The deadline to apply for the 2022-2023 cohort of the Department of Internal Medicine, Faculty Development Program (ACES), is January 14, 2022. ACES is a year-long program in which junior faculty learn how to conduct a scholarship and carry out a research project under the tutelage of the Program Director Donna Windish, MD, MPH, assistant professor of medicine, plus other faculty members.
The educational grant is a research into the topic of medical education in this case. Most often, according to Windish, this involves developing a curriculum and evaluating how that curriculum affects trainees’ understanding of the material or, less directly, the health of patients in their care.
ACES participants dedicate one day per week to the program: half a day to attend seminars on topics including statistics and questionnaire design, library research, manuscript preparation, and applying for funding; Half a day on the same research project. The ideal candidates are junior faculty members in the physician-educator track within the Department of Internal Medicine. “The mission is to enhance the career development of these clinical teachers,” Wendish said.
Wendish said the achievements of previous participants, whose research results at ACES have been published in leading medical journals and presented at prestigious conferences, are a testament to the program’s success.
Associate Professor of Internal Medicine Matthew Seegark, Associate Physician for ACES 2020-21, was curious about how medical interns responded to learning how their patients were doing after discharge from the hospital. Currently, there is no standard way for interns to receive feedback on their patients’ performance after hospital discharge. Our goal was to provide those comments and analyze the impact of providing those comments.”
Along with other colleagues in the department, he developed a curriculum in which attending physicians review the post-discharge outcomes of patients recently cared for by interns along with medical students and residents. The curriculum also included a general discussion of factors that could lead to poor post-discharge outcomes and time to reflect on factors that might have influenced the post-discharge outcomes of trainee patients. The attending physicians handed over the syllabuses to the trainees during teaching sessions called attendance rounds, and Zagark surveyed the trainees before and after the session. After the intervention, the trainees felt a greater sense of responsibility towards their patients after they were discharged from the hospital. More than half of the interns said they intended to change some aspect of their approach to layoff planning. Zegarek presented his findings at the Mountain West/New England Joint General Internal Medicine Association regional meeting in November 2021, and a manuscript of his work is under review in a peer-reviewed medical journal.
David J. Hur, MD, an ACES 2019-20 participant and assistant professor of medicine (cardiology), conducted a survey to determine how well fellowship programs train cardiologists in cardiovascular computerized tomography (CCT). Computerized tomography is an imaging technology that cardiologists can use to diagnose heart disease. The American College of Cardiology recommends that cardiology fellows receive first-level training in CCT, which covers when to order CCT scans and how to interpret results. Hoare wondered whether fellowship programs meet these guidelines. He surveyed fellows and cardiology faculty about the CCT training they had received during their fellowships and whether they felt it was adequate. Respondents reported that they received an average of five hours of CCT training but wanted much more. For comparison, a self-guided Level 1 course can take 10 hours to complete, Hoare said. Hoare presented his findings at the Society for Cardiovascular Computed Tomography (SCCT)’s 16th annual scientific meeting in July 2021, and the findings report appeared online at Journal of computed tomography of the heart and blood vessels In September 2021.
For Hoare, ACES was a gateway to the cardiology community outside of Yale. Since completing the ACES Fellowship, Hur has gained admission into the SCCT Future Leaders Program. “This has opened doors for additional collaborators and investigators in the field across different parts of the United States and even internationally,” Hoare said.
In her 2019-2020 research project, ACES co-author Parul Gandhi, MD, assistant professor of internal medicine (cardiovascular), assessed cardiology colleagues’ knowledge of using biomarkers to diagnose and predict heart failure. The biomarkers in question are proteins produced by the heart when exposed to stress. National guidelines strongly recommend that doctors measure levels of these biomarkers in patients with symptoms of heart failure. Gandhi wondered if colleagues were being trained to do so. It surveyed Connecticut cardiology colleagues about the biomarker training they received, the training they would like to receive, and their knowledge of national guidelines. More than half of the colleagues surveyed received some training on this topic. However, the survey showed that many colleagues wanted more training, and were not familiar with the guidelines. In November 2021, Gandhi published these findings in Journal of the American College of Cardiology.
Gandhi cannot say enough about how much she appreciated her experience as an ACES participant. When she applied for the program, she had extensive teaching experience but no scholarship training. “It is important to have all of these skills, but we rarely receive a dedicated education to guide us through the development of a project from start to finish,” she said. That’s exactly what ACES did.
“I think every doctor and educator should consider this programme,” Gandhi said. “I think it’s something every doctor and educator should do.”