What do teachers and Shark Tank have in common? Johns Hopkins University has the answer

Host: We're broadcasting live at the AAMC in Baltimore 2015. And this year's conversation is about change. What needs to change in health care? I know there are a ton of things. But we're asking each person what specific thing is on their mind right now.

Announcer: Asking questions, seeking solutions. Algorithms for Innovation live from Baltimore at AAMC 2015.

Cofrancesco, Jr.: Hi. My name is Cofrancesco, Jr. I am a faculty member at the Johns Hopkins University School of Medicine and the Director of our Institute for Excellence in Education.

Host: Joe, tell me what had to change at your institution?

Cofrancesco, Jr.: So several years ago, the then dean realized that our educational mission, particularly the teaching in the education components, were facing challenges. In the continued pressures with the needing to generate clinical income and the clinicians work, the ever-decreasing . . . the money available for grants, and of course, Hopkins has a very large part of its portfolio of NIH grants, that the education mission needed to be revisited and a plan for the future device.

Host: So were you feeling the educational mission wasn't exactly being seen to its fullest potential?

Cofrancesco, Jr.: I think there was a great concern that as we kept moving forward without a strategic plan and thought process, that would happen.

Host: Yeah. That the other things would take priority in precedence. Got you. So we know what the problem was, we know what needed to change, we have an idea of why. What was the barrier to actually making that change?

Cofrancesco, Jr.: I think the barrier is that Hopkins is a very large and diverse institution with a big number of faculty that are involved in education but also involved in a number of other activities such as clinical care, research. And teaching is such a broad term because we have medical students, graduate students, residence, fellows, allied health professionals, nurses and peers. In addition, education is more broad than just teaching. There's the curriculum development. There's the scholarship around education. There's the dissemination of the work we do.

Host: And what were you hoping that the institute would do then?

Cofrancesco, Jr.: So as part of this large committee called the Abeloff Committee, the dean gathered thought leaders and diversity of faculty non-physicians and people across our institutions to come up with a cohesive plan. And we were hoping to do was come up with a way to bring together the many wonderful but not always communicating parts of the institution to move forward, and also gain recognition for the faculty.

Host: And you'd mentioned that teaching is a broad thing. You're afraid that that mission was becoming ignored. How was this going to solve that problem?

Cofrancesco, Jr.: So we looked at a lot of options and many places. The universities have created academies of medical educators. It's a wonderful development in academic medicine. We embrace that movement but felt that we needed a uniquely Hopkins solution primarily because Hopkins has a philosophy that everyone should be involved in teaching, and those who do should be next one added. In addition, Hopkins always embraces the dissemination in scholarship aspect of what we do. So we needed to build something like an academy but it had to be more available to all of the faculty, so that's when the institute was born.

Host: And that was about five years ago. So explain how it's impacted your teaching mission.

Cofrancesco, Jr.: So the institute has four key pillars. One is to improve teaching. The other is to gain recognition for the educator. The third is to inspire and enable educational scholarship. And finally there's the fourth pillar which is more global of building more of a community and a feeling of the educators. And through summer teaching camp, conferences, grand rounds, endowed money to provide scholarship funds and grant funds to people to do projects, we've been able to bring people together and have had some wonderful successes both with having scholarship done, having junior faculty recognized.

We have something called Shark Tank where junior faculty come. They submit in writing potential proposals. We select four to present to our Sharks. And then at conference, they present in 10 minutes with back and forth questions. And at the end of the day, the Sharks decide, have a divvy up $10,000. And thus far, we've had some amazing proposals that had gone forward. One in fact has already led to a publication, a small publication.

Host: And is the teaching mission now more on the forefront as the result?

Cofrancesco, Jr.: Well, I don't want the institution take the full credit. But I think there's a cultural change that's happening at Hopkins both with our colleges system which has been around for 10 years. The Office of Faculty Development with Vice Dean Clements and Mike Barone as the Associate Dean for the faculty, as well as our partners at the Bayview teaching programs. That has really changed, I think, the tone on campus to our people are increasingly indicating they are educators, proud to say they are educators and becoming more visible.

Host: If you had a chance to do this over again, what lesson did you learned? What would you have changed?

Cofrancesco, Jr.: A couple of things we learned. At our five-year review, we went back and reinforced that out. Although we are open to all of our learners and they're able to attend our programs for free, that really our focus is the faculty, and that's always been our case. But that five-year retreat confirmed that. Things that we would changed is really appreciating the need to work with the development office actually to get the money we needed, we've been very successful with that, so that we can give grants.

Even small grants are important in education to our colleagues, to make sure we continue to involve our junior faculty. And one of the things personally that I think I should have done was been more aggressive early on in how we're going to assess the actual success of the institute so we can continue to demonstrate the leadership our value as we grow.

Host: Give me an indication of what the criteria for success was were.

Cofrancesco, Jr.: The number of faculty involved in our programs, the number and quality of applicants for our grants, the evaluations which were hard to put together but how our teachers are actually doing in the class. One of the areas we struggle with sometimes is small group teaching. So in our teaching camp and in our conferences, we have a focus on various faculty development sessions on how to run small groups appropriately. And that's seems to be helping.

And also just the recognition across the university. The university and the school of medicine, I'm very grateful, have given us their vote of support so the directorship now has a fully endowed position. The Berkheimer Faculty Development Scholars Program has a fully endowed amount for one grant a year of $50,000. And now through a variety of other sources, we're able increase our collaboration to build new programs.

Announcer: Reimagining health care. Explore more at AlgorithmsforInnovation.org.