and simulation teaching would you consider ideal? What things about the design of your center have limited or allowed flexibility with regard to changes in enrollment or changes in course scheduling. Intended Audience: Medical educators or administrators interested in developing new or modifying existing clinical skill teaching centers.	Hynes Convention Center Room 204
2:30 - 4:00p	GEA/GSA Small Group Discussion Session Videotaping Lectures: Balancing Student Technology Needs with Educational Practices that Promote Interactive Learning Moderator: Nancy Kheck, Ph.D. Assistant Dean and Director, Curriculum Office Mount Sinai School of Medicine Discussants: Maria Blanco, Ph.D. Assistant Dean for Faculty Development Tufts University School of Medicine Carol Capello, Ph.D. Associate Professor of Geriatric Education Associate Director of the Office of Curriculum Weill-Cornell Medical College Elza Mylona, Ph.D. Associate Professor of Clinical Preventive & Internal Medicine Associate Dean of Educational Development and Evaluation Stony Brook University School of Medicine Description of Topic and Rationale: Many medical schools provide students with video archives of recorded lectures. While this use of technology offers students expanded options for self-directed learning and time management, at some institutions the perception it that it has contributed to precipitous drops in attendance at non-mandatory didactic sessions. Measures to limit or delay access to these resources have been met with pressure from learners, and even raised ethical concerns about the motivations of educators.1 Recent studies have concluded that students find viewing accelerated lecture videos equally if not more valuable than attending live lectures.2 While educators express concern over this fundamental paradigm shift in student learning strategies and feel potentially marginalized, students are thriving and proactively "tailoring" their educational experiences to achieve their professional goals. This small group discussion is designed to facilitate an exchange amongst GEA and GSA faculty about the challenges medical educators face in balancing the needs of students with fostering an interactive learning culture. Discussants will share perspectives and practices from their own institutions and problem-solve through common challenges with the audience in guided large group discussion. The discussion will cover the following: 1) the impact of videotaped lectures on classroom attendance, 2) management strategies used by administration to retain students in live lectures, 3) video-technology and podcasts as instructional adjuncts to bridge the divides and 4) creating opportunities for more interactive engagement with learners. Questions for Discussion: What technology resources are used at your school to capture lectures, and what school policies govern the use of these resources relative to class attendance? Do these multi-media resources (e.g. videotaping, podcasts) influence class attendance at your school? What impact if any do these resources have on objective measures of learning, e.g. UMSLE Step 1, end of course exams, etc? How does this compare to the loss of interaction with faculty, role models, mentors, the ability to ask questions live to resolve questions, interaction with peers and learn from their questions? What is the impact of these technologies on students versus educators? Do faculty teaching and student learning styles play a significant role? What are the best strategies to keep students engaged in the classroom? Intended Audience: This discussion should be of interest to anyone involved in curriculum development and undergraduate medical student education: curriculum and student affairs deans, faculty, and medical students.	Hynes Convention Center Room 310
2:30 - 4:00p	GEA/GSA Small Group Discussion Session Collaborative Research Response to IIME Report Using Information Skills as a Theme Moderator: Rick Forsman Teaching/Learning Project Coordinator Association of Academic Health Sciences Library Directors Discussants: Linda Watson President, Association of Academic Health Sciences Library Directors Director, Health Sciences Libraries University of Minnesota RIME representative Purpose of Topic and Rationale: The AAMC has recently published two seminal reports calling for change in the overall medical educational system: Educating Doctors to Provide High Quality Medical Care; A vision for medical education in the United States, Reports of the Ad Hoc Committee of Deans (2004), and Implementing the Vision; Group on Educational Affairs Responds to the IIME Dean's Committee Report (2006). The report of the AAMC Ad Hoc committee of deans identified key strategies for affecting reform to achieve the "Ideal Medical Education System". Within each key strategy are suggestions to each constituency to re-design their programs or re-focus their activities to emphasize actions that would bring about 1) a patient-centered approach to medical care 2) ensure that doctors are capable of providing high quality medical care, 3) improve the efficiency of the educational process, 4) improve the effectiveness of the educational process. The AAMC recommendations for implementing the vision developed by the dean's detail some areas of research and investigation that would stimulate and justify these basic reforms. They are categorized within the four areas of concern listed in the first report. Many of these recommendations include developing skills in effective use of evidence for patient care and information technologies for learning and improved patient care. In both of these domains, libraries have already become effective partners locally, and across the continuum of the educational system to clarify skills needed, to effectively teach those skills, and to ensure constant renewal of those skills given the rapid pace of change and the availability of new resources and tools. This small group discussion will present an opportunity for those representing the breadth of professions attending the AAMC annual meeting to share ideas on how to begin collaborative research into the questions raised in the report by addressing one thematic subset of the agenda. The key strategic research areas concerning information skills and learning outcomes delineated in implementing the Vision will be framed as questions for discussion. The audience will be invited to share their views and suggestions on priorities, collaborative possibilities and possible interdisciplinary approaches. The hoped for outcome would be to identify priorities, stimulate ideas, and create connections for exploration between future researchers at the various sites represented by AAMC attendees. Questions for Discussion: Promote Patient-centered approach to medical care: How can physician-patient communication and patient information needs be readily defined, and addressed within the healthcare system. What do the levels of satisfactory communication and understanding have to contribute to patient satisfaction and health outcomes, such as compliance? What would be some interesting interdisciplinary partnerships that could address these questions and in what settings? Ensuring that Doctors are Capable of Providing High-Quality Medical Care: As tools and resources for discovering and efficiently using best evidence proliferate and change, it is critical that physicians' medical knowledge bases stay current and their practice-based learning incorporates the best evidence applied appropriately to each patient. How can we address research to determine whether these skills exist in the continuum of learning to practice, and how can we validate their effect on patient outcomes; how can we best teach these skills within the undergraduate and graduate curriculum? What new light can multi-disciplinary research shed on these questions? Improve the Efficiency of the Educational Process: How do you integrate core clinical competencies such as understanding of continuous learning and evidence based medicine concepts and techniques into the curriculum. Could research into the efficiency of various methods of teaching information skills to students and residents be a model for implementing other cross disciplinary topics into the curriculum? Improve the Effectiveness of the Educational Process: How do we examine the impact of self-directed learning throughout the professional's development? How can the link between outcomes such as patient care, practice change or learner gains and various educational processes, such as online learning be measured? Intended Audience: Medical educators and researchers in medical education; librarians, educational technology specialists; teaching faculty; residency program directors; continuing medical education directors; information technology professionals.	Marriot Copley Place Salon B
2:30 - 4:00p	GEA/GSA Small Group Discussion Session Sustaining the Momentum and Continued Development of Faculty to Deliver Successful Team Based Learning(TBL) Programs Moderator: Nagaswami Vasan, D.V.M., Ph.D. Professor of Anatomy New Jersey Medical School, Newark Discussants: Ruth Levine, M.D Professor of Psychiatry and Internal Medicine Director, Academy of Master Teachers University of Texas Medical Branch Sandy Cook, Ph.D. Associate Professor Associate Dean for Curriculum Development Duke-National University of Singapore Graduate Medical School Britta Thompson, Ph.D Assistant Professor Director of Evaluation and Assessment Baylor College of Medicine Description of Topic and Rationale: Nagaswami Vasan will illustrate the curriculum initiative at his institution and the opportunities it has provided to develop new ways to engage students in their basic science education. He will include how he implemented TBL in Anatomy course, what strategies he uses to sustain the momentum and faculty development at his institution. 2. Ruth Levine will add strategies she employed to implement and sustain a successful TBL program in both a clinical and pre-clinical courses. She will also share two instances in which adding TBL to courses failed and some of the reasons why. 3. Sandy Cook will share her experience in faculty development and administrative efforts used at Duke-NUS GMS to create a TBL culture and assist faculty in creating their TBL sessions as well as strategies planned to sustain this momentum. The entire basic science curriculum is delivered almost exclusively with TBL, labs, and clinical correlations. 4. Britta Thompson will lead participants in a discussion regarding inhibitors and enablers of implementation and maintenance of TBL. She will draw on the experiences of participants within the small group to identify "best practices" for sustaining TBL efforts. Questions for Discussion: What resources, time, and opportunities are needed for initial and ongoing faculty development? What are "best practices" for getting students, faculty, and administration involved in championing or "buying-in" to the TBL strategy? What data is being collected across institutions to determine "best-practices" for TBL, including effective faculty development, student performance outcomes? What are some of the reasons that attempt to add TBL to a course or curriculum does not succeed, and how can these be predicted or prevented?	Hynes Convention Center Room 201
Tuesday, November 10
1:00 - 2:30p	GEA/GSA Small Group Discussion Session Essential Components of Mentoring in Medical Education Moderator: Michele Millard, M.S. Academic Success Coordinator Creighton University School of Medicine Discussants: Angela Nuzzarello, M.D. MHPE Associate Dean for Student Programs Clinical Associate Professor of Psychiatry Oakland University William Beaumont School of Medicine Ramon Aldecoa, M.Ed Director of Student Life, Office of Admissions and Student Affairs UC San Diego School of Medicine Phyllis Carr, M.D. Boston University School of Medicine Erica Manczuk Boston University School of Medicine Description of Topic and Rationale: With increasing emphasis on mentoring relationships as an essential aspect of medical education, opportunities and challenges for medical schools to develop programs is also on the rise. A review of both new and existing programs in accredited medical schools reveals a wide variety of foci, strategies and perspectives as schools work within their existing cultures and structures. Most programs appear to fall somewhere on a continuum with the following themes:" Faculty----Peer " Advising----Career Development---Professional Development " Curricular----Extra-curricular " Mandatory----Voluntary " Structured----Unstructured " Large group-Small Group---Individual " New program---integrated into established structure The various critical components of mentoring programs will be explored as well as providing examples from the multiple perspectives of the discussants and their experiences in the development and implementation of mentoring programs. Attendees will have the opportunity to see variations on the theme of mentoring within several institutions while gaining insight into opportunities within their own educational environment. Mentoring has become a critical component in medical education for several reasons. For accreditation purposes, the LCME requires evidence of formal mechanisms for student mentoring and advocacy, structured advising and career development and emotional support during the medical education experience, all of which may be fulfilled with an inclusive mentoring program. Beyond requirements for accreditation, literature has described mentoring as essential for the development of professionalism, personal growth and increased satisfaction in choices of specialty and in the field of medicine as a whole. Creating opportunities for the formation of mentoring relationships needed to be integrated into the fabric of medical education as students move from the classroom into the clinical setting. Questions for Discussion: What would be considered the critical components within a mentoring program? What have been the challenges faced in implementing a mentoring program within your school? How were primary stakeholders engaged? (administration, potential mentors, students) How are programs established and branded to be seen as credible and substantive? How are training and resources provided and developed for both mentors and mentees? What are the best ways to evaluate a program and how can you incorporate feedback into modifications? What are the challenges faced working within budget constraints? What are the benefits you have seen as a result of your mentoring programs? What lessons have you learned from your experiences in developing and implementing mentoring programs? Intended Audience: The intended audience includes attendees from all medical schools who are involved with medical student development as advisors, student affairs officials, faculty or administrators. Participants at all levels will gain insight into multiple strategies for program development and implementation. Defining the essential components of mentoring programs will provide participants with practical ideas to implement into their individual initiatives at various institutions.	Marriot Copley Place Simmons
1:00 - 2:30p	GEA/GSA Small Group Discussion Session Fellowship and Teaching Scholars Program Moderator: Carol Hasbrouck, M.A Assistant Dean for Clinical Skills and Medical Education The Ohio State University Discussants: Larry Gruppen, Ph.D. Professor and Chair, Department of Medical Education University of Michigan Sheryl Pfeil, M.D. Associate Professor of Internal Medicine Director of the Introduction to Clinical Medicine Program Medical Director of the Clinical Skills Education and Assessment Center Charles J. Hatem, M.D. Co-Director, Rabkin Fellowship in Medical Education at the Shapiro Institute for Education and Research Director of Medical Education, Mount Auburn Hospital Director of the Academy Center for Teaching and Learning Harvard Medical School Professor of Medicine and Harold Amos Academy Professor, Harvard Medical School Description of Topic and Rationale: Faculty who teach in medical schools frequently do not have specific training in teaching, leadership and/or scholarship skills. As highlighted in the summary report from the AAMC Group on Educational Affairs Consensus Conference (AAMC, Simpson et al, 2007), teaching was historically an expectation in academic medicine, but preparation for the role was not typical, nor was teaching sufficient for promotion. Teaching was not viewed as "scholarship" and was not a key component in promotion processes. That view is in transition thanks to more recent efforts to redefine scholarship and to clarify roles and expectations of educators. Ernest Boyer helped alter the definition and expectations related to teaching and scholarship (Boyer, 1990). Boyer considered teaching a form of scholarship and suggested that it should be viewed and conducted in a scholarly way. The evolving view was further advanced by other authors such as Glassick (2000) who built on Boyer's thoughts by further defining criteria and expectations for scholarly teaching. A large portion of the September 2000 issue of Academic Medicine was devoted to a discussion of expanding the view of teaching and scholarship and highlighted how some institutions were dealing with these concepts and issues. (2000, Vol. 75:871-943). Frequently, institutions would implement curricular innovations yet they would not become published works to share more broadly in scholarly publications and presentations, so institutions began to encourage and expand the evaluation and documentation of educational discovery, novel programs, materials development, creative implementation strategies, and research in medical education. While expanding the definition and view on teaching as a scholarly endeavor, there still remained a tension between the three missions of academic medical centers (research, patient care and education) and the importance and role of each mission on the promotion and tenure process needed to be addressed (Nora, 2000; Lucey, 2003; Whitcomb, 2003). Likewise, it became increasingly clear that if education was to be more fully recognized and rewarded, faculty might benefit and enjoy the opportunity to gain skills that would enhance their careers in education. Many institutions began developing programs focused on the development of teachers, scholars, and academic leaders (Gruppen, 2006; Hatem, 2006; Searle, 2006). Academic Medicine devoted issues to such topics as faculty development (2002, Vol. 77, # 5), medical education research (2004, Vol. 79, #10), and educational training/fellowship programs for teaching, leadership and scholarship (2006, Vol. 81, #11). Thus in the last ten years there has been a significant multiplication of programs designed to better prepare select groups of faculty for their educational roles in medical and health education schools across the country. These programs are typically called faculty fellowship programs or teaching scholars programs, and they are often designed to augment leadership, educational research (Gruppen, 2007) and innovation in medical education rather than simply improve teaching skills. These programs vary considerably in duration, intensity, size, and structure. Although the faculty fellowship innovation has been adopted widely, most of the actual programs are built from scratch, with relatively little shared content or technique. Such reinvention of the wheel is inefficient and effective innovation needs to be promoted in such programs. For these reasons, we propose a small group discussion among GEA members who are involved in and considering a faculty fellowship program. The goal of this discussion is to share best practices, brainstorm solutions to shared problems, and identify curriculum resources that could be shared among the programs. Questions for Discussion: What is the environment like for faculty development in your institution? Who is your target audience for fellowship/teaching scholars programs? What type of learning opportunities do you offer faculty interested in medical education? What are the barriers to developing a fellowship/teaching scholars program? What innovations have been developed for faculty fellowship/scholars programs that have proven effective and might be worth considering by others. What resources are helpful and/or needed to offer a successful fellowship/teaching scholars program? Curricular, financial, time, etc. What ongoing problems do established programs wrestle with? What measures of success are appropriate in assessing success of a fellowship/scholars program? Intended Audience: This session would be of interest to faculty, staff and administrators in medical education who currently offer, or would like to develop, a teaching scholars or fellowship program for faculty interested in teaching, in careers in medical education, in academic leadership, and/or in pursuing research in the field of medical education.	Marriot Copley Place Salon J
1:00 - 2:30p	GEA/GSA Small Group Discussion Session Special Accomodations for Medical Students: Balancing ADA Compliance with Educational Objectives and Technical Standards Moderator: Toni Ganzel, M.D., M.B.A. Senior Associate Dean for Students and Academic Affairs Professor of Otolaryngology University of Louisville School of Medicine Discussants: Peggy Dupey, Ph.D. Associate Dean for Admissions and Student Affairs University of Nevada School of Medicine Leon Jones, M.D. Associate Dean for Student Affairs Professor of Psychiatry UTHSC San Antonio, School of Medicine Description of Topic and Rationale: The expanding number of medical students requesting special accommodations for a wide range of disabilities compels leaders in admissions, student affairs and medical education to become knowledgeable about the legal requirements and to develop a collaborative team approach to accommodating students with disabilities. Consensus is often lacking on what constitutes "reasonable accommodations" and how to balance the needs of the student with what the school is able to provide and the technical standards of its educational program. The purpose of this small group discussion is to review the applicable law in the educational and employment setting, to outline a framework for defining "reasonable" accommodations, and to share ideas on the challenges and successes of accommodating students while also meeting the essential requirements of the educational program. Specific examples to be discussed will include motor, visual, auditory, and learning disabilities, as well as mental health impairments. Discussion will also include the implications of disabilities and special accommodations for licensure examinations, the match and residency. Questions for Discussion: What challenges have schools faced and how did they overcome them in accommodating students who required wheelchairs? Those with serious visual or hearing impairments? Learning disabilities? Mental health impairments? Have the above disabilities and requests for accommodations ever collided with admissions technical standards or the essential requirements of the educational program and, if so, has interpretation of the standards or educational requirements been refined or modified to accommodate the student? How? What policies and processes do schools have in place to evaluate and make determinations regarding requests for special accommodations? What outcome have schools experienced related to students with disabilities being able to qualify for special accommodations by NBME and to successfully match into and complete residency programs? Intended Audience: Student Affairs, Medical Education and Admissions Deans	Marriot Copley Place Regis
1:00 - 2:30p	GEA/GSA Small Group Discussion Session Academic Support: Are we Meeting the Needs of Students? Moderator: Norma S. Saks, Ed.D. Assistant Dean for Educational Programs Director, Cognitive Skills Program Robert Wood Johnson Medical School Discussants: Suzanne Rose, M.D., M.S.Ed. Associate Dean for Academic and Student Affairs Professor of Medical Education and Medicine, Division of Gastroenterology Mount Sinai School of Medicine Linda Rowe, Ed.D Assistant Dean for Student Affairs University of Illinois College of Medicine at Peoria Description of Tpoic and Rationale: It is well known that students enter medical school worried about many things, including how well they will succeed academically (Cleland, Arnold, & Chesser, 2005). Students quickly become aware of the "fire hose analogy" as the need and expectation for learning an enormous amount of material becomes apparent. Students worry about passing licensure exams, particularly because many schools require that students pass the USMLE Step 1 to progress through school. Several scholarly articles have documented the prevalence of stress, burnout and suicide ideation among U.S. medical students. (Dahlin & Runeson, 2007; Dyrbye, et al., 2007, 2008.) Recently a physician (Chen, 2008) reminisced in an article in the New York Times about her experiences in medical school, and noted the necessity of a more supportive environment during these difficult years, thus bringing this issue to the popular press. The LCME mandates Student Services, in the form of both Academic and Career Counseling (Standard MS-18), and Health Services and Personal Counseling (Standard MS-26). MS-18 states: "The system of academic advising for students must integrate the efforts of faculty members, course directors, and student affairs officers with the school's counseling and tutorial services" with a notation that "Students should have options to obtain advice about academic issues or academic counseling from individuals who have no role in making promotion or evaluation decisions." But there is no further guidance given to medical schools as to how programs of academic support should be designed. A survey of all US and Canadian Medical Schools (Saks & Karl, 2004) indicated that most schools provided some form of academic support, but the conceptualization and nature of the programs were varied. Specifically, some programs were geared to specific assistance to pass courses, and others for skill development to enhance self-directed, life-long learning. Many medical schools around the country are now adopting ACGME Competencies for medical education, including Practice-Based Learning and Improvement. Students will need to demonstrate self-directed learning and improvement throughout medical school. What role can academic support play in this? The focus of this discussion will be to explore how medical schools are currently implementing programs of academic support and to provide information to those who are designing or rethinking existing programs. The discussion format will enable educators to participate in interactive discussion to learn more about how the mandate for academic counseling is being met, important factors to consider when planning programs of academic support, how these programs are evaluated, and how curricular objectives in self-directed learning and self improvement might be enhanced. Questions for Discussion: How are students encouraged to be proactive and to seek services? Should services be mandated for students in academic difficulty? How do we measure the success of programs in providing academic support? How effective are peer tutoring programs? Should there be limits to providing academic support to students? How do/should those providing academic support interact with the Promotions Committee? What are important elements to consider in designing programs of academic support? Where is the best place for programs to reside within institutions? Who should provide academic support? (faculty, education specialists, students, others)? Is special training necessary? How costly are successful programs of academic support? How are programs funded? Intended Audience: This discussion should be of interest to those involved in planning, providing, or participating in student services, e.g., education and student affairs deans, mental health professionals, faculty, students, and those who participate on Promotions Committees.	Marriot Copley Place Salon C
1:00 - 2:30p	GEA/GSA Small Group Discussion Session The LCME Standard on Diversity: Developing and Evaluating Pipeline Programs Moderator: Lawrence 'Hy' Doyle, Ed.D. Executive Director, UCLA PRIME David Geffen School of Medicine at UCLA Discussants: Sandra Daley, M.D. Associate Chancellor and Chief Diversity Officer University of California, San Diego Kathy Flores, M.D. Director, Latino Center for Medical Education and Research University of California San Francisco-Fresno Sebastian Uijtdehaage, Ph.D. Director of Research Educational Development and Research David Geffen School of Medicine at UCLA Description of Topic and Rationale: The new accreditation standard from the LCME will affect all medical schools in the US and Canada. While many schools will have such programs related to diversity in place, there has been not been a substantial body of research generated related to the evaluation, both formative and summative, for such programs. This small group discussion will give interested participants, especially from the GEA and GSA , an opportunity to discuss some of the major issues related to such program evaluation, and the sharing of evaluation results. Participants from GEA may be interested in Faculty Development, Curricular Development, and Evaluation issues raised in the discussion. Student Affairs participants will find interest in the development of programs, the opportunities available in diversity programming and in the sharing of information across programs. Questions for Discussion: What effect will the new accreditation standard have for your school in terms of the development, delivery and evaluation of such programming? What are the types of diversity programming being offered by your school? Are their new areas where such programming could develop, eg. Post-Baccalaureate Programs, Faculty Development, Advisor Education? What short-term and long-term indicators of success of diversity programs could be identified? What resources and partnerships are needed for long-term evaluation of diversity programs?	Marriot Copley Place Vermont
1:00 - 2:30p	GEA/GSA Small Group Discussion Session Answering Questions in Medical Education: Strategies for Successful Collaboration Moderator: Kathryn N. Huggett, Ph.D. Director of Medical Education Development and Assessment Creighton University School of Medicine Discussants: Ruth Greenberg, Ph.D. Associate Dean for Medical Education University of Louisville School of Medicine Maryellen E. Gusic, M.D. Associate Dean for Clinical Education and Professor of Pediatrics Penn State College of Medicine Jillian M. Ketterer, B.A. Administrator, The Edward J. Stemmler, MD Medical Education Research Fund Information Analyst, Center for Innovation National Board of Medical Examiners Description of Topic and Rationale: Collaborative research in medical education offers significant opportunities for investigators who wish to pool limited resources and expand professional networks. Collaboration also enhances research design so that intervention and investigation can occur in a number of comparative settings and provide rigor to an investigation. Multi-site research poses obvious logistical challenges and has therefore been difficult for many investigators to employ. This, however, has contributed to a persistent criticism of medical education research, namely the lack of high quality, rigorous studies whose results can be generalized to multiple settings and schools. Developing and ensuring successful collaboration is no small task. Collaborative groups form around a common idea or shared interest or in response to an RFP. Often lacking organizational structure, administrative oversight and support, defined leadership and funding, a collaborative effort must negotiate and navigate these challenges during the early stages of group development. Teams that successfully meet initial goals must then determine how to maintain interest and enthusiasm for the collaboration, share the workload, and assign credit for scholarly products developed by the collaboration. This small group discussion is designed to foster discussion and to facilitate the exchange of best practices for successful collaboration in medical education research. The discussion will address the following topics: strategies to initiate and sustain research collaborations; models for structure and governance; options for scholarship and authorship, and considerations for funding and research compliance. Questions for Discussion: What models of multi-institution collaboration are currently practiced in medical education? What practices have successful collaborators used to initiate and sustain their collaborations? What can be done at the national and regional level to encourage and support medical education collaboration? Intended Audience: All medical educators interested in learning about strategies to collaborate effectively on research in medical education.	Marriot Copley Place Salon B
2:30 - 4:00p	GEA/GSA Small Group Discussion Session Impact of Specialty Income and Student Debt on Career Choice and Quality of Life Moderator: Julie Fresne, M.A. AAMC Discussants: John Wiecha , M.D., M.P.H. Boston University School of Medicine Jay Youngclaus, M.S. AAMC Description of Topic and Rationale: Supply of primary care physicians to underserved areas is inadequate and student selection of primary care careers is insufficient to meet primary care workforce needs. While multiple factors contribute to career choice, the role of income disparity between specialties and the role of student debt continue to receive attention from researchers and health policy experts seeking to determine their influence on specialty selection. A recent report concluded that the "income gap between primary care and specialists has an impressively negative impact on choice of primary care specialties and of practicing in rural or underserved settings". (1) The influence of medical student debt on career choice is more complex, and controversial. Cost of medical education can be a deterrent to medical school applicants, particularly minority students. However, student debt continues to increase rapidly (2), and as primary care income continues to lag behind other specialties, only wealthy students may apply to medical school, and students may be unwilling to incur debt levels that may be unmanageable on a primary care income. (3) The influence of market forces on career choice is the subject of this discussion. We will briefly review trends in medical school costs and student debt, and what we know about the influence of market forces, both future income and student debt, on career choice with particular attention to primary care. We will share results of recent work being done at Boston University Department of Economics and Department of Family Medicine and at the AAMC examining the influence of debt and potential income on loan repayment strategies for medical school students. We will present how the constraints of repaying debt at levels approaching and exceeding $150,000 are borne by different specialties. How loan repayment impacts economic quality of life at various debt levels for different specialties is also considered. These analyses suggest that as debt levels exceed $150,000, participation in new federal loan repayment programs has increased appeal for all specialties, and may be necessary for many students entering careers in primary care. Questions for Discussion: Current research suggests that debt and potential income have less of an impact on specialty choice compared to other factors. Does this ring true with the experiences and observations of those participating in this discussion? If rising debt levels were to make these factors more prominent in the specialty choice decision, what would be the implications of that development on physician specialty distribution? At what level of student debt is a career at the salary of a primary care physician no longer feasible? What is the impact, in terms of quality of life, of the disparity in incomes between a primary care physician, and a higher-remunerated specialty physician? How will new federal loan repayment programs impact the financial feasibility of a primary care career at various levels of student debt? What are the implications of rapidly rising medical school tuition and student debt for future physician supply and specialty distribution? Intended Audience: Physicians, Physician-educators, medical students, health policy professionals, financial aid professionals in the health professions.	Marriot Copley Place Simmons
2:30 - 4:00p	GEA/GSA Small Group Discussion Session Accomodating Medical Students with Disabilities in the Central Region of the U.S. Moderator: Gina Paul, Ph.D. Associate Professor Southern Illinois University School of Medicine Discussants: Susan Kies, Ed.D. Associate Dean University of Illinois College of Medicine at Urbana-Champaign Georgia Hinman, Ph.D. Director of Educational Assessments University of Wisconsin School of Medicine and Public Health Sandra LaBlance, Ph.D. Director of Academic and Career Counseling Northwestern University Feinberg School of Medicine Description of Research and Rationale: Since the Americans with Disabilities Act became a law in the United States 25 years ago, medical schools have attempted to comply with this law by providing accommodations to students with disabilities. In 2008, members of the CGEA Academic Development SIG suggested conducting a study on accommodations in medical schools located in the central region of the US. An on-line survey was developed and sent to the central region's medical institutions to assess the responsible parties for determining student eligibility for accommodations, the number of students who receive accommodations and graduate, the types of disabilities commonly observed, and the various ways in which students are accommodated. The survey response rate was 67%. Questions for Discussion: How many of your students discovered they had a learning disability after entering medical school? How are these usually discovered? Do your faculty members support accommodations required under federal law? How do you address those with negative attitudes? Are audience members aware of AAMC materials supporting medical schools efforts in accommodating students? What are your experiences when students are given medical school accommodations, yet, do not receive accommodations on board exams. What types of accommodations does your institution provide? What are some issues audience members have experienced surrounding accommodations? What are some practical tips for helping students with disabilities? Intended Audience: Those who serve on accommodation and/or promotion committees, are responsible for curricular planning within the medical school, assist medical students experiencing difficulties, or provide faculty development.	Marriot Copley Place Regis
2:30 - 4:00p	GEA/GSA Small Group Discussion Session Pilot Implementation of a Symptom-oriented, Competency-based Curriculum Moderator: Robert W. Lash, M.D. Associate Professor of Internal Medicine University of Michigan Medical School Discussants: Rajesh S. Mangrulkar, M.D. Associate Professor of Internal Medicine University of Michigan Medical School Larry D. Gruppen, Ph.D. Professor and Chair, Department of Medical Education University of Michigan Medical School R. Brent Stansfield, Ph.D. Assistant Professor of Medical Education University of Michigan Medical School Description of Purpose and Rationale: Medical education is traditionally divided into a basic science-oriented preclinical phase, followed by a series of clinical experiences. The ENCORE (Ensure Competence and Inspire Excellence) program at the University of Michigan Medical School proposes to do away with this distinction, replacing it with a series of symptom-based Learning Experience Modules (LEMs) that students will encounter from the very beginning of their training. Each LEM will focus on immersive clinical experiences, while requiring the completion of basic science learning objectives through independent and team learning. Assessments are both formative and summative, and focus on higher order educational outcomes in specific competency domains. To test the underlying principles of ENCORE, as well as the practical issues involved in implementation, we will be running a summer pilot program for eight incoming second-year medical students. Students will simultaneously cover three symptom-based clinical problems: hyperglycemia, trauma, and renal failure. Both cognitive and procedural-based topics were chosen to "stress" the pilot from both practical and curricular viewpoints. Students will spend 40% of their time in clinical settings, 40% in independent study, and 20% in small-group activities ("together time"). Each topic will have specific learning objectives derived from graduation outcomes. These will include clinical skills, written and oral presentations, basic science topics (including anatomy), simulation training, case studies, patient education, and professionalism. Student performance will be evaluated by an Assessment Academy. Assessment Academy members will work with each student longitudinally, providing formative feedback. They will also be responsible for the development of summative evaluation tools. Each student will be expected to complete an educational portfolio that will be reviewed by the Academy. Competency-based medical education has evolved from a nice sounding concept to an emerging expectation of medical school curricula. Its implementation, however, remains unclear even to its most ardent proponents. During the development of ENCORE and our pilot program, we have come across many challenges, including defining learning objectives that will guide students' studying in independent settings, designing appropriate formative and summative assessment tools, and ensuring that we draw on clinically-relevant basic science concepts in all learning experiences. These challenges have given us the opportunity to address a variety of educational 'hot-button' issues, which we will soon be testing in both clinic and classroom. It is our hope that the results of our pilot program, combined with the expertise of our audience, will result in a provocative and useful discussion as the medical education community moves to competency-based curricula. Questions for Discussion: Who should be responsible for developing graduation outcomes? Who should not? How should we use outcomes written for graduating medical students to develop lower-level objectives for early learners. How do we best guide students in their independent learning? What is the role of mentors in this setting? How best to teach basic science in a competency-based model? What are potential sources of bias in performance-based assessment? Intended Audience: Medical educators with responsibility for, or interest in, curricular development and implementation.	Marriot Copley Place Salon J
2:30 - 4:00p	GEA/GSA Small Group Discussion Session Comprehensive Curriculum Redesign for UGME Moderator: Melissa A. Fischer, M.D., M.Ed UMass Medical School Discussants: Raymond H Curry, M.D., FACP Dean for Education Northwestern University Feinberg School of Medicine President McGaw Medical Center of Northwestern University Philip A. Gruppuso, MD Associate Dean for Medical Education Alpert Medical School of Brown University Scott K. Epstein, M.D. Tufts University School of Medicine Description of Topic and Rationale: Many schools are currently undergoing or contemplating significant curriculum revision. These processes have been spurred by self-study, and publication of priorities and initiatives supported by national organizations such as the Liaison Committee on Medical Education, the MACY foundation, Robert Wood Johnson Foundation and the Institute of Medicine. Comprehensive revision of a medical school curriculum requires attention to many aspects of the education process including engagement of stakeholders, identification of appropriate objectives, development of valid measures to meet new objectives, faculty development and support, integration of student and resident input, funding and allocation decisions, skillful implementation. Shared experiences and learning from others may help determine effective practice. This discussion group brings together leaders of comprehensive curriculum redesign from 3 schools to discuss their experiences, address key questions and problem-solve with group members. Questions for Discussion: What are the challenges to earning faculty buy-in and engaging faculty to dedicate time to planning curriculum reform and redesigning their own teaching? How have you been successful in meeting these challenges? Did your framework for course leadership and compensation change with curriculum redesign? If so, how and why? How did you engage students and housestaff in the process of curriculum redesign? How much did you choose to change your curriculum and how did you make this decision? Intended Audience: Faculty, students and administrators in any phase of curriculum redesign	Marriot Copley Place Salon C
2:30 - 4:00p	GEA/GSA Small Group Discussion Session Progress in the Core Competencies in an Academic Medical Center Moderator: Abdulla Gori, M.D. Program Director, Department of Pediatrics MetroHealth Medical Center Discussants: Tom Frank, M.D. Program Director, Department of OB/Gyn MetroHealth Medical Center/ Cleveland Clinic Foundation Michael McFarlane, M.D. Program Director, Department of Internal Medicine MetroHealth Medical Center Aleece Caron, Ph.D. Senior Medical Educator, Department of Medical Affairs MetroHealth Medical Center Description of Purpose and Rationale: All residency programs are required to teach, evaluate and analyze the six general competencies mandated by the ACGME which include Patient Care, Medical Knowledge, Practiced Based Learning and Improvement, Interpersonal and Communication Skills, Professionalism and Systems Based Practice. There are 374 ACGME accredited institutions and 339 single site sponsors that train residents in over 7800 accredited residency programs. Each residency program and each institution is facing the same dilemma as to how to teach the residents in their programs. However, the ACGME has not established guidelines for the facilitation of knowledge or the assessment of knowledge in these competencies. Additionally, the ACGME has requested that programs use creative methods in designing the framework, teaching method, and evaluative techniques that may assist in establishing competency in the six areas. MetroHealth Medical Center (MHMC) is a 752-bed academic medical center affiliated with Case Western Reserve University which serves as the public hospital for Northeastern Ohio. In 2008, MHMC hired a senior medical educator who conducted an in-depth analysis of the progress of implementing and evaluating the core competencies. Each of the 22 residency and fellowship programs were reviewed to determine progress on teaching, evaluating, documenting and measuring progress in each of the six competencies. This process will be described in detail during this discussion. While most programs excelled in the areas of patient care and medical knowledge, they struggled to understand how to implement and evaluate the remaining competencies. We created an interdisciplinary competency committee, comprised of 5 program directors, coordinators, and the senior medical educator who was charged with the task of designing curricula to teach, and assess progress in the remaining competencies. Each program director on the committee volunteered to become the organizational resource for one of the competencies, with the exception of Systems Based Practice(2 PDs). Based on the collaboration of these content experts and clinical teachers, several innovative programs have been introduced to address the competencies. The overall goal of centralizing the curriculum design and evaluation was to create tools that all programs could use for teaching and evaluation. We have designed curriculum and created evaluation tools for the following competencies. 1) Practice Based Learning and Improvement 2) Systems-Based Practice 3) Communication 4) Professionalism Questions for Discussion: How did you assess each program's progress with teaching and measuring the core competencies? Based on the results of the assessment, how did you set goals and objectives for teaching and measuring the core competencies? Describe the educational methods you implemented to teach the competencies. Describe your tools to assess competence and progress with the core competencies. What was your implementation process? Intended Audience: Program Directors, educators, DIOs, GME staff, teaching faculty in academic medical centers	Marriot Copley Place Vermont
4:30 - 6:00p	GEA/GSA Small Group Discussion Session Formalizing Service Learning in to the Medical School Curriculum: Two Case Studies Moderator: Nicole J. Borges, Ph.D. Director, Medical Education Research Wright State University Boonshoft School of Medicine Discussants: Katherine L. Cauley, Ph.D. Wright State University Boonshoft School of Medicine Denise D. Gibson, Ph.D. Assistant Dean for Academic Support, Student Affairs University of Cincinnati College of Medicine Description of Topic and Rationale: In July 2008, the LCME put forward a new standard on service learning (IS-14-A). The standard reads: Medical schools should make available sufficient opportunities for medical students to participate in service-learning activities, and should encourage and support student participation. Although some medical schools have had service learning opportunities for their students for years, medical schools are more inclined now to formalize these experiences and to document service learning activities for their medical students. This small group discussion will address the topic of formalizing and documenting service learning in the medical school curriculum. Two case studies describing experiences and perspectives from two medical schools will be presented. The descriptions will highlight the different nature and mission of each medical school (i.e., one is a community based medical school and the other is affiliated with a large academic health center) with each institution having its unique set of challenges and barriers to formally incorporate service learning into the structure of the curriculum. The discussion also will provide an opportunity for participants to discuss existing service learning opportunities at their medical school, identify opportunities in the medical school arena where service learning could be implemented, and strategize ways to enhance service learning opportunities for medical students at their institution. One of the discussants will briefly present a model for service learning from Wright State University Boonshoft School of Medicine (BSOM), which is, by design, engaged in community based, multiprofessional clinical education. Formalizing a Service Learning curriculum by adding a Service Learning requirement to the existing curriculum for first and second biennium students is primarily an enhancement of existing curriculum, and provides an opportunity to apply specific standards related to Service Learning longitudinally across the four years of undergraduate medical education. In the 2009-2010 academic year, BSOM instituted a 60 hour service learning requirement for the first biennium. A description of the process will be shared and handouts reviewing basic components of the program as well as sample tools provided to students and faculty will be disseminated, which include the curriculum for the orientation for first year students, a service learning syllabus template, and a process for course and program level evaluation. In comparison, a model for providing service learning opportunities that are principally student-run and faculty endorsed at the University of Cincinnati College of Medicine (UCCOM) will be briefly presented by the second discussant. UCCOM has a long tradition of students engaged in community service and volunteering and currently does not have a requirement for service learning within the formal curriculum. With no formal way of ascertaining the breadth and depth of volunteer, community, and international service opportunities with which their students engage, a survey was administered to 4th year students during the time they met with the student affairs dean to discuss the Medical Student Performance Evaluation (formerly referred to as the Dean's letter). Students voluntarily completed a one-page survey, detailing what, if any, service they provided while in medical school, where, when and how many hours it was provided, and were asked if they did any international service, to describe what they did and if academic credit and/or funding was available. The survey itself along with the results will be presented. Questions for Discussion: What are the advantages and disadvantages of requiring service learning at your institution? What do your students currently do for service learning? How do you document this? What opportunities (and partners) exist for service learning that you could expand upon at your school? Intended Audience: Faculty and administrators from Academic Affairs and Student Affairs who are responsible for and/or interested in service learning within medical education.	Marriot Copley Place Vermont
4:30 - 6:00p	GEA/GSA Small Group Discussion Session Palliative Care for End-Stage Academic Difficulty: The Delicate Art of Coaching a Student to Withdraw Moderator: Dawn Bragg, Ph.D. Assistant Dean, Student Affairs/Diversity Medical College of Wisconsin Discussants: Richard L. Holloway, PhD Associate Dean, Student Affairs Medical College of Wisconsin Isaac K. "Ike" Wood, MD Senior Associate Dean for Medical Education and Student Affairs Virginia Commonwealth University School of Medicine Description of Topic and Rationale:Of all the student affairs activities, counseling for withdrawal is the most emotional on the part of the student and counselor but requires logical, sound decision making in the student's best interest. While such activities are not the norm in many schools, it is imperative that student affairs personnel have an explicit process to follow in these cases. While each medical school may use a different process, there needs to be a conversation among medical schools about each school's experience with the intent to provide effective student counseling. Our medical school has developed a framework that accounts for students experiencing circumstances and makes our academic process fair and defensible. The framework includes: 1. Review of academic history required for "end-stage" difficulty including meetings with academic standing committee where student is present 2. Review of academic standards for progress and dismissal policies 3. Decision tree: a. When should a student go for dismissal hearing, when not? (indicators of potential success) b. Under what circumstances and given what indicators should a student be coached to withdraw? c. How should meetings be conducted when moving toward encouraging a student to withdraw? As each student is treated individually and have circumstances different from each other, we also developed some caveats and guidelines to help us through the process. These include: "�better be sure�" several experts, including student's academic advisor, should share the opinion that student is a poor fit for the profession of medicine Collect the facts, and place them in context of student's history, policy, history of the academic standing committees and other students with similar records Conduct preliminary meeting with student to lay out findings of the committee and likelihood of dismissal Never predict what the committee will do Do not coerce; offer facts, opinions and direct questions Discuss in terms of "goodness of fit" with the profession: big difference between "I've always wanted to be a doctor" and "am i a good fit for the profession of medicine? Medical school as analog for the profession of medicine: it won't be much different later; grades do predict success in the profession "This may not be the right time and place for you�" offers options in thinking Self disclosure? "I always wanted to be a________" but it didn't work out Offer contrast between the conduct of a dismissal hearing and the opportunity to withdraw, especially the opportunity to have some control over the decision-making process Discuss role of administration under each scenario (dismissal requires a more adversarial stance; "my relationship with you will change") Be honest about what the future holds! E.g., likelihood of getting into another medical school under each scenario (withdraw vs. dismissed) don't err on the side of unwarranted optimism for either Offer career counseling Discuss previous cases (anonymously, of course) where students have moved into other careers or have pursued medicine at a different time in their life Be directly supportive and assertive in demeanor Offer a 24 hour period for reflection; three days at most This small group discussion will help schools develop a process based on experiences of other schools to identify and counsel students for withdrawal at the appropriate time. Questions for Discussion: How do you determine when a student should withdraw from medical school? What information is used to determine? How do you break the news to student and how is student counseled? How much time do you allow before student makes the decision?	Marriot Copley Place Regis
4:30 - 6:00p	GEA/GSA Small Group Discussion Session Developing and Implementing Effective Interprofessional Education Programs at Academic Health Center Institutions Moderator: Sheree Aston, O.D., M.A., Ph.D. Vice Provost/Professor Western University of Health Sciences Discussants: Amy Blue, Ph.D. Assistant Provost for Education Professor, Department of Family Medicine Medical University of South Carolina Wendy Rheault, P.T., Ph.D. Vice President for Academic Affairs Dean of the College of Health Professions Professor of Physical Therapy Rosalind Franklin University of Medicine and Science Christine Arenson, M.D. Director, Division of Geriatric Medicine, Department of Family and Community Medicine Co-Director, Jefferson Inter Professional Education Center Associate Professor Thomas Jefferson University Description of Topic and Rationale: The current cumbersome and fragmented healthcare delivery system mandates that we implement more effective and efficient ways to deliver healthcare in order to improve patient outcomes and reduce medical errors. It has been reported that almost 100,000 patients die per year as a result of medical errors (Kohn et al, 2000). Several health care organizations and respected experts have recommended that medical and other health professional students spend a portion of their education training in an interprofessional manner. This need was strongly described in the "Crossing the Qualify Chasm: A New Health System for the 21st Century" (IOM, 2001). Carefully threaded yet meaningful Interprofessional teaching and learning activities early in medical education can lead to graduates with distinctive professional skills and one collaborative patient centered perspective. Patients would benefit from health providers who understand the training and scope of practice of other health professionals, and have the knowledge and ability to work in a multidisciplinary fashion. Details of comprehensive interprofessional health education programs at four academic health center institutions will be presented. The co-presenters will lead a discussion with the group about 1) elements of a model IPE program; 2) challenges of implementing a comprehensive IPE program at an academic health center and 3) ways to successful launch and assess a comprehensive IPE program. Questions for Discussion: What types of required and/or elective interprofessional activities are currently being conducted at your medical colleges? What other professions are integrally involved in these activities? What assessment tools are being used to measure the success of such programs? What are the elements of a model IPE program for academic medicine? What are the challenges to the development and implementation of IPE activities and strategies to overcome these challenges? Intended Audience: Faculty members and/or administrators from medical colleges at academic health centers who, currently have or would like to establish interprofessional education and practice programs at their institutions.	Marriot Copley Place Salon J
4:30 - 6:00p	GEA/GSA Small Group Discussion Session Keys to Successful Multi-Institutional Collaborations Moderator: Heather Hageman, M.B.A Director of Educational Planning and Program Assessment Director, Standardized Patient Program Office of Medical Student Education \| Washington University School of Medicine Discussants: Anthony Paolo Director, Assessment and Evaluation, Office of Medical Education University of Kansas Medical Center Brian Mavis Associate Professor Director, Office of Medical Education Research and Development Associate Professor Michigan State University College of Human Medicine Purpose and Rationale: Educational research is richly enhanced by cross-institution collaborations. However, working with other institutions involves a greater degree of complexity than working internally with local colleagues. Many factors must be considered, including the individual collaborators, their level of control/access to the data you will need, the institutional infrastructure and available resources. This small-group discussion will highlight the factors involved in forming and maintaining successful multi-institutional collaborations. Rationale: As the small pool of funding for educational research increasingly calls for multi-institutional research, medical schools will be called to collaborate more. Without proper planning a project can easily be derailed. However, too often researchers jump into collaborations without clearly communicating expectations and assessing the likelihood of a successful project participation and completion. Questions for Discussion: What characteristics should you look for when choosing a collaborator? A project leader? What are the ground rules and expectations that should be discussed at the outset of a collaboration? How do you keep all collaborators engaged throughout the project?	Marriot Copley Place Salon C
4:30 - 6:00p	GEA/GSA Small Group Discussion Session Mentoring a Medical Education Research Team: Cooperative Skill Building Using MERC for Medical Educators Moderator: Jeff Love, M.D. Georgetown University/Washington Hospital Center Sally Santen, M.D. Emory School of Medicine Ernest Yoder, M.D., Ph.D. St. John's Health Marc Martel, M.D. Hennepin County Medical Center Description of Topic and Rationale: There are a number of pathways to skill building in medical education research including advanced degrees, fellowships, mentoring, and the AAMC Medical Education Research Certificate (MERC) program. The MERC program is well established and offered to individuals at the national and regional AAMC meetings. The Emergency Medicine Council of Residency Directors (CORD) recently partnered with the AAMC to create a unique experience to fulfill an important faculty development need within Emergency Medicine. The concept of this joint venture is to create a strong mentored research network led by experienced medical education researchers within the specialty that builds upon the MERC workshops with the following goals in mind: 1) to develop a venue to support individual faculty development 2) to promote medical education research within the specialty of Emergency Medicine 3) to create a community/network of medical education researchers and 4) to facilitate collaboration & multi-institutional research. The MERC-CORD experience consists of three MERC workshops each presented at two CORD meetings that are held six months apart. In addition, each of the 35 participants also contributes to a mentored medical education research group project, with the expectation that each group will complete a multi-institutional collaborative project. Experienced medical education researchers in Emergency Medicine were recruited to participate as mentors for each of the groups and collaborate to design the MERC-CORD experience. Prior to the first set of workshops, a survey identified each participant's areas of interest. Once identified, the 2009 class was divided into groups based on the following interests: resident evaluation, teaching and assessment with simulation, learning settings, and assessment of clinical performance. The groups met just before the first MERC workshops to begin the process of identifying common and collaborative research ideas. The workshops complemented the project development progress, fostering working sessions that further developed and refined the research ideas. At the end of the first set of workshops, each group left with a clear research question, study hypothesis, and project. In the ensuing six months the groups are implementing their research plans. This process assures practical experience and MERC certification through the completion of six workshops, while promoting group problem solving and the networking of participants with similar educational research interests. Several projects are planned to study the success of this adaptation of the MERC program. Rationale for small group discussion. This was a novel approach to increasing professional development in educational research. As groups consider how they might implement similar programs for their institution or professional community of educators, this mentored project model might be adopted to improve effectiveness promote collaboration and transfer of the education skill building workshops. The group will include the perspectives of all of the key roles of the program including: Program organizer- Dr Love, Mentor-Dr. Santen, MERC instructor- Dr Yoder, Participant-Dr. Martel. Questions for Discussion: What are reasons that faculty might be interested in learning about medical education research in this format? What are the resources necessary for creating a mentored medical education skill building course? What are the benefits of a mentored group research approach to the MERC certificate program? What are the potential obstacles to success of this format of the MERC certificate program? What were the challenges and opportunities encountered in the planning and implementation of mentored multi-institutional research projects? Intended Audience: Medical educators, deans, specialty organization leaders who are interested in designing interactive faculty development programs in medical education research	Marriot Copley Place Vermont
4:30 - 6:00p	GEA/GSA Small Group Discussion Session AAMC Report on Undergraduate Clinical Skills Curricula Moderator: Elizabeth Nelson, M.D. Senior Associate Dean of Medical Education Baylor College of Medicine Discussants: H. Carrie Chen, M.D. M.S.Ed. Director, Foundations of Patient Care Course Director, Health Professions Education Pathway Associate Clinical Professor Department of Pediatrics University of California San Francisco Anne Gunderson, Ed.D, GNP Associate Director Curriculum, Undergraduate Medical Education Research Assistant Professor, Department of Medical Education University of Illinois Chicago, College of Medicine Benjamin (Jim) Blatt, M.D. Director of the CLASS Clinical Skills Center Co-Director, Practice of Medicine Doctoring Course Associate Professor of Medicine The George Washington University Description of Topic and Rationale: As part of the American Association of Medical Colleges' (AAMC's) Project on the Clinical Education of Medical Students three monographs have been published: 1. Clinical Skills Education published in 2004, 2. Recommendations for Clinical Skills for Undergraduate Medical Education in 2005., and 3. Recommendations for Clinical Skills Curricula for Undergraduate Medical Education, in 2008. In the 2004 report1, Dr. Gene Corbett stated that very few schools had an explicit approach to clinical skills development over the four years of medical education training. He also understood that there was wide variability in student expectations and little evidence to confirm student achievement of clinical skills. In his summary, Dr. Corbett established the following two key conditions necessary to formally embed clinical skills into the undergraduate medical education (UME) curriculum: 1. A set of overall clinical skills education objectives tailored to specified levels of clinical skills development, and 2. A delineation of how and when those clinical skills should be taught and evaluated as students progress through the curriculum. His work sets the stage for the 2005 report2 written by members of the AAMC Task Force on the Clinical Skills Education of Medical Students formed in 2003. The 2005 report was developed to establish a national consensus on the design and implementation of clinical skills curricula in the UGME. The Task Force made 6 recommendations for medical schools to: 1. adopt a common set of principles to guide clinical skills education 2. adopt an explicit set of clinical skill education objectives for the development of competencies 3. identify a specific set of skills 4. utilize a set of categories for organizing the selection of clinical skill learning opportunities 5. adopt a developmental approach to the design of clinical skills curriculum 6. embed specific essential programmatic elements into the curriculum The most recent monograph released in 2008 3 focuses on the clinical skill development in the pre-clinical years. It mirrors several of the recommendations from the 2005 report including more detail on the implementation of a developmental model for learning clinical skills. It also added the need to design and implement strategies to assess student achievement of the expected clinical skills outcomes. While progress has been made in designing curricula and assessing outcomes of clinical skills in many medical schools, there continues to be a spectrum of experience in these areas. Schools still vary from those with limited or no resources for objective assessments to those with sophisticated systems of assessment. As an example of the latter, the University of Michigan recently published an analysis of their summative OSCE against the Bloom and Simpson developmental model, to determine if they were adequately assessing the higher order skills expected at graduation.4 This discussion session will focus on two of the most challenging recommendations from the 2008 monograph: 1. the use of developmental models in implementing a clinical skills curriculum, and more importantly 2. how these developmental models can be used create appropriate assessment strategies. This issue is a topic of conversation across all of the UGME regions. To complement this small group discussion, Dr. Donna Elliot UGME Section chair has invited Dr. Corbett (author on all three monographs) to attend our section meeting at the AAMC this year. Questions for Discussion: What are your reactions to the clinical skills needs and assessment of medical students? Are your schools using the developmental frameworks to assess clinical skills learning and if so, How have they done it? Which framework have they found to be easiest to use? What other developmental modalities are you using to assess clinical skills performance outcomes? Given the budgetary constraints most are feeling, what low cost methods are being used at your school?	Marriot Copley Place Salon B
Wednesday, November 11
8:00 - 9:30a	GEA/GSA Small Group Discussion Session eFolios: Connecting Institutions Through Communication Standards: A Project of the e-folio Interoperability Initiative Moderator: Marianne Green, M.D. Associate Dean for Medical Education and Competency Northwestern University Feinberg School of Medicine Discussants: Lindsey Henson, M.D., Ph.D. Vice Dean for Medical Education University of Minnesota Medical School Kimberly Hoffman, Ph.D. Associate Dean for Education Evaluation and Improvement University of Missouri School of Medicine Kevin Souza Director, Office of Educational Technology University of California, San Francisco School of Medicine Description of Topic and Rationale: An increasing number of institutions are adopting portfolios for use in learning and assessment at multiple levels of medical training. Portfolios may provide functional data compilations and tools that not only stimulate self assessment, selection and mentoring, but also provide the ability to report out selected portions of other individuals and organizations for a variety of purposes. Portfolio systems are usually locally developed to indicate learner progression and performance while at the institution. The portfolio may also be enriched with actual examples of performance contributed by the individual. As a learner progresses from UME to GME and then to clinical practice, information about the individual is collected and shared for purposes of licensure, application, and maintenance of certification. As more attention is being paid to a shared set of competencies which may span the learners's training, concievably information about a learners unique strengths could be shared as well. To be able to communicate this range of information to another institution, interoperability of systems must be achieved. The e-folio Interoperability Initiative was developed with this purpose in mind. Questions for Discussion: What are the enabling and constraining factors to the development of an electronic portfolio both locally and across institutions? What are the advantages in developing an electronic portfolio at your own institutions? What are the advantages in sharing data about an individual across institutions? Intended Audience: All audiences	Marriot Copley Place Yarmouth
8:00 - 9:30a	GEA/GSA Small Group Discussion Session The Independent Study Program-30 years Later at Ohio State University Moderator: Douglas Danforth, Ph.D. Director of the OSU COM Independent Study Program Associate Professor, OB Gyn The Ohio State University College of Medicine Discussants: Holly Cronau, M.D. Clerkship Director, OSU COM Ambulatory Clerkship Director of Family Medicine, Pre-Doctoral Education Associate Professor-Clinical Department of Family Medicine The Ohio State University College of Medicine Melissa Stahr ISP Coordinator The Ohio State University Description of Topic and Rationale: The ISP, which began as a radical learning experiment in 1970 to increase the number of physicians with no new resources, is now a well-established and successful educational model. ISP is an alternative basic science MD program based on individualized study and testing in order to meet specific learning objectives. ISP emphasizes the independent pursuit of knowledge and the acquisition of skills in critical evaluation which provide a framework for lifelong learning. Faculty continually update the curriculum modules to provide a deep and broad knowledge base for students. The curriculum content is divided into 30 modules over the first two years of the MD program. Modules are interdisciplinary and are organized by organ systems. The first-year consists of 16 modules focused on the Normal Human and the second year consists of 14 modules on Pathophysiology. For each module, there are detailed learning objectives and lists of learning resources to direct reading and study. Some computer-based instruction and self-assessments are also available. Students take module examinations when they are ready within flexible time guidelines (with maximum dates established). Comprehensive National Board of Medical Examiners Shelf Examinations (NBSE) are administered at the end of year one for the following disciplines: Biochemistry, Physiology including Neurophysiology, and Histology. All ISP students must successfully complete Anatomy and a patient relationship centered communication and H&P physician development course during the first two years. Students generally complete the Independent Study Program curriculum over two years. The time flexibility can accommodate personal and professional needs such as the need to work, family needs, the desire to do research, or to pursue a dual degree or another advanced degree. Because students are allowed to self select ISP, the enrollment varies year to year. Total annual class size is 210. ISP enrollments have ranged from a low of 15 in 1993 to a high of 88 in 1983 with an average enrollment of 60 over the past decade. Questions for Discussion: How well do ISP students perform on outcome measures compared to traditional pathway students? What's the potential for student isolation due to limited student group work/interaction. How to best screen students for the ISP program? Student self-selection generally works well but not always. It is difficult to determine who will struggle and who will succeed in an ISP program? What is the commitment of ISP module leaders and administration to assure student and program success? How do faculty development needs differ from traditional needs in an ISP program? What about the lack of direct student contact and feedback? Is there a disconnect with the "joy" of live lecture teaching and student interactions which makes ISP teaching undervalued by faculty and their peers? What about LCME accreditation concerns in knowing if the traditional and ISP programs are comparable and cover the same content? There are differences in content covered, as well as time devoted to content; however, students from both programs have typically performed well and comparably on USMLE Step 1. How to address critical analysis and clinical problem solving knowledge and skills. How to integrate Anatomy, psychosocial, behavioral and physical exam competencies in a self-study format? Intended Audience: Medical school administrators and staff, curriculum planners and directors, basic science and clinical teaching faculty, residents and students.	Marriot Copley Place Harvard
8:00 - 9:30a	GEA/GSA Small Group Discussion Session Integration of the Basic Sciences in the Clinical years of Undergraduate Medical Education Moderator: Diane E. Chico, Ph.D. Assistant Professor, Department of Neuroscience and Experimental Therapeutics Texas A&M System Health Science Center - College of Medicine Discussants: Simon A. Lewis, Ph.D. Professor, Department of Neuroscience and Cell Biology University of Texas Medical Branch, Galveston Craig J. Hoesley, M.D. Associate Professor, Department of Medicine - Division of Infectious Diseases University of Alabama at Birmingham - School of Medicine Kathleen D. Ryan, Ph.D. Associate Professor, Department of Cell Biology and Physiology University of Pittsburgh School of Medicine Description of Topic and Rationale: Fundamental changes in health care management, changes in expectations of society, and advances in medicine have impacted the development of current undergraduate medical education (UME). Recent trend show medical institutions nationwide seeking approaches to curriculum design that structure student learning as a progressive and sequential process that integrate scientific foundations of medicine between disciplines and across years1-3. Conventional medical curriculum presents a period of usually two years with intensive coverage of basic sciences, followed by 2-3 years of clinical science instruction mostly provided in a hospital setting. Students undertaking such a curriculum may rarely revisit the basic sciences during their clinical instruction when they could grasp a better understanding of the foundations of medicine. With integration of basic and clinical sciences, beginning in the early years, the expectations are that students could relate knowledge to clinical skills and apply them in a hospital setting. As such, the knowledge gap between basic sciences and clinical instruction is decreased in an integrated curriculum. Most medical institutions have undergone a change in their curriculum to integrate basic sciences across disciplines and develop controlled clinical experiences in the preclerkship years. However, as recently discussed by Spencer and colleagues, only 19% of U.S. medical schools and 24% of Canadian schools require senior medical students to undertake basic science courses or experiences4. Furthermore, assessment of retention of basic science materials has seen a decline among many senior medical students, suggesting that basic sciences would need reinforcement in the clinical years5-6. Hence, integration of basic science teaching throughout all four years of undergraduate medical education would offer opportunities for senior medical students to revisit basic science material at increasing levels of complexity. Nonetheless, several considerations are needed to overcome any obstacles that could impede successful vertical integration of the basic sciences, including: (1) cooperation of basic science and clinical faculty in the clinical years, (2) consideration of student basic science competencies correlating with basic clinical skills, and (3) assessment and maintenance of oversight of basic sciences in the clinical years. Questions for Discussion: Why should revisiting the basic sciences be a component of the clerkship curriculum in undergraduate medical education? What are the challenges to designing or implementing an integrated curriculum of the basic sciences throughout all four years of UME? What approaches could provide successful integration of the basic sciences for senior medical students? Intended Audience: This small group discussion is open to all individuals involved in or are interested in issues related to designing curriculum for integration of the basic sciences across all four years of an undergraduate medical curriculum	Marriot Copley Place Salon J
8:00 - 9:30a	GEA/GSA Small Group Discussion Session Has Streaming Video Made the Conventional Lecture Obsolete Moderator: Jennifer Deitz, M.A. Interim Director of Evaluation Stanford University School of Medicine Discussants: Neil Gesundheit, M.D., M.P.H. Associate Dean for Medical Student Advising Stanford University School of Medicine Andrew Nevins, M.D. Faculty Instructor Stanford University School of Medicine Description of Topic and Rationale: Many medical schools across the country now videotape their lecture courses in response to student desire for flexibility and to accommodate different styles of learning. Yet offering videotaped lectures as an alternative to classroom attendance creates unintended consequences including limiting the richness and diversity of the audience and de-motivating the faculty, who are then often reluctant to teach in classrooms that are less than half full. Use of videotaped lectures may have unexamined impacts on teachers, learners, and the entire learning community. In this session, we will discuss the challenges that have arisen as a result of introducing videotaped lectures and engage in a discussion with participants about what solutions can be found to (re)build teaching and learning communities in a new media age. Through this small group discussion, we will invite discussants and audience members to share perspectives and experiences regarding the impacts of videotaped lecture on the learning community. Dr. Neil Gesundheit, Associate Dean for Medical Student Advising, describes the rationale for allowing medical students to watch videotaped lectures as a substitute for attending lectures in class, and the intended and unintended consequences of that policy on the learning community at Stanford. Dr. Andrew Nevins, Clinical Assistant Professor, will compare and contrast his experiences as a faculty member teaching students in small-group active learning settings where attendance is required as compared to teaching in traditional lecture courses, where attendance is not required. Jennifer Deitz, Interim Director of Evaluation, will facilitate the discussion by drawing upon research she has conducted at the Medical School exploring student and faculty behaviors and attitudes regarding the use of videotaped lectures. Questions for Discussion: What policies are institutions adopting regarding the use of videotaped and recorded lectures, and what are the intended and unintended consequences of those polcies? How are students making decisions about whether or not to attend live lectures or watch them on videotape? What solutions or challenges are students encountering as they seek to (re)build learning communities and connect with students and faculty in light of new technologies and lowered classroom attendance? Is lowered classroom attendance impacting faculty morale and motivation to teach at institutions where use of recorded/videotaped lectures in the norm, and how are those institutions responding? Are faculty/institutions changing their curriculum, teaching styles, or lecture format or content to try to respond to draw students back to the classroom and/or to try to (re)build a community of learners at their institution?	Marriot Copley Place Salon K
8:00 - 9:30a	GEA/GSA Small Group Discussion Session On That Note: A Discusion of Obstacles and Opportunites for Assessing the Clinical Reasoning Through the Patient Note Moderator: Sharon K. Krackov, Ed.D. Director of Medical and Dental Education Associated Medical Schools of New York Discussants: Linda Tewksbury, M.D. Co-Director, School of Medicine Comprehensive Skills Examination Assistant Professor of Pediatrics New York University School of Medicine Felise Milan, M.D. Director, Clinical Skills Assessment Program Director, Introduction to Clinical Medicine Program Professor of Clinical Medicine Albert Einstein School of Medicine Henry Pohl, M.D. Vice Dean for Academic Administration Albany Medical College Description of Topic and Rationale: Clinical reasoning is an essential clinical skill for the practice of medicine. Relevant theory has provided medical educators with a better understanding of the key components contributing to the quality of one's clinical reasoning (1). Unfortunately, there has been a significant lag in the development of valid, reliable and easy to use tools to assess such reasoning in medical students (2). The use of standardized performance-based exams (OSCE's) has enabled progress in the assessment of core clinical skills, for example, communication and physical examination. Such examinations may also provide the opportunity to assess the student's clinical reasoning through evaluation of the post-encounter patient note. The patient note format used in the United States Medical Licensure Exam (USMLE) Step 2 Clinical Skills Examination, requires the student to: summarize the key features of the history and physical exam; and list differential diagnoses and an initial diagnostic plan. Many schools have adopted the same kind of note. Because of the time-commitment necessary for reading and grading patient notes, this task can be daunting and cumbersome for faculty when used in multi-station school exams with large groups of students. The relationship between scores and reasoning is questionable. In addition, little has been published on the validity and reliability of scoring rubrics used for such notes (3). The assessment of clinical reasoning and the challenge of grading the patient note has been a focus of discussion of the Clinical Consortium Committee a state-wide standing committee of the 15 New York State medical schools that meet regularly under the auspices of the Associated Medical Schools of New York (AMSNY). Their mission is to promote excellence in the development of clinical competence through collaboration in creating educational methods, devising assessment techniques, and sponsoring research in medical education. Many of the consortium member schools use a patient note format similar to that of the USMLE Step 2 Clinical Skills Examination in their institutional third year clinical skills assessments. However, the method of scoring the notes varies widely among schools and typically requires significant faculty resources. New York University School of Medicine (NYU), an AMSNY member school, has presented the AMSNY Clinical Consortium Committee with an alternative format for the patient note, in which students provide supporting evidence for and against each differential diagnosis. The NYU faculty find this format easier to score than the USMLE method and their experience yielded promising preliminary data regarding validity and reliability. As a result, the AMSNY Clinical Consortium Committee is sponsoring a statewide pilot project comparing the rubric at several member schools. Session Goals: Brief presentations from representatives of the AMSNY Clinical Skills Consortium about their schools' experiences with patient notes on performance-based exams, including the alternative patient note format and scoring rubric used at NYU, will stimulate a broader discussion about the use of the patient note to assess clinical reasoning. Given the critical importance of clinical reasoning assessment and anticipated shared challenges encountered with grading the patient note, the discussion among session participants about the obstacles and opportunities will generate new ideas for developing better tools using the patient notes to assess clinical reasoning. We will provide a written handout with information about the formats used by other schools in the consortium to score patient notes. Questions for Discussion: What are some typically used formats for evaluation of clinical reasoning as part of a performance-based examination? What is the role of the patient note at your school? How do you assess the note and what role do faculty play in the assessment? What have been the challenges of using the patient note for pass/fail decisions? What are the elements of a good patient note and how can it capture a student's clinical reasoning ability? How can the patient note be best used as a means to assess clinical reasoning? Intended Audience: This group discussion will be of interest to medical educators involved in performance-based assessments and/or the teaching and assessment of clinical reasoning.	Marriot Copley Place Maine
10:00 - 11:30a	GEA/GSA Small Group Discussion Session Reaching a New Generation: Issues in Educating Millenial Medical Students Moderator: Carol Elam, Ed.D Associate Dean for Admissions and Institutional Advancement Professor of Behavioral Science University of Kentucky College of Medicine Discussants: Nicole Borges, Ph.D. Associate Professor of Community Health Boonshoft School of Medicine Wright State University Jennifer Brueckner, Ph.D Assistant Dean for Student Affairs Associate Professor of Anatomy University of Kentucky College of Medicine Description of Topic and Rationale: As faculty strive to educate the newest entrants into our medical schools, members of the Millennial generation, it is important to understand their defining characteristics and needed areas of development or improvement. By appreciating the unique qualities of Millennial students, medical educators can increase the probability of implementing effective curricular initiatives that are attuned to students' learning styles, while reinforcing their positive attributes. This session will allow participants to examine the common attitudes and behaviors of Millennial students and speculate on the appropriateness of particular strategies to engage these students in both interaction with faculty and administrators and in learning. Questions for Discussion: How has teaching and learning of medical students in the basic science years of the curriculum changed over the past 10 years? Of students in the clinical years? What elements of courses/clerkships do current students like/dislike? How responsive should faculty be to the students' characteristics and qualities as well as their preferences and demands? What uses of technology could be incorporated into the learning environment to meet the Millennials' needs? To what extent are Millennial students' expectations/needs expressed across academic support units in the institution: for example, desire for advising and mentoring, attitudes toward honor codes, interests in service activities and other extracurricular activities�etc.? What approaches seem to be most effective in interacting with and facilitating faculty/administrative communication with Millennial students?	Marriot Copley Place Harvard
10:00 - 11:30a	GEA/GSA Small Group Discussion Session The Promotions Committee Challenge Part II: Students and the Law-Collaborating for Interprofessional Practice Moderator: Laurie Brown, M.A. Assistant Dean for Student Affairs Mount Sinai School of Medicine Discussants: Angela Nuzzarello, M.D. Associate Dean for Student Affairs Clinical Associate Professor of Psychiatry Oakland University William Beaumont School of Medicine Suzanne Rose, M.D., M.S.Ed. Associate Dean for Academic and Student Affairs Professor of Medical Education and Medicine Mount Sinai School of Medicine W. Scott Schroth, M.D., M.P.H. Senior Associate Dean for Academic Affairs Associate Professor, Dept. of Medicine The George Washington University School of Medicine Description of Topic and Rationale: At the annual meeting in 2008, we discussed the trends facing Promotions committees - that having systems in place to document unprofessional behavior led to more students appearing before Promotions committees and that these committees did not have good outcomes with remediation programs. Students with multiple or egregious incidents of unprofessional behavior will ultimately lead to an increase in dismissals related to such behavior. This increase presents challenges to school Promotions (or other) committees and the need for enhanced collaborations between educational and student affairs administrators and with legal counsel. As Promotions committees are seeing increased numbers of students with an academic history that is peppered with incidents of unprofessional behavior and as remediation plans are mostly unsuccessful, processes for students who face an institutional action must be improved and well delineated. Data: At our three institutions, more often than not, student cases that reach a committee level have aspects of unprofessional behavior. Over the past several years, there have been more students dismissed for unprofessional behavior than in the previous decades. Students can choose to appeal and students are involving legal counsel. At the new Oakland University William Beaumont School of Medicine efforts are underway to establish ideal processes prior to admitting students. Discussion: In the process of training future physicians, educators are confronted by a spectrum of performance and an array of behaviors that are sometimes troubling and occasionally include complex legal dilemmas. Examples where institutional committees need legal input include: establishing appropriate processes for promotions and/or disciplinary actions, helping students navigate episodes of harassment, helping a marginal student decide between withdrawal and dismissal, managing concerns of liability, and negotiating the different expectations of Medical and Graduate schools for struggling MD/ PhD students. There are also the very rare instances of students who become involved in illegal activities. The only way to effectively deal with these issues is to partner with a strong advocate in the school's Legal Department who has an intimate understanding of medical school performance and expectations. This has become even more critical in recent years as schools have become more comfortable pursuing, and sometimes punishing, students for unprofessional behavior. Our discussion will provide an overview of trends and processes and how to create such inter-professional collaboration to contend with some of the more challenging situations described above. The discussion will be case-based and the cases will be drawn from real-life scenarios that we have had to confront over the past several years. Participants will have an opportunity to describe models (Promotions committee and/or Disciplinary committees, use of sub-committees) at their own schools and share best practices about these processes/systems. Participants will share sentinel cases from their experience, and develop a 'prescription' for how they can improve their inter-professional collaboration. Conclusions: Because of improved assessment of professional behaviors of our students, more cases of unprofessional behavior have been documented and brought to institutional attention. This has yielded an increase in challenging and complex cases for Promotions (or other) committees, an increase in dismissed students from medical school and increased litigation by students. Processes to handle institutional actions must have the integrated input of legal counsel. Questions for Discussion: What trends, if any, are you seeing at your school related to: Cases of unprofessional behavior rising to the level of the Promotions committee Dismissals by Dean, Promotions committee or other committee Legal action by dismissed students Intended Audience: Student Affairs, Educational/Curricular Affairs, Legal	Marriot Copley Place Salon J
10:00 - 11:30a	GEA/GSA Small Group Discussion Session Educating Medical Students About the Role of Spirituality in Medicine Moderator: Christina M. Puchalski, M.D., FACP Executive Director, Institute for Spirituality and Health (GWish) Associate Professor of Medicine and Health Sciences Associate Professor of Health Management and Leadership The George Washington University\ Discussants: Mimi McEvoy, N.P., M.A. Co-Director, Introduction to Clinical Medicine Program Assistant Professor, Pediatrics Albert Einstein College of Medicine Craig Stuck, M.D. Assistant Professor of Clinical Neuropsychiatry University of South Carolina Chaplain Bruce D. Feldstein, M.D. Adjunct Clinical Professor, Center for Education in Family and Community Medicine Stanford University School of Medicine Description of Topic and Rationale: This proposal aims to provide a forum for discussion among participants with three George Washington Institute of Spirituality and Health (GWish) Awardees who have implemented various curricula in spirituality at their medical schools. The Moderator is the Founder and Director of GWish. A discussion of spirituality with respect to our understanding of its effect on patients' health and illness is timely for two reasons: 1) Most people note that spirituality, broadly defined, has helped them cope with serious illness and suffering. Also, 75% of people claim that they welcome inquiry from their physicians about their beliefs and values related to health care, and would like their spirituality integrated into their care, especially if they are seriously ill . 2) Currently, about two-thirds of accredited medical schools in the US include some type of instruction on the role of spirituality in medical care, which indicates the importance of the topic in medical education. While many medical schools are attending to the topic, medical educators continue to grapple with strategies on how to teach medical students and trainees to address this topic with patients, particularly with respect to end of life issues, life threatening illness and chronic disability. Additionally, many medical and osteopathic schools are now encouraging opportunities to engender reflection for students and faculty about the effect of one's own beliefs on the meaning of their life, work and overall sense of wellness. Spirituality and medicine has been linked since the early 1900's. However, at some point a split occurred in that connection due in part to the Flexner Report. While there is a current evolution among schools to recreate this link, uniformity of mission is lacking. The Association of American Medical Colleges (AAMC) created a working definition of spirituality to give some direction to medical educators grappling with the relevance of this dimension in medicine. In the 1999 Medical School Objectives Report III, spirituality was defined as "a factor that contributes to health in many persons. The concept of spirituality is found in all cultures and societies. It is expressed in an individual's search for ultimate meaning through participation in religion and/or belief in God, family, naturalism, rationalism, humanism and the arts. All these factors can influence how patients and health care professionals perceive health and illness and how they interact with one another." It is the cross-cultural aspect of this definition that suggests reflection and self-assessment of one's spirituality in order to understand and engender therapeutic doctor-patient relationships, a dynamic that involves beliefs and values of both the patient and provider. The George Washington Institute of Spirituality and Health (GWish) has been a leader in supporting efforts to include the topic of spirituality in medical school and residency programs. Since 2001, under its Founder and Director, Christina M. Pulchalski, MD, GWish has made numerous grant awards to medical schools and residency programs to support the establishment and continuance of curriculum dedicated to the topic of spirituality. Undergraduate medical schools who are GWish Awardees have developed teaching initiatives and assessment strategies that serve as models for other medical schools who are interested in either developing programs of this nature or improving existing curriculum. The basis of this small group is to share some of these initiatives with participants and stimulate further discussion and idea generation. Questions for Discussion: What are some of your ideas about how to convey the importance of spirituality in medicine to medical students/trainees? What are your stories of the successes and challenges you have experienced (or anticipate) in teaching medical students/trainees about spirituality and medicine? Do you view teaching the topic of spirituality and medicine as knowledge, clinical skills or attitudinal development? Do you view it as encompassing all of these elements? How so? What are some of the ways in which you can assess students' learning of this topic with regard to knowledge, skills and/or change in attitude? How would you describe the qualities and skills of an ideal medical student or trainee who is competent and comfortable in dealing with the topic of spirituality at various intervals during medical training, including by the time of Graduation?	Marriot Copley Place Salon K
10:00 - 11:30a	GEA/GSA Small Group Discussion Session Peer Mentoring Meets Medical Education Moderator: Amy Fleming, M.D. Director of Gabbe Advisory College Pediatric Clerkship Coordinator Vanderbilt University School of Medicine Discussants: Michelle Shepard 2nd year Medical Student Vanderbilt University School of Medicine Mark Bicket 3rd year Medical Student Johns Hopkins University School of Medicine Bharath Nath MD-PhD Student University of Massachusetts Medical School Description of Topic and Rationale: In response to a growing awareness of the importance of academic and personal wellness among medical students, many medical schools have recently implemented or revised mentoring programs. In several institutions, "advisory colleges" that group students with faculty mentors have replaced traditional one-on-one advising models in an effort to create a more structured framework for student-faculty interactions. A growing body of literature highlights the salient features of such programs and documents some early data on their success. However, mentoring relationships in medical school develop not only between students and faculty, but also between medical students in different years of training. Given the amount of time that medical students spend interacting with one another, informal mentoring relationships among students are common. Students rely on each other for guidance on study strategies, advice on specific courses or clinical rotations, and tips for adjusting to personal and social life in medical school. In recognition of the value of peer mentoring relationships, some schools have instituted official programs to foster such interactions. Previous research from peer mentoring programs among nursing students and young physicians suggests that these programs can have a significant positive impact on the personal and professional development of medical professionals. However, we find no literature detailing the formal or informal elements of peer mentoring programs at medical schools. We propose a small group discussion on this topic as a venue for opening dialogue between medical students who have been actively involved in their institutions' peer mentoring programs. The schools represented by the participants in our proposed small group discussion have implemented a wide array of peer mentoring programs. Peer mentoring at Vanderbilt has been coordinated primarily though two larger programs, the Advisory College system and the Wellness Committee. The Advisory College system divides students into four colleges, each led by two faculty Advisory College Directors and a cadre of Faculty and fourth-year Student Affiliate Advisors, who organize programs and serve as mentors for the students. The Wellness Committee focuses on more academic elements of peer mentoring, organizing events such as study skills panels, mock practical examinations for anatomy, and dinners for the first-year and second-year students who are "matched" with one another based on shared interests. Additionally, it publishes a comprehensive student-generated study guide known as The Anchor, which encompasses the entire first-year curriculum. At Johns Hopkins, the Peer Advising Program is an initiative supported by the College Advisory Program, the learning community at Hopkins Med, and the Office of Student Affairs. It consists of approximately 50 second, third, and fourth year students whose goal is to serve as a source of practical information, counseling, mentoring, and support for the students of their respective colleges. In addition to engaging students one-on-one throughout the year, peer advising leaders host school-wide events ranging from a "Transition to the Wards" orientation for second-year students to a "What's It Like to Be �" panel series on career options. The peer advisors also share advice on coursework and study strategies by conducting panel sessions and managing a guidebook/wiki website. Students at the University of Massachusetts have recently implemented a system of Learning Communities, which group students of all years into "houses" and host events to facilitate discussion between 1st/2nd and 3rd/4th year students on issues such as coursework, residencies, research, and balance between academic and personal life. This initiative has been entirely student led and driven, and plans exist to expand the system in the coming years to incorporate more formal advising and curricular components. The student leaders of this peer mentoring system have also administered surveys to students regarding the type of information they seek out from one another and the networks they have to obtain it, and they plan to re-administer the survey after a few months of the program initiation to measure changes in these parameters. Given the paucity of literature to date on peer advising, this discussion should allow for a meaningful exchange of ideas between students, faculty, and administrators in attendance on how to implement or improve these programs at medical schools nationwide. Questions for Discussion: How does the peer mentoring program fit into the larger advising system at your medical school? To what extent do students have ownership of the peer advising program? What effects has this dynamic had on the execution and reception of the program? What type of support from your institution is available for the peer mentoring program? What additional resources would you like to have? What challenges have you encountered in developing and implementing your program? What can be improved in your peer advising program? Intended Audience: Faculty, Students and Administrators interested in peer advising	Marriot Copley Place Maine
10:00 - 11:30p	GEA/GSA Small Group Discussion Session The Development of Scholarly Concentration Programs: Strategies for Implementation and Integration into the Curriculum Moderator: Jeffrey Borkan, M.D., Ph.D. Professor and Chair, Department of Family Medicine Warren Alpert Medical School, Brown University Discussants: Bonnie Miller, M.D. Senior Associate Dean, Health Sciences Education Vanderbilt University School of Medicine Karen Zier, Ph.D. Associate Dean, Medical Student Research Co-director, Individual Scholarly Project and Independent Research Experience (INSPIRE) Mount Sinai School of Medicine Hugh A. Stoddard, Ph.D., M.Ed. Assistant Dean, Medical Education Director of Curriculum and Education Research University of Nebraska College of Medicine Description of Topic and Rationale: Scholarly concentration programs are emerging at many medical schools throughout the United States. These programs may be required or optional and, unlike joint degree programs or other formal medical school research programs, they are generally included within the four year curriculum and do not require additional years for completion. Established programs vary greatly with regard to structure and placement in the curriculum, and many questions remain as to how to best create space and time so that students can pursue their interests within the context of most traditional medical school curricula. This situation poses challenges to both the success and effectiveness of such programs, as well as their acceptance by medical students. This session will focus on the benefits and challenges of different program structures and the curricular design solutions that may move this innovative field forward. The panelists have leadership experience in the planning and implementation of scholarly concentrations programs at their schools, and their programs represent great variety in terms of program length, required versus elective status, placement in the curriculum, and potential areas of scholarship. Questions for Discussion: What are the advantages and disadvantages of placing scholarly concentration programs in the pre-clinical years, clinical years, or throughout the entire four years of medical school? What is the optimal balance between structured didactic components and independent scholarship? What are the obstacles associated with selection and monitoring of faculty mentors? How can these be managed? For required programs, how is time found and protected in the curriculum? For optional programs, how do schools assure that students will have the time to put forth a significant effort while satisfying graduation requirements? What are concerns related to the funding of these programs? Intended Audience: This session is intended for faculty members and administrators who are interested in establishing scholarly concentration programs or those who have already established such programs at their schools.	Marriot Copley Place Vineyard
1:00 - 2:30p	GEA/GSA Small Group Discussion Session Teaching Reflection Through Communication Moderator: Mark E. Quirk, Ed.D. University of Massachusetts Medical School Discussants: Rich Frankel, Ph.D. Indiana University School of Medicine Jeffrey Borkan, M.D., Ph.D. Warren Alpert Medical School of Brown University Shmuel Reis, M.D., M.H.P.E. Technion- Israel Institute of Technology Description of Topic and Rationale: This group discussion will focus on approaches to teaching and evaluating reflection through oral and written communication. The individual goals of reflection including self-awareness, perspective-taking (including cultural differences), detection of clinical bias to reduce error and self-assessment will be discussed within a metacognitive framework. Social and institutional goals such as professionalism and transparency will be discussed. Methods of reflecting on experience (both positive and negative) including written narrative, group discussion (synchronous and asynchronous - 'blogging') and observation with feedback will be analyzed in light of both teaching and learning. The group will consider how to formatively and summatively evaluate reflection in a variety of educational settings. Ethical issues related to reflection such as confidentiality and respect of individual differences will be raised in light of educational tasks such as grading. Intended Audience: All interested faculty	Hynes Convention Center Room 104
1:00 - 2:30p	GEA/GSA Small Group Discussion Session Designing and Collaborating on Research Studies Using the Careers in Medicine Model Moderator: Nicole J. Borges, Ph.D. Director, Medical Education Research Wright State University Boonshoft School of Medicine Discussants: George V. Richard, Ph.D. Director, Careers in Medicine Program Association of American Medical Colleges Anita M. Navarro, M.Ed. Virginia Commonwealth University School of Medicine Description of Topic and Rationale: Despite the fact that the Careers in Medicine program has existed for 10 years and the implementation of Careers in Medicine at over 90% of all U.S. and Canadian medical schools, very little literature exists on this topic in the medical education literature. A session conducted last year at the AAMC annual meeting, "Medical School Career Development Professionals - Why Aren't We Researching and Writing about Our Best Practices?", which sought to understand this void in the literature and to discover potential solutions for closing the gap, had workshop participants define the current state of research on medical student career development, explore issues around conducting research on this topic and strategies to address the issues. Two main themes identified by participants from the session were that they did not feel equipped with research skills to study Careers in Medicine related topics and that they desired to collaborate on research projects with colleagues who have similar interests related to medical student career development. Participants indicated formally addressing both themes would help to increase the likelihood that they would participate in scholarship related to careers in medicine. This small group discussion will build on the previous year's session and provide an opportunity for participants to identify common scholarship interests related to medical student career development. Participants will work to translate their interests into hypothesis; develop research questions; identify strategies for data collection and analysis; and discuss outlets for presentation and publication. Intended Audience: Student Affairs professionals, including AAMC Careers in Medicine liaisons; Graduate Medical Education professionals; Undergraduate Medical Education professionals; other individuals interested in medical student, resident and physician career development	Hynes Convention Center Room 108
1:00 - 2:30p	GEA/GSA Small Group Discussion Session Threat Assessment Teams: Creating a Climate of Safety Moderator: Angela Nuzzarello, M.D., M.H.P.E. Associate Dean, Student Affairs Clinical Associate Professor of Psychiatry Oakland University William Beaumont School of Medicine Discussants: Scott Warner, J.D. Partner Law Firm of Babbitt, Land & Warner LLP, Chicago Polly Moss, M.Ed. Assistant Dean, Student Affairs and Admissions Adjunct Instructor, Behavioral Sciences Northeastern Ohio Universities Colleges of Medicine and Pharmacy Nora J. Few, Ph.D. Executive Assistant Dean, Student Affairs and Medical Scholars Program University of Illinois College of Medicine at Urbana-Champaign Description of Topic and Rationale: The recent tragedies at Virginia Tech and Northern Illinois University serve as reminders that the potential for violence is a reality on college campuses everywhere. Although violence on medical school campuses is not common, student affairs and educational leaders need to be prepared to deal with situations that present a potential threat to the medical student body. The U.S. Dept. of Education and the U.S. Secret Service have recommended that all schools and districts implement a" team process for identifying, assessing and managing students who may pose a threat of targeted violence in schools". Student Affairs officials need the assistance of a collaborative, multi-disciplinary (law enforcement, legal, mental health, education) team of professionals to understand, manage and resolve critical situations.This topic is timely as it has been suggested that violence on University campuses is on the rise. Medical school campuses (whether part of a University or not) need to be prepared to deal with situations that pose a threat to student and faculty safety. Prior to most incidents, there are others that may have known about the potential for violence but, may have been afraid to speak out or were not aware that a process was in place to deal with issues of potential violence. Even if the threat of violence was not known, there may have been behaviors that caused concern or indicated a need for help. The questions that arise are: How do we know which students represent a real threat? Who needs to be notified? What are the legal ramifications of sharing information? What can be done to prevent violence? What role would a threat assessment team play? What is the role of Student Affairs and medical education personnel in threat assessment? What is the impact of a threat assessment team on other policies and procedures related to student enrollment? It is crucial that we understand the answers to these questions so that we can act in a way that preserves the integrity and confidentiality of the student in question, but also protects the safety of the medical school community. This topic will be of interest to anyone in the student affairs and education realm who deals with students and will give attendees the opportunity to speak with others who have been successful in organizing a threat assessment team at their medical school. Intended Audience: The intended audience includes attendees from all medical schools who are involved with medical students as an advisors, student affairs officials, or teachers. Anyone who may obtain information from students about the potential for violence would be interested in gaining insight in to how a threat assessment team can create a climate of safety and protect the medical school community. This session would be helpful for attendees who are considering setting up an assessment team or for attendees who already have a team in place but are interested in hearing others' experience.	Hynes Convention Center Room 109
1:00 - 2:30p	GEA/GSA Small Group Discussion Session Expanding Diversity: Strategies for Lesbian, Gay, Bisexual, and Transgender(LGBT) Inclusion in Medical Education Moderator: Jennifer Vanderleest, M.D., M.S.P.H. Executive Director, Thread Curriculum Faculty Advisor, MedPride Clinical Professor, Family and Community Medicine University of Arizona College of Medicine Discussants: Lee Jones, M.D. Associate Dean, Student Affairs Professor, Department of Psychiatry University of Texas School of Medicine at San Antonio Emily Ferrara, M.A. Assistant Professor, Family Medicine and Community Health University of Massachusetts Medical School Shane Snowdon Director, LGBT Resource Center University of California, San Francisco Description of Topic and Rationale: Many medical schools have created, or are considering, institutional programs and educational activities to address the needs of LGBT students and patients-needs that were highlighted in the Joint AAMC-GSA and AAMC-OSR Recommendations approved by the AAMC Executive Council in 2007. These programs and activities reflect the growing evidence of LGBT health risks and disparities, the increased inclusion of LGBT concerns in cultural competence initiatives, and requests from students and faculty that institutions provide a more LGBT-inclusive curriculum and a more LGBT-welcoming climate. Using the 2007 Joint Recommendations as a starting-point, this discussion will invite anyone interested in LGBT-related curriculum or climate changes to share what their institution has done (or is considering), what has been (or would be) most successful at their institution, what has been (or would be) most challenging, and what resources have been (or would be) most helpful. Recognizing that initiatives in this realm vary by institution, the session will feature discussants from four different institutions that have developed and implemented programs and activities to address LGBT needs. The discussion will be designed to help participants develop specific strategies and action plans for greater LGBT inclusion at their particular institutions, regardless of current levels of involvement with LGBT-related programs and activities. Information-sharing, problem-solving, brainstorming, and networking will be emphasized. The discussion will also provide an overview of LGBT-related initiatives nationwide. Participants will be invited to explore the possibility of continuing the discussion via a national network focused on LGBT medical education concerns. To support ongoing work, attendees will receive a wide range of materials that have proved useful in diverse institutional settings. These will include evidence-based information about LGBT health risks and disparities, a list of core LGBT competencies for medical students and physicians, an institutional self-assessment tool focused on curriculum and climate from an LGBT standpoint, a detailed list of possible LGBT-related curriculum infusions, and in-depth recommendations for LGBT equity and inclusion. The discussion is designed to be highly informative, engaging, and practical, regardless of attendees' previous experience with LGBT curriculum and climate initiatives. All are invited to learn more about this emergent area of diversity within medical education. Questions for Discussion: What are the major institutional programs or educational activities your institution is currently offering (or considering) with respect to LGBT student and patient needs? What have been your most successful experiences with LGBT-related programs and activities? What has proved most challenging with respect to LGBT-related programs and activities? What resources have you found most helpful with respect to LGBT-related programs and activities? Intended Audience: Anyone whose institution has created institutional programs and/or educational activities to address LGBT student and patient needs, as well as anyone interested in exploring these concerns at their institution. All levels of experience will be welcome	Hynes Convention Center Room 110
1:00 - 2:30p	GEA/GSA Small Group Discussion Session Patient Contact in the Preclinical Years: What, Exactly, is the point? Moderator: Marjorie D. Wenrich, M.P.H. Advisor to the Dean, School of Medicine Affiliate Instructor, Dept. of Medical Education and Biomedical Informatics University of Washington School of Medicine Discussants: Erika A. Goldstein, M.D. Professor of Medicine University of Washington School of Medicine Karen McDonough, M.D. Hospitalist Assistant Professor of Medicine University of Washington School of Medicine Molly Blackley Jackson, M.D. Hospitalist Acting Instructor of Medicine University of Washington School of Medicine Description of Topic and Rationale: Considerable attention has focused in recent years on introducing preclinical medical students to patients, but varying opinions exist about why this is important. Limited research has explored advantages and disadvantages for students. Why should or shouldn't preclinical students work with patients? Should preclinical patient contact be oriented to enhancing student comfort with patients, to clinical-skills development, or both? At the same time, the pressures of increased class size and diminishing time among clinician-educators and community physicians to teach may drive early clinical-skills training increasingly toward non-patient models, such as simulation and virtual patients. It is time for a conversation within the medical education community about whether, why, how, and how much time students should spend with real patients prior to clerkships. What outcomes and benefits result from different types of patient experiences? Should preclerkship clinical-skills development be performed with real patients or should patients be reserved for the clerkship setting? Discussants will briefly review the literature about early patient contact and describe their school's model for early patient contact-from "freelance" interviewing and preceptorships during first year to weekly guided bedside learning throughout second year. The entire group will then describe models used at their schools; each participant will describe approaches to early patient contact at his/her school, rationale, strengths and weaknesses. The group will then divide into small groups to address key questions, including, Is first and second year too early to introduce students to clinical skills with real patients? How orchestrated or structured should early patient contact be and for what purpose? What settings are appropriate? What is the appropriate time to introduce clinical skills, in what order, and to how advanced a level? Should clinical skills be learned on non-patients before students are introduced to real patients? The large group will then reconvene and review key points discussed. If incorporating patients into preclinical education is to become an established part of preclinical education and if increased attention to clinical-skills development in the preclinical environment is on the horizon, the medical education community needs to talk about why and how this should be done. This discussion will be relevant to all educators involved in preclinical medical student training and educators facing who contemplate starting clinical-skills training for preclinical students. Questions for Discussions: What are the goals of introducing medical students to patients in the preclinical years? Are they: a. Teaching clinical skills b. Introducing students to the mechanics of patient care? c. Getting students comfortable with patients? d. Promoting patient-centered care? e. Introducing students to the clinical environment so that the "shock" will be lessened as they enter clerkships? f. Giving them a break from classes and a reminder of why they went into medicine in the first place OR g. Some or all of the above? What are the benefits, opportunities, detriments, and challenges of different approaches to early patient contact? How orchestrated or structured should early patient contact be and for what purpose? Is first and second year too early to introduce students to clinical skills with real patients? What is the appropriate time to introduce clinical skills, in what order, and to how advanced a level? Should clinical skills be learned on non-patients before students are introduced to real patients? Intended Audience: The proposed discussion group will be of interest to medical educators who teach preclinical medical students as well as those who face challenges in teaching or refining clinical skills for third-year students and who are contemplating starting a comprehensive clinical-skills training program for preclinical medical students to give third-year students a better grounding.	Hynes Convention Center Room 111
1:00 - 2:30p	GEA/GSA Small Group Discussion Session The Benefits and Challenges of Multi-Institutional Program Planning and Development Moderator: Sharon K. Krackov, Ed.D. Director of Medical and Dental Education Associated Medical Schools of New York Discussants: William Branch, Jr., M.D. Division of General Internal Medicine Emory University School of Medicine Cathryn L. Nation, M.D. Associate Vice President Health Sciences University of California, Office of the President Jo Wiederhorn Chief Executive Officer Associated Medical Schools of New York Description of Topic and Rationale: Today, medical education exists in a period of diminished resources. There is neither lack of important needs nor a deficiency of good ideas to address these challenges. However, individual institutions are not always able to create the kinds of comprehensive programs that are needed or desired. The cost may be prohibitive for any one institution, and the quality of the overall curriculum likely would not be as rich as in a multi-institutional program. By combining resources, these academic medical centers have been able to create innovative, new educational programs with high quality curricula and faculty. Efforts like these strengthen and amplify the skills and effectiveness of the educators and administrative leaders at the individual schools while seeking to leverage and enhance resources in their own environment. The participants in such multi institutional programs can interact with a broadened cadre of colleagues from their sister institutions. In so doing, academic programs gain access to a range of expertise and resources through the collective experience and exchange of ideas of the participants. The programs described in this session highlight the importance of retaining some degree of local control in a cooperative program. Two of the programs described by the presenters, Drs. Branch and Nation, retain local variation in the curricula at individual sites. The third, presented by Ms. Wiederhorn, is characterized by a common curriculum across sites but maintains other features of importance to the individual school. Session goals: This discussion about the challenges and benefits of multi-campus program planning will stimulate thinking about ways in which other schools can benefit from collaboration. Questions for Discussion: What are your reasons for participating or thinking about participating in a cooperative multi-institutional project? What planning and implementation challenges do you anticipate or did you encounter and how would/did you address them? What are the benefits of one comprehensive curriculum vs. local variation that takes the individual school's culture into consideration? How would/did you gain the necessary approvals in your institution for a cooperative multi-institutional initiative? What do you do when a participant's responsibilities at his/her school make it difficult to participate in consortium activities? Intended Audience: This session will be of interest to any faculty who are considering or already involved in cooperative, multi-site planning activities.	Hynes Convention Center Room 208
1:00 - 2:30p	GEA/GSA Small Group Discussion Session Advancing Part-Time Careers in Academic Medicine Moderator: Hilit F. Mechaber, M.D., FACP Assistant Dean for Student Services Director, Office of Professional Development and Career Guidance Assistant Professor of Medicine University of Miami Miller School of Medicine Discussants: Mark Linzer, M.D. Chief, Section of General Internal Medicine Scholars University of Wisconsin Chair, Association of Specialty Professors (ASP) Task Force on Part-Time Careers LeRoi S. Hicks, M.D., M.P.H. Assistant Professor, Division of General Medicine Brigham and Women's Hospital Deborah M. DeMarco, M.D., FACP Associate Dean, GME Professor of Medicine University of Massachusetts Medical School Description of Topic and Rationale: The desire for part-time careers is increasing due to changing workforce values and demographics. More women and men entering the professional arena are seeking increased demands for workplace flexibility, parental leave and extended tenure clocks. Dual career couples are struggling to meet the emotional and physical needs of growing families. Students and residents are choosing careers which focus on work-home balance and a more manageable lifestyle. Minority students, with this same desire for a family life outside of medicine, are also more likely to engage in public service and work part-time, thus creating increased interest in part-time work. Employers in other professions have responded to these demands by making a "business case" for part-time practice. However, the support for part-time careers in academic medicine varies greatly between institutions and between specialties. Leaders in Academic Internal Medicine have taken some important steps to make the specialty more welcoming and supportive of part-time faculty. All five of the leading organizations of the Alliance for Academic Internal Medicine have endorsed a proposal to integrate part-time physicians into academic medicine. This effort originated in 2005 when the Association of Specialty Professors convened a task force to summarize the challenges and propose solutions to integrating part-time careers into hospitals and medical schools across the country. This discussion group will highlight the work of the Task Force on Part-Time Careers and will provide a forum to discuss models that work and obtacles to anticipate and overcome in helping institutions operationalize part-time careers. In addition, we will discuss the significance and importance of creating a framework for discussion about part-time careers with students and trainees. Faculty and academic administrators who formally and informally advise students and trainees about career options must be informed about the cultural and workplace changes that are evolving regarding part-time career options. The model for change within the academic internal medicine community will serve as one such example. Educating learners about part-time career options will become integral in career-advising programs. Discussants will provide a guide to group attendees either seeking to make part-time career options a reality for their faculty, or eager to learn about how to engage in dialogue about future career options for their trainees and students. Small Group Faculty will lead a discussion placing emphasis on how to help others recognize the role of values and priorities in visualizing the optimal work-life balance. The practical aspects of costs, benefits and solutions to the major stumbling blocks to part-time careers will be covered. Finally, we will suggest an organizational approach to address the culture change that may be required as institutions create a supportive work environment for part-time and full-time physicians. Academic Medicine is at an important juncture with major workforce issues to address. As a model for all professions and workplaces in academic medical centers, we hope to provide insights from the academic internal medicine community to those seeking a healthier, more robust medical profession. Questions for Discussion: What are the barriers to part-time career options? Are they generalizable between institutions? Between specialties? What innovations have others used to promote flexible careers? Are students and trainees aware of part-time career choices across a variety of specialties? Or within specialties (e.g. Hospitalist Careers in Internal Medicine) Can we encourage our students and trainees to consider flexible work options as a means of finding balance in their choice of specialty? How will we measure success of part-time careers? What are appropriate outcomes and are there benchmarks that we should be striving to achieve? Intended Audience: All Faculty and academic administrators including those who may formally and informally advise medical students, residents, and fellows	207

GEA/GSA Small Group Discussion Sessions

Sunday, November 8

Monday, November 9

Tuesday, November 10

Wednesday, November 11