1. Program cycle 2008–2009
“Transitioning Adolescent Patients (TAP) from Pediatric to Adult Care”
Principal investigator: Emily von Scheven, MD, MAS, Pediatric Rheumatology,
University of California-San Francisco
The TAP project is developing an institution-wide program to facilitate the transition of
adolescent patients with chronic health care needs from pediatric- to adult-centered
care. There are two core initiatives: resident training in core competencies for
transitional care, and the development of a “transition handbook,” to be provided as a
three-ring binder to adolescent patients in order to teach self-management skills. The
content of the transition handbook will be reviewed and critiqued by a group of
adolescent patients prior to distribution. Investigators expect the handbook will improve
quality of care, as measured by surveys of provider knowledge and patient reports.
“Improving Patient Rounds (IPR)”
Principal investigator: Walter J. Moore, MD, Center for Patient- and Family-Centered
Care, Medical College of Georgia
The IPR project will initiate patient- and family-centered care rounds in adult medical
and surgical rounds. Project will initially follow and measure improvement of one service
team, practicing patient- and family-centered rounds, on the inpatient medicine unit, with
attention to patient, family, staff and physician satisfaction; unit costs; resident and unit
efficiency; and quality and safety. Educational effectiveness and team performance in
PFCC rounds will also be evaluated through student/faculty culture survey (pre/post),
written evaluations and student debriefing and videotaped session(s). Project results
include identifying steps and strategies applicable to other adult-care units, and
discovering and overcoming specific obstacles in PFCC rounds. Results will be
developed into a blueprint for use in MCG units and other institutions.
“Resident Performance from the Patient’s View”
Principal investigator: Dick M. Wardrop, MD, PhD, FAAP, Director of Resident
Research, Internal Medicine, Carilion Clinic, Roanoke, Va.
The Resident Performance project intends to adapt an existing attendant-based
evaluation into a patient-centered prototype tool that is concise, valid and reliable, and
that enables patients to accurately assess resident performance on 4/6 ACGME
competencies. Performance with regard to ACGME core competencies of residents who
receive feedback and coaching using the patient-centered tool will be compared to that
of those who received attending-only feedback.

2. “Patient-Centered Training of Residents on a Medical Ward”
Principal investigator: Robert C. Smith, MD, MS, Internal Medicine,
EW Sparrow Hospital/Michigan State University College of Human Medicine
The patient-centered training project intends to establish integrated patient-centered
care teams of project faculty and nursing staff to direct residents on a dedicated patient-
centered care ward. Project includes two visits from outside consultant Dr. Richard
Frankel for the purpose of developing integrated-care teams and a method for delivering
patient-centered care. Dr. Frankel will work with project faculty, nurse teachers and
hospital administration, with a focus on strategies for becoming successful change
agents. Success of patient-centered care delivery will be determined by descriptive and
patient-specific data.
Program cycle 2007–2008
“Emergency Medicine Resident Training
in Interprofessional Skills: Evaluating
a Needs-Based Curriculum”
Sondra Zabar, M.D., Principal Investigator
Associate Professor of Medicine
Linda Regan M.D., Co-Investigator
New York University School of Medicine
Since the 1960s, Emergency Medicine (EM) researchers have worked to demonstrate
the importance of patient-centered doctor-patient communication, only acknowledging
decades later that advancing such patient-centered care will require increased and
effective provider education. Having had experience with the development and
implementation of a controlled study on the impact of a comprehensive, integrated
clinical communication skills curriculum on students’ patient-centered skills, Section of
Primary Care faculty at New York University School of Medicine were prepared and
eager to partner with Emergency Medicine faculty on this very important topic. With the
commitment of NYUSOM-Bellevue Emergency Medicine Residency leadership, we
created the Emergency Medicine Professionalism and Communication Training
(EMPACT) Project.
EMPACT aims to expand on previous work by assessing and improving EM resident
competency in communication and professionalism through the development,
implementation, and evaluation of new curriculum and assessment measures. Our
objectives are to:

3. 1. Design, implement and evaluate a patient-centered healthcare curriculum for all 60
EM residents.
2. Evaluate the predictive validity of Objective Structured Clinical Examinations
(OSCEs) by assessing the correlation of OSCE performance with actual resident
performance in emergent care setting for cohort of PGY2 residents (n=15).
3. Disseminate this Patient-Centered Care educational program to EM programs
nationally.
We plan to complete EMPACT in four phases:
Phase I: Establish baseline competency of EM interns using a 5-station OSCE.
Phase II: Integrate an interactive skills-based series of five workshops focusing on
interpersonal and professionalism skills into monthly required EM seminar series.
Phase III: Conduct post-curriculum OSCEs to evaluate the impact of the curriculum.
Phase IV: Develop and implement a 2-case “unannounced” standardized patient (USP)
program.
Click here to read Dr. Zabar’s final report in its entirety.
Program cycle 2006–2007
John M. Tarpley, M.D.
Vanderbilt Medical Center
Vanderbilt University
“Cultural Sensitivity Initiative
for Medical Education”
Patient-centered care requires knowledge of and
sensitivity to cultural and faith-related issues. Dr.
Tarpley’s research revealed the degree to which
people in the medical profession are surrounded by
these issues, and the subsequent need to educate
medical personnel to understand and respond to
Dr. John M. Tarpley
patients’ cultural and spiritual concerns.

4. His findings include a proposal for the development of a graduate medical education
curriculum focusing on teaching healthcare professionals how to respond to patients in
a culturally appropriate manner.
Cultural and spiritual sensitivity is “useful in all eight of Picker Institute’s dimensions of
patient-centered care,” Dr. Tarpley concludes, and essential in these six”:
• Respect for patient’s values, preferences and expressed needs
• Information, communication and education
• Physical comfort
• Emotional support and alleviation of fear and anxiety
• Involvement of family and friends
• Transition and continuity
Click here to read Dr. Tarpley’s final report in its entirety.
Pamela J. Boyers, Ph.D.
Riverside Methodist Hospital
“Simulation Used to Measure the
ACGME Core Competencies and
Patient-Centered Care”
In 2002, the Accreditation Council for Graduate
Medical Education (ACGME) introduced
competency-based education into the institutional
and program requirements for all U.S. allopathic
residency programs. The six core competencies—
medical knowledge, communication,
professionalism, practice-based learning and
Dr. Pamela J. Boyers
improvement, systems-based care and patient
care—comprise a set of standard principles by which residents can be evaluated and a
general framework for curriculum development.
At present, there are no uniform guidelines to measure the successful integration of
these core competencies into residency education or resident progress toward
proficiency. By “simulating” doctor-patient scenarios involving such common complaints
as retinal detachment, colon cancer and low back pain. Prior to and after each

5. simulation, residents were asked to assess their own level of expertise, as was a
physician who had observed the simulation.
An examination of these scores indicated that “it is possible to objectively measure the
principles of patient-centered care embodied in the ACGME Core Competencies,” Dr.
Boyers concluded. The multifaceted evaluation process, which includes residents’ self
perceptions, recorded observations by attending-level physicians, 360-degree
evaluations by standardized patients and an objective examination, has the specific
advantage of measuring and recording the data generated by multiple separate
observations of a given skill set. Dr. Boyers concludes that “we must continue to work to
better define and measure skill sets within each competency, and to demonstrate that
mastery of each competency translates into excellence in patient-centered medical
care.”
Click here to read Dr. Boyers’s final report in its entirety.
William H. Hester, M.D.
McLeod Family Medicine
Residency Program
“Improving Patient Compliance
and Outcomes in Hypertension
Management in the ‘Stroke Capital’
of the World”
Dr. William Hester
The study was conducted at the McLeod Family Medicine Residency Program from March 1,
2006, to Dec. 31, 2006. The residency program is a 21-resident (eight PGYIII, six PGYII and
seven PGYI) community-based, stand-alone program affiliated with McLeod Regional Medical
Center in Florence, S.C. The six PGYII residents enrolled eligible patients from their practices.
Patients with uncontrolled hypertension (systolic blood pressure greater than 140 mm Hg) were
eligible for the study. Only patients who requested not to participate in the study were excluded.
At the initial visit, enrolled patients received introductory information (Appendix A). At each
subsequent visit, one of the four patient education tools was discussed. These tools were used
to trigger resident physician discussion of an important aspect of the need for hypertension
management. These tools were as follows:
Appendix B Tool #1: Nutrition Modification
(Food: Stay away from the salt "sodium")

6. Appendix B Tool #2A: Creatinine (Blood Test)
Appendix B Tool 2b: Urinalysis (Urine Test)
Appendix B Tool 3: Cholesterol
Appendix B Tool #4: EKG (Electrocardiogram)
Click here to read Dr. Hester’s final report in its entirety.
Anthony A. Meyer, M.D., Ph.D.
Renae E. Stafford, M.D., M.P.H.
Trauma and Critical Care Services/
The University of North Carolina
at Chapel Hill
“Development and Implementation of
an Interdisciplinary Palliative Care
End-of-Life Education Program for
Residents Who Rotate through the
Surgical Intensive Care Unit”
Dr. Renae Stafford
Drs. Meyer and Stafford prepared for their study by surveying 28 surgical residents on
end-of-life issues and bioethics and by administering to them a standardized palliative-
care knowledge examination. Survey data and exam scores “clearly elucidated the need
for further education.”
The doctors then instituted an educational program that involved the surgical residents in formal
lectures, role playing, experiential learning with participation in family meetings, grand rounds
presentations and journal clubs. Residents were also exposed to discussions about end-of-life
and palliative care in morbidity and mortality conferences and in surgical intensive-care-unit
daily rounds.
While the study has not yet been formally concluded, it has led to several initiatives that
have enhanced patient-centered care at UNC, according to Drs. Meyer and Stafford.
These include inclusion of surgical ICU nurses and students in the educational program;

7. an enhanced relationship with the palliative-care service; and the institution of a “family
center” near the surgical ICU to provide a place for family meetings and a quiet, restful
space where families can gather, process information and grieve as loved ones face the
end of their life.
Click here to read Drs. Meyer’s and Stafford’s final report in its entirety.