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Medical Education, Medical Schools, Stanford News

Stanford Medicine Music Network brings together healers, musicians and music lovers

Stanford Medicine Music Network brings together healers, musicians and music lovers

sarahkenricMore than 100 physicians, students and members of the Stanford community gathered last week at the Li Ka Shing Center for Learning and Knowledge for the inaugural concert of the Stanford Medicine Music Network.

During the event, Lloyd Minor, MD, dean of the medical school, told the audience, “It is so gratifying to be here this evening, and to see that musicians in the medical community have a means to continue to play and perform.” Music was a big part of Minor’s life in medical school and he played the cello in a musical trio that played at various events during that time.

The network was launched last year after Minor and Steve Goodman, MD, PhD, associate dean for research and translational science, discovered they both attended a 1976 cello performance by Yo-Yo Ma, who was then a student at Harvard. The shared memory inspired them to establish a musical home for the medical community. They joined forces with Audrey Shafer, MD, professor of anesthesiology and director of the Medicine and Muse Program, and Ben Robison, a medical student and professional violinist, and created the Stanford Medicine Music Network (SMMN, pronounced “summon”).

Among the goals of the network are to connect musicians for group practices, organize chamber music and string quartet groups and stage performances at Stanford and in the surrounding community in an effort to contribute to healthy communities.

The concert featured classical and contemporary music as well as a special gift presentation by Charles Prober, MD, senior associate dean of medical education, thanking medical student Kenric Tam and his parents, Carol and Kingsang, for their generous donation of a grand piano. The piano, which will reside outside Paul Berg Hall, will be available for events and members of the Stanford Medicine community to play.

As the program ended, Goodman noted in his concluding remarks that the word “summon” describes multiple aspects of what the network represents. “As musicians, we are summoned to perform, and this in turn summons those who care to listen,” he said. “As physicians and medical students, many of us are answering a summons we felt to care for others, and I think keeping music in our lives allows us to do a better job of that.”

Previously: Stanford’s Medicine and the Muse symposium features author of “The Kite Runner”“Deconstructed Pain:” Medicine meets fine artsStanford network launched to connect musicians, music lovers and What physicians can learn from musicians

Events, History, Medical Education, Medical Schools, Stanford News

A trip down memory lane: Stories from the early days of the School of Medicine

A trip down memory lane: Stories from the early days of the School of Medicine

When Philip Pizzo, MD, came to interview for the position of dean of Stanford’s medical school in 2000 he stayed in a nearby hotel. Taking a cab each day to campus for interviews, Pizzo would ask the driver to take him to the School of Medicine. Not one driver knew where to go, recounted Drew Bourn, PhD, while leading a recent architectural tour of the School of Medicine.

At the time the dean’s office was buried in a courtyard of the Stone Building and hidden from street view. But now the medical school has a face, the stately Li Ka Shing Center for Learning and Knowledge, which will soon have a twin to the east. Within a decade or so, a new, matching building will replace the research building currently beside it.

This was just one of the many stories Bourn shared about the first medical school on the West Coast, which has its roots in Illinois, where physician Elias Samuel Cooper, MD, diced up cadavers of executed criminals to teach surgery.

The Gold Rush brought him west, and soon the Cooper Medical College sprouted up in San Francisco, before aligning with Stanford and moving south to the Farm in the 1950s.

Its first building was the current hospital, known as the Stone Building not for its construction material, but for its architect, Edward Durrell Stone, a famous midcentury architect who designed Radio City Music Hall, among many other national and international works.

Lest I steal all of Bourn’s best bits — including how Stone met an Italian fashion writer on a plane, and before landing convinced her to marry him — I’ll leave it to you to enjoy the experience on your own. Local readers: Bourn offers tours regularly — the next is Nov. 12 at 2 PM — free and open to all. All who want to spend an enjoyable hour learning, that is.

For more fun photos, check out the Stanford History Medical Center’s Flickr collection.

Previously: Stanford building houses one of the world’s largest medical simulation facilities, Stanford’s Clark Center, home to Bio-X, turns 10 and A new era in education at Stanford’s Medical School
Photos from Stanford History Medical Center

 

Medical Education, Medical Schools, Stanford News

Free online Stanford course examines medical education in the new millennium

Free online Stanford course examines medical education in the new millennium

Prober_092314At this year’s Stanford Medicine X, executive director Larry Chu, MD, announced the launch of a new group of initiatives that would expand the conference and “quicken the pace of changing the culture of health care.” In addition to continuing to build community, the Medicine X Academy will aim to use technology, the principles of design thinking, and a model of inclusivity to redefine medical education.

“We’re moving from talking to doing,” said Chu. “We want to move the conversation earlier into the education system so students begin to think differently about health care and [so we can] improve medical education with the input of all stakeholders.”

As part of the academy, Chu, Kyle Harrison, MD, clinical assistant professor at the Palo Alto Veterans Affairs Hospital, and Nikita Joshi, MD, an academic fellow at Stanford, will begin teaching a massive open online course (MOOC) course titled “Medical Education in the New Millennium” this Thursday. Anyone can enroll in the class through Stanford OpenEdX. Additionally, it will be webcasted on the Medicine X website and live tweeted on the @StanfordMedX feed.

The eleven-week course will ask the fundamental question: What is the definition of medical education? Participants will explore a variety of topics including how to improve the educational experiences of today’s Millennial medical students and residents; how patients and caregivers can be active participants in their care teams; how MOOCs, social media, simulation and virtual reality change the face of medical education; and how to make learning continuous, engaging, and scalable in an age of increasing clinical demands and limited work hours.

Among the class guest lectures are Charles Prober, MD, senior associate dean for medical education at Stanford; Kirsten Ostherr, PhD, an English professor at Rice University and co-founder of the Medical Futures Lab; ePatient Britt Johnson; and medical and nursing students from Duke, Stanford and other universities.

As noted on the course website, the course is targeted not only towards medical students and educators but also patients, caregivers, and anyone who wants “to join a conversation about how to improve medical education.”

Previously: Medicine X aims to “fill the gaps” in medical educationRethinking the traditional four-year medical curriculum and A closer look at using the “flipped classroom” model at the School of Medicine
Photo of Charles Prober by EdTech Stanford University

Medical Education, Medical Schools, Mental Health, Stanford News, Surgery

New surgeons take time out for mental health

New surgeons take time out for mental health

rope webI spent a recent morning watching about 30 Stanford surgical residents take time off from their operating rooms to participate in a series of team-building games out on the alumni lawn on campus. These are busy, dedicated professionals who are passionate about their work, so getting them to take time off is hard. “I can tell you a surgical resident would rather be in the operating room than anywhere else on earth,” Ralph Greco, MD, a professor of surgery, told me as he sat on a nearby bench watching the residents play games.

In a story I wrote about the games, I describe how the Balance in Life program, which sponsored the day’s event, was founded following the suicide of a former surgical resident, Greg Feldman, MD. Greco, who helped build the program, was committed to doing whatever he could to prevent any future tragedies like Feldman’s, as I explain in the piece:

“The residency program was just rocked to its knees,” he said, remembering back to the death in 2010 of the much-loved mentor and role model for  many of the surgical residents and medical students at the time. Feldman died after completing his surgical residency at Stanford and just four months into his vascular surgery fellowship at another medical center. “It was a very frightening time,” Greco said. “Residents were questioning whether they’d made the right choices.”

Today, the Balance in Life program includes, among other thing, a mentorship program between junior and senior residents, group therapy time with a psychologist and a well-stocked refrigerator with free healthy snacks. Residents themselves, like Arghavan Salles, MD, who participated in the ropes course, plan and coordinate activities:

“Some people think this is kind of hokie,” said Salles, who was one of a group of residents who helped found the program along with Greco following Feldman’s death. “Surgery is a super critical field,” Salles said. She paused to instruct a blind-folded colleague: “Step left! Step left!” “You face constant judgment in everything you do and say,” she added. “Everyone is working at the fringes of their abilities. They’re stressed.”

While writing this story, my co-workers suggested I read a September editorial in the New York Times that brought the issue into sharp focus. Spurred by the suicides two weeks prior of two second-year medical residents who jumped to their deaths in separate incidents in New York City, Pranay Sinha, MD, a medical resident at Yale-New Haven Hospital wrote about the unique stresses of new physicians:

As medical students, while we felt compelled to work hard and excel, our shortfalls were met with reassurances: ‘It will all come in time.’ But as soon as that MD is appended to our names in May, our self-expectations skyrocket, as if the conferral of the degree were an enchantment of infallibility. The internal pressure to excel is tremendous. After all, we are real doctors now.

Pranay’s message was similar to the one promoted by Stanford residents during the games: The key to battling new physician stress is realizing that you are not alone, that your colleagues are there to support you. “It sounds touchy feely to say that we care,” Salles told me. “But at the end of the day, if we want to have better patient care, we need to take care of each other too.”

Previously: Using mindfulness interventions to help reduce physician burnout and A closer look at depression and distress among medical students
Photo by Norbert von der Groeben

Medical Education, Medical Schools, Stanford News, Videos

Stanford students design "enrichments" for lions, giraffe and kinkajou at the San Francisco Zoo

Stanford students design "enrichments" for lions, giraffe and kinkajou at the San Francisco Zoo

My job took me to the zoo.

It was a rather unorthodox assignment for a medical writer, but one of our faculty at Stanford medical school was teaching a rather unorthodox class at the San Francisco Zoo. A dozen Stanford sophomores signed up to spend two intensive weeks there learning about animal welfare and behavior and designing “enrichments” to make life more interesting for the lions, a giraffe and a kinkajou at the zoo.

These included a “Poop Shooter” to lob animal poop into the lion’s cage, a urine-soaked scratcher for a lone giraffe and a “Robo-Flower” to automatically dispense smoothies to the kinkajou, a tree-dwelling rainforest mammal that looks like a cross between a squirrel and a raccoon.

“Zoo animals have pretty good welfare already,” said Stanford’s Joseph Garner, PhD, an associate professor of comparative medicine who helped design and lead the class. “So it’s not about fixing things. It’s about how we can turn this animal on a little. How can we help the keepers manage the animal and improve the experience for guests.”

“It’s like if you lived in the same room your whole life. We want to change it up, keep it fresh and interesting – something novel,” said student Jennifer Ren.

For Floyd the giraffe, the students shook things up a bit by building a scratcher soaked in female giraffe urine to make it appealing to him. Instead of lurking in a corner of his paddock near the female enclosure, Floyd ventured out into his large pad to explore his new toy, where he was a lot more visible to zoo-goers.

“The giraffe is one of the largest and strongest animals on the planet, so building something that he is not going destroy in 30 seconds is a real challenge,” Garner said.

For the lions, the students adapted a conveyor-belt system to periodically shoot giraffe poop into the lion’s cage, where the male lion in particular found the aromatic pellets extremely interesting.

“Lions lie around all day watching and waiting. But when the zoo put the enrichment in, it was like somebody just flipped a switch,” Garner said. “The male lion was up and about and smelling and searching for the giraffe droppings, and performing all of this wonderful lion behavior.”

The students took their assignments very seriously, videotaping the animals’ responses and designing charts and graphs to measure the results, which they presented at a zoo ceremony last Friday in which they were celebrated for their contributions.

The students said they came away with a whole new perspective on zoos and wildlife behavior, as well as a gratifying sense of having designed something to improve the animals’ lives.

Previously: How horsemanship techniques can help doctors improve their art
Photo in featured entry box by Norbert von der Groeben

Medical Education, Medical Schools, Medicine X, Technology

At Medicine X, four innovators talk teaching digital literacy and professionalism in medical school

At Medicine X, four innovators talk teaching digital literacy and professionalism in medical school

med ed panelOne of my favorite talks yesterday at Stanford’s Medicine X was “Fostering Digital Citizenship in Medical School,” where four esteemed panelists talked about the innovative programs they’ve put in place at their institutions.

The physicians joked several times that a good panel often involves controversy or conflict among speakers – but the four of them weren’t in disagreement about much. They all believe that things like understanding social media and knowing how to build one’s digital footprint are crucial skills for doctors-to-be, even if those aren’t an obvious focus for the students themselves. “We can’t expect students to understand” this, said Warren Wiechmann, MD, an associate dean at UC Irvine School of Medicine. “They’re focused on learning core forms of medicine.” (Wiechmann started in 2010 a program to provide each incoming medical student with an iPad and has since added to the school’s curriculum courses on topics such as social media, wearables, and new digital trends in medicine.)

Kyra Bobinet, MD, PhD, who worked alongside Stanford anesthesiologist (and Medicine X executive director) Larry Chu, MD, to develop and teach Engage and Empower Me, an online course that focuses on patient-engagement design, noted that it’s academic leaders’ job to be “forward-thinking” for the students “so they’re so they’re not behind” when they become physicians. And Bryan Vartabedian, MD, who created at Baylor College of Medicine Digital Smarts, a four-year curriculum that focuses on “professionalism, safety, and mindfulness with social media,” agreed. “We’re asking big questions here,” he told the audience. “What does a doctor need to know 20 years from now? Will he (or she) know how to send a tweet? Do we have to be platform-specific [when teaching]?”

A portion of the 45-minute talk was devoted to the difficulty of incorporating new things in a medical school’s curriculum, which is, panelist Amin Azzam, MD, said, already “chock full.” Said Wiechmann: “The big dilemma is what do we take out to put in in?” In turn, many of the schools’ instructions on digital professionalism and literacy come in the form of elective courses.

When discussing other challenges, Wiechmann said the “line ups not very deep” when it comes to leaders in medical school who know about digital media. These topics aren’t “even on the radar” of many faculty-instructors, he said. The panelists also mentioned that the students – most of whom barely remember a time before e-mail, and many of whom consider themselves tech-savvy – don’t always think they need training on digital issues. “In one way they know a lot about technology, but they don’t get how to be doctors,” pointed out Azzam, who developed a University of California elective course that allows 4th year medical students to edit Wikipedia for academic credit. (“We want them to be digital contributors, not merely digital consumers,” he explained.)

Vartabedian said the information that Baylor provides to their students is contextual. Teaching medical students about smartphone use or social media in general wouldn’t be terribly helpful, he pointed out – but it becomes valuable “if you talk about it in the wards.” What should you do, for example, if a patient engages you via Twitter?

The end of the discussion shifted to patient engagement and the need to educate students about just the thing Vartabedian mentioned (i.e. how to interact with patients on social media) and how the e-patient movement works. “I have a responsibility as an educator to put this content [about patient engagement] – more than, say, biochemistry – in front of students,” said Wiechmann.

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

Previously: Medicine X aims to “fill the gaps” in medical education, More reasons for doctors and researchers to take the social-media plunge, A reminder to young physicians that when it comes to social media, “it’s no longer about you”, A conversation about digital literacy in medical education, Advice for physicians when interacting with patients online and How can physicians manage their online persona? KevinMD offers guidance
Photo by Stanford Medicine X

Medical Education, Medical Schools, Stanford News

Medical students start "transformational" journey

Medical students start "transformational" journey

With the help of Lars Osterberg MD, MPH, and Dr. Neil Gesundheit, MD. they give Brandon Turner  his official white coat at at the Stanford Medicine White Coat and Stethoscope Ceremony on Friday, August 22, 2014,at Stanford School of Medicine.  ( Norbert von der Groeben / Stanford School of Medicine )

The new school year has begun for students across the country, including Stanford’s 90 first-year medical students – who started class on Monday and spent last week at orientation activities anxious and excited for the  journey to finally begin.

To help the students prepare, faculty talked to them about the emotional and academic challenges of medical school and emphasized that it can be metamorphic and, not surprisingly, somewhat stressful. “They are seeing life and death,” said one faculty member at orientation, who added that medical school “is a transformational time the likes of which I don’t think you see in any other level of education.”

The week of preparation concluded with the traditional stethoscope ceremony, which I wrote about in an article published online today. The ceremony symbolizes the importance of the personal connection between doctor and patient, and during the event each student walks across the stage to accept their stethoscopes. As Laurie Weisberg, MD, president of the medical center alumni association, told the students:

The great thing about the stethoscope is you have to be close to your patient to use it. This is your chance to truly interact with the patient. You are listening to what the patient has to tell you.

In his address to the students, Dean Lloyd Minor, MD, told them the four-year, or longer, journey would change the way they see the world and that they “will learn some of life’s most valuable lessons from your patients.” He also highlighted some of the demographics of the new class:

Fifty-one percent of you are women; 15 percent of you are from communities underrepresented in medicine; 21 of you were born outside of the U.S., coming from China, Columbia, India, Vietnam, just to name a few. You come from a diverse and wide range of universities — 10 of you from Stanford, 13 from the Stanford of the East [Harvard]. Eighteen of you already have a master’s or a doctorate, and many of you have already published research, participated in varsity athletics, shined in the arts and contributed to your community.

Previously: Abraham Verghese urges Stanford grads to always remember the heritage and rituals of medicine, Top 10 reasons I’m glad to be in medical school and “Something old and something new” for Stanford medical students
Photo, of Brandon Turner receiving his official white coat at a ceremony last Friday, by Norbert von der Groeben

Medical Education, Medical Schools, SMS Unplugged

Buzzwords in medical school

Buzzwords in medical school

SMS (“Stanford Medical School”) Unplugged was recently launched as a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the SMS Unplugged category.

Learning in medical school often feels like learning a completely new language. There are numerous acronyms (OPQRST, CAGE, etc.) and molecules (IL-1, TGF-beta, etc.) and more. But most striking to me are two particularly ubiquitous buzzwords: “high-yield” and “protected time.”

I feel like I heard both these terms – and particularly the former – thrown around every single week of this past school year. “High-yield” has been used to refer to, as you might guess, the material that yields the highest amount of gain – i.e. for us students, it’s the material that’s going to show up on our tests. This term pervades not only conversations among classmates but also study materials. First Aid – one of the main Step 1 book resources – takes pains to highlight “high-yield” concepts, and Pathoma – another Step 1 resource – goes even further, identifying ideas that are not just “high-yield” but also “highEST-yield.”

This idea of focusing on “high-yield’ concepts bothered me at first and continues to bother me a little bit today, largely because my classmates and I often determine for ourselves what is “high-yield” and what is “low-yield,” dedicating our study time to the former and ignoring the latter. The worst part is that we may be ignoring information that may be “low-yield” in the context of exams but actually “high-yield” in the context of patient care. The flip side of this is that we only have a certain number of hours in the day; perhaps it makes sense for us to be judicious about what we focus our attention on?

Another phrase that has been widespread in medical school is the term “protected time.” I started hearing this during the very first week of medical school, when we had part of our afternoon off for “protected study time.” Later in the year, I attended a panel featuring five pediatricians. The question of work-life balance came up, and one of the doctors mentioned that she carved out “protected time” to be with her 2-year-old daughter every evening between 5 and 7 PM. This statement was met with general appreciation but also minor panic. There are so many aspects of our life that deserve “protected time” – family, friends, time for creativity, and more – and yet, again, there are only 24 hours in a day. Where does “protected time” start and end? And what does it include? And is it really reasonable to expect “protected time” when there are so many patient -care demands for physicians to navigate?

As I’m about to enter my second year of medical school, some of my questions remain unanswered. How can my classmates and I make sure to learn medicine well enough and thoroughly enough that we can both meet and exceed expectations in patient care? Is identifying “high-yield” material an ineffective, shortsighted approach? And how do we identify what falls under “protected time”? Here’s hoping I figure out this tentative balance during this upcoming year!

Hamsika Chandrasekar just finished her first year at Stanford’s medical school. She has an interest in medical education and pediatrics.

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From August 11-25, Scope will be on a limited publishing schedule. During that time, you may also notice a delay in comment moderation. We’ll return to our regular schedule on August 25.)

In the News, Medical Education, Medical Schools, Stanford News

Rethinking the traditional four-year medical curriculum

Rethinking the traditional four-year medical curriculum

In an effort to meet the needs of medical students, physicians and patients, a number of universities are considering ways to shorten the traditional four-year medical curriculum without compromising quality of care. The New York Times reports that “a recent, unpublished survey of 120 medical schools, conducted by the New York University School of Medicine, found that 30 percent were considering or already planning to start three-year programs” and notes that the American Medical Association is among those advocating for such innovative approaches. Denise Grady writes:

More than a dozen medical schools already have programs to move students more quickly from the classroom to the clinic, but by shortening premedical studies rather than medical school. Among them are Albany Medical College, Northeast Ohio Medical University and the medical schools at Boston University, Drexel, George Washington, Howard, Jefferson, Meharry and Northwestern. Gifted high school seniors or early college students are guaranteed admission to medical school if they perform well during freshman year of college. Combined bachelors/M.D. programs have been around for half a century, but these students complete both degrees in six or seven years instead of the usual eight.

“I absolutely think it’s doable,” said Dr. Charles G. Prober, senior associate dean for medical education at Stanford School of Medicine, which is considering such a program. Well-designed programs to accelerate doctors’ training “don’t send them out prematurely, but send them out with adequate tools, recognizing that they will grow,” said Dr. Prober, who writes and speaks extensively on medical education reform. “Real learning begins when you are actually beginning to take care of patients, doing what you were trained to do.”

While research is scant, a few studies show promising results. Comparisons of graduates of three-year programs at the University of Calgary and McMaster University to graduates of four-year Canadian medical schools found “equivalent performance.” And a small study at Marshall University in the 1990s, which for almost a decade incorporated fourth-year requirements with the first year of residency in family practice, declared it a success for “carefully selected candidates.”

Indeed, educators make clear that not all students can handle the accelerated curriculum. Dr. Prober notes that with the explosion of medical information, students more than ever must learn to work smart, figuring out what they need to memorize and how to find out the rest. Part of the education process today is learning to collaborate and tap the expertise of others.

Previously: A closer look at using the “flipped classroom” model at the School of Medicine, Combining online learning and the Socratic method to reinvent medical school courses, Rethinking the “sage on stage” model in medical education and Stanford professors propose re-imagining medical education with “lecture-less” classes

Medical Education, Medical Schools

Does medical school debt cause students to choose more lucrative specialties?

Last week, we re-published a Wing of Zock post on medical school debt. Over on that same blog, Julie Fresne, director of student financial services for the Association of American Medical Colleges (AAMC), takes issue with one of the original writer’s points: that concern over medical school debt affects students’ decision about specialties. Fresne writes:

While many claim that debt leads medical students to choose more lucrative specialties, AAMC research indicates that debt does not play a determining role in specialty choice for most students. The report, “Physician Education Debt and the Cost to Attend Medical School,” includes a section outlining evidence on the “minor role of debt in specialty choice.” Studies show that specialty choice is a complex and personal decision involving many factors. Some students with high debt do in fact choose primary care and AAMC data suggests that there is no systematic bias away from primary care specialties by graduates with higher debt levels…

Previously: It’s time for innovation in how we pay for medical school, 8 reasons medical school debt won’t control my life and Will debt forgiveness program remedy doctor shortage?

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