A new perspective on resident and education
The Flexner revolution continues…

David M. Worthen, MD

Objectives

Flexner report on medical education

Old perspective

Why do we need to change?

Public concerns about quality

Medical error makes lay press headlines: Institute of Medicine

The Market demands quality & cost effectiveness: The “45/55” problem

Historical shift in medicine

The new paradigm train is on its way to your hometown

New perspective

Slide 13

The context: old perspective:
The “academic triad”

Balancing the mission: Clinical

Balancing the mission: Research

Balancing the mission: Education

What is the original mission of academics…what is our core mission?

Slide 19

Slide 20

Alarming trends in program directors in ophthalmology

Tenure of program directors

Moving towards solutions

Pyramid of competence

Pyramid of competence:
Old perspective

Pyramid of competence

Competence

Sample escalating competence pyramid

Curriculum:
….Who’ s on first…

Sample learning objective pyramid (stratified  by year)

How did we get here???

What is the ACGME?

Who is ACGME?....Depending on your perspective

Accreditation Council for Graduate Medical Education (ACGME) competencies

Define competencies

Define competencies

Define competencies

Defining competencies

Defining competencies

Paradigm shift in assessment

Tools for the toolbox

Old tools

New tools for the toolbox

The solutions are right beneath our eyes

Matrix matching tools to competencies

What is the matrix?

ACGME:
What is the matrix?…what will your answer be??….

Osler was….

Osler was…wrong

Education train is here
 Be on it or under it….

Standardization is key

Great Baltimore Fire of 1904

The tragedy of lack of standards

Slide 54

Summary

Bottom line

Thank you for your time and attention