Baystate Learner-Manager-Teacher Model
Our model is based on the recognition that autonomy and supervision must be balanced at every stage of learning.
The adult learner flourishes with autonomy, however, early learners require supervision to deliver high quality patient care. As Learners become more competent, the balance of supervision and autonomy shifts. The new balance leads to the development of the skills necessary for high quality future patient care.
Through these stages you will not only gain competence and autonomy, but will develop a partnership with your colleagues and faculty, an increased awareness of safety and quality, and the skills necessary to become a life-long learner.
You will build a solid foundation of clinical skills and competence managing patients with common medical problems under the supervision of a Teacher and an attending.
You will become competent managing patient with more complex medical problems and making independent decisions as you work 1-on-1 (collaboratively) with your attending
You will become proficient in managing patients with complex medical problems while building leadership and teaching skills as you supervise a pair of learners.
Among First Chosen for ACGME's Educational Innovations Project (EIP)
Our program was one of only 21 Internal Medicine residency programs chosen in March 2006 to participate in the first round of the Accreditation Council for Graduate Medical Education's Educational Innovations Project (EIP).
The EIP empowered programs to develop innovative training models. Baystate's LMT Model is the result of that project.
Our Primary Care program runs concurrently with the Categorical program, and during the first 6 months of intern year, they have the same core rotations.
We offer four career tracks that let you explore your options during training.
A highly structured experience that will teach you the fundamental skills needed to be successful, including pre-rounding, presentations, ordering labs/diagnostic studies, handover skills, medical reconciliation, and note-writing, as well as how to utilize our Electronic Health Record and order sets. Conferences and controlled patient volume enhance the experience and opportunities for learning. Built-in social events help you get to know your peers.
Block One Immersion
All learners spend 2 weeks on the wards, one week in ambulatory and one week in the CICU or ICU service. These core experiences ensure exposure to, and development of, the foundational skills necessary for the successful transition into residency.
Intern Boot Camp
Incorporated into the Block One Immersion experience is a robust simulation curriculum. Boot camp is comprised of 8 sessions for which Learners care for acutely ill simulation patients with chest pain, shortness of breath, hypotension, and change in mental status. After each 30-minute case, there is a 60-minute debriefing and teaching period led by out chief residents. The goals of intern boot camp are to teach new learners how to recognize sick patients, stabilize them, and know when to and how to call for help.
A 2 week block experience in late June of alternating 1 week rotations to facilitate each resident’s growth into their new role as manager or teacher before new learners arrive. Upcoming managers (night float, CICU, Wards and Codes) and Teachers (ICU and Wards) are on-call with at least one peer. Didactic conferences focus on the unique needs of these groups.
An intensive two-week curriculum in the Learner year focusing on transitions of care and quality improvement. The Tracer acts as a quality officer for a ward team and as a key member of a multi-disciplinary performance improvement team. Tracer residents follow ward patients into rehabilitation and home where they use formal survey tools to assess the quality of the transitions. Tracer residents participate in root cause analysis as well as quality improvement and patient satisfaction efforts within the system
The Tracer block is a meaningful educational experience with residents gaining invaluable insight into the macro-systems of care. The Tracer residents experience is central to the transitions PI team and has impacted our processes leading to improved clinical outcomes.
A four hour block of protected educational time for ALL of our residents on Tuesday afternoon from 1 – 5 pm. Led by faculty and Teacher residents with the expertise of subspecialty colleagues, AHD is a robust and dynamic opportunity for our education and team-building curriculum. Intern morning reports and board preparation are dedicated weekly sessions.
Self-Reflection & Self-Assessment
Promoting resident well-being and personal and professional growth is increasingly important to us as concern about burnout in the medical community grows.Working together, our IM and Med-Peds residency programs developed a structured, yearlong self-reflection curriculum—building in protected time for residents to participate.
Facilitators help guide self-reflection and self-assessment using different techniques that residents can use at work and in their outside lives. The curriculum uses a variety of educational modalities to achieve this goal—journaling, multi-media, humanities, active facilitation, and the arts.
(Photo collage: Residents participating in sessions devoted to Imposter Syndrome and Divergent Thinking.)
Robust educational session, led by chief residents, focusing on diagnostic and clinical reasoning, pathophysiology, guidelines, and journal review.
Competency-based Assessment and Multi-source Feedback
The entirety of assessments in our program are competence-based and we use MSF (self-assessment, patient, peer, nursing, and faculty surveys, etc.) to develop an accurate assessment of each resident. These assessments are used to direct feedback and develop experiences that support resident advancement into competent providers.