Interprofessional observerships provide insight

By Dr. Lindsay Davidson, Collaborator Lead

 

For several years, first year medical students have had the opportunity to shadow a non-physician health care provider for a half day as part of the Introduction to Professional Roles course. This initiative, championed by Dr. Sanfilippo, initially involved nurses at one institution and has grown to include 3 sites (KGH, HDH and PCCC) and 11 different groups of health care providers. First year students are charged with beginning to understand their role (as future physicians) as well as the role(s) of the myriad types of health care providers that they will work with over the course of their careers. Most years, the Observerships have been preceded by an in-class brainstorming session, where student infer what various professionals’ roles might be. Following this, students are assigned to work with one of the available health care providers during curricular time. This practical experience allows students to act as ‘anthropologists’, observing for themselves what various health care providers actually do, day-to-day as well as how they collaborate with patients, family members and other members of their team. Finally, at the end of term, students convene in groups to compare and debrief their experiences, collating new lists of the roles and functions that they have observer, to be contrasted with their initial brainstorming. Invariably, the end-of-term collations reflect the insight of the experiences that they have shared.

Here are some of the observations students have made:

“I liked being able to be a part of the meetings with families so that I could better understand what role the social worker played.”

“My preceptor was very approachable and forthcoming with information about her profession; she seemed very enthusiastic about participating in the IP program.”

“… I just had not thought about how the social worker-patient encounter would rely on the same trust- and rapport-building methods as the physician physicians do.”

“I had pictured a dietitian’s work to be office-based, with patients coming for consults at her desk. It never occurred to me that in the hospital, they would accompany the rest of the health teams to do rounds.”

“And I now appreciate the importance of an OT in helping a patient adapt to their new health and return to their normal life as best as possible.”

“I had envisioned a solemn chaplain giving last rites, but clearly this is not the role of the spiritual care practitioner at KGH. Instead, I was surprised by the breadth of the role – there are people who do not consider themselves spiritual or religious at all, yet still speak at length with the spiritual care practitioner about their life and their thoughts about death.”

“I believe it is important to be aware of how physicians can collaborate with allied health professionals to provide the best care, recognizing that we cannot do everything.”

The Interprofessional (IP) Observership has been met with enthusiasm by students and our hospital partners alike and this year, we are offering students the opportunity to participate in an optional second observership, to broaden their experience an understanding of their future IP colleagues. Additionally, in 2017-18, we will be piloting an advanced IP Observership at the Kingston Community Health Centre, where groups of students will spend half a day observing a team-based Interprofessional clinic in our community.


With thanks to students Sarah Edgerley,  Shannon Willmott, Ameir Makar, and Etienne Benard-Seguin who have been working on tracking and analyzing the Interprofessional Observership experience.

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5th Annual Medical Student Research Showcase

By Drs. Heather Murray & Melanie Walker

This year the School of Medicine is proud to invite you to the 5th annual Medical Student Research Showcase on Wednesday September 21st.

This event celebrates the research achievements of our undergraduate medical students, with both posters and an oral plenary session featuring research showcase-judgingperformed by students while they have been enrolled in medical school. All students who received summer studentship research funding through the School of Medicine in 2016 will be presenting their work, as well as many other research initiatives. The posters will be displayed in the David Walker atrium of the School of Medicine building from 8 am until 5 pm, with the students standing at their posters answering questions between 1030 and noon.

The oral plenary features the top research projects selected by a panel of faculty judges, and will run in room 132A from noon until 1:30pm on Sept 21st, immediately following the poster session Q&A. We are pleased to announce that we have a faculty guest speaker, Dr. Adrian Baranchuk, who will give a short presentation on his research and career to launch the oral plenary session.

This year’s faculty judges included:

  • Dr. Tanveer Towheedshowcase-discussion
  • Dr. Andrea Winthrop
  • Dr. Yuka Asai
  • Dr. Ryan Bicknell
  • Dr. Megan Carter
  • Dr. Jennifer Flemming
  • Dr. Nader Ghasemlou
  • Dr. Dianne Groll
  • Dr. Paula James
  • Dr. David Maslove
  • Dr. Katrina Gee

We are very grateful to these faculty members for evaluating our oral plenary applicants this year.

The three students who have been selected for the oral plenary session, and the titles of their research presentations and faculty supervisor names are listed below. Each of these three students will receive The Albert Clark Award for Medical Student Research Excellence.

Peter Wang – A database review using the CHADS2 score to detect new Atrial Fibrillation (Supervisor: R. S. Pal)

Frances Dang – Impacts of Preeclampsia on the Brain of Offspring (Supervisor: A. Croy)

Zhubo Zhang – Differential DNA methylation profiles reflect distinct molecular subtypes and clinical outcomes of urothelial bladder carcinoma (Supervisor: R.J. Gooding)

Please set aside some time to attend the Medical Student Research Showcase on September 21st. The students will appreciate your interest and support, and you will be amazed at what they have been able to achieve.

 

 

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Tartan, threads, and an integrated curriculum

By Lindsay Davidson
Director, Teaching, Learning and Integration

Summer is a funny time – for some, relaxing with family on the dock, for others seeking out new adventures. I’ve been amused as I’ve watched from a distance, as my university-age son embraces his Scottish roots by running in “kilt runs” in Perth and Quebec City. This exploration of his ancestors’ fashion choices has led to a whole new appreciation of tartan in our family. Queen’s University, of course, is home to its own tartan, worn by band members and enthusiastic alumni alike. Just as the tartans of Scotland identify clan membership, the unique pattern of coloured warp and weft threads are instantly identifiable as the plaid cloth associated with our Queen’s.

Over the past year, the members of the Teaching, Learning and Integration Committee (TLIC) have been busy identifying teaching threads for a virtual “curricular tartan”, just as unique and emblematic of our medical school. Integrated threads represent topics that are taught in a longitudinal fashion, spanning multiple courses, terms and even years of the curriculum. These include intrinsic physician roles, some medical disciplines (typically those that do not have an identified course as well as those that relate to multiple courses) as well as other “hot topics”. Last September, the Committee Screen shot 2016-08-08 at 9.10.00 AMpresented the notion of integrated curricular threads to the Curriculum Committee, as well as an inaugural list of 28 threads which are shown here. (The active Integrated Threads list will be reviewed and possible revised by the Curriculum Committee each September).

To date, members of the TLIC and the Educational Development team have worked with course directors, discipline leads and other content experts to identify how these topics are taught and assessed across the length of our curriculum. The exercise has created exciting opportunities to connect teachers across courses and terms and has led to new opportunities for collaboration: a pharmacologist teaching about complementary and alternative medicines in the context of the CARL course, pathologists co-teaching about lung cancer in the Oncology course, Palliative care and Genetics experts identifying how relevant their disciplines are to multiple courses and creating explicit pockets of teaching.

The threads, now identified, are beginning to be woven into an intricate cloth. You can explore some examples of these by searching for a particular Integrated Thread as part of a Learning Event search on MEdTech. We hope that students will benefit from having an opportunity to understand how teaching on these topics progresses over the curriculum.

 

 

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Teaching the Way You Practice: Collaborative Active Learning in Different Teaching Settings

By Michelle Gibson (gibson@queensu.ca) and Melissa Andrew (andrewm@providencecare.ca)

Most health professionals are actively engaged in collaborative practice: working with many different team members from different disciplines to support patients or clients in achieving their health goals.

However, we often teach our learners in isolation from one another, and, if we are being honest, co-teaching and integration between disciplines in an educational setting can be challenging.  When it ‘works’, however, it is very rewarding, and it is an opportunity to role-model explicitly for learners how different disciplines with differing approaches can work together to enhance care. When co-teaching is combined with active learning that mimics the wonderful messiness of real clinical practice, learners can start to envision how complex problems are approached in “real-life”.  In our experience, this is particularly powerful when we have students also working in teams on complex, real-world cases.

We offer up tips and lessons learned in six years shared teaching between geriatric medicine and geriatric psychiatry in undergraduate and post-graduate settings, to different audiences. We have also co-taught with other health care disciplines but our examples come from our co-teaching.

Examples of what we teach together:

  • Second year medical students:  We built on-line modules for students to use first on dementia and delirium, and then we co-teach the session that applies this learning to real-life cases.  Dr. Andrew co-teaches a 2nd session on “Brain and Behaviour” with a psychogeriatric resource consultant.
  • Family Medicine residents: We have 2 half-days which deal with common, complex, outpatient problems in older adults: the patient who arrives on a Friday afternoon with falls, confusion, and a letter from an anxious daughter; the patient who is extremely cognitively impaired, falling frequently, with a nightmarish medication list, and no family members who can provide history; this same patient who has a valid drivers’ license, and who may or may not be depressed.

top-tips

Tip # 1:  Start with being clear about your purpose(s), goals, objectives.

While this is important for all teaching, it becomes essential when more than one individual is involved.  For example, when we started to design academic half-days for family medicine residents, we worked out that we were aiming to help them approach complex patients with multiple problems in an outpatient setting, while highlighting how geriatric psychiatry and geriatric medicine are similar, how they are different, and how we work together.  These sessions work best with a shared vision.

Tip #2:  Be explicit about roles and expectations.

Similar to Tip #1, this does get increasingly complex when more than one (extremely passionate and very dedicated) teacher is involved in any learning event.  Who is preparing what? By when? How are the different parts going to be taught?  There is nothing worse than realizing the day before that you were the one expected to prepare the quiz. J

Tip #3:  Avoid ‘parallel play’.

Some attempts at integration or co-teaching end up being a series of lectures or teaching sessions that happen to be scheduled in approximately the same time period and are not really integrated.   The best sessions involve a back-and-forth approach, with many opportunities to address areas of controversy in a respectful manner. (See Tip #4)

Tip #4:  Embrace controversy, respectfully.

Junior learners in particular, in our experience, become stressed when it appears there is no one “right” answer.  We live, wallow, and celebrate the land of the gray-zone in geriatrics (pun intended), so we rarely have one correct answer.  However, how we address this in our teaching is important.  We frequently check in with one another: “How would you approach this in your setting?” and acknowledge strengths in differing approaches.

Tip #5:  Embrace complexity, carefully.

We have been pleasantly surprised as to how groups of learners are able to work together to approach very complex cases, when there is a safe learning environment.  For example, we give learners a very complex medication list, while providing an approach for them to practice, and we emphasize that there are many ‘right’ answers.  When we debrief this exercise, we use our different backgrounds/expertise to help students navigate the pros and cons of different decisions.  The team setting for teaching appears to allow students to feel safe to address areas of discomfort – that wondrous gray zone in which we revel. We all consult when there is a great deal of complexity, and we should role-model this for our learners.

Tip #6:  Play your best cards.

This is a great time to determine who is best at which parts, and use these skills to your advantage.  This applies both to clinical expertise, but also to teaching styles: who is the best person to teach X? Who is better at addressing this particular issue?  Why not compensate for each other’s’ weaknesses? You also have the huge benefit of learning from your colleague.

lessons-learned

Lesson #1:  It takes more time up front, but less time the more you do it.  The discussions, planning, negotiations about “what is the way we want to approach X” does require more time initially, but it gets easier each time.

Lesson #2: If possible, it’s best (in our opinion), and more fun, to co-teach with people that you work with regularly. The established trust and long-standing respectful relationships, we believe, shine through for learners, allowing them to feel comfortable when we ‘disagree’ on certain issues.  This is much easier to do in a collegial way when you know how the other teachers work and think.  Plus, teaching with friends is fun.

Lesson #3:  Going out for lunch to plan teaching is optimal.  ‘Nuff said.  Seriously, though – it’s hard to plan teaching in the midst of busy clinical work.  Set aside time to think about things, and to meet in a positive environment.

Lesson #4:  Where there is assessment involved, co-marking is hugely informative – as in, set aside time, sit down together, and mark together.  It allows us to delve into why students thought X, when clearly we thought we were teaching Y.  There is also the distinct advantage of being able to share the marking load, whilst sipping on pleasant beverages.  More importantly, though, by discussing the answers, we are able to immediately adapt our teaching plans for the following year.

 

 

 

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Reducing the Burden of Concussions Through Education

By Chris Griffiths

The Concussion Education, Safety and Awareness Program (CESAP) seeks to reach a broad audience on the prevention, identification and management of concussion injuries. According to the Centre for Disease Control, 65% of all concussions occur in those aged 5-18, and concussions make up 13.2% of high school sports injuries (CDC, 2015). As high school populations are at increased risk of injury, it is important that they are properly educated on the risks they incur by participating in sport, and how to best minimize these dangers. However, a study in Florida examining high school football players, a sport at the highest risk of injury, found that only 1 in 4 received proper concussion education (Cournoyer & Tripp, 2014). As 20% of those injured eventually develop long-term sequelae of concussion, such as depression and anxiety disorders, it is important that schools develop supportive environments for those injured (Hudak et al., 2011). Increased awareness has been demonstrated to increase the likelihood students will adhere to management and prevention strategies, and increase the level of compassion received from their peers (Taylor & Sanner, 2016).

Chris Griffiths and Jesse Topley presenting at Super Elite Football Camps in Aurora, ON
Chris Griffiths and Jesse Topley presenting at Super Elite Football Camps in Aurora, ON

This past fall, a group of medical and graduate students teamed up to work on reducing the burden of concussion in our community. Two second year medical students, Logan Seaman and Chris Griffiths, began working with MSc Neurosciences candidate, Allen Champagne, to develop a free education program for high school students and athletes. With the advice of physicians at Queen’s University, namely Dr Mike O’Connor, Dr Fraser Saunders and Dr Andrea Winthrop, and endless support from the Centre of Neurosciences Studies, CESAP developed a classroom session focused on the biomechanics, symptoms, and management of concussions. With help from students at the School of Rehabilitation Therapy and their faculty, we have put emphasis on the many healthcare professionals who can help in injury rehabilitation around Kingston.

What we believe sets CESAP apart, however, is our behaviour modification and prevention arm. CESAP runs clinics for youth football teams with classroom sessions followed by on field drills led by Queen’s football players to teach proper tackling technique. The drills were developed based on research at the University of New Hampshire, showing that equipmentless drills that focus on fundamentals, or “heads up tackling”, reduced the number of head impacts by 4.4 per game in collegiate athletes (Swartz et al, 2016). CESAP has committed to expanding these principles to other sports, with drills developed for soccer and hockey.

Logan Seaman presenting to Ottawa Titans Water Polo Club in Ottawa, ON
Logan Seaman presenting to Ottawa Titans Water Polo Club in Ottawa, ON

CESAP’s classroom sessions are modified specially for each target audience. While some sections are shortened for particular groups, the structure of each talk is the same. We begin by introducing basic neuroanatomy, localizing different areas of the brain to their function. For senior high school classes, we go into greater depth into axonal structure, and show different imaging modalities such as MRI and Diffusion Tensor Imaging. Emphasizing that concussion is a functional injury, we explain how injury can occur and the symptoms that are caused. The goal is that students can identify unusual behaviour in themselves or their teammates, and encourage them to make a safe choice by removing themselves from play if necessary. We outline red flags or concerning symptomatic developments, and equip students with questions to ask their peers if they suspect injury.

Unfortunately, the reality is that injury does happen. With help from physicians, occupational therapists and physiotherapists in the field, we have compiled the best resources for management plans in concussion rehabilitation. Parents are provided with information on all of the health care professionals in the area who they can consult, and youth are educated on what to expect in their recovery. Perhaps the most powerful part of our program, however, are the testimonies offered by concussed athletes on our team, such as former Queen’s Football player Jesse Topley. The stories our athletes give make the effects of concussion a reality, as we hope to foster supportive environments around concussions in the community. By outlining the difficulties that follow injury, we hope that athletes understand they have the power to prevent severe sequelae by playing it safe in their recovery. We hope that athletes and youth are able to identify the injury in themselves and take it seriously, and reverse the “warrior culture” that exists in sports that encourages young athletes to play through any injury.

Allen Champagne (middle) teaching proper blocking technique with Sherbrooke Varsity Football players in Sherbrooke, QC
Allen Champagne (middle) teaching proper blocking technique with Sherbrooke Varsity Football players in Sherbrooke, QC

Since the middle of January at program launch, CESAP has presented to over 1,100 students, athletes, parents and coaches in Kingston, Sherbrooke, Quebec City, and across the GTA. Our program hopes to continue to expand into the Limestone District School Board, with regular classes in grade 9 PHE and senior biology classes. In athletics, we are advocating for more education of coaches, referees and trainers in leagues in the Kingston area.

With help from our colleagues at the Centre for Neurosciences, and in partnership with students in the School of Rehabilitation Therapy, we hope that CESAP can continue to grow across Canada. Our dream is to make CESAP, and programs like it, standard education for high school students and athletes. Through increased education, we believe that youth, parents and coaches can make safer decisions regarding head injury and reduce the burden of concussion and its chronic effects on society at large.

If you are interested in booking CESAP for an education session, please contact us at cesapkingston@gmail.com. We will accept any audience and are happy to tailor a presentation to your needs! Please follow us on Twitter @cesap100 to learn more about our sessions and concussions in the news.


 References:
  1. Centres for Disease Control and Prevention. “Online Concussion Training for Health Care Providers.” Centers for Disease Control and Prevention. N.p., 4 May 2015. Web. 31 Mar. 2016.
  2. Cournoyer, Janie, and Brady L. Tripp. “Concussion knowledge in high school football players.”Journal of athletic training 5 (2014): 654-658
  3. Hudak, A., Warner, M., Marquez de la Plata, C., Moore, C., Harper, C., & Diaz-Arrastia, R. Brain morphometry changes and depressive symptoms after traumatic brain injury. Psychiatry Research, 191(3), 160–165 (2011).
  4. Swartz, E. E., Broglio, S. P., Cook, S. B., Cantu, R. C., Ferrara, M. S., Guskiewicz, K. M., & Myers, J. L. (2015). Early Results of a Helmetless-Tackling Intervention to Decrease Head Impacts in Football Players. Journal of Athletic Training, 50(12), 1219–1222. http://doi.org/10.4085/1062-6050-51.1.06
  5. Taylor, M. E., & Sanner, J. E. (2015). “The Relationship Between Concussion Knowledge and the High School Athlete’s Intention to Report Traumatic Brain Injury Symptoms: A Systematic Review of the Literature.”The Journal of school nursing : the official publication of the National Association of School Nurses. PubMed. Web.

 

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Teachers and Learners “Spring” Forward for Each Other

By Jonathan Krett, Aesculapian Society President, Meds’18

Recently I attended the Canadian Federation of Medical Students Spring General Meeting in Montreal, QC. Sitting around a table with medical student society presidents from across the country discussing a variety of issues really drove home that at Queen’s School of Medicine, we students have it pretty good.

One of our strengths is certainly the huge part that learners play in driving the student experience. The peer-peer support at our medical school is a true standout and I believe it fosters a strong sense of community. Another one of our notable strengths is without a doubt, the engagement and responsiveness of the faculty that come into the classroom to teach us each day.

Twice a year, the Aesculapian Society (AS) Council hosts general assemblies in which we have an opportunity to recognize both faculty and student contributions to our life as learners at the Queen’s School of Medicine.

It’s on these rare occasions where I have the opportunity to reflect on, and be proud of, the above-and-beyond efforts of a handful of very special people. I wanted to take this chance to celebrate peers and faculty who fuel the very essence of our wonderful community at Queen’s.

Without further adieu…

First-year President and AS President-Elect, Gray Moonen presented two AS lectureship awards on behalf of the Class of 2019.

(From left to right): Gray Moonen (First-year President), Dr.’s Filip Gilic and David Lee – Term 1 and 2A award winners
(From left to right): Gray Moonen (First-year President), Dr.’s Filip Gilic and David Lee – Term 1 and 2A award winners

Dr. Filip Gilic (Family Medicine), applied his direct and practical teaching style, helping to render common presentations in Family Practice accessible to medical students in their very first term of school.

Dr. David Lee (Hematology), engaged students in the classroom with a life-sized red blood cell piñata to demonstrate hemolysis. His careful and thoughtful approach to lecturing went a long way towards enabling material to percolate into the heads of his students.

Second-year President, Monica Mullin, presented four AS lectureship awards on behalf of the Class of 2018.

Dr. David Holland (Renal Course), won over students with his simplified framework for approaching renal disease. Leaving us with the wise words, “Teach Once, Learn Twice,” Dr. Holland thanked his students for the lessons they have taught him along the way.

Dr. David Holland, award winner for Term 3 and Monica Mullin, Second-year President. Dr. Robyn Houlden was not available to attend.
Dr. David Holland, award winner for Term 3 and Monica Mullin, Second-year President. Dr. Robyn Houlden was not available to attend.

Dr. Robyn Houlden (Endocrinology Course), was recognized for her organized course framework and emphasis on key concepts for practice in endocrinology. Her sense of humour in the classroom brought a certain levity to otherwise intimidating, complex material.

Dr. Alex Menard (Radiology), made several appearances before the second-year class and de-mystified diagnostic imaging using an interactive teaching method. He left us with pragmatic approaches to common clinical scenarios.

(from left to right): Monica Mullin (Second-year President), Dr.’s Alex Menard and Heather Murray – Term 4A award winners.
(from left to right): Monica Mullin (Second-year President), Dr.’s Alex Menard and Heather Murray – Term 4A award winners.

Finally, Dr. Heather Murray (Extended CARL, 2nd-year Course Director), was applauded for her extensive contributions to the well designed second-year curriculum. This year she incorporated a brand new initiative called “Case of the Month.” This series runs longitudinally through second-year, helping students to consolidate approaches to several core clinical presentations and get comfortable with applying our non-medical expert physician competencies.

In addition, non-academic awards were distributed to non-graduating students. (Note that students in fourth year receive their awards at graduation, and will not be specifically mentioned here.)

Wei Sim presented the A.A. Travill Award to Graham Skelhorne-Gross.
Wei Sim presented the A.A. Travill Award to Graham Skelhorne-Gross.

Wei Sim, AS VP Internal Affairs, presented the A. A. Travill Award to Graham Skelhorne-Gross. Graham was congratulated for his immense work and sacrifice on behalf of the entire student body at Queen’s in his role as our VP External. He spent countless weekends out of town representing us on provincial committees, such as the Ontario Medical Students Association (OMSA).

The AS Awards of Merit were presented to several students who excelled in their efforts to promote student life and learning in a variety of areas.

Adam Mosa (Meds’18), was applauded for his work as Queen’s Medical Review Co-Editor-in-Chief and as one of the Class of 2018’s Clerkship Curricular Representatives.

Peter Wang (Meds’18), was heavily involved in enhancing extra-curricular learning for his peers (SSTEP, Emergency Medicine Interest Group), along with his work in the community teaching first-aid to youths with Junior Medics.

(from left to right): Peter Wang, Henry Ajzenberg, and Wei Sim – winners of the AS Awards of Merit. Adam Mosa was not able to attend. Graduating recipients will receive their awards at convocation on May 19, 2016.
(from left to right): Peter Wang, Henry Ajzenberg, and Wei Sim – winners of the AS Awards of Merit. Adam Mosa was not able to attend. Graduating recipients will receive their awards at convocation on May 19, 2016.

Henry Ajzenberg (Meds’18), provided a great deal of leadership on the advocacy scene this year. He co-chaired the successful Health Policy Interest Group (HPIG) and acted as Chief Outreach Officer for the Ontario Political Advocacy Committee (OPAC).

Wei Sim (Meds’18), also received an award for heading up the popular acapella group, Hippochromatic Notes, and his many behind-the-scenes efforts on student council.

When all was said and done, I had to stop and think once again, at Queen’s we have things pretty good.

Please don’t hesitate to contact me at president@qmed.ca with any questions or comments.

A list of past faculty winners can be found here.

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QMed students cooking up wellness strategies

 by Meghan Bhatia, AS Wellness Officer

and Monica Mullin, Nutritional Wellness Lead

What is wellness? This is a question that proves far more complex than it would appear to be. Although on the surface it may seem easy to define, wellness is an interesting topic to discuss because it can be very personal and take different roles in students’ lives. Buzzwords often surround the wellness curriculum, things like work-life balance, healthy eating, ‘Get Your 150’ and mental or emotional well-being. These categories do indeed contribute to wellness, but with 400 different students and multiple faculty, one size does not fit all.

The idea of taking ownership of one’s own wellness was what piloted Wellness Month at Queen’s University. We may all know the areas of personal wellness, but this month added structure and challenge to these categories, in a hope that people would get new ideas, form habits and lifelong learning would result naturally.

The #keepsmewell challenge was piloted at Queen’s Medicine last year and this year was taken nationally through the CFMS, and run across the country concurrently. At Queen’s we had 160 QMed students participate (including clerks) as well as 18 faculty/staff and 16 QuARMS students.Salad

What was the #keepsmewell challenge? It was a positive habits challenge that had four themed weeks: nutrition week, mental health week, physical week and social academic balance week. Students would receive points for completing tasks on the spreadsheet and were often asked to promote these activities on social media with #keepsmewell.

It was always interesting seeing students stay active and well through their photos with all of the creative paths they took. In particular, the amazing cooking photos from last year were the inspiration behind the QMed cookbook. We decided to compile what students did throughout the challenge so they would have a reference for the rest of the year, of ideas and inspirations; QMED COOKS is available in ibooks or pdf and is free for anyone. It is available here and has been shared nationally and provincially. One of our contributions to the book was adding in nutrition facts and tips that we learnt in school, through resources, or the dietician talk during nutrition week to keep it fun and educational!

Our wellness curriculum is wide and quite diverse, but it is really only a part of QMed students’ wellness. The interest in this month and the positive feedback we have received from this book really does show that students are invested in their own wellness. We both hope that this is just a launching pad for even more nutritional integration into the curriculum, and that many wellness months will continue on, as wellness is difficult to teach, but so essential to learn.

 

 

 

 

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Smashing Stereotypes Using YouTube™ in Teaching – a Geriatric Medicine Perspective

By Michelle Gibson

Why Use Videos in Geriatric Medicine Teaching?

I teach first year medical students about the awesome world of geriatric medicine. I am a family medicine-Care of the Elderly trained doctor who loves her work, and although I am dutifully teaching about all the sacred geriatric syndromes (falls, confusion, frailty, etc.), my main motivation is to help (very) young medical students start to see why I fundamentally love my patients – because they are truly wonderful human beings.

Many students, most of whom are under 25, have little or no experience with seniors, particularly in health care settings, and some have unfortunately had negative experiences. Regardless of their experience, they, like all of us, are often bombarded by negative portrayals of older adults in the media.

To make matters worse, I am (ahem) “competing” with the following courses:

Pediatrics (cute babies and kids – unfair advantage), Genetics (the future of medicine according to everyone, with cool, high-tech tricks), and Musculoskeletal (broken bones! surgery! trauma!). I know my patients can take any of these competing patient populations in terms of general coolness, but my students don’t always realize this.

I have often invited my patients to come to class to discuss their experiences in the interdisciplinary outpatient program in which I am based, but due to their general frailty, this often doesn’t work out, and even when it does, there are many logistics barriers that must be overcome (such as a lack of accessible parking, but I digress).

My solution? I use carefully selected YouTube videos in class. I show these videos mostly at the beginning of class, so it also takes care of the (super-rare … or not) incidents of students arriving late for an 8:30 a.m. class, and missing my carefully constructed, brilliant opening teaching gambit.

Below, I have included a selection of the videos I use, including some information about how I found them, and why I use them.

Dancing Nana

This is one of the first videos I used, and it remains a fan favourite. Dancing Nana is 88 years young, and her grand-daughter takes her out for lunch every week. On this week, her grand-daughter played one of her grand-mother’s favourite songs, and you can see what happens next.

This video also illustrates one of the challenges of YouTube videos. The original video has had the audio blocked due to a copyright complaint. So far, as of today (February 2016), the music is intact here.

Why do I love it? Because Dancing Nana is real. She’s just like many of my patients. She has a great outfit, complete with her personal alarm system in place, and she puts her purse down to dance down the stairs. She is aging (she’s 88!) and but she loves life, and her granddaughter takes her out to lunch every week. It’s perfect.

It’s also a good length to show in class – 2.5 minutes long. How did I find Dancing Nana? I searched “old person dancing” on YouTube back in 2013. Complex search strategy, n’est-ce-pas?

I show this video before I teach about prescribing exercise to the elderly. I can’t think of a better introduction.

Pearls of Wisdom

This is a video I can use before any of my teaching sessions.

This is a lovely little video full of humour and poignancy. Older adults in a care home in the UK provide “Pearls of Wisdom” – which reflect lifetimes of experience.

This video makes me smile, and (sometimes) can make me tear up. The folks are eloquent, witty, and have obviously thought about what they are going to say – and each Pearl reflects their individual personality, which then shines through. The stars of the video really demonstrate the great spirits contained in older bodies, which are often frail. It really helps us appreciate the person and not the disease, age, or condition. I choose it because it demonstrates that one’s humanity does not depart upon admission to a care home.

Hal Lasko: Painting with technology

Hal Lasko is an amazing 97 year old man, who was losing his vision, and his grandson introduced him to a software program that allowed him to continue to “paint”. The video is in fact produced by a huge company (you’ll see if you watch the movie) but it’s really all about the amazing art that Hal can make using technology.
I think this video truly “smashes stereotypes”. Hal’s cognition appears very much intact, at the age of 97. He has embraced technology, and he makes art that most of us could never hope to make. He has a passion, and he pursues it, despite his disability.
How did I find Hal? I was searching for another video, since taken down, about “Old man painting”, and Hal popped up.

I do address explicitly in class that I have no financial affiliation with the company in question, nor have I ever used the product. I wish it wasn’t a commercial, but it is, so I just discuss it explicitly. I have decided not to use other videos that were produced by pharmaceutical companies, as I am not comfortable with the implied endorsement.

Mark Ronson ft. Bruno Mars – Uptown Funk “Oldtown Cover” ft. Alex Boye’, & The Dancing Grannies

Some videos are just plain fun, and need to be shown.
This one was posted by a friend of mine on Facebook (sometimes these videos just fall in my lap), but also by a number of first year students after I started to show the videos in the geriatrics unit. It’s a great resource. It’s impossible for students to ignore at the beginning of class and it works better than coffee to wake up in the morning. It’s got great seniors being, well, funky. It’s very clever.
I often point out that many of the seniors are “too young” for me, in terms of the patient population I see, but it’s important to me to show healthy aging at all ages.
As Alex Boyé says in the notes on YouTube:

“All the grandmas and Grandpas in this video did their own stunts 🙂
They range in age from 65-92! Between them, they have raised 500 children, 1,200 grandchildren, and 250 great grandchildren!!!”

(And not, I do not show videos to make me seem cool. That ship sailed eons ago. I don’t even pretend to try anymore. You get what you see- quirky, middle-aged, me.)

100 Year Old Drivers (I saved the best for last)

This is my all-time favourite teaching video. It’s actually much too long to show in class in its entirety, but it is so well done, that showing 3-5 minutes worth hooks many of my students. I give you, the BBC’s 100 Year Old Drivers. I encourage you to watch the first 5 minutes, but I should probably warn you not to do this unless you’re ready to devote 46 minutes to frequent, uncontrollable bursts of laughter.

This was another accidental find. I was searching YouTube for videos of centenarians and found this gem. Harry, Ken, Basil, and friends are spectacular. They’re amazing examples of healthy aging, with perfectly intact senses of humour. I dare you not to laugh WITH these amazing folks. Basil is my especial favourite – with his exercise program, his patents, and his tennis. (Intrigued yet?)

This video is actually a perfect teaching video for those of you who might have to teach about determining medical fitness to drive. If you do, you’re likely like me, and you dread it. Or rather, I used to dread it, until I found this video.

Now, I love teaching about driving. I use clips from this video to illustrate many features of aging and how they may (or may not!) affect driving safety. In addition, it leads to a great discussion about differences in regulations in different countries.

In this case, I embed the YouTube link into my slides (insert hyperlink works well), and I note when to start and stop the video right on the slide, and I post the link to the full video for my students.

Summary

I’ve received very positive feedback from students about my use of videos. It’s great to see students smiling as they watch these great folk, all of whom remind me of my own patients. Instead of seeing one patient in class, they see many over the course of my unit.

(For those who wonder, I do use lots of clinical videos in teaching- they are great for demonstrating movement disorders, gait analysis, etc, and they’re great resources for students. )

All the videos are of “regular” seniors- not famous folk, by design. I will only show videos where seniors are treated like adults, with respect. (This means there are many news interviews I won’t use, sadly, because they often have a patronizing “yes dear” tone to them that I can’t stand.)

Although some of the videos are more professionally produced than others, so long as the sound is clear, and the image is reasonably clear, I will consider using them. I try to match something to my teaching session, but even if I can’t, I still start with a video.

I have elected not to show videos that are negative in tone or portrayal of seniors, and I’m explicit with my students about this. They will see enough of ageist attitudes, and people treating seniors like children/problems/not worthy of care over and over and over again in their health care training, sadly. I aim to challenge stereotypes, have my students question their assumptions, and, ultimately, to have them think of their first year geriatrics unit with a smile.

In fact, every year, students themselves send me videos to use in class – which I view as a major victory in my efforts to engage students with the awesomeness of my patients!

Contact Information – Feel free to ask questions

Michelle Gibson
gibson@queensu.ca
@MCG_MedEd

 

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Using Copyrighted Images in an Educational Setting: A Primer

By Mark Swartz, Copyright Specialist

Understanding a few of the basic concepts behind Copyright law can help explain why some images can be used in certain situations and others cannot. The most useful concept to consider when thinking about how images can be used is balance.

A Balancing Act

In the landmark Supreme Court case Théberge v Galerie d’Art du Petit Champlain Inc, Justice Ian Binnie characterizes Copyright Law with the following statement:

The Copyright Act is usually presented as a balance between promoting the public interest in the encouragement and dissemination of works of the arts and intellect and obtaining a just reward for the creator.

When you create a work, whether it is a book or an article, a photograph, a painting or any of the other types of expression covered by copyright (Copyright Act, RSC 1985, c C-42, s 5 retrieved on 2015-10-16), you automatically get a bundle of exclusive rights to that work. These rights include the right to copy, to distribute, and to assign your rights to others. The full sets of rights that you get are listed in the Act (Copyright Act, RSC 1985, c C-42, s 3 retrieved on 2015-10-16). And, while these rights are exclusive, they are limited in both time and scope. The balance between exclusive rights and limitations ensures that creators are fairly compensated for their work, while still allowing for some permission-free uses in ways that contribute to the public good.

Limitations to the exclusive rights of copyright holders include the following:

  1. Copyright protection does not last forever. In Canada, the general rule is that Copyright lasts for 50 years after the death of the copyright holder. After that point, the work will fall into the public domain and can be used for any purpose.
  2. The Copyright Act lists a number of situations where Copyrighted works can be used with permission from Copyright holders. These situations are called exceptions. The most well-known exception is called the fair dealing exception, which allows for some use of copyrighted material, as long as the use falls under one of the purposes listed in the Act, and if the dealing is fair (Copyright Act, RSC 1985, c C-42, s 29.1 retrieved on 2015-10-16).

If you have determined that you are using a copyright protected image, you need to get permission from the copyright holder or you must ensure that your use falls under one of the exceptions in the Copyright Act.

So what does this mean if I want to use images in my class?

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Creative Commons copyright licenses provide a simple, standardized way to give the public permission to share and use creative works like images. More information is available at creativecommons.org.

There are a wide variety of exceptions that apply to the use of copyrighted images in a closed, educational setting like a classroom or a Learning Management System. In the classroom, there is an exception that permits the reproduction of copyrighted images for use in PowerPoint presentations on campus (Copyright Act, RSC 1985, c C-42, s 29.4 retrieved on 2015-10-16). Additionally, fair dealing and the publically available materials exception will allow for the inclusion of many images in PowerPoint slides uploaded to Learning Management Systems like MEdtech. For more information, please see the In the Classroom and the On the Internet sections of the copyright and teaching section of my website.

As for images used in student assignments and presentations, most of the images used by students are likely to fall under the fair dealing exception. I do, however, always recommend that students do their best to find copyright free (or suitably licensed) images, so that when students leave the university and are asked to use images in the workplace, they know how to find images that can be easily used without having to get permission. Suggestions for finding these types of images are available on the Resources page of the copyright and teaching section of my website.

What about using images in materials that I post to the open web? What about images in conference presentations, posters and in research projects?

When you move from a closed environment like a Learning Management System to an open environment, it becomes more difficult to rely on exceptions like fair dealing, particularly if you intend to use your work for commercial purposes at any point.

In these situations, I would avoid using copyright protected images without permission and instead rely on finding works that are either licensed through the Creative Commons or that are in the public domain. The “resources” link I included in the section above provides some resources for finding these types of images. Images used in conference presentations and posters are much more likely to be fair than those on the open web, but I would be careful posting these presentations and posters on conference websites.

Finally, most images used in research projects and theses are likely to be fair dealing. One complication is that if you are going to publish in a traditional journal or publication, it is likely that the publisher will require that you get permission for everything. Fair dealing is often perceived to be too much of a risk for these publishers, so, if you are going to go that route, make sure you find materials where permission can be granted easily or is not required.

Mark Swartz
Mark Swartz

This is just a brief overview outlining some of the main image-related considerations that you might come across as an instructor or researcher. If you have any further questions about the use of images, please get in touch with me at extension 78510 or at mark.swartz@queensu.ca.

Citations

Théberge v. Galerie d’Art du Petit Champlain inc., [2002] 2 SCR 336, 2002 SCC 34 (CanLII), <http://canlii.ca/t/51tn> retrieved on 2015-10-16.

Copyright Act, RSC 1985, c C-42, s 29.1 <http://canlii.ca/t/52hd7> retrieved on 2015-10-16.

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Medical Students Recognize Exemplary Teaching

Contributing Authors:

Laura Bosco, Class of 2017 Co-President

Michael Baxter, Class of 2017 Co-President

Jonathan Krett, Aesculapian Society President

The Aesculapian Society (AS), the medical student society at Queen’s, administers a number of awards throughout the course of an academic year. One of our most treasured awards is for some influential educators in our preclerkship

Latest Recipients: 2015 Term 4B and Term 2B Lectureship Award Recipients (from left to right): Drs. J. Gordon Boyd, Stuart Reid, Lindsay Davidson, and Bob Connelly
Latest Recipients: 2015 Term 4B and Term 2B Lectureship Award Recipients (from left to right): Drs. J. Gordon Boyd, Stuart Reid, Lindsay Davidson, and Bob Connelly

curriculum: the AS Lectureship Awards. Twelve of these awards are distributed each year, two during each semester from each preclerkship class. These are important for us to award because, as students, we are privileged to have many dedicated and passionate people involved in our education. To be able to formally recognize the educators that have a lasting impact on our classes – those that go above and beyond for our education, is very meaningful to all students.

Near the end of each term of medical school (3 in each of Year 1 and Year 2), an open call for nominations is sent out to the class. Nominations are received by the respective class president, who tallies the nominations and creates an online vote. All students in that class then get to vote for one or two professors who they feel are most deserving of the award.

Take a look at the following list of recipients from the past two years. While every instructor is different, there were several common threads that lead to students feeling like they went above and beyond. These teachers engaged students in classroom sessions using highly interactive small-group learning. They delivered didactic lectures with skill and with a digestible level of simplicity. At all times, these professors remained approachable and open to student questions. They were receptive to feedback and allowed course content to evolve to suit the unique group of students in the classroom.

We as students definitely sense when an instructor challenges us and brings us along as a junior colleague and not just as a passive observer. Students appreciate being active participants even early on in medical training, and all of these professors were skilled in encouraging us to do just that.

2013-2014 Academic Year Recipients

Term 1 Recipients (Class of 2017)

  • Dr. Michael Sylvester (Family Medicine)
  • Dr. Conrad Reifel (Anatomy)

Term 2A Recipients (Class of 2017)

  • Dr. David Lee (Blood & Coagulation)
  • Dr. John Matthews (Blood & Coagulation)

Term 2B Recipients (Class of 2017)

  • Dr. Bob Connelly (Pediatrics)
  • Dr. Kathleen Nolan (Pediatrics)

Term 3 Recipients (Class of 2016)

  • Dr. Robyn Houlden (Endocrine)
  • Dr. Paul Malik (Cardiology)

Term 4A Recipients (Class of 2016)

  • Dr. Alex Menard (Radiology)
  • Dr. Greg Davies (Genitourinary and Reproduction)

Term 4B Recipients (Class of 2016)

  • Dr. Sean Taylor (Neurology)
  • Dr. Stuart Reid (Neurology)

2014-2015 Academic Year Recipients

Term 1 Recipients (Class of 2018)

  • Dr. Michael Sylvester (Family Medicine)
  • Dr. Heather Murray (Critical Appraisal, Research, & Lifelong Learning [CARL])

Term 2A Recipients (Class of 2018)

  • Dr. David Lee (Blood & Coagulation)
  • Dr. Jacalyn Duffin (History of Medicine)

Term 2B Recipients (Class of 2018)

  • Dr. Bob Connelly (Pediatrics)
  • Dr. Lindsay Davidson (Musculoskeletal)

Term 3 Recipients (Class of 2017)

  • Dr. Robyn Houlden (Endocrine)
  • Dr. David Holland (Renal)

Term 4A Recipients (Class of 2017)

  • Dr. Romy Nitsch (Genitourinary and Reproduction)
  • Dr. Heather Murray (Critical Enquiry and Expanded CARL)

Term 4B Recipients (Class of 2017)

  • Dr. J. Gordon Boyd (Neurology)
  • Dr. Stuart Reid (Neurology)

 

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