Background: In 2014, UCLA Health embarked on a journey to train and inspire the future generation of medicine. The Healthcare Improvement & iNnovation in Quality (THINQ) Collaborative aims to radically shape care delivery by building transformative interdisciplinary platforms to catalyze and nurture innovation at UCLA that lead to large-scale impact. Further, THINQ aspires to engage [...]

Background: The Accreditation Council for Graduate Medical Education (ACGME) realizes the importance of ambulatory medicine as an integral part of internal medicine (IM) training. Therefore, program requirements specify that at least one third of the training needs to be spent in ambulatory settings. ACGME requires residents to spend between 4 to 8 weeks in emergency [...]

Background: Hospitalists’ favorable impact on student education is well described.  There is an emerging mandate to equip health care professionals with skills in navigating complex systems, interprofessional teamwork, and quality improvement.  Surgical teams are ideal settings for demonstrating such concepts, and hospitalists in the co-management role are uniquely positioned to facilitate education in these areas. [...]

Background: Scholarly activity is an important component of academic medicine. Medical schools have traditionally used publications when considering promotion. In previously published studies, academic clinician-educator generalists’ publication productivity was considerably less than that of academic specialists. Prior to 2012, our Department did not have specific scholarly activity promotion requirements for clinician-educations. In an attempt to [...]

Background: The transition of an experienced Registered Nurse into a novice hospital-based Nurse Practitioner (NP) is frequently met with trepidation. The novice NP is often uncertain if s/he possesses the level of clinical competency and scientific knowledge required to provide high quality evidence-based care to complex hospitalized patients. How does one ease the stress associated [...]

Background: Self-reflection facilitates the identification of performance gaps and is a critical step in the process of behavior change among physicians.  However, little is known about reflection and its relation to behavior change in hospital medicine (HM) continuing medical education (CME).  Our objectives were to identify associations between validated reflection scores and characteristics of CME [...]

Background: Medical schools and residency programs have competency and milestone-based frameworks to assess trainees. A parallel framework does not exist for the assessment of hospital medicine fellows and faculty in their initial years of practice. This study aimed to develop consensus among hospitalists on the most important clinical competencies for early career hospitalists. Methods: The [...]

Background: Medication errors are common, with more than half of patients estimated to have greater than or equal to one unintended medication discrepancy at hospital admission.  Medication reconciliation can identify errors. Although there has been significant investigation into the most effective logistical strategies for performing medicine reconciliation within the healthcare system, there is little investigation [...]

Background: With the roll out of ACGME  outcomes-based milestones as a framework for determining resident and fellow performance within the six ACGME Core Competencies in 2013, residency training programs have been tasked to directly observe and evaluate learner progress. Competencies such as systems based practice, interpersonal and communication skills, and professionalism need to be directly [...]

Background: Health care policy is currently under scrutiny due to health care reform, yet in our experience the majority of house staff have insufficient opportunity to learn about the environment they will soon be practicing medicine in. The ACGME attempts to address this through the Systems-based practice competency, but further guidance is lacking. Purpose: Our [...]