Tuesday, October 6, 2015

Stanford Medicine X | Ed Day 1

Introduction to Stanford Medicine X | Ed

A MedX hangover kit, educational learning labs, 3D printing, and the famous Zoe Chu, the dog – these were all aspects of Stanford Medicine X | Ed 2015, as envisioned by the creative mind of conference founder and executive director Larry Chu, M.D. As I listened to the myriad of student and teacher experiences ranging from “learning module recommendation engines” to “social media’s roles in patient safety”, I realized how unique Stanford Medicine X | Ed was. I also realized how there was no medical education innovation conference like it in the world.
Dr. Chu opened with comments on how patients and their caregivers were the biggest untapped resources in healthcare. He wanted everyone in the audience to focus on five major themes: 1) Acknowledging the unique needs and challenges millennial learners are experiencing to pursue their education. 2) Focus on how to scale 3) See how social media and tools serve as a new classroom 4) Explore interdisciplinary cooperation to improve clinical care 5) Lifelong learning.

Stanford Medicine X |Ed

Howard Rheingold (Stanford University, USA) kicked off the first day of Stanford Medicine X | Ed with a talk on the value of the networked patient (i.e. e-Patients). He discussed five pitfalls of networked patients: 1) Technology and the way people use it had a lot of different sides to it 2) Patients relied on false medical information found on the internet 3) Overconfidence in the internet 4) Quality of “crap detection” 5) Guiding e-Patients takes time. Conversely, Mr. Rheingold also highlighted the opportunities of the e-Patient industry: 1) Learning was about knowledge, not technology. 2) No individual would keep up with every development in a particular disease as well as a well-informed network could. 3) Learning was about relationships, not technology.
Next up was Joseph Santini (Gallaudet University, CA) giving a talk on Autonomy, Access, and Patient Engagement via American Sign Language. He talked about how deaf medical students were denied access to basic healthcare needs. Moreover, remote access to healthcare providers did not equate to autonomy. Joseph closed with the three requirements of autonomy: 1) Engagement with the patient 2) Education 3) Ensurance. Ryan Hanes (Osmosis, USA) spoke on the unmet needs of medical learners and how to address them. He focused on the problem with human memory associations – they associated one word with only one memory. In reality, memories were associated with multiple associations. To reinforce medical principles, Osmosis takes real celebrity patient cases. For example, Osmosis explained how Serena Williams’ dry eyes from her Sjogren’s Syndrome affected her tennis game.
Dhruv Khullar, M.D. (Massachusetts General Hospital, MA) spoke briefly on the importance of sitting with patients. Dr. Khullar purported that the most draining aspect of medical education was not long hours, rude colleagues, or steep learning curves. It was taking the time to sit with the patient and see things from their perspectives.
Nisha Pradhan (De Anza College, Pennsylvania) spoke on the unmet needs of today’s pre-medical learners and the need to engage early and often to nurture next generation providers. Ms. Pradhan spoke about the importance of teaching pre-med students critical thinking skills instead of memorization techniques. She mentioned how she has on the MCAT more psychology and sociology related questions requiring open-minded critical inter-disciplinary thinking.
Shiv Gaglani (Osmosis, USA) commented on how medical schools could be improved by transitioning to a competency based model from a time-based model. Overall, the panel agreed that the new millennial learners are creative and innovative.

Medical Educators – Opportunities and Challenges for Innovation

The day continued with another student speaker, Tim Van de Graft, M.D. (University of Amsterdam, NLD) gave an Ignite! talk on how to re-shape medical education with empathy in the Netherlands.
Dave deBronkart (ePatient Leader, USA) started his talk about the importance of being able to screen for quality medical content on the Internet. He brought to Plenary Hall’s attention that 1/20 Americans are misdiagnosed every year. To demonstrate the importance of the engaged patient, he cited a case where doctors apologized for telling a 19-year-old cancer patient to ‘stop Googling’ symptoms – she died. Charles Prober, M.D. continued the discussion with an emphasis on bringing patient-centered education to basic science courses. He closed with a list of six benefits of a new educational paradigm: 1) Consensus-driven content creation 2) Efficient & Widespread dissemination 3) Curricular flexibility 4) Locally adapted 5) Broadened faculty participation 6) Enhanced student engagement.
Michael Evans, M.D. (University of Toronto, CAN) introduced the motto “we suck less incorporated” to Stanford Medicine X. Dr. Evans re-iterated it as “we failed a lot.” He analogized his company to that of a urinal stall that has nudges for the urine to flow down the stall without splattering. Each product the company failed with counts as one nudge – more nudges mean a  better functioning stall.
Anne Marie Cunningham (Cardiff University, UK) moderated a panel of the aforementioned medical educators. Adeel Yang (Picmonics, USA) thanked his school (University of Arizona) for supporting his efforts to create Picmonics by “staying out of his way.” Professor deBronkart challenged that not every innovation was disruptive. Dr. Prober exemplified Gilbert Chu, M.D., Ph.D.’s molecular biology course as the perfect example of patient-centered education because he starts each lecture off with a patient’s story.

Social Media, Collaboration + Open Access: The New Classroom

Marie Ennis O’Connor (BCCEU, IRL) spoke about social media as a tool for patient-driven medical education. Her key point was that learning was enhanced by social cognitivity. Stuart Haines, Pharm.D. (University of Maryland, USA) spoke on social media in pharmacy education. He described the tool he made where Twitter was used to page pharmacy students and the students would call using Google Voice. Ajay Major, M.B.A. (Albany Medical College, USA) highlighted his experience helping with “The White Coats for Black Lives Die In” to garner 28,000 participants across the country. Bertalan Mesko (The Medical Futurist, HUN) spoke about his new book “My Health Upgraded.” He also gave his views on the five necessary components of providing a cutting edge medical curriculum: 1) Engaging presentations with the most exciting up to date information 2) e-Learning platform 3) Facebook challenge 4) Evaluations 5) Chocolate-based rewards.
Bryan Vartabedian, M.D. moderated the panel on social media and the new classroom. Rob Rogers, M.D. mentioned how this is the first time he had ever thought about involving patients into the medical conversation in his life. Ajay poked fun at how one of his colleagues teaches students by posting educational rap videos. Dr. Haines brought up a sobering point that 1st year student-pharmacists were not ready to contribute to a professional setting, only to a social space like Facebook Groups or Instagram posts.

Update from Singapore: Challenges and Opportunities for Innovation in Medical Education in an Asian Context

Naomi Low-Beer (Lee Kong Chian School of Medicine, SGP) gave Medicine X| Ed an update on the challenges and opportunities for innovation in medical education in an Asian context. She also recognized that there was more to medical education than identifying with medicine.

Update on Medical Education from Europe

Anne Marie Cunningham, M.D. gave plenary hall an update on innovation in medical education in Europe. She highlighted the First International Medical Education Hackathon where medical students, learners, and coders tried to get together to develop new projects. She also brought to our attention The Tuning Project and a problem-based learning MOOC.

Interdisciplinary Learning

Moving on to the 4th and diversity-friendly theme of the conference: interdisciplinary learning. Emily Kramer-Golinkoff regailed the crowd with a story on her battle against cystic fibrosis. Ms. Kramer-Golinkoff was an orphan of the disease, holding two non-sense copy mutations resulting in cystic fibrosis. Paul Haidet, M.D. (Penn State Hershey Internal Medicine, USA) opened his talk with a rendition of the Waltz Trio. He analogized the roles of the pianist, bassist, and drummer to those of a pharmacist, physician, and nurse. Heather Davidson, Ph.D. (Vanderbilt University, USA) highlighted her work with the Vanderbilt Program in Interprofessional Learning (VPIL). VPIL trained medical, nursing, and pharmacy students to work collaboratively. The program’s goals were to: 1) Cultivate 2) Prepare 3) Improve 4) Integrate 5) Nurture. Tina Brock, Ph.D. (University of California San Francisco, USA) shared here experiences providing clinical services in Sub-Saharan Africa. There, the region’s top two priorities were healthcare and education. Comparing Namibia’s meager pharmacist staff size of 350 to California’s 25,000 (Namibia’s country is twice the size the state of California), she brought to our attention Namibia’s pharmacist staff shortage.
Kevin Clauson, Pharm.D. moderated the panel of leaders on how to overcome the challenges in the field of interdisciplinary learning. Dr. Haidet chimed that unless nurses, physicians, and pharmacists could see things from each other’s point of view, they could not “play music together.” Ms. Kramer-Golinkoff proposed to crowdsource the issues we were experiencing. Moreover, she highlighted the importance of learning about what her friends were doing to solve the same cystic fibrosis issues she was experiencing. Dr. Low-Beer purported the importance of identifying a curriculum that was authentic.

Longitudinal and Lifelong Learning: The Future of CME

Leslie Rott, Ph.D. (Sarah Lawrence College, USA) gave a talk on her journey of lifelong learning as a patient with chronic illness. Paul Teirstein, M.D. Paul S. Teirstein, M.D. (Scripps Health, USA) shared his work that concluded physicians learned best through professional Continuing Medical Education courses. Brian McGowan, Ph.D. (ArcheMedX, Inc., USA) presented the results of his Continuous Learning research project with three aims: 1) Understand what actions millennial learners wanted to take 2) Understand how and when the actions were used 3) Verify if those actions were effective. Dr. McGowan drew four conclusions on effective actions to improve learning: 1) Note-taking 2) Setting reminders 3) Searching 4) Externally nudging on important points.
Kirsten Ostherr, Ph.D. (Rice University, USA) moderated the panel on the future of continuing medical education composed of Dr. Haidet, Dr. McGowan, Jamia Crockett, Dr. Cunningham, and Dr. Teirstein. Dr. Teirstein highlighted the importance of experiential design. Brian McGowan expounded upon a controversial opinion – just because a student scored great on the MCAT did not mean he was a good learner. Ms. Crockett spoke about the role patients needed to play in medical education. With regard to collection patient feedback on doctor visits, Anne-Marie said we needed to look at how many people were “Yelp’ing” their physicians.

Closing MedEd Keynote Day I:

Abraham Verghese, M.D. (Stanford University, USA) closed the opening day of Medicine X|Ed with a spectacular keynote. His first point was on how our teachers made us who we were as professionals. He moved on claim that doctor burnout was due to physicians spent most of their time on the computer. Unless physicians develop a ritual of actually being with the patient, no amount of time on the computer would prevent “short-changing” our patients. He also claimed no YouTube tutorial could teach physicians to develop an “engaged patient” ritual. To teach these skills required daily mentorship over years of time.

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