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.
