Educational Retreat Research Articles

570-P: Empowering Wellness through a Diabetes Education Retreat

570-P: Empowering Wellness through a Diabetes Education Retreat

“Catholicism Is Getting to Be the Style”: White Women and the Making of Catholic Culture at the Catholic Summer School of America, 1892–1914

ABSTRACTThis article presents a new account of the Catholic Summer School of America (CSSA), founded in 1892 as the “Catholic Chautauqua.” Long relegated to the footnotes of book history and Catholic studies, the Summer School and its reading circle antecedents are here reclaimed for the study of women and American religion. As a Catholic institution, the Summer School was directed by clergy and laymen; men's names fill the published histories of the site as a religious and educational retreat. I argue, however, that it was Summer School women who nurtured a complementary vision of middle-class respectability and intimate association among a white Catholic elite that promoted theirs as the aspirational and ascendant U.S. Catholic “style” at the turn of the new century. Loosened from their parish boundaries, these summer Catholics traveled north to New York's Adirondack region and converged on the lakefront, lecture hall, and ballroom, extending their social networks, and creating an exclusive space of belonging that distinguished themselves from the diverse “immigrant church” at home. With close readings of the traces that Summer School visitors left behind in visual and textual sources—including photographs, postcards, local newspaper reports, and previously overlooked fiction and nonfiction by Catholic women writers—I draw attention to the Summer School during its first decades as a critical site for studying an upwardly mobile white Catholic leisure class concerned with its social and cultural reproduction.

University of Massachusetts Medical School.

University of Massachusetts Medical School.

A Faculty Development Graduate Medical Education Retreat to Teach and Address Social Determinants of Health.

Background:Social determinants of health (SDH) account for a large percentage of health outcomes. Therefore, ensuring providers can address SDH is paramount yet curricula in this area is limited.Aim:The authors aimed to raise awareness, identify learning opportunities, foster positive attitudes, and equip educators to implement SDH curriculum.Setting and participants:This retreat occurred at a large academic institution and had over 130 participants who represented 56 distinct training programs and over 20 disciplines.Program description:The retreat was titled “Social Determinants of Health: Walking in Your Patients’ Shoes.” The retreat was holistic and used a multidimensional approach that included traditional learning, team-based learning, reflective practice, and prompted action.Program evaluation:The evaluation of this retreat included electronic surveys and both qualitative and quantitative data. The retreat’s quality and effectiveness at improving participants’ knowledge and skill in addressing SDH was highly rated and resulted in numerous programs, including surgical and subspecialty programs reporting adopting SDH curricular and clinical workflow changes.Discussion:The retreat was successful and reached a wide and diverse set of faculty educators and can serve as an education model to the graduate medical education community on how to start to develop “physician-citizens.”

Developing a Framework of Integrated Competencies for Adaptive Expertise in Integrated Physical and Mental Health Care

Phenomenon: Despite the emergence of the integrated care (IC) model, IC is variably taught and is challenged by current siloed competency domains. This study aimed to define IC competencies spanning multiple competency domains. Approach: Iterative facilitated discussions were conducted at a half-day education retreat with 25 key informants including clinician educators and education scientists. Seven one-on-one semistructured interviews were subsequently conducted with different interprofessional providers in IC settings within a Canadian context. Data collection grounded in patient cases with a physical illness and concurrent mental illness (medical psychiatry) were used to elicit identification of complex patient needs and the key medical psychiatry knowledge and skills required to address these needs. A thematic analysis of transcripts was performed using constant comparison to iteratively identify themes. Findings: Participants described 4 broad competency domains necessary for expertise in IC: (a) extensive integrated knowledge of biopsychosocial aspects of disease, systems of care, and social determinants of care; (b) skills to establish a longitudinal alliance with the patient and functional relationships with colleagues; (c) constructing a comprehensive understanding of individual patients’ complex needs and how these can be met within their health and social systems; and (d) the ability to effectively meet the patient’s needs using IC models. These 4 domains were linked by an overarching philosophy of care encompassing key enabling attitudes such as proactively pursuing depth to understand patient and system complexity while maintaining a patient-centered approach. Insights: The study addresses how development of IC expertise can be fostered by integration of individual IC competency domains. The findings align with previous research suggesting that competencies from existing frameworks are being enacted jointly in expert capabilities to meet the complex needs of patients, in this case with comorbid physical and mental health concerns.

Performance Assessment of Pharmacotherapy: Results from a Content Validity Survey of the Psychopharmacotherapy-Structured Clinical Observation (P-SCO) Tool.

The Psychopharmacotherapy-Structured Clinical Observation (P-SCO) tool is designed to assess performance of a medication management visit and to enhance feedback. Prior research indicated that the P-SCO was feasible to implement in a resident clinic and generated behaviorally specific, high-quality feedback. This research also highlighted problems with some of the instrument's items. This study seeks to improve the items. The authors initially revised the P-SCO items based on the problems identified by a prior study. Next, these items were iteratively modified by experts in clinical pharmacotherapy and educational assessment. Forty-five items emerged. Finally, faculty attending an annual department education retreat rated each item on its relevance (4-point scale) and provided comments on how the item might be revised. For final inclusion, an item must have met a quantitative threshold (i.e., content validity index equal to or greater than 0.8 and the lower end of the asymmetric confidence interval equal to or greater than 3.0) and received comments that were supportive. Forty-one of the 45 items had strong quantitative support. However, the comments endorsed lumping a number of items in order to decrease overlap between items and to shorten the instrument. This process resulted in the further elimination of 15 items. The revised 26-item P-SCO builds upon prior evidence of feasibility and utility and now possesses additional evidence of content validity. The use of the tool should enhance feedback and improve the capacity of educational programs to assess performance.

Peer coaching for nurse managers.

Peer coaching for nurse managers.

Engagement in a program promoting lifestyle modification is associated with better patient-reported outcomes for people with MS.

There is increasing interest in patient-centered approaches to chronic disease management and prevention. For people with multiple sclerosis (PwMS), patient empowerment plays a role in improving a range of health-related outcomes. This study aimed to compare health-related quality of life (HRQOL), fatigue, and depression risk between people who have and have not attended a week-long physician-led residential educational retreat or accessed other self-help resources (a book and online content) that foster patient empowerment including the adoption of healthy lifestyle behaviors. PwMS were recruited to the study using online platforms and asked to complete a comprehensive online survey. Data from 2,233 respondents were analysed. Bivariate results indicated that PwMS who had attended a retreat (n = 247), read the associated book (n = 1,167) or regularly visited online sites promoting lifestyle modification (n = 795), had better HRQOL and lower rates of depression and fatigue than those who had not. The depression risk among retreat attendees (8.6 %) was around half that of the whole sample. Regression analysis showed that, controlling for age and gender, compared to the highest level of engagement, no engagement with the resources was associated with nearly threefold higher odds of clinically significant fatigue, tenfold higher odds of depression risk, and physical and mental HRQOL scores 19.5 and 15.6 points lower, respectively. These results are congruent with previously reported post-retreat improvements in HRQOL, and strongly support a role for patient engagement in resources promoting lifestyle modification. Physicians should encourage more active involvement of PwMS in their own health care.Electronic supplementary materialThe online version of this article (doi:10.1007/s10072-015-2089-1) contains supplementary material, which is available to authorized users.

An educational forum to engage infectious diseases and microbiology residents in resource stewardship modelled after the Choosing Wisely campaign.

Rising costs present a major threat to the sustainability of health care delivery. Resource stewardship is increasingly becoming an expected competency of physicians. The Choosing Wisely framework was used to introduce resource stewardship at a national educational retreat for infectious disease and microbiology residents. During the 2014 Annual Canadian Infectious Disease and Microbiology Resident Retreat in Toronto, Ontario, infectious disease (n=50) and microbiology (n=17) residents representing 11 Canadian universities from six provinces, were invited to participate in a modified Delphi panel. Participants were asked, in advance of the retreat, to submit up to five practices that infectious disease and microbiology specialists should not routinely perform due to lack of proven benefit(s) and/or potential harm to patients. Submissions were discussed in small and large group forums using an iterative approach involving electronic polling until consensus was reached for five practices. A finalized list was created for both educational purposes and for residents to consider enacting; however, it was not intended to replace formal society-endorsed statements. A follow-up survey at two-months was conducted. Consensus was reached by the residents regarding five low-value practices within the purview of infectious diseases and microbiology physicians. After the retreat, 20 participants (32%) completed the follow-up survey. The majority of respondents (75%) believed that the session was at least as relevant as other sessions they attended at the retreat, including 95% indicating that at least some of the material discussed was new to them. Since returning to their home institutions, nine (45%) respondents have incorporated what they learned into their daily practice; four (20%) reported that they have considered initiating a project related to the session; and one (5%) reported having initiated a project. The present educational forum demonstrated that trainees can become actively engaged in the identification and discussion of low-value practices. Embedding residence training programs with resource stewardship education will be necessary to improve the value of care offered by the future members of our profession.

Interprofessional Education: Fad or Imperative

Interprofessional Education: Fad or Imperative

The Value of an Annual Educational Retreat in the Orthopedic Residency Training Program

Over the past decade, there have been major changes implemented at both surgical and nonsurgical residency training programs across the country. Much attention has been placed on the implementation and enforcement of the 80-hour workweek for residents, yet this is only 1 of many changes with which programs have been faced. One could argue that the more important changes have occurred in the manner in which residents are, and should, be trained. In a period that has seen an exponential rise in overall body of medical knowledge as well as the number of publications, surgical procedures, and available surgical products from industry, training residents today demands constant attention to the structured curriculum in place to train them. Across surgical specialties, there is a general concern of how to do more, or even the same, with less. Meaning, how can residency programs be expected to prepare future surgeons when there are limits in place that regulate how much time residents can spend not only in the hospital but also at residency sanctioned events, such as educational conferences, training laboratories, and journal clubs. These issues are not unique to any 1 program or surgical discipline and have been in the crosshairs of program directors and chairpersons for many years now. To help address these issues, and incorporate the perspective of the residents as well, our institution has implemented an annual educational retreat to address and reevaluate our curriculum and residency program and provide a critical selfevaluation of the way in which we train residents. An annual review of educational effectiveness is required by the Accreditation Council for Graduate Medical Education (ACGME) but there is little language on what exactly is expected of this review. Other nonsurgical training programs have pubished data with regard to the format and structure of the etreat used at their institution, but these data may not be pplicable to surgical specialties as well.

College 2.0: An Entrepreneurial Approach to Reforming Higher Education - Overcoming Barriers and Fostering Innovation (Papers from the Entrepreneurship in Higher Education Retreat, December 2011)

A far-reaching discussion is taking place in the United States about the challenges facing higher education and the possible forms postsecondary learning might take in the future. Notwithstanding the strengths of our best research institutions, the shortcomings of many U.S. colleges and universities are significant. There is growing evidence that they need to focus more effectively on student learning, improve completion rates, lower costs, make much better use of technology, boost productivity, improve delivery of instruction for nontraditional students, and take innovations to scale more quickly.To make this happen - and to provide brand-new alternatives to traditional models - a more entrepreneurial approach to postsecondary education is sorely needed. But even as a period of unusual ferment in U.S. higher education gets under way, numerous barriers continue to slow innovation and thwart experimentation, both in traditional institutions and in start-up ventures.In an effort to understand the nature of those barriers and to generate ideas for overcoming them, in December 2011 the Ewing Marion Kauffman Foundation convened a diverse group of analysts and practitioners for a two-day retreat in Palm Beach, Florida. Participants included Shai Reshef, founder of the University of the People; the management editor of The Economist; the founders of startups 2tor, Inc. and StraighterLine; senior leaders of nontraditional universities such as Olin College and Western Governors University; the president and CEO of Kaplan, Inc.; the directors of education policy at the American Enterprise Institute, the Brookings Institution, and the Center for American Progress; and professors who both study and participate in postsecondary reform initiatives.The gathering, part of the Kauffman Foundation’s Law, Innovation and Growth series, was organized into panels addressing six broad themes: Tackling Campus-Level Obstacles to Innovation; Rethinking Accreditation; Streamlining State and Federal Regulations; Improving Incentives to Boost Academic Productivity; Filling Information Gaps about Student-Learning and Job-Market Outcomes; and Overcoming Barriers to Taking Innovation to Scale. The aim was not to limit discussion to these issues, but simply to provide provisional categories that might foster wide-ranging conversation.Each participant prepared a short background paper and presentation linked to one of the retreat’s themes. The resulting essays are collected in this report, organized by theme. (A full list of authors can be found on page 7.) These thoughtful analyses offer a window into how a range of articulate thinkers and doers approach the question of what is wrong with U.S. higher education, and how it ought to be fixed.

Building a Rheumatology Education Academy: Insights from Assessment of Needs During a Rheumatology Division Retreat

To implement a rheumatology department education retreat to systematically identify and address the key factors necessary to improve medical education in our division in preparation for developing a rheumatology academy. The Hospital for Special Surgery organized a retreat for the Rheumatology Department aimed at (1) providing formal didactics and (2) assessing participants' self-reported skills and interest in education with the goal of directing this information toward formalizing improvement. In a mixed-methods study design, faculty and fellows in the Division of Rheumatology were surveyed online pre- and post-retreat regarding various aspects of the current education program, their teaching abilities, interest and time spent in teaching, divisional resources allocated, and how education is valued. Enthusiasm for teaching was high before and rose further after the retreat. Confidence in abilities was higher than expected before but fell afterward. Many noted that the lack of specific feedback on teaching skills and useful metrics to assess performance prevented the achievement of educational excellence. Most responding felt lack of time, knowledge of how to teach well, and resources prevented them from making greater commitments to educational endeavors and participating fully and effectively in the department's teaching activities. While most rheumatology faculty members want to improve as teachers, they know neither where their educational strengths and weaknesses lie nor where or how to begin to change their teaching abilities. The key elements for an academy would thus be an educational environment that elevates the quality of teaching throughout the division and promotes teaching careers and education research, and raises the importance and quality of teaching to equivalence with clinical care and research.

The RIPPER Experience: A 3 Year Evaluation of an Australian Interprofessional Rural Health Education Pilot

AbstractBackground: The Rural Interprofessional Program Educational Retreat (RIPPER) uses interprofessional learning and educational strategies to prepare final year Tasmanian nursing, medical, and pharmacy students for effective healthcare delivery. RIPPER provided students (n = 90) with the opportunity to learn about working in an interdisciplinary team using authentic and relevant situational learning. RIPPER allowed students to work and learn interprofessionally in small teams and to apply their different professional skills and knowledge to a variety of rural healthcare situations.Methods and Findings: This article reports on three years of results from the program’s evaluation which used a pre-post test mixed method design. The findings show a significant and positive shift in students’ attitudes and understanding of interprofessional learning and practice following their participation in RIPPER. The evaluation findings suggest the need for sustainable interprofessional rural health education that is embedded in undergraduate curricula.Conclusion: The evaluation of RIPPER suggests that exposure of healthcare students to interprofessional education can positively affect their perceptions of collaboration, patient care, and teamwork. The evaluation also points to the rural context as an ideal place to showcase elements of effective interprofessional practice.

Energising a faculty medical education retreat with liberating structures

Energising a faculty medical education retreat with liberating structures

Weill Cornell Medical College of Cornell University

Weill Cornell Medical College of Cornell University

Case Western Reserve University School of Medicine and Cleveland Clinic

Case Western Reserve University School of Medicine and Cleveland Clinic

Family Presence at the Bedside

“In Our Unit” highlights unique practices, innovations, research, or resourceful solutions to commonly encountered problems in critical care areas and settings where critically ill patients are cared for. If you have an idea for an upcoming “In Our Unit,” send it to Critical Care Nurse, 101 Columbia, Aliso Viejo, CA 92656; fax, (949) 362-2049; e-mail, ccn@aacn.org. The ICU team has embraced families and welcomed them at the bedside. We now have open visitation, so our families are integrated into the care of their loved ones. At Southern Ohio Medical Center in Portsmouth, Ohio, the intensive care unit (ICU) patient satisfaction team made a proactive choice to offer family presence during invasive procedures and cardiopulmonary resuscitation. In September 2007, a resuscitation team was formed consisting of 8 members, all registered nurses (RNs). In order to gain a better understanding of staff perceptions regarding family presence at the bedside, the project Family Presence During Resuscitation and Invasive Procedures was put together; the first phase of the project included a basic 5-item survey with answers measured on a 4 to 1 Likert scale. This survey was given to all ICU RNs, respiratory therapists, ICU physicians, pastoral care, unit clerks, nurse technicians, and security personnel. The survey questions were as follows: 1. Should family presence be permissible during simple procedures such as intravenous insertions? 2. Should family presence be permissible during phlebotomy? 3. Should family presence be permissible during all procedures, including central catheter insertions? 4. Should family presence not be permissible during any procedures? 5. Should family presence be permissible during resuscitation? The survey identified a common theme among staff members, namely, that education of the family is vital; however, almost half (47%) of staff members were opposed to family presence during resuscitation and procedures. During phase 2 of the project, a second survey was given to RNs, ICU physicians, and pastoral care representatives. Results from this survey indicated that a formal policy or protocol and a family facilitator would significantly improve the family presence process in our ICU. Phase 3 of the project consisted of compiling the data of both surveys, which were then presented to the ICU staff during the annual ICU education retreat. A PowerPoint presentation with the data results was shown as well as a video recorded by the resuscitation team. The video presented various scenarios the staff might encounter, including family members who were violent or angry, excessively emotional, drugor alcohol-altered, or arguing with one another. The staff members were then given helpful tips on how to use appropriate techniques to resolve the difficult situations shown in the video. It was reinforced many times that the safety of the patient and staff members is the priority in every situation. In Our Unit

A 'RIPPER' Project: advancing rural inter-professional health education at the University of Tasmania

Attending to the shortage and sustainability of health care professionals and resources in rural areas in Australia is a continuing challenge. In response, there is a heightened focus on new models of healthcare delivery and collaboration that optimise the quality of patient care, respond to complex health needs and increase professional job satisfaction. Interprofessional rural health education within universities has been proposed as one way of addressing these challenges. This article reports on the development, design, implementation and evaluation of the RIPPER initiative (Rural Interprofessional Program Education Retreat). RIPPER is an interprofessional rural health education initiative developed by a team at the University of Tasmania's Faculty of Health Science. The objective of the program was to develop a rural interprofessional learning module for final year undergraduate health science students at the University of Tasmania. The program was first piloted in a rural Tasmanian community in 2006, with a second iteration in 2007. Participants in the program included approximately 60 students from the disciplines of Medicine, Nursing and Pharmacy. The format and educational design of the RIPPER program was focussed on a multi-station learning circuit using interprofessional case-based scenarios. Each learning station employed experiential and interactive educational strategies that included high and low fidelity simulation, role play and reflection. The learning stations required students to work collaboratively in small interprofessional teams to respond to a series of rural emergency healthcare scenarios. Qualitative and quantitative evaluation data was collected from student participants over two years utilising a pre- and post-test quasi experimental design. Results demonstrated a positive shift in students' understanding of interprofessional practice and the roles and skills of other health professions. There was also an increase in the value ascribed by students to collaboration and team work as a way of problem solving and improving patient outcomes. The project evaluation indicated the importance of developing a sustainable and embedded interprofessional rural module within the undergraduate health science curriculum. The project evaluation findings also point to some of the strengths and limitations of implementing interprofessional education activities in a rural setting.

Echoes of Leadership Education: Reflections on Failure, Forgetting, and Our Future

Despite the popularity of leadership education on college campuses, little is known about what individual participants learn and remember. This longitudinal study examines the impact of a leadership education retreat through the eyes of six undergraduate college men. Entry and exit interviews, along with intensive one and two year follow-up interviews, were conducted. Cross case analysis reveals that leadership identity was reshaped by perceived personal failure during crisis. Longitudinal analysis suggests that students attribute improved leadership capabilities less to leadership education than to their own development and leadership experiences. This study questions the value of stand-alone or short-term leadership education models and suggests new curricular approaches to leadership education that incorporate potential future crucible experiences.