- Email: [email protected]
The Association of Pediatric Program Directors’ Strategic Plan: An Opportunity for Transformational Change
View from the Association of Pediatric Program Directors
The Association of Pediatric Program Directors’ Strategic Plan: An Opportunity for Transformational Change Ann E. Burke, MD; Susan Guralnick, MD; Patricia Hicks, MD Academic Pediatrics 2010;10:220–1
I
n late February 2010, the leadership of the Association of Pediatric Program Directors (APPD) assembled key representatives of the pediatric undergraduate medical education and graduate medical education community to develop a new APPD strategic plan, a road map that could potentially transform pediatric medical education. This collaborative process included past and present leaders of APPD and current leaders of the Academic Pediatric Association (APA); the dialogue served to inform our understanding of history, where we are now, and consider what we might want to explore. It is unusual for strategic planning to take place in the presence of others outside an organization, but within the same field. However, the APPD board felt that the inclusion of all key stakeholders was critical to our deliberations and would allow us to learn and grow from the valuable contributions of many current and past leaders in pediatric medical education. In addition to the APPD leaders and representatives, others present for the 2-day proceedings were Gail McGuinness, APPD member and executive vice president of the American Board of Pediatrics (ABP); Janet Serwint, president elect of the APA and an associate program director; Ted Sectish, a past president of the APPD and director of the Federation of Pediatric Organizations; Jerry Woodhead, president elect of the Council on Medical Student Education in Pediatrics; Jim Bale, incoming chair of the Council of Pediatric Subspecialties; Carol Carraccio, director of the Initiative for Innovation in Pediatric Education (IIPE) and the Milestones Project; and Hilary Haftel, director of the Longitudinal Educational Assessment Research Network
(LEARN). The complement of other talented individuals present represented a broad sweep of pediatric medical education. The APPD board’s clear beginning was the existing APPD vision statement: ‘‘Exemplary Pediatric Education.’’ Importantly, during our discussions, this statement was supplemented with the phrase, ‘‘across the continuum.’’ The work of the strategic planning process was to further define and delineate the components of the plan’s conceptual framework, aimed to move us toward this vision. The APPD has grown rapidly over the past decade. In fact, the number of members has gone from 1576 to 2329 in the past three years! Ken Roberts described the historical work and challenges of the organization from its infancy 25 years ago to the present. He recaptured the key historical events, reflecting on those situational or contextual features that influenced the many successes; he also shared some lessons learned and cultural insight. Informed by Dr Robert’s discussion, the group recognized that although individual member’s needs should be respected and met, the organization has historically considered each program as a ‘‘member.’’ Dr Robert’s reflective and thoughtful recounting of historical events had a significant impact on the group, giving all of us a great appreciation for the tremendous development of the organization. The strategic plan was framed by 4 goals that fell under the following headings: programs and membership, research and education, collaboration and outreach, leadership and performance. Further, all goals are interconnected at many levels and aimed to assist the organization in accomplishing our vision of ‘‘exemplary pediatric education across the continuum.’’ The preamble of the strategic plan is as follows: The APPD has served residency programs and program directors for over 25 years. Beginning in 1985, the organization was first guided by the doctrine of enhancing the career development and satisfaction of the individual program directors. The organization evolved into providing career development within the broader setting of pediatric graduate medical education and, by the late 1990s, advanced into promoting leadership and collaboration among other pediatric educational organizations.
From the Department of Pediatrics, Wright State University Boonshoft School of Medicine, Dayton, Ohio (Dr Burke); Winthrop University Hospital, Department of Pediatrics, Mineola, NY (Dr Guralnick); and Department of Pediatrics, The Children’s Hospital of Philadelphia and the University of Pennsylvania School of Medicine, Philadelphia, Pa (Dr Hicks). Dr Burke is the current president of the Association of Pediatric Program Directors. Dr Guralnick is immediate past president and Dr Hicks is president elect. Address correspondence to Ann E. Burke, MD, Dayton Children’s Medical Center, Wright State University Boonshoft School of Medicine, Department of Pediatrics, Medical Education Department, One Children’s Plaza, Dayton, Ohio 45419 (e-mail: [email protected]). ACADEMIC PEDIATRICS Copyright Ó 2010 by Academic Pediatric Association
220
Volume 10, Number 4 July–August 2010
ACADEMIC PEDIATRICS
APPD Strategic Plan
Programs and Membership Research and Education
Leadership and Performance
Collaboration and Outreach
Figure. Four goals of the Association of Pediatric Program Directors.
The 4 goals headings and how they may intersect and overlap is shown in the Figure. The ‘‘triangles within a triangle’’ figure illustrates in 2 dimensions how we envision the 4 goals interacting and working synergistically, with ebb and flow of activities and outcomes across the various compartments. Note that Research and Education is at the center. It is an exciting time in the field of pediatric education, with a number of interesting and innovative opportunities. The Milestones Project, a joint endeavor of the ABP and the Accreditation Council for Graduate Medical Education (ACGME), has the following aims: 1) further delineate and define the 6 competencies while establishing thresholds for each specialty; 2) set performance standards by level of training for residents; and 3) identify and develop assessment tools to measure performance that can be used by educators. This project has been ongoing for the past year, with pediatric program directors participating in the working group and APPD membership having great input into the discussions.1 As well, the IIPE, 2 which streams out of the recent ABP Residency Review and Redesign Project,3 is attempting to foster innovation and new ways to educate residents. The strategic plan addressed and reinforced the collaborative work between the APPD and the Milestones Project and the IIPE projects. The Institute of Medicine’s duty hours report is expected to recommend dramatic changes to work hours, supervision of residents, and patient care handovers.4 We anticipate that these new work hours will present challenges and opportunities to all pediatric educators. In our strategic planning process, we were mindful of the potential effects and possible unforeseen consequences of these work hour changes, as well as the other above-mentioned factors/ forces on pediatric graduate medical education. The strategic plan describes avenues to assist the membership in operational planning when the ACGME work hour requirements are announced. As well, by partnering with the IIPE and the Milestones Project to help enhance and improve
221
graduate medical education, the APPD remains optimistic that the opportunity to educate residents is one that will be transformative. One APPD initiative that has been planned for some time and is now ripe for pursuing is APPD LEARN. The APPD has hopes that by working together as a community of pediatric educators and teachers, we can collaborate to realize an organized approach to meaningful research questions posed regarding resident assessment. We are coming out of our silos! APPD has a vigorous, passionate membership that will, given the right support, infrastructure, and leadership, succeed in increasing the validity evidence of various assessment tools and residency training practices. Our strategic plan has much effort and support aimed at this project. Assessment and database repository experts have been contracted to start the work of ‘‘building’’ LEARN. APPD LEARN will offer the membership and the larger pediatric educational community opportunities to collaborate, learn, and develop as researchers while contributing to the quality of graduate medical education. Other strategies that will move us toward our goals include the following: a) plans for a program director ‘‘school;’’ b) development of international medical educational initiatives with collaboration among our partner organizations; and c) collaboration with the ACGME in the development of assessment methods and testing of the pediatric milestones. Having highlighted only a few of the concepts and elements of the new APPD strategic plan, we leave with a clear and humble understanding that there is a lot of work at hand. The time is right in pediatric graduate medical education to provide the evidence to inform the direction of pediatric medical education and our own professional development.5 The APPD will continue to seek input from individual members and those from other organizations as we both elaborate and focus our plan with concrete action items. This process will take quite a bit of imaginative thought, hard work, and careful planning. REFERENCES 1. Rushton JL, Hicks PJ, Carraccio CL. The next phase of pediatric residency education: the partnership of the milestones project. Acad Pediatr. 2010;10:91–92. 2. Initiative for Innovation in Pediatric Education (IIPE) Web site. Available at: http://www.innovatepedsgme.org. Accessed April 18, 2010. 3. Jones MD, Leslie LK, McGuinness GA. A supplement to pediatrics. Residency review and redesign in pediatrics: new (and old) questions. Pediatrics. 2009;123(supp1):s1–s60. 4. Ulmer C, Wolman DM, Johns MME. Resident Duty Hours: Enhancing Sleep, Supervision and Safety. Washington, DC: National Academy of Sciences; 2008. 5. Hicks PJ. Planning for change: medical education program design, patient care, and measures of effectiveness. Acad Pediatr. 2009;9:67–68.
The Association of Pediatric Program Directors’ Strategic Plan: An Opportunity for Transformational Change Ann E. Burke, MD; Susan Guralnick, MD; Patricia Hicks, MD Academic Pediatrics 2010;10:220–1
I
n late February 2010, the leadership of the Association of Pediatric Program Directors (APPD) assembled key representatives of the pediatric undergraduate medical education and graduate medical education community to develop a new APPD strategic plan, a road map that could potentially transform pediatric medical education. This collaborative process included past and present leaders of APPD and current leaders of the Academic Pediatric Association (APA); the dialogue served to inform our understanding of history, where we are now, and consider what we might want to explore. It is unusual for strategic planning to take place in the presence of others outside an organization, but within the same field. However, the APPD board felt that the inclusion of all key stakeholders was critical to our deliberations and would allow us to learn and grow from the valuable contributions of many current and past leaders in pediatric medical education. In addition to the APPD leaders and representatives, others present for the 2-day proceedings were Gail McGuinness, APPD member and executive vice president of the American Board of Pediatrics (ABP); Janet Serwint, president elect of the APA and an associate program director; Ted Sectish, a past president of the APPD and director of the Federation of Pediatric Organizations; Jerry Woodhead, president elect of the Council on Medical Student Education in Pediatrics; Jim Bale, incoming chair of the Council of Pediatric Subspecialties; Carol Carraccio, director of the Initiative for Innovation in Pediatric Education (IIPE) and the Milestones Project; and Hilary Haftel, director of the Longitudinal Educational Assessment Research Network
(LEARN). The complement of other talented individuals present represented a broad sweep of pediatric medical education. The APPD board’s clear beginning was the existing APPD vision statement: ‘‘Exemplary Pediatric Education.’’ Importantly, during our discussions, this statement was supplemented with the phrase, ‘‘across the continuum.’’ The work of the strategic planning process was to further define and delineate the components of the plan’s conceptual framework, aimed to move us toward this vision. The APPD has grown rapidly over the past decade. In fact, the number of members has gone from 1576 to 2329 in the past three years! Ken Roberts described the historical work and challenges of the organization from its infancy 25 years ago to the present. He recaptured the key historical events, reflecting on those situational or contextual features that influenced the many successes; he also shared some lessons learned and cultural insight. Informed by Dr Robert’s discussion, the group recognized that although individual member’s needs should be respected and met, the organization has historically considered each program as a ‘‘member.’’ Dr Robert’s reflective and thoughtful recounting of historical events had a significant impact on the group, giving all of us a great appreciation for the tremendous development of the organization. The strategic plan was framed by 4 goals that fell under the following headings: programs and membership, research and education, collaboration and outreach, leadership and performance. Further, all goals are interconnected at many levels and aimed to assist the organization in accomplishing our vision of ‘‘exemplary pediatric education across the continuum.’’ The preamble of the strategic plan is as follows: The APPD has served residency programs and program directors for over 25 years. Beginning in 1985, the organization was first guided by the doctrine of enhancing the career development and satisfaction of the individual program directors. The organization evolved into providing career development within the broader setting of pediatric graduate medical education and, by the late 1990s, advanced into promoting leadership and collaboration among other pediatric educational organizations.
From the Department of Pediatrics, Wright State University Boonshoft School of Medicine, Dayton, Ohio (Dr Burke); Winthrop University Hospital, Department of Pediatrics, Mineola, NY (Dr Guralnick); and Department of Pediatrics, The Children’s Hospital of Philadelphia and the University of Pennsylvania School of Medicine, Philadelphia, Pa (Dr Hicks). Dr Burke is the current president of the Association of Pediatric Program Directors. Dr Guralnick is immediate past president and Dr Hicks is president elect. Address correspondence to Ann E. Burke, MD, Dayton Children’s Medical Center, Wright State University Boonshoft School of Medicine, Department of Pediatrics, Medical Education Department, One Children’s Plaza, Dayton, Ohio 45419 (e-mail: [email protected]). ACADEMIC PEDIATRICS Copyright Ó 2010 by Academic Pediatric Association
220
Volume 10, Number 4 July–August 2010
ACADEMIC PEDIATRICS
APPD Strategic Plan
Programs and Membership Research and Education
Leadership and Performance
Collaboration and Outreach
Figure. Four goals of the Association of Pediatric Program Directors.
The 4 goals headings and how they may intersect and overlap is shown in the Figure. The ‘‘triangles within a triangle’’ figure illustrates in 2 dimensions how we envision the 4 goals interacting and working synergistically, with ebb and flow of activities and outcomes across the various compartments. Note that Research and Education is at the center. It is an exciting time in the field of pediatric education, with a number of interesting and innovative opportunities. The Milestones Project, a joint endeavor of the ABP and the Accreditation Council for Graduate Medical Education (ACGME), has the following aims: 1) further delineate and define the 6 competencies while establishing thresholds for each specialty; 2) set performance standards by level of training for residents; and 3) identify and develop assessment tools to measure performance that can be used by educators. This project has been ongoing for the past year, with pediatric program directors participating in the working group and APPD membership having great input into the discussions.1 As well, the IIPE, 2 which streams out of the recent ABP Residency Review and Redesign Project,3 is attempting to foster innovation and new ways to educate residents. The strategic plan addressed and reinforced the collaborative work between the APPD and the Milestones Project and the IIPE projects. The Institute of Medicine’s duty hours report is expected to recommend dramatic changes to work hours, supervision of residents, and patient care handovers.4 We anticipate that these new work hours will present challenges and opportunities to all pediatric educators. In our strategic planning process, we were mindful of the potential effects and possible unforeseen consequences of these work hour changes, as well as the other above-mentioned factors/ forces on pediatric graduate medical education. The strategic plan describes avenues to assist the membership in operational planning when the ACGME work hour requirements are announced. As well, by partnering with the IIPE and the Milestones Project to help enhance and improve
221
graduate medical education, the APPD remains optimistic that the opportunity to educate residents is one that will be transformative. One APPD initiative that has been planned for some time and is now ripe for pursuing is APPD LEARN. The APPD has hopes that by working together as a community of pediatric educators and teachers, we can collaborate to realize an organized approach to meaningful research questions posed regarding resident assessment. We are coming out of our silos! APPD has a vigorous, passionate membership that will, given the right support, infrastructure, and leadership, succeed in increasing the validity evidence of various assessment tools and residency training practices. Our strategic plan has much effort and support aimed at this project. Assessment and database repository experts have been contracted to start the work of ‘‘building’’ LEARN. APPD LEARN will offer the membership and the larger pediatric educational community opportunities to collaborate, learn, and develop as researchers while contributing to the quality of graduate medical education. Other strategies that will move us toward our goals include the following: a) plans for a program director ‘‘school;’’ b) development of international medical educational initiatives with collaboration among our partner organizations; and c) collaboration with the ACGME in the development of assessment methods and testing of the pediatric milestones. Having highlighted only a few of the concepts and elements of the new APPD strategic plan, we leave with a clear and humble understanding that there is a lot of work at hand. The time is right in pediatric graduate medical education to provide the evidence to inform the direction of pediatric medical education and our own professional development.5 The APPD will continue to seek input from individual members and those from other organizations as we both elaborate and focus our plan with concrete action items. This process will take quite a bit of imaginative thought, hard work, and careful planning. REFERENCES 1. Rushton JL, Hicks PJ, Carraccio CL. The next phase of pediatric residency education: the partnership of the milestones project. Acad Pediatr. 2010;10:91–92. 2. Initiative for Innovation in Pediatric Education (IIPE) Web site. Available at: http://www.innovatepedsgme.org. Accessed April 18, 2010. 3. Jones MD, Leslie LK, McGuinness GA. A supplement to pediatrics. Residency review and redesign in pediatrics: new (and old) questions. Pediatrics. 2009;123(supp1):s1–s60. 4. Ulmer C, Wolman DM, Johns MME. Resident Duty Hours: Enhancing Sleep, Supervision and Safety. Washington, DC: National Academy of Sciences; 2008. 5. Hicks PJ. Planning for change: medical education program design, patient care, and measures of effectiveness. Acad Pediatr. 2009;9:67–68.