If you don't know where you are going, you will probably end up somewhere else. —Yogi Berra As lamented in recent discourse,1–6 residents' engagement with, and success in, scholarly endeavors has been variable, and although mediocre scholarship may reflect resident inability or poor faculty mentorship, it may also indicate the ambiguity and inconsistency of our expectations and how we communicate them to residents. Although we want residents to paddle vigorously toward the shores of scholarly activity, we often ask them to do so without a compass. Thus, it is no wonder that many simply lay back and float gently with the current. Articulating the general sentiment surrounding this ambiguity in the development of residents as scholars, Ledford et al1 suggested that “codify(ing) the goal” around scholarship expectations was 1 way programs could mitigate resident uncertainty. In other words, arming our residents with the functioning compass of consistent guidance could help to not only ensure progress but also articulate what such progress might entail.;Eliciting Expertise We (the authors) are responsible for assisting faculty and residents across all departments in the training and mentoring of research, and we are aware of the inconsistencies and unclear expectations for our residents. To “codify the goal” for residents, we set about to establish reasonable and consistent expectations for residents' scholarship. We engaged leadership from our 10 residency and 14 fellowship programs in a half-day retreat in July 2013. Nearly 40 program and fellowship leaders and key faculty who frequently mentor residents responded to the invitation to discuss the current state of resident scholarship at our institution. Participants formed multidisciplinary, small groups and were asked to identify essential components and skills they believed residents should acquire through the Accreditation Council for Graduate Medical Education (ACGME) scholarly activity requirement.7 Each group was then asked to rate those skills in order of importance: Their top 5 skills were then reported to the full group. Some groups identified similar skills that reflected how scholarly activity should be a tool to enhance medical knowledge and patient care competencies. Two such skills were “how to ask an answerable, relevant clinical or research question” and “how to critically review the literature.” Not surprisingly, the lists generated by the groups reflected the ambiguity and variability plaguing the scholarly activity requirement at large. As much as faculty agreed the ACGME requirement was an opportunity for residents to expand their research and scholarship skills, the group had some difficulty articulating these skills. Some groups emphasized ambiguous yet banal skills, such as “writing skills” and “hypothesis generation.” Others set the bar much higher, stalwartly expecting residents to learn “the process from question to manuscript” and “project management, including time management, understanding the regulatory process, and understanding team roles.” Beyond a lesson in extremes, this exercise from our half-day retreat also produced outright disagreement among faculty. Fundamentally, faculty wrestled with whether skills such as Institutional Review Board navigation and project management were part of the resident scholarly activity process or simply burdensome byproducts of it. Drawing on experiences with incredibly different resident projects, agreement was settled on the fact that “it depends on the project.” This and other discussions at the retreat reinforced the sentiment articulated by Ledford et al1 and exposed variation in values across mentors and programs, bringing again into sharp relief the barriers that inconsistent messages can present to residents. Yet, ultimately, a compass cannot have 2?points toward North, so some sense and arrangement had to be made through the process.;Making Sense of It All We walked away from the retreat with a mixed ba
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