A New Paradigm for Resident Training

Residency directors Richard Redett, middle, and Scott Lifchez, right, talk with resident Dan Calva, who helped implement the department’s new Learning Portfolio.

In the world of reconstructive surgery, even the plastic surgery residency program at Johns Hopkins is fair game for transformation. Two new innovative and interlocking approach­es are poised to change everything about resident training at Johns Hopkins, from the curriculum and assessments to the length of residency.

Residency directors Richard Redett and Scott Lifchez have just completed the pilot version of a new cloud-based digital resource for the entire curriculum, the Learning Portfolio, which is now up and running and available by Web, tablet, and smartphone. The portfolio houses everything relat­ed to the residency program—grand round notes; the core curriculum; the digital library; links to journals, books, and articles; ongoing research proj­ects with faculty members; patient censuses; and a photo library.

“This generation of residents walks around with tablets and smartphones,” says Lifchez. “That’s where the information is; why not invent a system that takes advantage of that?”

Meanwhile, a grant from the School of Medicine’s Institute for Excellence in Education provided an opportunity to redesign the residency program, enabling Redett, Lifchez, and their team to completely rethink the way residents learn.

Moving forward, resident education will be organized by topic in the Learning Portfolio, simulations will augment the reading typically done to prepare for the operating room, and assessment will be ongoing and highly responsive.

“By continually evaluating the resident in real time, you have a minute-by-minute tally of how they’re doing,” Redett says, enabling faculty to immediately identify and address any gaps in a resident’s knowledge or skill.

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Such a sensitive assessment system may ultimately allow some residents to advance more quickly through the program, paring as much as a year off their residencies. During the fifth year, for example, faculty could determine if residents are ready for specialty directed training, or to stay on as junior faculty.

The department is the only one in the country entering such new territory and already has had two articles accepted for publication in the peer-reviewed Journal of Surgical Education. “This has the means to put us in the public eye as a leading institution in education and cur­riculum in plastic surgery,” says Lifchez.

The Johns Hopkins residency program, which has operated in partnership with the Uni­versity of Maryland Medical Center since 1989, will retain the interactive, individualized mentorship for which it’s known. “Our residents emerge as highly skilled surgeons who can perform even the most complex reconstructions,” says Redett.