Mentoring Conversations Reflective Writing Exercises for Interns MAJ
![Mentoring Conversations: Reflective Writing Exercises for Interns MAJ Jason Sapp, MD, FACP Associate Transitional Mentoring Conversations: Reflective Writing Exercises for Interns MAJ Jason Sapp, MD, FACP Associate Transitional](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-1.jpg)
![Disclosure • No conflicts of interest to report. • The views expressed are those Disclosure • No conflicts of interest to report. • The views expressed are those](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-2.jpg)
![Agenda • • • “My Mistake” overview Milestone analogy Mapping “My Mistake” to milestones Agenda • • • “My Mistake” overview Milestone analogy Mapping “My Mistake” to milestones](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-3.jpg)
![Poll Question 1 Poll Question 1](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-4.jpg)
![Poll Question 2 Poll Question 2](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-5.jpg)
![“My Mistake” Project “My Mistake” Project](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-6.jpg)
![“My Mistake” Project • Second half of the academic year • Residents summarize a “My Mistake” Project • Second half of the academic year • Residents summarize a](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-7.jpg)
![“My Mistake” Project • Give a brief description of the circumstances surrounding the mistake: “My Mistake” Project • Give a brief description of the circumstances surrounding the mistake:](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-8.jpg)
![My Mistake Project • Did you tell your team and how did they react? My Mistake Project • Did you tell your team and how did they react?](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-9.jpg)
![Common Mistakes • Sign out or transfer errors • Order entry errors • Nursing Common Mistakes • Sign out or transfer errors • Order entry errors • Nursing](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-10.jpg)
![Factors Leading to Errors • Fatigue • Miscommunication • Knowledge deficits Factors Leading to Errors • Fatigue • Miscommunication • Knowledge deficits](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-11.jpg)
![Milestone Analogy Milestone Analogy](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-12.jpg)
![Milestone Practicing physician Ambulate without assistance Half way through TY year After medical school Milestone Practicing physician Ambulate without assistance Half way through TY year After medical school](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-13.jpg)
![Milestone Example SBP 2: Works in interdisciplinary teams to enhance patient safety and improve Milestone Example SBP 2: Works in interdisciplinary teams to enhance patient safety and improve](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-14.jpg)
![Milestones Milestone committees define levels Practicing Physician End of PGY-3 Medical school graduate Novice Milestones Milestone committees define levels Practicing Physician End of PGY-3 Medical school graduate Novice](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-15.jpg)
![Mapping “My Mistake” to Milestones Mapping “My Mistake” to Milestones](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-16.jpg)
![Competencies Addressed • Systems Based Practice • Practice Based Learning and Improvement • Professionalism Competencies Addressed • Systems Based Practice • Practice Based Learning and Improvement • Professionalism](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-17.jpg)
![TY Milestones TY Milestones](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-18.jpg)
![Milestone Evaluation 0 – No opportunity to assess these skills 1 – Not demonstrated Milestone Evaluation 0 – No opportunity to assess these skills 1 – Not demonstrated](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-19.jpg)
![Milestone Evaluation Milestone Evaluation](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-20.jpg)
![TY Milestones TY Milestones](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-21.jpg)
![](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-22.jpg)
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![](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-26.jpg)
![Family Medicine Milestones Family Medicine Milestones](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-27.jpg)
![Quality Improvement Opportunities Quality Improvement Opportunities](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-28.jpg)
![My Mistake Project • Information/recommendations relayed to the appropriate hospital committee or department • My Mistake Project • Information/recommendations relayed to the appropriate hospital committee or department •](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-29.jpg)
![“My Reflection” Project “My Reflection” Project](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-30.jpg)
![Poll Question 3 Poll Question 3](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-31.jpg)
![Question 4 Question 4](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-32.jpg)
![“My Reflection” Project • Quarterly learning activity • Reflection of a specific event, situation, “My Reflection” Project • Quarterly learning activity • Reflection of a specific event, situation,](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-33.jpg)
![Topics 1) Cost-conscious patient care 2) Patient diversity and vulnerable populations 3) Ethical dilemma Topics 1) Cost-conscious patient care 2) Patient diversity and vulnerable populations 3) Ethical dilemma](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-34.jpg)
![“My Reflection” Questions • Summarize the case or experience you will reflect upon: • “My Reflection” Questions • Summarize the case or experience you will reflect upon: •](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-35.jpg)
![“My Reflection” Questions • Self reflective statement: – Identify individual deficiencies or strengths, system “My Reflection” Questions • Self reflective statement: – Identify individual deficiencies or strengths, system](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-36.jpg)
![Mapping “My Reflection” to Milestones Mapping “My Reflection” to Milestones](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-37.jpg)
![Competencies Addressed • Systems Based Practice • Professionalism • Interpersonal and Communication Skills Competencies Addressed • Systems Based Practice • Professionalism • Interpersonal and Communication Skills](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-38.jpg)
![TY Milestones TY Milestones](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-39.jpg)
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![](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-44.jpg)
![Family Medicine Milestones Family Medicine Milestones](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-45.jpg)
![Summary • • • “My Mistake” overview Milestone analogy Mapping “My Mistake” to milestones Summary • • • “My Mistake” overview Milestone analogy Mapping “My Mistake” to milestones](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-46.jpg)
![Questions? jason. e. sapp 2. mil@mail. mil Questions? jason. e. sapp 2. mil@mail. mil](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-47.jpg)
- Slides: 47
![Mentoring Conversations Reflective Writing Exercises for Interns MAJ Jason Sapp MD FACP Associate Transitional Mentoring Conversations: Reflective Writing Exercises for Interns MAJ Jason Sapp, MD, FACP Associate Transitional](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-1.jpg)
Mentoring Conversations: Reflective Writing Exercises for Interns MAJ Jason Sapp, MD, FACP Associate Transitional Year Intern Program Director Madigan Army Medical Center Tacoma, WA 7 January 2015
![Disclosure No conflicts of interest to report The views expressed are those Disclosure • No conflicts of interest to report. • The views expressed are those](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-2.jpg)
Disclosure • No conflicts of interest to report. • The views expressed are those of the authors and do not reflect the official policy of the Department of the Army, the Department of Defense or the U. S. Government.
![Agenda My Mistake overview Milestone analogy Mapping My Mistake to milestones Agenda • • • “My Mistake” overview Milestone analogy Mapping “My Mistake” to milestones](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-3.jpg)
Agenda • • • “My Mistake” overview Milestone analogy Mapping “My Mistake” to milestones Quality improvement opportunities “My Reflection” overview Mapping “My Reflection” to milestones
![Poll Question 1 Poll Question 1](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-4.jpg)
Poll Question 1
![Poll Question 2 Poll Question 2](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-5.jpg)
Poll Question 2
![My Mistake Project “My Mistake” Project](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-6.jpg)
“My Mistake” Project
![My Mistake Project Second half of the academic year Residents summarize a “My Mistake” Project • Second half of the academic year • Residents summarize a](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-7.jpg)
“My Mistake” Project • Second half of the academic year • Residents summarize a mistake they or their team made • Written reflection • Oral presentation and discussion
![My Mistake Project Give a brief description of the circumstances surrounding the mistake “My Mistake” Project • Give a brief description of the circumstances surrounding the mistake:](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-8.jpg)
“My Mistake” Project • Give a brief description of the circumstances surrounding the mistake: • What was your specific role in the mistake? • What factors contributed to the mistake (i. e. fatigue, miscommunication…)? • What did you do when you realized the mistake was made?
![My Mistake Project Did you tell your team and how did they react My Mistake Project • Did you tell your team and how did they react?](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-9.jpg)
My Mistake Project • Did you tell your team and how did they react? • Did you or someone from your team tell the patient (if a patient was involved)? • How did the patient or patient’s family react (if a patient was involved)? • What could be done to prevent others from making this same mistake?
![Common Mistakes Sign out or transfer errors Order entry errors Nursing Common Mistakes • Sign out or transfer errors • Order entry errors • Nursing](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-10.jpg)
Common Mistakes • Sign out or transfer errors • Order entry errors • Nursing interactions
![Factors Leading to Errors Fatigue Miscommunication Knowledge deficits Factors Leading to Errors • Fatigue • Miscommunication • Knowledge deficits](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-11.jpg)
Factors Leading to Errors • Fatigue • Miscommunication • Knowledge deficits
![Milestone Analogy Milestone Analogy](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-12.jpg)
Milestone Analogy
![Milestone Practicing physician Ambulate without assistance Half way through TY year After medical school Milestone Practicing physician Ambulate without assistance Half way through TY year After medical school](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-13.jpg)
Milestone Practicing physician Ambulate without assistance Half way through TY year After medical school Expert (12 months) Proficient (3 -6 months) Competent Advanced Beginner Novice TY graduate Residency graduate The 5 Dreyfus Levels Dreyfus SE, Dreyfus HL. A five-stage model of the mental activities involved in directed skill acquisitions. February 1980
![Milestone Example SBP 2 Works in interdisciplinary teams to enhance patient safety and improve Milestone Example SBP 2: Works in interdisciplinary teams to enhance patient safety and improve](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-14.jpg)
Milestone Example SBP 2: Works in interdisciplinary teams to enhance patient safety and improve patient care quality Dreyfus Level 1 Novice Recognizes failures in teamwork and communication in health care as a leading cause of preventable patient harm After medical school Dreyfus Level 2 Advanced Beginner Dreyfus Level 3 Competent Dreyfus Level 4 Proficient Dreyfus Level 5 Expert Works with other Works in Analyzes team Leads members of the interdisciplinary experience and interdisciplinary health care teams to identify works with the teams to improve to identify system solutions (action team to enhance health care errors and areas plans) to identified patient safety and delivery systems of potential system errors care quality in the quality specialty area improvement Half way through TY year TY graduate Resident graduate Practicing physician
![Milestones Milestone committees define levels Practicing Physician End of PGY3 Medical school graduate Novice Milestones Milestone committees define levels Practicing Physician End of PGY-3 Medical school graduate Novice](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-15.jpg)
Milestones Milestone committees define levels Practicing Physician End of PGY-3 Medical school graduate Novice End of PGY-1 Year Advanced Beginner End of PGY-2 Year Expert Graduation Proficient Competent The 5 Dreyfus Levels Dreyfus SE, Dreyfus HL. A five-stage model of the mental activities involved in directed skill acquisitions. February 1980
![Mapping My Mistake to Milestones Mapping “My Mistake” to Milestones](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-16.jpg)
Mapping “My Mistake” to Milestones
![Competencies Addressed Systems Based Practice Practice Based Learning and Improvement Professionalism Competencies Addressed • Systems Based Practice • Practice Based Learning and Improvement • Professionalism](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-17.jpg)
Competencies Addressed • Systems Based Practice • Practice Based Learning and Improvement • Professionalism • Interpersonal and Communication Skills
![TY Milestones TY Milestones](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-18.jpg)
TY Milestones
![Milestone Evaluation 0 No opportunity to assess these skills 1 Not demonstrated Milestone Evaluation 0 – No opportunity to assess these skills 1 – Not demonstrated](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-19.jpg)
Milestone Evaluation 0 – No opportunity to assess these skills 1 – Not demonstrated 2 – Developing 3 – Consistently demonstrated
![Milestone Evaluation Milestone Evaluation](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-20.jpg)
Milestone Evaluation
![TY Milestones TY Milestones](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-21.jpg)
TY Milestones
![](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-22.jpg)
![](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-23.jpg)
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![](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-26.jpg)
![Family Medicine Milestones Family Medicine Milestones](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-27.jpg)
Family Medicine Milestones
![Quality Improvement Opportunities Quality Improvement Opportunities](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-28.jpg)
Quality Improvement Opportunities
![My Mistake Project Informationrecommendations relayed to the appropriate hospital committee or department My Mistake Project • Information/recommendations relayed to the appropriate hospital committee or department •](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-29.jpg)
My Mistake Project • Information/recommendations relayed to the appropriate hospital committee or department • One topic group quality improvement project
![My Reflection Project “My Reflection” Project](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-30.jpg)
“My Reflection” Project
![Poll Question 3 Poll Question 3](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-31.jpg)
Poll Question 3
![Question 4 Question 4](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-32.jpg)
Question 4
![My Reflection Project Quarterly learning activity Reflection of a specific event situation “My Reflection” Project • Quarterly learning activity • Reflection of a specific event, situation,](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-33.jpg)
“My Reflection” Project • Quarterly learning activity • Reflection of a specific event, situation, or learning point during one of their rotations • Written summary: – Resident’s thoughts – Self-reflection – Identification of strengths and weaknesses – Plan for improvement
![Topics 1 Costconscious patient care 2 Patient diversity and vulnerable populations 3 Ethical dilemma Topics 1) Cost-conscious patient care 2) Patient diversity and vulnerable populations 3) Ethical dilemma](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-34.jpg)
Topics 1) Cost-conscious patient care 2) Patient diversity and vulnerable populations 3) Ethical dilemma and personal belief system 4) Managing personal wellbeing in the setting of clinical duties.
![My Reflection Questions Summarize the case or experience you will reflect upon “My Reflection” Questions • Summarize the case or experience you will reflect upon: •](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-35.jpg)
“My Reflection” Questions • Summarize the case or experience you will reflect upon: • Briefly describe why you chose this case or situation to reflect upon:
![My Reflection Questions Self reflective statement Identify individual deficiencies or strengths system “My Reflection” Questions • Self reflective statement: – Identify individual deficiencies or strengths, system](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-36.jpg)
“My Reflection” Questions • Self reflective statement: – Identify individual deficiencies or strengths, system deficiencies or strengths, and/or areas of varied practitioner approach as they pertain to your case. – Devise a plan for improvement of self or the system if needed. – Assess what you learned from this case / experience and how it will change the way you practice medicine in the future. – If applicable, devise a plan for improvement / future learning.
![Mapping My Reflection to Milestones Mapping “My Reflection” to Milestones](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-37.jpg)
Mapping “My Reflection” to Milestones
![Competencies Addressed Systems Based Practice Professionalism Interpersonal and Communication Skills Competencies Addressed • Systems Based Practice • Professionalism • Interpersonal and Communication Skills](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-38.jpg)
Competencies Addressed • Systems Based Practice • Professionalism • Interpersonal and Communication Skills
![TY Milestones TY Milestones](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-39.jpg)
TY Milestones
![](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-40.jpg)
![](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-41.jpg)
![](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-42.jpg)
![](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-43.jpg)
![](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-44.jpg)
![Family Medicine Milestones Family Medicine Milestones](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-45.jpg)
Family Medicine Milestones
![Summary My Mistake overview Milestone analogy Mapping My Mistake to milestones Summary • • • “My Mistake” overview Milestone analogy Mapping “My Mistake” to milestones](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-46.jpg)
Summary • • • “My Mistake” overview Milestone analogy Mapping “My Mistake” to milestones Quality Improvement Opportunities “My Reflection” overview Mapping “My Reflection” to milestones
![Questions jason e sapp 2 milmail mil Questions? jason. e. sapp 2. mil@mail. mil](https://slidetodoc.com/presentation_image/f944388c42c515fd30ad884a0e3fc314/image-47.jpg)
Questions? jason. e. sapp 2. mil@mail. mil
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