Helping Trainees Advocate for Their Needs

Published on in CHOP News

How do trainees feel about serving on hospital-wide committees? And are their experiences and learning perspectives being utilized in important conversations regarding these committees? These are questions Meghan Craven, MD, a pediatric endocrinology fellow, has sought to answer through her fellowship.

As a physician with interests including global health and medical education, Dr. Craven recently partnered with Dan C. West, MD, and Dorene Balmer, PhD, to complete a program evaluation of the Graduate Medical Education Committee (GMEC) at CHOP.

The Graduate Medical Education Committee oversees a hospital’s ACGME programs. Every hospital has one, and it is a requirement that at least two trainees who have been selected by their peers serve on their hospital’s GMEC. Dr. West, the head of CHOP’s GMEC, was looking to re-structure the committee, which prompted Dr. Craven to step in.

“I’ve always been a big proponent of trainees being advocates for themselves,” says Dr. Craven. “Being part of the Fellows Association, I spoke with Dorene (Balmer) about restructuring the committee in a way that allows trainees to be more meaningfully involved.”

Identifying needs and getting feedback

With the help of Drs. West and Balmer – and following a program evaluation framework published in an edition of the Journal of Graduate Medical Education (JGME)– Dr. Craven conducted brief qualitative interviews with three groups:

  • Chief residents and fellows who had participated in the committee
  • Committee members who are not trainees
  • Individuals outside of CHOP

The goal of these interviews was to:

  • Collect feedback
  • Get a sense of best practices
  • Identify key stakeholders

The team coded responses to note common themes addressed by each of the three groups and to rank them higher or lower on their list of improvement items based on how frequently they appeared.

Trainees expressed frustration that expectations about their roles were unclear, while non-trainees who served on the committee wanted learners to bring “ideas and action items” to the committee. Individuals from outside CHOP shared similar sentiments, but also requested that trainees’ administrative tasks be limited.

Additionally, Drs. Craven, West, and Balmer found these issues were applicable to other committees within the hospital. They noted the feedback could be used to make far-reaching improvements.

The COVID-19 pandemic also highlighted another issue with the GMEC for Dr. Craven and her team to consider while completing their program evaluation: accessibility of committee meetings.

“With GMEC meetings shifting to a virtual format due to COVID, attendance among residents and fellows has gone up quite a bit,” Dr. Craven explains. “It’s interesting to see what removing the physical barrier of attendance has done, and I think offering a virtual meeting option is definitely something that should be considered going forward.”

Sharing their findings with CLIME and beyond

Another thing Dr. Craven is thinking about going forward: How to disseminate the work that she and Drs. West and Balmer conducted.

Dr. Craven hopes to submit a perspective piece on the GMEC program evaluation to the JGME. In discussing this venture with Dr. Balmer, Dr. Craven says they both agree that presenting the process of how they conducted the program evaluation would probably be the “most useful” piece of information to give potential readers. Emphasizing how improvements can be applied to other committees is another important consideration that’s worth considering.

Besides preparing a manuscript for submission, Dr. Craven is also looking to take her program evaluation and present it at a national conference or meeting next year, hopefully as a workshop. This is also something she and Dr. Balmer have discussed, but “we haven’t gotten quite there yet” in terms of execution, she says.

For now, Dr. Craven is thankful she’s been able to share her scholarship via presentations at the Education Collaboratory sessions (hosted by Dr. Balmer as part of CLIME’s initiatives to promote learning and community across CHOP) as well as this year’s Interprofessional Education Day (an intensive hospital-wide symposium that connects a variety of staff and allows them to discuss their scholarship with each other) in January 2021.

And while Dr. Craven and her team have done extensive work on their program evaluation of the GMEC at CHOP, she acknowledges the task is far from over. This type of undertaking will probably be “ongoing,” says Dr. Craven.

“As a resident, it always bothered me to hear, ‘you’re only [at this hospital] for three years’ because there will always be residents and fellows rotating through,” Dr, Craven says. “You certainly may not be able to change everything for the three years you spend there during residency, but you can make change. I think it’s important to try and improve things for the next person.”

Sharing their findings

Following up on that point, Dr. Craven notes that constantly having a new batch of people rotate through the hospital is yet another benefit to completing a program evaluation of a hospital committee. Despite the high turnover rate, new people equal new and fresh ideas and the ability to see what might work and how.

In closing, Dr. Craven has some advice for her counterparts at other institutions who might be seeking to conduct a program evaluation but feel timid about doing so.

“It may seem overwhelming, but it can be easy to do,” she says. “Think about how trainees can meaningfully participate and how you can value their time.”