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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When is an hour only 50 minutes?

This blog post is part of the series of periodic updates from UGME committees.

Have you looked at your teaching or learning schedule recently? You know those hour-long and two-hour long blocks? They’re a bit misleading.

We’ll admit it, we’re part of the problem since we routinely talk about hour-long and two-hour-long classes. The reality, however, is that our class blocks are really divided into 50 minutes for class and 10 minutes for a break. If you’re teaching a two-hour block, that first 10-minute break can be a little flexible about where it lands, but for finish times, it’s vital to stick to the end at 20 minutes past the hour rule.50min_icon_cyan-01

What are those 10 minutes for? That’s actually time for the next instructor to get set up, so they’re ready to start on time. Time for folks to grab a coffee or hit the washroom – or check their Facebook or email. It’s also the 10 minute traveling time from room to room. This hasn’t always been much of an issue for our medical students, but it’s more important than ever as we cope with the classroom disruptions because of the flood in the Medical Building in August.  Often, our students are now moving between farther-flung campus buildings for back-to-back classes – those 10 minutes are golden.

If you’re concerned about how to plan your lecture or SGL or other learning event with timing in mind, get in touch with the Educational Development team. We’re happy to help with plotting out sufficient flexibility so you can finish on time without missing out on essential instruction. (Email Theresa Suart at theresa.suart@queensu.ca)

Integrated Threads

The Curriculum Committee recently approved the TLIC proposal to map a series of “Integrated Threads” through the UGME curriculum. Integrated Threads represent important domains of learning for medical students that span multiple courses, terms and academic years.  These may represent disciplines (e.g. genetics, geriatrics, imaging, pathology), competencies (e.g. communication, leadership) or other defined groupings (e.g. patient safety, diversity) which contribute to the attainment of the skillset of a graduating physician.

queen's tartan fabricThe aim in mapping Integrated Threads is to clearly articulate where particular topics occur and re-occur through our curriculum. It will help guide both learners and instructors in expectations and achieving learning objectives. Some integrated threads have an “anchor” unit within a course with other related material taught elsewhere throughout the curriculum (for example: Genetics). Others don’t have an identified unit, but are taught in relation to other material throughout the four-year UG program (for example: Imaging).

The inaugural Integrated Threads list – also approved by the Curriculum Committee –  includes 28 distinct topics.  Over the next academic year, TLIC will be working with faculty and the Education team to map existing curricula and identify opportunities for enhanced teaching of each topic. The Integrated Threads list will be reviewed on an annual basis.

The TLIC will keep you posted as the Threads are identified and mapped. Faculty who would like to suggest additions to the Integrated Threads list should contact the TLIC Chair, Dr. Lindsay Davidson (lindsay.davidson@queensu.ca) or the Educational Development team.

 

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Medical Student Research Showcase

By Dr. Heather Murray and Dr. Melanie Walker
Scholar Competency Team

Queen’s School of Medicine is proud to host the 4th Annual Medical Student Research Showcase on September 22, 2015. This event offers opportunities for medical students engaged in extra-curricular research activities to showcase their work in posters displayed in the School of Medicine Building. These posters will be displayed all day during the 22nd, and students will be standing at their posters and discussing their work from 10:30 until noon in the David Walker Atrium of the School of Medicine Building.

It is also an opportunity to celebrate excellence in the form of an oral plenary session, which will feature the top 3 student projects as selected by a panel of faculty judges.

Showcase 3This year’s faculty judges include:

  • Dr. Anne Ellis
  • Dr. Rob Brison
  • Dr. Tanveer Towheed
  • Dr. Paula James
  • Dr. Jennifer Fleming
  • Dr. Gordon Boyd

We are very grateful to have these experienced researchers evaluating our oral plenary applicants. Showcase 2

The three students selected by the faculty judges to present at the oral plenary beginning at noon will each receive an Albert Clark Award for Medical Student Research Excellence. Their names and project titles, along with their faculty supervisors, are listed below in alphabetical order:

  1. Steven Alexander Hanna: Extended sensory blockade using a hydrogel combined with bupivacaine. Supervisor: Dr. Gregory H. Borschel
  2. Sophie Palmer: A cross-sectional survey of reproductive-aged women’s willingness to participate in medication or vaccine research trials during pregnancy. Supervisors: Dr. Robert Reid & Dr. Graeme N. Smith
  3. J. Connor Wells: Repurposing off-patent drugs in the treatment of cancer: the ongoing story of disulfiram. Supervisor: Dr. Stephen Robbins

We look forward to seeing you in the School of Medicine Building on September 22nd to celebrate the outstanding research achievements of our students.


Check back here on Tuesday afternoon for updates and pictures from the event!


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Dr. Melanie Walker, Dr. Heather Murray, Steven Hanna, Sophie Palmer, J. Connor Wells, and Dr. Albert Clark following the Showcase Plenary on Tuesday.

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A tale of two sports, a 7-year-old, and how we train doctors

By Michelle Gibson, MD, MEd, CCFP

Director, Year 1
Director, Student Assessment

Fall is a time of transition in many ways. In the land of Undergraduate Medical Education, our 4th year students are facing up to the joys and pains of the CaRMS process, our 3rd year students are anxiously and excitedly contemplating starting clerkship, our 2nd year students are returning to class as experienced students, and we have a whole new crop of 1st year students arriving to engage our curriculum.

In my main job (co-parent to a 7-year-old), it’s the time of year when soccer finishes, and skating starts up (and, of course, the fun and perils of Grade 2 must be addressed).

In the land of 7-year-old sport, as skating is about to start, there is a certain dread that I once again have to bundle up on a beautiful fall day to stand in a cold arena listening to (at times) dreadful music that we know will be played over and over all year long.   The 7-year-old adores skating, though, and looks forward to each new ribbon or badge, and a report card outlining the skills he has acquired over the year. These are proudly displayed in his room. He jumps at every opportunity to skate, including in the middle of a heat wave in August.

While the outdoor soccer venue is generally much nicer for parents (except when we get to encounter Kingston’s weather extremes), it is, for me, fraught with frustration about how my child is supposed to learn soccer, which is a universe away from the approach in skating.

This year, I vowed I would try to be analytical about the differences (versus getting frustrated and emotional, which is the natural parenting reaction), so as to help my kiddo, who really, really likes soccer, but who gets upset because he can’t play as well as he would like, and can’t figure out why.  kids' soccer

In soccer, the theory seems to be that if you find someone who knows how to play soccer, and they volunteer to show kids how to play, kids will learn—even if the much-appreciated volunteer has been given no guidance about how to teach the eager young Padawan. In practical terms, in our experience, this has meant having the kids do drills for 30 minutes, and then having the kids play a game. Somewhere in there, they are supposed to learn soccer. The skills are simple, right? You just run, and kick the ball. How hard can that be?

I have been to about 90% of the practices & games, and I have only rarely seen the kids being shown how to do something. My child has never been taught how to approach a game, even at a very basic level, except that he knows the point is to get goals. He knows that he should pass the ball and he generally understands why this is a good idea, but since he can’t quite figure out how to get the ball passed to him, this is not very helpful at present.

The boy can kick a ball, of course, and he improves a bit yearly, but no one has shown him how to control the ball at soccer practice. Fortunately for us, he loves soccer, and despite all of this, he plays with enthusiasm but not much skill. Other kids have real skills—possibly because their parents were actually taught how to play soccer, so they teach them, or, because they had different coaches over the years.  As the boy ages, he gets more and more aware of the skills differential, and doubt is starting to creep in.

Contrast this to skating. From the first day of his first skating class (with the same child:coach ratio), he was taught HOW to skate, by a certified coach. There was a nice clear list of skills he needed to master before moving up a level. In pre-skate, one key skill is getting up from the ice. (I like that one in particular.) Having moved up to the “real” skating lessons, he works on different skills at three different stations at each lesson. As he masters the skills in any one station, he will get a ribbon, and move up a level.

My child responds to this, and so, having also been born with reasonably good balance, he has moved up the levels quickly, often skating with older kids. Some skating Lessons2skill sets are harder for him, so he might be working on level 5 in ‘agility’ but only level 3 in ‘control’. Anytime he struggles with a skill and he can’t work it out himself, a coach will spend a few minutes watching him and then working with him on the skill. Each group has a teenaged program assistant who also helps show the kids how to do the skills. The report card we get each term has this all laid out for us, and we as parents can help him to know what skills he should work on (spirals, anyone?) to complete his current level.

The parallels to medical education are obvious to me. My medical education, and my clerkship in particular, was much very similar to the soccer approach: here’s some basic info, now go out there with practicing physicians, who have likely never learned how to teach, and, well, absorb it all and figure it out.  If you found a resident, or other clerk, or a nurse who could show you how to do something, or who would explain why something was being done, it was a golden day.  I don’t think this was very different than what most clerks of my era experienced.

Now, I will admit I learned a lot, and, I dare say, I was a good clerk—most of the time. My friends and I banded together, and taught one another. We passed on tips as one of us exited a rotation and the other one started. I definitely remember those days of not knowing what to do, being told to do it, and then not knowing why or how to do it. It wasn’t pretty. Some rotations were worse than others.

Skating lessons are much more in line with competency-based education. Our medical students crave clear directions, and clear instructions. The expectations are high but achievable, if they are clear, and feedback is provided. For some students, it’s easier (but never easy), and they are fortunate, and still deserve good teaching, assessment and feedback so they can improve. Other students really benefit from more explicit descriptions of what is expected, and feedback about what they need to do to meet these expectations. In my experience, most students welcome clear, high, but achievable expectations, in a supported environment. Learning medicine will never be easy, but we should not make things harder by just dropping them into an environment and hoping they figure out how to get the clerkship ball, so to speak.  A few minutes of direct observation can help me determine where a student is struggling, and I can provide feedback—something I am (mostly) comfortable with, having benefited from many hours of faculty development and good mentors.

As we enter fall, the boy’s soccer medal has joined his collection, and he is anxiously awaiting the beginning of skating in a few weeks. I am not looking forward to the hours in the cold rink, but I know my frustration level will be significantly decreased. I’ll be ready and happily working with all the students in our curriculum, but I’ll work hard to ensure that our new clerks, in particular, do not feel like a somewhat lost soccer player in the middle of a field, knowing they want to be there, but not actually knowing where the ball has gone.

Welcome to clerkship, #QMed2017. I look forward to seeing you on the wards, and remember to have fun!

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Put your own oxygen mask on first: Helping medical students develop good self-care habits

By Janet Roloson, M.Ed., Chartered Psychologist

When you are on an airplane, you may have noticed how the flight attendant instructs you to put your own oxygen mask on first before assisting others. This is important because if you run out of oxygen, you cannot help others with their oxygen masks – or with anything else. The same general principle applies to self-care in any context. Research suggests that good habits of self-care may begin to suffer in medical school; the pace and pressure of work can “push” self-care off to the side of a medical student’s priority list. In the longer term, the self-care habits medical students employ can also influence their performance as physicians. Taking good care of oneself is a central foundation for being able to provide good care to one’s patients (Ball & Bax, 2002).

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Janet Roloson

If you are feeling as though you are treading water in medical school, you are not alone. Virtually all students will experience significant stress and pressure during their time in medical school; in some cases, this can develop into anxiety or depressive symptoms. This can interfere with a student’s ability to function effectively, and may prevent them from achieving at their full potential.

My name is Janet Roloson and I am the designated counsellor for The School of Medicine. My office is located with Health, Counselling, and Disability Services (HCDS) in the LaSalle Building on the second floor.

I am employed to offer counselling to medical students and residents; my affiliation is with HCDS. As such, services are offered at an arm’s length from the School of Medicine for the purposes of maintaining anonymity and confidentiality.

I am an experienced psychologist and I offer a range of services. These include evidence-based approaches for treating anxiety disorders, depression, and other diagnosable mental health issues; I also see many students who may not have a mental health problem, but who are experiencing difficulties/stresses which disrupt their functioning. Counselling may also be conducted in combination with psychotropic medications, prescribed by your physician. Students may also be referred to a physician or psychiatrist (in HCDS) if they are wishing to explore this possibility.

It is important to highlight that therapy is not exclusive to those with a mental health problem. If you are working to develop good habits and maintain healthy self-care strategies I’d be happy to see you to help with this process. As we all know, preventative measures are important to both overall physical and mental health. It is not necessary to wait on problems because they are not “big enough” or because “others need counselling more than me.” Dealing with smaller issues may assist in the prevention of more firmly-established and undesirable habits, plus anyone can benefit from counselling.

Some common examples of areas in which students may benefit from receiving further support include: procrastination, increasing motivation, perfectionism, establishing healthy boundaries, family issues, self compassion, dealing constructively with difficult feedback, disordered eating, grief, sexual identity, and relationship issues. Sessions are client-driven and one session may be all that is needed.

If you wish to schedule an appointment, contact Counselling Services at 613.533.6000 ext. 78264 or counselling.services@queensu.ca and request an appointment with Janet. Therapy is available free of charge. Hours of availability are M, W, F 10:00 am-3:30 pm & T, Th 11:00 am-7:00 pm. Lunch appointments are also available from 12:30-1:30. Additionally, sessions are also available virtually or via phone for those who are unable to attend sessions in person. One initial face to face session is often preferable prior to scheduling these alternatives. For those who may prefer a self-help approach, the following self-help workbooks are free and accessible online: http://www.queensu.ca/hcds/workbook.php.

Good2Talk is another resource that is available 24/7/365 at 1.866.925.5454 or good2talk.ca. It is a toll free number funded through the provincial government that offers free, professional, and confidential support.

Ball S, Bax A. Self-care in Medical Education: Effectiveness of Health-habits Interventions for First-year Medical Students. Acad Med 2002; 77: 911-7.

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