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HCPro.com
Residency Program Alert | 5
February 2020
© 2020 HCPro, a Simplify Compliance brand.
Somehow they’ve heard through the grapevine about
the new evals and have wanted to start using them over
the prior evaluations. That is signicant for us because
it helps us know that this is something other people are
appreciating even outside our core faculty group.
Moving forward our plan is to start formally reach-
ing out to all the subspecialties about the option of
using our new evals over the old system. We like this a
lot, and we think it’s denitely been better than the old
system.
RPA : Do you have any advice for other programs
who want to try a similar assessment system?
Rayl: You have to get faculty buy-in. If you start
this project and say you want to change something but
your core faculty aren’t on board, your chances of
success are pretty slim. And from there, take a real
hard look at your old system. Are you actually getting
meaningful data? Are you getting comments that are
actually helpful, or are you just getting 7 out of 10s on
all of these things and it’s not even useful—and why are
we even asking faculty to do things that we don’t even
nd useful? So nding out how to get buy-in from the
rest of the core faculty is incredibly important.
Dr. Tatar mentioned that the culture is starting to
change; their residents are starting to realize not only
that they’re going to be evaluated, but also the benets
of being directly observed by faculty. And part of the
culture has been utilizing Google Forms, with the
ability to immediately send the eval to the resident and
the advisor.
Before, the residents didn’t even know when or if
they were being evaluated, and only went searching for
evaluations if they suspected someone had rated them
poorly. Otherwise, they were never actually learning
anything from their observations. Now, with the chang-
ing culture, they want to read the live email that’s sent
to them because they know the content of their evals is
actually going to be useful for them.
RPA : Anything else you’d like to add?
Rayl: There’s one thing I think people get anxious
about, and it’s Google. I think addressing that out of
the gate is probably important, which is why we say you
could honestly use any survey tool you want. Some
institutions hate Google because they think you’re
going to share patients’ protected information. We have
faculty review all of our evals—we’re well over 570—
and none of them have included patient health informa-
tion. We have core faculty monitoring that, but that’s a
potential barrier that people are going to have to
address.
If your institution hates Google, then maybe gure
out if this is doable on some other platform. Is there a
platform your hospital allows for surveys that you can
also use? That may just be a good place to start. For us
with Google, we use it on mobile phones and personal
laptops instead of on the hospital computers. Our
approach to allowing Google in was by building up a
base—we’ve had so many evals—and then asking the IT
department to open up just this form. There’s no real
need to put patient health information in the eval; it’s
just how is the resident doing in general with the
patients. If someone is going to take a negative stance
up front with the project, it’s probably actually going to
be that, because there’s some big systems against
Google. But I would really hesitate to just say no to the
idea just on that basis alone. I would try to gure out
how to work around that.
Also, if anyone wants to see a sample of the eval,
they can go to DirectObs.com and it has an exact parallel
of the system we actually use in our hospital. People can
go there and play around with it to see if it’s something
they actually want. We’re more than happy to share the
tools we’ve created and used to help people get off the
ground if that’s something they would like.
Diversifying your GME program
by Deepak Gupta, MD, anesthesiology clinical assistant professor,
Wayne State University, Detroit; and Sarwan Kumar, MD, internal
medicine assistant professor, Wayne State University, Detroit
According to ACGME Common Program Require-
ments I.C., sponsoring institutions and programs must
have policies and procedures in place to recruit and
retain a diverse workforce, including residents, faculty,
and administrative staff. An exploration into diversity
in GME requires understanding what it is.
The call for diversity aims at achieving a demo-
graphic environment inside similar to the demographic
environment outside. How nature innately creates
demographic environments outside can never be
understood completely. However, every human-made
environment (HME)—especially workplace environ-
ments based on arts, science, commerce, entertainment,
or sports—is warranted to evolve its demographic
HCPro.com
6| Residency Program Alert February 2020
© 2020 HCPro, a Simplify Compliance brand.
situation inside to closely correlate with the demo-
graphic environment outside. The instinct to succeed
forces each HME to constantly adjust its demographics
to ensure its survival and even excellence, but these
adjustments are monitored and regulated to prevent the
HME from completely losing its diversity correlation
with the environment outside.
The diversity inside an HME can only aspire to
match the diversity that is immediately outside of it
when one considers the local prominent and unique
factors the HME faces compared to the mitigating
global factors affecting that HME.
Consider when a GME program aims to diversify. It
may have to just ensure that the diversity in its ranked
recruits correlates strongly and positively with the
diversity of its eligible applicants. In a nutshell, the
perfect diversity score will be when this correlation
coefcient is +1 and the perfect bias score will be when
the correlation coefcient is -1.
Diversity scores can be specic to age, gender, race,
ethnicity, and place of origin. So to ensure that the
applicant pool is as diversied as each GME program’s
feeder medical schools, each GME program can
proactively advertise its diversication efforts to meet
its diversity target (i.e., an approximation to its feeder
medical schools’ diversity) by transparently document-
ing those efforts on its website.
This initiates a chain of events that may lead to
medical schools diversifying their applicant pools to
approximate their feeder colleges’ diversity. In turn,
those colleges may diversify their applicant pools to
approximate their feeder school districts’ diversity. This
would eventually achieve GME programs’ diversity
targets, ensuring the programs correlate with the
diverse local, regional, state, and national populations
being catered to and served.
To ensure diversity with these processes, the eligibility
parameters for applicants as designated by each GME
program’s requirements may have to be disclosed on the
program’s website for transparency of the screening
process. Subsequently, standardized review of screened
applicants meeting the eligibility parameters should ensure
the reviewers are blinded regarding applicants’ name, age,
gender, race, ethnicity, place of origin, and other self-iden-
tiers before invitations for interviews are sent. Moving
forward, for the sake of transparency, the standardized
interview questions can be disclosed beforehand to the
interviewees. This is because the interpretations of these
disclosed questions, along with the presented responses by
each interviewee, will still be as unique as each interview-
er’s evaluations of an interviewee’s responses.
Further, as it may be difcult to overcome preju-
dices and biases, diversication among recruits may be
better achieved by also diversifying interviewers along
the lines of age, gender, race, ethnicity, and place of
origin. A diverse recruitment force of associate pro-
gram directors, faculty, residents/fellows, residency/
fellowship coordinators, and staff can condentially
rate interviewees on a numerical scale of predeter-
mined potential recruit characteristics.
GME program directors can then consider correlating
their own condential scores with their diverse recruit-
ment force’s cumulative scores for each interviewee. By
doing this, the need for open-forum subjective discussions
about ranking each interviewee can be relinquished in
favor of objectively correlated cumulative scores.
We have discussed improving diversity because
each one of us has a unique perspective about others as
predetermined by our unique life experiences, which
are shaded by our gender, race, ethnicity, and place and
era of origin. Each one of us may see ourselves as the
centers of our perceived universes, but having a diverse
environment can help us acknowledge and respect each
other’s perspectives.
It’s time for healthcare organizations
to take ownership of burnout
by Megan Headley, from Patient Safety and Quality Healthcare
magazine
The World Health Organization has recently dened
burnout as an ofcial medical diagnosis, explaining it as
a syndrome that results “from chronic workplace stress
that has not been successfully managed. It is character-
ized by three dimensions: feelings of energy depletion or
exhaustion; increased mental distance from one’s job, or
feelings of negativism or cynicism related to one’s job;
and reduced professional efcacy.”
According to Laura Hamill, PhD, chief science
ofcer and chief people ofcer for the Limeade Insti-
tute, an evidence-based research rm, since the prob-
lem of burnout is unique to the workplace, the responsi-
bility of solving it should fall squarely on the
workplace’s shoulders.