2026 Catalyst Awards

The Metacognitive Analysis Project advances equity in graduate medical education by using a biopsychosocial lens to optimize resident and fellow performance in high-stakes evaluations. The project addresses the multidimensional problems faced by residents and fellows whose performance in high-stakes evaluation does not match their capabilities. Clinical training often occurs in high-pressure, evaluative spaces where learners’ performance is impacted by biological factors (e.g., anxiety), psychological factors (e.g., mindset, self-efficacy), and socio-cultural factors (e.g., bias, stereotype threat). By investigating interventions that mitigate imposter syndrome and optimize performance, we highlight critical areas for change, ensuring that our efforts support individual growth and increase belonging and relatedness in the graduate medical education community, all of which contribute to professional identity development and career success.

The Metacognitive Analysis Project has the potential to meaningfully transform the clinical learning experience and environment at the University of Rochester School of Medicine by directly equipping trainees with evidence-based strategies to bring their performance in line with their knowledge, understanding, and capabilities. Nationally, this project offers a scalable model to advance clinical excellence and equity in residency and fellowship programs.

PIs: Brett W. Robbins, MD, Senior Associate Dean, Graduate Medical Education, Professor, Department of Medicine, University of Rochester Medical Center; Anika Simone Johnson, EdD, Assistant Dean for Engagement and Enrichment, Warner School of Education and Human Development

The clinical learning environment lacks structured opportunities for interprofessional conversations related to the prioritization of patient safety while building team resilience through reinforcement of proactive safety behaviors. This limits trainees’ development of essential teamwork competencies and systems thinking that prioritize patient safety.

The “One Safe Act” is a brief, structured team reflection that brings together healthcare professionals to share specific actions they personally take to keep patients safe. This proposal aims to identify individual and team behaviors that contribute to patient safety. By analyzing these elements, we can develop strategies to enhance clinical team resilience and further reduce errors. This project will deploy huddles in clinical units selected based on the presence of teaching services across a range of medical, procedural, and ambulatory specialties. Rather than focusing solely on what goes wrong, One Safe Act emphasizes and amplifies the daily practices that contribute to successful patient outcomes.

This project directly addresses ACGME competency requirements for interprofessional teaming and patient safety, preparing future healthcare leaders for collaborative, team-based practice models essential in modern healthcare delivery.

PIs: Justin B. Ziemba, MD, MSEd, Assistant Professor of Urology in Surgery; Caoimhe C. Duffy, MD, MSc, CPPS, FCAI, Assistant Professor, Anesthesiology and Critical Care

Medical errors are inevitable in clinical practice, yet many physicians are unprepared to respond in ways that support patient trust, personal resilience, and team learning. Despite growing attention to safety culture in graduate medical education (GME), most trainees lack meaningful opportunities to observe or practice error disclosure and emotional recovery.

This project will implement and evaluate a multi-phase intervention to develop emotionally intelligent, ethically grounded responses to error. This includes validating a multi-domain assessment scale (AMERS), integrating narrative pedagogy to foster ethical growth, and designing an AI-compatible rubric to support scalable feedback and learning. The program centers storytelling, systems thinking, and psychological safety to transform how errors are experienced, discussed, and taught.

Grounded in institutional priorities and prior pilot successes, this initiative aims to shift GME's culture toward transparency, growth, and equity. It offers a sustainable, national model to support physicians in learning from imperfection while preserving their humanity.

PIs: Sherry Adkins, MD, MPH, Clinical Assistant Professor, Family Medicine; Danielle Bornhorst, MD, Family Medicine Resident; Stacy Flowers, PsyD, Associate Professor & Director of Behavioral Science, Family Medicine; Assistant Professor, Geriatrics