The core of the academic meeting is the dissemination of new information through abstracts. This session will provide the young investigator with an approach to the preparation and presentation of abstracts. Innovative science requires crafting an innovative abstract to assure program selection. Points concerning abstract presentation to enhance acceptance and the dos and don'ts of platform and poster presentations will be presented in depth.

Rebecca A. Simmons, Assistant Professor of Pediatrics, University of Pennsylvania, Children's Hospital, Philadelphia, PA
Edward S. Ogata, Chief Medical Officer, Children's Memorial Hospital, Chicago, IL

In the current climate of funding opportunities, the ability to successfully obtain extramural support involves applying for grants that are appropriate for an investigator's career stage and drafting a clear and focused application. In this session, we will discuss career-stage-appropriate funding opportunities from the NIH and other agencies. We will also address how to write a grant application, focusing on strategies with proven success. The working of NIH study sections will be reviewed along with how to best address the concerns of review panels. We will also focus on how to obtain funding for fellowship postdoctoral training and early stages of an academic career.

Pedro A. Jose, Professor of Pediatrics and Physiology and Biophysics Georgetown University Medical Center, Washington, DC
Anshumali Chaudhari, Scientific Review Administrator, Experimental Cardiovascular Sciences Center for Scientific Review, NIH, Bethesda, MD
M. James Scherbenske, Renal Physiology/Cell Biology and Kidney Centers and SBIR Program Director, Bethesda, MD

This session will delineate the patterns of academic clinical practice. Co-led by a general pediatrician and pediatric subspecialist, the session will address the following topics.

1. How do I decide if I want to pursue a career in academic medicine or in community practice?
2. Are there models of practice which allow me to combine academic medicine and community practice?
3. How do I decide if I want to become a general pediatrician or want to subspecialize?
4. What are the requirements for a career in general academic pediatrics? What for subspecialists?
5. How and when do I apply for fellowships?
6. Who in my institution can help me with these career decisions?

Judith S. Palfrey, Chief, Division of General Pediatrics, Children’s Hospital, Boston, MA
Laurie Cohen, Instructor of Pediatrics, Harvard Medical School, Boston, MA

The purpose of this workshop is to demonstrate a faculty development program that is tailored to the needs of individual faculty members, since mentoring should be a vital component of faculty development. An appropriate mentoring program strengthens the relationship between supervisor and faculty member and mandates that the faculty member should envision his or her career goals. Evaluation, counseling and mentoring are essential contributors to departmental esprit de corps because they convey worthiness among the faculty members. Faculty development and mentoring should be the highest priority of departmental chairmen and division heads, but has been downgraded because the mentors have been encumbered with financial responsibilities in recent years. Without a faculty development and a mentoring program, a department loses one of the foundations of an academic department. The workshop will present a faculty development program that can be used by a faculty member and his or her supervisor. For those faculty members who are not being supervised, the program can be used by the faculty member for short- and long-term planning of his or her career.

Robert L. Brent, Distinguished Professor, Louis and Bess Stein Professor of Pediatrics, Professor of Radiology, Pathology, Anatomy and Cell Biology, Emeritus Chairman of the Department of Pediatrics, Jefferson Medical College, A. I. duPont Hospital for Children, Wilmington, DE

This session will provide an overview of the federal Agency for Healthcare Research and Quality's (AHRQ's) research priorities and grantmaking policies and procedures—from concept development and programmatic technical assistance, to notification of award (or not), and resubmission; provide a checklist of handy tops for applicants; and entertain questions about grantsmanship. In addition, two senior health services researchers and experienced grant reviewers will lead a lively, informative, and provocative mock study section to demonstrate how applications are reviewed and scored at AHRQ. The mock study section will use an actual, but de-identified, funded AHRQ application as a learning tool, and workshop participants will be invited to provide their own comments on the application.

Denise M. Dougherty, Senior Advisor, Child Health, Agency for Healthcare Research and Quality, Rockville, MD

In this interactive session, a junior faculty member along with her chairman will facilitate an active dialog from what core questions should be asked during the interview to how to maximize your chances for promotion. Many issues will be directly addressed, including: interviewing questions to ask and answers to have at the ready, salary negotiations, percent effort distribution, departmental commitment and support, faculty development programs, and identification of mentors.

Jon S. Abramson, Wake Forest University School of Medicine, Winston-Salem NC
Shari Barkin, Assistant Professor of Pediatrics and Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC

Career and program development in Pediatric Departments is increasingly tied to the generation of resources that support these efforts as well as cost-containment efforts. This seminar will address the application of business principles and approaches that should be useful to current directors of programs, or those who aspire to be directors, as they plan and manage these programs. Concepts to be introduced in a case discussion format include cost analyses, longitudinal budgeting, mission-based budgeting, business plan development and productivity analysis and enhancement.

Thomas F. Boat, Children's Hospital Medical Center, Cincinnati, OH
Michael K. Farrell, Professor of Pediatrics and Chief of Staff, Children's Hospital Medical Center, Cincinnati, OH
Lori Mackey, Director of Finance, Research Administration, Children's Hospital Research Foundation, Cincinnati, OH

Reviewing articles for peer-reviewed journals combines many skills, including knowledge of the area of investigation, methodology, epidemiology, statistics and the scientific context of the research being reviewed. Judging one’s peers and colleagues is difficult and represents an important aspect of the scientific method. Unfortunately, there is little "formal" teaching of this activity.

In this workshop we will review the process of peer review and discuss those areas that reviewers are usually asked to comment on, including: importance and originality; validity of data; clarity of manuscript; importance for readers; and assignment of priority. Samples of checklists that some journals provide for reviewers will be distributed and discussed. Participants will be asked to review a brief manuscript and formulate their opinions during the workshop. The manuscript and reviews will then be discussed. Finally, sample reviews will be distributed and participants will be asked to assess how helpful the review would be for both the editors as well as the authors. Areas that are most subjective, such as importance for practitioners and scientists and assigning priority will be discussed, with particular attention paid to each participant’s own biases.

There is little formal instruction in the peer-review process – an important aspect of academic medicine. This workshop should help faculties who are beginning to be peer-reviewers.

Howard Bauchner, Professor of Pediatrics and Public Health, Boston University School of Medicine, Boston, MA
Patricia Shiono, The David and Lucile Packard Foundation, Los Altos, CA

The 3rd PEM Directors SIG will be meeting to discuss academic issues in education and research for enhancement of the faculty growth within the field. One area of focus will be the mentoring of junior faculty. There will be a discussion on developing the future PEM Directors and enhancing the longevity in the field. Directors are encouraged to contact: richard.ruddy@chmcc.org for further details.

We have a busy agenda planned that will focus on the following areas and updates.

1. Pediatric training handbook for Family Practice Residents.

* SIG members have established that there is no widely used resource for the Pediatric component of Family Practice Residency. A handbook developed by the York Hospital Family Practice Residency (the Reilly Handbook) was reviewed. SIG members agreed that this resource would provide a good starting point and several members agreed to work on revisions. Efforts to develop a CD ROM format were also initiated. Our goal is to develop a resource that will have broad based appeal to Family Practice Residency programs across the country.

*Competency based questionnaire

*As an adjunct to the handbook, members felt it would helpful to have coordinated questions to help focus pediatric learning. Several members agreed to contribute questions.

How is pediatric training addressed in Family Practice Residencies?

This question was last addressed in a 1992 article by published by Baldour and Luckman. SIG members felt it would be useful to conduct a similar survey of current Family Practice programs.

*Annual review of Pediatrics Guidelines for Family Practice residents

*New members in particular have found this discussion useful in terms of providing a foundation for pediatric learning objectives.

Competency based education has become a top priority in medical training. It places the emphasis in integrating knowledge, skills and attitudes into the actual performance of the essential tasks of an effective practicing pediatrician. In the field of Community Pediatrics, it has been particularly difficult to define the competencies necessary to become an effective community advocate. Our Community Pediatrics program has achieved a comprehensive competency based approach to training by incorporating Service Learning as the core of the educational experience. Service learning integrally involves the community in the design and implementation of the curriculum. It combines specific learning objectives with community service, evaluation and reflection. With this educational methodology, competencies are defined mutually by members of the community and the academic medical center.

Participants in this workshop will: 1) Develop competency statements in the area of Community Pediatrics, 2) Identify appropriate educational methods to achieve those competencies, with particular emphasis in Service Learning and 3) Explore appropriate methods for evaluating the residents' mastery of the articulated competencies.

D. Meyer, M. McCord, P. Hametz, M. Irigoyen, M. Batista, and V. LeBlanc.

As the clinical venues and topics continue to evolve in pediatric education, faculty are being asked to revise or develop new curricula. Unfortunately, the medical education literature provides little guidance in the specific steps required to develop educationally sound clerkships and rotations. In this workshop, participants will learn a validated model for developing medical curricula. The model has been successfully used with faculty development fellows at Michigan State University for the past decade. At the end of this workshop, participants will be able to: 1) develop curricula using the model, and 2) explain the political and communication issues involved in getting curricula adopted.

The workshop format will include a simulated curriculum development task, brief presentations of essential concepts, and small group activities with feedback. Participants will be provided with an extensive take-home curriculum development manual.

Anne Armstrong-Coben, Columbia University, New York, NY; and William A. Anderson, Michigan State University, East Lansing, MI

Back by popular demand, this seminar uses multiple real examples from the pediatric literature to teach participants how to be more discriminating consumers of statistics. Topics to be covered include standard deviation vs. standard error of the mean, commonly violated assumptions of statistical tests, including normality and independent sampling, between- vs. within-groups comparisons, "type 3" (dumb or careless) errors, odds ratios versus risk ratios, relative versus absolute effect sizes, and multiple comparisons. In the last part of the seminar, participants will have the opportunity to test what they’ve learned on a set of "unknown" examples.

Thomas B. Newman, Professor, University of California, San Francisco, CA
Yvonne Wu, Clinical Instructor, University of California, San Francisco, CA

Elements of managed care and uncertainty in research funding have substantially increased the financial pressure on many academic medical centers. This educational program will review and discuss new financial analysis techniques that eliminated a hospital’s unit deficit of more than $2,000,000 within 4 months, provided nearly $1,000,000 in unrestricted funding for a new research institute, and significantly improved the collection process of professional fees. All these outcomes were accomplished without the added benefits/risks of cost-cutting programs. At the completion of this seminar, participants will have a clearer understanding of their role in the fiscal health of their academic centers as well as have specific tools and approaches with which they can assess and possibly improve the fiscal health of their respective institutions or professional practices.

David T. Tanaka, Associate Clinical Professor of Pediatrics, Duke University Medical Center, Durham, NC
Billy Newton

Clinician educators are those physicians whose career activities combine patient care and the teaching and supervision of medical students and residents, and whose scholarly activities promote excellence in medical education.

With this workshop, it is expected that participants will:

1. have a better understanding of the motivations and works responsibilities of clinician-educators, and will be able to compare the motives for their careers with those of other clinician-educators.

2. learn how a mentoring program can help the clinician-educator plan and develop his/her career.

3. have a better understanding of specific faculty development activities (workshops, microteaching, teaching evaluations, teaching consultations) and the evidence for the effectiveness of these activities.

4. have a better understanding of the evaluation of teachers and how these evaluations are used for faculty development, promotion and compensation, and will learn guidelines for developing an effective Teaching Dossier which can be the key to successful promotion.

Robert I. Hilliard, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
Karen Leslie, Division of Adolescent Medicine, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
Ann Jefferies, Division of Neonatology, Mount Sinai Hospital, Toronto, ON, Canada

The physician scientist is the individual who is most responsible for helping translate the basic sciences into clinically important investigations. Given the increasing difficulties in obtaining funding as either a physician or a scientist, some people have questioned the viability of this hybrid. We will discuss the necessary background, environment, support and mentoring necessary to train and sustain the physician scientist in a complex and changing environment. Individuals choosing either laboratory or other basic sciences as major components of their career are encouraged to attend.

Frederick J. Suchy, Professor and Chair, Department of Pediatrics, Mount Sinai School of Medicine, New York

Presenting scientific information clearly is an essential part of a successful scientific career. Colleagues will infer your scientific ability from the clarity and quality of your oral presentations. Presentation skills can be learned and improved. In this seminar, we will discuss the following topics:

- Organizing your presentation
- Choosing audio-visual aids
- Making effective slides
- Presenting data
- Handling questions
- Practical hints

Thomas A. Hazinski, Professor of Pediatrics, Associate Chair for Academic Affairs, Vanderbilt University Medical Center, Nashville, TN

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 seminar will provide participants with such strategies that will in turn aid in the recruitment, faculty development, and retention of preceptors. Mock teaching codes, videotapes, and other live demonstrations will be used to highlight the techniques and innovations to be introduced. Content areas will focus on the importance of a good orientation, feedback, evaluation, and creative teaching techniques that will make teaching fun and a true learning experience for all involved.

Lewis First, Professor and Chairman, Department of Pediatrics, University of Vermont College of Medicine, Burlington, VT

The purpose of this seminar, which is designed for junior faculty, fellows, and residents, is to provide an opportunity for participants to increase their comfort in giving and receiving feedback in an educational setting. Although physicians are expected to give and receive feedback throughout their experiences as students, teachers, researchers, and clinicians, these skills are seldom discussed as components in the process of teaching and learning. This session will include self-reflective, interactive, and role-playing exercises.

John M. Leventhal, Professor of Pediatrics, Yale University School of Medicine, New Haven, CT
Mary Anne Johnston, Assistant Professor, Department of Internal Medicine, University of Colorado Health Science Center, Denver, CO

This workshop will address multiple aspects of publication in scientific journals. Presenters will discuss preparation of materials, including the initial decision that the data are sufficient to justify publication. Issues related to manuscript writing will include length, focus, adherence to journal formats, and referencing. The editorial process, from submission to publication, will be described in depth, with particular attention to ways in which authors can interact with journal editors. Another section of the workshop will cover ethical issues in publication including review boards, authorship, duplicate publication, intellectual property rights, and conflict of interest. There will be open discussion of sample cases and questions derived from the experiences of the participants.

William F. Balistreri
Thomas R. Welch, Louise M. Williams Professor of Pediatrics, Children's Hospital Medical Center, Cincinnati, OH
Stephen R. Daniels, Professor of Pediatrics and Environmental Health, Children's Hospital Medical Center, Cincinnati, OH
Alan H. Jobe, Professor of Pediatrics, Children's Hospital Medical Center, Cincinnati, OH

This workshop will discuss the multiple paths to academic leadership. There will be three distinct perspectives presented: leadership at an institutional level--climbing the academic ladder; leadership at an organizational level--opportunities to become involved with national organizations such as the American Academy of Pediatrics, the Ambulatory Pediatric Association, American Pediatric Society; and networking: differences in gender styles and opportunities. There will be a panel discussion following individual presentations, and an opportunity for workshop participants to discuss their personal experiences.

Carol D. Berkowitz, Professor, Harbor/UCLA Medical Center, Torrance, CA
Philip Pizzo, Harvard Medical School, Children's Hospital, Boston, MA

The publication and dissemination of new knowledge has long been the goal standard of academic pediatrics. However, inertia remains a substantial barrier to successful publications and presentations for many faculty. A well-organized and systematic approach to the presentation of scientific data can substantially reduce the impediments to success and lead to high-quality and well-received efforts. This seminar will take a practical and focused approach to the conceptualization, derivation and presentation of scientific material to be presented as a manuscript, abstract or oral presentation. Group discussions, critique and analysis will be an inherent component of this seminar.

Norman Siegel, Professor of Pediatrics and Medicine, Interim Chair and Physician-in-Chief, Department of Pediatrics, Yale University School of Medicine, Yale-New Haven Children's Hospital, New Haven, CT

This workshop is intended to help pediatric fellows and young junior faculty with challenges they face at each stage of their training including: how to identify worthwhile research projects, how to apportion time between research and course work, how to choose and work with a mentor, how to complete projects during one's fellowship, when and how to write grants, how to get and negotiate a job, how to balance career and family, and how to transition to life as a junior faculty member. This workshop will be of particular interest to current pediatric fellows of any year, but it will also provide useful insights for those who recently completed or are considering a fellowship. The facilitators will include faculty at all stages of their career and will include both clinician scientists and clinician educators. There will be ample time for open discussion and question and answer.

Dimitri A. Christakis, Assistant Professor Pediatrics, Co-director of Child Health Institute, University of Washington, Seattle, WA

This session will provide participants with the necessary background for developing and conducting successful multi-site collaborative research projects in inpatient and outpatient settings. The co-leaders, who have overseen numerous diverse multi-site observational studies and clinical trials, will begin the session with a focused presentation outlining the rationale for multi-site collaborations, the principles of successful collaboration, and the potential pitfalls of this type of research, answering questions about these issues. Subsequently, they will lead the participants in a step-by-step exercise of planning, developing and implementing one inpatient and one outpatient study suggested by the audience.

Richard C. (Mort) Wasserman, Professor of Pediatrics, University of Vermont College of Medicine, Burlington, VT
Roger F. Soll, Professor of Pediatrics, University of Vermont College of Medicine, Burlington, VT

This seminar will focus on the unique issues related to the challenges of women in academic medicine. The first topic will be the various tracks within the academic community, and the expectations related to promotion within these tracks. The second topic to be discussed will be maintaining a balance between professional and personal life, and the presentation will include a discussion of the pros and cons, and ups and downs of part-time employment. The last issue to be discussed will be negotiation skills for women in academia. Problematic scenarios will be presented and strategies for solutions will be proposed.

Phyllis A. Dennery, Associate Professor and Associate Division Chief, Neonatal and Developmental Medicine, Stanford University School of Medicine, Palo Alto, CA
Susan B. Shurin, Professor of Pediatrics, Rainbow Babies and Children's Hospital and Case Western Reserve University, Cleveland, OH

Workshops are a popular and versatile method of teaching adults. From teaching a procedure to teaching how to teach, from local departmental retreats to national meetings, from precepting students to working to develop the skills of colleagues, workshops are widely used in medical education. This workshop will give participants the tools/framework necessary to construct and lead their own effective workshops. Facilitators of this workshop are from a variety of institutions and are participants in the APA national Pediatric Faculty Development Scholars Program, a project to develop regional faculty development training expertise. We will draw from our experiences in this program and the literature on education to review concepts of adult learning theory and techniques for working with small groups. Through participatory and interactive segments, the group will address how to conduct a needs assessment of the target audience and use the results to plan an effective workshop. Techniques for effective communication, use of audio-visual supplements, and evaluation will be covered. Various techniques for role-playing and audience participation and interaction will be demonstrated. Breakout sessions will allow participants to practice some of the skills that are taught. Participants will receive a listing of national Pediatric Faculty Development Scholars by region to facilitate further networking and long-range access to workshop development expertise.

Medical students have not always had access to information and behavior skills training related to malpractice, and communication skills for difficult situations. Perhaps, as a result, some pediatricians become involved in lawsuits that might have been avoided by using interpersonal skills to enhance the physician-patient relationship. Research suggests that many families file malpractice suits when adverse outcomes are associated with poor physician-patient relationships, physicians' criticism of one another, and unclear communications. This research has led multidisciplinary faculty and risk management staff to develop a 6 hour, small group course for practicing physicians, residents and 4th year medical students taking their 4 week ambulatory pediatrics rotation. The proposed workshop presents a mini version of the course and suggests how it may be adopted elsewhere.

Participants are challenged to: identify patient dissatisfactions that increase risk of suits, communicate effectively in adverse circumstances, relate physician's interpersonal behaviors to patients' perception of quality care and understand risk management's issues and roles. Participants practice with surrogate patients who present 10 cases based on research and actual lawsuits. Scenarios range from a diagnosis of cerebral palsy in which a mother wants to blame her obstetrician to a case of iatrogenic death. The workshop will include a brief lecture, role plays and discussions that focus on: structuring difficult interactions, dealing with patients varied responses to bad news, what to do when you or another physician has erred and principles of risk reduction.

J. Gigante, G. B. Hickson, T. Trotter, J. W. Pichert, Vanderbilt Children's Hospital, Nashville, TN

Many academic general pediatricians, subspecialty pediatricians and community pediatricians serve regularly as attending physicians in the outpatient setting. In this role both teaching of trainees and supervision of patient care occur concurrently in a busy, often fast-paced environment. The goal of this workshop is to provide strategies for physicians to improve the efficiency and effectiveness of their teaching in the outpatient setting. The workshop will be structured as follows: first, participants will identify features of outpatient settings that facilitate good teaching and will delineate potential barriers to effective teaching. Second, we will develop feasible solutions to the barriers. Third, we will identify efficient outpatient teaching strategies that incorporate principles of adult learning. Fourth, we will discuss examples of successful outpatient teaching programs at both our own institution and participants' institutions. Fifth, we will examine and then role-play difficult teaching situations. Finally, we will review the principles and challenges of giving feedback in this setting. Participants will be asked to share their own insights, experiences, and effective outpatient teaching strategies/programs.

P. H. Kaleida; K. Rajakumar; D. L. Bogen. Department of Pediatrics, University of Pittsburgh School of Medicine and Children's Hospital of Pittsburgh, Pittsburgh, PA.

Objective: To enable clinicians to evaluate and interpret results of studies which utilize multivariate regression analytic techniques.

Introduction: Medical journals increasingly publish clinical observational studies which utilize complex statistical analyses. Because treatment and prevention recommendations may be founded on such studies, clinicians need to understand the basic principles of multivariate regression to appropriately evaluate and interpret these results.

Course: This workshop will utilize a case-based teaching approach to illustrate how multivariate regression techniques work, when they are appropriate, and how they are interpreted. The participant will understand how to evaluate and interpret studies which use multivariate analytic models. Minimal computer and math skills are necessary. We will begin by defining confounding in an example study and how it is distinguished from bias. Next we will define/calculate crude odds ratios and confidence intervals using data sets from studies of common pediatric emergency diagnoses as examples. We will then explain and demonstrate the results from the same datasets using logistic regression to adjust for confounding. This case based approach will be repeated using an example of simple linear and multiple linear regression. In the final portion of the workshop, we will discuss how to detect inappropriate/inadequate presentations of multivariate regression, including lack of model diagnostics, unstable models, lack of model validation and co-linearity of variables.

Robert Wright, Jacqueline Grupp-Phelan, Nathan Kuppermann. Divisions of Emergency Medicine, Brown University, Providence RI, University of Cincinnati, Cincinnati OH, University of California-Davis, Davis, CA

In 1997, the Residency Review Committee required that all pediatric residents be prepared for the role of child advocate. Last year, our SIG accepted the challenge of developing standards for child advocacy training. We welcome all who are interested in teaching about child advocacy to join us in that task. We are particularly interested in hearing from residents about their experiences - what have you done, what worked and what are the generalizable lessons for other programs. E-mail your thoughts to the co-chairs, David Keller (david.keller@ummed.edu) or Rosalind Vaz (RVaz@lifespan.org). We look forward to seeing you in Baltimore!

The Continuity Directors SIG, which was organized by Jan Drutz over 10 years ago, has continued as a very active network for preceptors in resident continuity settings.

We're very pleased that over the years, the group has grown and completed projects that none of us individually could have accomplished. The annual SIG meeting, workshops, directories with clearing house information, newsletters (The Continuity Connection), and research have blossomed by the involvement of countless individuals committed to enhancing resident education. Our group has remained consistently enthusiastic and highly motivated because of all the Continuity Directors' and preceptors' attendance and active participation!

Everyone is welcome to join us for our annual meeting in Baltimore. This provides an opportunity for preceptors and directors to network and learn about current projects and "hot topics" of interest. As usual, we will focus primarily on one interactive discussion interest (selected from suggestions made at our 5/00 meeting) and continue discussion on the Continuity Program evaluation in the RRC accreditation process and curriculum development. Specific agenda information will be available in the spring newsletter and on the APA Web site.

The Special Interest Group on Managed Care is committed to educating medical students, pediatric housestaff and faculty about managed care and its impact on pediatric education, teaching and research. This year's program will focus on several training programs who have developed formal curriculum and clinical experiences highlighting managed care. Representatives from the "Partners in Quality Care" programs funded by the Robert Wood Johnson will be invited to discuss what they have done locally to improve education of students and housestaff in managed care. It should be an interesting and exciting session. All are welcome!!

Two cases of children with asthma will be presented. The group will work through these cases formulating a plan for diagnosis and management. Objectives Include: Recognize warning signs of asthma, determination of asthma, class severity; identification of asthma triggers; familiarity with concepts of pulmonary function testing and peak flow monitoring; understanding of the role of inflammation and anti-inflammatory therapy; recognition and comprehension of potential side effects of medications and the disease patterns, development of asthma action plans using peak flow measurements and formulation of environmental control measures based on history and allergy testing.

Diane Schuller, Penn State College of Medicine, Jay Selcow, AAP Section on Allergy and Immunology

The importance of community-based pediatric training was formally recognized when, in 1996, the Residency Review Committee (RRC) for Pediatrics mandated structured educational experiences in community pediatrics. Under the leadership of late Foundation president pediatrician Anne E. Dyson, the Dyson Foundation, launched a program to stimulate innovation in community pediatrics residency training. The ultimate goal of The Dyson Initiative-Pediatric Training in the Community, which allocates $2.5 million over five years to pediatric residency programs, is to expand the repertoire of residency training to include teaching and experiences in community-based medicine and advocacy.

This workshop will focus on curricular changes that can be implemented to strengthen community-based training. Representatives from Dyson Initiative-funded sites will present innovative curricular enhancements, focusing on those changes that need not require a large monetary investment. They will also discuss the faculty development strategies that accompany curricular change. In the second part of the workshop, Dyson Initiative grantees will present their experience with community collaboration. Practical lessons learned from taking the residency outside the hospital/clinic walls will provide participants with insight into this integral facet of community pediatrics.

M. K. Goyal and J. S. Palfrey, The Dyson Foundation, Millbrook, NY and Dept of General Pediatrics, Children's Hospital, Boston, MA.

The process of designing curriculum begins by identifying specific educational objectives or "competencies" that must be achieved. We will discuss the concept of establishing a "minimal set" of required competencies, and whether that process actually enhances or reduces learner achievement. The steps of curriculum development will be presented, including the process of needs assessment, and the conversion of published educational guidelines (such as those of the APA and COMSEP) to specific, objective, measurable competencies. The development of evaluations appropriate for each competency will also be described. We will then discuss practical considerations regarding implementing, evaluating, and revising the curriculum.

The University of Maryland Pediatric Residency Program is one of the few in the country to have adopted a competency-based curriculum. Excerpts will be presented, along with practical lessons learned from their experience in curriculum development and implementation.

Finally, participants will split into smaller, multidisciplinary Curriculum Development Teams to identify competencies and design a competency-based curriculum focused on a specific clinical topic.

Sponsored by the APA Education Committee.

J. M. Devries and C. Carraccio, Depts. of Pediatrics, Oakwood Healthcare System, Dearborn, MI and Univ. of Maryland Medical Center, Baltimore, MD

An OSCE is a clinical performance evaluation tool designed to appraise student behaviors or skills in a variety of areas. OSCEs can provide powerful formative and summative feedback to both students and curricula. Unfortunately, an OSCE can be quite labor intensive and expensive to set up and operate.

The objective of this workshop will be to design OSCE stations that minimize the use of scarce labor and financial resources yet still effectively measure student performance. Participants will review different methodologies, costs associated with each, and the National Core Curriculum in Pediatrics. Using a combination of inexpensive "low tech" and "high tech" props, participants will design OSCE stations to measure specified student skills and competencies. By the conclusion of the workshop, the participant should be familiar with how to create and implement a low-cost 10-15 station OSCE designed primarily to give students formative feedback.

W. V. Raszka and P. B. Patterson, Department of Pediatrics, University of Vermont College of Medicine, Burlington, VT and The Barbara Bush Children's Hospital at Maine Medical Center, Portland, ME

Children are a vulnerable class of research subjects because they lack the developmental, intellectual and legal capacity to provide informed consent. Research information is given to parents who are asked to make a decision regarding participation based on their perception of what is in the best interest of their child and society at large. We propose to conduct a workshop for new investigators that will accomplish the following goals: (1) Workshop participants will be able to present the essential elements of informed consent to parents in both written and verbal format. (2) Participants will be able to discuss research involvement with children in a manner appropriate for the child's age, maturity and psychological state. (3) Participants will be able to evaluate the appropriateness of involving adolescents in research with/without parental permission. These goals will be accomplished using a combination of didactic and interactive methods. Case studies consisting of background information, case vignettes, discussion questions and references will be used to explore ethical principles and federal regulations guiding the consent process. Sample consent documents, and videotapes of investigators interacting with parents and potential subjects will be reviewed and critiqued by workshop participants for content, style and effectiveness of communication. The workshop evaluation will consist of pre and post-test questions designed to allow the participant to directly assess their knowledge and skill acquisition.

K. L. Meert, G. Deisinger and E. R. Stinson, Department of Pediatrics, and Office of Research and Graduate Studies, Wayne State University, Detroit, MI.

Quality training of medical students and residents can be quite demanding and difficult. Issues such as time, resources, curriculum, evaluation and teacher development are important for any educational program. However, the success of such a program is best measured in terms of how well trainees are learning. Effective teaching can only be determined by looking at how well learners change their behavior.

The goal of this workshop is to closely examine how medical students and residents learn in clinical settings. An emphasis will be placed on what constitutes effective learning, rather than effective teaching. Through the use of brainstorming, small group discussion, videotaped vignettes, photograph analysis and role play, participants will actively explore ways in which medical trainees learn. Medical students will participate in this workshop to enhance discussions and simulations. The advantages and disadvantages of rote learning versus meaningful learning will be discussed. Participants will be challenged to find practical solutions to common learning problems and apply these to their own settings.

L. W. Greenberg and R. T. Sarkin, George Washington School of Medicine, Washington, DC and SUNY at Buffalo School of Medicine, Buffalo, NY

Poster session on current general pediatric residency and faculty development grant activities funded under section 747 of the public health service act

This poster session will:

1. Highlight the uniqueness of these grant activities as well as their contributions in shaping graduate medical education for the nation;

2. Provide a forum for project directors to discuss their activities, challenges and innovations directly with other project directors and colleagues interested in medical education, with the possibility for replication in other programs;

3. Provide an opportunity for initiating networks and collaborative activities with other grantees and participants at the annual meeting and;

4. Provide an opportunity to showcase measurable outcomes from residency and faculty development programs.

This symposium will address a topic of considerable public debate, especially as it relates to research involving human subjects, among these clinical trials using children as subjects, and research involving gene therapy. A recent two-day meeting at NIH was devoted to this subject and it is likely that there will be new and more explicit guidelines promulgated by HHS. The symposium will address these issues from the perspective of academic pediatrics and pediatric research, in particular with regard to the impact on education at both the undergraduate and graduate levels and the availability of appropriate tests and therapies for children. The role of professional societies, such as the sponsoring members of the PAS meeting, will be examined. The symposium is planned to allow at least 30 minutes of interactive discussion between the members of the panel and the audience.

The Division Directors in General Pediatrics SIG addresses all issues pertaining to Sections of General Pediatrics, including section and clinic management, patient care issues, finances, educational responsibilities and clinical research.

This workshop provides continuity faculty an opportunity to collaborate in the development of core competencies for the continuity experience. Currently the Residency Review Committee (RRC) offers a broad description for continuity but does not address specific competencies or site-specific differences. The RRC is moving towards competency-based requirements in its next revision. Thus, it is timely to consider which competencies should be core for the continuity experience and which are most appropriate to emphasize in specific types of continuity settings (e.g., hospital- based and community sites).

The Continuity Directors' SIG Task Force will present a working draft of competencies for continuity, developed with input from the SIG membership over the year. Attendees will break into subgroups to prioritize these competencies and to select those most appropriate for emphasis in hospital and community-based continuity sites. Teaching and evaluation methods for several key competencies will be explored. Subgroups will bring their recommendations and non-consensus suggestions to the full group for discussion. After the meeting, a summary of recommendations will be sent to attendees and to the APA Education Committee, in order to guide the APA's response to the RRC and to aid in revision of the next APA Educational Guidelines for Residency Training in. General Pediatrics.

D. Kittredge, M. Dumont-Driscoll, P. Algranati, R. Collins, W. Davis, J. Drutz, S. Feigelman, J. Olsson, S. Riesen, J. Serwint. (Continuity Directors SIG Task Force)

In education, research is often focused on the determination of progress that students have made toward educational goals. These studies use methodologies which not only determine outcomes but also analyze the process with which these outcomes are derived. Researchers in medical education are often faced with the difficulty of defending their methodologies to "peer-reviewers" who are accustomed to quantitative analysis of traditional scientific papers.

The methodologies in educational research may be classified into two broad categories: quantitative and qualitative studies. For medical education research, quantitative studies focus on the outcomes of the study while qualitative studies explore the process. Both types of research are necessary and should be selected based on the research question.

This workshop will address the use of varying methodologies in medical education research by reviewing the evaluation methods for several innovative curricular programs. By comparing and contrasting the methodologies employed in each of the programs, participants will be able to appreciate the uses of quantitative and qualitative studies in medical education.

A. A. Kuo, G. S. Blaschke, B. S. Siegel, W. Risko and J. P. Hafler, UCLA Medical Center, Los Angeles, CA, Naval Medical Center, San Diego, CA, Boston Medical Center, Boston, MA, Children's Hospital, Boston, MA, and Harvard Medical School, Boston, MA

Primary care physicians increasingly encounter behavior problems (e.g., noncompliance, sleep problems, and ADHD), but sometimes these problems do not resolve with an exclusive child-symptom centered approach. Furthermore, physicians are encountering interaction-psychosocial problems (e.g., relationship and communication problems, family affective disorders, social-emotional complications of ADHD and learning problems, parent-teen conflict, and parent stresses) that require a family systems approach to assessment and treatment, i.e., viewing the problems and the solutions within the family-social context in which they arise. Most physicians are not trained in family systems-family interviewing techniques, which are needed for these clinical situations.

The goal of this workshop is to teach these techniques. Specifically, attendees will learn basic family systems principles, three models of interviewing techniques, the use of family drawings and genograms, and how to deal with the difficult family.

The workshop will be very interactive. Teaching techniques include case studies, brief didactics, videotapes of family interviews, and extensive handouts. Attendees should bring their own case studies for discussion.

William Coleman, Dept. of Pediatrics, Univ. of North Carolina, Chapel Hill, NC

While integrated health care systems where patient care is intensely managed are becoming more common, young physicians are not being taught how to provide high quality health care within these systems. Therefore, the Health Resources and Services Administration (HRSA) has funded a national medical education program, Undergraduate Medical Education for the 21st Century: A demonstration of curricular innovations to keep pace with a changing health care environment (UME-21). The $7.6 million project began in October 1997 and is administered by the American Association of Colleges of Osteopathic Medicine. UME-21 provides contract funds to eighteen allopathic medical schools to develop, implement and evaluate innovative primary care educational strategies in the clinical years of medical school. The goal of the curricular innovations is to provide future physicians with the knowledge, skills, values and attitudes necessary to provide high quality, population-based, cost-effective medical care to their patients within integrated health care systems. This project aims to foster effective primary care interdisciplinary teaching and learning in ambulatory and community-based settings.

The main goal of this workshop is to identify challenges and opportunities that arise when medical schools collaborate with integrated health systems (including managed care organizations) to effect curricular change in the clinical years of medical school. At the conclusion of the workshop, common barriers to implementation and effective strategies to address those barriers will be identified.

J. Pascoe, C. Christian, K. Ling-McGeorge, H. Loeser, F. McCurdy, C.A. Olson, S. Rattner, B. Zatelli

Recent guidelines for health supervision include Bright Futures, AAP GHS III, and DSM-pc codes of psychiatric risk. Problems with implementation include: lack of evidence, time required, lack of economic reinforcement, complexity of DSM-pc coding, and lack of training for management, particularly of mental health concerns. Our Child Health and Development Interactive System (CHADIS) facilitates implementation of guidelines using computerized parent questionnaires, e.g., all DSM-pc categories, child strengths, health risks. Computer analysis of responses results in suggested diagnoses with specifically related prompts and guides (e.g., trigger questions, differential diagnoses, potential recommendations, menus of appropriate products and resources such as tutors, etc.) on the electronic medical record worksheet the clinician uses during the visit. The clinician's interaction with the system results in reports (health passport and memory book) for parents. Products and local resources are provided with reviews by experts and without advertising. CHADIS will include validated tools for some aspects of developmental surveillance (e.g., START; Communication Screening System) and for further evaluation of problems (e.g., autism checklists, depression inventories). CHADIS will be free, initially offered to faculty interested in training and collaborative research. We will: demonstrate how CHADIS addresses common problems such as encopresis, sleep problems, ADHD; present data on parent response to CHADIS and pilot prevalence data for DSM-pc; elaborate on its use for collaborative research; and provide an opportunity for joining the network.

Raymond Sturner and Barbara Howard, The Johns Hopkins U School of Med., Baltimore, MD

The second meeting for this group will be held on Monday, April 30 from 9-12 am at the Baltimore PAS meeting. This SIG is designed for those community-based APA physicians involved in academic pursuits such as practice-based research or teaching in a community setting. Items to be covered include the relationship of our group to the APA (faculty development, academic appointments etc.) and the AAP (CATCH, PROS etc.) and how the group can develop a network for better communication about programs (the first newsletter should be published this Fall) including a data-base to allow trainees to access those sites involved in a variety of teaching and research functions. Any questions or suggestions should be addressed to Dr. Emanuel Doyne (doyne0@chmcc.org or 513-636-8043).

This year we will focus on enhancing our skills in the evaluation of competencies. The format will include three critical components.

1. Brief review of concepts of competency based evaluation from experts in the field, including (but not limited to) OSCE's, Standardized Patients, Oral Exams and Written exams.

2. Group work to develop a template for competency based evaluation of skills that are part of the national curriculum for students (COMSEP). This has relevance for residents as well.

3. Organizing collaborative work for the entire year, in the spirit of the Physical Examination Video.

We will also have time for poster presentations (submit any ideas including program description and new ideas) this is a terrific forum for first time academic forays in a friendly environment - an update on the PE video, and a review of other national work that affects medical education.

Finally, we will reserve some time to share Palm applications through poster presentations and informal discussion.

Anyone interested in medical education should attend.

The Women in Medicine Special Interest Group will have presentations dealing with the experiences of minority women: the past, the present and the future, lessons for us all. There will be personal presentations highlighting barriers as well as opportunities. The SIG will hear about efforts aimed at increasing minority recruitment.

The objective of this workshop will be to introduce strategies to teach pediatric residents about the Healthy Steps approach of developmentally-oriented, primary care. With the support of the Commonwealth Foundation and other funders, we developed an innovative program (presently in 24 practices nationally) called "Healthy Steps" (HS). HS enhances services for young children in primary care through such strategies as teachable moments, promotion of early literacy, parent handouts, and other family supports. To implement HS, we have created an interactive curriculum involving video vignettes of children's behavior and a CD-ROM to help pediatricians better understand and respond to the social, emotional, fine motor, and cognitive development of infants and toddlers. Specifically, the curriculum emphasizes improving observational skills and understanding the meaning of children's behavior and development.

The curriculum and associated videos have been presented to more than 50 faculty of pediatric residency training programs and are presently used in a variety of settings, including pre-clinic primary care conferences or as part of developmental and behavioral pediatrics rotation. This workshop will provide the tools to enhance resident training in developmental and behavioral issues through its innovative, multi-media, interactive approach.

Barry Zuckerman, Steven Parker, Margot Kaplan Sanoff, Marilyn Augustyn. Boston University, Boston MA

As pediatricians are called upon to manage more complex clinical and administrative information, educators of residents should respond by providing relevant curricula in medical informatics (MI).

In this workshop, participants will relate their experiences with two different but long-standing MI electives for pediatric house officers. The workshop leaders will demonstrate templates, reading lists, web-based course administration, syllabi, and curricula used to facilitate MI experiences. Curricular content areas for these rotations include basic information technology literacy, the Internet, accessing medical literature, evidence-based medicine, practice management systems, hospital information systems, decision support, and health services research. The workshop includes an orientation to educational guidelines, a tutorial on web-based course administration, and strategies for integrating the experience into the residency program. Participants should have some familiarity with information technology but not necessarily special expertise in MI. Participants who desire to create an elective experience as described in this workshop should need no special resources other than internet access and as little as four hours a month to devote to supervising the residents. Participants will also be able to take away evaluation tools for pre-test and course evaluation purposes.

S. Andrew Spooner, University of Tennessee at Memphis, Memphis, TN, and Raymond G. Duncan, Cedars-Sinai Medical Center, Los Angeles, CA

Introduction: Practicing evidence-based decision-making (EBDM) is an essential skill for lifelong learning among practicing pediatricians and pediatric residents. The author has developed a set of workshops for general pediatricians designed to help build skills in EBDM and to teach these skills to residents in their clinics.

Goals: As a result of this workshop, participants will be able to 1) translate a clinical scenario into a well-built clinical question; 2) describe basic literature search techniques; 3) critically appraise an article; and 4) describe several tools useful for the daily practice of EBDM. This workshop will be useful for those just learning about EBDM and those want to teach this material to students or residents in their offices.

Format: Following a brief overview of EBDM, the participants will self-select small groups to focus on skills in the practice or teaching of EBDM. Each will have its own facilitator, to ensure that each participant comes away with the skills and comfort to be able to apply this knowledge in their daily practice. Special attention will be given to the newest sources available through the internet to facilitate the practice of EBDM. The session will conclude with discussion of useful pearls for the practice and teaching of EBDM generated by the participants. Participants will receive a workbook with handouts, pediatric case discussions, and teaching materials.

J. G. Frohna, Sheila Gahagan, Kenneth Pituch, Stephen M. Park, Department of Pediatrics, University of Michigan, Ann Arbor, MI

The Faculty Development SIG is a forum for ongoing exchange in the area of medical education and faculty development The SIG is open to anyone that has an interest in those areas. This year we will use the majority of our time for a training session in tools to measure effectiveness. We will also allow time for sharing and brainstorming. The SIG is co-chaired by Michelle S. Barratt, Charlene Gaebler-Uhing and Ronald V. Marino. Contact Michelle for questions or to join the list serve (Michelle.S.Barratt@uth.tmc.edu or 713-500-5810).

This year's Pediatric Telephone Care SIG will focus on resident education in pediatric telephone triage. We will revisit the goals of a resident curriculum in pediatric telephone triage. We will then have several programs present the details of their curriculum for discussion. The session will include the presentation of current tools being used in the evaluation of resident telephone triage education. It is the intent of this session to allow the participants to leave this working session with the goals of a resident curriculum, examples of types of resident training modalities and the means to evaluate the success of resident learning. Anyone interested in presenting their curriculum or resident training ideas should contact Andrew Hertz, M.D. at 216-844-7731 (HertzA@aol.com) or Allison Kempe, M.D. at 303-764-8245 (Kempe.Allison@tchden.org).

The Brief Structured Observation (BSO) method can be an effective way to observe and assess learners' competencies. It allows for more structured observation and specific feedback in inpatient settings and moreover, in the outpatient setting, it is efficient, fast and patient-friendly. It applies several principles of adult learning, since we collect information that is learner-centered and provide immediate, specific feedback to the learner.

In the 'BSO' a faculty member or senior resident watches a trainee (student or intern) perform a short segment of a patient encounter. During this encounter the preceptor writes verbatim the questions or statements of the student. Following the segment the preceptor debriefs the learner and uses the recorded script to provide specific feedback on the encounter.

In an interactive format, workshop participants will practice the technique by observing live medical students and simulated patients. We will also model the BSO method by giving participants feedback on their skills. We will also discuss our experience with using the BSO in different settings (inpatient and outpatient) and for the assessment of the competencies of different learners (students and residents).

Ken Pituch, Jonathan Fliegel and Katherine Layton, University of Michigan Medical School, Ann Arbor, MI

Academic health centers require new methods to develop physician compensation packages that encourage physician accountability for individual clinical productivity as well as contribution to the academic success of the institution. Often, educational responsibilities - teaching of residents and students - are not addressed in compensation programs, resulting in diminished physician effort and a perception that teaching is not valued.

This workshop will focus on the tools needed for creation and implementation of a productivity-based compensation program in an academic health center. Measures of physician productivity, including collections, visit numbers, and relative value units (RVUs) will be discussed and evaluated. Participants will have the opportunity to review, analyze and critique two years of experience with a field-tested program.

At the conclusion of the workshop, participants will be able to: 1) define performance responsibilities and expectations for faculty, 2) establish a market-based productivity benchmark using national norms, 3) define educational efforts in terms of work RVUs, 4) link salary to performance, 5) implement work RVU as measure of productivity, and 6) establish a regular checks and balance system for accurate recording of performance activity.

Margie Andreae, Gary L. Freed, Div. of General Pediatrics, Univ. of MI, Ann Arbor, MI

Each year there are thousands of injuries and deaths in US hospitals from medication errors. These blunders cost millions of dollars and result in loss of public confidence in our health care system. Medication errors are the second most frequent and the second most expensive event causing liability claims. Errant orders on the inpatient unit and incorrect prescriptions in the ED and clinics are common. Physicians, nurses, pharmacists, students, manufacturers and even caregivers all share responsibility. Many errors are preventable. This workshop will focus on common sources of medical errors and ways to prevent them. Workshop leaders will discuss specific issues including:

Root cause analysis looking at systems issues rather than individuals
Moving toward non-punitive approaches to reporting errors
Developing teaching programs for housestaff and students
The role of the pharmacist - how can they help?
New technology-are computer systems useful? Are the programs affordable?
Creating multidisciplinary medication use process improvement teams
Approaching the family after a medical error - legal and ethical implications

Participants will be asked to share their ideas and experiences. It is hoped that participants will be able to develop a multidisciplinary program in their own institutions to reduce and manage medical errors.

S. Selbst,* S. Levine,* J. Gould,* B. Taylor,* J. Fein,# K. Osterhoudt# A.I. duPont Hospital for Children,* Wilmington, DE and Children's Hospital of Philadelphia#, PA

Asset Based Community Development (ABCD), a community building approach promoted by John McKnight and Jody Kretzmann, can be an important skill in community pediatrics. ABCD stresses identifying and mobilizing community assets to improve well-being. CATCH developed an educational curriculum to teach pediatricians the fundamentals of mobilizing communities. The Northern California CATCH Committee and the ABCD Institute presented this curriculum to pediatricians and their community partners with the support of Sierra Health Foundation.

The goals of this workshop are to introduce the CATCH curriculum, present ABCD concepts, and establish a basic framework for community building activities. This workshop includes an overview of the whole CATCH curriculum and presentation of two components: asset mapping and forming partnerships. In asset mapping, participants learn about the potential of associations and how to identify these untapped community resources for improving children's health. The participants then develop strategies to mobilize these community partners for a potential community-based project in the second session. The other components of the curriculum, setting goals and objectives and evaluating results, will be described in the overview.

Arnold Gold, Diane Littlefield, Carol Pandak and Richard Pan; Fremont-Rideout Health Group, Yuba City, CA; Center for Collaborative Planning, Public Health Institute, Sacramento, CA; Dept. of Community Pediatrics, American Academy of Pediatrics, Elk Grove Village, IL; UC Davis, Dept. of Pediatrics, Sacramento, CA.

Despite increasingly prevalent curricula on cultural sensitivity and awareness in medical school, there are no published descriptions of faculty development programs to prepare primary care educators to teach students this material in community settings. This workshop will describe and involve participants in a curriculum developed at the UMASS Community Faculty Development Center that teaches primary care physicians to incorporate cultural competence and patient advocacy into their office-based teaching activities. The curriculum is delivered in 3 modules presented to our community faculty during a faculty development series. Participants will be provided with a concentrated version of our three modules.

Participants will be oriented to the educational planning process (GNOME) developed at our institution. We will discuss how to assess the needs of students with regard to cultural sensitivity, using an interactive format and videotaped examples. Teaching methods that assist with attitudinal objectives including collaborative and facilitative teaching styles, self-reflection and role modeling will all be emphasized. After a short break, 4 specific strategies that facilitate the development culturally competent students will be reviewed: the Patient-Centered Interview; the Social Review of Systems; the LEARN negotiation technique; and use of the community as teacher. Following a large group video demonstration role-play, participants will then break out into small groups. Teaching case vignettes that emphasize needs assessment, attitudinal objectives and teaching skill objectives will be role-played in the small groups, and discussed. Finally, we will reconvene to present workshop evaluation data and discuss ways in which this curriculum could be adapted to their home institution.

D. M. Keller, W. J. Ferguson. Departments of Pediatrics and Family Medicine/Community Health, UMASS Medical School, Worcester MA

The Human Genome Project is impacting every aspect of medicine. Dr. Craig Venter, President of Celera Genomics, one of the chief architects of this venture, will discuss the accomplishments of the human genome project and implications for future impact on health and disease in this special one-hour state of the art lecture.

Sequencing the Human Genome
J. Craig Venter, President, Celera Genomics, Rockville, MD

Supported in part by an educational grant from the Columbus Children's Hospital, Columbus, OH