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WIsconsin CARES Program Aims

WIsconsin CARES describes our program’s priorities, each aligned with our values and literature-derived medical education principles. These priorities underpin our teaching philosophy and methods. We believe residency should focus on learning skills to foster:

  • Wellness of our residents is of paramount importance as we coach them toward self-care, finding meaning and purpose, mindfulness, resilience, having a growth mindset, gaining control over time and emphasizing the integration of personal and professional life.
  • Identity development is promoted by applying the principles of self-reflection, social cognitive theory, transformational and significant learning, professionalism, self-efficacy and living an undivided life.
  • Career Development is promulgated by mentorship, role modeling and preparing learners to achieve and succeed in their next position.
  • Achievement of clinical excellence to provide patient-centered care is realized through: deliberate practice, competency based education, situational and experiential learning, progressive responsibility and scaffolding learning in alignment with each resident’s zone of proximal development, interprofessional teamwork, leadership and relationship centered care.
  • Recruit broadly, so that we have a richer learning environment with a diverse set of learners.
  • Environment of respect, kindness and professionalism is essential to our learning climate and interprofessional education.
  • Support Faculty Educators is key for role modeling lifelong learning, faculty development and valuing the faculty’s strong support of our residents.

Each aim is described in more detail below, including the education principles underpinning the aim, processes to achieve the aim, outcome measures, and innovation. Superscripts refer to references. To download a PDF table of WIsconsin CARES aims, click here: Downloadable PDF

Wellness

Education Principles Underpinning Wellness Aim

  • Meaning & Purpose1
  • Growth Mindset2
  • Mindfulness3
  • Resilience and Grit4
  • Positive work climate
  • Control over time
  • Access to and education on self-care and help-seeking

Processes to Achieve Wellness Aim

  • Learner-centered curriculum
  • Residency Wellness Group
  • Wellness periodical
  • Inclusive social events
  • Available support services
  • Learner-directed pathway
  • Fatigue management curriculum
  • Self-care curriculum
  • Faculty Development
  • Learning environment (climate) enhancement

Outcome Measures

  • Evaluations of rotations & attendings
  • Focus groups
  • Town hall discussion
  • Wellness events are monthly
  • Year-end survey
  • Validated survey results (burnout, depersonalization, emotional exhaustion)

Innovation

  • Empathy Course: self-care curriculum
  • Screening and training faculty supervisors as role models
  • Department-wide professionalism doctrines

Identity development, Internally directed learners, Integration of Personal and Professional Life

Education Principles Underpinning Aims

  • Critical reflection skills5
  • Professionalism6,7
  • Fostering Identity Development7–9
  • Self-Efficacy10
  • Undivided life11

Processes to Achieve Aims

  • Role models assigned as supervisors
  • Critical reflection exercises
  • Conferences explicitly demonstrating meeting and purpose

Outcome Measures

  • Semiannual review critical reflection skills
  • Reflection demonstrates internally directed and growth mindset thinking

Innovation

  • Professional identity development curriculum
  • Semi-annual review and coaching
  • Conferences celebrate meaning and positive effects of care

Career Development (Prepare learners for their next position)

Education Principles Underpinning Career Development Aim

  • Deliberate practice12
  • Meaning & Purpose1
  • Mentorship13
  • Scaffolding14
  • Significant Learning15

Processes to Achieve Career Development Aim

  • Coaching, Commitment to Change (CTC), Individualized Learning Plans (ILPs)
  • Research & education electives
  • Learner-Directed Pathways (LDPs)
  • PC and Research Tracks
  • Faculty Development

Outcome Measures

  • Positions obtained
  • Feedback from next supervisor
  • Grad survey
  • Learner use of LDPs and tracks
  • Critical Reflection Skills
  • Program metrics
  • Pubs and abstracts

Innovation

  • Second continuity clinic
  • Expand electives
  • Speed Workshop for Interns and Faculty to Talk about Research (SWIFT)
  • Commitment to Change (CTC) and Individualized Learning Pathway (ILP) processes
  • The Education Academy for Clinical Housestaff (TEACH) Pathway
  • Primary Care (PC) track
  • Internal Medicine Pathway for Academic Career Training (IMPACT) Physican-Scientist Pathway

Achievement of clinical excellence (Develop knowledge, skills, attitudes and behaviors (KSABs) to provide, professional, patient-centered care)

Education Principles Underpinning Clinical Excellence Aim

  • Deliberate practice12
  • Situational learning13
  • Progressive responsibility aligned w/ zone of proximal development14
  • Experiential learning16
  • Transformational learning17
  • Competency based evaluation18
  • Social Cognitive Theory19
  • Interprofessional team work20
  • Relationship Centered Care21
  • Leadership22

Processes to Achieve Clinical Excellence Aim

  • Coaching, Commitment to Change (CTC), Individual Learning Plans (ILPs)
  • Multimodality curriculum
  • Humanism, empathy, communication, professional identity development, self-care curriculum
  • Quality Improvement (QI)/patient safety program
  • Simulations, Role play
  • Critical reading program
  • Implicit bias training
  • Simulations
  • Workshops/Retreats
  • Faculty Development
  • Diverse clinical experiences across three hospitals, community, VA and academic and pts from urban and rural backgrounds with primary and tertiary needs

Outcome Measures

  • Evaluations: Patient, peer, faculty, team, summative
  • ITE and Board results
  • Learner portfolio artifacts
  • Reporting and curricular milestone achievement
  • Individual practice metrics
  • Projects completed and implemented
  • Learner self-evaluation and reflection

Innovation

  • Humanism, empathy, communication, professional identity development, self-care curriculum
  • QI/patient safety program
  • Implicit bias training

Recruit broadly

Education Principles Underpinning Recruitment Aim

  • Richer learning environment with diverse set of learners23–25

Processes to Achieve Recruitment Aim

  • National invites
  • Additional value for research and education scholarship, community and school service
  • Careful review of background experiences

Outcome Measures

  • Interns with:
  • Geographic and school diversity
  • Gender Diversity
  • Background diversity
  • Experience diversity (e.g., community, school service, research, teaching, life experiences)

Innovation

  • Increase exposure to role models & mentors to whom learners can relate
  • Expanded curriculum in humanism/empathy/personal-career development
  • Expand The Education Academy for Clinical Housestaff (TEACH) Pathway
  • Expand Internal Medicine Pathway for Academic Career Training (IMPACT) Physician-Scientist Pathway
  • Strengthen Primary Care track
  • Strengthen Learner-Directed Pathway (LDP)

Environment of respect, kindness and professionalism

Education Principles Underpinning Aim

  • Meaning & Purpose1
  • Growth Mindset2
  • Psychosocial Identity Development26
  • Feeling valued
  • Inclusivity and voice
  • Equity

Processes to Achieve Aim

  • Learner-centered curriculum
  • Learner-directed pathway
  • Self-care
  • Faculty Development

Outcome Measures

  • Evaluations of rotations & attendings
  • Focus groups
  • Town hall discussion
  • Wellness events
  • Year-end survey
  • Data from validated instruments assessing Empathy and Self-Compassion

Innovation

  • Empathy Course: Professional identity development & self-care curriculum
  • Screening faculty supervisors as role models
  • Department-wide professionalism doctrines

Support Faculty Educators

Education Principles Underpinning Aim

  • Lifelong learning
  • Faculty development
  • Valuing faculty

Processes to Achieve Aim

  • Workshops to improve skills of all faculty teachers
  • Mentorship and faculty advisor programs to coach future educators
  • Leadership skills training
  • Program development and curriculum training
  • Education scholarship training

Outcome Measures

  • Innovations and new curriculum development
  • National presence and leadership of our faculty
  • School of Medicine and Public Health (SMPH_ leadership roles of our faculty
  • Publications and presentations in regional and national venues

Innovation

  • Department of Medicine grants for innovation
  • Department of Medicine grants for faculty development
  • The Education Academy for Clinical Housestaff (TEACH) Pathway for residents, fellows and faculty
  • Masters in Adult (ELPA) or medical education

References

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  2. Dweck CS. Mindset: The New Psychology of Success. New York: Ballantine Books; 2008.
  3. Kabat-Zinn J, Hanh TN. Full Catastrophe Living (Revised Edition): Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. Rev Upd edition. New York: Bantam; 2013.
  4. Duckworth A. Grit: The Power of Passion and Perseverance. First Scribner hardcover edition. New York: Scribner; 2016.
  5. Schön DA. Educating the Reflective Practitioner. San Francisco: Jossey-Bass Publishers.; 1986.
  6. Blank L. Medical Professionalism in the New Millennium: A Physician Charter 15 Months Later. Ann Intern Med. 2003;138(10):839. doi:10.7326/0003-4819-138-10-200305200-00012.
  7. Cruess RL, Cruess SR. Teaching professionalism: general principles. Med Teach. 2006;28(3):205-208. doi:10.1080/01421590600643653.
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  9. Cooke M, Irby DM, O’Brien BC, Carnegie Foundation for the Advancement of Teaching. Educating Physicians : A Call for Reform of Medical School and Residency. San Francisco, CA: Jossey-Bass; 2010.
  10. Pajares F. Self-Efficacy Beliefs in Academic Settings. Rev Educ Res. 1996;66(4):543-578. doi:10.3102/00346543066004543.
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  21. Beach MC, Inui T, and the Relationship-Centered Care Research Network. Relationship-centered Care. A Constructive Reframing. J Gen Intern Med. 2006;21(S1):S3-S8. doi:10.1111/j.1525-1497.2006.00302.x.
  22. Bolman LG, Deal TE. Reframing Organizations : Artistry, Choice, and Leadership. San Francisco: Jossey-Bass; 2008.
  23. Nemeth CJ. Minority dissent as a stimulant to group performance. In: Worchel S, Wood W, Simpson JA, eds. Group Processes and Productivity. ; 1992.
  24. Pascarella ET, Terenzini PT. How College Affects Students: Findings and Insights from Twenty Years of Research. 1st ed. San Francisco: Jossey-Bass Publishers; 1991.
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