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Events, Medical Education, Medicine X, Stanford News

Learning from patients by walking in their shoes

Learning from patients by walking in their shoes

digital storytelling workshopWhere else but at a medical conference in Silicon Valley would you hear the term “empathy hack”? The concept of the empathy hack unites the acknowledged need for education geared toward fostering empathy in health-care providers with the innovative, disruptive mentality of the valley. The result is “One Day,” a pilot project led by Rice University’s Kristen Ostherr, PhD, and Roni Zeiger, MD and CEO of, who shared their hacking concept with attendees at a Stanford Medicine X | ED workshop yesterday.

The concept behind “One Day” is to pair a patient and a learner (a medical student, doctor, researcher, hospital administrator, or educator) and have the learner experience a day in the life of that patient, with everything that entails, including self-treatments and physical challenges caused by the patient’s illness.

The learner receives a “kit” containing materials that simulate the condition of the patient for the learner, i.e.  a thin straw and air pack to simulate a nebulizer used by patients with cystic fibrosis, or leg weights to be worn to simulate the drag caused on limbs by Parkinson’s disease.

Once patient and learner are matched, they agree on a form of communication for the day, with modalities including SMS Text, Facebook chat or texting with video, audio and photographs. The learner then follows the actions of the patients during the day, whether administrating nebulizer treatments or trying to negotiate crossing a street quickly with limbs that are weighed down.

After describing the project, Ostherr and Zieger asked attendees to brainstorm ideas for expanding this model to be used for other patient illnesses and experiences. Participants in the outdoor workshop were doctors, patients and medical educators, and their responses included chronic pain, diabetes, homelessness patients, and palliative care and end of life treatment. Caroline Okorie, MD, a Stanford pediatric pulmonologist, said she would like to see an exercise like this for teenagers dealing with CF: “They really have a unique issues, even in comparison to adults.”

A patient who has been dealing with chronic pain for years suggested that learners should deal with multiple challenges, as many patients do. “It may not just be that the pain is your back, that can lead to shoulder pain, or headaches, and all this happens at once.”

Zieger and Ostherr, who hope to bring the project to medical schools, emphasized the simplicity of the model: The kits cost approximately $30, and HIPPA concerns are handled by informed consent filled out by the patient participants. It’s small investment for the potentially-eye opening and revelatory experience of health-care providers walking in the shoes of a patient, even just for a day.

Jacqueline Genovese is assistant director of the Arts, Humanities and Medicine Program within the Stanford Center for Biomedical Ethics.

More news about the conference is available in the Medicine X category. Those unable to attend the event in person can watch via webcast; registration for the Global Access Program webcast is free. We’ll also be live tweeting the keynotes and other proceedings from the conference; you can follow our tweets on the @StanfordMed feed.

Photo of Kristen Ostherr and Roni Zeiger (both standing) courtesy of Stanford Medicine X

Events, Medical Education, Medicine X, Patient Care, Precision health, Technology

“No ordinary conference”: The magic that is Medicine X returns to the stage

"No ordinary conference": The magic that is Medicine X returns to the stage

Larry Chu welcoming attendeesMedicine X, Stanford’s popular conference on emerging technologies and medicine, returned to the stage today.

The conference, which was proceeded by the first-ever Medicine X | Ed, is now in its fourth year, and the momentum and magnitude of the event has steadily increased since it began.

Last year, more than 4,000 participants in 69 countries took part in the Medicine X experience via Twitter, making it the most-discussed academic conference in the world. Its past successes were reflected in the theme for Medicine X 2015: “Great Xpectations.”

After executive director Larry Chu, MD, welcomed attendees with a reminder that they “all belong here,” Lloyd B. Minor, MD, dean of the medical school, officially opened the conference with remarks that encouraged this engaged audience to take action and seize opportunities to improve health care. “This is no ordinary time in our history, and Medicine X is no ordinary conference,” he said. “We are here today to have discussions and generate ideas about how to leverage the power of information and the latest technology to improve health for people in our own communities and across the globe. Health care is truly the opportunity of our lifetime.”

Minor talking“Since last year’s Medicine X conference, Stanford Medicine has launched a bold new initiative — our vision to lead the biomedical revolution in precision health,” he said. “Precision health as the next generation of precision medicine: Precision medicine is about sick care, precision health is about health care.” Everyone participating in this event is an important part of moving this conversation forward, he explained.

Eric Topol, MD, chief academic officer at Scripps Research Institute and bestselling author, went on to give an opening keynote on ways we can use new technologies to democratize medicine and involve the patient in his or her own care. “We have views of the human being that we never had before,” Topol said, referencing smartphones and other technologies that people use to monitor their health metrics.

These new technologies are important because they’re interactive and easy for patients to use, and they allow patients to become more involved in their health care, Topol explained. He showed an image of the iconic black doctor’s bag. “These are vintage tools,” he said. “This is my bag,” he explained, pointing to an image of a several digital tools.

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Events, Medical Education, Medicine X, Stanford News

At Stanford Medicine X | ED, breakthroughs and a prescription for change

At Stanford Medicine X | ED, breakthroughs and a prescription for change

Medicine X Ed

As editor of Wing of Zock for the past four years, I’ve had the honor of learning about hundreds, perhaps thousands, of innovative ideas to reimagine medical education. On the first day of the inaugural Stanford Medicine X | ED conference Wednesday, I got enough new ideas to fuel a year’s worth of posts. A diverse lineup of presenters — educators, students, and patients — collectively created, through words, images, videos, and music, a vision of a possible future for medical education. They reported on promising innovations in medical education that aim to better prepare the doctors of tomorrow. Accompanied by colored lights, diffuse video backgrounds, and a varied soundtrack, the high-energy atmosphere that is the hallmark of Stanford Medicine X pervaded a conference on medical education.

Designed to be different in every way from traditional academic meetings, Med X | ED features numerous icebreaking and networking opportunities; a low-key product exhibit area; announcements by Gary Williams, the voice of the San Francisco 49ers (“the voice of God”); and constant visual reminders of its living mascot, Zoe, a French bulldog owned by MedX executive director Larry Chu, MD. Attendees received glowsticks in their registration packets that they used to reward effective presenters.

“Jazz and glowsticks. Things not found at traditional #meded meetings,” tweeted Bryan Vartabedian, MD, a gastroenterologist from Baylor University in Houston.

The trappings, rather than making the content seem less serious, instead make it more accessible, more memorable. The entire conference is an incarnation of the Von Restorff effect, a concept I learned just this morning, that posits that we are more likely to remember things that are unusual, or fun, or inappropriate. While you might not remember the last session you attended on interprofessional education, you would remember the one Paul Haidet, MD, delivered. Haidet, a general internist and health sciences researcher at Penn State University Hershey, used three recordings of the same jazz standard, “Waltz with Debbie,” to illustrate the ways in which small teams can collaborate. It’s likely that many attendees were searching iTunes for the tracks afterward.

Taking its theme from Chu’s opening remarks, in which he said, “The care we receive tomorrow depends on the doctors we prepare today,” the schedule featured 10-minute Ignite! talks, panel discussions, and keynote presentations by Howard Rheingold (described here earlier) and Abraham Verghese, MD. Topics ranged from the collaborative redesign of a mental health unit in Nashville to the use of whiteboard videos to encourage healthy behaviors to the rise of medical student communities of practice. Leveraging technology and social media, it’s clear that medical schools are trying to address the needs and learning styles of this generation of learners.

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Events, Medical Education, Medicine X, Stanford News

“How might we…” redesign medical education?

“How might we…” redesign medical education?

Sarah Stein Greenberg at MedX Ed3What does “medical education” really mean? In its current form, it means four years of medical school with mostly synchronous, live instruction by a faculty member, followed by three to seven years of residency. But what if we took all of our existing notions about medical education and threw them out the window? What if we went back to the drawing board, to design from scratch a new model of medical education that no longer assumes that knowledge acquisition happens in a single, continuous four-year span? That no longer assumes that faculty members are the arbiters of that knowledge? That no longer assumes that teachers and learners must be co-located? That no longer assumes that people learn by sitting and listening?

In her keynote address at Stanford Medicine X | ED this morning, Sarah Stein Greenberg, executive director of the at Stanford, outlined what happened when her team took apart similar assumptions about college. They then created a new model using design thinking tools and techniques. (The title of this post references a key design thinking technique: problem solving by asking, “How might we…?”) The resulting construct, known as Stanford 2025, relies on four “provocations:” open loop university, paced education, axis flip, and purpose learning. The latter suggests that students pursue educational paths based on a mission rather than a major.

“Most everyone has had some kind of experience with education, and these core ideas really seem to resonate with people from a wide variety of fields,” Greenberg said. She also noted that much invention and innovation is coming from outside the academy.

The is “radically interdisciplinary,” bringing together students from all seven schools at Stanford to equip them with a common vocabulary that allows them to navigate the complexity of working within diverse teams. Its approach encourages a bias toward action, to experiment and prototype and test, and to think through challenges incrementally. Its deployment engenders creative confidence and resourcefulness in practitioners, Greenberg says, and leads to “profound learning experiences” as well as “spectacular failures.” Health-related projects have looked at encouraging organ donation, medication adherence post-cardiac arrest, devices for children with club foot, and a breathing apparatus made of paper for children with asthma.

The Med X | ED emphasis on patient inclusion as planners, experts, and participants echoes design thinking principles. “The end user is always at the heart of a project, and that doesn’t mean we send out a survey,” Greenberg says. “That means that we really try to go and walk in the shoes of the end user, to have empathy for the experience of the end user. The idea that people are subject matter experts in their own lives is a core tenet of design.”

Jennifer J. Salopek is founding editor of Wing of Zock and can be found on Twitter: @jsalopek. A modified version of this post originally appeared on Wing of Zock.

More news about the conference is available in the Medicine X category. Those unable to attend the event in person can watch via webcast; registration for the Global Access Program webcast is free. We’ll also be live tweeting the keynotes and other proceedings from the conference; you can follow our tweets on the @StanfordMed feed.

Photo of Sarah Stein Greenberg courtesy of Stanford Medicine X

Events, Medical Education, Medical Schools, Medicine X, Patient Care

Day One of Medicine X | Ed: Understanding and equipping today’s medical learner

Day One of Medicine X | Ed: Understanding and equipping today's medical learner

patient Dave on stageThe first day of Medicine X | Ed began with a suite of talks and technology demonstrations that focused on understanding and equipping today’s medical learner. The first grouping of talks, themed “meet the millennial learner,” explored how medical students learn and how technology and social media present new opportunities and challenges for these students.

Joseph Santini, PhD, kicked off the first set of presentations by discussing information barriers that disabled students, and patients, face. Santini gave his presentation in sign language, with subtitles and an interpreter so everyone could understand what he wanted to say. Unfortunately, he explained, these modes of communication aren’t always available for disabled students.

Many deaf medical students — and physicians — must pay for their own interpreters, he explained. This financial burden dissuades many deaf people from pursuing or remaining in the field of medicine. The recent shift from text-based communication to more audio and visual systems is also a challenge, Santini said. “Have you ever tried to watch videos on YouTube with automatic captioning?” he asked. We call it a crap shoot… The text is a jumble. Advances in these areas would be key.”

Speaker Dreuv Khullar, MD, a resident physician at Massachusetts General Hospital and Harvard Medical School, highlighted another challenge that medical learners face: A lack of time.

Khullar recounted a story from medical school. He was sitting with a critically ill patient when his pager buzzed. He wanted to stay with the patient, but he had eight more patients to see, and he was already late. He vowed to spend extra time with with patient the next day, but the patient died that night.

“It turns out that the most draining aspect of medical school is not the hours, it’s that you cannot be there for patients the way you thought you would be,” Khullar said. “I think of the countless opportunities for compassion that I squander for things that are less important… I think that next time [this happens] I will sit.”

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Events, Medical Education, Medicine and Society, Medicine X, Patient Care

Medicine X | Ed keynote speaker: “Networks are fundamental to what it means to be human”

Medicine X | Ed keynote speaker: "Networks are fundamental to what it means to be human"

Larry Chu's jacketToday marked the opening of the first-ever Medicine X|Ed conference, a two-day event dedicated to delving into important issues related to medical education in the digital world. The aim of the event is to help attendees understand the medical learners of today and to shed light on how technology and social media affect the way future doctors learn and interact with patients.

Larry Chu, MD, Stanford anesthesiologist and executive director of Medicine X|Ed and Medicine X, got the conference rolling, bounding onstage sporting a life-sized image of his dog, Zoë Chu, on the back of his suit jacket. “We want to create a culture of health where everyone is trusted and respected for their expertise,” he told attendees. “Join us in the future of imagining medical education…”

Chu’s infectious enthusiasm set the tone for the day of TED-style talks, learning labs and panel discussions that emphasized the value of shared knowledge and the importance of doctors and patients informing and educating one another. Howard Rheingold, the opening keynote speaker and bestselling author of several books, underscored the importance of networked patients with a simple yet powerful opening.

“I’m really happy to be here,” he told the audience. “I’m a cancer survivor, so I really mean that. I’m grateful to my oncologist and to a network of people online, some of whom I knew before, and many of whom I did not know before.”

“I was diagnosed with cancer in 2010,” he continued. “It was a kind-of an embarrassing cancer, anal cancer, but I knew I’d need to talk about it.”

Howard Rheingold on stageRheingold started a blog, called Howard’s Butt, where he could turn to other networked patients for information and support. “It became an important source of catharsis for me,” Rheingold explained. “I came back from a treatment, and I needed to get my feelings out. I’ve been cancer-free for 5 years, and [this experience] gave me a deep appreciation for the power of social media.”

“Networks are fundamental to what it means to be human,” Rheingold said. “When you face a crisis, you need to connect with other people. Technology enables this in a way that wasn’t possible before.”

Yet, networked patients face some pitfalls too, Rheingold cautioned. “Cyberchondria” (where patients Google their disease, and what they find online is worse than what they actually have) and overconfidence are two big issues. Networked patients need to learn how to separate the bad information from the good, and they need to evaluate how much they really know, he explained. “I call it crap detection,” Rheingold said. Being a networked patient, as well as being a doctor that works with the networked patient, takes time and practice, he said.

After his talk Rheingold told me, “Many doctors and physicians don’t get or understand the networked patient. But there’s an emerging group of physicians that are attuned to this.” He looked around at the packed conference hall and said, “By virtue of being here, people are interested… This is how things start.”

More news about the conference is available in the Medicine X category. Those unable to attend the event in person can watch via webcast; registration for the Global Access Program webcast is free. We’ll also be live tweeting the keynotes and other proceedings from the conference; you can follow our tweets on the @StanfordMed feed.

Photo of Larry Chu (top) by Holly MacCormick; photo of Howard Rheingold courtesy of Stanford Medicine X

Events, Medical Education, Medicine X, Stanford News

Inaugural Medicine X | ED event kicks off with a call to redefine medical education

Inaugural Medicine X | ED event kicks off with a call to redefine medical education

scopeLarryChuMedXIn a rousing address this morning to an eager crowd of hundreds, Stanford anesthesiologist Larry Chu, MD, kicked off the first annual Medicine X | ED conference with a call to redefine medical education as we know it. Chu, the visionary educator who has conceived and executed a number of unique learning forums, exhorted the members of the crowd to bring a “beginner’s mind” to the challenges facing medical education in the 21st century.

In a nod to the increasingly popular design-thinking method, Chu encouraged approaching problems and challenges in medical education by asking, “How might we…?” For example, how might we reject the notion that medical education is the exclusive domain of doctors and move forward with a new definition that is inclusive and free of cultural bias? Many conditions in the current health care environment necessitate such re-examination, said Chu as he outlined the several raisons d’etre for this new conference. Among its foundational assumptions are these:

  • Health care needs to be improved, and we can and should invite everyone to help.
  • Health professionals and educators need to learn to bring innovative new technologies thoughtfully into patient care.
  • The care we receive tomorrow depends on the practitioners we nurture today.
  • Many working in medical education struggle to understand and meet the needs of today’s learners.
  • Patients can be experts in their own care and in medical education.

The conference program, designed by an interdisciplinary group of faculty members, students, patients, and others, features five overarching themes: understanding the needs of millennial learners, learning from those already pushing the boundaries of medical education, optimizing technology and social media for learning and collaboration, improving interprofessional learning, and building a system that embraces and supports lifelong learning. As mentioned here yesterday, keynote addresses are to be delivered by Howard Rheingold, who coined the term “virtual community;” Abraham Verghese, MD, who advocates a renewed focus on medical education as apprenticeship; and Sarah Stein Greenberg, executive director of the Stanford, who will discuss the’s exploration of the future of undergraduate learning at Stanford, resulting in innovative and radical ideas about the form and nature of “college.”

Chu, who announced the creation of the new conference on Wing of Zock last year, expressed his hope that this new conference represents the beginning of an “evolution in the training of health care professionals to care for the wellness of the learner while giving them the knowledge and skills to care for others.”

Jennifer J. Salopek is founding editor of Wing of Zock and can be found on Twitter: @jsalopek. A modified version of this post originally appeared on Wing of Zock.

More news about the conference is available in the Medicine X category.

Photo of Larry Chu by Kris Cheng Photography

Events, Medical Education, Medicine X, Research, Stanford News, Technology

Medicine X 2015 kicks off this week with a focus on the theme “Great eXpectations”

Medicine X 2015 kicks off this week with a focus on the theme “Great eXpectations”

15146055376_5600a69df1_zThought-leaders and innovative thinkers will gather on campus this week for Medicine X. Stanford’s premier conference on emerging health-care technology and patient-centered medicine, the three-day event will be held at the Li Ka Shing Center for Learning and Knowledge and focus on the theme “Great eXpectations.”

Eric Topol, MD, chief academic officer at Scripps Research Institute, will kick off the conference on Friday with a keynote on democratizing medicine. Additional keynote speakers include Robert Pearl, MD, executive director and CEO of The Permanente Medical Group; and Peter Bach, MD, director of Memorial Sloan Kettering’s Center for Health Policy and Outcome. The program will also feature panels and presentations exploring the topics of precision medicine, aging, health and community and misconceptions and misperceptions in health care.

This year, Medicine X will be preceded by the first-ever Medicine X|ED conference. The two-day event, which begins on Wednesday, will examine the role of technology and networked intelligence in shaping the future of medical education. Digital media pioneer Howard Rheingold; Abraham Verghese, MD, vice chair for the theory and practice of medicine for Stanford’s Department of Medicine; and Sarah Stein Greenberg, executive director of the Stanford, will deliver keynote speeches at the conference. Medicine X|ED will focus on five core themes: Engaging millennial learners, opportunities and challenges for innovation in medical education, interdisciplinary learning, and how digital media and massive open online courses are redefining the educational landscape. Participants will also have the option to participate in a range of interactive and educational opportunities.

Those unable to attend the conferences in person can participate in the plenary sessions virtually through a high-quality streaming webcast; registration for the Global Access Program webcast is free. We’ll also be live tweeting the keynotes and other proceedings from the conference. You can follow our tweets on the @StanfordMed feed or follow the hashtag #MedX.

More news about the conference is available in the Medicine X category.

Previously: Medicine X conference to focus on the theme of “Great eXpectations”, Registration now open for the inaugural Stanford Medicine X|ED conference and Stanford Medicine X: From an “annual meeting to a global movement”
Photo by Medicine X

Events, Stanford News

Tailgate party, Stanford Medicine style

Tailgate party, Stanford Medicine style

Before Stanford defeated UCF last weekend, scores of cardinal-wearing medical students joined Dean Lloyd Minor, MD, for a pre-game tailgate party. Photographer Norbert von der Groeben was on the scene and shared these photos.

More photos of Stanford Medicine events, people and places can be found on Instagram

Chronic Disease, Events, Pain, Stanford News

Stanford expert on back pain: “The important thing for people to know is that it’s treatable”

BackPainSeptember is Pain Awareness Month and later this month, Stanford will host a Free Back Pain Education Day. The event, sponsored by the Division of Pain Medicine, offers community members the opportunity to come to campus and hear about current back pain management strategies and the latest research. The event will also be live-streamed via YouTube for people unable to make it in person.

In anticipation of the Sept. 13 event, I sat down with Beth Darnall, PhD, a pain psychologist at Stanford’s Pain Management Center, and one of the day’s speakers. I was interested to understand why back pain is such a critical health problem worldwide and what people living with back pain can do to manage their pain.

Back pain is a leading cause of disability in the U.S. and other countries. Why is chronic back pain so common?

I think there are many different reasons why back pain is the number one pain condition. The back seems to be the place that’s really most related to the development of chronic pain and debility from chronic pain. Pregnancy can either trigger or flare back pain, but there are a multitude of reasons: aging (there is degeneration of the spine), obesity (when people gain weight, it puts additional load on the spine), activity levels, and influence of posture. Dr. Sean Mackey will be talking about some of the reasons why back pain is the most prevalent pain condition in the world at the event.

[Back pain] is something that almost everyone will experience at some point in their lifetimes, so it’s really relevant to all of us, whether we have pain now or not.

Why have a community event about back pain now?

There has been increasing global and national attention to chronic pain in terms of its impacts and costs to society. In the United States alone, 100 million suffer from pain on a regular basis, and that is associated with costs of $635 billion dollars annually. That includes treatment costs and loss of productivity.

What we also know is that the incidence and prevalence of chronic pain has been increasing, despite the fact that theoretically, we have better treatments. So then the question is why. While we have a multitude of treatments available, we haven’t been focusing on back pain as comprehensively as we really should. We need a broader approach to the treatment of pain. This was recently outlined in the National Institute of Health’s National Pain Strategy (Note: Mackey co-chaired the oversight committee).

Some people may be under the misconception that the best way to treat back pain is simply with a pill… While medication can be one helpful component, the best way to treat back pain is with a comprehensive approach that involves self-management strategies.

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