2nd Annual Medical Student Research Showcase

Queen’s School of Medicine is proud to host the 2nd Annual Medical Student Research Showcase on September 26, 2013. This event has been designed to offer opportunities for medical students engaged in summer research activities to showcase their work in posters displayed in the School of Medicine Building, and to celebrate excellence in the form of an oral plenary session. This plenary session, moderated by Dean Reznick, will feature up to three outstanding submitted projects, each delivered in a ten minute oral presentation. The students selected for the oral plenary and the top student poster presenter, as adjudicated by a judging panel, will jointly receive the Albert Clark Award for Medical Student Research Excellence.

The conference organizers are pleased to announce the development of a **NEW** Medical Student Research Showcase Community accessible via MEdTech. Here you will find all important information regarding the research showcase. We have also implemented a new electronic system for all abstract submissions. We encourage you to visit the new community regularly to stay up to date on important information regarding the showcase. Abstract submissions open on August 12, 2013 (08:00am) and more information will be forthcoming in the coming weeks.

https://meds.queensu.ca/central/community/researchshowcase

We look forward to seeing you on September 26, 2013!!

Heather Murray & Melanie Walker

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A book that’s in my beach bag — Teaching What You Don’t Know

beach-bag-on-shore
You know how there are books that everyone says you should read, and you just can’t get to it? I finally got to sit down with Teaching What You Don’t Know by Therese Huston after hearing about it, well, since she published it in 2009.

The author wrote the book for those faculty in a university/college who are asked to teach on subjects far outside their research areas, and end up teaching by the skin of their teeth, staying a day or two ahead of their students.

This may not seem as relevant for our meds, nursing or rehab therapy teachers, at first glance, but as I read through the book there were so many messages that I thought our colleagues in Health Sciences Education would value.

So here’s a smattering…(I’m still dipping back into this book, and it’s going up to the cottage with me.)

First of all, why not volunteer to teach in an area that is not that familiar to you? For example, could a cardiologist teach in a respiratory course? Could a neurologist teach in an anatomy course? What would an obstetrician bring to a gastro course?

Teaching in an area you’re not as familiar with can be very beneficial:
You learn something new and interesting, you connect with faculty outside of your traditional area, and you broaden your own areas of research and interest. But most importantly (to me anyway), you may spend more time thinking about the topic, more time thinking about the students and their learning level, and you may end up learning along with the students, perhaps thinking a bit more like them than you usually do. When I’ve seen some of our clinical faculty instructing outside their own comfort zone, what impresses me most is that they’re breaking down material into very understandable chunks–really helpful to our students.

Teaching as telling breaks down when you’re more of a novice in an area. It’s actually “disastrous” especially if you’re anxious already. As Huston says, students don’t learn as well when we’re doing all the work for them, and falling back on default lecture mode isn’t helping them any. If we’re teaching outside our comfort zone (or frankly in it :)) we should avoid asking ourselves “What do I have to cover today?” Huston offers these questions to start the planning with instead:

What do students already know about this topic?
How can I connect this new material to their knowledge?
Which examples will be meaningful to them and how can I structure time in class so they’ll get the most from these examples

Huston gives a great summary that is an effective introduction to “planning backward” or “backward design” made popular by two those two innovators in the field, Wiggins and McTeague. In Chapter 4, she cites 3 mistakes that novices to a subject area can make: over-preparing, lecturing too much, and focusing on lists. I blush to say that it’s not only novices who can make this mistake (ahem:).

Some of the best tips are in Chapter 5, “Thinking in Class”, where Huston looks at some great strategies to get students active, whether in a lecture, or small group session. Two of my own personal favourite activities are listed here: Think Pair Share, where students think about a question, work with a partner on the answer and present a shared answer to the class and Category Building, where students work to create charts/tables/schema and generate categories from the work they’ve done OR where you give students a list of categories and ask them to put the work into the right spaces. (This works well with an algorithm).

I enjoyed learning about Sequence Reconstruction, where students reconstruct a list of items into a proper sequence. This got me started thinking on how students learn well from errors, a fact borne home to me in a recent conversation with our Meds students about Directed Independent Learning. Several said they like having quizzes where the wrong answers have explanations for why the answer is wrong–“I go through all the wrong answers, even if I’ve gotten it right, because I learn so much more then,” said one. This is a whole other conversation, Teaching from Errors!

There are other chapters with gold in them, in the book: “Teaching Students You Don’t Understand” and “Getting Better” (Huston says she was going to call the chapter “Getting Feedback” but she realized that if we’re being honest, many of us shy away from feedback, especially if we’re already anxious:). I think I’d like to try her “clarity grid” exercise with students–it will give me a great understanding of what students are getting and where they are getting lost. And there is a good advice for Course Directors, Department Heads, and Faculty Developers etc. in “Advice for Administrators.”

In her appendices, Huston give us some great stuff: Ten solid books on teaching strategies (2 of our blog’s favourites are in there), a great activity for a Syllabus Review, and a sample mid-term evaluation (which is a very useful time to get student feedback).

I hope I’ve convinced you that even if you’re not a novice teacher, and even if you’re teaching in an area in which you’re knowledgeable, this book has great value. And who knows? Maybe you’ll be inspired to teach a bit outside your comfort zone. Either way, this is a good book to take on your vacation.

Have a good one!

image from http://cruise-dude.com/

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Mentoring – a “win-win-win” proposition

What do practicing physicians remember about their medical school experience?  What do they feel had the greatest impact on their development?  What do they retain?  My guess, based on many reunions and even more conversations with graduates, is that it’s not the classes, labs or examinations, but rather the faculty they encountered along the way.  Of course we all remember the “characters” and the “larger than life” personalities that populate every medical school, but it’s those faculty with whom we were fortunate enough to develop a personal, one-on-one relationship that have the most enduring and significant impact on our development as physicians, and on our personal lives.  We call such folk “Mentors”.

mentorThe derivation of the word “mentor” is interesting.  The origin is Greek and is traced to Homer’s Odyssey.  Mentes was a wise and valued friend of Odysseus to whom he entrusted the education of his son Telemachus when he set out on his epic voyage.  The elements of wisdom and trust are therefore intertwined in the term, qualities obviously central to the role as we understand it today.

The value of mentorship is well known in all facets of professional education.  It’s this realization that leads many schools and departments to deliberately develop programs designed to promote these mentoring relationships.  At Queen’s, we have developed a program that assigns a mixture of students from all years in groups led by two faculty members.  Like all such programs, much depends on the specific and usually unpredictable “chemistry” that develops among the group.  When it works (and it usually does) the relationships that emerge are highly rewarding.  Below I provide testimonials from two students and one faculty member regarding their mentorship experience that may provide some insights.

Eve Purdy
Eve Purdy, MEDS 2015

In a 1973 article “Indoctrination of the Medical Student” Dr. Vilter pointed out that turning a new, eager medical student into a competent, caring physician takes more than just training in science, more even than just training in science and clinical skills. The mentorship program at Queen’s has been a special part of my indoctrination to the profession. Our group’s main goal is to have fun in a relaxed way but I am always surprised at the impact of these casual interactions. Whether it be a night of bowling, an intense night of trivia or a simple evening over shared drinks and food, I always leave more energized and excited about what’s to come. 

When a clerk in your mentorship group gives you a tip for the wards next year, you don’t forget. When the fourth year students graduate, you celebrate with them and picture yourself walking across the stage in a few years’ time. When a mentorship group leader encourages you to dream big, you might just. 

And a few more interesting links that I have come across about mentorship in medicine: 

Trivia…or is it? – this is a link to a post on my blog about trivia night earlier this year

Being a Mentor for Undergraduate medical Students Enhances Personal and Professional Development

Mentoring Programs for Medical Students- a review of the literature

Informal Mentoring Between Faculty and Medical Students

simmons
Graydon Simmons, MEDS 2016

The Queen’s Medicine Mentorship Program has provided me the opportunity to have informal interaction and communication with Queen’s faculty and residents that I wouldn’t be able to experience anywhere else. In the hospital or after a lecture, it is hard to just walk up to a physician to inquire about what they enjoy about their profession or how they balance their personal lives with their work. Through the mentorship program, I have been able to build relationships with faculty and residents in a more relaxed atmosphere that is conducive to conversations about one’s future directions in medicine. Additionally, the mentorship program has also increased that sense of Queen’s community for me. As a pre-clerkship medical student, it can be intimidating to enter the hospital during your first clinical experiences. With something like the mentorship program in place, you begin to see the quality of physicians we have here at Queen’s and the encouraging, open teaching environment that they create. Ultimately, this interaction and positive community that the mentorship program has created for me has contributed to my learning and career exploration as a Queen’s medical student.

Dr. Peter O’Neill
Dr. Peter O’Neill

It is About Mentorship

Being a mentor in the mentorship program has been one of the most exciting aspects of being on faculty at Queen’s. At my mentorship group’s last meeting, we had breakfast. For our group, breakfast was a good time to get everyone together without the distractions that can happen with an evening out.

One of the first year students asked if we should have an agenda for the meeting, but the senior students just laughed. The agenda is always the same. I ask the senior students: “what is cool in what you are doing right now”? They answer, in the usual spectrum of experiences, and the junior students say: “wow, how do I get to do that”! That is mentorship in action.

While I enjoy checking in with all the students to see what is cool or if they are struggling, I think the students would rather hear from their near peers. I see our relationships not so much as a vertical structure, but a horizontal one. The clerk explains how to get an elective to the second year student. The second year student describes the observership program as a kind of “back stage pass” to the first year student.

Our group has enjoyed the group events and while I couldn’t make the “Great Mentorship Race & BBQ” in the park this spring, our group was well represented. Over the years we have had fun with Guitar Hero, and had pot luck suppers (which means that everyone has some food that they can surely eat without looking into all the dietary restrictions).

At the Convocation in May, I enjoyed meeting the family of one of my mentees. He said: “Dad, this is Dr. O’Neill, I beat him at guitar hero the second month of medical school.  You couldn’t believe it when I told you we were playing guitar hero in his basement. I smoked him at guitar hero. In spite of that, three years later he taught me how to deliver a baby.”

In the years to come, memories of delivering a baby might fade in this future internist, but I will bet he will remember beating me at guitar hero. He may never know that I let him win.

win-win-winAnd so it seems mentoring is truly a “win-win-win” proposition, benefiting both parties involved, as well as our school, which is becoming known for the value we place on faculty-student interactions at many levels.  We’re always looking for more faculty willing to become involved in this program.  If you’re interested, or simply wish to learn more about it, feel free to contact myself, Peter O’Neill or Erin Meyer in the UG office who coordinates the program.  Erin can be reached at ugmelwc@queensu.ca.

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Nourish your educational health and wellbeing

It’s summer time, and a good time to think of health and wellbeing. I heard of this concept from MaryEllen Weimer who writes in Faculty Focus when she wrote about taking care of our teaching vitality. She reminds us, “for too long we have assumed that by force of will we can make it through, semester after semester. Like someone out of shape climbing too fast, we gasp for air between semesters, over spring break, or that 2 week family vacation but it’s never enough.”

In our blog today, we’d like to challenge you to consider how you can nourish your educational wellness. What will you do for your educational self this year? What muscles can you stretch? What nourishing ideas can you take in?

Last week Theresa Suart featured several books that take medicine in different directions—novels, poetry…
(What’s on your summer reading list?)
It started me thinking of some other nourishing ideas for us all.

1. First is attending conferences. Many of you have attended or will attend conferences in your area of medical expertise. Don’t neglect conferences in education. Here are a few to think of:
a. CCME (Canadian Conference on Medical Education (CCME), Ottawa, April 26-30, 2014. http://www.mededconference.ca/ccme2013/
b. STLHE (Society for Teaching and Learning in Higher Education) (at Queen’s next!) http://www.queensu.ca/stlhe2014/stlhe2014 Kingston, June 17-20, 2014
c. ICRE (International Conference on Residency Education): http://www.royalcollege.ca/portal/page/portal/rc/events/icre Calgary, Sept. 26-28, 2013
d. The Ottawa Conference: Transforming Healthcare through Excellence in Assessment and Evaluation (not always in Ottawa but this coming year it is) April 25-29, 2014 http://www.ottawaconference.org/#!ottawa-2014/c16br

2. Other nourishment: great educational writers. Here’s what’s on my bookshelf for “dipping into”:
Bain, K. What the best college teachers do (great advice based on a huge study with lots of exemplars—very readable)
Kotter, J.P. Leading Change (anything by Kotter—a leader in the field of leading change—another definition of education?)
Holmboe, E.S. & Hawkins, R.E. Practical guide to the evaluation of clinical competence (Holmboe is intensely readable, intensely useful—and clinically oriented)
Marzano, R. et al. Classroom instruction that works: Research-based strategies for increasing student achievement (anything by Marzano et al is very useful!)
Angelo, T. & Cross, P. Classroom Assessment Techniques: A handbook for college teachers. (These two have a lot of practical ideas based on sound theory about assessment!)
Brookfield, Stephen & Preskill, Stephen. Discussion as a Way of Teaching (Brookfield has 2 new books out that I want to get my hands on: Teaching for Critical Thinking: Tools and Techniques to Help Students Question Their Assumptions (2011) and Powerful Techniques for Teaching Adults (2013))
Palmer, Parker. The courage to teach: exploring the inner landscape of a teacher’s life. (10th edition is now out. I think I have the third! One of the first teaching books I ever read)
Wiggins, G. and McTighe, J. The Understanding by Design Guide to Creating High-Quality Units (“Backward Design” is a great concept you’ll find so intuitive!)

3. Stretch those educational muscles: Follow a Blog or list:
There are a few I follow:
Faculty Focus, edited by MaryEllen Weimer, published by Magna http://www.facultyfocus.com/ I’ve quoted from MaryEllen before—she has a real gift and reads prolifically
Tomorrow’s Professor (actually it’s a list) from Stanford: http://cgi.stanford.edu/~dept-ctl/tomprof/postings.php
Medical Education Blog by Deirdre Bonnycastle (U. Sask) Lots of great ideas! Last one I read had a list of songs that match to different medical disciplines http://words.usask.ca/medicaleducation/
Team Based Learning Collaborative http://www.teambasedlearning.org/ (drink the TBL cool-aid—it’s very refreshing!:)

4. Consistent high quality nourishment is a good idea for the whole year. Subscribe (Try RSS feed) to Journals
Here are the top ranked medical education journals and one education journal I never skip. Our Bracken Library subscribes to all and the librarians can show you how to get an RSS feed so you get alerts and topics only! (Someday I’ll write about some general education journals—fascinating reading!:)
o Academic Medicine
o Medical Teacher
o Medical Education
o Advances in Health Sciences Education
o Medical Education Online
o Teaching and Learning in Medicine
o Medical Science Educator
o Basic Science Educator
o Journal of the International Association of Medical Science Educators

Do you have advice for nourishing our educational wellbeing? Please let us know through posting to the blog.

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Student Directed Learning ”Everything old is new again”

My undergraduate education was enlivened by a number of professors who were fond of taking rather unconventional points of view, many of which would be considered “politically incorrect” in today’s parlance.  They were even fonder of defending those perspectives with spirited and colourful debate.  Perhaps travillthe leading proponent of this approach was Dr. Tony Travill, professor of Anatomy, who would spend more of his curricular time discussing points of professional practice and social foibles than the assigned topics of embryology or anatomy.  On the rare occasion that one of us mustered the temerity to point this out, he would make the rather emphatic point that “universities aren’t centres of teaching, they’re centres of learning”.  The message was clear – it wasn’t his business to teach so much as it was our responsibility to learn.  Our goal should be to learn for the benefit of our future patients, not simply to satisfy curricular goals.  I recognize in retrospect that his not-to-subtle shift of emphasis helped us to transition from being passive consumers of information to what today’s educational theorists would term “active learners”, although we had no idea this was happening at the time.

Turing our attention to the present, one of our 2015 students, Eve Purdy, spoke eloquently at the recent Celebration of Teaching Day of how she addressed her interest in the process of clinical decision-making.  She searched the internet and came upon a free web-based seminar series from the University of California (San Francisco) that she accessed over several weeks and found quite useful.  She shared the information with others, both students and faculty who also made use of this resource.  As teaching faculty, we should take considerable comfort in the fact that our students are, on their own, seeking opportunities to advance their learning, often going beyond the baseline requirements of our curriculum.

In fact, our students make use of a wide variety of unstructured learning opportunities in addition to standard curricular offerings such as Courses, Integrated Learning Streams, various types of Small Group Learning, clinical rotations and assigned projects.

Last academic year, about 20 Student Interest Groups were active, each developing a series of at least 8 learning sessions outside standard curricular time that were devoted to a particular discipline or theme.  Although supported by faculty on a voluntary basis, students developed the themes and content of these sessions.  The following is a list of some of the groups that were active this past academic year:

hidden

In addition, our students informally access the world of information available to them through the internet and social media.  A world of information is studentsliterally at their fingertips, and they make use of this almost continuously, both to search information and to dialogue with each other, with faculty (sometime during lectures), and people farther afield.  The challenge is not access, but rather discernment of relative value.

Perhaps the most powerful non-curricular learning experience our students engage is what’s been termed the Hidden Curriculum.  This term refers to all of the unintentional but incredibly powerful messaging that occurs in the context of their environment and clinical experiences.  Observing a respectful and effective interaction between an attending physiciansphysician and nursing staff provides a much more effective and durable lesson than hours of formal teaching on the topic of professionalism.

The challenge for teaching faculty in the midst of all this is to keep pace what’s happening around us, and to shift our focus from delivering content to guiding the learning process.  To borrow an old adage – we can’t control the wind, we can only set our sails.  In this environment, it becomes more important to set the objectives and provide direction than to attempt to rigidly control the process.

And so, as the song says “Everything old is new again” when it comes to student directed learning in medical education, although technical advances and connectivity expand the potential (and our challenge) tremendously.  I like to think Dr. Travill would be amused.

 

Anthony J. Sanfilippo, MD, FRCP(C)
Associate Dean,
Undergraduate Medical Education

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Why should you be an FSGL Tutor?

This blog article is brought to you by Dr. Michelle Gibson, Year 1 Director, and Coordinator of our FSGL stream in pre-clerkship. gibsonm1@providencecare.ca

Why should you be an FSGL Tutor?

But first … what is FSGL anyway?

FSGL is Facilitated Small Group Learning, a modified form of Problem-Based-Learning (PBL), adapted for the curriculum at Queen’s University. In Terms 2, 3, and 4, students work in small groups of 6 or 7, with one tutor, over the course of the term, to learn from cases linked to their courses.

FSGL is like PBL in that the tutors are not there to be content experts, but rather as “facilitators” of student learning. In general, students receive the first part of a case, and they work together to identify what their learning needs are. The case is usually that of a patient with an as-yet undifferentiated presentation, and the students work through it together, gradually getting more information about the case. It is, in educational terms, enquiry-based learning, where the students are (mostly) driving the learning.

So what does an FSGL tutor do?

They are there to help the group really delve into the case, to probe student understanding, to help the students with their clinical reasoning, and, really, to help students understand what a doctor does. They are not teaching about the intricacies of interpreting ECGs, for example, but rather, to challenge the group about their approach to a differential diagnosis in a patient with syncope (with the help of a trusty written tutor guide…)

In addition, tutors are essential in observing individual student contributions to the group, and the group dynamic over the course of the term. They can help the group form a high-functioning team, and they provide feedback to individual students about their performance. Twice a term, the tutors will review peer-feedback and self-assessment data from their students, and provide mid-term and end-of-term feedback to the students about their progress that term.

Why do tutors like FSGL?

In the 5 years since I’ve taken over this part of the curriculum, I hear the same comments over and over. Tutors enjoy working with a stable group of students over the course of a term, and getting to know them. They appreciate watching their students grow in their skills, as they strive to become doctors. They even admit to enjoying the learning they do about material they don’t see everyday.

What is involved in being an FSGL tutor?

Tutors commit to at least one term (timelines below) for one afternoon a week, from 1:30 to 4:30 p.m. We understand that tutors have other commitments, so we accommodate tutors being away up to twice a term by providing substitute tutors, and 3 absences might be accommodated in certain circumstances. This includes participating in an orientation on the first afternoon of the term. You will receive a tutor binder, with all the cases and the tutor guides, and learn about how to be an effective tutor.

Tutors will learn how to provide constructive narrative feedback to students about students’ own learning goals and their progress over the term.

I might be interested, but I have questions – what should I do?

Email me at gibsonm1@providencecare.ca , and I’d be happy to chat.

Final words:
When I was asked to take over the old PBL by Dr. Sanfilippo, many people (myself included), really wondered if we should keep it in the curriculum. Through the helpful feedback provided by students and those they rated as excellent tutors, I have tried to keep what was working, and fix what was not. If you did PBL more than 5 years ago, I can assure you it’s a new creature now. While it’s not perfect, it is mostly fun, and the students really appreciate their tutors- they tell me so all the time. And, as one new tutor told me this year: “This is the best experience I’ve had in undergraduate medicine at Queen’s in 10 years.” I would be delighted if this would be the case for other new tutors too, so please feel free to email me with questions! gibsonm1@providencecare.ca

Timelines

Fall 2013:
Term 3, second year med students (experienced FSGL-ers) – cases are based on mostly cardio-resp, renal, and endocrinology material. Runs from September to the 1st week in December. Wednesday afternoons, from 1:30 to 4:30.

Winter 2014: (Two terms)
Term 2, first-year med students (novice FSGL-ers) – cases are based on therapeutics, pathology, immunology, hematology, geriatrics, MSK, and pediatrics. Runs from January to April or the first week of May. Monday afternoons, from 1:30 to 4:30, with many Mondays off, including Family Day, 2 weeks around March Break, and Easter Monday.

Term 4, second year med students (very experienced FSGL-ers) – cases are based on OB/Gyn, GI/Gen Surgery, neuro, ophthalmology, and psychiatry. Wednesday afternoons, from 1:30 to 4:30 with 2 weeks off around March Break.

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“The Light Who Pursues Kindness”

Each year, our graduating class is asked to nominate a member to speak on their behalf at the Convocation ceremony.  Last week, Alex Summers delivered an address he entitled “The Light Who Pursues Kindness” on behalf of the Meds 2013 class.  It was clear to me and to many other faculty attending that Alex’s words deserved a broader audience and so, with his permission, I am providing the complete and unaltered text of his address below.  Alex’s words require no editorializing on my part, but I would simply say that all who are involved in our school in any way, be it teaching, leadership, administration or support, should take justifiable pride that our graduates should feel this way about their careers, to date and beyond.  In the midst of the day-to-day challenges we all face, Alex’s words reaffirm the faith that what we do is worthwhile, and we must be doing something right.  And so, the words of Dr. Summers:

Picture - Alexander SummersMr. Chancellor, Principal, Rector, ladies and gentlemen; 
Let me get started by taking you back to the spring of 1885 with some words borrowed from a day just like today:
“Medicine is a liberal profession, requiring culture and knowledge and skill. It is not a trade for money making, nor a field for vaulting ambition. The physician’s object is to combat disease; he is, therefore, the servant of the suffering.”
Those are the words of George Spankie, Queen’s Medicine 1885, spoken during his convocation address. Since the fall of 1854, medical students have trained here at Queen’s. Trained, and despite all the doubts, graduated too. And today, it’s our turn to cross this stage. We’ve been done for almost a month, but I know many of us have been resisting the urge to call each other doctor, for as we know from last week’s hockey game, it isn’t over till it’s over. Unless you’re the Senators of course; even Alfie says it’s over. But be re-assured folks, I think we’ve made it.
My hope today is to quote the collective voice of the Class of 2013, an outstanding group of people for whom my respect and admiration has grown daily since September 2009. To my classmates, may the words I speak for you today echo your thoughts, and may the words I speak to you have value and meaning. For the wisdom imparted, the memories shared, the friendship and support, and for the humbling privilege to stand here today, thank you.
The medical school journey is not one that is walked alone. It is only through the support of so many that we have achieved what we have achieved. To the staff of the UGME, thank you for tireless efforts on our behalf. To the faculty, we are grateful to you for so many things, but most especially for the examples of professionalism and excellence that you have modeled for us. Queen’s, in my overtly biased opinion, is a remarkable place, and it is so because of its people. Leonard Brockington, Rector of Queen’s from 1947 to 1966 (and the last non-student rector), said that this university was “…an example of the personal and national good that springs from intimate association between devoted teachers and eager learners.” That sentiment still holds true. Thank you for your commitment to us, and to Queen’s.
And to our families and friends, words simply are not enough. Our gratitude for your support, encouragement, and love, cannot be adequately conveyed from a stage. To all of you, may the lives we have lived thus far, and the lives we will lead from this day on make you proud, and be our most sincere expression of thanks.
I last addressed a graduating class in June 2002. I was fourteen years old, and it was the graduation ceremony for Grade 9 students at Montgomery Junior High School in Calgary. I do not remember one word of my speech. But I remember what followed. With spiky fluorescently dyed hair and skater shoes to accent the dress pants, Cassie, David, Terry and Cam came to the stage to play, you guessed it, the convocation classic Good Riddance, aka Time of Your Life, by the punk rock band Green Day. It was a beautiful rendition of that four-chord tune, and I even think David, the guitar player, managed to slip in that little four-letter word that follows the second prematurely attenuated guitar lick.
At the time, there was no better articulation of our feelings and hopes. The words were simple and the band was cool, and it was our anthem. Today however, 11 years later, would that song still cut it? Would it still capture the significance of a day like today?                                                   
Of course not.
Certainly, part of today is very much about remembering the last four years. But that’s not it. That song doesn’t cut it because today is only so much about yesterday. Today is about tomorrow. Not only does the university acknowledge today four years of effort by bestowing upon us this degree, in accepting that degree we answer, with humility and respect, a call. We accept a profound responsibility; a social contract between us and our neighbours. As we begin to feel the weight of that responsibility, it is good to once more reflect upon what exactly we have been called to do.
In my first year of medical school, under the guidance of Dr Duffin, I had the opportunity to learn about Dr Norman Bethune. For a man long dead, he has made a transformational impact on my understanding of what it means to be a physician. A Canadian physician of overwhelming humanitarianism and global compassion, he plied his trade across the globe, believing there was “code of fundamental morality and justice between medicine and the people.” He died in 1939 in rural China, and is remembered in that country as a hero for his selflessness and sacrifice. His name amongst the Chinese is Bai Qiu En – The Light Who Pursues Kindness.

I love that. And I find purpose and inspiration in the idea that we too can be, and should be, lights who bring and share kindness in the darkest hours of human suffering. As we go from here, we tread in the footsteps of giants like Norman Bethune and others – just look around this stage. As our forbearers have, may we stumble courageously and persistently in the pursuit of compassion and excellence. Let us never forgo the good of the patient and the public for the advancement of ourselves or the profession. If the economy does finally manage to implode on itself and the funds for public salaries disappear, may it be seen that Queen’s physicians are the ones that will still show up for work; that Queen’s physicians are, in the words of that valedictorian of old, “servant[s] of the suffering.”  Whether we are destined for a career in a ward, a clinic, an OR, a lab, or a public health unit, if we embark from this place, humbly emboldened with a commitment to pursue kindness in everything we do, we will not go wrong.

Let me finish with one more quote; with words borrowed from Dr Bethune. Spoken in 1938 at the opening of a military hospital in remote China, he would die within the year at the age of 41 as a result of a blood-borne infection he would acquire while operating on a soldier.

“There’s an old saying in the English hospitals… “A doctor must have the heart of a lion and the hand of a lady.” That means he must be bold and courageous, strong quick and decisive yet gentle, kind and considerate. Constantly think of your patients and ask “Can I do more to help them?”

Congratulations, my friends. Thank you for the last four years, for today, and most especially for the good work you will do as you go from this place.

 

Anthony J. Sanfilippo, MD, FRCP(C)
Associate Dean,
Undergraduate Medical Education

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It Takes a Village

Last week’s convocation ceremonies provided opportunities to not only pay tribute to the 2013 class, but also reflect on the progress of our school and curriculum.  I was congratulated several times for the changes that have taken place, and the success of our graduating class.  In truth, those changes have been made possible only by the efforts of many faculty and support staff, who are the real heroes of any success we’ve achieved.  I thought it appropriate to devote an article to those remarkable people.  In doing so I tread cautiously, always wary of omitting someone, but not willing to pass up the opportunity to recognize the deserving.  So, here goes:

Screen Shot 2013-05-30 at 8.54.21 AMTed Ashbury.  Several years ago, he (perhaps foolishly) Ted agreed to become a curricular advisor.  From that, he has become the “heart and soul” of Professionalism within our curriculum and within our medical school.  He began by chairing a working group that examined and developed a competency framework, the work of which served as a model for all the professional competencies.  He has continued to teach and advocate for professionalism, serving on our Curriculum Committee since it’s inception.  He does not speak often, but is always thoughtful and his usually incisive commentary often brings the group back to fundamentals and keeps our collective eye on what’s important.  I’ve come to count on his advice.  Ted’s trying to retire and I guess we’re going to have to let him do that at some point, but we don’t have to be happy about it.

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Henry Averns has, for the past 5 years directed our Clinical Skills program.  A difficult portfolio at the best of times, Henry had to manage through the departure of a number of faculty leads, transition from a five to four term format, introduction of new teaching requirements, and transition to a new Clinical Education Centre.  Henry managed all this with characteristic aplomb, the final result a program that continues to be highly regarded by our students and accreditors, and improved for his contributions.  More recently, he has taken on chairmanship of our OSCE committee, a role that continues to bring both learning and administrative challenges, but he is engaging with his usual enthusiasm and characteristic pragmatism.

belliveauPaul Belliveau has been a consistent liaison and representative of Surgery within our curriculum, both at the pre-clerkship and clerkship levels.  He has also willingly taken on a number of key roles, including initially chairing our Student Assessment Committee and taking on leadership of our Student Awards Committee as it undergoes necessary reforms.

Screen Shot 2013-05-24 at 3.55.07 PMJennifer Carpenter
has, for many years, provided counseling for students experiencing a variety of personal and health problems.  In doing so, she has made herself continuously available to them and, since most of what she does is held in confidence, she largely carries out this role without attention or fanfare.  She has also led the development of our Advocacy curriculum and promoted the development of Learner Wellness initiatives.  She is unfailingly supportive of our students, and I have come to rely on and trust her advice on many student related issues.

Screen Shot 2013-05-24 at 4.20.34 PMSue Chamberlain has been instrumental in developing our curriculum and clerkship in Obstetrics and Gynecology, shaping both into a very well regarded components of our curriculum, reflected by high levels of success of our students in Medical Council of Canada examinations and disproportionate interest in Ob-Gyn careers among our students.  For these past 4 years, she took on Chairmanship of our Student Assessment Committee.  This was a mammoth task, requiring a combination of policy development, faculty support and oversight of the curricular courses.  Her success in developing effective assessment methodologies for our courses was absolutely essential and key to our accreditation success.

 

Screen Shot 2013-05-24 at 3.57.52 PMLindsay Davidson is a dedicated and successful career educator who has also been part of our curricular transition from the start.  During her time as Clerkship Director she guided the clerkship through its transition to a 2 year model.  She has also taken on the roles of MSK Course Director for many years and, more recently, Year 2 Director.  Her overriding contributions, however, relate to her willingness to fearlessly engage novel educational models, combined with technological expertise rare in medical faculty.  She has been an unapologetic champion of small group learning techniques, leading the way and assisting many faculty in making that transition.  She has become a growing presence within the university and national education communities.

Screen Shot 2013-05-27 at 9.12.59 PMAs the Hannah Chair for the History of Medicine, Jackie Duffin has provided our students insights into the history of our profession and done so in a highly engaging manner, mixing award winning lectureship with individual research and highly regarded field trips which she personally organizes and supervises.  Her contributions, however, go far beyond that role.  She engages the students on a personal level with enthusiasm and warmth, and is held in high regard by all.  Her publications and global work bring much credit to our school.

Renee Fitzpatrick has provided steadfast and innovative leadership for all aspects of our Psychiatry curriculum.  She has developed novel approaches to teaching complex psychiatric presentations through the use of standardized patients, as well as developing individualized preparation opportunities for students undertaking the Integrated Community Clerkship.  She has become the champion of Psychiatry within the UG curriculum, and her efforts have provided our students with a much more realistic and attractive impression of that career track.  As she moves on to other challenges, she leaves strong pre-clerkship and Clerkship programs for colleagues to follow.

Michelle Gibson has skillfully and efficiently guided Year 1 of our curriculum for several years, been an important member of our Curriculum Committee (taking over responsibilities as Chair for these past 2 years), all while completing her Master’s degree in Medical Education and carrying out her practice in Geriatric Medicine.  During that time, she managed to have a baby, and young Conor has become an honorary member of Curriculum Committee, amassing an impressive attendance record.

Cherie Jones-Hiscock has provided leadership and oversight for two key competencies within our curriculum, those related to the Collaborator and Communicator roles.  In doing so, she has developed curricular content and novel, creative methods to provide that content.  These roles have required that uncommon combination of educational creativity and administrative skill.  She has brought these skills to her roles with our Professional Foundations and Curriculum Committees.

H_Macdonald_7472_Hugh MacDonald has guided our Admissions Committee through a transition to a much more sophisticated and, in my view, effective process based on an understanding of key applicant attributes and incorporating mini-medical interviews.  The committee’s mandate has also expanded to involve admission of students to our MD-PhD and QuARMS programs, each requiring creative thinking and novel processes.  Hugh has guided these processes with a steady hand and good judgment, all the time filling other key clinical and administrative roles in our school.

Screen Shot 2013-05-24 at 4.26.11 PMSue MacDonald, as our first Academic Advisor, has taken on this new role with energy and commitment.  She provides personal counseling with students experiencing academic challenges, effectively identifying opportunities for improvement and complementing the efforts of other counselors.  Many students have benefitted from her counseling and sound, practical advice.  She has also been very active in the delivery of our Professionalism/Ethics curriculum, and a strong contributor to our Student Progress and Promotions Committee.

Screen Shot 2013-05-24 at 4.17.46 PMJennifer MacKenzie has, together with Theresa Suart, developed a de novo pre-medical curriculum for our QuARMS program which is highly creative, delivering competency based learning in a variety of creative teaching formats.  This program, and Jennifer’s continued oversight, will be key to the success of this exciting new initiative.

 

Sue MoffattSue Moffatt has been making major contributions to our curriculum for more years than she would like me to mention.  Most recently, her contributions to our curricular renewal process, guidance of the Cardio-Respiratory course through transition, and wholesale development of the three Clerkship Curriculum courses have been remarkable even for someone with her track record.  Her recent selection by our graduating students to receive the Connell Award (given to the faculty member deemed to have made the greatest contributions to their medical education) speaks clearly to her dedication and commitment to our students.  It’s always clear to me and others that Sue’s perspectives and opinions on various issues, although often controversial, are always motivated by a genuine concern for the interests of our students.

Screen Shot 2013-05-24 at 4.09.58 PMHeather Murray has transformed the teaching and expression of Scholarship within our curriculum.  She has done so by developing and managing the CARL (Critical Appraisal, Research and Learning) course, now in it’s third year, and building on Albert Clarke’s longtime contributions to transform our Critical Enquiry course.  She is transforming those components of our curriulum into a very active and highly relevant learning experience for our students.  The Student Research Showcase, which she developed and offered for the first time last fall, promises to become a regular highlight of the academic year.

Screen Shot 2013-05-24 at 4.11.03 PMPeter O’Neill tirelessly guides our students through their career planning and CARMS application processes.  He also, quietly and without fanfare, provides personal guidance and advocacy for those few who have difficulty with the postgraduate match process.  In his spare time, he has developed a program in Spirituality, which has been well received by both students and other medical schools.

Conrad Reifel and Steve Pang have provided a Normal Human Structure course that is, in the view of many, among the best programs in the country.  They have also been open to change and cooperation with clinical course directors that continues to promote integration throughout our curriculum.

59Mike Sylvester has developed and operated a Family Medicine course in first semester that not only introduces our students to that specialty, but provides their first exposure to clinical presentations and diagnostic reasoning.  He has represented and promoted the integration of Generalism within our curriculum tirelessly through his participation on the Curriculum Committee.

David Taylor and Cathy Lowe have very effectively reformed our Internal Medicine Clerkship rotations, converting what were weaknesses to strengths within the clerkship.  In doing so, they have introduced innovative teaching and assessment methodologies.

Screen Shot 2013-05-24 at 4.27.25 PMLewis Tomalty, during his term as Senior Associate Dean, was a strong supporter of curricular change and continuing source of advice, guidance and support.  Since then, he has assumed responsibility for our Mechanisms of Disease course and is in the process of reforming that curriculum.

vanwylickRichard VanWylick seems to be everywhere.  He has, over the past few years, directed the development and implementation of our Pediatrics pre-clerkship curriculum, directed the Pediatric Clerkship, directed our Integrated Community Clerkship Program and, just for good measure, Chaired the Progress and Promotions Committee, a role that requires the knowledge of a litigator, diplomacy of a career diplomat and patience of Job.  I’m not really sure how he’s managed all this, but I’m smart enough not to ask.  He’s one of those folks who just does everything well, and can be relied upon with difficult jobs.  In addition, I know he is a source of advice and counsel to many of our junior faculty.

Screen Shot 2013-05-24 at 4.07.30 PMChris Ward has quietly, effectively, deliberately reformed our teaching in basic science through his leadership of the Normal Human Function course, and dedicated participation in our Curriculum Committee.  He has also found ways to interact effectively with clinical course directors and thereby promote integration of basic and clinical science in our curriculum.

wilsonRuth Wilson has generously taken on the considerable challenge of chairing our Professional Foundations Committee.  Her steady leadership has guided and promoted the development and integration of those essential components of our curriculum. 

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Andrea Winthrop, in a short period of time back at Queen’s, has taken on and successfully engaged a number of challenging and critical portfolios, including Clerkship Director and Chair of the Course and Faculty Review Committee.  She has also been the person most responsible for developing and managing our successful exchange program with the University of Queensland.  In all these roles, Andrea brings incredible energy, commitment and an attention to detail that is both apparent and rather astounding to everyone who works with her.  Her dedication to the welfare of our students is obvious to all.

013Brent Wolfram has quietly and effectively assumed responsibility for the Family Medicine clerkship, as well as providing valuable contributions to our Course and Faculty Review and Curriculum committees.

In addition, many faculty have provided leadership as Course Directors:

Screen Shot 2013-05-27 at 9.26.05 PMMichael Adams who has energetically revised the curriculum and teaching of Fundamentals of Therapeutics, receiving important recognitions for his teaching from the students and university in the process.

Stephanie Baxter who developed our Ophthalmology curriculum, recently transferring that role to Jim Farmer

Cheryl Cline has been instrumental in developing and leading the Professional Foundations course content.

Basia Farnell has taken on leadership of our Term 2 Clinical Skills course.

Melissa Fleming leads the challenging Perioperative Medicine rotation in our Clerkship, which integrates experiences in Anaesthesia, Emergency Medicine and Surgical Subspecialties.

Keith Gregoire who has recently taken on responsibility for the Pediatrics Clerkship, building on the program developed by Richard VanWylick and Maxine Clarke.

Russell Hollins has directed and supervised Elective rotations for many years, an administratively and educationally challenging role very important to our students as they consolidate their career directions.

Robyn Houlden and David Holland have developed a very effective Renal-Endocrine curriculum in second year.

Paula James and her colleagues have developed and implemented a course in Blood and Coagulation that is consistently very highly regarded by our students.

Paul Malik coordinates and teaches many sessions of the Cardiovascular component of our Cario-Resp course.

Romy Nitsch has expanded and refined the teaching within our Reproduction and Genito-urinary course.

Chris Parker and Armita Rahmani have worked diligently with Sue Moffatt to develop and deliver the first interation of Clerkship Curriculum Courses, which was very highly rated by out students.

Lindsey Patterson directs the development and delivery of Technical Skills within our curriculum.

Stuart Reid directs our Neuroscience course which, under his leadership, has undergone considerable revision in both content and teaching methods which have resulted in a much more effective and well reviewed curriculum.

Richard Thomas directs the Obstetrics and Gynecology rotation within our Clerkship, traditionally one of our most highly rated rotations, and a discipline where our students have excelled in their Medical Council of Canada examinations.

Shayna Watson has been a very effective liaison with the Oncology group, directing the integration of that content within our “GOP” course.

I also wish to make special mention of two Educators who have been essential components of our school and our transformation process:

Screen Shot 2013-05-27 at 2.29.05 PMSheila Pinchin has been central to our curricular reform since the outset.  She now leads a highly effective educational support team (Theresa Suart, Eleni Katsoulis, Alice Rush-Rhodes, Catherine Isaacs) and remains a key member of our leadership team, providing sound and practical advice, while maintaining a critical link to our students that allows us to understand and respond to issues and concerns.

Screen Shot 2013-05-24 at 4.15.59 PMElaine VanMelle was an original member of our Curricular Review group and, in those formative days, provided sound guidance and insights as to relevant educational theory that allowed us to ensure our changes were solidly grounded.  Her work as the original chair of our Teaching and Learning Committee led to policies and practices that were instrumental in our accreditation success and continue to guide the curriculum.

Finally, our Undergraduate support staff, under the capable leadership of Jacqueline Schutt, provide highly effective and much appreciated support to our students throughout their years with us.  In recent Canadian Graduation Surveys, the students have rated our support services well above national averages.

The origin of the phrase “it takes a village to raise a child” is obscure, but appears to derive from an African proverb.  Whatever the origin, it is certainly well applied to the tremendous effort that has gone into our curricular evolution here at Queen’s.

What motivates all these people?  Certainly not simply the money or prestige, both of which are entirely inadequate to their contributions.  In all cases, the primary motivation is a remarkable dedication to our school, our students, and the very best interests of our profession.  They deserve our admiration and our gratitude.

 

Anthony J. Sanfilippo, MD, FRCP(C)
Associate Dean,
Undergraduate Medical Education

 

 

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Why should you teach Clinical Skills?

Today’s blog article comes from Dr. Cherie Jones, MD, FRCPC,
Course Director, Clinical and Communication Skills and Ms. Kathy Bowes, RN, Clinical Skills Coordinator.

Clinical Skills training is core to any undergraduate medical curriculum. Here at Queen’s University, first and second year medical students learn “the tools of their trade” in a variety of settings and formats every week. Medical students and clinical skills tutors identify the small group teaching as the most useful and enjoyable aspect of the entire program. Furthermore, despite the significant time commitment clinical skills tutors report that the afternoon small group teaching is a highlight of their week.

“Students are so excited to be finally looking and acting like doctors with their white coats, new stethoscopes…. (they are) keen to learn the skills they associate with physicians. At this stage we can really influence the way they will interact with their patients and the type of physician they will eventually be.”

Dr. Jay Engel MD, FRCPC, Division Head of Surgical Oncology, KGH

In the pre-clerkship clinical skills curriculum, much of what is learned by students occurs in a small group setting of ten students supervised by two tutors. Once a week they meet for an afternoon and tutors guide and direct their students so that they can learn the history taking and physical exam skills that are essential to the competent practice of medicine. This year we asked tutors “Why do you teach clinical skills?”, especially since many return year after year. As most eloquently stated by Dr. Peter Froud….

“Because for many years I have felt that some of the most necessary skills for MDs are those that involve listening and questioning skills and the self-confidence needed for these skills… if I am able to impart all or most all of these skills to a group of new students every year, in my own small way I will be helping….”

Clinical skills tutors take their jobs very seriously. They feel that the role they play in providing feedback is critical for making good doctors; whether it be in the context of interacting with their students every week or during the time outside of the scheduled curriculum correcting case write-ups, reviewing reflection essays and communicating narrative feedback over the course of the term.
Additionally when tutors were asked what advice they would have for physicians interested in becoming tutors, one of our award winning tutors responded …..

“…..I seem to be more confident at it (teaching clinical skills) then I originally thought I was …. now I recognize that I possess professional expertise that not every tutor will have, and that I bring something unique and valuable.”

Clinical Skills tutors teach basic skills for future physicians. It begins with teaching students how to use shiny new stethoscopes, interact with patients, and culminates in the making of a medical student who is well equipped to enter clerkship. At Queen’s University tutors who have participated in clinical skills teaching find it rewarding, one hopes because they have come to realize that their input is critical if we are to create the next generation of competent physicians.

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Why should you teach Clinical Skills?

Today’s blog article comes from Dr. Cherie Jones, MD, FRCPC,
Course Director, Clinical and Communication Skills and Ms. Kathy Bowes, RN, Clinical Skills Coordinator.

Clinical Skills training is core to any undergraduate medical curriculum. Here at Queen’s University, first and second year medical students learn “the tools of their trade” in a variety of settings and formats every week. Medical students and clinical skills tutors identify the small group teaching as the most useful and enjoyable aspect of the entire program. Furthermore, despite the significant time commitment clinical skills tutors report that the afternoon small group teaching is a highlight of their week.

“Students are so excited to be finally looking and acting like doctors with their white coats, new stethoscopes…. (they are) keen to learn the skills they associate with physicians. At this stage we can really influence the way they will interact with their patients and the type of physician they will eventually be.”

Dr. Jay Engel MD, FRCPC, Division Head of Surgical Oncology, KGH

In the pre-clerkship clinical skills curriculum, much of what is learned by students occurs in a small group setting of ten students supervised by two tutors. Once a week they meet for an afternoon and tutors guide and direct their students so that they can learn the history taking and physical exam skills that are essential to the competent practice of medicine. This year we asked tutors “Why do you teach clinical skills?”, especially since many return year after year. As most eloquently stated by Dr. Peter Froud….

“Because for many years I have felt that some of the most necessary skills for MDs are those that involve listening and questioning skills and the self-confidence needed for these skills… if I am able to impart all or most all of these skills to a group of new students every year, in my own small way I will be helping….”

Clinical skills tutors take their jobs very seriously. They feel that the role they play in providing feedback is critical for making good doctors; whether it be in the context of interacting with their students every week or during the time outside of the scheduled curriculum correcting case write-ups, reviewing reflection essays and communicating narrative feedback over the course of the term.
Additionally when tutors were asked what advice they would have for physicians interested in becoming tutors, one of our award winning tutors responded …..

“…..I seem to be more confident at it (teaching clinical skills) then I originally thought I was …. now I recognize that I possess professional expertise that not every tutor will have, and that I bring something unique and valuable.”

Clinical Skills tutors teach basic skills for future physicians. It begins with teaching students how to use shiny new stethoscopes, interact with patients, and culminates in the making of a medical student who is well equipped to enter clerkship. At Queen’s University tutors who have participated in clinical skills teaching find it rewarding, one hopes because they have come to realize that their input is critical if we are to create the next generation of competent physicians.

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