Where do generalists fit in the exploding field of genetics? Until recently genetics has played a relatively small part in the medical school curriculum. Its research has proceeded at a phenomenal rate along with its implications for enhanced patient care. Generalists’ expanding responsibilities to incorporate this thread of genetics through each patient encounter and acknowledge the role of genetics in every disease has become increasingly apparent. However the emerging gap in physician knowledge has created an enormous need for education in a previously underemphasized area of medical education.

As generalists, we are the gateway (not gatekeepers) to better health. This session is designed to help us understand the emerging importance of viewing each patient through a "genetic lens." Basic genetic concepts, core competencies and new paradigms will be discussed using a collaborative faculty presentation.

Strategies for teaching genetics and incorporating its practice into primary care will include "missed opportunities," case presentations and interactive educational games. Examples of resources, including internet user-friendly sites will be distributed.

Speakers:

Suzanne B. Cassidy, University of California-Irvine, Orange, CA
Marilyn C. Dumont-Driscoll, University of Florida College of Medicine, Gainesville, FL
Joseph Gigante, Vanderbilt University, Nashville, TN
Teri Lee Turner, Baylor College of Medicine, Houston, TX
 

The United States rapidly is growing more culturally diverse. In several cities, whites already are in the minority. Culture has a profound impact on pediatrics, affecting multiple aspects of clinical care, including outcomes, processes, quality, satisfaction, obtaining an accurate history and adherence. Cultural competency is the ability to recognize and appropriately respond to key cultural characteristics that affect clinical care in the major cultural groups seen in your practice. In this workshop, participants will learn about a model of cultural competency that can be applied to any cultural group that might be encountered by the pediatrician. This model is based on five aspects of culture that affect clinical care: (1) normative cultural values, (2) language issues, (3) folk illnesses, (4) parent beliefs and (5) provider practices. The spectrum of the world's cultures will be used to illustrate the most important ways that culture impacts pediatric care, drawing on the rich available literature and the personal experience of the workshop leaders.

Using an evidence-based approach derived from critical studies on Latino and African-American culture, workshop participants will learn and master the cultural competency model. Illustrative cases (including videotapes) will be presented to challenge participants and further solidify their skills. Participants can expect to acquire practical skills for recognizing and appropriately responding to crucial aspects of culture and language that affect pediatric care.
 

This workshop will introduce a new teaching tool that can be used to improve the skill of cardiac auscultation. The Cardiac Auscultatory Recording Database (CARD) is an interactive, internet-based virtual cardiology clinic designed to improve the skill of cardiac auscultation among trainees at all levels. By providing the teaching module to health profession trainees and educators, it is envisioned that study of this clinical skill, which has traditionally been possible only during limited hours, on certain clinical rotations, in an often suboptimal learning environment, can proceed at any time, in any location, at the student's convenience and pace. Workshop participants will use infrared stethophones to allow for simultaneous auscultation. This program can be used for individual study or teaching by logging onto our CARD website at www.murmurlab.com.
 

Parents whose children have required intense or repeated health care encounters bring unique expertise and perspective to a research process, particularly in areas of inquiry such as patient/physician communication, parent/physician relationship and professionalism. The workshop presenters have involved parents in designing, implementing and interpreting research on topics such as competencies for medical education, shared medical decision-making, parent decision-making about complementary and alternative medicine and health-related quality of life. This workshop will explore topics of research that parents can inform and introduce participants to feasible research methodologies that involve parents as collaborators in designing research, generating data and interpreting results.
 

Many new developments are confronting pediatric residents, faculty and educators interested in effective and appropriate training of the next generation of pediatricians. In particular, the impact of the new ACGME work duty hours regulations and the impending effects of the move to Core Competency assessments for residents present a new paradigm for pediatric resident education. These developments offer both a challenge and an opportunity for pediatric faculty to improve pediatric resident education.

Ingrid Philibert, ACGME Director of Field Staff, will present The New Work Duty Hours Standards—Genesis, Implementation and Future Directions; Susan Guralnick, Program Director at SUNY-Stony Brook, will discuss The New RRC Core Competencies and what these new methods mean for pediatrics; John D. Mahan, Program Director at Children's Hospital, The Ohio State University, will discuss The Pediatric Residency Programs of the Future: In This Brave New World. Participants will be asked to provide feedback and, after discussion in small group settings, will provide a series of recommendations from pediatric faculty regarding the direction of pediatric residency education in the future. We look forward to a stimulating discussion and useful interchange.
 

The challenge of accomplishing the Institute of Medicine's goal of safe, equitable, high-quality health care is a particularly difficult issue for academic pediatric health care centers. Basic principles of process improvement that have been used to effectively increase quality in industry have proven to be equally effective in health care. This workshop will present active process improvement techniques utilized by CCHMC to influence change in clinical settings, including the charting of data over time and statistical process control. Workshop leaders will provide experiential perspectives through several case studies. An overview of the processes of development, implementation, feedback and ongoing assessment of impact for each case study will be presented and discussed. Active involvement of participants will be encouraged during the didactic and case presentations. A subsequent interactive session will utilize participants' own clinical scenarios and experiences for general and individual discussion. At the end of the session participants should know:

1. The key principles of process improvement related to measurement and reduction of variation,
2. How to use these principles to integrate quality issues into clinical care in academic divisions/departments, and
3. How to measure the impact of the process.
    

The inpatient bedside is a complex, challenging and forever-changing milieu. Learners lament that the inpatient team spends little time at the bedside versus too much time in the conference room, and that they are not being observed performing critical bedside skills such as history-taking, physical exam and assessment. Faculty, on the other hand, feel increasingly stressed from their multi-tasking, which includes patient care, teaching, note writing, timely discharges and appropriate billing. They express discomfort with bedside teaching and may not always set examples as good role models at the bedside regarding what, when or how to teach. Therefore, it is not surprising that bedside teaching in many centers is either moribund or extinct. We suggest that a return to bedside teaching would enhance learning, promote a closer teacher–learner relationship to build trust and ensure competency and improve the overall educational experience of the inpatient unit.

In this workshop, we will focus on issues such as when to teach at the bedside, what should be taught, how to engage the learners, the art of questioning, how to make teaching learner centered, time management and involving patients. Participants will have several opportunities for practice and will be challenged to apply what they have learned to their own educational settings.

Assessment of clinical competence in pediatric medical education presents both a challenge and an opportunity for teachers and learners. In the past, the emphasis on assessment has been primarily based on performance on standardized tests (e.g., Boards) and global summative evaluations by faculty. There is now increased demand for demonstrating clinical competence from national organizations as well as public outcry for accountability in medicine. In 2001 the ACGME defined the six core competencies in resident training, and pediatric residency programs are now required to assess competence in these areas. Residents, program directors and faculty now are confronted with a variety of new concepts in both curriculum development and competency evaluation. Much more work needs to be performed to develop useful curricula and methods for assessing clinical competence, and research projects are now underway to assess the validity of such methods and the impact on patient care.

We will discuss how the emphasis on core competencies is changing pediatric resident education and how pediatric educators can join in the effort. Participants will engage in an interactive project to demonstrate how pediatric faculty can contribute to the design and implementation of competency-based assessment in pediatric resident education.

The ACGME Six Core Competencies: The Prevailing Paradigm
John D. Mahan, Children’s Hospital, The Ohio State University, Columbus, OH

Designing Curriculum and Assessment Methods in a Competency-Based System
Carol Carraccio, University of Maryland School of Medicine, Baltimore, MD

Assessing Competence in Pediatric Medical Education: The Portfolio Approach
Robert Englander, Connecticut Children's Medical Center, University of Connecticut, Hartford, CT

What does success mean to you? Achieving academic success can be difficult owing to the multiple, conflicting personal and professional responsibilities that compete for our time. It is a challenge to develop and apply techniques and practices that allow us to effectively achieve balance in our lives. Participants in this workshop will define individual success, set personal and professional goals and explore innovative techniques to achieve them. Through round table and small group discussion and through individual exercises, participants will consider successful approaches to defining their professional efforts. We will discuss working with a reduced FTE (part time), developing an educator's portfolio, establishing a relationship with a mentor, tackling the promotion and tenure process and successful negotiation techniques. Breakout sessions on individual topics provide opportunity to share experiences and problem solve. Creative ways to achieve success and maintain balance will be presented, discussed and practiced.
 

Humanism and professionalism are essential components of outstanding clinical work. The AAMC and ACGME have mandated they be explicitly included in medical student and resident curricula. Although schools and programs have begun to develop curricula to teach students and residents humane and professional behavior, evaluating these competencies has proven to be a difficulty challenge. A number of tools have been developed to assess the humanism and professionalism of individuals and of programs. These tools include competency-based checklists, which can be used to assess behavior in real life (bedside observations) and in standardized situations (OSCEs). There are also several different qualitative approaches, which use prompted collections of descriptions from multiple sources (patients, nurses, peers, faculty and self) to capture information that may be difficult to obtain from a checklist. Finally, there are tools that assess the humanism and professionalism within a particular program.

This workshop will identify a variety of different methods for evaluating humanism and professionalism. Working definitions for humanism and professionalism will be established through brainstorming and focused discussion. Competency-based checklists and qualitative assessments will be demonstrated and explored using videotape and paper case analysis. Participants will be challenged to develop short, written actions plans identifying how one or more of these assessment tools might be applied to their own programs and institutions.
 

Develop animations with a little imagination and learn how to use it in various settings. Animations are exciting and offer visual enhancement of the learning process. Do animations really help learning? Hear from students and residents on the evaluation of animations as a teaching tool. This interactive workshop will cover an overview of animations as a teaching tool, view an animation entitled, "How does blood clot?" as well as "Understanding von Willebrand disease," and then go through the steps involved in developing animations. We will also teach you how to insert animations in PowerPoint presentations as well as how to further enhance your presentations by other means. On what subject do you spend the most time in your practice explaining to students, residents and patients? Can it be animated? Come with your ideas and we will explore how to develop an animation. A new feature added this year will be some animations of laboratory tests.

By the end of the workshop, the participant will:

1. Learn the various steps involved in making animations,
2. Be able to identify topics that may be presented using animations,
3. Learn about inserting animations into PowerPoint presentations as well as enhancing presentations.
    

The performance of minor procedures is important in pediatric residency and office practice. Training for these procedures varies between residency programs causing some residents and practitioners to avoid a procedure or call a consultant because they are uncomfortable with a procedure.

The goal of this workshop is to convey specific techniques and instruction methods for several minor office procedures. This hands-on workshop will demonstrate skills and allow practice as participants rotate through the following stations:

1. Wound repair (use skin glue, staples, sutures)
2. Foreign body removal from ears, nose, eyes. Reimplant avulsed teeth
3. Trouble-shoot G-tubes, trach tube complications
4. Vascular access (master IO lines, needleless systems and IV safety devices)
5. Skin extractions (embedded fishhooks, subungual hematomas, hair tourniquets
6. Genital issues—manage paraphimosis, rectal prolapse, zipper entrapment. Participants should become adept at several procedures and will be able to teach them to others.
    

Teaching individuals, small groups and large groups requires the ability to focus the topic and produce a clear and coherent explanation that students can follow. The steps in producing an explanation and use of enhancements such as examples will be presented in this interactive workshop. Participants will work together to produce their own personal explanation. Lectures are often a series of explanations, and an introduction to the structuring of a lecture and its presentation will be discussed.
 

Pediatric residency programs are adding residents projects to their curricula. The CATCH (Community Access to Child Health) Planning Funds program provides grants to pediatric residents to develop community-based initiatives that increase children's access to medical homes or to specific health services not otherwise available. We will teach program directors and their residents how to develop a community-based project curriculum, including project design and grant writing. Participants will:

1. Identify the steps necessary in preparing the components of a successful resident community based project,
2. Describe the features of successful and unsuccessful grant applications and
3. Identify tools available to residents for project development.

Resources available to residents planning community-based initiatives, including a copy of "A Pediatrician's Guide to Proposal Writing," will be provided.
 

To help pediatric residency programs update their curricula and meet new ACGME competency requirements, the APA has created a new, web-based edition of the Educational Guidelines for Pediatric Residency (EG). This workshop will allow participants to explore the EG website in a computer lab setting. The workshop will begin with a live demonstration with role plays. Small groups will use the EG to create an educational plan for a selected residency experience or develop an evaluation tool. The small groups will discuss the challenges that they encountered. The workshop will conclude with a summary of results of initial beta tests of the EG and plans for future evaluation. Handouts will provide the website URL and sitemap and a practical set of instructions for new users.
 

The focus of the Culture, Ethnicity and Health Care SIG continues to be research, education and policy/advocacy about cultural issues (including race/ethnicity and linguistic issues) and how these issues impact children’s health and health care. Continuing our annual tradition, we will have a nationally renown guest speaker make a cutting-edge presentation, followed by an interactive discussion session with our SIG members. Next, the highest-scoring submitted abstracts on cultural issues will be presented. Finally, we will continue our discussion (initiated last year and continued on our list-serve) about a possible collaborative SIG project on educational/curricular issues.
 

This mini course will set the stage for several discussions of particular issues of major importance and interest. What is "preparedness" and what are the real risks of continuing terrorism in the United States? What is the current status of preparedness in the U.S. hospital and public health systems? How do children differ from adults in terms of response to weapons of mass destruction (chemical, biological and radiological)? How do these differences matter in disaster planning? Are the needs of children being incorporated in local, state and federal disaster plans? Smallpox, anthrax and other biological threats: Where do we stand? What do we do? Nuclear power plants, nuclear weapons, dirty bombs and potassium iodide: What do we know? The mental health consequences of terrorism: What have we learned since 9/11, how do we prepare children for an increasingly vulnerable world, building resiliency and sustaining a positive vision. The new pediatric agenda: What do we have to teach students, residents and pediatricians about the pediatric aspects of terrorism planning. Children and exposure to weapons of mass destruction: science and the essential research agenda.

Introduction
Paul H. Saenger, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY

Welcome and Context
Irwin Redlener, National Center for Disaster Preparedness, Columbia University Mailman School of Public Health, New York, NY

Pediatric Preparedness for Terrorism and Disasters
David S. Markenson, Columbia University Mailman School of Public Health, New York, NY

Biological Weapons of Terror: What Pediatricians Need to Know
Theodore J. Cieslak, U.S. Army Research Institute of Infectious Diseases, Ft. Detrick, MD

Helping Children and Families Cope with Terrorism
David J. Schonfeld, Yale University School of Medicine, New Haven, CT

Radiologic Terrorism, Children and the Question of Potassium Iodide
Thomas P. Foley, University of Pittsburgh, Children's Hospital of Pittsburgh, Pittsburgh, PA

Potential conflicts of interest litter the halls of academic medical centers like unexploded ordnance. This symposium will discuss both non-financial and financial conflicts of interest and will demonstrate their power to erode trust. There is now overwhelming evidence for systematic bias due to conflicts of interest associated with financial links between researchers and their institutions to commercial entities. We will discuss managing and eliminating conflicts of interest and propose steps to regain public trust.

Overview
Ruth A. Etzel, George Washington University School of Public Health and Health Services, Washington, D.C.

The Importance of Conflicts of Interest to Clinical Researchers
Drummond Rennie, University of California, San Francisco, CA

Discussion
 

Many PAS members commit substantial effort to medical education, and many carry out innovative and imaginative strategies to enhance pediatric education. Nonetheless, publication of this work in peer-reviewed journals has been difficult. Ambulatory Pediatrics has a major commitment to publishing high-quality research in pediatric education. This workshop builds on the journal's experience in setting standards for educational research and in reviewing and publishing good manuscripts.

The workshop provides an overview of how to define research questions, qualitative and quantitative methods used in education research and presentation of methods and findings in research manuscripts. We will also use case examples from the journal files. Participants can bring their own research work for small group discussion, although the leaders will provide research questions and abstracts for participants to learn how to study the questions and how best to present the findings.
 

This workshop is intended to provide the foundation for understanding how to compose a grant to provide research education for postdoctoral fellows. The major issues that will be discussed related to the construction of the program and grant include:

1. Qualifications/responsibilities of faculty
2. Qualifications of the students/fellows
3. Types of research opportunities
4. Education related to academic development
5. Resources of the institution
6. The instructions
7. The interface with clinical education

We will also discuss the review process and factors that influence success of a new program or one undergoing competitive renewal.

The workshop is intended for Division Directors and mid-level-senior faculty who are constructing a training program or facing a competitive renewal of their current program.
 

The critical role of mentoring will be discussed from both the perspective of the mentor and the mentee. The workshop will provide an opportunity for personal reflection. The format will be an interactive discussion with the intention of engaging all participants and encouraging them to share their own experiences. The intended outcome for participants is the identification and implementation of suggestions for improving their own mentor–mentee relationships. The dynamics of the mentor–mentee relationship will be explored in the context of characteristics that facilitate and impede the development of a successful relationship. The facilitators will provide a framework for the discussion based on the literature, their own experiences and lessons learned from facilitating previous workshops on mentoring.
 

The Faculty Development SIG offers a forum for exchange in the area of faculty development, with particular emphasis on education. Our main activity is implementation of the APA Faculty Development Program. The SIG is creating a systematic curriculum to enhance the academic skills of our membership in six domains: education, research, administration/leadership, advocacy/health policy, communication/technology and career development. At each PAS meeting, we co-sponsor three workshops with the Educational Committee. The SIG is open to all APA members, and we welcome collaboration with other SIGs that wish to enhance the academic skills of APA members in their areas of interest. The SIG is co-chaired by Latha Chandran and Constance Baldwin. To join our list-serve, contact Michelle.S.Barratt@uth.tmc.edu.
 

Children who are victims of violent behavior or merely observers of violence may learn destructive or self-destructive patterns of behavior. Violence is a major public health problem. This symposium will focus on breaking the cycle of violence and will showcase speakers who are working on violence prevention in the pediatric emergency department, school and community. The speakers will demonstrate what can be done by physicians who see the importance of this issue and the ways in which we can make a difference.

Violence Prevention in Primary Care: Moving from Public Health to Private Practice
Robert D. Sege, Tufts-New England Medical Center, Boston, MA

Beyond Treat and Street: Violence Prevention in the Emergency Department
Joel Fein, The Children’s Hospital of Philadelphia, PA

Efforts in the Community
Sheryl A. Ryan, University of Rochester School of Medicine, Rochester, NY

The 21st century heralds a paradigm shift in medical education with a focus turned to competence and outcomes. The overarching goal of this workshop is to explore the value of using technology as a tool for promoting self-assessment and lifelong learning in continuous professional development. We will demonstrate how physicians can use an innovative web-centered tool to document competence in practice-based learning and improvement.

The outcome of implementing this web-based technology will be the ability to demonstrate competence of our trainees in the domain of practice-based learning and improvement to the ACGME and the preparation of tomorrow's physicians to demonstrate evidence of continuous professional development in maintaining their certification.
 

Timely and objective feedback to learners and teachers has been an ongoing problem in medical education despite efforts to teach these skills through faculty development efforts. In this workshop the traditional feedback paradigm as described by Jack Ende in the 1980s will be briefly reviewed. This process basically represents a checklist to determine which of the characteristics of feedback occur in the interaction.The facilitator will then present a qualitative approach to providing feedback based on Bloom's taxonomy. This process helps to assess what is the cognitive level of feedback. Interactive scenarios to compare both processes will include the use of videotapes, reflection and role plays.
 

Clinician-educators are those physicians whose career activities combine patient care and teaching and whose scholarly activities promote excellence in medical education. With this interactive workshop, it is expected that participants will learn a practical approach to their career development and will:

1. Have a better understanding of the motivations, career plans and challenges of clinician-educators;
2. Be able to develop a career 'map' for junior clinician-educators;
3. Learn how a mentoring program can help the clinician-educator plan and develop his/her career, including suggestions on how mentors and mentees can contribute to enhancing professional academic skills;
4. Be able to identify faculty development needs and participate in useful and effective faculty development, having a better understanding of specific faculty development activities and the evidence for the effectiveness of these activities;
5. Have a better understanding of the evaluation of teachers and how these evaluations are used for faculty development and promotion;
6. Learn guidelines for developing an effective teaching dossier.

This workshop will be of interest to both junior faculty with an interest in developing their academic careers as clinician-educators and to senior faculty and administrators responsible for supporting junior faculty in the areas of teaching and education.
 

Many new developments in hand-held technology or personal digital assistants (PDA) can positively impact on medical education and medical care. As the technology improves and interfaces with internet-based information and electronic medical records become available, the potential for improving access to information and defining standards of care are clear. Residency programs have utilized PDAs for provision of program information, documentation of procedures/patient panels and access to medical references and information. PDAs have proved useful in a variety of applications in residency program administration. The ability to access medical information from PDA formularies, medical texts and internet sites is now changing the ability of pediatricians to obtain relevant information in a timely manner. Interfaces with electronic medical records offer new opportunities for clinical decision making, documentation and billing.

This workshop will review the trends in the use of the PDA in these areas and demonstrate the use of the PDA in patient tracking, residency program documentation, access to formularies and medical references, searches of medical literature and office and hospital documentation. Participants will be asked to provide feedback and, after discussion in small group settings, will provide a series of recommendations from pediatric faculty regarding the direction of PDA development for pediatric medical education and care and emphasis for PDA applications in the future. We look forward to a stimulating discussion and useful interchange.
 

Participants will utilize the APA's web-based Educational Guidelines for Residency Training in Pediatrics to identify specific educational topics relevant to the continuity experience. Four preventive screening topics will be used as the educational goals. Participants, working in small groups, will determine in which of the six ACGME competencies the educational goals fit best. Practice-based learning and systems-based practice will be emphasized. Guidelines for teaching and evaluating resident competencies will be developed. The teaching and assessment tools developed will be generalizable to other curriculum topics, including QI projects.
 

The newly formed Fellowship Directors' SIG welcomes directors of General Pediatrics fellowship programs throughout the United States and Canada to this inaugural meeting. The SIG is designed to offer a forum for fellowship directors to discuss their common goals and challenges. The agenda will include discussions of recruitment, program funding, fellow performance feedback and review and relationships with Divisions of General Pediatrics and other academic units. We will also hold breakout sessions for directors whose programs predominantly focus on different training areas: clinical expertise, medical education and research.
 

The National Children’s Study is a national prospective, longitudinal study of environmental effects, including physical, chemical, biological and psychosocial effects, on child health and development. The goal of the study is to improve the health and well-being of children. The study will examine these environmental effects on the health and development of more than 100,000 children across the United States, following them from before birth until age 21. The study is led by a consortium of federal agency partners: the U.S. Department of Health and Human Services, including the National Institute of Child Health and Human Development (NICHD); the National Institute of Environmental Health Sciences (NIEHS); the Centers for Disease Control and Prevention (CDC); and the U.S. Environmental Protection Agency (EPA). For additional information, visit the website at http://www.nationalchildrensstudy.gov/.

The National Children’s Study—An Overview
Duane Alexander, NICHD, National Institutes of Health, Bethesda, MD

The National Children’s Study—Methods
Peter C. Scheidt, National Institutes of Health, Bethesda, MD

Children’s Health and Environmental Exposures: The Most Important Unanswered but Answerable Questions
Michael Weitzman, The AAP Center for Child Health Research at the University of Rochester, Rochester, NY

Tom Tonniges will provide some background on the evolution of the relationship between the Department of Community Pediatrics at the American Academy of Pediatrics and the ABCD Institute of Northwestern University. He will give a brief introductory presentation on ABCD Principles and its applications to the health care arena. The ABCD Model essentially promotes the concept of recognizing and identifying the inherent assets in each community, in the form of community-based organizations (CBOs) and the need to integrate those assets into community improvement efforts.

Andrew Gold will discuss his involvement with the Community Child Health Partnership (CCHP) Collaboratives and his perspective on the applications of ABCD to achieving child health outcomes.

Richard Pan will provide insight into how he used ABCD principles as the basis for the advocacy program he developed (Community Partnerships with Pediatricians for Healthy Children) for pediatric residents at University of California, Davis Medical School. Specifically, he will discuss the merits of using the ABCD as the basis for fulfilling the ACGME Requirements in Community Experiences for pediatric residents.

Tom Tonniges will then ask participants to break into small groups and complete the following exercises:

1. List the associations that you belong to (not as a part of your job).
2. List the professional associations you belong to.
3. Describe one way you could use your association relationship to address one child health issue (ex. Obesity).

This workshop will address the following questions:

1. Do you think ABCD methodologies provide a useful framework for:
   1. pediatric resident community projects?
   2. Practicing pediatricians?
2. How can ABCD Concepts be used to promote the practice of Community Pediatrics?
3. How does the ABCD Concept help to identify and establish effective partnerships with Community Based Organizations(CBOs)?

With increased pressures to treat patients as efficiently as possible, teaching of medical students and residents has become more of a burden or even an afterthought and less of a major priority in the clinical setting. Effective, efficient and innovative teaching strategies are needed.

This workshop will provide participants with such strategies that will in turn aid in the recruitment, faculty development and retention of preceptors. Content areas will focus on the importance of a good orientation, feedback, evaluation and creative teaching techniques that will resolve conflicts with time constraints and make teaching fun and a true learning experience for all involved.
 

Practicing evidence-based medicine (EBM) is an essential competency for lifelong learning and critical thinking among pediatric residents and practicing pediatricians. Yet, with multiple demands on curricular planning, programs have found it difficult to make time and space to incorporate this material. Drawing on our successful teaching of EBM to students, residents and faculty in a variety of settings and sharing what we have learned from the occasional misstep, we have developed an interactive workshop to simplify the development and evaluation process for others wishing to launch a similar curricular program. Throughout the workshop, participants will work in small groups to:

1. Identify practical ways of integrating key EBM competencies into a variety of educational venues,
2. Develop a focused curriculum to teach EBM to students or residents in a specific setting at their home institution and
3. Explore and discuss methods to evaluate this important competency.

The session will conclude with a participant-generated discussion of useful pearls for teaching and evaluating evidence-based medicine skills. Participants will receive sample curricular materials, examples of evaluation methods and a list of resources that can foster the teaching and practice of EBM.
 

The Minority Faculty Development workshop will engage junior, mid-career and senior faculty in the discussions of how to promote and actively support minority faculty in choosing academic careers and/or sustaining them through the academic promotion system. In this, the third year of this workshop, prominent faculty at institutions from around the country will respond to key questions on mentorship, success in obtaining research and program funding and maintaining focus on the commitment to medicine and community. The panelists will also emphasize leadership in academics, presented against the backdrop of the current AAMC statistics on minority faculty. As in the previous two years, this workshop will be highly interactive with participants actively engaged in discussions with the moderators and the panelists.
 

The ACGME has instituted new resident work hours regulations to take as of July 2003. Clearly such regulations will impact on the structure of most residency training programs. The goals of this workshop are to explain the regulations and learn ways to accommodate to the regulations—not only meeting the work hour limits but how to continue to incorporate teaching in the lives of the residents. The presenters are all experienced New York residency directors who have taken different approaches to meeting the 405 regulations. After an introduction reviewing the regulations the presenters will explain some specific methods that have been successfully used, including creative scheduling, night float systems and the incorporation of additional providers.
 

Most formal instruction in professionalism and communication occurs in the pre-clinical years of medical school, with an acknowledged need to fortify and apply these competencies during the clinical years. Role modeling provides a powerful way to teach professionalism, particularly when mentors identify specific learning goals and focus the learner's observations. This workshop will teach participants a process called the Students' Clinical Observations of Preceptors (SCOOP), which reverses the traditional direction of structured observations. With written cues to focus their observations, students observe their preceptors, who intentionally model professionalism and communication during clinical encounters. Students and preceptors discuss the observed patient/physician interaction during post-encounter sessions. Film clips, video presentation, group discussion and role play will be utilized to ensure participants gain the knowledge and skills necessary to perform SCOOPs.
 

The use of rubrics for performance-based (competency-based) assessment is widely used in the social sciences but is new to medical education. This workshop will present the concept of rubrics in performance-based assessment including assessment trends in medical education. Guidelines for the development of rubrics will be provided and discussed using medical examples developed by the program leaders. Participants will then work in small groups to develop a rubric assessing one of the ACGME core competencies. The products of this hands-on session will be shared and discussed with the rest of the participants. Participants will then use these rubric-based competency assessment tools to evaluate actual resident–patient encounters videotaped in a primary care setting.
 

Calling all residents! Now in its third year, the Pediatric Resident SIG provides residents with a forum for discussion, advice, support and unique educational experiences. By sharing different approaches and solutions to key issues in training programs, members of the Pediatric Resident SIG will:

• learn effective teaching techniques,
• learn to handle stress of long work hours and sleep deprivation,
• receive financial advice about loan repayment and retirement funds,
• learn about fellowship opportunities and application process,
• learn about different career choices,
• learn about end-of-life care issues,
• learn to recognize and solve ethical dilemmas,
• network with other residents interested in areas such as advocacy or research.

The SIG will host a guest speaker who will lead an interactive discussion on a topic relevant to residency training and education. After the presentation, we will rank and discuss the issues of residency that we find most pressing to us. Finally, we will invite the Program Directors attending the Association of Pediatric Program Directors Spring Meeting to hear our thoughts and give us their best response. Join us for a lively round of resident discussion, philosophy and dialogue.
 

The application of imaging technologies to solving questions in biology and medicine is revolutionizing medicine by accelerating analyses in situ and in vivo and providing new perspectives on biological processes as diverse as development, neoplasia and injury repair. In this plenary session, three internationally recognized speakers will focus on developmental processes and discuss how these new imaging technologies are providing dynamic insights into the genetic and epigenetic mechanisms that underpin hematopoiesis and vascular development.

Introduction
Lisa M. Guay-Woodford, University of Alabama at Birmingham, Birmingham, AL

Dynamic Imaging of Fluid Forces in Developing Mouse Vasculature
Mary Dickinson, Beckman Institute–Caltech, Pasadena, CA

Microscopic Imaging of Angiogenesis
Donald M. McDonald, University of California, San Francisco, CA

Watching Hematopoietic Stem Cell Engraftment and Hematopoiesis in Living Animals
Christopher H. Contag, Stanford University School of Medicine, Stanford, CA

Questions from the audience
 

This debate will be an hour of "edu-tainment," intended to raise some important issues but all in the spirit of fun.

Pro the resolution:
Kenneth B. Roberts, Director, Pediatric Teaching Program, Moses Cone Health System, Professor of Pediatrics, University of North Carolina, Greensboro, NC
Daniel Lee Coury, Professor of Clinical Pediatrics, Chief, Developmental-Behavioral Pediatrics, Columbus Children’s Hospital, Columbus, OH

Con the resolution:
Lolita M. McDavid, Medical Director Child Advocacy and Protection, Rainbow Babies and Children's Hospital, Cleveland, OH
Richard Sarkin, Professor of Clinical Pediatrics, University at Buffalo School of Medicine, Buffalo, NY

Audience Comment
 

This workshop will focus on available simulation technology and its application to pediatrics. The incorporation of a pediatric human patient simulator (METI), with the ability to respond in real-time fashion to student interventions, will be the basis of the workshop. Minilectures and demonstrations will clarify educational theory and the required elements for simulation program development. Small and large group activities will concentrate on practical aspects of simulation use including resource allocation, financing, scenario development, competency-based evaluation and incorporation of simulation technology in a pediatric educational program. Videos (DVDs) will be used to demonstrate the use of a patient simulator as well as generate discussion of its utility and application to pediatrics.

The participant will:

1. Be able to describe various types of medical simulation.
2. Be able to describe the capabilities of the pediatric human patient simulator, a computerized life size simulated pediatric patient. The simulator can reproduce normal and abnormal breath sounds, heart sounds, pulses, papillary responses and cardiac rhythms. In addition it responds in real time to student interventions such as medication or fluid administration and physiologic states such as hypoxia, hypercarbia and shock. The student can also perform endotracheal intubation (with and without a difficult airway), defibrillation and cardioversion.
3. Understand the educational theory behind simulation technology—why it works.
4. Understand the elements required to develop and sustain a successful simulation program including issues of personnel, utilization and financing.
5. Be able to summarize methods in which simulation technology can be incorporated into medical education including incorporation into existing classes, development of effective teaching scenarios and the use of simulation in competency-based evaluations.
6. Discuss methods of evaluation of the effectiveness of simulation technology in the medical educational setting.

Participants will be encouraged to adapt this information to their own environment.
 

Motivating patients to change unhealthy behaviors is a daily challenge for physicians. Working to change behaviors such as overeating, lack of exercise and substance use is difficult.

This workshop focuses on providing knowledge and skills in assessing readiness and motivating patients to change behaviors. An overview of the literature on motivational interviewing and stages of change will provide the framework for discussion and skill development. Participants will observe, review and discuss videotapes of interviews and counseling sessions for patients in various stage of change. Discussion will identify methods to motivate and facilitate change.

To further refine skills, participants will role play interviewing and counseling in groups. Provisions will be made for discussion after role playing. Resource sharing and networking will be incorporated into the workshop.
 

Faculty often find it difficult to provide feedback about unprofessional behaviors to learners. Finding the right words and being able to explicitly identify the problem exacerbate the discomfort of providing criticism.

This workshop will focus on three components of addressing professionalism:

1. Defining the elements of professionalism,
2. Operationalizing these elements and
3. Crafting feedback to learners that is explicit.

After a brief presentation of the elements of professionalism, small groups will discuss examples of unprofessional behavior, identify the specific problem and then create feedback using explicit language to highlight what breach has occurred and how to resolve it. The results will be discussed with the entire group, and additional strategies identified.
 

Patient safety is a growing national initiative, particularly for children. Several studies have shown that hospitalized children experience rates of medical errors equal to or more frequently than adults and tackling safety in ambulatory settings is a relatively new but growing priority area. Many institutions, organizations and practices have started tackling patient safety as Job One in the context of routine daily practice. Overarching this the AAP and ABP have joined forces to place safety and quality on the forefront for practicing pediatricians and for board certification. This workshop will have several brief presentations from two institutions adopting wide-scale safety initiatives encompassing inpatient and outpatient settings and two representatives from the AAP and ABP to discuss joint efforts to promote quality and safety. Workshop participants will gain knowledge, attitudes and skills to help them bring patient safety and quality to real-time implementation in their daily practice. The workshop will include one hour of presentations from the workshop leaders and then rotating 30-minute roundtables with individual leaders for workshop participants to share:

1. Pediatric patient safety concerns and strategize on wide-scale systems solutions, and
2. Ideas and inputs on joint efforts of AAP and ABP on quality and safety.
    

Genetics and molecular medicine have revolutionized medicine in the past decade. Rapid advances have posed a challenge for faculty who are charged with teaching and role modeling how to incorporate molecular medicine into everyday practice.

This workshop will engage participants to develop a framework that they can use at their home institutions to both train faculty and model for students and residents, how to incorporate these principles for all patients. We will then share a framework, conceived at a national conference of experts in genetics and medical education and adapted from the model used at Montefiore by Bob Marion, and have participants develop a process for incorporating this into their home settings.
 

Since 1993, the Family Advocacy Program at Boston Medical Center has provided legal assistance to low-income patient-families whose children's health is compromised by lack of access to basic needs such as housing, public benefits, family stability/safety, education services and health insurance. FAP also trains clinical staff and residents. We have helped start up dozens of medical–legal collaborations nationally in the past several years. The goal of this workshop is to teach participants how to initiate and/or support a similar effort in their own clinical setting. Participants will learn basic legal advocacy through tools and curriculum developed by FAP and participate in facilitated small group discussion on concrete strategies for implementing a collaboration, including: identifying stakeholders, navigating confidentiality and ethics, demystifying legal services for the health care provider, linking individual advocacy to systemic change and incorporating training for providers and residents. The workshop will utilize case examples and advocacy action plans to bring to life the integration of advocacy in the clinical setting.
 

Little time has been devoted to identifying and improving the teachings skills of physicians who are not good teachers, the "problem teachers." This workshop will define a problem teacher from different viewpoints within the academic health center, explore methods of identifying exemplary or poor teachers and review resources and strategies available to improve teaching quality. The workshop is designed to be interactive. Trigger tapes will be used to initiate discussion, provide examples and test developed tools. Participants will break into small groups to develop and assess evaluation tools and devise remediation strategies. By the conclusion of the workshop, the participant should be able to design appropriate faculty evaluation tools, identify teaching deficiencies, provide effective feedback to faculty members and design systems to improve faculty performance.
 

This workshop will focus on the successes and pitfalls associated with implementation of telemedicine to provide healthcare to rural, underserved populations. An introductory didactic presentation will describe the basics of telemedicine, including a brief technical description of the evolution of telemedicine techniques. Four examples of current clinical programs will be presented: an outpatient model assisting in the care of children with special healthcare needs, a pediatric ICU to rural adult ICU model to help in the care of moderately sick children, a pediatric ED to rural adult ED model to help in the care of acutely ill and injured children and a pediatric physical assault and sexual abuse model to assist rural counties in the assessment and evidentiary exams of acutely abused children. Discussion on these telemedicine programs' effect on quality of care, financial viability, sustainability and benefits to rural communities will be discussed.
 

Worldwide, more than 1,500 children per day become infected with HIV through mother-to-child transmission. Currently there are 2.7 million children living with HIV infection across the globe, >90% of whom reside in developing countries. While there have been enormous successes in the prevention and treatment of pediatric AIDS in the United States and Europe, it remains an open question as to how effectively these public health gains can be replicated in the poor countries of the world, which bear the greatest burden of disease. Efforts to develop an HIV vaccine appropriate for preventing infection among the world's children and adolescents are finally under way on a global scale. We will discuss these issues and accompanying controversies as they apply to the children of the developing world.

AIDS in Children—A Global Public Health Crisis
David L. Pugatch, Hasbro Children's Hospital and Brown Medical School, Providence, RI

Preventing Mother-to-Child Transmission of HIV in Developing Countries—Successes, Failures and Challenges
Catherine M. Wilfert, Elizabeth Glaser Pediatric AIDS Foundation, Santa Monica, CA and Washington, DC

HIV Treatment for Children—Can the Successes of Rich Countries Be Duplicated in Resource-Poor Settings?
Mark W. Kline, Baylor College of Medicine, Houston, TX

Finding an AIDS Vaccine That Works for the World's Children
Richard A. Koup, Vaccine Research Center, National Institutes of Health, Bethesda, MD

Patient safety has become a national focus and initiative from government to regulatory/accreditation bodies to institutions. A substantial proportion of the initial efforts are on understanding epidemiology and risk factors and developing organizational models and tools for identifying concerns and fostering safety improvements. Research to date has identified that children do experience medical errors, these events have unique risk factors and while some types of errors are comparable to adult populations, other types are unique to children. In this session we will examine several key elements in efforts to address safety now and in the future: how to tackle patient safety in real time and create cultural change, role of information technology, how to create and promote metrics to measure performance and sources of funding for ongoing work.

In specific, we will examine one institution’s successes and lessons learned from implementing a combined ‘top down’ and ‘bottom up’ system of teams to address safety. We will examine the history of information technology and hear work evaluating the use of information technology in the primary care setting. Next we will examine national efforts to create pediatric-specific measures of quality of care and how these measures are being promoted and implemented nationwide. Last we will hear an overview of research findings to date from the Agency for Healthcare Research and Quality’s $165 million investment in patient safety research and explore new and ongoing funding sources for this research.

The Josie King Patient Safety Program at Johns Hopkins University
Marlene R. Miller, Johns Hopkins University, Baltimore, MD

Role of IT in Patient Safety
Kevin B. Johnson, Vanderbilt University Medical Center, Nashville, TN

PediQS and National Efforts To Promote Measurement of Children’s Healthcare
Stephen Lawless, Nemours Foundation, Wilmington, DE

AHRQ’s Patient Safety Initiative and Findings to Date
Dan Stryer, Agency for Healthcare Research and Quality, Rockville, MD

Discussion
 

ACGME rules for residency hours have created new challenges in the development of residency curricula. New models for service coverage, pediatric residency education, and outcome measurements have been implemented in many residency programs. Many of these models have resulted in residents spending more time on "night coverage." Residents consequently have limited access to attending staff and traditional teaching venues.

This workshop will focus on how three residency programs are working collaboratively to develop a curriculum and a competency-based evaluation system specific for the "night owl." The workshop will include a short didactic review of an approach to overcoming the obstacles of educating and evaluating the night owl. Non-traditional venues, such as videotaped conferences and web-based cases, will be discussed. The participants will break into small groups to identify unique curricular needs and expand upon the curriculum developed by the three residency programs. Night owl curriculum will include sign-in/sign-out techniques, oral presentations on morning rounds, clinical decision-making with a skeleton crew, appropriate use of faculty consultation in clinical decision-making during the night and precepting interns and students. Participants will also have the opportunity to discuss evaluating the night owl with multiple evaluators in a 360-degree process.
 

This workshop grows out of our 20 years of experience in running a clinical ethics consult service at an academic pediatric medical center. We will present audience participants with several consultations that we have evaluated at our hospital and elicit from the participants various strategies to deal with these consults. We will guide the discussion toward solutions and methods that we have found successful, while pointing out pitfalls that we have learned to avoid.

In addition, with the willing participation of the audience, we will induce several of the more important "framing issues" upon which modern clinical medical ethics stands (autonomy, informed consent, beneficence, distributive justice, etc.). We will attempt to demonstrate clinical situations in which some of these concepts appear to dominate and others where they appear to come into conflict. We will provide an intellectual framework that will allow the audience participants to feel comfortable not just "answering" consults, but teaching others why some "answers" are better than others.

We will offer specific methods for participants to create programs in clinical ethics at their own institutions, and specific suggestions for how clinical ethics programs can be evaluated, both by their creators and by other "outside" educators and administrators.
 

Medical education studies reveal that medical students and residents often report data on clinical rounds without demonstrating higher levels of understanding, such as the ability to analyze or synthesize information. Workshop attendees will learn to address these learning gaps by diagnosing different cognitive levels of Bloom's taxonomy and then use adult learning models to move trainees to higher levels of cognition. A brief active discussion of key learning concepts will be followed by group participation in evaluation of videotaped teaching interactions, followed by small group exercises to practice new skill sets. Bibliographic resource lists and access to follow-up consultations from faculty of the CNMC/GWU Master Teachers Program will be provided.
 

How can educators document their clinical observations of students and residents AND precept more efficiently? In this workshop, we will introduce participants to a scheme for standardizing your clinical observations using the mnemonic P.R.I.M.E. (Professional, Reporter, Interpreter, Manager, and Educator). P.R.I.M.E. is a valid and reliable method for organizing observations of learner performance along the lines of the new competencies. We will provide practical examples of P.R.I.M.E. that we have used over the last three academic years.

Participants will then break into small groups to develop evaluation tools utilizing the P.R.I.M.E. system in the clinical context of their home institution. In the second half of this workshop, we will also introduce participants to the 5 W's (What, Why, When, Whoops, and Warm fuzzies) of the one-minute preceptor concept through role play and videotape examples. Participants will then debrief their performances and discuss how to export these skills into their own clinical environment.
 

Giving bad news is an essential skill that all pediatricians should master. Unfortunately, it appears that most pediatricians receive little formal training in this critical area. To better prepare residents for practice, an innovative small group seminar utilizing a standardized patient (SP) case has been instituted at UCLA. The goal of this workshop will be to help participants develop the skills required to design and implement a similar seminar at their own institution. The workshop will include a demonstration of giving bad news to an SP with audience members playing the roles of the residents. A description of the process of case development and training of the SP will also be presented. Finally, barriers and challenges to implementation will be discussed.
 

Estimates of children exposed to intimate partner violence (IPV) range from three to ten million annually. In 1998 the AAP issued a policy statement that identified the abuse of mothers as a child health issue. As pediatricians we have a role in recognizing and intervening in IPV. This workshop presents components of the curriculum we devised to provide pediatricians with the knowledge, attitudes and skills needed for screening for IPV in a pediatric setting. The curriculum uses a mixture of formats—interactive lecture, large group discussion and small group scenarios. We will also discuss the results of our experience with designing, implementing and evaluating an IPV screening program in a pediatric ED.
 

Medical trainees have been described as learning by a model of apprenticeship, and their best learning is done at a patient's bedside. Communities of practice facilitate such situational learning and allow trainees opportunities to integrate their experiences. Effective learning communities, however, do not thrive naturally; rather, they must be nurtured. The ability to sustain and create such communities requires skills that are different from preparing a lecture.

This workshop is aimed at the physician-educators interested in the components of situated learning and communities of practice. Participants will learn ways to enhance and maintain an effective community. After an introductory didactic session, participants will have the opportunity to explore the elements of their own existing learning communities as well as discuss ideas on how to develop a new learning community in a small group setting. Then the group as a whole will process the methods to sustain a community of practice. Participants will come away with a toolbox of strategies to tailor their own learning community.
 

This workshop is for pediatric medical educators interested in systematically exploring the challenges to successful research in medical education. The workshop will begin with a state of the art message from medical education research expert David Irby, Vice Dean of Education at the University of California-San Francisco School of Medicine. Addressing publication issues will be Ben Siegel, Senior Editor for Medical Education of Ambulatory Pediatrics; and addressing IRB issues will be Patricia S. Lye, chair of the Educational IRB Committee at Medical College of Wisconsin. Workshop participants will review examples of successful medical education research efforts, review research design options, discuss formal vs. on-the-job research training and consider funding options. There will be time for sharing creative ideas and research interests and developing networking contacts.
 

This workshop will focus on enhancing faculty comfort with sports medicine using a hands-on review of functional anatomy related to the lower extremity. This will be followed by small group creative problem solving around three common sport injury cases. Participants will be gently reminded of anatomic considerations with visual aids and guided examination of a live model. Case discussions will emphasize development of creative teaching strategies and discussion of potential trainee evaluation techniques. Participants are encouraged to bring along any sports medicine curricular modules they are willing to share.

Participants completing this workshop should be able to:

1. Identify functional anatomic landmarks,
2. List the most common pediatric sports injuries,
3. Describe teaching strategies to improve trainee access to sports medicine curricula and
4. Develop trainee evaluation strategies.
    

Computers, PDAs and the Web are integral tools for academic physicians, teachers and students. Though available resources and their ease of use are increasing, their potential for advancing academic programs remains relatively untapped. The University of Utah's Eccles Health Sciences Library has led several projects enabling and integrating digital and multimedia resources for academic applications, including the Health Education Assets Library (HEAL) and the Utah MedHome Portal. This workshop will offer:

1. An overview of digital resources and the expertise/support required to take advantage of them;
2. Detail on new technologies for communication, collaboration and teaching;
3. A survey of PDA resources and applications for use in the clinic and classroom; and
4. Hands-on experience with some of the resources described.
    

The Medical Student Education SIG welcomes those who are interested in any of the numerous aspects related to medical student education. We are an eclectic, dynamic and creative group! This year we will be focusing on "preparation" of students for the upcoming Clinical Skills Assessment that will be part of Step 2 of the boards. We will examine those aspects of clinical reasoning, interpersonal skills, physical examination skills and documentation skills that students need to master to successfully complete the cases on the CSA. Discussion will focus on how to teach and evaluate these skills. We will have contributions from guests as well as our own SIG members. We hope to see you and look forward to your participation and contribution to the session.
 

Every day, nearly 5,000 children in the United States smoke their first cigarette. Approximately 60% of smokers start by the age of 13 and fully 90% before the age of 20. Publicly the tobacco companies have always maintained that they do not target youth, but internal documents reveal that they set out to aggressively advertise to kids.

This session will describe litigation as a public health strategy for fighting Big Tobacco in the United States and provide examples of the techniques used to attract children to smoking. Global trends and counter-advertising measures will be discussed.

Overview
Ruth A. Etzel, George Washington University School of Public Health and Health Services, Washington, DC

Hugo Lagercrantz, Astrid Lindgren Children's Hospital, Karolinska Institute, Stockholm, Sweden

Fighting Big Tobacco in the United States: Litigation as a Public Health Strategy
Madelyn J. Chaber, Law Offices of Wartnick, Chaber, Harowitz & Tigerman, San Francisco, CA

Goliath Fleeing from David: The Global March of the Marlboro Man
Ronald M. Davis, Henry Ford Health System, Detroit, MI

Discussion
 

Hot Topics in General Pediatrics is a potpourri of topics of interest to all pediatricians. The topics include lead poisoning, West Nile Virus infection, sleep disorders and esophagitis. Each of these conditions has varied symptoms, signs and manifestations. For each topic there have been new findings that are in the "need to know" category for all pediatric generalists and subspecialists.

Kawasaki Disease
Jane C. Burns, University of California, San Diego, CA

West Nile Fever
Janak A. Patel, Children's Hospital, University of Texas Medical Branch, Galveston, TX

Lead Poisoning
Kevin Osterhoudt, The Children's Hospital of Philadelphia, Philadelphia, PA