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Cover Story Contnued

The Scoop on Policy
Evaluaton Corner w/Bryna Koch, MPH
Call for Presentatons
Technology: Apps
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Editor Karen Spear Ellinwood, PhD, JD Editor Karen Spear Ellinwood, PhD, JD
Med/Ed eNews launches its third volume with
teaching strategies for clinical educators. This
article describes the BDA (Before-During-
After) and RIME frameworks and how to apply
and combine them to enhance clinical teaching
practice.
What is the B-D-A framework?
The B-D-A framework originated in scholarly
literature on teaching content area literacy
(Vacca and Vacca, 2005; also Laverick), but
can be used to create a structure for teaching in
any setting.
The B-D-A framework enables the clinical edu-
cator to structure the learning experience, even
when there is little time for planning to teach.
The framework is compatible with Schn's
(1983) framework for reflective practice and
professional learning. In the reflective frame-
work, the learner or professional practitioner
M
ake the BDA
& RIME
Frameworks Work
for You
engages in reflection IN, ON, and FOR patient
care and all aspects of learning or practice
(see Plack & Santasier, 2005, 2004).
The B-D-A framework focuses on the use of
educational strategies at these key points in
time: before (FOR), during
(IN) and after (ON) the learning experience.
Ideally, these strategies ought to direct the stu-
dent to be reflective.
Karen Spear Ellinwood, PhD, JD, EdS
Electronic Newsletter for
faculty & resident
educator development
01
Volume 3
AUG 2014
continue continue continue
Article I. Statement of Faculty Instructional Development Philosophy
The UA COM takes an active approach to developing and improving teaching and assessment
skills of its faculty. Therefore, the UA COM education philosophy defines remediation as faculty
instructional development and support.
An Active Approach
The Office of Medical Student Education is proactive in creating opportunities for faculty to
enhance their teaching practices, learning new skills, incorporating technology into teaching or
improving exam items. This means that FID offers workshops and seminars featuring experts
on such issues, providing a chance for faculty to hear what others are doing and how it might be
adapted for use in the settings in which they teach, clinical or preclinical. Faculty can brain-
storm new ideas and collaborate on projects. Block Directors or Residency Program Directors
may identify faculty or residents, respectively, who would benefit from one-on-one engagement
in faculty development. The key is that all instructional development activities aim to include
the direct input of faculty and residents.
Resources for Enhancing Skills
Any faculty or resident may request one-on-one guidance in developing teaching skills from
OMSE FID. Departments or Residency programs may request FID sessions for small or large
groups, as part of teaching days, didactic sessions, retreats or Grand Rounds. In addition, the
OMSE FID website has many resources for preclinical and clinical educators: Playlists of
YouTube videos from reputable sources on how to use and integrate technology in teaching;
videos of FID Series seminars dating back to 2011; references with links to scholarly articles and
books on topics such as reflective teaching, inquiry-based strategies, case-based instruction,
Med/Ed eNews [2]
UA CoM Policy
All education program policies, as
well as educational program objec-
tives. are located on the College of
Medicine website. General infor-
mation about policies on faculty in-
structional development are also ref-
erenced on the FID website.
As part of an ongoing effort to keep all
faculty up to date on education policy
at the UA CoM, this page is now de-
voted to highlighting UA CoM educa-
tion policies that affect faculty, fel-
lows, residents and affiliate faculty
who teach medical students.
In this third volume of Med/Ed
eNews, The Scoop will start with the
Article I of the FID policy at UA CoM.
Subsequent issues will address suc-
cessive articles of the policy..
More about UA CoMs FID Policy
The Scoop on Policy
metacognition, the RIME framework and bedside teach-
ing.
Defining Remediation as Support
Finally, UA CoM framed its FID policy by its educational
philosophy: Remediation should be supportive, not puni-
tive. UA CoMs policy recognizes that no educator knows
everything they need to know and the demands on educa-
tors and learners change over time. Therefore, teachers
are perpetual learners. FID support may translate to
shadowing faculty or residents as they teach, observing
strengths as well as missed opportunities, before offering
any advice or guidance for improvement.
More about FID Opportunities!

Med/Ed eNews [3]
E
valuation 24/7

Introduction 1.1
Welcome to the first edition of the
Evaluation 24/7!
As a community of doctors, re-
searchers, and other health profes-
sionals we are dedicated to ensuring
the delivery of high-quality inter-
ventions, treatment, education, and
other programs designed to create
positive outcomes for individuals
and communities. We all strive to
ensure that we achieve our goals no
matter if our goals are in the area of
resident education, medical student
clinical education, continuing edu-
cation, or patient satisfaction. The
discipline of evaluation is an es-
sential tool in the professional
toolkit to ensure we can clearly
state if our programs and interven-
tions are meeting their goals.
The ability to plan and implement
an evaluation will enable you to
leverage research methodologies in
a real world setting in order to
assess if your program or interven-
tion is successfully meeting its
goals and how it may be improved,
changed, or replicated. Imple-
menting a sustainable evaluation
also supports the ongoing process
of improvement in any area.
Bryna Koch, MPH
Director, Program Evaluation & Student Assessment
Evaluation 24/7 is a new segment of Med/Ed
eNews! Bryna Koch, MPH, is the Program
Analyst for OMSE at UA CoM. This section will
begin with an introduction to program
evaluation. Each month, Ms. Koch will feature
the next in the sequence on program
evaluation.
Please contact Ms. Koch if you have questions
about program evaluation or would like
guidance for a project involving program
evaluation.
About Evaluation 24/7
In the following newsletters the Evalua-
tion 24/7 section will provide tips and
resources in the six essential areas that
will set you up for a successful evalua-
tion; evaluation and research, program
theory, evaluation frameworks, goals
and objectives, logic models, and design,
methods and analysis.
If you want to get started right away
here are a few great resources that each
provide a unique perspective on plan-
ning and implementing an evaluation.
Centers for Disease Control and
Prevention (CDC) Evaluation
Framework

W.K. Kellogg Foundation Evalua-
tion Handbook
COVER [continued from 1]
Med/Ed eNews [4]
To strengthen your application of the B-D-A framework for teaching practice, combine it with Pangaro's (1999) RIME framework that
highlights the integral roles physicians perform in practice, Reporter, Interpreter, Manager, and Educator.
BEFORE the experience, ask the learner to...
Indicate what she or he knows about the particular medical knowledge relevant to this patient;
Read relevant literature;
Watch a video of an exam technique to prepare for the encounter.
DURING the experience, ask the learner to...
Obtain specific information from the patient
Observe for particular symptoms with a specific purpose in mind.
AFTER the experience, ask the student to ...
Think about whether what they anticipated finding matched what they discovered in the patient interview, diagnostic tests or
other inquiry;
Identify and articulate reasoning for appropriate next steps, e.g., follow-up questions or testing;
Assess their performance to help them identify skills, attitudes or behaviors for improvement.
A sample set of B-D-A strategies for a patient encounter
BEFORE the encounter... Ask the student to identify the criteria for the suspected illness or condition.
DURING the encounter Ask the learner to observe for or seek information to confirm the presence or absence of these criteria.
AFTER the encounter... Ask the learner to describe their observations and indicate whether this information helps them to differ-
entiate from among possible diagnoses, what other information they might need to do so; did they find what they expected?
What is the RIME Framework?
RIME is an educational framework used in clinical medicine to teach as well as assess residents (Pangaro, 1999) and medical students
(Ogburn & Epsey, 2003). RIME is a mnemonic for Reporter-Interpreter-Manager-Educator, four integral roles physicians perform on
a regular basis. Growing into these roles, being able to perform them effectively and fluidly, requires reflective practice and formative
Three of the AMES/OMSE Teaching Scholars of the 2013-14 program presented their Com-
mitment to Change projects on June 10, 2014. This special 2-hour presentation is now
available online!
Click on the icon above to access the video online. You must use your UA Net ID to login.
Teaching Scholars Presentations
FID Series 2014-13
feedback from peers and supervising physicians. Many have conducted and published research on the use of this framework in gradu-
ate and undergraduate medical education. Strengthen your application of this framework by combining it with the strategic use of
the B-D-A framework to structure the learning experience.
How can you apply the RIME Framework to Clinical Teaching
Identify the role you want them to perform in a specific patient encounter or other clinical experience, e.g., morning report. Describe
what the role entails. For students with more clinical experience, you may ask the student to identify the role that is pertinent to the
objective of a given clinical situation, and to describe the key skills, behaviors and/or attitudes they need to perform that role effective-
ly. Below are examples of how you could describe specific, relevant behavior for each of the four RIME roles.
[Context: Patient is being brought to the Emergency Room with possible sepsis.]
REPORTER I need for you to gather and report to me the information we need to determine whether the patient has sepsis.
INTERPRETER Please review the lab results and results of the physical exam and history to determine whether the evidence
allows us to differentiate sepsis from other possible diagnoses. Identify what additional diagnostic testing we need to do, if any.
MANAGER The patient is homeless. We will not be able to release him without an assurance of follow-up care. I
COVER [continued from 4]
Med/Ed eNews [5]
continue continue continue
Call for Presentations
Information Technology Solu-
tions
The theme of the 2014-15 AMES/OMSE
FID Series is Lessons Learned from
Education Research at the UA College
of Medicine. If you would like to pre-
sent your education research project
and facilitate discussion on the implica-
tions it might have for improving teach-
ing or assessment practices at the col-
lege, please submit your idea.
The FID Series is an opportunity for you
to:
Share what youve learned with
colleagues
Discuss the implications of your
research for teaching, learning and
assessment of medical students,
residents or other learners in
health care professions
Enhance the education research
youre doing; and
Explore ideas for new or ongoing
projects
Topics could include:
Challenges and successes in imple-
menting milestones in resident
education;
SHARE YOUR
RESEARCH
Present preliminary
findings or findings to
date in ongoing educa-
tion research.

DISCUSS
IMPLICATIONS
Suggest or discuss impli-
cations for teaching and
learning at the College of
Medicine and with col-
leagues teaching at other
AHSC colleges.

FIND
INSPIRATION
Find inspiration for en-
hancing your education
research projects or ex-
ploring the implications
of your research.
C
all for Presentations in the
AMES/OMSE FID Series
2014-15
Med/Ed eNews [6]
SUBMIT
The implications of the milestones
approach for undergraduate medi-
cal education;
Instructional development for pre-
clinical or clinical educators;
The education research conducted
by faculty, staff and students at the
College of Medicine and colleagues
from other AHSC colleges.
Writing effective clinical path con-
ferences for interactive lecture;
Use of technology for engaging
students in self-assessment or feed-
back;
Feedback and assessment in pre-
clinical and clerkship contexts.
Submission Form Online
If youre interested in submitting an
idea or proposal for an FID Series ses-
sion, please click on the Submit FID
link above.
Questions?
want you to identify the resources available, get whatever consults we need
to determine whether this patient might be admitted to ensure appropriate
follow-up care.
EDUCATOR Now that we have determined the patient has sepsis. Your
role is to explain to the patient what sepsis is and describe the next steps we
recommend he take to treat it.
Combine BDA with RIME to Strengthen your Teaching
Strengthen your application of this framework by combining it with the strategic
use of the B-D-A framework to structure the learning experience.
In our example of applying the RIME framework, above, the request to perform
the functions associated with the Reporter role would be done BEFORE the stu-
dent encounters the patient. Discussing this objective before the encounter gives
the student an opportunity to reflect on the medical knowledge she or he needs
to perform the role, whether there is a gap in knowledge as well as to locate re-
sources, if needed, to amplify their knowledge. It also gives the student a focus
for the patient encounter, making their performance in the encounter goal-
directed, purposeful. Using this framework, then, establishes criteria by which
the student can expect to receive and you can offer constructive feedback follow-
ing the encounter. Formative feedback is critical to improving performance.
The performance of the Reporter and, to some extent, Interpreter roles described
above constitute the DURING aspect of the applied BDA Framework. The Manager role is performed AFTER the encounter, but im-
plies the performance of the Reporter and Interpreter roles in gathering, reporting and synthesizing information learned from con-
sults.
Finally, the Educator role takes the student back into the patient encounter, and offers another opportunity for repeating the BDA
framework and providing feedback to the student.
To strengthen the application of RIME, then, a clinical instructor (attending, resident, preceptor) could identify and describe expecta-
tions for student performance and establish criteria for giving feedback following the experience. In other words, the combined BDA-
RIME framework generates a map for both the educators and learners approach to the patients case as learning situation. By delib-
erately and systematically treating the encounter as a learning situation, the educator also communicates that they care about the
depth and quality of the students learning experience. In other words, applying these frameworks helps clinical educators build rap-
port with students even with little time for teaching.
Below are some references and a link to Teaching Guides for applying the combined BDA-RIME framework.
References
DeWitt D, Carline J, Paauw D & Pangaro LN. Medical Education 42: 12051209; 2008.
Ogburn T & Epsey E. The R-I-M-E Method for Evaluation of Medical Students on an Obstetrics and Gynecology Clerkship. American
Journal of Obstetrics and Gynecology 189(3) 666-669; 2003.

COVER [continued from page
Med/Ed eNews [7]
Residents as Educators
Program
RAE

If you are a Residency Program Director and would
like support for including residents as educators cur-
riculum into your program s didactics or teaching day,
or you would like to provide additional support for
teaching for your residents one-on-one, please check
out the RAE Program!
RAE Program GuideAn outline of the goals,
objectives and educators involved in the RAE Pro-
gram; includes a sample of workshop topics.
RAE iDNAInstructional Development Needs
Assessment
Shadowing Residents Observation of teaching
with opportunities for individualized feedback
Additional RAE Resources
continue continue continue
Smart Apps for Learning
[TECHNOLOGY TIPS]

3D Brain ED Radiology 2.0 AnkiMobile Flashcards Sound Builder
T
echnol ogy
Tips
The FID Series offers at least one seminar
each year that provides an introduction to
apps for teaching, learning, and practice as
well as those that are useful in conducting
education research. in December 2013,
Mike Griffith, MS, now with the UA College
of Education, and Kevin Moynahan, MD,
presented iPads in Medical Education. You
can view the seminar online at the FID
website. To access a variety of apps and
related materials and launch your explora-
tion on how to integrate technology in your
teaching, click on the icon for iPads in
Medical Education, above.
You may also click on any of the icons at
right, to access information about the apps
represented. Many of these apps have mul-
tiple purposes, and may be helpful to both
students and instructors.
The FID website contains scholarly re-
sources and links to how-to videos about
technology and education, and more infor-
mation on smart apps (menu, far right).
More about Teaching with Technology
Contact Karen Spear Ellinwood
Med/Ed eNews [8]
Dropbox Evernote iAnnotate Notability

Smart Apps for Research
Smart Apps for Teaching
TWT Series 2014-15 Workshop No. 1
Poll Everywhere
August 25, 2014 Time: 9 - 11 am MDL-3116
Facilitator: Karen Spear Ellinwood, PhD, JD
Description
This TWT Series workshop will introduce faculty to Poll Everywhere, and how to use this audience
response software in classroom and clinical learning situations. During the workshop participants
will learn and practice the following functions:
Create polls (open-ended, multiple choice, and discourse questions)
Generate Exit Tickets and Survey formats of questions
How to incorporate Polls \into your PowerPoint or KeyNote
How to display the poll results in various formats, including word clouds
How to download data and reports
Device/App Requirements
None required. Participants can use PCs in the lab.
If you bring your PC or Mac laptop, please go to Polleverywhere.com to create a FREE account, and install the Poll Every-
where "Presenter App".
TWT Series 2014-15
Med/Ed eNews [9]


Pangaro LN. A Shared Professional Framework for Anatomy and Clinical Clerkship. Clinical Anatomy 19:419428; 2006.
Pangaro LN. A New Vocabulary and Other Innovations for Improving Descriptive In-Training Evaluations. Academic Medicine 74:11
(November); 1999.
Laverick C. B-D-A Strategy: Reinventing the Wheel Can Be a Good Thing. Journal of Adolescent & Adult Literacy 46(2) (October),
pp. 144-147; 2002.
Plack MM & Santasier A. Reflective Practice: A Model for Facilitating Critical Thinking Skills Within an Integrative Case Study Class-
room Experience. Method-Model Presentation in, Journal of Physical Therapy Education, 18(1); 2004.
Plack MM & Santasier, LG. The Reflective Practitioner: Reaching for Excellence in Practice. Commentary, In Pediatrics. pp. 1545-
1553; 2005.
Schn D. The reflective practitioner: How professionals think in action. NY:Basic Books; 1983
Vacca RT and Vacca JL. Content Area Reading: Literacy and Learning Across the Curriculum. Boston: Pearson Publishers; 2005
(now in its 13th edition).
Click to View/Download
Teaching Guide
Click to View/Download
RIME Guide
Cover [continued from p. 7]
More about
Poll Everywhere
Office of Medical Student Education ~ 1501 N. Campbell Avenue ~ Tucson, AZ 85724 ~ 520.626.1743 ~ fid.medicine.arizona.edu
Professional
Devel opment
The AMES\OMSE FID Series presents a topic
relevant to teaching, assessment and/or medical
education research from August through May
each year. Please subscribe to our newsletter for
current information on topics, presenters, and
special events.
Save the date!
Instructonal development for faculty and residents
Karen Spear-Ellinwood, PhD, JD
Associate Specialist for Faculty Development
Ofce of Medical Student Educaton (COM-3215)
Em. [email protected]
Ph. 520.626.1743

Educatonal support for residents and fellows, and Instruc-
tonal development for residents
T. Gail Pritchard, Ph.D.
Interim Senior Learning Specialist
Ofce of Medical Student Educaton (COM-3210)
Em. [email protected]
Ph. 520-626-2390

Program Evaluaton & Student Assessment
Bryna Koch, MPH
Director, Program Evaluaton & Student Assessment
Ofce of Medical Student Educaton (COM-3204)
Em: [email protected]
Ph. 520.626.3684


Assessment of Student Performance
Susan Ellis, EdS, MA
Program Manager for Assessment of Student Performance
Ofce of Medical Student Educaton (COM-3204)
Em. [email protected]
Ph. 520.626-3654

C
OM accreditation self-
study summary report
available






Accreditation visit
dates:
January 12-15, 2014


Meet the FID team!
Date/Time/Room Presentation Title Presenters
25 August 2014 [9-
11 am, MDL-3116]
TWT Series: Using Poll
Everywhere to Enhance In-
teraction
Karen Spear Ellinwood,
PhD, JD
08 September 2014
[8:30-10:00 am]
[COM-3230]
FID Series: How to Develop
your Educator Portfolio
Sean Elliott, MD, Professor,
Residency Director, Depart-
ment of Pediatrics, AMES
member
07 October 2014
[121:30 pm, COM
-3230]
FID Seri es: Lessons
Learned from RRHP & CUP
Carol Galpher, PhD
E
ducator
R
esources
There are a variety of resources
online for clinical and classroom
educators, including links to learning mod-
ules, a guide for engaging students in in-
quiry learning, Microskills for teaching, and
encouraging students to examine for cogni-
tive error.
The AMES\OMSE Faculty Instructional
Development (FID) Series is video recorded,
so you can access recordings of seminars
onlinesimply Click&Go!
Find out more about team learning , CBI
and other instructional methods and the
recently developed etools, ThinkShare
(formerly GroupShare) and CBI
ThinkShare (formerly, ThinkSpace).
Check out our Faculty Instructional Devel-
opment Calendar online!
Med/Ed eNews [10]