At the beginning of the 2016/2017 academic year, in partnership with the director of medical resident education at VABHS, the chief medical residents met to reconcile these into a single shared mission statement. Special attention was paid to educational gaps at each affiliate institution that could be filled while residents were rotating at VABHS. Once all educational goals and priorities of the shared mission statement were identified, the chief medical residents and director of medical resident education adopted the mission statement as the blueprint for all educational programming for the academic year. Progress toward enacting the various components of the mission statement was reviewed monthly and changes in educational programming to ensure adequate emphasis of all components were made accordingly.
Our first goal was to promote the personal and professional development of residents who rotate through VABHS, particularly interns, in a setting that fosters cross-institutional collaboration, respect, and friendship. The West Roxbury campus of VABHS is the only hospital in the city where internal medicine residents from 3 large training programs work together on teams that have been intentionally built to place residents from different institutions with one another. In educational conferences, we encouraged residents from different training programs to share their experiences with patient populations that others may not see at their home institutions, based on the specialized care that each institution provides. The conferences also give residents the opportunity to provide and receive near-peer teaching in a collegial environment.
Our second goal was to maintain an environment of educational excellence. We produced thought-provoking conferences that prioritized inspiring curiosity and teaching systems of thought over the dissemination of facts. We regularly focused on the broader context of medicine in case conferences and journal club, including topics such as public health, health policy, advocacy, health economics, quality improvement (QI), and high-value care. Our morning reports were interactive and participatory, emphasizing both technical skill practice and sophisticated clinical reasoning.
We embraced the principles of cognitive learning theory by priming learners with preconference “teasers” that previewed conference topics to be discussed. Every Friday, we played a medical version of Jeopardy!, which used spaced learning to consolidate the week’s teaching points in a fun, collaborative, and collegial atmosphere. Our dedicated patient safety conference gave residents the chance to use QI tools to dissect and tackle real problems in the hospital, and our monthly Morbidity and Mortality conference served as inspiration for many of the resident-driven QI projects.
Our third goal was to challenge physicians to provide the best possible care to veterans, including learning about issues unique to this often-marginalized population. We emphasized that training at a VA hospital is a privilege and that the best way to honor our veterans is to take advantage of the unique learning opportunities available at VA. To that end, we exposed residents to veteran-specific educational content, ranging from the structure and payment model of VHA to service-related medical conditions, such as posttraumatic stress disorder, other mental health issues, traumatic brain injury, Agent Orange exposure, and Gulf War Syndrome.