Back to Bedside Project Summaries

The Minds Matter Project is designed to break down the stigma associated with mental health care and establish a therapeutic alliance prior to the psychiatric consultation, to both reduce resistance to care and achieve better outcomes. There is a high prevalence of co-morbid psychiatric conditions in hospitalized patients that exacerbate their presenting concerns, and addressing these symptoms not only improves outcomes but also leads to a better quality of life. To lessen aversion and the impression of being taken by surprise when receiving a psychiatric consult, this project endeavors to establish a relationship with the patient before the appointment. To help patients and their families understand the nature of the consultation and what to expect, residents will provide a pre-consultation fact sheet. This will help reduce patient resistance and apprehension and ultimately improve patient care.

The pediatric mental health crisis has emphasized the need for improved behavioral health education and training in pediatric residency programs. This project aims to address this current need via a creation of a curriculum focused on brief psychotherapy skills that can be used in a primary care setting, as well as a creation of a space where residents can process the challenges of being a frontline mental health practitioners. Project evaluation will occur at three points during the project and will also include a reflective, qualitative portion to continue informing future program revisions.

In collaboration with the Art Therapy department and Art Department, this project plans to develop a novel opt-in program for residents. With the help of art therapy, patients and residents will be paired to work together on a project that seeks to express the patients’ experience with illness, and who they are outside of their illness. After the art is created, residents will write about the art and their experience with the patient. Once complete, the art pieces will be displayed within the children’s hospital in a location that is frequented by residents to remind them of their nuanced interactions and connections with patients.

This project aims to implement a group prenatal care model in the family medicine residency continuity clinic in Harlem, New York. In this model, patients will receive their prenatal care through two-hour group visits with a resident, attending physician, prenatal care navigator, and patients of similar gestational age. This will hopefully result in fostering more trusting practitioner-patient relationships so that patients feel more comfortable and safer throughout their pregnancy and during their labor and delivery. Residents will be brought “back to the bedside” by fostering deeper connections with patients in facilitating group discussions, providing prenatal medical care, and teaching patients how to advocate for themselves on the labor floor. This project will additionally focus on nutrition and wellness for patients and residents as healthy meals and wellness activities will be provided for the group to share together. 

This project aims to implement a group prenatal care model in the family medicine residency continuity clinic in Harlem, New York. In this model, patients will receive their prenatal care through two-hour group visits with a resident, attending physician, prenatal care navigator, and patients of similar gestational age. This will hopefully result in fostering more trusting practitioner-patient relationships so that patients feel more comfortable and safer throughout their pregnancy and during their labor and delivery. Residents will be brought “back to the bedside” by fostering deeper connections with patients in facilitating group discussions, providing prenatal medical care, and teaching patients how to advocate for themselves on the labor floor. This project will additionally focus on nutrition and wellness for patients and residents as healthy meals and wellness activities will be provided for the group to share together. 

Nutrition has a strong role in combating the epidemic of diet-related non-communicable diseases. There is currently limited emphasis on dietary counseling in medical training and residency programs. This project aims to educate program peers on nutritional competencies for bedside application. The program will equip residents to not only apply nutritional knowledge at the bedside but also train their peers in using motivational interviewing as a dietary counseling strategy. This approach fosters a meaningful, patient-centered connection and empowers residents to guide patients from diverse backgrounds toward sustainable, healthier lifestyle changes, ultimately aiding in the prevention of chronic diseases.

Patients are often embarrassed by pictures in the medical record taken in the emergency room when they are in distress and seeking psychiatric care. Other practitioners could potentially have unconscious negative biases toward the mentally ill that may also be activated by seeing such images. Residents have commented how dehumanizing it is for the pictures to continue to haunt the patients when they are working with them in the clinic. This project will empower residents to change the photograph of a patient to one in which the person is recovered and healthy—a picture that reflects their recovery, as opposed to their worst day. This intervention will give residents the opportunity to transform their relationship with their patients. This project uses mixed methods to explore psychiatry residents' experiences working in a health care system that often stigmatizes people with mental illness. The exploratory hypothesis of this initiative is that residents will report improved engagement in their work based on this intervention.

The ability to cultivate a trusting patient-physician relationship, provide appropriate preventive care and screening recommendations, and utilize inclusive language, are essential skills necessary to improving the care of patients who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ+). The goal of Proud to Practice Inclusive Care: A Residency-Focused LGBTQ+ Health Curriculum is to help internal medicine residents build skills, confidence, and knowledge relevant to providing comprehensive care for LGBTQ+ patients. The project consists of a three-part curriculum designed for internal medicine residents (PGY-1-3): a workshop and patient panel; a simulation session; and an online educational toolbox. The study methods are designed with a community-focused approach, including community member input at each stage.

Medical residents often take care of patients with a substance use disorder (SUD), yet have little dedicated education on the subject, and thus limited comfort in assessing and treating SUDs. Alcohol use disorder, specifically, is a very common cause of emergency department visits and hospitalizations. This project aims to empower residents to provide comprehensive, evidence-based care for hospitalized patients with alcohol use disorder through education, skill building, and a new electronic health record order-set for evidence-based medications. This will promote honest patient-practitioner relationships and enhance the care provided to patients with alcohol use disorder within the hospital system.

Empathy and strong communication skills are vital in medical care, yet these skills are often underemphasized in medical education and training, particularly in the context of end-of-life conversations. This project leverages Artificially Intelligent Conversational Agents (AI-CAs) and extended reality to enhance the teaching and practice of these essential skills. By integrating large language models with advanced gaming engines, the project will create realistic, interactive simulations that offer scalable and immersive learning experiences. This innovative approach addresses the limitations of traditional soft skills training, which tends to be brief, passive, and costly. The methodology involves deploying these AI-CAs through virtual reality headsets, providing medical residents with a robust and practical foundation in end-of-life care communication. This project aims to better prepare clinicians for challenging conversations, ultimately improving patient care.

Admission to the intensive care unit (ICU) can be a distressing experience for patients and their families, who often feel helpless and face difficult decisions. Similarly, resident physicians may find the transition to the ICU especially challenging due to demanding hours, higher patient acuity, mortality rates, and steep learning curves, leading to stress and burnout. Music is a universal language that transcends cultures and emotions and has the power to heal. This project aims to enhance the emotional well-being and connection between patients, their families, and resident physicians through the use of music and other forms of therapeutic audio in the ICU.

In the fast-paced and high-stress environment of the intensive care unit (ICU), residents often find themselves immersed in the technical aspects of patient care, sometimes losing sight of the human beings behind the medical conditions. In addition, critically ill patients frequently face communication barriers due to intubation or physical weakness, and residents are often occupied with documentation tasks that limit patient interaction. To address these challenges, this study proposes integrating patient-centered conferences (PCCs) into the residency curriculum through a randomized crossover design to enhance empathy and communication skills. By inviting former ICU patients to share their stories during medical conferences, PCCs will aim to foster meaning in work and reconnect residents with the core of their profession – the patient. Each conference will feature a didactic portion followed by patient narratives, where ICU survivors will discuss their medical history, treatment experiences, and the impact of critical illness on their lives. Residents will have the opportunity to engage in dialogue with patients, gaining invaluable insights into the emotional journey, recovery challenges, and patient-practitioner interactions. The impact of PCCs will be measured using the Jefferson Scale of Physician Empathy, pre- and post-conference surveys, and semi-structured interviews with residents. This innovative approach seeks to enhance patient-centered care in the ICU.

Increased confidence and competence with bedside procedures has many benefits for the patient-physician relationship. The process of obtaining consent, performing the procedure, and subsequent follow-up builds trust between the patient and the physician. This project involves building an interdisciplinary curriculum between internal medicine and interventional radiology. The primary aims are to improve the patient procedural experience in peri-procedural anxiety, patient satisfaction, and trust, and to increase internal medicine residents’ confidence and competence in bedside peri-procedural patient care.

VITAL was developed in response to patient requests for more therapeutic opportunities in the inpatient setting. The challenge was to find a solution that could effectively address the complexities of the inpatient psychiatry experience, particularly in cases of involuntary hospitalization and limited autonomy. Developing a therapeutic alliance seems nearly impossible when resident-patient interactions are often adversarial. Currently, the programming is multidisciplinary, including social workers, nursing trainees, recreational therapists, and psychologists. Incorporating residents into patient education increases collaboration with mental health colleagues. Resilience-focused activities will highlight the program’s veteran population's strengths, using the six domains defined by the Predictive 6 Factor Resilience Scale (PR6): Health; Reasoning; Composure; Vision; Collaboration; and Tenacity. This will allow the care team to see patients beyond their pathology and connect in neutral spaces that foster creativity. The project will also support resident wellness and burnout prevention by integrating these domains into weekly check-ins and processing patient encounters, both positive and negative.

This project’s vision is to create an inpatient internal medicine-pediatrics (med-peds) consult service (MPCS) focused on delivering equitable clinical care and promoting patient advocacy to provide transitional support and medical care for vulnerable youth, adolescents, and young adults with childhood onset conditions, while creating opportunities for residents to develop autonomy, engage in research/quality improvement, and educate practitioners on transitions of care. Med-peds residents will take ownership of the MPCS while collaborating with others to advocate and improve the quality of care for these special populations. This will help to foster a sense of med-peds identity in the residents, and in turn be protective against burnout. Services provided by the MPCS include coordination of care, disease-specific management, age and developmentally appropriate inpatient support, discharge coordination, and transition of outpatient services/practitioners.

The highest rate of maternal mortality in the first postpartum year is related to maternal mental health and substance use. Pregnant women with a history of trauma and adverse childhood experiences can have higher levels of pregnancy-related trauma, which can exacerbate anxiety, depression, and post-traumatic stress disorder symptoms. The keys to recognizing impending pregnancy-related trauma can be difficult to navigate within the high-risk field of obstetrics and gynecology, in which birthing mothers are faced with one of the most personal experiences of their life. This project’s goal is to improve recognition and management of pregnancy-related trauma while embodying a culture of mindfulness among obstetrics and gynecology residents, fellows, and nurse trainees by implementing a screening tool for recognition of perinatal trauma and formulating a simulation-based curriculum for mastery of trauma-informed care. 

This pilot, mixed-methods interventional study aims to evaluate the effectiveness of a modified PAUSE debrief in reducing provider burnout and enhancing social capital following pediatric death in the emergency department (ED). Child death is a significant, traumatic, and often isolating event for medical practitioners. Burnout among health care professionals is associated with emotional exhaustion and depersonalization, often leading to negative outcomes, such as medical errors and high turnover. The PAUSE debrief, a structured reflection ritual, has previously improved team cohesion and resilience but has yet to be incorporated in the pediatric ED. In this study, attending physicians, fellows, and charge nurses will receive training to lead PAUSE debriefings; ED staff members and physician learners who participate in the PAUSE will complete pre- and post-intervention surveys to assess burnout and social capital. Feasibility assessment, addressing five domains, will be incorporated within the pre- and post-intervention surveys and focus groups. Results of this study aim to create a stronger medical community, humanize the patient death experience, and improve patient and family care.

Hair is a significant aspect of identity and cultural expression, particularly for minoritized individuals.​ However, the current selection of hair and skin products available for hospitalized patients doesn't meet the unique needs of those with coily hair, textured hair, or locs, and can cause hair breakage and pseudofolliculitis.​ The Inclusive Hair, Inclusive Care project aims to meet this need by providing culturally appropriate hygiene products, such as satin bonnets, wide-tooth combs, and single-blade razors, to hospitalized patients. Paired with innovative resident cultural competency education, this initiative strives to foster a deeper connection between residents and their patients, inspiring greater empathy and inclusivity in medicine.

Inspired by the patient-centered care model, which emphasizes the importance of seeing patients as individuals with unique backgrounds and medical and personal goals, this project plans to create a home visit program within the University of Texas Medical Branch’s internal medicine residency program. Residents at all levels will identify patients in need of a home visit, either post-hospitalization or within their continuity clinic panel; particular attention will be paid to patients who face barriers coming to clinic. Prior to the home visit, residents will receive an introductory education to home health visits. Both patients and residents will be surveyed about their experience. This program aims to strengthen the physician-patient relationship while exposing residents to social determinants of health that impact patient care.​

The Empathy Enhancement Initiative: Resident-Led Training for Enhanced Patient Satisfaction, Outcomes, and Physician Well-Being is not just a project or research; it is a mission and passion at the University of Texas Rio Grande Valley Knapp Medical Center to impact patients in the community by providing empathetic, holistic care. This intervention will include resident-led didactics, simulation labs, and a Back-to-Bedside elective in the residency curriculum. This initiative aims to improve patient satisfaction, outcomes, and physician well-being.

Central Virginia has a large population of native Spanish speakers who do not have a strong knowledge of the English language. UVA Health regularly has more than 55 patients a month who need surgery (elective, urgent, or emergent) who require a Spanish language interpreter to properly receive care, yet the Departments of Anesthesiology and Surgery combined have fewer than five faculty members who are fluent in the Spanish language. This project aims to improve care and diminish health disparities in the peri-operative space for Central Virginia’s LHS+ [Latinx, Hispanic, or of Spanish Origin +] population through operating room physician edification.

This project’s goal is to humanize the patient encounter and instill meaning in residents’ work by sharing an interactive and collaborative autograph and activity book that improves the practitioner-patient experience through connection, creativity, and trust. This book will include four types of content: basic information to help orient patients and their families to the hospital and medical team; “autograph” pages for faculty and staff members to sign; coloring and activity pages to encourage creativity and engagement; and free writing space for reflections or questions for the medical team. Ideally, to minimize the task burden placed on residents, the book will be delivered to patients by residents in their visit to complete the history and physical, and depending on the clinical scenario, residents can introduce the book and engage with the patient in an activity or return at a later time. The primary outcome of this project is the resident’s perception of meaningful work, for which the project will utilize “The Work and Meaning Inventory” as well as qualitative data collection. The hypothesis is that use of this book will bring residents back to the bedside and improve their meaning in work.

Shared decision-making (SDM) and its impact on health quality and equity have been a recent focus in medicine, including emerging work on the understanding and implementation of SDM within the complex milieu of pediatrics.  As they become the next generation of pediatricians, pediatrics residents are essential to the immediate understanding of the complexities of pediatric SDM, and to enacting lasting change in the culture of SDM. This resident-driven project is aimed at simultaneously addressing the perceived disparities in SDM use and at empowering pediatrics residents to champion the use of SDM for all patient encounters, thus increasing their sense of connection to patients’ families and solidifying their role in patient/family-centered care. 

Enhancing Goal-Concordant Care: Integrating Palliative Performance Scale in Clinical Practice aims to enhance medical residents' ability to conduct serious illness conversations (SICs) with patients facing end-stage diseases by incorporating the Palliative Performance Scale (PPS) into their admission and daily documentation processes. The PPS is a validated tool used to assess a patient's baseline functional status. It will be utilized on the inpatient Liver and Cardiac Services, where patients often have complex palliative care needs. By providing updated note templates and an educational toolkit, residents will be empowered to initiate timely discussions about prognosis and care preferences. The goal is to increase the use of the PPS to 50 percent or higher among admissions in these services. This will foster a holistic understanding of patients' lives outside the hospital and better equip residents to support patients during serious illness conversations. This systematic approach seeks to promote early palliative care assessments and ensure that crucial conversations regarding treatment preferences and end-of-life wishes are conducted effectively.