1. Picker Institute, Inc. &
The Arnold P. Gold Foundation
G R A D UA T E M E D I C A L E D U C A T I O N
C H A L L E N G E G R A N T P RO G R A M

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Graduate Medical Education
Challenge Grants Program
The purpose of the Picker Institute/Gold Foundation Challenge Grant Pro-
gram is to support the research and development of successful patient-
centered care initiatives and best practices in the education of our coun-
try’s future practicing physicians. The Picker Institute/Gold Foundation
Graduate Medical Education Challenge Grant Program funds proposals
that illustrate specific interventions and innovations in graduate medical
education programs regarding patient-centered healthcare and/or human-
ism in medicine. The expected outcome of a grantee’s project will be a
demonstration, including a robust dissemination plan, of the measurable
effects and sustainability of the effort to enhance compassionate, patient-
centered-care in residency education. For more information and to visit
the GME toolbox go to: http://cgp.pickerinstitute.org

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Picker Institute Mission
Picker Institute Inc. is an independent nonprofit organization dedicated to
the global advancement of the principles of patient-centered care. Picker
Institute sponsors research and education in the fields of patient-centered
care in support of and in cooperation with educational institutions and
other interested entities and persons. The Institute’s mission is to foster a
broader understanding of the concerns of patients and other healthcare
consumers, and of the theoretical and practical changes needed to facili-
tate a more patient-centered approach. Picker Institute supports the ad-
vancement of the patient-centered care approach through a variety of
education programs, awards, research and dissemination of evidence-
based knowledge focused entirely on fostering continued improvement in
healthcare from the patient’s perspective.
“Through the patient’s eyes.”
Gold Foundation Mission
The Gold Foundation is a nonprofit organization dedicated to the ad-
vancement of humanism in medicine, restoring a balance between the
science of medicine and compassionate, respectful patient care. The
Foundation is a proponent of medical care that is as humanistic in its de-
livery as it is sophisticated in its technology to improve healing and health-
care outcomes. The Gold Foundation supports the development and dis-
semination of innovative medical education that furthers this mission.

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The Arnold P. Gold Foundation criteria to
advance humanistic, patient-centered care:
 Shows respect for the patient’s viewpoint
 Displays effective & empathetic communication & listening skills
 Demonstrates sensitivity in working with patients and family mem-
bers of diverse cultural and social backgrounds
 Is sensitive to and effectively identifies emotional and psychological
concerns of patients and family members
 Engenders trust and confidence
 Adheres to professional and ethical standards
 Displays compassion and respect throughout the patient interaction
Picker Principles of Patient-Centered Care:
 Respect for patients’ values, preferences and expressed needs
 Coordination and integration of care
 Information, communication and education
 Physical comfort
 Emotional support and alleviation of fear and anxiety
 Involvement of family and friends
 Continuity and transitions
 Access to care
Advancing Excellence in Patient-Centered Care Through Education,
Research and the Dissemination of Best Practice Strategies

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2011/2012 Graduate Medical Education
Challenge Grant Initiatives
Children’s National Medical Center
Principal Investigator: Dale Coddington, MD, MA
Project Title: Caring for Children with Special
Health Care Needs: An Online Medical Home Pro-
fessionalism Curriculum for Pediatric Residents
Objective: This initiative is an experiential and online curriculum to help
pediatric residents acquire the necessary knowledge, attitudes, and skills
to deliver effective, patient‐centered care to children with special health
care needs. This initiative will utilize direct experience in care delivery,
individual and collective reflections, and collaboration with a broad health
care and community team, all in the setting of residency continuity clinic
experience. A component of this initiative is for residents to engage in
reflective blogging with feedback from faculty and peers as an innovative
method to learn professionalism in the context of caring for children with
special healthcare needs in resident continuity clinic. This initiatives Al-
ways Event will be that, at the close of each clinical encounter, the physi-
cian and patient/family agree on next steps and on the specific responsi-
bilities of the physician and the patient/family.
Dana Farber Cancer Institute
Principal Investigator: Kristen G. Schaefer, MD
Project Title: Teaching Patient‐ and Family‐Centered Care in the Setting
of Life‐Threatening Illness: A Resident Outpatient Palliative Care Rotation
Objective: This initiative is a competency‐based, clinical rotation in a
variety of interdisciplinary palliative care outpatient specialty settings, with
emphasis on addressing the physical, emotional, social, spiritual and exis-
tential dimensions of suffering that accompany advanced illness. Through
outpatient clinical encounters, individualized feedback about patient-
centered communication skills, and mentored self-reflection exercises,
residents will learn about the importance of humanism in patient care and
professional development.

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Geisinger Medical Center
Principal Investigator: Michelle Thompson, MD
Project Title: Employing a Patient-Centered Approach to Develop a
Medical Passport to Improve Transitions and Educate
Health Care Providers
Objective: This initiative is designed to gather patient preferences
through focus groups, refine the medical passport using a patient-
centered approach and pilot its use, emphasizing training of healthcare
providers in maintaining a patient-centered approach during its implemen-
tation.
Jacobi Medical Center
Principal Investigator: Kenneth Rivlin, M.D., Ph.D.
Project Title: Experiential Learning of Patient/Family-Centered Care
Objective: This initiative addresses a critical question: “how do we moti-
vate residents to practice patient/family-centered care?” Building upon a
successful model for resident-run quality improvement, the project team
will introduce the practice of PFCC by partnering our residents with pa-
tient/family advisors to solve patient and resident identified problems
(gripes). It is believed that this program will alter resident perspectives
because the value of PFCC will be experienced not merely taught.

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New York Presbyterian Hospital
Principal Investigator: Nicholas H. Fiebach, MD
Project Title: The Patient’s Voice: Institution-wide Training for
House staff in Patient-Centered Care
Objective: This initiative targets resident interactions with patients at the
key transition points of hospital admission and discharge. Guidance for
house staff will be developed and disseminated to promote Always Events
at these critical junctures, including clear introductions and orientation,
assessment of patients’ language and communication needs, empathic
communication, eliciting questions and concerns from patients’ and their
families, and checking on patients’ preferences and understanding. This
project will integrate three distinct components that will serve to identify
the “voice of the patient,” develop and pilot strategies for delivering patient
-centered care that grows out of residents’ experiences with patients; and,
design a half day intensive workshop on patient-centered practices inte-
grating lessons learned from the first two components.
SUNY Upstate Medical University
Principal Investigator: Stephen Knohl, MD
Project Title: Learning to Talk
Objective: This initiative will build on and enhance the established
"Learning to Talk" program at SUNY Upstate Medical University with the
addition of the Always Event of "Discharge Guides". The "Discharge
Guides" will be firmly grounded in respect, clarity, and education and will
improve physician-patient communication skills. This initiative will intro-
duce residents to hand-written "Discharge Guides" for outpatient cases.
“Discharge Guides” will foster the patients’ comprehension of, and comfort
with, their discharge plan and will be portable to follow-up appointments to
ensure quality continuity of care.

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University of Chicago
Principal Investigator: Vineet Arora, MD
MAPP
Project Title: Engineering Patient Oriented Clinic Handoffs
(EPOCH) Project
Objective: To truly design a patient‐centered clinic handoff, understand-
ing the patient experience is imperative. The goals of this initiative in-
clude: (1) To understand how patients cared for in a resident clinic per-
ceive the end of year handoff process, with a particular focus on barriers
and challenges that they face; (2) To develop a patient‐centered end of
year clinic handoff process for internal medicine training; (3) To evaluate
the impact of this patient‐centered end of year clinic handoff process on
resident satisfaction, patient satisfaction, and relevant patient outcomes.
University of California
San Francisco /
VA Medical Center, San Francisco
Principal Investigator: Calvin L. Chou, MD, PhD
Project Title: Development of Interprofessional Team-based Observed
Structured Clinical Examinations to Ensure Patient-Centeredness in
Primary Care Teams
Objective: We propose to construct an Interprofessional Team-based
Observed Structured Clinical Examination (ITOSCE): an assessment that
uses standardized patients and team members to ensure that a trainee
explicitly incorporates the patient’s goals of care and illness perspective
into a comprehensive care plan.
University of South Florida
Principal Investigators: Deanna Wathington, MD ,
MPH and Charles N Paidas MD, MBA (DIO)
Project Title: Enhancing Medical Resident Cultural and
Linguistic Competency
Objective: This project evaluates the efficacy of two unique training inter-
ventions to enhance cultural and linguistic competency among a diverse
group of trainees and program directors across a variety of specialties in a
large urban residency program. The project seeks to evaluate potential
best practice interventions/curriculum for residents to enhance patient
centered and humanistic care.

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2010/2011 Graduate Medical Education
Challenge Grant Initiatives
Dartmouth-Hitchcock Medical Center
Principal Investigator: Marc L. Bertrand, MD
Project Title: Integrating Patient and Family-Centered Care Principles
into a Simulation-Based Institutional Curriculum
Overview: This project will develop a curriculum and simulation-based
training experience for DHMC residents that will improve physician-patient
communication related to patient safety. We propose to develop an insti-
tution-wide curriculum based on the key principles of PFCC that will iden-
tify “always events”- observable behaviors that ensure all patient care
experiences are firmly grounded in dignity, respect, and information shar-
ing. The curriculum will specifically include simulations focused on in-
formed patient choice and breaking bad news.
Hebrew Rehabilitation Center/
Beth Israel Deaconess Medical Center
Principal Investigator: Jennifer Rhodes-Kropf, MD
Project Title: “How Do You Have the Conversation?”
A Curriculum for Residents.
Overview: The goals of this initiative are to, 1) Develop an innovative
curriculum that will teach internal medicine residents how to discuss with
families the natural progression of dementia and what their options are for
the goals of care for their loved ones; 2) To increase internal medicine
residents comfort levels and knowledge for discussion of living wills with
patients. Each resident will be better able to work positively and effectively
with patients and their families, and end-of-life discussions will become an
Always Event during the taking of a patient’s history and physical exami-
nation.

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Johns Hopkins University
Principal Investigator: Roy C. Ziegelstein, MD
Project Title: Development and Implementation of a
Patient-Centered Discharge Curriculum
Overview: The overall goal of this curriculum is to teach interns and resi-
dents the skills and attitudes necessary to facilitate safe, effective, patient-
centered transitions of care. It is hypothesized that an additional critical
element for safe, effective, transitions of care is the inclusion of the patient
and significant others as full partners in discharge planning. This project
proposes that the inclusion of the patient, and the patient’s perspective, in
Mount Sinai Medical Center
Principal Investigator(s): Joel Forman, MD &
Christine Low, LCSW
Project Title: Project PARIS (Parents And Residents In Session)
Overview: The goal of this initiative, which was implemented during the
2010/2011 grant cycle, is to implement and test a novel approach to teach
pediatric residents about patient and family-centered care (PFCC). The
approach calls for a supervised meeting between a family member of a
previously hospitalized child and a resident in the context of a pediatric
residency rotation (behavioral and developmental pediatrics).
Project Title: Project PARIS: Parents and Residents In Session – the
next generation
Overview: This 2011/2012 initiative builds on the previous results and
extends them to provide the PARIS intervention to a large group of medi-
cal students while performing a controlled trial of its efficacy in promoting
knowledge and improving attitude about patient and family centered care
(PFCC). The goal of this initiative is to implement a meeting between fam-
ily faculty and medical students who are on their pediatric rotation in the
medical center. The meeting will be standardized to include discussions of
the core components (core tenets of family centered care) that were iden-
tified in the pilot study.

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Riverside Methodist Hospital/
Ohio Health Foundation
Principal Investigator: Sara Sukalich, MD
Project Title: Teaching Disclosure: A Patient-Centered Simulation
Training for the Crucial Conversation
Objective: This project will attempt to close the gap by providing a robust
training and competency assessment for medical residents on how to
disclose medical errors and improve communication skills, using the Na-
tional Quality Forum’s guidelines. The goal of this project is to ensure that
the skills needed to provide full disclosure of medical errors are taught to
trainees, and assessment of trainees’ competence in these skills is evalu-
ated.
The Regents of the University
of California
Principal Investigator: Danielle Perret, MD
Project Title: Humanism in the Perioperative Environment
Objective: This curriculum centers on the patient’s entire perioperative
experience, with close attention to the patient’s fears, pain, and anxiety.
The goal is for residents to develop perioperative Always Events that inte-
grate and promote patient-centered medicine, resulting in a personalized
patient perioperative experience. The program creates an overt and com-
prehensive curriculum that gives anesthesia residents the skills to identify
and address a patient’s pain, anxiety and personal needs in the pe-
rioperative setting.

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University of Maryland School of
Medicine
Principal Investigator: Susan D. Wolfsthal, MD
Project Title: Empowering Patients to Optimize Their Medication Regi-
mens: A multidisciplinary approach.
Objective: This initiative will provide residents with skills in assessing
their continuity patients’ barriers and adherence with medication use.
Residents will gain knowledge through a series of seminars and evaluate
their own clinical practice through a practice based learning (PBL) exer-
cise. Through an interdisciplinary partnership with a clinical pharmacist,
residents will utilize existing resources to assist patients to cope with in-
creasing economic pressures.
University of Massachusetts Medical Center
Principal Investigator: Kathleen E. Walsh, MD, MSc
Project Title: Home Medication Education and Support (HOMES): A
Resident Module on Home Care in Children
Objective: This study will address the challenges that families face, when
caring for chronically ill children, by training new physicians to be sensitive
and responsive to parents needs and to proactively provide parents with
the support needed to successfully care for children with chronic condi-
tions at home. The overarching goal is to develop a curriculum that will
give residents the knowledge and clinical skills needed to support safe
home medication use for children and families in their practice.

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University Medical Center Foundation, Arizona
Principal Investigator: Eric Brody, MD, FACC
Project Title: The Native American Cultural Competency Curriculum
Objective: This project will develop a cultural competency curriculum that
will include, but not be limited to, eight hours of lecture time to explore
topics such as: an overview of health issues among Native Americans,
language/translation issues in providing care for Native American pa-
tients, culture and spirituality of Native American peoples (particularly in
the Southwest), presentation/discussion of multiple case studies under-
scoring specific points regarding clinical care for Native American pa-
tients, a session of resident case presentations, and a session of conclud-
ing remarks/wrap-up.
Wake Forest University
Health Center
Principal Investigator: Franklin Watkins, MD
Project Title: Improving Transitions of Care for Older Adults through
Interdisciplinary Education for Medical Residents
Objective: This initiative will develop an Acute Care for the Elderly Unit
Transitional Program (ATP) to teach optimal discharge planning and
reinforce interdisciplinary communication through trainee home visits to
vulnerable older patients after hospital discharge. The ATP will provide a
“living laboratory” to enhance the medical trainees’ understanding of the
importance of appropriate discharge planning, communication with the
patient, family and caregivers, as well as impact a culturally and socio-
economically diverse population. Successful hospital discharge and tran-
sitions of care can be considered Always Events, as all patients experi-
ence at least one (and often multiple) care transition following hospitaliza-
tion.

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Challenge Grant Program Cycle: 2009-2010
Train Pediatric Residents in the Delivery of News and the Discussion of Issues
Related to Death and Dying in a Pediatric Population
Principle investigator: Heather Huszti, PhD, Director of Training, Psychology
Children’s Hospital of Orange County, CA
Communication in Family Meetings: Developing and Assessing a Curriculum for
Residents
Principle investigator: Julie T. Irish, PhD,
Beth Israel Deaconess Medical Center
Improving Patient Communication Skills Among Surgical Residents
Principle investigator: Rajiv Y Chandawarkar MD
University of Connecticut Health Center
Develop Health Care Transitions, a Resident Learning Module on Building Bridges
Principle investigator: Suzanne McLaughlin, MD
Brown University Alpert School of Medicine/Rhode Island Hasbro Hospitals
Teaching Family-Centeredness in the PICU: a novel approach using medical simu-
lations
Principal investigator: Ira M. Cheifetz, MD
Duke Children's Hospital
Introduce a Family Centered Care Curriculum to a Pediatric Residency Program
and Measure its Effects on the Centeredness of Pediatric Residents
Principal investigator: Keith J. Mann, MD
Children’s Mercy Hospital
Transitioning from Pediatric to Adult .Centered Medical Care (the patients perspec-
tive)
Principal investigator: Niraj Sharma, MD, MPH
Brigham & Women's/Boston Children's Hospitals/Harvard Medical School
Screening and Managing Interpersonal Violence During Pregnancy at an Urban
Teaching Hospital
Principle investigator: Suneet Chauhan, MD
Aurora Health Care, Inc.
Create a patient-centered care plan (PCCP) within an electronic medical record;
and evaluate the impact of PCCP use on patients and health-care team members
Principal Investigators: Judith Pauwels, MD & Larry Mauksch, M.Ed
Univ of WA Family Medicine Residency
Challenge Grant Program Cycle: 2005-2009
Transitioning Adolescent Patients (TAP) from Pediatric to Adult Care
Principal Investigator: Emily von Scheven, MD, MAS, Pediatric Rheumatology,
University of California San Francisco
Improving Patient Rounds (IPR)
Principal investigator: Walter J. Moore, MD, Center for Patient- and Family-
Centered Care, Medical College Georgia

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Resident Performance from the Patient’s View
Principal investigator: Dick M. Wardrop, MD, PhD, FAAP, Director of Resident
Research, Internal Medicine, Carillion Clinic, Roanoke, Va.
Patient-Centered Training of Residents on a Medical Ward
Principal investigator: Robert C. Smith, MD, MS, Internal Medicine,
EW Sparrow Hospital/Michigan State University College of Human Medicine
“Emergency Medicine Resident Training in Interprofessional Skills: Evaluating a
Needs-Based Curriculum”
Principal investigator: Sondra Zabar, M.D., Associate Professor of Medicine
Linda Regan M.D., New York University School of Medicine
“Cultural Sensitivity Initiative for Medical Education”
Principal investigator: John M. Tarpley, M.D. Vanderbilt Medical Center/Vanderbilt
University
“Simulation Used to Measure the ACGME Core Competencies and Patient-
Centered Care”
Principal investigator: Pamela J. Boyers, Ph.D., Riverside Methodist Hospital
“Improving Patient Compliance and Outcomes in Hypertension Management in the
‘Stroke Capital’ of the World”
Principal investigator: William H. Hester, M.D., McLeod Family Medicine Resi-
dency Program
“Development and Implementation of an Interdisciplinary Palliative Care End-of-
Life Education Program for Residents Who Rotate through the Surgical Intensive
Care Unit”
Principal investigator: Anthony A. Meyer, MD, PhD & Renae E. Stafford, MD, MPH
The University of North Carolina at Chapel Hill, Trauma and Critical Care Services/
External Evaluation Committee Members
Max Bassett, Georgia Health Sciences University
Pamela J. Boyers, PhD, University of Toledo
Jim Cichon, ACGME
Virginia Collier, MD, Christiana Care Health System
Nettie Engels, Georgia Health Sciences University
Susan Frampton, PhD, Planetree
Richard Frankel, PhD, Veterans Administration Medical Center
Mary Joyce Johnston, ACGME
Adina Kalet, MD, MPH, NYU School of Medicine
Susan Edgman-Levitan, Executive Director, John D. Stoeckle Center for
Primary Care Innovation
Carl Patow, MD, MPH, MBA, FACS, University of Minnesota
V. Seenu Reddy, MD, MBA, FACS, UT Health Science Ctr. - San Antonio
Christopher Simien, ACGME
Richard Wardrop III, MD, University of North Carolina School of Med.
Mitzi Williams, MD, Georgia Health Sciences University

16. Picker Institute Board of Directors
J. Mark Waxman, Esq., Chairman
Stephen C. Schoenbaum, M.D., Vice Chairman
Samuel Fleming, Treasurer and Secretary
Sir Donald Irvine, MD, FRCGP, FRCP, F.Med.Sci
David C. Leach, M.D., Former Executive Director, ACGME
Gail L. Warden, MHA, President Emeritus, Henry Ford Health System
Lucile Hanscom, Executive Director
11 Main Street, 4th Floor
PO Box #777
Camden, Maine 04843
Tel 1.207.236.0157
1.888.680.7500
Fax 1.207.236.3570
Email lhanscom@pickerinstitute.org
Website http://pickerinstitute.org
http://alwaysevents.pickerinstitute.org
Hannah Honor, Grants Coordinator, hhonor@pickerinstitute.org
The Arnold P. Gold Foundation
Barbara Packer, Managing Director, COO
619 Palisade Avenue
Englewood Cliffs, NJ 07632
Tel 1.201.567.7999
Email goldfdtn@gold-foundation.org
Website http://humanism-in-medicine.org
Ann Bruder, Director of Programs