Oregon Health & Science University

Oregon Scholars Program

The Oregon Scholars Program (OSP) is an innovative program that combines a core anesthesiology residency program with a fellowship in either Critical Care Medicine (CCM) or research. Residents choosing the CCM track complete two additional resident CCM rotations in the PGY1 to PGY 3 years. Over the PGY 4 and 5 years, Oregon Scholars combine fellowship training with CA3 residency requirements. Upon completion of the program, they are eligible for core certification by the American Board of Anesthesiology as well as subspecialty certification in CCM.

The OSP research residents complete all requirements of the core anesthesiology residency program while also completing 18 months of research, over 4 years. The research periods are variable depending on the specific needs of the resident research project. The OSP research residents can begin research training as early as the PGY2 year.

http://www.ohsu.edu/xd/education/schools/school-of-medicine/departments/clinical-departments/anesthesiology/education/oregon-scholars-program/

Anesthesiology Toolbox/JIVE

In 2014 OHSU embarked on a project to develop an online learning platform that would support self-guided resident education and act as a resource for faculty to provide them with tools to deliver higher quality educational experiences. In addition, the project endeavored to produce on-line curricula/study guides for residents on subspecialty rotations. Over the past 3 years the project has progressed at a rapid clip. Over 50 US anesthesia residency programs now utilize the Anesthesia Toolbox to supplement resident training. In addition, several programs in Canada, Australia and New Zealand now utilize the Toolbox.

Fun facts about the Toolbox as of July 2017

Our goals for 2017-2018 include the roll-out of a new web-portal for the Toolbox that will incorporate features to encourage collaborative and social learning including online discussion groups, wiki case tips, collaborative clinical pearls, an ask a questions forum moderated by over 100 faculty from 50 different institutions, online journal clubs, etc. From a research perspective we will continue to publish about this innovative project including an ongoing study on utilization of the Toolbox.

APOM Academy

There has been a national trend in higher education to incorporate learning communities. In 2015, we introduced the APOM Academy into the residency program curriculum. The Academy, comprised of 3 separate smaller learning communities called “Colleges”, has 4 main goals: 1) Social support: Each college has a student and faculty lead who are responsible for planning a social event. Each college has a small budget to support the event and it is intended to foster social connectedness within the residency. In addition, each college meets several times per year to review and discuss interesting and educational cases. The more junior residents in the college come up with interesting cases they have had, and the senior residents are assigned to facilitate discussion, promoting peer-peer learning from seniors to juniors that is not possible in their class-level didactics. Each college has a logo and each member receives a jacket with the logo of their assigned college on matriculation to the program. 2) Academic Advising: Each college has 3 faculty designated as Advancement Advisors. These advisors meet with the residents in their college quarterly to go over their evaluations, test scores, and milestones, and to help set goals for academic achievement, as well as moderate Individual Education Plans if necessary. 3) Quality Improvement Curriculum: The Quality Improvement curriculum extends beyond the colleges, in that there are on-line modules and experiential learning by participating on the CQI committee. However, each college is responsible for demonstrating CQI principles by working on a project using the PDSA cycle. Each college has a faculty member assigned to be the QI project lead as well. Currently there is no funding to support this work. 4) Student Affairs support: Each college has a staff member liaison who has experience in Student Affairs at an outside institution. They are available to help residents navigate any problems they encounter in residency.

In the 2017-2018 academic year we will introduce programing to help educate trainees about physician burnout and resiliency. While the details are still being discussed, our plan is to assign each trainee to a faculty coach. Coaches will ensure that residents are developing skills to socially and emotionally navigate their role as a physician.

Point of Care Ultrasound

We introduced a hands-on curriculum to teach point of care ultrasound skills to our residents and interns. The curriculum involves reading, didactic sessions and active learning session with simulated patients. We teach this curriculum within our perioperative medicine rotations as well as our intern curriculum (described above). This is an interdisciplinary program which includes our outstanding colleagues in Emergency Medicine and Internal Medicine. We are expanding this program this academic year under the leadership of Dr. Mike Wollenberg and our Critical Care Fellowship leaders. We are looking into purchasing advanced echocardiography simulators as part of this expansion.

Humanitarian Overseas Physician Education Program (HOPE)

OHSU anesthesiology has a long tradition of training physicians to provide care to underserved populations across the globe. We have linked the clinical portion of this training to the ASPIRE Global Health training. In this way, residents and fellows can learn the core concepts of global medicine in an ongoing multidisciplinary educational program within ASPIRE. After completing this training, they can participate in a one to four week clinical rotation with a qualified faculty member as part of a perioperative care team. Over the past 10 years, 26 residents, 7 fellows and 6 medical students have provided care in Ecuador, Peru, Ethiopia, Nigeria, India, Thailand and Guatemala as part of the HOPE program.

ASPIRE

Many residents are interested in and capable of learning and developing far beyond the ACGME and ABA core competencies and requirements. While traditional “required” curricula offerings are effective at delivering the required core curriculum to residents, these offerings do not include areas of interest beyond ACGME and ABA requirements or help residents meet individual learning goals. OHSU APOM has developed a multi-topic, robust curricular innovation to provide structure for self-directed learners to meet personal learning goals that span beyond required core curricular offerings.

We developed an optional curriculum of advanced electives called the ASPIRE curriculum. Topics include: Global Health, Trans-Esophageal Echocardiography (TEE) basic certification, Cardiac Implantable Electronic Device Interrogation, Advanced Ultrasound Anatomy for Regional Anesthesia, Risk Management, Financial Management and Perioperative Acupuncture. Topics are chosen based on resident interest and faculty expertise and content is offered either as a stand-alone seminar or as part of a longitudinal, multiple session course.

Learning Support and Education Scholarship

Providing top-notch education is a vital component to the advancement of anesthesia. Effective education includes the incorporation of best practice principles, development of learning tools, and promotion of education-based scholarship. We have a doctoral-level, non-physician faculty member responsible for integrating best practices into our education mission. We also have several scholarly education projects in various stages of completion, and always welcome and encourage learner participation. Projects include:

  1. Efficacy and user experience: in-person versus online problem-based learning discussions
  2. Utilization and user engagement of an online social knowledge management application for medical education
  3. Validation of a direct observation tool for the assessment of competency for common anesthesia procedures
  4. Accuracy and completeness of online medical wikis
  5. Determination of the set of procedural skills for which graduating anesthesia residents should be competent
  6. Feasibility of a simple method of determining entrustment decisions for anesthesia entrustable professional activities
  7. Trajectory, predictive value, and significance of milestone achievement during anesthesiology training
  8. GRIT and the residency recruitment process
  9. A call to action: Predictors, causes and proposed solutions to burnout in academic anesthesiologists in the United States
  10. Reflective practice and self-directed practice in anesthesiology trainees in the United States.