Office of Academic Affiliations

Dr. DiNardo is a leader both locally and nationally in educating medical students early in improving clinical reasoning and reducing diagnostic errors. This important instructional area, which impacts the care of Veterans and all patients, includes a conference series that introduces the clinical reasoning concept, an online curriculum and an elective that focuses on enhancement of reasoning skills in preparation for residency training.

"Clinical reasoning is something we're doing all the time every day,” said DiNardo. "To approach it from a more deliberate standpoint is very important.”

Her interest in this field of focus that is now exploding began while she was completing her Master’s in Medical Education at the University of Pittsburgh, and it became the focus of her Masters project.

"I'm a real believer in the philosophy that starting this training very early in medical school is important,” she said, adding “incorporating training in how students think as physicians is important in the way they approach patients and their problems.”

DiNardo has worked diligently to spread clinical reasoning education across the healthcare professional trainee spectrum. She has led efforts to develop, implement and evaluate curricula within the internal medicine residency program, and has disseminated her work nationally via presentations at national meetings and with multiple peer-reviewed publications. She was also awarded the Sheldon Adler Award for Innovation in Medical Education and the Clinical Educator of the Year Award from the University of Pittsburgh School of Medicine in 2020.

Dr. Topor created, implemented and currently leads the nationwide VA faculty development program: "First Friday Faculty Development Presentation Series." This accessible, cost-efficient program has widespread impact teaching VA-based health professions faculty effective ways to teach, supervise and mentor health professions trainees. The series is offered in-person and virtually and offers Continuing Education (CE) credits, reaching faculty at all VAs nationally as well as state and federal agencies. This is of particular benefit to faculty in rural locations providing CE opportunities in their location, which in turn improves access to care for Veterans by keeping these providers in their clinic.

"It's really important to make sure that VA provides the best training experience for learners," said Topor. "That's where faculty development comes in. For our clinicians, we have licensure and certifications and peer review, and for our researchers, we have credentialing and Institutional Review Board (IRB) and peer review. We do not have that in education."

That is why Topor began the faculty development program that includes core teaching skills such as writing teaching objectives, writing curriculum, setting learning goals and learning assessment, and giving feedback to learners. The presentation program also includes offerings on using spaced learning and experiential learning activities in teaching, the science of learning, leadership skills for educators, and preventing burnout in educators.

"It grew very organically," said Topor. "People started hearing about the program (initially only offered at Boston VAHCS) and asked to join from other sites in VA. Now we have participants as far away as Hawaii." To date, VA educators participating in the program have earned over 1,500 CE credits. Faculty participants include nurses, physicians, dentists, counselors, nurse practitioners, pharmacists, psychologists, social workers, physician assistants, healthcare executives, speech-language pathologists, audiologists and dieticians.

Dr. Topor has published outcomes from this program, along with a framework for faculty development at VA medical centers (VAMC). He also provides phone and on-site faculty development consultations to VAMCs nationwide. By advancing faculty development and the VA's health profession trainee education mission, this innovative program has set the standard in providing accessible and effective training that supports the delivery of outstanding care for our nation's Veterans.

Dr. Wipf created the "Resident as Teacher" course to prepare second-year medical residents for their roles as educators and leaders. The course, which has been taught annually at the University of Washington for the past 28 years, has been replicated at numerous other institutions across the country. She was recognized for this novel curriculum, receiving the 1996 Society of General Internal Medicine (SGIM) National Award for Innovation in Medical Education.

Growing up in rural Minnesota, Dr. Wipf was the first person in her family to go to college. She always wanted to be a teacher and began working in a hospital as a lab tech while completing her undergraduate degree. As a medical resident, she remembers always thinking, "What am I supposed to be doing with this entourage of trainees?"; By 1992, she started developing the “Resident as Teacher” course to answer that question.

"We emphasize that residents are the team leader on their rotation," explained Wipf, adding the curriculum teaches management and leadership of the team, refining teaching skills, teaching on admitting days, and the resident's role in morale of the team.

"Medicine has always been about the teaching of those more junior," she said. "It's very collaborative. Many of us believe learning is better when the student is taught by people who are one step or two steps ahead of them."

Wipf, who is also a believer in interprofessional training, spearheaded the effort to establish Seattle's VHA Center of Excellence (CoE) in Primary Care with the University of Washington School of Medicine and School of Nursing. The CoE is one of five original legacy sites initially funded by VHA. Under her leadership, the CoE has integrated health professions education via a team-based approach that includes internal medicine residents, advanced practice nursing students and residents, psychology fellows, pharmacy residents and social work interns.

"I think what our trainees are learning is how rewarding it is to practice when you have a team," said Wipf – a belief that has proven correct. Approximately 80 percent of primary care medical and nurse practitioner residents stay in primary care, she added.