Aesculapian Society Students Represent their Peers in Many Ways

A few days ago, the student representative for the First Patient Program wrote to ask if we would like him to touch base with his classmates before our next session with them. He even had the feedback survey questions designed! How helpful and proactive this is. And this made me think: our meds students and our Aesculapian Society are extremely supportive of and committed to our Undergraduate Medical Education Program.

In this article, I’d like to write a huge “Thank You” note to the students in our Queen’s Aesculapian Society!

The Aesculapian Society (AS) was first organized by the medical students of Queen’s University in 1872, and has remained a strong voice for Queen’s medical students ever since. All students registered in the School of Medicine become members of the Society, which includes as honourary members, all graduates in Medicine and members of the School of Medicine at Queen’s University.

The Society is dedicated to the promotion of the general interests of the School of Medicine and to the control of matters affecting medical students in their relationships to one another, to other student organizations at Queen’s and elsewhere, and to the School of Medicine, Senate, and other governing bodies of Queen’s University.

While the AS is active in working with its members in many ways, I wanted to talk about the work of AS student representatives on the Undergraduate Medical Education (UGME) Committees and in advising and acting on UGME programs.

Aesculapian Society student representatives sit on all of our UGME Committees (and there are over 11!) including Curriculum Committee, Admissions Committee and Student Assessment Committee. Many students sit on more than one committee providing a very thoughtful and important voice for students and voting on key issues. In some committees there are often 3 or more representatives, (one for each year of meds school), and in the case of the UGME Teaching and Learning Committee, currently 7 students are representatives, as there are 4 student monitors who track learning event types for our annual reports in addition to the three students representing preclerkship and clerkship.

Appointed student representatives for each class meet, often weekly, with Course Directors to give them feedback about the course, including Clinical and Communication Skills as well as all other courses. Our Technology representatives podcast classes, and also are there to spring to the aid of faculty when struggling with technology.

We also have student representatives for programs. For example, there is that representative for the First Patient Program who started this article, who will help us plan our final event of the program, and who is poised to give us feedback on the program as it is unfolding for the students. We have student Competency Reps, usually two for each competency/role, who work with the Competency Leads and plan events and strategies related to that competency, and funnel student feedback to the Leads.

In fact students are also involved in the accreditation process, including the self-study which is mandated by all schools, and also in tours and dialogues and discussions with accreditation visitors. Our students have impressed our accreditation visitors over the years!

Queen’s medical students run the Orientation Week for new students in the fall with the first year class council and Vice President coordinating it. Students are also heavily involved in the Admissions Weekends for the MD program. In first year, the students are ambassadors to the new students as well as making those great videos that have gone viral in many years. In second year, the students assist with the interview process and admissions process. Conservative estimates put 80% of the students involved in Admissions work.

The point of this is twofold: Queen’s Medical School has a tradition of listening to its students, even in the highest committees, and seeks their representation out actively. Not only do those leaders in the school listen, they take often act on the student concerns, suggestions and proposals.

But my main point today in writing is to laud the active participation, and willingness to serve that is a part of many many students enrolled in Queen’s Meds and serving on the AS. These students are giving precious time taken from study and sleep to give to their school. To me, they are already demonstrating the competencies of a good physician, in their collaboration, in their communication, in their advocacy, and in their management of time and energy. They are demonstrating their commitment to be part of solutions rather than problems, and they are demonstrating the importance of service. We are fortunate to have such a committed group to help us in our school. So Thank You! to the Aesculapian Society Executive and all its student members!

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Your new curriculum committee – would you like to nominate someone to join?

As of September 2013, the UGME Curriculum Committee is operating under new Terms of Reference, and, as a result, we are looking for new members.

Specifically, we have 5 “nominated” positions;  the Curriculum Committee’s decision was to seek nominations from the faculty at large for these positions, in addition to asking curricular leaders and curriculum committee members for nominations.  For more on these positions, see below.  To nominate, send to the Acting Chair, Dr. Michelle Gibson at gibson@queensu.ca.

These positions are:

  • Scientific Foundations Course Director (from our basic sciences courses)
  • Clinical Foundations Course Director (from our pre-clerkship clinical courses)
  • Clerkship Course Director (from any of the clerkship courses)
  • Competency Lead (From the Professional Foundations committee)
  • Discipline Lead (A discipline lead from any discipline)
  • Humanities Lead – Dr. Cheryl Cline has accepted this position.

The Curriculum Committee meets on the 2nd and 4th Thursdays of the month, from 4:00 to 6:00 p.m, from September to June, with monthly meetings in July and August.

The rest of the committee members are present as a direct result of a specific role they play in the curriculum.  There are vacancies here too, as the new terms of reference specify that no one person can represent two positions on the curriculum committee.  We are working to fill these vacancies. Currently, the membership includes:

  • Director, Curriculum – Vacant
  • Associate Dean, UME – Dr. Tony Sanfilippo*
  • Year 1 Director and Acting Chair – Dr. Michelle Gibson*
  • Year 2 Director – Dr. Lindsay Davidson*
  • Clinical Clerkship Director – Dr. Andrea Winthrop*
  • Clerkship Curricular Courses Director – Dr. Susan Moffatt
  • Clinical Skills Director – Dr. Cherie Hiscock-Jones
  • Chair, PF Committee – Vacant
  • Director, Student Assessment – Dr. Michelle Gibson*
  • Director, TLIC – Dr. Tony Sanfilippo*
  • Director, CFRC – Dr. Andrea Winthrop*
  • Manager, Educational Development and Faculty Support – Ms. Sheila Pinchin
  • Aesculapian Society representative – Elizabeth Clement (Meds 2016)

*Currently, in this transition period, all these individuals are representing two roles, and they are in the midst of seeking delegates for one of their roles.

Nominations will be accepted until October 29, 2013.  The process after that date is to discuss nominations with the individuals concerned.  MD-PEC will be appointing the nominated members in November.

Questions can be directed to the Acting Chair, Dr. Michelle Gibson at gibson@queensu.ca

 

 

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Curricular Council meets Oct. 29

The Curricular Council for Undergraduate Medical Education meets Oct. 29 at the University Club, from 4:30-6:00. RSVP notes have been sent out to Curricular Leaders. Topics for discussion will include the new governance structure for UGME, an update on accreditation, best methods of communicating with all faculty, new electronic exam format, and upcoming professional development opportunities. Slides from the Curricular Council will be posted for all on the Faculty Resources website in MEdTech: https://meds.queensu.ca/central/community/facultyresources

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Not your Father’s (or Mother’s) Clinical Clerkship

Meds 2015 students get their white coats and begin the contemporary Clinical Clerkship 

This week, the students of Meds 2015 begin the phase of medical education still referred to as the Clinical Clerkship.  Last Friday afternoon, family and friends joined them to celebrate the White Coat Ceremony, a longstanding tradition that marks this important transition.  It was a pleasure to meet many family members, some of whom were physicians who remarked on the changes between their own educational experiences and those of their offspring.

white-coats

The need to provide supervised learning within the clinical setting has always been regarded as essential to the development of future physicians.  Indeed, early versions of medical education consisted entirely of what could only be termed apprenticeships under the direction of a fully qualified physician who was engaged by the student as their tutor, mentor and assessor.  It was largely as a result of Abraham Flexner’s (pictured) transformational 1911 review of medical education in North America that medical schools were required to provide formal instruction in the basic and medical sciences.  However, Flexner continued to emphasize the critical role of education within the context of clinical service.  flexnerThe role of medical students within service delivery, largely in hospital settings, became consolidated into the discrete role that came to be known as the Clinical Clerkship.  Being a “Clerk” was to have a job or role within the hospital’s complex service delivery.  The role consisted of “clerking” patients (carrying out admission histories and physicals), following the progress of patients through their hospital stay, arranging and following up on investigations, and coordinating discharge and post hospitalization follow-up.  In addition, Clerks had unofficial but widely accepted service delivery roles of their own within hospitals, including phlebotomy, administering intravenous medications, performing simple procedures such as Foley catheter insertion and cast removal, simple suturing and recording electrocardiograms.  Appropriately supervised and monitored, this role provided opportunities to engage patient care in all its complexity in a transitional fashion, leading eventually to the ability to engage patient care independently after graduation.  The service delivery component of the clerkship was eventually recognized as such with the provision of a modest stipend, which continues today.  Interestingly, the role of the Clerk varied very little between services, specialties and differing patient populations, the goal being to develop strong foundational skills in patient assessment and management, which were felt to be consistent and “learnable” within any patient care context.

As the “service” component of the clerkship grew and hospital care became more procedurally driven, understandable concerns were raised regarding the balance between service delivery and education.  Medical educators, buttressed by increasingly specific and prescriptive accreditation standards, developed standards and objectives for the medical student role, coupled with a need for more structured and objective assessment.  At the same time, our students were developing an increasing need to use clerkship experiences to explore career options in an increasingly complex and competitive postgraduate training environment.

Today’s clinical clerkship has evolved considerably from the model experienced by most mid or late career practitioners.  Now usually consisting of the final 2 years of medical school, it is intended to provide clinical exposures that vary not only in focus but also in setting, recognizing the reality that our students have a critical need to explore career options and to encounter patients in a variety of settings that will reflect their own career paths.  The rotations are enhanced with formal educational experiences, formalized feedback on all curricular objectives, and structured assessments of various types.  To illustrate the modern clerkship, the following example profile is provided to illustrate the journey of one medical student through a clerkship:

  • A six week General Surgery rotation on an in-hospital unit at either Kingston General Hospital or our affiliated teaching hospital in Oshawa.
  • A six week Peri-operative Medicine rotation rotating through a series of experiences with surgical subspecialties (such as Plastics, Orthopedics, Urology), Anaesthesia and Emergency Medicine.
  • Six weeks on Core Internal Medicine spent as part of the care team assigned to a Clinical Teaching Unit in Kingston, Oshawa or Peterborough.
  • A further six weeks on Specialty Medicine spent undertaking consultation or out-patient clinics within three medical sub-specialties.
  • Six weeks of Psychiatry in Kingston, Oshawa or Markham, generally office or consultation- based.
  • Six weeks of Family Medicine working with a community family physician or Family Health Team.
  • Six weeks of Pediatrics, provided in either a hospital ward or community practice.
  • Six weeks of Obstetrics and Gynecology, consisting of shifts in Labour and Delivery, gynecology ward, or outpatient clinics.
  • Sixteen weeks of electives, during which the students a series of 2 week experiences in specialty services and locations across Canada designed to broaden their clinical experience and exposure to career options.
  • Three 4 week “Core Curriculum” rotations placed at the beginning, within and at the end of the clinical rotations, intended to provide common instruction and assessment in advanced topics and practice related instruction.

All these rotations feature, in addition to the clinical experiences, structured teaching, all guided by objectives linked to the overall Curricular Goals and Competency Based Objectives document which was developed and is regularly reviewed by our Clerkship Committee and approved by the Curriculum Committee. 

In addition, students can elect to undertake our Integrated Community Clerkship, consisting of an 18 week placement within a smaller community working with community tutors and Family Health Teams, intended to provide longitudinal experiences in Family Medicine, Pediatrics and Psychiatry.

Students can also apply for an increasing number of International exchanges which allow them to undertake a core rotation at universities in another country.

All rotations feature content relevant to the various Professional Competencies (Professionalism, Advocacy, Collaboration, Management) and their achievement in these domains is a component of rotation assessments.

All students continually log their clinical experiences and technical procedures in order to ensure all learning objectives are being met.  They also undertake comprehensive structured clinical examinations (OSCEs) in order to ensure core clinical skills are mastered and maintained.

So…a far cry from the service dominated Clinical Clerkship so familiar to most practicing physicians.  A key, and very reasonable question could be posed: Does it matter?  Are our students better prepared for the demands and rigours of residency and practice than their predecessors?  This intriguing question will be the subject of my next Blog.

 

 

 

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Upcoming dates for Undergraduate Medicine at Queen’s

Curricular Council: Dr. Sanfilippo is calling meetings of the Curricular Council on the following dates at 4:30 p.m.
Oct. 2, Jan. 22 and May 14.

Professional Development Days for Curricular Leaders: There will be a full day Professional Development retreat for Curricular Leaders on Friday Nov. 22 and Friday, June 13.

Stay tuned for more details, sent via email.

Writing for Health Care Providers Workshop: Carrying on the theme of narratives in medicine, so ably begun by Dr. Lam at the HG Kelly address, please note that Dr. Hilton Koppe is presenting a writer’s workshop “Beyond the Medical Record: Creative writing as burnout prevention for health professionals” on Oct. 16, 1:30-5:00 at the Bracken Library. Please see attached folder for more details.
Please contact The Office of Faculty Development at fac.dev@queensu.ca to sign up.

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Upcoming dates for Undergraduate Medicine at Queen’s

Curricular Council: Dr. Sanfilippo is calling meetings of the Curricular Council on the following dates at 4:30 p.m.
Oct. 2, Jan. 22 and May 14.

Professional Development Days for Curricular Leaders: There will be a full day Professional Development retreat for Curricular Leaders on Friday Nov. 22 and Friday, June 13.

Stay tuned for more details, sent via email.

Writing for Health Care Providers Workshop: Carrying on the theme of narratives in medicine, so ably begun by Dr. Lam at the HG Kelly address, please note that Dr. Hilton Koppe is presenting a writer’s workshop “Beyond the Medical Record: Creative writing as burnout prevention for health professionals” on Oct. 16, 1:30-5:00 at the Bracken Library. Please see attached folder for more details.
Please contact The Office of Faculty Development at fac.dev@queensu.ca to sign up.

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Facilitating Millennials’ Learning

Welcome to our class of Meds 2017! Dr. Sanfilippo talked about our incoming class of 2017 medical students in our last blog.

I thought those of you preparing to teach this class, and our other classes in undergraduate medicine might appreciate the great ideas from an article called Twelve tips for facilitating Millennials’ learning by David H. Roberts, Lori R. Newman and Richard M. Schwartzstein of the Harvard Medical School, published in “Medical Teacher”.

Now the discussion about Millennials is not new: Millennials refer to students who turned 18 in 2000 and entered college or the workforce as defined by Howe & Strauss in 2000. Since then there have been many articles, texts and videos that outline what the characteristics of a Millennial are.

And, while the characteristics of Millennials have some new traits, they share traits with all of those learners who have come before them. However, there are some key factors that distance them from their teachers, and therein lies the crux of this article and the really great advice the authors offer. Millennials are influenced by and influence technology so much more than their teachers who are usually Baby Boomers or those from Generation X. Millennials have not experienced global economic stability, have lived through “9/11” and other terrorist threats, have experienced what to their teachers are novel ways of communication (email, social media, cell phones) and the ubiquitous nature of online technology. The article has some very provocative characteristics of Millennials from several studies.

The authors have 12 key tips for teachers and they range from educating ourselves about the concept of generational differences to recognizing the environmental and cultural forces that affect the Millennial learner, from recognizing the importance of team dynamics and encouraging collaboration to identifying the limits of multi-tasking.

Here are a few of the strategies the authors use to help us as teachers bridge any gap with our students. These tips are useful, frankly, no matter who your learners are.

For example, with the overwhelming power of the Internet at their fingertips, for Tip 4, “Millennials need guidance and focus in their learning” , these strategies are offered:
1. Remind learners to focus on the “why, how, and in what context”
2. Avoid asking students to list or identify specifics (answers easily found with an Internet search), and encourage students to apply knowledge through problems that require critical thinking
3. Help learners prioritize and identify the context in their learning

To help learners form a connection to you and see the relevance of your teaching, for Tip 5, “Identify your teaching or life philosophy,” here is one of three suggestions: Always introduce yourself to your learners and provide details on your background and path to your current role.

For Tip 7, “Recognize that Millennials value (and expect) aesthetically appealing educational presentations,” one strategy is to ask colleagues or invite students to review your slides or curricular materials and provide feedback and suggestions as you learn to embed video, create interesting slides, etc.

For Tip 8, “Emphasize opportunities for additional help and support”, there are 4 strategies that I would advocate with any learner:
1. Post directions, reading assignments, and a list of available resources on a website that students can easily access
2. Establish “office hours” when a student can drop by to discuss a concern
3. Directly observe student performance and provide specific feedback
4. Provide structure to learning activities and set specific achievable targets for learners (e.g., “By the end of this 3-month internal medicine block, you will be able to perform a complete history and physical on 2 new patients per session.”)

For tip 12, “Identify the limits of multi-tasking,” I have to highlight this excellent strategy from the authors: Ask students to complete The New York Times online test “How Fast You Juggle Tasks” (Ophir & Nass 2010, to measure how fast they can switch between tasks and discuss their results and how multitasking may affect patient care.

As we begin our new academic year, and another group of “Millennials” are in front of us and beside us in learning, it’s good to think about the key question a good teacher always asks: “Who are my learners?” While you may not subscribe to the characterization of generations, it’s always best practice to get to know your learners, how they may be similar to and different from you, and to consider strategies to make the learning relevant to them.

I offer my best wishes for a very successful year to the teachers and the students both here at Queen’s and elsewhere, and, as always, look forward to hearing from you.

Featured Article:
Roberts, David. H., Newman, Lori R., Schwartzstein, Richard M. (2012). Twelve tips for facilitating Millennials’ learning. “Medical Teacher”, 34, 274-278.

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Facilitating Millennials’ Learning

Welcome to our class of Meds 2017! Dr. Sanfilippo talked about our incoming class of 2017 medical students in our last blog.

I thought those of you preparing to teach this class, and our other classes in undergraduate medicine might appreciate the great ideas from an article called Twelve tips for facilitating Millennials’ learning by David H. Roberts, Lori R. Newman and Richard M. Schwartzstein of the Harvard Medical School, published in “Medical Teacher”.

Now the discussion about Millennials is not new: Millennials refer to students who turned 18 in 2000 and entered college or the workforce as defined by Howe & Strauss in 2000. Since then there have been many articles, texts and videos that outline what the characteristics of a Millennial are.

And, while the characteristics of Millennials have some new traits, they share traits with all of those learners who have come before them. However, there are some key factors that distance them from their teachers, and therein lies the crux of this article and the really great advice the authors offer. Millennials are influenced by and influence technology so much more than their teachers who are usually Baby Boomers or those from Generation X. Millennials have not experienced global economic stability, have lived through “9/11” and other terrorist threats, have experienced what to their teachers are novel ways of communication (email, social media, cell phones) and the ubiquitous nature of online technology. The article has some very provocative characteristics of Millennials from several studies.

The authors have 12 key tips for teachers and they range from educating ourselves about the concept of generational differences to recognizing the environmental and cultural forces that affect the Millennial learner, from recognizing the importance of team dynamics and encouraging collaboration to identifying the limits of multi-tasking.

Here are a few of the strategies the authors use to help us as teachers bridge any gap with our students. These tips are useful, frankly, no matter who your learners are.

For example, with the overwhelming power of the Internet at their fingertips, for Tip 4, “Millennials need guidance and focus in their learning” , these strategies are offered:
1. Remind learners to focus on the “why, how, and in what context”
2. Avoid asking students to list or identify specifics (answers easily found with an Internet search), and encourage students to apply knowledge through problems that require critical thinking
3. Help learners prioritize and identify the context in their learning

To help learners form a connection to you and see the relevance of your teaching, for Tip 5, “Identify your teaching or life philosophy,” here is one of three suggestions: Always introduce yourself to your learners and provide details on your background and path to your current role.

For Tip 7, “Recognize that Millennials value (and expect) aesthetically appealing educational presentations,” one strategy is to ask colleagues or invite students to review your slides or curricular materials and provide feedback and suggestions as you learn to embed video, create interesting slides, etc.

For Tip 8, “Emphasize opportunities for additional help and support”, there are 4 strategies that I would advocate with any learner:
1. Post directions, reading assignments, and a list of available resources on a website that students can easily access
2. Establish “office hours” when a student can drop by to discuss a concern
3. Directly observe student performance and provide specific feedback
4. Provide structure to learning activities and set specific achievable targets for learners (e.g., “By the end of this 3-month internal medicine block, you will be able to perform a complete history and physical on 2 new patients per session.”)

For tip 12, “Identify the limits of multi-tasking,” I have to highlight this excellent strategy from the authors: Ask students to complete The New York Times online test “How Fast You Juggle Tasks” (Ophir & Nass 2010, to measure how fast they can switch between tasks and discuss their results and how multitasking may affect patient care.

As we begin our new academic year, and another group of “Millennials” are in front of us and beside us in learning, it’s good to think about the key question a good teacher always asks: “Who are my learners?” While you may not subscribe to the characterization of generations, it’s always best practice to get to know your learners, how they may be similar to and different from you, and to consider strategies to make the learning relevant to them.

I offer my best wishes for a very successful year to the teachers and the students both here at Queen’s and elsewhere, and, as always, look forward to hearing from you.

Featured Article:
Roberts, David. H., Newman, Lori R., Schwartzstein, Richard M. (2012). Twelve tips for facilitating Millennials’ learning. “Medical Teacher”, 34, 274-278.

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Meds student Joe Gabriel completes his ride

On June 5, I wrote about Queen’s Meds 2015 student Joe Gabriel and his ride across Canada. Joe was riding across Canada to benefit a series of 10 small charities (one in each province).http://meds.queensu.ca/blog/undergraduate/?p=635

Well, Joe’s completed his ride. He’s in Halifax and has raised almost $3000.00 of the $10,000 he’d hoped for. http://www.cyclingforcanada.org/

joe gabriel 3

Joe is a great example of the physician as advocate in action. He has taken on some extremely worthwhile focused causes that all contribute to quality of life of people in each province. From Native housing to recycling bikes for those in need to a music program for at-risk youth to pay-what-you-can transportation services for medical visits, Joe has taken the concept of determinants of health and made them real. Here are descriptions of all 10 charities that Joe was riding for: http://www.cyclingforcanada.org/?page_id=15

We here at Queen’s Undergraduate Medical Education support Joe and are donating to his causes. Can Joe count on you too?

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Planning for the upcoming academic year? Here are some resources that you may find useful

The beginning of the academic year 2013/14 is drawing near. You may have already begun to plan for your course or sessions. If you’re in a planning mood over the next few weeks, here are some resources that may help you:

Curricular Coordinators:: Our UGME Curricular Coordinators assist with all operational aspects of your teaching: putting the timetable into MEdTech, assisting with your session page, helping to build quizzes and RATs, and a host of other activities. They are:
Zdenka Ko: Year 1: zk@queensu.ca, ext 77804
Tara Hartman: Year 2: tara.hartman@queensu.ca, ext. 79546
Candace Miller: Clerkship Core Academic Courses (“C Courses”): candace.trott@queensu.ca, ext. 74102
Jane Gordon: Clerkship Clinical Courses, ugme.clerkship@queensu.ca, ext. 75162

The Educational Development Team (Education Team) at Undergraduate Medical Education: We are:
Sheila Pinchin, Educational Developer, assisting with curriculum planning, clerkship teaching and learning, and teaching about physicians’ intrinsic roles through Professional Foundations
sheila.pinchin@queensu.ca, ext. 78757
Theresa Suart, Educational Developer, assisting with planning and observations for years 1 and 2 in medical school and for QuARMS (Early Entry Program) theresa.suart@queeensu.ca, ext.75485
Eleni Katsoulas, Assessment and Evaluation Consultant, assisting with assessment planning in all years, and planning and analysis for OSCEs eleni.katsoulas@queensu.ca ext. 78094

Here are some resources you may find helpful:

In MEdTech, we have placed many of our curriculum documents and ideas for you in our Faculty Resources Community:
https://meds.queensu.ca/central/community/facultyresources

Don’t feel you have to plan alone! Give one of us a call or email to help out.

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