Goal: To teach future family physicians to effectively integrate behavioral science principles and skills into primary care practice

Transcription

1 Goal: To teach future family physicians to effectively integrate behavioral science principles and skills into primary care practice Graduate Feedback In a recent survey, graduates of the Columbia Family Practice Program were asked to rate how well their training in 19 curricular areas prepared them for practice. Training in behavioral science was ranked 5 th. Curricular Element Rank Rating* Gynecology Adult Medicine Preventive Medicine Pediatrics Behavioral Science Geriatrics *Rating Scale: 1 = Highly Prepared; 5 = Poorly Prepared Graduate Performance on ABFP Certifying Exam, Psychiatry/Behavioral Science Section In the past five years Columbia Family Practice Program graduates have exceeded the national average score on the Psychiatry/Behavioral Science subsection of the Board Certification Exam. Year of Exam Graduates Score National Average Resident Evaluation of Teaching From data compiled by the Department of Family & Community Medicine, my teaching effectiveness has consistently been rated in the Major Strength category and has exceeded department average in 7 of the past 8 years. Residents have also rated my clinical competence as a Major Strength and above the department average in 7 of the past 8 years. Bold =Resident Rating of Dennis Butler, PhD; (Value) = Resident Ratings of all DFCM faculty Year Overall Teaching Effectiveness Clinically Competent (1.80) 1.30 (1.50) (1.80) 1.14 (1.50) (1.80) 1.15 (1.45) (1.80) 1.30 (1.54) (1.84) 1.29 (1.57) (1.76) 1.21 (1.53) (1.84) 2.00 (1.67) (1.84) 1.30 (1.59) 1=major strength; 2=strength; 3=neither strength or weakness; 4=weakness; 5=major weakness

2 External Evaluation of the Behavioral Science Curriculum: There are focused experiences in human behavior and mental health, the curriculum for which is very good. Dr. Butler deserves a lot of credit. -Internal Review of the Columbia Family Practice Program, August, Reviewer: K. Kutty, M.D. Professor of Medicine, MCW. I also think of Dr. Butler as a particular asset of the program, since he has helped it to develop over the prior years and understands its workings and history very well. Charles Driscoll, MD, Program Director, Lynchburg (VA) Family Practice Program, in a letter regarding his candidacy for program director at the Columbia Program, September, The Columbia Family Practice Program s Behavioral Science training was one of five national programs highlighted for teaching collaborative care between physicians and psychologists The Monitor on Psychology, April, The Monitor is the trade journal of the American Psychological Association and has a national circulation of 110,000. Goal: To effectively prepare primary care physicians to understand and work with patients and their families. 1. The Family Medicine Chart Review (FMCR). The FMCR is an innovative synthesis of existing methods for teaching family that effects the incorporation of family systems into primary care teaching and resident clinical practice. 2. The Pre-encounter Psychosocial Review. This is a teaching method that utilizes the traditional chart audit in a pre-patient encounter format. The method encourages the rehearsal and use of psycho-social interviewing skills by residents and emphasizes a family and biopsychosocial approach. 3. Family Conference/Meeting Leadership Training. I have published research on family meeting experiences of family practice residents, guidelines for a curriculum for teaching residents to work with families around critical issues in patient care and co-authored, with a family physician, guidelines for family meetings for the practicing primary care physician. 4. The Career Innovations in Clinical Teaching Award, given by the Society of Teachers of Family Medicine Group for Behavioral Sciences, in recognition of the above teaching methods. In commenting on this award, the editors of Family Systems & Health noted These articles remain classics on the integration of biopsychosocial care, the impact of family systems, and the value of collaborative relationships among healthcare professionals.

3 Goal: To prepare the primary care physician to care for the psychologically traumatized patient and, to personally provide excellent clinical services to patients. Eight peer-reviewed articles and chapters in nationally recognized journals focusing on patients who have experienced physical, medical or sexual trauma and the concomitant psychological effects. These articles have focused on: 1. The effects of sexual abuse of males and females, and on medical students; 2. Post-traumatic stress reactions following motor vehicle crashes, 3. The effects of torture and manifestations of trauma in refugee populations; 4. The traumatic impact of medical conditions or procedures (sickle cell disease, amputation, abnormal Pap smears); and 5. The trauma associated with terrorism and September 11th. Over 20 presentations on trauma-related responses among patients, the consequences of sexual abuse, post-traumatic stress disorder and reactions to the 9/11attacks, given at the MCW Refresher Course for Family Physicians, and Grand Rounds at the Medical College of Wisconsin and local community hospitals and at national educational conferences. Community education and intervention efforts including: Multiple media interviews and commentary on trauma Consultation to SafeStart Domestic Violence Program, Racine, WI Consultation to Survivors of Victims of Homicide Group, Milwaukee, WI Facilitated Sickle Cell Support Group Mental health clinician, Refugee Mental Health Program, Medical College of Wisconsin Authored patient education handout: AFTER A TRAFFIC ACCIDENT, published in American Family Physician Paper of the Year, Department of Family & Community Medicine, Medical College of Wisconsin This award recognizes a published paper for having made a significant contribution to the family medicine literature during the previous calendar year, exhibiting literary, scholarly and scientific merit: Butler, DJ, Moffic, HS, Turkal, NW. Post-traumatic stress reactions following motor vehicle accidents. American Family Physician 1999; 60 (2): Goal: To establish national standards for obtaining patient informed consent when videotaping in medical education settings. Two peer reviewed articles and two letters to the editor in national journals (Academic Medicine; Family Medicine) addressing the need to develop national guidelines for videotaping patients in medical education settings.

4 Consultations to the following medical education programs and academic institutions to design/modify patient videotaping consent forms consistent with the principles of informed consent and readability. Hudson Valley Family Practice Program, Mount Sinai School of Medicine, Poughkeepsie, NY John Peter Smith Family Practice Program, Fort Worth, TX Department of Family Medicine, Medical College of Ohio, Toledo, OH University of Mississippi Medical Center, Department of Family Medicine, School of Medicine, Jackson, MS Citrus Health Center APA internship, Miami, FL Pomona Valley Family Practice Residency Program, Pomona, CA Department of Family & Preventive Medicine, University of Oklahoma (OUHSC), Oklahoma City, OK Mountain AHEC Family Practice Residency Program, Asheville, NC Department of Family Practice, Quillen Medical School, Eastern Tennessee State University, Johnson City, TN Carlos Albiza University, Chancellor s Office, Miami, FL Eau Claire Family Practice Residency Program, University of Wisconsin Medical School, Eau Claire, WI Genesys Regional Medical Center, Family Practice Program, Michigan State University, Grand Blanc, MI Family Practice Residency Program, Case Western Reserve Medical School, Cleveland, OH Department of Pediatrics (Surgery), Medical College of Wisconsin, Milwaukee, WI Goal: to enhance the personal adjustment of resident physicians. Member, 17 years, Housestaff Health & Welfare Committee, Medical College of Wisconsin (charter member appointed in 1983). This committee was established to identify and respond to housestaff logistical, psychological and family needs, and prevent resident impairment. Lead investigator & first author, Issues and Concerns of Housestaff at the Medical College of Wisconsin: A Focus Group Report. An internal report prepared under the auspices of the Housestaff Health & Welfare Committee and distributed to administration and department chairs.

5 Workshop leader at 5 chief resident retreats, focusing on identifying and supporting distressed and impaired housestaff, teambuilding and personal development How to be in three places at once when you feel like you are no place at all A presentation on stress and coping given at orientation to all first year family practice residents, since The Little Man with the Big Couch Award, presented by the graduating class of the Columbia Family Practice Residency in 2000 in recognition for support of residents during their training. Residents rating of my ability and availability to provide personal support for them during their training. Rated in the Major Strength category (Value in parenthesis is the departmental average). Year Supportive of Learner (1.60) (1.58) (1.38) (1.58) (1.62) (1.62) (1.75) (1.60) Rating: 1=major strength/5=major weakness Anonymous comments from residents (Source: DFCM Clinical Teaching Evaluations) Great at improving your clinical skills. (2001) Dr. Butler is always there, standing in the background there for us whenever we need him. He gives very constructive feedback. His suggestions for patient interactions are very helpful. (2000) Dr. Butler does an excellent job overall with behavioral medicine, always has time for the resident, listens well. (1998) Dr. Butler was also very helpful. He was willing to be sided several times to help with difficult patients. (1998) Easily approachable, fun to be around. (1997) Dennis is a good teacher and cares about the residents and his patients. Overall a good faculty. (1996) Solid teacher. Easily impacts both science and art of psych. Never intimidating. Really cares about making us better at what we do. (1995).