Conference and patient care conflicts

Residency Program Insider, January 11, 2005

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Dear residency program colleague:

Many residency programs struggle with inevitable conflicts between patient care and conference attendance. Some programs have found that requiring residents to attend a certain percentage of conferences means that some residents come up short because they could not leave rounds. In addition, a resident may be unable to attend a conference because he or she was on an off-service rotation that wouldn't allow leaving for conference. Conflicts can occur between conference attendance and patient care, so you must be realistic about requiring residents to attend conferences.

For instance, you must factor in real world concerns such as vacation and post-call needs. To resolve such conflicts, keep in mind the real purpose of conferences--teaching the resident new information or a new skill. Focus on whether the resident learned whatever was presented in the conference and not so much on whether he or she was physically present. That might mean making the material presented at the conference available in other ways.

Conferences should be structured so that when a resident is unable to attend, he or she can be directed to other ways to learn the same material, such as readings, patient care, rounding, informal discussions with faculty, or self study. Rather than focusing on conference attendance, residency programs might opt to require residents to demonstrate mastery of content though post tests, standardized patients, chart audits, or other means.

Some residency programs deal with missed conferences by archiving the presentations on a Web site or with lower tech solutions such as passing out paper handouts or Powerpoint presentations to residents who could not attend.

Try to identify what residents were supposed to know or demonstrate or do as a result of conference attendance, and then see if the program can find a way for the resident to demonstrate those skills. For example, if a resident is unable to attend a conference on diabetes, perhaps he or she could get credit for the conference by performing a self audit of 10 patients to demonstrate the appropriate knowledge for assessing a diabetic patient and making the right medical choices.

That's all for this week!

All the best,

Kathryn M. Andolsek, MD, MPH
Associate Director for Graduate Medical Education
Clinical Professor of Family Medicine
Duke University Medical School

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