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UCSF Pediatric Residency

Mount Zion

The UCSF Pediatrics Residency Program is based at UCSF Benioff Children’s Hospital, an academic teaching hospital. Residents in the primary care track who are involved in this project have their continuity clinic at the Mount Zion Pediatric Clinic.

The UCSF Pediatrics Residency Program Primary Care Track implemented the UCSF Double Helix Practice Transformation curriculum into their program in July 2016. Because their residency program is more hospital-focused than the other three sites, they had less time available for outpatient didactic teaching. To adapt, they used materials from this website to provide short, 30 minute teaching sessions to residents before clinic. These short bursts of content allowed them to introduce residents to the concepts of practice transformation and re-acquaint them with the concepts throughout the year.

We are currently developing an interactive timeline detailing how this residency implemented the UCSF Double Helix Practice Transformation curriculum into their program. It will be available on this page in Summer 2017.

Tips from the Residency Program...

- We did not re-create an entire curriculum, but adapted it into our current continuity clinic curriculum as well as used them to bolster our new resident orientation and QI curriculum.

- In our clinic, we have 30-minute resident continuity clinic talks from 1 to 1:30 before clinic begins; we used that time to present some materials in as interactive a way as possible.

- Residents really wanted to know how our clinics functioned, i.e., who was on the care team, how we measured access to care, so the content was naturally interesting (and we could invite other team members to provide real life examples of things going right and wrong).

- Some materials naturally fit existing curriculum, i.e., having R1s work on the Mission Statement (CM1) during orientation and including QI Basics (CM2) in our QI curriculum.

- Other materials had to be shortened and modified to fit our particular curriculum, such as including some aspects of Team Based Care (CT1) and Patient Team Partnership (CT2) in our talks on specific chronic illnesses, i.e, asthma, obesity, cerebral palsy (so main objective may be condition specific but subtly included were ways to incorporate best practices).

- We have just started so that we are monitoring both feasibility and impact.

- It’s great to start with the low hanging fruits, to adopt or adapt what seems easiest.

- It’s also helpful to pick one per area, i.e., one each from PCMH, access, population, etc..

- It is important to think long term; some topics require repetition and others incorporation into what we normally do in patient care so that we do not realize that we are learning.

- Two key time periods to consider are the orientation and goal setting at the beginning of the academic year and the legacy planning (anticipated transfer of care) when residents graduate.

Our program was the only one that focused on the pediatric population so we have had to constantly change the cases so that they would fit our population. There are some that are just not applicable. I think the overall goal is to encourage residents and those who teach residents to do practice transformation, which is really problem solving “here and now” and following impact over time, and including the entire clinic (and not just trainees) to do so.
Residents have generally been very enthusiastic; however, the faculty has to be enthusiastic when introducing the topics and methods. This requires faculty development prior to rolling out any new curriculum, and that can be a challenge. Fortunately our entire clinic has been doing practice transformation so teaching residents about doing this seemed natural.
Start slow, give yourself strokes for small successes, involve residents to develop and test the curriculum (especially senior residents), also use the curriculum to get other faculty excited, make sure there is buy in from the staff and include them as much as possible. If there are practice goals that the curriculum can be applied to, all the better. Be efficient!


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