The deadline to apply for the 2022-2023 cohort of the Department of Internal Medicine Advancement of Clinician-Educator Scholarship (ACES) Faculty Development Program is January 14, 2022. ACES is a yearlong program in which junior faculty learn how to conduct educational scholarship and carry out a research project under the tutelage of program director Donna Windish, MD, MPH, associate professor of medicine, as well as other faculty.
Educational scholarship is research on the subject of education—medical education, in this case. Most often, according to Windish, it involves developing a curriculum and evaluating how that curriculum influence trainees’ understanding of the material or, less directly, the health of patients under their care.
I think every clinician-educator should consider this program. I believe it's something that every clinician-educator should be required to do.
Parul Gandhi, MD
ACES participants devote one day per week to the program: half a day taking seminars in topics including statistics and survey design, library research, manuscript preparation, and applying for funding; half a day on the research project itself. Ideal candidates are junior faculty in the clinician-educator track within the Department of Internal Medicine. “The mission is to foster the career development of these clinician educators,” Windish said.
The achievements of past participants, whose ACES research findings have been published in leading medical journals and presented at prestigious conferences, is a testament to the program’s success, Windish said.
Assistant Professor of Internal Medicine Matthew Zegarek, MD, a 2020-21 ACES participant, was curious how medical trainees would respond to learning how their patients fared after hospital discharge. “Currently, there's no standard way that trainees receive feedback on how their patients do after discharge. Our goal was to provide that feedback and analyze what the effect of providing that feedback was,” Zegarek said.
Along with other colleagues in the department, he developed a curriculum in which attending physicians would review with medical students and residents the post-discharge outcomes of the patients the trainees’ had recently cared for. The curriculum also included general discussion of factors that can lead to poor post-discharge outcomes and time for reflection about the factors that may have influenced the post-discharge outcomes of the trainees’ patients. Attending physicians delivered the curriculum to trainees during teaching sessions called attending rounds, and Zegarek surveyed trainees before and after the session. After the intervention, trainees felt a greater sense of responsibility for their patients following their discharge from the hospital. More than half of trainees said they intended to change some aspect of their approach to discharge planning. Zegarek presented his findings at the Society of General Internal Medicine Combined Mountain West/New England Regional Meeting in November 2021, and a manuscript about his work is under review at a peer-reviewed medical journal.
David J. Hur, MD, a 2019-20 ACES participant and assistant professor of medicine (cardiology), conducted a survey to determine how well fellowship programs train cardiologists in cardiovascular computed tomography (CCT). CCT is an imaging technique that cardiologists can use to diagnose heart disease. The American College of Cardiology recommends that cardiology fellows receive Level 1 training in CCT, which covers when to order CCT scans and how to interpret the results. Hur wondered if fellowship programs were meeting those guidelines. He surveyed cardiology fellows and faculty members about the CCT training they received during their fellowships and whether they felt it was sufficient. Respondents reported receiving on average five hours of CCT training but wanted much more. For comparison, a self-guided Level 1 course might take 10 hours to complete, Hur said. Hur presented his findings at the 16th Annual Scientific Meeting of the Society of Cardiovascular Computed Tomography (SCCT) in July 2021, and a report of the findings appeared online in the Journal of Cardiovascular Computed Tomography in September 2021.
For Hur, ACES has been an entrée into the cardiology community beyond Yale. Since completing the ACES fellowship, Hur gained acceptance to the SCCT’s Future Leaders Program. “That's opened doors to additional collaborators and investigators in the field across different parts of the U.S. and even internationally,” Hur said.
In her research project 2019-2020 ACES participant Parul Gandhi, MD, assistant professor of internal medicine (cardiovascular), assessed cardiology fellows’ familiarity with the use of biomarkers to diagnose and prognosticate heart failure. The biomarkers in question are proteins that the heart produces when it is stressed. National guidelines strongly recommend that doctors measure levels of these biomarkers in patients with heart failure symptoms. Gandhi wondered whether fellows were getting the training to do this. She surveyed Connecticut cardiology fellows about the biomarker training they’d received, the training they wish they’d received, and their knowledge of the national guidelines. More than half of fellows surveyed had received some training on the subject. Nonetheless, many fellows wanted more training, the survey revealed, and were fairly unaware of the guidelines. In November 2021, Gandhi published these results in the Journal of the American College of Cardiology.
Gandhi cannot say enough about how much she values her experience as an ACES participant. When she applied for the program, she had ample experience teaching but no training in educational scholarship. “It's important to have all these skills, but we rarely receive dedicated education to guide us through developing a project from start to finish,” she said. ACES did just that.
“I think every clinician-educator should consider this program,” Gandhi said. “I believe it's something that every clinician-educator should be required to do.”