Honoring Excellence: Q and A with Danielle L. Clark, MD

2022-2024 Jeremiah A. Barondess Fellow Danielle L. Clark, MD

This interview is one in a series of interviews with recipients of the 2022 ACGME Awards. The awardees join an outstanding group of previous honorees whose work and contributions to graduate medical education (GME) represent the best in the field. They will be honored at the ACGME Annual Educational Conference, taking place virtually March 30-April 1, 2022.

The Jeremiah A. Barondess Fellowship in the Clinical Transaction is an annual award jointly presented by the ACGME and the New York Academy of Medicine. 2022-2024 Jeremiah A. Barondess Fellow Danielle L. Clark, MD is a hospitalist, assistant professor of medicine, and associate program director for the internal medicine residency program at the University of Cincinnati Medical Center. Dr. Clark specializes in internal medicine.

ACGME: Why did you want to become a physician?

Dr. Clark: While in high school, my father was diagnosed with gastric cancer. That winter I spent many afternoons in doctor offices and hospital rooms, meeting different members of his care team. During one hospital admission, his physician sat down with us and spoke in a true patient-centered way—sitting at eye level, letting my father lead the conversation, and even encouraging his 13-year-old daughter to ask questions while patiently drawing diagrams to explain the answer. This was the first physician I witnessed take time to really listen and respond, placing my father and his family at the center of his care. I don’t remember the physician’s name, specialty, or credentials, only that I trusted him to care for my father. This moment had a lasting impact on my view of the medical field and my choice to become a physician as I hoped to develop that level of trust with my patients and their family members.

ACGME: What has been the most rewarding part of your medical education?

Clark: The most rewarding part of medical education for me has been the relationships I have witnessed or been a part of. Watching residents interact at the bedside and helping learners grow in these interactions has been amazing. Beyond that, I also appreciate forming trusting relationships with residents and being in a position to advocate for them. And finally, the mentorship and sponsorship I have received from the amazing medical educators at my institution was incredible, and I am so happy that I am now starting to be able to provide mentorship to those interested in medical education as well.

ACGME: What has been the most challenging?

Clark: The pandemic has certainly posed significant challenges in the clinical setting, especially with patient-provider relationships at the bedside. Early during the pandemic and prior to COVID-19 vaccines, our institution limited the number of team members in the room to conserve PPE [personal protective equipment], as well as minimize exposure. In addition, medical students did not see patients unless the patients were COVID-19 negative. Like other institutions, we also limited visitors for patients with COVID-19. The isolation of patients from those they loved, and from the ability to communicate with the full team at the bedside, was particularly difficult.

ACGME: What, to you, is the most important or most meaningful part of the clinical transaction?

Clark: In my eyes, the most important part of the patient-[practitioner] interaction is establishing trust with patients. During an inpatient stay, patients and family members are often at their most vulnerable. It is up to the clinical team to establish trust with the patient so excellent two-way communication can occur. I chose the University of Cincinnati for residency due to the emphasis on patient-centered care, and am so thankful for the education and training I received; I hope to continue to improve the patient experience at the institution through the support of the Barondess fellowship.

ACGME: How will you apply the fellowship?

Clark: The Jeremiah A. Barondess Fellowship will provide the ability to re-evaluate the patient-clinician relationship in the setting of patient-centered bedside rounds at the University of Cincinnati. While our institution has a long-standing history of bedside rounds, our process has decayed over the last few years due to the COVID-19 pandemic, as well as a lack of continued faculty development, resident education, and reassessment from the patient perspective. Using quality improvement methods to first assess the needs of all stakeholders, structured communication strategies will be developed and implemented.

ACGME: What does it mean to you to receive this award?

Clark: Improving communication at the bedside will allow providers to better establish that sense of trust with patients that I first experienced with my father’s physician. The fellowship will provide dedicated time for the creation of curricula to educate medical students, residents, and faculty members, impacting patient interactions throughout the entire internal medicine department at my institution. While these skills will initially focus on patient-centered bedside rounds, they will likely be applicable to interactions in the clinic setting as well. I hope to give back to the University of Cincinnati community of physicians, residents, medical students, and patients that have inspired me as a medical educator through this project.

ACGME: What advice would you give to other residents/fellows looking to either replicate your project or implement an original idea in their own program or institution?

Clark: One important thing I’ve learned is the importance of following a framework when implementing educational innovations. By following something like Kern’s six steps for curriculum development or the Model for Improvement, you can ensure a strong groundwork for your project. So often we design a project to solve a problem that we do not fully understand, jumping to a solution. Instead, we must make sure to engage all stakeholders that the project involves, especially patients and other members of the care team, to correctly assess and address problems.

ACGME: Is there anything else you would like to add?

Clark: I am so thankful for the support of the phenomenal medical educators at my institution who have supported me through the creation of this project, including Drs. Eric Warm, Jen O’Toole, Danielle Weber, Ben Kinnear, Matt Kelleher, and Rita Schlanger. Being surrounded by these educators has greatly impacted my path in medical education, and I could not be more grateful!

Learn more about the Barondess Fellowship on the New York Academy of Medicine’s website.