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Leisa Oglesby, the executive director of Medical Services and designated institutional official at LSU Health Shreveport, joins to share best practices for engaging residents in graduate medical education. Plus, ways to support resident well-being and the transition from medical school to residency. AMA Chief Experience Officer Todd Unger hosts.
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- Leisa Oglesby, executive director, Medical Services; designated institutional official, LSU Health Shreveport
Unger: Hello and welcome to the AMA Update video and podcast. Today, we're talking about the best practices to engage residents in their training around how to deliver safe, equitable, high quality medical care. I'm joined today by Leisa Oglesby, the executive director of medical services and designated institutional officer at LSU Health Shreveport in Louisiana. I'm Todd Unger, AMA's chief experience officer in Chicago. Leisa, it's a pleasure to have you today.
Oglesby: Thank you, Todd, for having me.
Unger: Well, every institution has to ensure that its residents meet the ACGME Common Program Requirements. And every institution takes a slightly different approach. Let's start talking about you and your institution and how you're currently doing it at LSU Health Shreveport.
Oglesby: Currently, we actually have it broken down into a curriculum for the first, second and third years. And that's whether it is a first, second, third year and fellowship or in residency. And there are nine modules—I'm sorry, eight modules—they have to complete as PGY1's, or the first year of fellowship. There's nine in the second year and then seven in the third year. And then the other additional modules can be appointed or assigned at the program director's discretion.
Unger: Now, there's a lot to learn. And you have only so many resources in the program. The question is—how do you supplement that work? One of the things we talked about prior to getting on the discussion here is the AMA GME Competency Education Program. Your institution happens to rank among the highest in terms of course completions for the program this year. We want to know what the secret is. How have you been able to get the residents so engaged with online courses from that platform?
Oglesby: Last year, we actually reviewed the compliance with how we had assigned the modules. And we had a subcommittee of the GMEC—our program directors—review. And it was comprised of both resident and fellowship program directors to give us input in how they felt like we should be assigning it—how we should be monitored it and reporting it. And they came up, I think, with some real valuable ideas, which we implemented, and GMEC approved.
And that was assigning specific curriculum to the first, second and third year, whether you're here as a resident or a fellow. And we also—we used to monitor it through the annual program evaluations that we do as an institution. And we changed that, where we put the deadline for completion as December, the 31st, of each year. And also, we report the results of that monthly to GMEC. That has been—
Unger: Do most of those course completions then happen on December 30?
Oglesby: Yes. Yes. By December 31, everybody has to be 100% complete. And that's not only residents, fellows, but also faculty, with the five faculty modules that they're assigned.
Unger: Now, you've really succeeded in some specific places in graduate medical education in topic areas like health equity, professionalism and resident well-being, which is not easy. What are some of the challenges that you've encountered along the way, either engaging in this, or just getting residents to engage with a platform like this?
Oglesby: I think, sometimes, we are heavily assigning modules. And I think we have to be very careful about the number of modules that we assign residents to make them make sure that they are—number one, that they can apply the principles that are taught in those modules to everyday life and in their residency, but also that the program director can also make sure that those requirements that are assigned to each program are also covered in the—we commonly—we nicknamed it AMA GCEP.
So that's how you'll hear us talk about it—is—that's why, if anybody ever asks, I hope they'll say AMA GCEP because they'd probably say, what is that? So anyway—and we have found it to be extremely beneficial in helping us meet all of the requirements.
Also, if you'll remember, a lot of those are also included in the resident survey and fellow survey that's assigned by ACGME. And, with us having the modules due in December, that's why we wanted to make sure they were fresh on the resident and fellows' minds—that, yes, we have had education regarding these topics.
Unger: Do you have any advice for other program leaders who might be struggling with similar obstacles to getting at least those required courses completed?
Oglesby: I would say the best thing that we did was last year, after—because we had implemented the program several years ago. And, last year, we decided—I asked—when I brought it to GMEC I asked for their input into—how do we want to revise this? How can we make it most successful for the programs? And I think that assigning that to the program directors as a subcommittee for them to bring back recommendations was probably the most important thing we could have done. So ask me in December. This will be our first year. So I do believe we'll be 100%.
Unger: Oh. It looks like your changes are really going to pay off then. Leisa, one of the things that I had a chance to do last week was attend the AMA MedEd conference that was here in Chicago. And a lot of the focus there is about the identification and meeting the gaps that we see in physician training from the transition from medical school to residency. Can you tell us just one way that you support your first year residents, in particular, in that transition period?
Oglesby: Well, one of the things we do are in—the modules that we assign that first year, I think, are important because they include building the patient-physician relationship, patient handoffs, resident intimidation, residents as teachers, privacy and confidentiality, working effectively with an interprofessional team, promoting medication adherence, and racism in medicine.
And I think those really help us. But we also started several years ago—which has been probably the most successful in helping medical students transition to residency. And we have what we call process groups. And we have them meet with a counselor once a month. And it is on team building, and also covers the difficulties and the challenges they have in transitioning from medical students to real MDs, as we call them.
Unger: That's great. Well, for my final question, I want to talk to you a little bit about your thoughts on physician burnout. A new AMA report showed that over 2 of 5 residents are feeling burnout. And, from an education standpoint, how do you think that institutions can equip residents with the skills to manage their well-being as they transition into practice?
Oglesby: Number one—I would love it if the AMA GCEP modules would start including a series of well-being. I think that would help in looking at what they could do in first year, second year, third year in using some resiliency training. But, for us, we do things as an institution. We also have the tool that we are required through the ACGME requirements to offer residents—the screening tool.
We actually require them to do that at their semi-annual evaluation. The results are anonymous. However, they are able to print out a certificate to show that they have completed it. So, when they go for their semi-annual evaluation, they share that with the program director, and it reminds the program director—or prompts them—to discuss their specific well-being. The second thing we did was, in our annual program evaluations of each of the programs, we ask that they give us examples of what they have done. And it seems like one of the things most successful in the programs is that they appoint or elect a social or well-being chair for their own program.
Unger: Leisa, thank you so much for joining us. Your advice has been great. And it sounds like the AMA GME Competency Education Program, or GCEP, as you and we call it for short, has been a benefit for your institution and your residents. If those of you out there would like to learn more about AMA's GME Competency Education Program, you can find out this at ama-assn.org/gme-program. We'll be back soon with another AMA Update. In the meantime, you can find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us today and please take care.
Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.