Month: November 2014
WHAT’s NEW in the world of Learning Technologies ?
I recently had the opportunity to attend the DevLearn 2014 Conference.
The conference was about discovering tomorrow’s learning technologies, strategies and practices today and joining the community of industry pioneers that are exploring the new learning universe and are defining the future of training and development.
I jam packed my days with amazing learning sessions that I thought we as a team would get the most out of. One of which I thought would benefit all of us back at the office was Forty-five Free (or Cheap) Online Learning Tools in 45 Minutes: What many instructional designers may not know is that for every $1,500 tool, there’s a free or low-cost alternative that can do the job just as well. This session covered a selection of tools that are available today and have many of the capabilities of expensive applications that can decimate a budget.
Some of the free tools I found may come in handy include:
To download the free version visit windows marketplace
OneNote is your digital notebook for keeping track of what’s important in your life.
To download the free version visit Microsoft Marketplace
Inkscape is professional quality vector graphics software which runs on Windows, Mac OS X and Linux. It is used by design professionals and hobbyists worldwide, for creating a wide variety of graphics such as illustrations, icons, logos, diagrams, maps and web graphics. Inkscape uses the W3C open standard SVG (Scalable Vector Graphics) as its native format, and is free and open-source software.adobe illustrator, use for prep work.
To download the free version visit www.inkscape.com
Audacity – great tool to record and edit sound. To download the free version visit http://audacity.sourceforge.net/download/
HandBrake is a tool for converting video from nearly any format to a selection of modern, widely supported codecs.
To download the free version visit https://handbrake.fr/
To download the free version visit www.fotosizer.com
Delicious is a free service designed with care to be the best place to save what you love on the web. We keep your stuff safe so it’s there when you need it – always. Delicious remembers so you don’t have to. Delicious is a free and easy tool to save, organize and discover interesting links on the web. To download the free version visit https://delicious.com/
and the list goes on…
IRfanview – image editor, convert to any file format, edit – simple to use. Visit http://www.irfanview.com/
Windows Movie Maker used to make movies with images, videos and sound – Visit http://windows.microsoft.com/en-us/windows/get-movie-maker-download
TotalRecorder – capture any sound played by a computer (including streaming audio, Internet telephony, and PC games), and use the included time shift-feature for off-hours recording. Visit www.totalrecorder.com/
VLC is a free and open source cross-platform multimedia player and framework that plays most multimedia files as well as DVDs, Audio CDs, VCDs, and various streaming protocols. Visit http://www.videolan.org/vlc/index.html
Freesound is a collaborative database of Creative Commons Licensed sounds. Browse, download and share sounds. www.freesound.org royalty free music to use
Playlater is the first DVR for online video. Visit http://www.playon.tv/playlater
Sketchup easiest way to draw 3D drawings. Visit www.sketchup.com
Onedrive storage, keep your files and photos in onedrive.Visit www.onedrive.com
Join Me – screen sharing. Visit JoinMe
StoryboardThat online storyboard creater, powerful and easy to use. www.storyboardthat.com
7-zip is a file archiver with a high compression ratio. Visit www.7–zip.org/
Neobook create your own windows app (wysiwig) Visit Neosoftware.com
Open Source Windows – utility for manipulating archives. Formats 7z, ZIP, GZIP, BZIP2 and TAR are supported fully, other formats can be unpacked. Visit http://opensourcewindows.org/
ProjectLibre – open source (similar to microsoft project) gantt charts Visit www.projectlibre.org
Gspilt split 10 dvds into smaller ones to share, exe on the disc. Visit www.gdgsoft.com/gsplit/
Malwarebytes protects you from new online threats that antivirus can’t detect. Visit malwarebytes.org
Coursera is an education platform that partners with top universities and organizations worldwide, to offer courses online for anyone to take, for free. Visit www.coursera.org
Any Video Converter takes videos from your computer or downloaded from the Internet and converts them into just about any format you’d like. Visit http://www.any-video-converter.com/products/for_video_free/
Awesome Screenshot Capture the whole page or any portion, annotate it with rectangles, circles, arrows, lines and text, one-click upload to share. Visit http://awesomescreenshot.com/
Snagit Use images and videos to show people exactly what you’re seeing. Snagit gives you an easy way to quickly provide better feedback, create clear documentation, and change the way you work together. AVG Antivirus updates on a regular basis Visit http://www.techsmith.com/download/snagit/
Jump Desktop free remote access tool, anywhere you are (works through google) Visit https://jumpdesktop.com/
PowToon is the brand new Do-It-Yourself animated presentation tool that supercharges your presentations and videos! Save massive amounts of time and money by creating Presentoons that bring the WOW!-factor to your educational presentations, and much more. Visit www.powtoon.com
Doro PDF Writer installs a virtual printer on your system with which you can create PDF documents for free from any Windows app. Visit http://doro-pdf-writer.en.softonic.com/
FLVTO free conversion tool pull files from youtube. Visit http://www.flvto.com/
Red Kawa is a video converter. Visit http://www.redkawa.com
PDFtoword is a pdf convert it into work excel ppt etc Visit https://www.pdftoword.com/
Infogr.am is a tool to make infographics the easy way, create charts that are quick and easy to use and easy on the eyes. Visit https://infogr.am/
Otixo ties all your cloud drives together in one app. Visit www.otixo.com
Bitstrips is a tool used to turn yourself and your friends into cartoon characters, and create and share your own awesome comic strips. Visit www.bitstrips.com
Lunapic if you would like to create an image with a transparent background, upload an image to change to transparent (no download) Visit www.lunapic.com
Google Web Designer a tool to create engaging, interactive HTML5-based designs and motion graphics that can run on any device. Visit www.google.com/webdesigner/
Along with this useful session on Forty-five Free (or Cheap) Online Learning Tools, I went to sessions on the The Top 10 Authoring Tools of 2014 – and the Forecast for 2015, The xAPI—Liberating Learning Design, Building Interactive Slides in Storyline, Transform Users into Contributors: Kaplan’s Path to User-generated Content, xAPI Hyperdrive Showcase, The xAPI for the Non-developer, Demo Fest featuring eLearning Modules, and How to Make Community Part of Your Training.
If any of these topics interests you or you are thinking of exploring any of these tools, please contact Lynel Jackson 613-533-6000 x74919 E-mail: email@example.com
A Call for Clarity
Beyond competencies – What should every Canadian medical graduate be able to do?
Consider this: When you find yourself a passenger on an aircraft coming in for a tricky landing on a stormy night, would you be more comforted by the knowledge that your pilot is an expert in aeronautics and aircraft design, or that he/she has demonstrated the ability to successfully land similar aircraft, in similar conditions, many times previously?
I think most folks would hope, and reasonably expect, that somebody at pilot school is ensuring that their graduates are able to land airplanes safely before pinning those wings on his or her chest.
Let’s switch to a medical equivalent. If you or your loved one is brought to an emergency department with severe abdominal pain, you should certainly expect that the physician providing care has all of the attitudes and personal qualities that have been articulated by our professional bodies and engaged by our medical schools. But, at that moment, I suspect that what you’re looking for is someone who can deal efficiently and effectively with the vessel, viscus or infectious process that’s causing the grief. There are, after all, priorities, and there are things that we expect doctors, and only doctors, to do.
Undergraduate medical education programs have become increasingly competency-based. A “competency”, in the educational sense, can be defined as an attribute, knowledge or skill that an individual learns and eventually possesses. Being an effective communicator, professional, scholar are examples of such competencies that all would agree should be part of any physician’s toolbox. In such frameworks, being a “Medical Expert” (knowing about clinical conditions and how to manage them) is another independently described competency. Many organizations have developed very well thought out and comprehensive descriptions of the competency set they feel describes the ideal, fully formed and practice-ready physician. For example:
- The Royal College of Physicians and Surgeons is in the process of updating their widely praised and globally recognized CanMEDS framework, which describes 7 physician “roles”, 28 “key competencies” that inform those roles, and no fewer than 97 “enabling competencies” that inform the competencies. http://www.royalcollege.ca/portal/page/portal/rc/common/documents/canmeds/framework/canmeds2015_framework_series_III_e.pdf
- The College of Family Medicine describes a “Triple C” curriculum–comprehensive care, continuity of care, centred on Family Medicine. The CFM has also provided an examination of CanMEDS from a Family Medicine perspective, interpreting the seven roles as 63 more tailored competencies, many of which are further described with bulleted sub-competencies. http://www.cfpc.ca/uploadedFiles/Education/CanMEDS-FMU_Feb2010_Final_Formatted.pdf
- South of the border, our American colleagues at the Association of American Medical Colleges (AAMC) has recently released a vision which articulates 8 “Domains” informed by 58 “competencies”, which are roughly equivalent to the CanMEDS “enabling competencies”.
- The Medical Council of Canada, the body responsible for developing the examinations that qualify medical school graduates to practice, has largely embraced the CanMEDS framework in describing objectives for their examinations. It describes the “Medical Expert” in terms of “clinical presentations”, which are patient issues that graduates are expected to handle effectively. http://apps.mcc.ca/Objectives_Online/objectives.pl?loc=home&lang=english
In this increasingly cluttered landscape, our seventeen Canadian medical schools are independently working to produce graduates ready to engage residency programs. (Read this “on the way to, but not yet quite there” with respect to full qualification). To do so, they develop frameworks based on competencies, usually leaning heavily on CanMEDS. As they go about this, they face a number of challenges:
- These competency frameworks were developed with the intention of describing attributes and skills of practicing physicians, not novice learners. They therefore require upstream translation, which can lead to inconsistent interpretation.
- Competencies are notoriously difficult to objectively and fairly assess. (How would you design a final examination for the “professionalism” competency?).
- The evaluative standard used to measure success of medical school graduates is established by the Medical Council of Canada and is based primarily on clinical presentations (ie. do-ing, not be-ing). Purely competency-based curricula are therefore at risk of being out of step with the testing their graduates will be expected to undertake.
- Dedicating increasing curricular time and attention to teaching and assessment of individual competencies threatens to further stress already packed curricula and displace core teaching of the basic and clinical sciences.
And there’s an even more fundamental problem. Any profession, indeed any occupation, is best understood in terms of the services provided. We understand lawyers, for example, as people who defend us in court, ensure our legal documents are in order etc, not as expert communicators, translators of legislation, advocates for social justice, or any of what I am sure are many important competencies that enable lawyers to be lawyers.
The competencies, whether considered individually or in aggregate, fall short in providing a clear and universally understood image of the “complete” medical school graduate.
Doctors, I think anyone would agree, are people trained to care for other people in the context of clinical illness.
If we extend that understanding a little further, we could pragmatically define the mission of undergraduate medical education to produce graduates capable of assessing, diagnosing, stabilizing and initiating both preventive and therapeutic management for the patients they will serve. If we accept that definition, then it would appear we have a “gap” between our mission and our competency frameworks.
Out of all this, the concept of “Entrustable Professional Acts” (EPAs) is beginning to emerge. This concept, attributed to and well articulated by by Dr. Olle ten Cate (ten Cate,2013: Nuts and Bolts of Entrustable Professional Activities. Journal of Graduate Medical Education: March 2013, Vol. 5, No. 1, pp. 157-158).
and has recently been promoted by the AAMC who have developed an approach that is being trialed at ten US medical schools. https://members.aamc.org/eweb/upload/Core%20EPA%20Curriculum%20Dev%20Guide.pdf
EPAs can be regarded as the specific set of skill and knowledge- based responsibilities that graduates can be expected to achieve. Competencies become the component attributes, knowledge and skills students must achieve in order to adequately carry out the EPAs.
Examples of EPAs would include the following:
- the ability to carry out an efficient and effective history and physical examination
- developing a useful differential diagnosis for patients presenting with common clinical problems
- the recognition of critically ill patients, and how to stabilize their condition
- accurate documentation of clinical encounters
- the ability to obtain informed consent for medical procedures
The performance of EPAs must be informed by and incorporate appropriate competencies, such as communication, scholarship, professionalism and collaboration with other providers. EPAs cluster competencies into meaningful activities that can be observed in the workplace and therefore much more amenable to assessment.
Each competency may relate to multiple EPAs. The scholar competency, for example, would be critical to the ability to diagnose, develop management plans, and provide informed consent.
A set of EPAs in aggregate, provide an intuitively appealing and holistic impression of physician expectations that can be consistently understood by students, UG teaching faculty, postgraduate training programs, medical regulatory agencies and the public. As such, they provide a point of common understanding that may provide clarity as to developmental milestones, including the UG-PG interface (ie. Post-graduate programs can more easily understand and provide input as to the expectations at entry).
The AAMC document describes 13 EPAs and how they relate to their competency framework. The “Scottish Doctor” is another EPA-based framework. Beyond the particular items these two groups have identified, I think their value is in the demonstration that a clear, performance-based, objectively assessable and intuitively understandable articulation of the Canadian medical graduate is within our reach.
The Canadian undergraduate medical education community, at recent meetings, has been engaging these issues with increasing interest and commitment. The vision that’s emerging is for a pan-Canadian definition of the medical school graduate, based on EPAs, and informed by the excellent work carried out by organizations such as the Royal College, CFP and MCC. Such a consensus would benefit our medical schools, students, faculty, postgraduate program leaders and, importantly, the Canadian public.
I, for one, am looking forward those discussions.
Anthony J. Sanfilippo, MD, FRCP(C)
Undergraduate Medical Education
New Policy – Feedback requested
Prior to a new or amended policy or regulation being submitted for final approval, it must be published for review and comment by faculty and/or students within the School of Medicine. Feedback received will be directed to the Policy Sponsor.
In the event that major changes are made based on this feedback, a new draft will be posted for additional comments.
In keeping with this procedure the following policies are being posted for comment or feedback:
- Policy governing curricular time in Years 1 and 2 and in the Clerkship Core Academic Courses CC-01 v1
- Supersedes: none
- To provide your comments click here
- Policy on Examination Regulations (SA-02 v2)
- Supersedes: SA-02 v1
- To provide your comments click here
If you wish to comment on any of these documents, please add your feedback to the discussions in this community or email firstname.lastname@example.org
Congratulations to our UGME committees for their hard work and action plans!
Soren Kierkegaard wrote “Life can only be understood backwards; but it must be lived forwards.” It was in this spirit that the UGME Curriculum and MD PEC Committees met a few weeks ago to review and celebrate the past work of the major subcommittees and their action plans for moving forward.
We teach our students that it’s important to pause, reflect, and then use those reflections to employ change, solve dilemmas, reinforce their strengths and begin new actions. It’s salutory to note too that in these reflections should be a sense of honest satisfaction at jobs well done, lessons learned, innovations practiced and accomplishments of which to to be proud.
It was extremely gratifying to see these principles put into effect when the major sub-committees gave their reports on November 3rd, 2014 to the combined membership of the UGME MD PEC and the UGME Curriculum Committee. Served with refreshments came a series of reports that truly emphasize how busy, productive and conscientious our committees are, how hard-working their memberships are, and how they consistently consider student feedback and keep student learning as a focus.
Here are the reports of the Student Assessment Committee (SAC), the Course and Faculty Review Committee, the Teaching, Learning and Innovations Committee, the Academic Affairs Committee, the Admissions Committee, and Student Affairs.
Student Assessment Committee Report:
Dr. Michelle Gibson kicked off the evening as Director and Chair of the Student Assessment Committee with a report from the SAC. She thanked Dr. Susan Chamberlain, inaugural Chair of the committee and Catherine Isaacs, longtime administrative support for the committee. Dr. Gibson introduced the new administrative support person, Amanda Consack; Eleni Katsoulas, Assessment and Evaluation Consultant came in for words of praise for her continuing support, advice and work on the committee.
Dr. Gibson noted that this was a year of review and information-gathering, with the focus primarily on revising the Assessment Policy and Procedures, working with the OSCE working group, and the Progress, Promotions and Remediation Committee. Her Annual Report SAC report Nov 2014 is attached.
Course and Faculty Review Committee Report:
Dr. Lewis Tomalty is our newest Director and Chair of the UGME Course and Faculty Review Committee. He has taken over from the excellent work done by Dr. Andrea Winthrop in her role as inaugural Chair and the developer of our internal review process. Dr. Tomalty and Dr. Winthrop have worked together to revise and streamline the process of review and it was included in a flowchart that was presented. Dr. Tomalty noted that the review process ensures that all courses receive full reviews every three years (unless there is a new course or significant curriculum change, a new course director, or major recommendations/red flags from the previous year) and a screened review every year. In clerkship rotations are evaluated and follow the same process as for pre-clerkship. A minimum of 2 and a maximum of 4 faculty are evaluated per rotation, and specific evaluation data are not provided to faculty unless aggregated in larger amounts (annually) or until students have graduated. His flowchart_CFRC Process is attached as is his Annual Report from the Course and Faculty Review Committee to MD PEC.
Teaching, Learning and Innovations Committee Report:
Dr. Lindsay Davidson, Director and Chair of the newly branded Teaching, Learning and Innovations Committee, noted that there had been many foci of the committee this year: analysis of MCCQE part 1 data; online modules review, consideration of residents as teachers of our clerks, and longitudinal curricular threads. Upcoming topics include: Recommendations regarding a pilot implementation of i-Human cases, Review and recommendations of specific teaching in the UGME curriculum, a process for feedback on the MCC data, documentation of action plans. guidelines regarding minimum acceptable standard for DIL sessions and guidelines regarding the creations/review of online modules for UGME teaching. Some scholarly projects have been discussed: a survey of current processes for the assessment of resident teaching performance at Queen’s/across other institutions, an audit of the form and function of SGL sessions across the pre-clerkship curriculum and the development and implementation of created or curated resources to assist in the learning/review of neuroanatomy/neurophysiology. For the full report, see Annual Report_TLIC Nov 14.
Student Affairs Report:
Dr. Renee Fitzpatrick, new Director of Student Affairs cleared up nomenclature and focus for us as a beginning of her report: The Learner Wellness Centre houses the Student Affairs Team whose mission it is to provide a resource in supporting the individual and professional growth of medical students throughout the undergraduate medical course. The team act as advocates and advisors throughout medical school and provide a link between students and faculty when concerns are raised or when new innovations are conceived. Dr. Fitzpatrick introduced a new embedded counsellor for medical students, working out of Student Health and Counseling Service. She reviewed the Wellness Days, which focused on resilience; these were implemented for the clerks in September. Dr. Fitzpatrick celebrated the student/faculty driven Wellness and Mental Health Group, and noted that Student Affairs has forged stronger links with Queen’s Disability Services. Dr. Fitzpatrick reviewed the work of the Career Advisors, the Academic Advisor and looked at future directions. This involve a learning climate working group and a focus on student debt. For more on this report, please see Annual Report Student Affairs.
Progress, Promotions and Remediation and the Academic Affairs Committee:
Dr. Richard Van Wylick, the Director of Progress, Promotions and Remediation spoke about the major accomplishments of his committee: the revision of the Progress and Promotion Policy, and the Professionalism Policy and the development of an Accommodation Policy as well as a new procedure for access to student records. The committee worked with the SAC to ensure consistency of their revised policy especially around the role of Examiners’ teams.
A new committee, the Academic Affairs Committee, was created via the approval of new Terms of Reference that bring the policy-making process for student progress and promotion, professionalism, communicable diseases and immunization, student registration, leave of absence and reintegration, student awards, content of transcripts, medical student performance records , academic accommodation, complaints, ethical conduct and the content and management of student records under a single structure that includes broad stakeholder representation including students. Progress and Promotion Committee Terms of Reference were revised as well and the Professionalism Advisory Committee’s terms of reference were revised. Dr. Van Wylick listed other accomplishments, and spoke of these initiatives in progress: Student Appeal Board Terms of Reference, Criminal Records Check Policy, Awards Committee terms of reference and process review, a Communicable Disease Advisory Group and review of Communicable Disease and Immunization Policies and Attendance and Absences in Undergraduate Medicine Policy. For the full report, please see Annual Report from Academic Affairs to MD PEC_CC.
Admissions Committee Report:
Dr. Hugh MacDonald rounded off the evening with a report from the UGME Admissions Committee. He discussed the four admissions streams, the Regular Admission Stream, the Aboriginal Admissions Stream, the MD/MSc and MD/PhD Stream and the Queen’s University Accelerated Route to Medical School (QUARMS). Dr. MacDonald discussed the June 2014 Admissions Retreat where the focus was Continuation of Queen’s Medicine’s three staged process for selection (academic qualifications, personal attribute evaluation through file review and interview), and further alignment of the desired attributes for chosen Medical Students with the various elements of our selection process. Future work for the Admissions Committee includes and improved admissions process, a social accountability mandate with alignment of initiatives with the newly created Diversity Panel and in accord with the recently released Diversity Statement for the School of Medicine. For a summary of the report, please access Annual Report Admissions Committtee Summary.
John Dewey has said, “We do not learn from experience…we learn from reflecting on experience.”
Reviewing the past year was a beneficial exercise…it’s important to stop and reflect on how much has been done. So often we lose that sense of achievement and accomplishment in the busy rush of the day-to-day, and in the pressure of new work to be done. We have hard-working Directors and hard working committee members. Each of these committees reflects the work of several faculty who meet monthly in order to help our program, support our faculty, aid our students and generally help to make Queen’s Medicine the success it is. For a list of faculty who are involved in these committees, please see the Community in MEdTech for each committee.
“Learning without reflection is a waste. Reflection without learning is dangerous.”–Confucius
It’s also important to stop and reflect and to plan for the future: making informed decisions about which direction to take, pursuing goals that arose from reflective retreats, making change that benefits our program. Our committees have accomplished much but are not resting on their laurels…Already they are busy at work, with new meetings, new agendae, and new plans. It’s an exciting time of year, and an enervating group of people as partners!
Dr. Renee Fitzpatrick is the new Director of
The Greatest Generation: Our Greatest Teachers
There is, perhaps, no more common or expected site on a warm, late summer afternoon than that of a man mowing his lawn. When I came upon just such a scene during a solitary walk not too long ago, I nonetheless found it distinctive for two reasons. Firstly, the gentleman mowing the lawn was elderly. In fact, very elderly. A conservative estimate would be well past 80, closer to 90. He was also a small, thin man who seemed to weigh not much more than the lawnmower he was pushing, and had a prominent kyphosis that necessitated him raising his head in order to see forward, making the task all that much harder.
The second remarkable thing was that he was not simply mowing his own lawn, but as pushed the machine back and forth, it was apparent that he was also mowing the lawn of his neighbor.
While I was passing by, two random encounters occurred in rapid succession. The neighbor whose lawn he was mowing drove into the driveway, returning home. A lady emerged from the car, perhaps in her late 30’s or early 40’s, and after extracting a baby from a car seat hurriedly thanked and waved to the gentleman who acknowledged with a smile and dismissive wave of the hand, as if to say “think nothing of it”. She quickly disappeared into the house with her baby and packages, leaving him to the lawn.
At the same time, a young boy, perhaps 14 or 15, was walking past on the sidewalk, headphones on, deeply engrossed in whatever was playing on his device. As he passed, he actually slowed down for a moment, took off the headphones and glanced back at the scene of the lawn mowing, shaking his head briefly, and then turned back resuming his walk and his musical solitude.
I have no idea what he was thinking, or what caused him to pause, but whether it was reflection or simply irritation from the noise of the mower, that elderly gentleman somehow, unknowingly and however briefly, shook that young man from his self-imposed isolation.
It occurred to me that in that very brief scene we’d been afforded a glimpse into the characteristics of three generations, or four if you count mine.
Authors William Strauss and Neil Howe have popularized the concept of Generational Theory in their enormously popular, if controversial, 1991 book “Generations”. Fundamentally, they advance the notion that groups of people born into the same culture at about the same time are subjected to common sociologic influences and global events that serve to shape that group in a characteristic manner. In their original book and a number of follow-up works, they trace history as a series of such generational periods.
In Strauss and Howe terminology, the young man passing on the street is a Millennial (Millennials Rising: The Next Generation, 2000), born 1982-2004. The neighbour lady is a Generation X-er (1961-1981), and I am a Baby Boomer (1943-1960).
The elderly gentleman, the central focus of my brief summer encounter, is a member of what Strauss and Howe dubbed the G.I. Generation (1901-1924), but has come to be more commonly referred to as “the Greatest Generation”, a term attributed to Tom Brokaw who used it as the title of his excellent 1998 book. In his 1960 inaugural address, President John Kennedy was speaking of this remarkable group when he spoke of a generation that was “born in this century, tempered by war, disciplined by a hard and bitter peace, proud of our ancient heritage…”
These folks were born between the First World War (1914-1918) and the late 1920s. The dominant influence during their childhood was the great economic depression of the late 1920s and 1930s. Just as the depression was lifting, and as they were reaching late adolescence and early childhood, they were drawn into the global cataclysm that was the Second World War. Whether or not they were direct combatants in that struggle, the life of everyone living at that time, male or female, was affected and influenced by those events. The early and formative years of that generation was therefore characterized by struggle, joint effort against great social threats, encounters with great personal and public loss, and shared suffering. For those 12 or so million men who returned to Canada and the United States after the war, and for the families they rejoined, there was also the sense of success brought about by common effort, and a confidence in and loyalty for the society they’d struggled so hard to support. For those survivors of European countries who’d been part of the same struggle, many turned to Canada and United States as places where they could, through their own effort, earn a place for themselves and their progeny in that “great society”.
Shaped by these influences, the members of this generation are patriotic and self-reliant, taking on responsibility for earning through the efforts of one’s own labour, eschewing social assistance, but supportive of those truly in need. They did not feel the need to speak of their early war experiences or the suffering they’d encountered at that time, as touchingly described by James Bradley in “Flags of our Fathers”. They believed in family, were fiscally conservative, religious and led by example. They parented the Baby Boomers, and attempted, with variable success, to impart their values to that generation. Like the gentleman mowing his lawn of his neighbour, they are generous and address needs without being asked or thought of reward. They have a sense of duty to those who did not survive the struggles they have witnessed. In short, they endeavor to “do the right thing”.
Those still surviving are also our patients.
One of the great and unanticipated benefits of our First Patient Program at Queen’s has been to facilitate encounters between our young students and members of this special generation. In reading the reflections provided by our students, and learning of the relationships that have been formed, it’s clear that these patients have imparted invaluable insights far beyond any knowledge of their medical conditions. Here’s a sampling of “lessons learned” provided by our students:
Perhaps just as importantly for me, I found Mr. X to be an excellent mentor, who taught us that to be good physicians we must go beyond understanding a patient’s medical problems to appreciate the holistic patient experience, including social and family histories.
Being with this patient made me appreciate how much patients benefit from, and value the time that you take to educate them about their treatment and their medical condition. I will hold on to these experiences and remember how it felt for our patient on the opposite side of the healthcare system. I think that some of the experiences that I’ve had in the First Patient Program will help me shape into a more compassionate, patient, and understanding physician.
Who ever knew that old patients were so cool?
Don’t assume you know what an elderly person is capable of. Always ask
Set aside your stethoscope, and connect with your patient beyond his/her diagnosis
Talk with the patient, not at the patient. Even better, listen more than you talk, and both you and the patient will be better for it.
There are many changes associated with normal aging, but it is important to remember that these don’t necessarily represent pathology. Patients who are elderly can also be healthy, and it is essential for physicians to understand the numerous community resources that can help facilitate happy and healthy aging
A chronic illness is truly that. It is a consideration in every decision, of every day. Living with a lifelong disease requires day-to-day adjustment of plans and a lifetime with medicine by your side
Seniors can be Apple fans, too. Technology can play a huge role in helping people stay connected to the world and their loved ones, especially if they are frail and find it difficult to leave the house
I don’t know the name or personal history of the lawn-mowing gentleman I encountered that afternoon. I do know that he is part of a generation of remarkable people whose life experience was far beyond that of myself, my contemporaries, or that of our children. That afternoon, with a selfless, generous gesture and quiet example, he continues to give and to teach us what it is to care and contribute to our society.
These remarkable people who lived through two global wars are the parents and grandparents of my generation of “Baby Boomers”, who are now involved in the education and leadership of these emerging, highly talented and technologically sophisticated “Millennials”. When I was in elementary school, I recall that each Remembrance Day veterans would visit our classrooms, dressed in their dark blue jackets, berets and decked out with medals. They were soft spoken and sombre, never glorifying themselves or their war exploits, but rather trying to express their respect for their fallen colleagues. The word that kept creeping into their dialogue, and the word I still recall so many years later, was “sacrifice”. Those gentlemen were veterans of the First World War, and are no longer with us. Soon, our Second War veterans will also be gone. Let us listen and learn from them while we have the opportunity.
Lest we forget.
Anthony J. Sanfilippo, MD
Undergraduate Medical Education