Innovations in Fellowship Education: A Q&A with Katie McAvoy

Katie McAvoy, MD, clinical fellow (pulmonary, critical care and sleep medicine), was awarded top abstract by the American Thoracic Society (ATS) Innovations in Fellowship Education Working Group. One of two recipients to receive the honor, she was recognized on May 21, 2023, at the ATS International Conference in Washington, D.C.

McAvoy gave a presentation of the winning abstract, “A Comprehensive Approach to Pulmonary & Critical Care Fellow Ambulatory Training with the Implementation of Dedicated Ambulatory Blocks and a Novel Curriculum” at an ATS session on May 20. In addition, her work was published in the ATS Innovations in Fellowship Education booklet.

“We are so pleased to see her work recognized in this way,” said Jennifer Possick, MD, associate professor of medicine (pulmonary, critical care and sleep medicine), who along with Shyoko Honiden, MD, associate professor of medicine (pulmonary, critical care, and sleep medicine), helped steer the project. “We know that Yale’s pulmonary and critical care (PCCM) trainees will continue to reap the benefits of her creativity, hard work, and steadfast devotion to medical education for years to come.”

“She identified an unmet need, designed an intervention, and the intervention worked,” said Naftali Kaminski, MD, Boehringer Ingelheim Pharmaceuticals, Inc. Professor of Medicine (Pulmonary) and chief of Yale-PCCSM, noting the exceptionality of her achievement. “We are all very excited and proud, especially because she will join our faculty ranks when she graduates.”

Below, McAvoy discusses her passion for medical education, her work enhancing outpatient pulmonary training, and the potential impact of her project on other PCCM programs.

I am passionate about medical education and exploring creative approaches to engaging adult learners. This project, guided by my mentors and co-investigators Drs. Honiden and Possick, provides a foundation for future work I hope to continue at Yale. It’s an honor for our project to be recognized by the ATS Innovations in Fellowship Education Working Group, which recognizes the impact of these interventions. We are grateful for the opportunity to present our work at the 2023 ATS conference to the members of the Association of Pulmonary and Critical Care Medicine Program Directors and Pediatric Pulmonology Training Directors Association, who may ultimately adopt similar approaches at their own institutions. I would also like to highlight that this award recognizes the commitment that the entire section made to fellowship education through our project—the award was made possible through the dedication of our faculty.

The goal of our project was to enhance and expand outpatient pulmonary training for Yale’s PCCM fellows by pairing a novel ambulatory—or outpatient—pulmonary curriculum with increased experiential learning opportunities in clinic. Our approach was similar to the “x+y” system used in most internal medicine residency programs. During the 2021–2022 academic year, our fellows rotated through a total of four two-week ambulatory blocks, which included subspecialty clinics (e.g., ILD, pulmonary hypertension, airways disease), general pulmonary clinics, and a half-day weekly for ambulatory education. This immersive, protected experience allowed fellows to hone their ambulatory skillsets, capitalize on exposure to clinical experts in the subspecialties, and foster their clinical and academic development. Our curriculum sessions were embedded within ambulatory blocks during academic half-days and leveraged case-based formats, flipped classroom models, multidisciplinary teachers (pharmacists, respiratory therapists), and practical skill development (inhaler technique, airway clearance equipment, home oxygen devices). These interventions not only significantly increased the fellows’ knowledge, but also improved satisfaction with their pulmonary training, self-assessed comfort in managing pulmonary diseases, and readiness for independent practice. We followed up objective data collection with fellow focus groups, which were incredibly informative. These discussions revealed how the ambulatory block structure reinforced skills, fostered career development, and enhanced fellow and faculty engagement in education.

My hope is that other PCCM programs will consider making similar changes at their own institution to enhance fellows’ pulmonary training. Certainly, the intervention might be adjusted based on program resources and needs, but there are components of our initiative that can be applied to many other fellowship programs. Our data highlight the positive impact of providing dedicated and detailed ambulatory pulmonary clinical experiences as well as the benefits of emphasizing a curriculum rooted in adult learning theory. I am excited to collaborate with colleagues at other institutions to develop interventions that could further enhance trainee education and delineate best practices in ambulatory pulmonary training.