#49 AIMW25 Recap: Pearls and (Educational) Practice Changing Knowledge from the Alliance for Academic Internal Medicine

May 7, 2025 | By Molly Heublein

Audio

With guests Drs. Vidya Gopinath, Chavon Onumah, Jen Spicer, and Sarah Vick

Get inspired by this high-energy recap of AIMW25, where Drs. Vidya Gopinath, Chavon Onumah, Jen Spicer, and Sarah Vick share the most practice-changing pearls from Academic Internal Medicine Week. From rethinking feedback to boosting board pass rates and advancing ambulatory education, this episode is packed with insights every health professions educator can use. Recorded live in New Orleans, it brings the highlights—and the heart—of the conference straight to your ears.

Sorry no CME for this one!

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Meet our Guests:

Dr Vidya Gopinath is the Primary Care Program Director at the University of Utah, mother of two (and one more on the way), her clinical focus is in Women’s Health.

Dr Chavon Onumah is the Internal Medicine Residency Program Director at George Washington University in Washington, DC.  She is a primary care doctor and an HIV specialist, mother of two boys, and guest on this season of Teach–a future episode on Anti-Deficit Frameworks.

Dr Jennifer Spicer is an Associate Program Director in the Internal Medicine Residency at Emory University.  She is an infectious disease specialist, a wife, dog mom, and prior Teach guest on Rounding Skills.

Dr Sarah Vick is an Associate Program Director at the University of Kentucky, a wife and mother of two, and a prior Teach guest on Clinical Reasoning Remediation. 

Show Segments

• Intro, guest introductions, favorite things about Academic Internal Medicine Week
• Comprehensive Board Preparation Curriculum
• Teaching Learners to Maximize Feedback
• Embracing Conflict and Crucial Conversations
• High Quality Medical Education Research in 2024
• EHR User Analytics
• Roadmaps to Teach Clinical Reasoning
• Professionalism Coaching
• SDOH Curricula
• Master Group Facilitation
• Conferences beyond the Standard Lecture
• Reflections on the Opening Plenary
• Take home points
• Outro

AIMW25 Recap Pearls

1. A targeted board prep curriculum using spaced repetition, individualized learning plans, and peer-led sessions dramatically improved ABIM pass rates.
2. Effective feedback requires understanding feedback receiver responses like “wrongspotting” and “switchtracking” to foster constructive conversations.
3. Using EHR analytics to identify resident “in-basket phenotypes” can tailor coaching and improve intervisit care quality.
4. Teaching clinical reasoning with tools like the Four-Square Animal Framework helps learners prioritize diagnoses and recognize high-risk conditions.
5. High-quality medical education research in 2024 highlights the need for LLM prompt training and addresses gender disparities in EHR workload among residents.

AIMW25 Recap Notes 

Mind the Gap: Creation and Implementation of a Comprehensive Board Preparation Curriculum presented by Zain Alfanek MD, Margaret Hayes Baker MD, Sarah Freeman MD, and Alexis Jacobson MD 

• You are not alone if you noted a recent drop in ABIM pass rates. Nationwide, pass rates went from 93% in 2020 to 87% in 2023. 
• A comprehensive, targeted prep course (focused on what’s on the test and how to prepare) along with coaching for residents at risk for not passing led to a dramatic improvement in Brown’s IM residency’s pass rates.  This included two didactic sessions a week lead by chief residents, so used the knowledge of someone who has good cognitive congruence with their learners (ie they had just taken the boards)- COUPLED with individual learning plans and coaching for everyone under 35% on the Inservice Training Exam (ITE).
• They also utilized learning science to boost retention- using spaced repetition based on sessions of the week (chief-led) and interleaving or overlapping information.
• They were thoughtful about including a balance of specialist and generalists educators (including chief residents)
• A self assessment tool on MedEd Portal by Dr Guerrasio which includes a learner self assessment with suggestions for each of the identified concerns.  

I’m just a bad test taker: effective strategies for remediating medical knowledge deficiencies and enhancing board pass rates by Andrea Carter MD, Amy Farkas MD, Andrew Klein MD, and Casey McQuade MD. 

• Tools for learners who not only are performing lower, but also those who have areas for improvement (e.g. emphasize teaching moments for learners)
• Normalized that these challenging situations/conversations are happening at many institutions. 
• Emphasized adult learning strategies; overlapping subjects and repeating/recall as best strategies to retain info
• Highlighted some great resources!
  • Recommended pointing learners toward general review articles, like Annals In the Clinic, rather than super detailed sources like UpToDate.  
  • MKSAP questions & reading within MKSAP
  • Ted Talk by Amy Cuddy for anxious test takers. Share videos on Growth Mindset, Grit, or Power of Belief with learners
  • The book, Make It Stick by Brown, Roediger, and McDaniel on the science of learning/improving study skills.

“Read More” No More: Teaching Learners to Maximize Feedback presented by Margot Cohen MD, Ashok Linganna MD, Ian Ross MD, Peter Yen MD

• Focused on the book Thanks for the Feedback: The Science and Art of Receiving Feedback Well by Douglas Stone and Sheila Heen 
• Be aware of the triggers (e.g. identity, truth, relationship) that feedback can elicit in the receiver, and in naming those defensive responses, think about how to respond constructively to them. Specific maladaptive responses to feedback include:
  • Wrongspotting: point out a specific/small error or flaw in the feedback to invalidate all of it 
  • Discrediting: respond with comments that show that you think the feedback giver doesn’t know what they are talking about (or calling them names) or doesn’t know what is right (or enough about the content to have an opinion) or that their current understanding is wrong
  • Switchtracking: change the topic entirely, or switch the focus back to give feedback to the original feedback giver

Embracing Conflict and Crucial Conversations with Confidence presented by by Abby Spencer MD MS, Ronda Mourad MD, Kelli A. Corning MSEd

• Crucial conversations or conflict resolution are such important skills for leaders and really anyone who cares about others and wants results with less stress/pain. 
• Use the Thomas-Hilmann Conflict Mode Instrument (TKI) to gain better insights into yourself.
• Knowing what type of asker you are impacts your initial reaction to the asks of others.  If you are someone that gets all the information and makes sure your ask is so perfect that the only answer would be yes versus you’re someone that just asks for the sake of asking because the worst they could do is say no.  
• When faced with a no but you want to collaborate and keep the negotiation going, open up possibilities, try saying “what would it take to…?” 
• Try sharing out loud (or in your head depending on the relationship) “the story I am telling myself” to explain exactly what you are hearing/feeling
• Lots of helpful reading recommendations, like classic Crucial Conversations: Tools for Talking When Stakes are High, by Grenny, Dare to Lead and anything by Brene Brown, Influence Is Your Superpower: How to Get What You Want Without Compromising Who You Are by Zoe Chance, Nonviolent Communication by Marshall Rosenberg 
• Don’t listen to the word, listen for the need. What’s the problem we’re trying to solve? Where can we meet in the middle?

Update in Internal Medicine Graduate Medical Education: Systematic Literature Review of High Quality Medical Education Research in 2024 presented by Elaina Furr DO, Evelyn Murray DO, Alexander Rittenberg MD, and Marygrace Zetkulic MD

• Large Language Model Influence on Diagnostic Reasoning: A Randomized Clinical Trial (Goh 2024) comparing the diagnostic reasoning and accuracy of physicians when they used traditional support resources (e.g., Uptodate) versus LLMs (e.g., ChatGPT). They used a really robust process to score physician responses! Ultimately, they found no difference. But the most interesting part was that data scientists putting prompts into LLMs actually did BETTER than both groups of physicians. It’s important to recognize that the actual take home point here is that LLMs can likely help us, but we need training in how to put in prompts most effectively – because the physician group using LLMs in this study didn’t have any training in prompt engineering.
• Gender Disparities in Electronic Health Record Usage and In-basket Burden for Internal Medicine Residents (Liddell 2024) found that women received more inbasket messages despite the same number of patients, appointments, and tests ordered as compared to their male counterparts. Other studies have shown this, but this has important implications for GME since residency training is a time where residents are really time-crunched, and any extra work means less time for outside of work activities or even work-related extracurriculars like research, which could impact female residents’ wellness and career trajectories.
  

Harnessing EHR User Analytics to Provide Individualized Feedback to Improve Continuity Clinic Intervisit Care presented by Zachary Boggs MD, Heather Frazier MD, Jason Ojeda MD, and Ashley Traczuk MD

• This workshop highlighted how little supervision residents receive on intervisit care in the outpatient setting: ~1/3rd of programs had no intervisit oversight and 21% of PDs in the study cited were aware of a patient safety event related to unsupervised intervisit care (Stelling 2023).   
• They shared techniques of using Epic Signal Data to “diagnose” a resident’s intervisit care skills using inbox message/refill/etc days to completion and time addressing the individual message to help improve intervisit care.  For example, the “inefficient” trainee spends a lot of time in the in-basket but may have average response times as opposed to the “under-checker” who has low time in the in-basket and a high turn around time on messages. Coaching techniques should be targeted to each different phenotype to focus on their areas for improvement.

Put the Shark Before the Horse: Applying Roadmaps to Teach Clinical Reasoning at the Bedside presented by Zeynep Kubilay MD, Satya Patel MD, Ashley Saito MD; Chase Webber DO

• Teaching clinical reasoning saves lives! Presenters shared an article that reported that diagnostic errors were linked to nearly 800,000 deaths or cases of permanent disability each year (Newman-Toker 2023). 
• Shared a roadmap for teaching clinical reasoning: 4-square prioritized differential diagnosis: FOUR SQUARES: (top left) Type 1: horse= almost identical diagnosis and problem representation (PR), (top right) 1b: shark= threat to life within minutes. (bottom left) 2b: goat= less likely. (bottom right) 3: pig= unlikely (don’t get stuck in the mud).  Educators can ask learners to construct a PR and use the four-square to prioritize their differential diagnosis.

Building your Professionalism Coaching Toolbox presented by Dr Kristy Deep MD MA, Devin Oller MD, Megan Wolak MD

• Recommended to go back to the underlying issues to diagnose the professionalism deficit area. Coaching someone who is having stressors at home is very different from helping someone who doesn’t understand expectations. Consider professional identity domains including attitudes, personal characteristics, duties and responsibilities, habits, personal experiences, relationships, and perceptions/recognitions (Holden 2015).
• Normalized the angst when considering professionalism remediation and encouraged preparation to coach through the criticism. Be aware of emotional intelligence and its impact on professionalism skills (Taylor 2011)

Out of Didactics and into the District presented by Ashley Duckett MD, Chelsy Petz MD, FACP, Kaitlin Gordon MD, Erin Murphy MD

• Explored Medical University of South Carolina College of Medicine and University of Louisville School of Medicine’s approaches to social determinants of health (SDOH) curriculum, including examples of making it a positive, sustained experience for both trainees and the community.
• Consider collaborations within the departments, social workers, local government, what support staff you need, mutual arrangement with community partners, and what barriers could come up for community informed/engaged curricula. Examples of the curricular sessions include working with a food bank, going to a middle school (pathway building), and community group practice (group therapy). 
• Shared their individual curricula from each school (and data from their learners) and a curriculum development tool they created to help people design/revise their own community-engaged curriculum.  Drs Duckett, Petz, Gordon, and Murphy were kind enough to share their tool here for anyone interested.  

But Wait… I have a question: Strategies for Chief Residents to Master Group Facilitation while Teaching presented by Drs Kylie Anthony, Daniel Barboto, James Pennoyer, and Suyu Alexander Zhang

(Slides presented at their workshop, shared with permission)

AIMW25 Opening Plenary: Medical Training at a Crossroads: Getting Comfortable with Being Uncomfortable presented by Lisa Rosenbaum, MD

Goal

Listeners will learn frameworks to improve clinician educator skills from various workshops at AIMW25.

Learning objectives

After listening to this episode listeners will be able to …

1. Describe tools for clinical reasoning instruction on the fly via 4 quadrant, animal method
2. Name targeted approaches to improve board exam preparation to improve pass rates
3. Recognize the need for clinician LLM training and further EHR data collection to improve experiences in clinical settings  

Citation

Kryzhanovskaya E, Heublein M, Gopinath V, Onumah C, Spicer J, Vick S.  “#49 Recap of AIMW25: Pearls and (Educational) Practice Changing Knowledge from the Alliance for Academic Internal Medicine.” The Curbsiders Teach Podcast. https://thecurbsiders.com/teach. May 7, 2025.