Chief Resident Chief Resident Immersion Immersion

Training Training (CRIT)(CRIT)

University of RochesterUniversity of Rochester

Division of Geriatrics & AgingDivision of Geriatrics & Aging

Principal InvestigatorsPrincipal Investigators

Annie Medina-Walpole MDAnnie Medina-Walpole MDPaul Katz MDPaul Katz MD

Don Bordley MDDon Bordley MD

 

HistoryHistory

Initial program developed at Boston Initial program developed at Boston University Medical Center with University Medical Center with funding from the Donald W. Reynolds funding from the Donald W. Reynolds Foundation - 2003Foundation - 2003

National dissemination project funded National dissemination project funded by the John A. Hartford Foundation by the John A. Hartford Foundation and the Association of Directors of and the Association of Directors of Geriatric Academic Programs - 2007Geriatric Academic Programs - 2007

Overall Goal of ProgramOverall Goal of Program

Foster collaboration among Foster collaboration among disciplines in the management of disciplines in the management of complex older patientscomplex older patients

Secondary GoalsSecondary Goals Incorporate geriatric principles into Incorporate geriatric principles into

teaching and administrative roles as Chief teaching and administrative roles as Chief ResidentsResidents

Develop leadership/teaching skills around Develop leadership/teaching skills around the care of complex older patientsthe care of complex older patients

Enhance leadership/teaching skills Enhance leadership/teaching skills required in the Chief Resident rolerequired in the Chief Resident role

Develop an achievable project to be Develop an achievable project to be carried out during the Chief Residency carried out during the Chief Residency yearyear

Have fun and foster collegialityHave fun and foster collegiality

Who is Invited?Who is Invited?

All Chief Residents for 2008 – 2009 All Chief Residents for 2008 – 2009 academic year involved in the care academic year involved in the care of older patientsof older patients

All Program DirectorsAll Program Directors Families and Significant OthersFamilies and Significant Others Division of Geriatrics FacultyDivision of Geriatrics Faculty

Three ModulesThree Modules

ModulesModulesCaseCaseSmall Group BreakoutSmall Group BreakoutMini-LecturesMini-Lectures Interspecialty Clinical PearlsInterspecialty Clinical Pearls

Geriatric Topics Within Geriatric Topics Within ModulesModules

Decision Making / CapacityDecision Making / Capacity Preoperative Assessment in the Preoperative Assessment in the

Older PatientOlder Patient An Approach to DementiaAn Approach to Dementia Delirium in the ElderlyDelirium in the Elderly PolypharmacyPolypharmacy Functional AssessmentFunctional Assessment Discharge PlanningDischarge Planning

Leadership Training Leadership Training TopicsTopics

The Reluctant LearnerThe Reluctant Learner Giving FeedbackGiving Feedback Teaching in a Small GroupTeaching in a Small Group Conflict ResolutionConflict Resolution

Chief Resident ProjectChief Resident Project Chiefs meet 1:1 with faculty to develop a Chiefs meet 1:1 with faculty to develop a

project / action plan that focuses on project / action plan that focuses on management of complex older patientsmanagement of complex older patients

Project should be achievable in first 6 monthsProject should be achievable in first 6 months Projects may focus on trainee education, Projects may focus on trainee education,

improvement of clinical care, institutional improvement of clinical care, institutional changes, administration or patient educationchanges, administration or patient education

Projects should fit with interest of participant Projects should fit with interest of participant and needs of residency programand needs of residency program

Subspecialty collaboration is encouraged to Subspecialty collaboration is encouraged to create joint projectscreate joint projects

Examples of Chief Resident Examples of Chief Resident ProjectsProjects

Medication use/polypharmacy on a rehab unitMedication use/polypharmacy on a rehab unit ADL assessment: training residents to use a ADL assessment: training residents to use a

validated tool in assessing cognitively impaired validated tool in assessing cognitively impaired and vulnerable patientsand vulnerable patients

MMSE to predict post-CABG deliriumMMSE to predict post-CABG delirium MMSE and CAM to diagnose dementia and MMSE and CAM to diagnose dementia and

deliriumdelirium Gait assessment and falls risk in neurological Gait assessment and falls risk in neurological

patientspatients Utilization of pre and post-testing using online Utilization of pre and post-testing using online

Wikipedia during intern reportWikipedia during intern report

Friday AgendaFriday Agenda

Check in and pre-test 4:00 pmCheck in and pre-test 4:00 pm Evening Session 6:00 – 8:00 pmEvening Session 6:00 – 8:00 pm

DinnerDinner Announcement of Chief Resident Announcement of Chief Resident

Project / Action PlanProject / Action Plan

Saturday AgendaSaturday Agenda

Breakfast: 1:1 discussion with Breakfast: 1:1 discussion with faculty mentor on project / action faculty mentor on project / action planplan

Modules I and IIModules I and II Leadership/Teaching SkillsLeadership/Teaching Skills LunchLunch Afternoon freeAfternoon free Dinner with family and facultyDinner with family and faculty

Sunday AgendaSunday Agenda

Breakfast: 1:1 discussion with Breakfast: 1:1 discussion with faculty mentor on project / action faculty mentor on project / action planplan

Module IIIModule III Leadership/Teaching SkillsLeadership/Teaching Skills Announcement of ProjectsAnnouncement of Projects Post-testPost-test LunchLunch Wrap-upWrap-up

““To be seventy years young is To be seventy years young is sometimes far more sometimes far more cheerful and hopeful than cheerful and hopeful than to be forty years old”to be forty years old” Oliver Wendell HolmesOliver Wendell Holmes