Practical Medicine:

A monthly interdisciplinary lecture series

Sara Sukalich, MD
This is a revision to the current monthly Riverside Methodist Hospital Interdisciplinary
Conference lecture series. The Kern six-step approach to curriculum development in medical
education was utilized.

Background
Riverside Methodist Hospital is a large independent academic medical center with
approximately 125 residents in five specialties (Internal Medicine, Family Medicine, Ob/Gyn,
General Surgery, and Transitional Year). All residents are expected to attend a monthly
conference held on a Tuesday from 7:15 am to 8:15 am. The meeting occurs in a large
conference room that can be either set up classroom style or with tables that can seat 6-8 to
accommodate small group discussions.
A Medical Education department-wide lecture series is documented as far back as 2001. For 9
years the lectures were held weekly at noon on Fridays but over the past three years they
occurred monthly. It is likely that the initial impetus for the lectures was to address some of the
more nebulous ACGME competencies (i.e. practice-based learning and systems-based
practice).
In the earliest documentation of the weekly series it was written that, this series provides a
regular review of ethical, socioeconomic, medical/legal, cost containment, professional
development, and communication issues, while addressing Geriatrics, Economics of Medicine,
Preparation for Practice, Quality in Medicine, Radiology, and Behavioral Medicine. The first
course director of the monthly series included topics such as sleep deprivation, resident as
teacher, health disparities, and core quality measures. Topics covered in the current academic
year include: Resilience and impairment, resident as teacher, error disclosure, professionalism,
learning styles, contracts, communication skills, conflict management, quality improvement
initiative, generational gap, and a few others.
Key problems with the current curriculum include: lack of explicit goals and objectives for the
curriculum, conference planning driven by speaker availability rather than topic suitability,
inconsistent use of interactive, adult-learning methodologies and lack of an evaluation tool.

Problem identification
There are limited opportunities for all learners to come together for educational experiences (or
otherwise). There is benefit in having interactions with peers in other specialties as it builds
collegiality and breaks down communication barriers between departments.
There are topics in medicine that are of interest to all specialties that could be presented at a
single interdisciplinary conference (rather than at different times to multiple groups) which would
be a good use of resources.

Needs assessment
In December of 2014 during the monthly lecture the residents were asked to submit suggestions
for topics for the lecture series in the next academic year. Sixty five responses were received.
The suggestions clustered roughly into five areas: personal well-being, business of medicine,
quality improvement/patient safety, communication, and miscellaneous.

Personal

Business

Quality/safety

Self-care tips

Insurance (2)

Sleep
deprivation (2)
Healthy lifestyle
(2)
Stress relief (2)

Contracts and
negotiation (7)
Financial
planning (3)
Job search (5)

Quality
improvement (6)
Lean

Burn out
avoidance

Loan repayment
(3)
Hospital
rankings
Politics and
medicine
Law and
medicine
Billing/coding (2)

Patient safety
Health care
disparities
Cost effective
medicine

Communicatio
n
Patient
communication
Interpersonal
skills
Leadership
development
Patient
satisfaction
Difficult
diagnosis
Interdisciplinary
teams
Handoffs

Misc.
Medical topics
(2)
Speaker from
ER
Hospital updates
(2)
Updates about
residencies
Resident led
lectures
Learning styles
(2)
Electronic health
record
Med Ed
research

The program directors were queried regarding topics of interest and limited feedback was
received other than it is helpful to have some of the ACGME competencies addressed and that
practical topics, such as coding and business, are useful.

Goals and objectives

1. Create an opportunity for all residency programs to come together for interdisciplinary
education and interaction.
2. Address high-yield topics that focus on practical aspects of medicine and that are align
with self-identified areas of interest by key stakeholders.
3. Create educational experience that lead to active participation by the trainees and create
opportunities for questioning.
4. Utilize an evaluation tool that allows for continued refinement of the lecture series.
Educational strategies
Adult-learning theory should guide teaching at the postgraduate level. Briefly, Dennick (2012)
recommends incorporating constructivist, experiential and humanistic learning theories into

medical education teaching This foundation could be useful for this lecture series by using
group work and active learning techniques (constructivist learning theory), experiential
opportunities (experiential), and emphasizing the learner-teacher relationship (humanistic).
Generational differences need to be considered when teaching todays millennial cohort.
Millennial learners have been surrounded by technology for most of their lives and traditional
lectures will not capitalize on their learning preferences. Eckleberry-Hunt and Tucciarone (2011)
state that when lectures are used, they should incorporate multimedia presentations or bring in
live patients for case discussions with audience participation (p 458). Active participation should
be built into the proposed lecture series.
Another way to engage learners is to add questioning strategies. According to Jonassen (2011),
problem solving is enhanced when learners add questions and the quality of questions
increases with better understanding. He states that, questioning prompts help students to
monitor and regulate the problem-solving process (p 291). To add this scaffolding method to
the lecture series, speakers could be given guidelines for how to add questions to their
presentations and be provided with examples.
The following strategies will be utilized: splitting groups by PGY year at times to more closely
target groups with different educational needs, mixing of the different residency groups to
encourage collaboration, setting the room with tables for small group work, encouraging
speakers to utilize active methods of teaching (e.g. small groups, audience-response,
questioning, etc.), and inclusion of technology.

Implementation
This lecture series would be implemented in July 2015 (the third Tuesday of each four-week
block, no lecture in December or June). The proposed schedule is as follows:
Block 1
Block 2
Block 3
Block 4
Block 5
Block 6
Block 8
Block 9
Block 10
Block 11
Block 12

Quality/Safety topic #1 (Communication)

PGY1: Stress/Resilience PGY2-5: Resident as teacher/leader
PGY1: Learning styles PGY2-5: Life after residency (job search, interviewing)
Coding: Applying ICD-10
Quality/Safety topic #2 (Core measures, score cards)
Self-care
Financial planning (loans, insurance)
Politics and Medicine (malpractice)
Joint topic with faculty development series
Quality/Safety topic #3 (population based healthcare management)
PGY1&Chiefs: Resident as teacher/leader PGY2-4: Contracts/negotiations

Evaluation and feedback

The program directors will be asked to provide feedback about the proposed lecture topics.
An evaluation tool will be given to the residents to allow speakers to receive feedback and also
to help the course director make changes to the curriculum in the future.
Tentative evaluation tool:

5 point Likert scale from strongly agree to strongly disagree

1.
2.
3.
4.
5.
6.
7.
8.
9.

The presentation was well organized

The presenter was well prepared
The presenter communicated clearly
The presenter demonstrated expertise regarding this topic
Audiovisuals (slides, videos, etc.) enhanced the presentation
There was an opportunity to practice using a new skill
There was sufficient time for discussion and questions
The content today was relevant to me as a resident
The presentation should be kept in the lecture series

References
Dennick R. Twelve tips for incorporating education theory into teaching practices. Medical
Teacher 2012;34:618-624.
Eckleberry-Hunt & Tucciarone J. The Challenges and Opportunities of Teaching Generation Y.
Journal of Graduate Medical Education December 2011:458-461.
Jonassen DH. Learning to Solve Problems: A handbook for designing problem-solving learning
environments. New York: Routledge, 2011.
Kern DE, Thomas PA, & Hughes MT. Curriculum Development for Medical Education, 2nd
Edition. Baltimore: Johns Hopkins University Press, 2009.