• General Internal Medicine
• Geriatrics
• Medical Education

I have many potential education projects. They focus on faculty development, teaching residents to teach, and resident education.

Title of research project:

1. Learning in the Valley of Death
   1. A cohort study of UCSF medical students from the Class of 2005 investigating the hidden curriculum in end-of-life care training. This project includes survey research from the entire class yearly since the second year and qualitative analysis from repeated interviews from a subset of students.
2. Symptom Management and Palliative Care at the UCSF/Mount Zion Comprehensive Cancer Center This project is to perform a detail needs assessment among both patients and clinicians, and then to develop, implement, and evaluate a symptom management and palliative care consultation service.

Title of research projects:
I have five areas of inquiry where residents would be welcome and could contribute significantly.

• Delineating the relationship between communication and professionalism: In collaborative work with Anna Chang and Karen Hauer on developing a curriculum in remediation, it has become increasingly clear that students identified as having deficits in communication skills may also (or instead) have professionalism issues. There is ample literature that connects communication and professionalism, but there is no paper that explicitly and formally links the two. The student/resident would conduct a literature review, gaining important fundamental skills in systematic and critical analysis of the literature, with the goal of preparing a manuscript for publication.
• Literature review of effective teaching behaviors and curricula for physical examination skills: Som Mookherjee (Dept of Hospital Medicine, Parnassus) and I are embarking on a narrative literature review of physical examination curricula to examine the features that will effectively move early medical students from the comprehensive approach of gathering information to a more targeted, reasoning-based approach. The student/resident would conduct a literature review, gaining important fundamental skills in systematic and critical analysis of the literature, with the goal of preparing a manuscript for publication.
• Completing a survey study of medical student comfort levels and partnering practices in co-ed settings: Kali Stanger (UCSF class of 2009) and I are working on analyzing data from one medical school class about their relative comfort with practicing on co-ed peers. The data has been collected; the resident would complete the data analysis, and critically analyze how this study adds to the literature (most recent lit review done in 2008). The project is very near completion; the goal is to edit and complete a manuscript for publication.
• Analyzing how the impact of student feedback to faculty can be enhanced: Marieke Kruidering (Dept of Pharmacology) and I have recently published a manuscript showing that feedback from students to faculty improves soon after the institution of a curriculum in feedback but slowly devolves in specificity over time. The decrease in specificity is wholly attributable to the loss over time of positive specific feedback. There are two sub-projects, both potentially publishable, that grow from this initial study (students/residents may choose one or both to work on):
  a. We are currently undertaking a follow-up study in which we electronically remind first-year students to remain specific in their positive feedback. The student/resident would gain experience in qualitative analysis by helping with the analysis of the impact of these electronic reminders on specific feedback in MS1s' evaluations of faculty lectures, using a previously-established rubric we developed.
  b. How do faculty actually use evaluations that students write of their teaching? There is surprisingly no literature addressing this question. Students/residents would work with us to develop a list of open-ended and closed-ended questions for faculty, help us select the types of faculty to interview, conduct focus groups or individual interviews, and analyze quantitative and qualitative data.
• Determining the impact of the VALOR Program: VALOR is a six-month longitudinal clerkship based at the VA in which cohorts of students rotate through surgery, medicine, neurology, and psychiatry. VALOR is currently the highest-rated such program at UCSF, and there are a number of projects related to individual components of VALOR that can be studied. VALOR students have written narratives on what patients have taught them during the program, and these are ripe for qualitative analysis. VALOR students undergo a mini-curriculum in professional development and career choice using a structured inquiry model that has not yet been described. Finally, as VALOR students graduate, tracking where they have matched for residency and determining the effect of their training at the VA will be of great interest, both to the School of Medicine as well as to the VA. Please contact me for further details about the directions in which these projects may develop.
• Career Counseling for Medical Students: To describe a novel method of helping medical students choose their eventual careers. The trainee(s) would interview MS4's who have undergone the counseling to determine their satisfaction with the method, the limitations, and follow the eventual outcomes.

Title/Description of Research Projects

Promoting reflection in medical students: A randomized trial Can reflective ability be assessed independently from writing and storytelling ability?
Teaching reflection: Impact of a faculty development program
The biopsychosocial approach: Potential impact on compliance and care transitions
Bolus v. drip: Teaching geriatrics to third year medical students
Systematic review: UME geriatrics education
Multiculturalism: A narrative medicine reader

Title/Description of Research Projects

I am completing a book on medical education, along with colleagues Dave Irby and Bridget O'Brien; publication is anticipated in mid-2008. Working on the book has provided me with a strong command of the theoretical frameworks supporting educational innovations in workplace/clinical learning and a broad grounding in the empirical literature. As I return from sabbatical I am re-engaging with a wide variety of educational program development projects at both the undergraduate and residency level. I am able to assist residents with relatively defined research interests to realize their own research project. In addition, I have a detailed understanding of the entire curriculum and am aware of many opportunities for a resident interested in medical education to participate in program development, assist with assessment and/or conduct research in either undergraduate or graduate level medical education.

Chronic Illness Curriculum - We implemented a chronic illness curriculum in 2007 at UCSF. We have collected outcomes data that is mostly quantitative. The resident's role would be to assist in the analysis of data and preparation of a manuscript for publication.

Title of research project: Impact of Decreased Duty Hours on the Well-Being of Residents.
Brief description of research project: Lange longitudinal survey of all disciplines with standardized questions done longitudinally for interns last year. Plenty of questions to ask this database.

Title of research project: An ECG and Cardiac Physical Exam Curriculum for Residents.
Brief description of research project: We are implementing a computer based cardiac physical exam training module to our established curriculum and looking and its availability to improve resident learning on the cardiac physical exam.

Title of research project: Presently have multiple research projects.