Motility Review Conference:
Faculty with expertise in motility from the adult and pediatric GI services will review instructional clinical cases of motility tracings. Trainees from pediatric GI service will also attend.
GI Core Clinical Conference:
Presentations of core lecture series by fellows, faculty, and visiting faculty. Topics rotated annually and assigned by Program Director to ensure broad representation of digestive diseases based on the GI Core Curriculum and state of the art gastroenterology as well as topics important for professionalism in medicine. Topics are adjusted also based on the results of the ABIM board exam and the prior year’s Gastroenterology Training Examination. Topics include review of biostatistic methods and study design and other topics required for broad based education. Lectures throughout the 3 year training experience will address specifically or have incorporated in them the required fields of medical genetics, ethics, palliative care, pain management, risk management, physician impairment, substance abuse, quality improvement, and medical coding and billing.
Based on feedback, a move towards lean learning will transition this conference from 60 minutes to 30 minutes with an emphasis of speakers focusing their transfer of knowledge to efficient high yield presentations.
Conferences included in this series
Systems of Care Improvement Conference:
The conference is divided into two sections. The first 30 minutes is dedicated to reviewing adverse events or near misses to identifying system errors. Goal of identifying systems issues which may lead to risks to patient’s safety and to review with the hospital and nursing staff means to improve patient safety. The second 30 minutes are dedicated to three 10 minute update reports from the three inter-professional committees. This later process is part of the new QI and patient safety experience described below that is centered around the inter-professional committees designed to improve the process of care in 1. The OUMI endoscopy lab, 2. The OUMI continuity clinic, and 3. the VA Medical Center endoscopy lab. At the completion of each session the PD will collate action items for the respective clinical service or entity to implement for care improvement and the progress of the implementation will be reported at the beginning of the subsequent conference session.
Quality Improvement Conference:
All second year fellows identify an outcome based medical issue in the management of digestive diseases that may warrant an intervention for improvement. The project is selected with the guidance of the Program Director and presented to the entire section for review and comment. A period of baseline data is collected (typically 4 months) and then the intervention is implemented followed by collection of outcome data for the next 4 months. There will be scheduled meetings of the multidisciplinary team on the second Thursday of the month 4:00 – 5:00 PM. The team will make recommendations for care improvement on the basis of project results. The results are then presented and an evaluation is completed by the entire section.
Patient Safety Project Conference:
All third year fellows meet with and work throughout the year with a team of nurses and other health care staff from OUMC to identify a patient safety concern. An intervention to improve patient safety is implemented and the results reported to the entire section at the end of the academic year. Human Factors Theory and Systems Theory are reviewed with learning modules from the AHCQR. There will be scheduled meetings of all disciplines on the second Thursday of the month 4:00 – 5:00 PM. The team will make recommendations for care improvement on the basis of project results. The results are then presented and an evaluation completed by the entire section.
Visiting Faculty Lectures:
Attended by fellows and staff. Speaker is usually a nationally known figure. Often this individual will serve as visiting professor and will have direct contact with fellows.
The 2016-2017 academic calendar year, the GI Section was the recipient of the American College of Gastroenterology Edgar Achkar Visiting Professorship. On April 25 and 26, 2017, we were honored to host Dr. Brian Edward Lacy, Ph.D., M.D., Chief of Gastroenterology and Hepatology, Professor of Medicine and Director of the GI Motility Laboratory at Dartmouth-Hitchcock Medical Center; and Director, MD-PhD Program at Geisel School of Medicine in Lebanon, New Hampshire. Dr. Lacy presented Clinical Dilemma in Functional Bowel Disease at the Oklahoma City Golf and Country Club for community physicians and medical staff on April 25th and provided a second presentation for the GI Conference at the Samis Education Center on April 26th entitled, Functional Dyspepsia and Gastroparesis: One Disease or Two? (Right-Dr. Lacy pictured with our gastroenterology fellows.)
We were also honored to have Dr. Bincy P. Abraham, M.D., through MCM Education, visit our campus to present, Identifying and Managing Patients with IBD at Risk for Progressive Disease on May 17, 2017. Dr. Abraham is an associate professor of clinical medicine in the Academic Division of Gastroenterology and Hepatology at Houston Methodist-Weill Cornell Medical College.
IBD Case Files Conference:
Clinical case conference led by IBD faculty with two fellows assigned who will work as a team to present the conference. One fellow is identified as the case presenter and the other as EBM literature reviewer. The case presenting fellow selects one complex or two noncomplex cases from his/her clinic and will give a short presentation on the clinical course. This will include review of appropriate pathology and imaging with the assistance of multiple disciplines (i.e. pathologist and radiologist). The literature reviewing fellow presents a review of one or two current articles justifying the management of the case presented. The Case presenting fellow will, 1) place date and assigned fellows name on the sheet; 2) don’t use actual patient name; 3) provide concise history with important findings, labs, and follow up clinical course as relevant; 4) provide one question for the other fellows; and 5) submit to GI Fellows and the conference facilitator(s) one week before conference. The EBM fellow will, 1) perform literature search and summarize results; 2) provide figures and charts (encouraged); 3) provide one line limitation of the study referenced providing help for interpreting the data correctly; 4) write a paragraph on how you would apply your literature search to the case; 4) write full references in AMA style and; 5) Mention suggested readings for the topic.
Liver Case Files Conference:
Liver Case Files Conference; monthly alternating with IBD conference (typically conducted on first Wednesday of the month). Clinical case conference led by hepatology faculty with two fellows assigned who will work as a team to present the conference. One fellow is identified as the case presenter and the other as EBM literature reviewer. The responsibilities of each presenter is outlined below (Program Improvement 2016)
Case presentation: The case presenting fellow selects one educational case from his/her clinic/inpatient consult service month and will give a short presentation on the clinical course. This will include review of appropriate biochemistries, serologies, pathology and imaging. The assistance of multiple disciplines (i.e. pathologist and radiologist) can be obtained as necessary. Case presenting fellow will present an interesting liver case in a set format as outlined below.
- Place date and assigned fellows name on the sheet
- Don't use actual patient name
- Concise history with important findings labs and follow up clinical course as relevant
- One question for the other fellows
- Submit to GI Fellows and conference facilitator one week before conference
Literature review :
The fellow assigned for literature review will present an EBM review in a set format as outlined below:
- Perform literature search and summarize results
- Figures tables and charts encouraged
- One line limitation of the study referenced will help interpret the data correctly
- Write a paragraph on how you would apply your literature search to the case
- Write full references in AMA style
- Mention suggested readings for the topic
Advanced Endoscopy Conference:
Cases presented by fellow, radiographs reviewed by fellows and faculty and issues of case management discussed in open forum.
Fellow Board Review:
A fellow organized conference to review sample board questions with evidenced based discussion of appropriate answers as means to supplement discussion in pathophysiology conference. Participation is voluntary.
Fellows present cases and slides reviewed with staff pathologist. GI staff members are in attendance.
Consult Service-Clinical Case Conference:
At least one challenging case from both consult services presented including imaging and relevant pathology. The case presented should be either a highly educational value case due to uncommon disease state or complex diseases interactions or a complicated decision process. In the former, the case should be presented as if the diagnosis is not clear and the presenter should challenge the audience to proceed through diagnostic and therapeutic decision making to highlight the educational experience of the specific case. In the latter, complicated decision model case the presentation may be done to seek further audience guidance and experience to help direct the care of the patient. In both instances the clinical presentation and decision making should be the majority of the 20 minute presentation with the last 3-4 minutes consisting of a brief overview of the teaching points and literature review to demonstrate practice based learning. The fellows are encouraged to include lower level trainees including Internal Medicine residents rotating on the GI consult service in the presentation of the case with the fellow focused on providing the practice based learning literature.
This conference is held weekly except when a Systems of Care Improvement Conference is scheduled. Fellows are expected to read pertinent chapters in current reference textbooks. Two weeks prior to the assignment the faculty preceptor will divide the assigned reading into approximately 8 equal sections that will then be assigned to individual trainees from our current reference textbook, Sleisenger and Fordtran's comprehensive gastroenterology textbook (currently 10th Edition). New Practice and Clinical Guidelines are added as additional reading for all trainees. The trainees are expected to highlight three learning principles from their assigned section.The three learning principles will be submitted to the coordinator no later than the Monday prior to the session for collating and distribution. Trainees are expected to review these principles prior to the session and the 30 minute session will be dedicated to answering board style questions written by the faculty preceptor and clarifying concepts as part of the lean learning initiative.
Two fellows and one staff review pertinent articles from the recent literature. To enhance the structure and emphasize critical analytic skills a systematic report form for each article reviewed will be completed by the presenter and made available to the attendees at the presentation. This will emphasize study strengths, methodolic weaknesses and generalizability.
Research (both Basic and Clinical Sciences) in progress is presented by staff, fellows and visitors. Fellows will be expected to present their research performed during Research Rotation in this venue.
Other conferences/events attended by gi fellows:
Multidisciplinary Team Building:
To emphasize the importance of teamwork in healthcare, new activities will be added to build relationships between trainees with other disciplines. This will include an introductory meeting at the beginning of every academic calendar year with critical care fellows and surgical residents. In addition, there will be a team building event later in the academic year outside the hospital setting.
Internal Medicine-Grand Rounds (weekly):
Fellows are expected to attend at least those that address gastroenterology related topics.
Multidisciplinary GI Tumor Board (weekly):
Fellows and faculty attend clinical case discussion in collaboration with trainees and faculty of Departments of Surgery, Pathology, Radiology, Radiation Oncology and Section of Oncology.
Evidenced Based Medicine and Teaching Skills Workshop:
All faculty and fellows encouraged to attend (senior fellows required to attend). This conference is administered annually by the College of Medicine. Teaches practice based learning skills and tools to promote effective teacher to learner communication.
Professional Development Conferences:
Annual conference given by GI Section Faculty or visiting faculty devoted to instruction on methods to strengthen the trainee’s emphasis on professional growth and development. Topics will include: Curriculum vitae development, volunteering for professional and community service, time management and managing personal affairs in a medical career. Every year a component of wellness will be incorporated into this retreat.
Practice of Medicine Seminar:
Sponsored annually by College of Medicine and the Southern Medical Society. (All senior fellows required to attend). The conference incorporates broad introduction to health care systems including legal, ethical, and fiscal topics important for practice of medicine.
All first year fellows will be required to attend the ASGE First Year Fellow's Endoscopy Course in Chicago, IL which has systematic exposure through hands on ex vivo animal model stations to a comprehensive menu of endoscopic interventions. Beginning in 2017, fellows have ad access to the endoscopic simulator located in the OU Clinical Skills Education and Training Center. This is required for first year fellows. Second and third year fellows may find basic endoscopic procedure review helpful and the advanced endoscopy simulator can help give them further exposure to supplement the advanced endoscopy elective rotation.
Gastroenterology Training Examination:
Completed each spring by all trainees. This structured and benchmarked exam is securely administered by the AGA through the University of Michigan. Trainees will be benchmarked in 9 knowledge areas with trainees from across the country. Results will be used to identify areas in individual trainees and the program as a whole that require improvement. These results will be used to adjust the curriculum for the subsequent years to enhance medical knowledge and practice based learning improvement.