The National Clarion Competition sponsored by the University of Minnesota
by John W. Overton, Jr., M.D.
In an attempt to provide more coordinated healthcare teamwork in solving clinical challenges, and thus get students in healthcare out of their “silos” of expertise, the University of Minnesota started an extra-curricular program in the early 2000s called the Clarion Competition. This program has grown in popularity over the years and now annually involves 15 to 20 academic healthcare centers.
At the program’s inception students enrolled in various graduate programs in healthcare-related fields at the University of Minnesota could volunteer to participate on multidisciplinary teams that would address a complex clinical scenario. The teams have normally consisted of 4 to 6 student representatives made up from students of the medical school, nursing school, school of public health, school of healthcare administration, the dental school, pharmacy school and the veterinary school. Most often fellow team members do not know one another when then start work on the assigned case for that year.
Annually healthcare professionals and academic writers at the University of Minnesota would create a new fictional, complex clinical case for which competing teams would suggest and defend pragmatic solutions, which they research and devise.
Within their solutions and recommendations the teams are asked to address all the domains that add complexity to the case: medical, nursing and dental care, inter-provider communications and handoffs of care, public health issues, social issues, educational opportunities, issues with third party payers and any other areas that add interest and/or complexity to the scenario. Usually a case description has consisted of well-written and referenced documents of 15 to 20 pages. Team participation has been a totally volunteer, extracurricular activity for which no academic credit has been offered.
When the Clarion Competition was started at the University of Minnesota, only teams on the Minnesota campus competed among themselves before a panel of judges. However, as interest in the Clarion Competition increased and spread nationally, other academic medical centers became interested and began sending their local winning team to the University of Minnesota each spring to compete in the National Clarion Competition. In 2014 fifteen universities sent teams to the national competition, and in 2015 sixteen teams participated in the competition.
A group of 6 to 9 judges is selected and asked to hear the presentations for the national competition each spring. The panel of judges changes from year to year, and the judges consist of healthcare professionals from different disciplines. Occasionally a judge may be asked to return for a second year, or, may be asked back several years after he or she has initially served.
The judges are assigned to random rotations between “hearing” rooms in an effort to provide more consistent evaluations. The teams and judges are also given a list of elements that need to be addressed in the team presentations. At the conclusion of all team presentations, the judges meet, discuss each team’s presentation, evaluate and total judges’ scores, then select teams winning first, second and third place.
At a banquet the evening following the national competition, attended by all team members, their coaches and the judges, the groups network, celebrate completion of their weeks of hard work and the three winning teams. Small cash awards are given to the three winning teams.
The networking among competing teams and across professional disciplines has been inspirational. Hopefully, such efforts to help us healthcare professionals work effectively as teams in solving difficult issues will grow, as has the national interest in this Clarion Competition grown. Some speculation has suggested that in the near future multidisciplinary healthcare teamwork will be required in all graduate healthcare education.
I, as a retired surgeon and emergency medicine physician, have had the privilege to serve as a judge in two of the National Clarion Competitions. These experiences have been inspirational and given me great hope that younger healthcare professionals, who follow my generation, are well educated, motivated and equipped to improve the valve and quality of our current healthcare system.
Bio Sketch: John W. Overton, Jr., M.D.
Dr. Overton earned his B.S. degree from Virginia Tech and his M.D. degree at the University Of Virginia. Following two years of residency, he practiced of emergency medicine for six years then trained in general surgery and cardiothoracic surgery at Tufts University. He is board certified in emergency medicine and cardiothoracic surgery.
From 1986 until 2001 Dr. Overton practiced cardiothoracic and vascular surgery in Minneapolis, Minnesota. During his practice years he worked with the Institute for Healthcare Improvement to improve outcomes in cardiac surgery. Due to unexpected medical issues, Dr. Overton retired from clinical practice in 2001.
Since leaving surgical practice, Dr. Overton has focused on improving safety and quality in the perioperative surgical environment and for medical transport systems, combining his interests in EMS, trauma, surgical care, safety and aviation. He has been a pilot for 40 years.
From 2005 to 2011, Dr. Overton served as a board member of the Commission on Accreditation of Medical Transport Systems (CAMTS), which develops standards for, and conducts site surveys for accreditation of helicopter, airplane and critical care ground patient transport programs. He trained as a Line Operations Safety Auditor (LOSA) to provide safety evaluations for airline transport cockpit crews and also trained as a risk advisor to provide integrated risk and safety management for high consequence industries. He served as the medical risk advisor on an international team of risk management consultants that wrote an industry risk profile for Helicopter EMS Transport (HEMS) in the United States (2009).
In 2011, Dr. Overton served as the medical officer for the National Transportation Safety Board.
He co-edited a reference textbook on medical transport safety and quality that was published in 2012
Since 2005 Dr. Overton has had growing interest in improving social justice and the philosophy of a just culture. He trained as a Champion for Just Culture and has taught the philosophy and practice of collaborative just culture to healthcare groups and to medical transport programs.