Macy GME Innovation Conference
Don Berwick, MD, MPP, giving the opening presentation at the Macy GME Innovation regional conference.
Partners HealthCare recently hosted the Macy Regional Conference on Innovation in Graduate Medical Education. Approximately 80 individuals including program directors, deans, institutional GME leaders, faculty, residents, and fellows attended the May 6, 2016 conference. Participants came from 7 New England and Atlantic states and 28 institutions. At least eight specialties and a large number of subspecialties were represented. In addition, several national medical education-related organizations were represented: ACGME, AAMC, The Arnold P. Gold Foundation, and the Veterans Administration, as well as the Josiah Macy Jr. Foundation.
The highlights of the conference included
- Plenary Session: Don Berwick, MD, MPP, widely known as an innovator in health care improvement, described some of the major changes underway in healthcare and noted that today’s residents will practice in a system different from the one in which they are training.
- Innovation Presentations: 12 innovations, spanning a range of topics, were selected for brief presentations in three areas:
1. Professional Development of Residents: Evaluation, Coaching, and Individualized Training
2. Interprofessional Education and Practice
3. Curriculum Development
- Obstacles and Enablers to Innovation was the topic for afternoon break-out sessions. Groups were asked to highlight key obstacles – other than time and money – and discuss what they have seen or imagined as effective enablers. The groups were asked to concentrate on the dynamics at play at one of three levels: 1) programs and institutions; 2) national organizations; or 3) public policy. At the institutional level, competing priorities and the inability to see beyond current limitations were cited as significant obstacles, along with a siloed approach to educational planning and an inherent resistance to importing good ideas “not invented here”. Not surprisingly, the tension between “service” and education arose as an issue. Enablers to cultivate were thought to include: a political strategy aligned with institutional priorities, an influential champion, strong relationships, stories of success, and preparation, planning, and persistence. Similar ideas emerged when considering the role of national organizations: insufficient priority placed on education; a lack of communication across specialties; and the lack of a mechanism to endorse new educational technologies to stimulate broad implementation. It was suggested that medicine could apply effective models from other disciplines. Also, some called for more publications about innovations, even in advance of solid outcomes data, and a dynamic online source of information was suggested.
A lack of funding was cited as both the dominant obstacle and perhaps greatest potential enabler of GME innovation at the national policy level. Participants also commented on suboptimal use of available GME funding and inadequate public dialogue about GME.
- Disseminating innovation was addressed in the final session. David Blumenthal, MD, President of the Commonwealth Fund and a member of the Macy Foundation Board of Directors, gave an introductory presentation, noting the attributes of a successful innovation and encouraging participants to remember that we are in the “innovation diffusion business”. Dr. Blumenthal then facilitated a panel of speakers who brought perspectives honed by their experience in academic publishing, public policy, consumer advocacy and accreditation.
Feedback from participants at the end of the conference was uniformly positive.
The conference affirmed that innovation is alive and well in GME. Dedicated educators at various types of teaching institutions are focused on improving GME in order to enhance our trainees’ education and achieve better health outcomes for individuals and society at an affordable cost. Participants appreciated the opportunity to communicate about their work and to connect with colleagues, especially since conferences are becoming more difficult to access as budgets get tighter.