Queen’s UGME well-represented at CCME
Queen’s UGME was well-represented in the oral and poster presentations at the recent Canadian Conference on Medical Education (CCME) held in Winnipeg, MB.
Four oral presentations showcased UG work with another oral highlighting a teaching innovation in the QuARMS Program while a dozen posters featured Queen’s UG research and innovations featuring work by faculty, students, and staff.
As explained on the CCME website, “the purpose of the CCME is to highlight, and allow participants to benefit from, developments in medical education and to promote academic medicine by establishing an annual forum for medical educators and their many partners to meet and exchange ideas.”
The Queen’s oral presentations included:
- The Next SSTEP: The Surgical Skills and Technology Elective Program decreases cognitive load during suturing tasks in 2nd year medical students by Henry Ajzenberg, Peter Wang, Adam Mosa, Frances Dang, Tyson Savage, Peter Thin Vo, Justin Wang, Stephen Mann, Andrea Winthrop
- The Newborn Book – An evaluation of an interactive eBook as course material by Lauren Friedman, Jonathan Cluett, Bob Connelly
- Altering the scoring of global rating scales on an Undergraduate OSCE: Does it affect the identification of candidates with borderline performance? By Michelle Gibson, Eleni Katsoulas, Stefan Merchant, Andrea Winthrop
- Sampling Patient Experience to Assess Communication (SPEAC): A Targeted Needs Assessment by Adam Mosa, Andrea Winthrop, Sachin Pasricha, Eleni Katsoulas
- Fireside chats – High Impact Informal Learning by Jennifer MacKenzie, McMaster University, Theresa Nowlan-Suart, Anthony Sanfilippo
Posters, presented both during facilitated poster sessions and the new, dedicated poster session, included:
- An Inter-professional, Cross-cultural Service Learning Project: Development of a Nutrition Education Program in Rural Tanzanian Schools by Jenn Carpenter, Queen’s University, Donna Clarke-McMullen, Renee Berquist, Saint Lawrence College
- Pathways to community service learning: The Queen’s Service-Learning Framework by Lindsay Davidson and Theresa Nowlan Suart
- Introducing Medical Students to Stories of Indigenous Patients by Lindsay Davidson, Melanie Walker, Steven Tresierra, Jennifer McCall, Michael Green, Laura Maracle,
- Predictors of medical student engagement in an e-Portfolio for intrinsic CanMEDS roles by Steven Bae, Danielle LaPointe-McEwan, Sheila Pinchin, Anthony Sanfilippo, John Freeman, Queen’s University Ulemu Luhanga, Emory University Jennifer MacKenzie, McMaster University
- Evaluating the effectiveness of the First Patient Program’s use of resources in achieving learning objectives for medical students by Stephanie Chan, Vincent Wu, Sheila Pinchin, Phillip Wattam, Leslie Flynn
- Evaluation of a multi-modality nutrition program for first year medical students by Andrea Guerin, Theresa Nowlan Suart, Shannon Willmott, Karen Kaur Grewal
- Assessing the Effect of the Eye Matching System on Clinical Competency with the Ophthalmoscope in Medical Students by Etienne Benard-Seguin, Jason Kwok, Walter Liao, Stephanie Baxter
- Curriculum to Cookbook by Moncia Mullin, Meghan Bhatia, Renee Fitzpatrick, Shelia Pinchin
- The CFMS National Wellness Challenge: evaluating a new initiative to promote development of healthy habits in medical professionals by Alyssa Lip, Renee Fitzpatrick
- Ontario Medical Students Association Wellness Retreat: A Program Evaluation by Shannon Chun, Renée Fitzpatrick, Queen’s University, Christine Prudhoe, University of Ottawa
- Evaluating Student’s Perspective of Team-Based Learning In Undergraduate Medical Education by Kate Trebuss, Vincent Wu, Jordan Goodridge, Gemma Cramarossa, Lindsay Davidson
- Preclerkship Interprofessional Observerships: What I Know Now by Shannon Willmott, Ameir Makar, Etienne Benard-Seguin, Sarah Edgerley, Lindsay Davidson
Next year’s conference is set for April 28 – May 1 in Halifax, NS. The abstract submission portal is already open. Find it here.
The Value of Medical History
By Sallya Aleboyeh, MEDS 2019
A group of passionate and curious medical students chose to venture to Ottawa on the Family Day weekend this past February. Instead of visiting their families, they dove into history, with a group of equally-passionate curators and assistant legislators to Elizabeth May who also gave up time to give us private tours of:
- The Preservation Centre in Gatineau, which houses vaults filled with paintings, media and lots of important archives
- The Museum of Science and Technology’s Storage Facility (which is apparently cooler than the museum itself)
This year was the final time Dr. Jacklyn Duffin, Hannah Professor in the History of Medicine, organized the history of medicine trip, making the fate of future trips uncertain. So instead of telling you how cool everything was (hopefully the photos can show that), I thought I’d share the value I see in keeping the tradition alive.
1. Cool Architecture: The Role of design, décor and architecture in medicine
Arriving at our first stop, the Gatineau Preservation Centre, what stood out most was the architecture. The vaults were inside a huge cement box that looked like the set of a parkour film; while the top floor, where restoration was done, resembled a Lego village complete with primary colour paints and street names for corridors. Whether you cared about the science behind restoring artifacts or not, the design was very hard to ignore.
On a day-to-day basis, physicians not only interact with patients, but with their environment as well. While it’s not practical or financially viable to have an architect design each hospital as a unique piece of art, the impact of space is large enough to warrant investing some thought. There are already lots of examples of environment helping with patient or doctor experiences:
- Having windows in the ICU rooms to help with delirium
- Having paintings/magazines in waiting rooms to make wait times seem shorter
- Having healing gardens to reduce stress for patients and health care workers
- Having cartoon characters on walls in children’s hospitals
- Having the nursing station in the middle of a room, visible to all patients, to reduce anxiety
- Decorating your office with pictures of family to make working there more enjoyable.
(for more evidence of the importance of environment in health- check out this NYT article here!)
Obviously, during an emergency, it won’t matter how aesthetically pleasing the sheets or walls are, but the vast majority of hospital interactions with patients and among health care workers aren’t immediately urgent. In these instances, a little interior design can work its subtle magic on people’s mood and their interactions because we all (I think) appreciate pretty things. It’s why chefs create garnishes and why companies invest in packaging. In the long run these small effects can add up to increase overall wellbeing and happiness.
2. Studying History is humbling and reminds you that your actions might outlive you
If you’ve ever been to a really old place, you’ll know that you get a strange surreal feeling, like you are experiencing something bigger than yourself (hopefully it’s not just me). When I was 16 and my mom took me to the ruins of Persepolis (wiki: “the ceremonial capital of the Achaemenid Empire”) and I felt it for the first time while trying to imagine what it looked like thousands of years ago before Alexander attacked it. It reminds you at once of how insignificant you are and how capable you are of creating something that can last for generations after you are gone.
The profession of medicine can be demanding: long hours, bad news, on call shifts, high stake decisions and emotional fatigue to name but a few. It’s in these moments when remembering that you’re working towards something bigger helps. One day when we’ve all left this planet, curators, historians and medical students may look through the ultrasound machines, pacemakers and lounge room coffee machines we used and try to uncover the story of our daily lives. We can’t predict which of the thousands of items we see and use in our lifetime will survive as artifacts, but we can choose what kind of story they tell.
3. History is full of lessons and wisdom
Finally, most important of all is that history is an endless resource of wisdom and lessons. We constantly look to our tutors, teachers and mentors for guidance for medicine because it’s easily accessible; but why stop there?
From history you can learn to be creative, and to draw inspiration from new places. Over the course of the weekend, we saw multiple examples of technology from other industries being adapted to medicine.
- The cloth used to make sails being used as a backing for fragile paintings
- Ultrasound machines being used to detect aircraft defects and in the navy before being applied to medicine
- The Fibroscan for the liver coming from cheese manufacturing (I technically learnt this in class after the trip but it helps prove the point)
History’s mistakes teach us to not just accept what we’ve been told but to dig deeper and ask questions because things may not be what they seem. During our visit to the Storage room, the curator’s personal research on artifacts in the storage revealed that Sir William Osler – a great Canadian medical teacher – may have used the remains of aboriginal bodies for research purposes. Another inquiry led the curator to discover that models of babies with syphilis were used to promote eugenics and not medical education as previously believed. If we remain passive in our learning and acceptance of new information, it’s often the patient who will pay the price.
(In conclusion) I hope there will be many more history of medicine trips to come because there is still a lot that history can teach us (and lots of cities to be seen) before we begin our practices.
A version of this blog post appeared previously on the Medicine and Literature blog. Find it here. Thanks to Sallya Aleboyeh for her permission to repost it here.
Are you a constructive problem-solver or a destructive problem-solver? Some strategies for working in groups
Here at Queen’s UGME, we use small group learning a great deal—from our prosections to PBL-based Facilitated Small Group Learning, to our TBL-based Small Group Learning.
One very important aspect of group learning is preparing students to work successfully in teams. We do this in our first sessions in Orientation Week and in our new course, Introduction to Physician Roles.
In my quest to support our faculty in promoting successful group learning, I recently came across a jewel and I thought I’d share it with you.
The jewel is actually a whole book: Team writing: A guide to working in groups by Joanna Wolfe (2010, Bedford/St. Martin’s). I started with my usual dipping into sections and found myself reading cover to cover because of the concise, sensible and evocative ideas.
The concept I wanted to talk to you about today is what Wolfe terms Constructive and Destructive Conflicts.
Our students have lots of experience negotiating in groups (Think of all those high school groups! And case work in Commerce and projects in Engineering! And Lab partners!) and in making sure their groups work well. But research tells us that conflict in groups is a very challenging part of arriving at a successful outcome. Teams that deal with conflict by competing or trying to avoid the conflict are likely to suffer. One main aspect of conflict is not to prematurely close a discussion because of conflict but to make sure it’s healthy.
I think Joanna Wolfe’s ideas would further help students solve problems themselves, by deciding if they are constructive or destructive in a conflict situation.
The term constructive conflict was coined to stress the productive role that healthy conflict can play in problem-solving. Constructive conflict occurs when two people share the same goal but hold different ideas about how to achieve that goal. (Wolfe p. 52)
This type of conflict is good especially when there is productive debate of merits and drawbacks of ideas in pursuit of the best solution to a problems. But not all conflict aids learning. Destructive conflict occurs when there is intransigence, mockery or ridicule, personal affronts, and emotional defensiveness. (Wolfe, p. 53)
Here are the differences between Constructive Conflict and Destructive Conflict as recorded by Wolfe. Can you see aspects of yourself in the Destructive Conflict? in Constructive Conflict?
If you find you are in destructive conflict mode, here are some strategies Wolfe recommends (italics mine):
- Clarify roles and responsibilities up front in a task schedule.
- Lay ground rules for conversation
- Set aside time for uncritical brainstorming
- Get input from everyone in the group including the introverts who may need more time
- Restate ideas (to help with listening)
- Don’t interrupt or if you do, apologize, write down your idea, listen, and wait
- Set time limits for discussion of certain items before moving to an action proposal
- Establish team priorities in a project plan or team charter
I found a few other helpful ideas from GOE, a group which has worked with NASA on simulation of small groups for space missions.
- When a team members offers a dissenting point of view, thank her/him for speaking up (to encourage others to speak up).
- Easiest way to kill psychological safety? Punish someone for voicing a dissenting opinion.
- When two team members have an interpersonal conflict, it should typically be handled in private perhaps with a neutral mediator.
- Conflicts sometimes emerge because small concerns go unchecked. Talk with your team to bring irritants to the surface before they become bigger problems.
- Be constructive when you disagree with a team member (to model how to disagree effectively).
- Admit your own concerns or mistakes (so other team members become comfortable voicing theirs).
And here’s one I use: Think of a role model who handles conflict well, and channel their behaviour or even their words.
I haven’t even touched on the communication styles Wolfe identifies (Competitive vs Highly Considerate, Self-promotional vs Self-deprecating, and Action-Oriented vs. Holistic problem-solving styles) in Chapter 7. But this will give you a good taste of self-analysis and strategies to assist in moving the team forward.
Stay tuned in a later blog article for Jewel 2 for small group learning: What are good roles a small group learner can adopt? A small group facilitator can adopt?
In the meantime, what do you feel can aid in preventing destructive conflict in a group? And enhance constructive conflict?
When your objective is to write learning objectives…
Several times over the last few weeks, I’ve had conversations with course directors and instructors about writing learning objectives.
Many people – from award-winning educators to rookies and everyone in between – find writing learning objectives a challenge. The typical advice of write out who will do what under what conditions is vague, so it’s often not very helpful.
“General” learning objectives – from our UGME Competency Framework, aka the Red Book* – are already assigned to your course, and possibly to your session by your course director.
The key task for instructors is to take these general objectives and annotate them with specific objectives for their sessions, including what level of learning, such as comprehension, application or analysis. (This is from something called “Bloom’s Taxonomy”, if you’re interested in the research behind this).
A natural starting point is: What do you want your learners to take away from your session?
Frequently the response is:
- “I want them to know….”
- “I want them to understand….”
- “I want them to be able to…”
Once you’ve wrestled something like this into sentences, I realize it’s disheartening to have someone like me come along and say, “Uh, no, that’s not up to scratch.”
What’s wrong with “know” and “understand”? Isn’t that exactly what we’d like our students to walk away with – knowledge, understanding, skills? Absolutely. The challenge with these so-called “bad objective verbs” is that we can’t measure them through assessment. How do we know they know?
That’s the starting point for writing a better learning objective. If you want to assess that students know something, how will you assess that?
For example, while we can’t readily assess if a learner “understands” a concept, we can assess whether they can “define”, “describe”, “analyze”, or “summarize” material.
Here’s my “secret” that I use all the time to write learning objectives – I can’t memorize anything to save my life, so I rely on what I informally call my Verb Cheat Sheet. The one I’ve used for many years was published by Washington Hospital Centre, Office of Continuing Medical Education. It list cognitive domains (levels) and suggests verbs for each one. There are many such lists available on the Internet if you search “learning objectives” (here’s another one that’s more colourful than my basic chart, below).
Well-written learning objectives can help learners focus on what material they need to learn and what level of mastery is expected. Well-written objectives can assist instructors in creating assessment questions by reminding you of the skills you want students to demonstrate.
Here’s my quick three step method to annotating your assigned objectives on your MEdTech Learning Event page with your learning-event specific objectives:
- Start with writing your know or understand statements: what do you want learners to know or understand after your session?
- Think about what level of understanding you want students to demonstrate and how you would measure that (scan the verb chart for ideas)
- Write a declarative sentence of your expectation of students’ abilities following your session. In your draft, start it off with “The learner will”. For example: The learner will identify the bones of the hand on a reference diagram. Your objective would be: “Identify the bones of the hand on a reference diagram.”
As a fourth step, feel free to email your draft objectives to me at firstname.lastname@example.org for review and assistance (if needed). I’m happy to help.
Table excerpted from Washington Hospital Center, Office of Continuing Medical Education’s “Behavioral Verbs for Writing Objectives in the Cognitive, Affective and Psychomotor Domains” (no date).
* The “Red Book” got its name because for the first edition (we’re now on the fourth), the card stock used for the cover was red. Over time, everyone started calling it the “Red Book”.
Online modules can enhance curriculum content delivery
Do you want to build an eModule?
Online modules, or eModules, are one of the content delivery methods available for use in our UGME curriculum.
As with any content delivery method, the teacher’s job is to define objectives, then organize and deliver new content to students. Online modules can deliver content efficiently and creatively but they’re not without potential pitfalls, so planning is key.
Unlike traditional lectures, online modules can curate other online content like a museum exhibit: you can select useful works from others and present these with guidance. The potential pitfall here is if not done carefully, modules can be information overload.
Modules can have interactivity, such as multiple choice questions with automated feedback. This can help keep students engaged as they work through the new content. Remember, though, for UGME, we aren’t building complete online courses – our eModules are prefaces to in-class interactive case/problem-based learning.
Carefully created eModules can be particularly useful where there is no resource appropriate for this level of learner.
Using an online module to deliver new content means you can use classroom time for interactive problem-solving: having completed the module, students come in prepared to apply their new knowledge.
Online modules are intended to be fully integrated with the rest of the UG curriculum – they don’t stand alone, but are one tool to deliver content students later apply in other settings, both classroom and clinical. Modules used to deliver new content in pre-clerkship can later be used by students as review during particular clerkship rotations, for example.
Here are some examples of the types of online modules in use in Undergraduate Medicine:
- Collaborative Leadership & Conflict Resolution
- Introduction to Social Determinants of Health & Advocacy
- An Approach to Lung Cancer
- Residents preparing to teach 1: Know your learner (This last one isn’t technically part of the UG curriculum; it’s for residents who teach our UG students).
We also have a newly-created MEdTech community “Queen’s UGME E-Curriculum” designed to provide links to all UGME online modules. (Requires MEdTech log-in to access). As it’s currently under construction, there may be a few modules missing at the moment.
To help avoid some of the pitfalls of online modules – such as content overload, not providing sufficient guidance for students, and lack of linkage to subsequent sessions, the Teaching, Learning, and Innovation Committee, the UGME Education Team, and EdTech have implemented a streamlined process for creating and adopting new eModules for the UGME curriculum.
The process starts with content creation and/or compilation, followed by design, then support and follow-up for incorporating the module in your teaching.
If you already have a good idea of what you’d like to do, you can use the form found here to start the process.
Tips to help with Teaching Dossiers in your upcoming reports:
Here’s a riddle for you:
It may not be the type of writing you’re used to, and it requires thinking and reflection about an aspect of your work that you may not think as much about. It has an intimidating word in the title and is the first hurdle in preparing an outline of your work. What is it?
Answer: A Teaching Philosophy Statement
What is a teaching philosophy statement?
A Teaching Philosophy Statement is a reflective statement of your beliefs about of vision of teaching, your educational goals, and preferred educational practices/approach(es). Included are reasons for your teaching approaches. Critical self-reflection is a key component here. Your Teaching Philosophy can inform all of the subsequent materials in your dossier—acting as the spine of your dossier. It should also discuss how you put your beliefs into practice by including concrete examples of what you do or anticipate doing in the classroom.
Often medical faculty are required to prepare a teaching dossier or portfolio. These are often requirements for awards, for competitions or for promotion.
The actual dossier may be a familiar piece of writing for many of you: Describe what I do, prove what I do, summarize what I do.
But most dossiers start off requiring you to write a Teaching Philosophy Statement.
And this is where you may come up against a form of writing that is somewhat unfamiliar, unless you specialize in narratives or reflection.
Annual reports are coming up, and awards are being bruited about. So I thought it was timely for some ideas, tips and definitions for you, some from a much longer piece I’ve written on the Teaching Dossier for OHSE, and others from readings that have struck me.
(If you’ve done all your thinking and just want some writing tips, skip to TIP 4.)
Tip 1: Don’t do it…first
First of all, I suggest leaving your teaching philosophy alone until you’ve prepared some of the other parts of your dossier. So my tip is: Get your materials, your explanations, proof and evidence of your teaching together. Then…
Look through all your data. What similarities do you see? Any patterns?
What does this say about you as a teacher? What have your students said about you over the years? (or year, if you just started). What have your colleagues or your Course Director or Dept. Head said about your teaching?
These are all other parts of the dossier, necessary, and helpful to reflection.
Tip 2: Reflect
Yes, there’s that word again…Reflect. Or, if you don’t like to reflect, try: Analysing or recalling. You can also mull, ponder or ruminate.
I find it helps me reflect if I have prompts or hooks to anchor my thoughts. Try these 3 questions first, and just jot ideas down as they come to you. (You can “word splash”–just what the phrase says.)
Make your teaching philosophy personal to you
1) Why do I teach?
2) What do I want my students to leave my class with?
3) What do I believe my role is in the classroom?
Now try this: What in your experience and/or in your study of education has lead you to believe this? Describe your preferred approach, practices, and methods.
Need more help with your reflection?
Try these prompts to make your writing soar: (but don’t use all of them to write your statement or it will be a book, not a statement!)
- Put students first: In many courses on pedagogy, teachers are advised to place the students as learners at the centre or forefront of their teaching. If you begin with knowing how your students learn, how does that impact on you? What would be some of the first steps you would take in your classes?
- Learning: What is your definition of learning? How do you facilitate this in the classroom? How have your experiences influenced your view of learning?
- Teaching: What is your definition of an effective teacher? What are the roles and activities of an effective teacher? How do you challenge or engage learners? How do you teach? This should be a reflective statement describing your preferred approach, practices, and methods.
- Your teaching experiences: Think of times when you have been an effective teacher. What were you doing? Why and how? Times when you were ineffective? What were you doing? How can you improve that?
- Your teaching strengths: What are your strengths as a teacher? How will you capitalize on this? What are your weaknesses? How will you improve this?
And lastly, try these prompts:
- What are the chief goals you have for your students?
- What content knowledge and process skills, including career and lifelong goals, need your students achieve?
- How do you help your students achieve their goals?
NOTE: Please don’t try to answer all of these questions in one Teaching Philosophy Statement. Select a few that will guide you personally as they relate to you. See Tip 10 below in #4.
So what we’ve done so far is Collect, Select, and Reflect*. (*Sheila’s patented approach to dossiers and portfolios.)
TIP 3: Use and outline or a graphic organizer
Some people are gifted enough to have full statements spring full blown from their minds. I on the other hand, need an outline. Now, my outline is usually just a mass of words that I start organizing into themes. Thematic organization is actually just pattern recognition. However, you may find some helpers such as word clouds or concept maps useful. Here are some I found on the web as examples:
If we’re still using my approach, now we’ve done: Collect, select, reflect, connect.
TIP 4: 10 TIPS for crafting your writing:
i. Write in the first person with “I”, “my” etc.
ii. Some people use a metaphor to guide their statement. (teacher as coach, fitness trainer, gardener, strike a spark, not filling a pail but lighting a fire, tour guide, 911 dispatcher… Teaching is like….)
iii. Use the teaching philosophy statement as a guide to link with your responsibilities, strategies and effectiveness sections to form a cohesive dossier by drawing connections this statement.
iv. Buff or polish it to ideally 3-4 paragraphs—max. full page for physician educators’ teaching dossiers. (Some requirements are for 2 pages. That violates writing tip # 10.)
v. Provide specific supportive evidence, either from personal teaching experience or relevant teaching literature (See prompts above). Treat this like evidence in a study, if that expository kind of writing is more familiar.
vi. Use language appropriate to the audience.
vii. Work with another person as an editor and/or brainstormer. And view others’ statements as exemplars.
viii. Ensure that you can refer back to the key points of your philosophy in later components.
ix. If you can, make it a narrative, engaging and rhetorically effective text. Whoever is reading this might as well enjoy the experience.
x. Be brief and concise.
OK, I’m pushing it, but we’ve done all these steps: Collect, select, reflect, connect and now we’re beginning to “perfect” or “confect”.
I hope these are helpful tips and strategies for you. Please let me know if they are helpful and also if you have tips and strategies as well! Happy writing!
- Components of a Teaching Dossier, Queen’s OHSE.
- Elements of a Teaching Dossier: the Basics Centre for Teaching and Learning
- Writing a teaching philosophy
- R. Neil Johnson. Assessment Rubric for Teaching/Learning Philosophy. Schreyer Institute for Teaching Excellence. Penn State University.
- My Philosophy
Fall Education Retreat set for December 6
The annual UGME Fall Education Retreat will be held December 6 with plenary and breakout sessions designed to help our faculty improve their teaching and assessment skills as well as to provide opportunities for networking and informal discussions.
The retreat brings together course directors from pre-clerkship and clerkship, unit leads, intrinsic role leads, and administrative staff who support the program. Session topics were developed based on course evaluation feedback, faculty team suggestions and accreditation priorities.
The full-day program will be held at the Donald Gordon Centre on Union Street.
New to the program, this year’s retreat will feature guest speaker Dr. Jay Rosenfield addressing the topic of The future of medical education in Canada and our places in it. Dr. Rosenfield is a professor of paediatrics (and former vice-dean, MD Program) at the University of Toronto and a Developmental Paediatrician at the Hospital for Sick Children and Holland-Bloorview Kids Rehab.
Associate Dean Dr. Tony Sanfilippo will provide an update on UGME news and initiatives and two other plenary sessions will address using a competency-based education lens to frame completion of Years 1 & 2 and incorporating principles of diversity in the curriculum.
Break-out workshops will address effective SGL sessions, Entrustable Professional Activities (EPAs) in clerkship, creating key features questions and improving resident teaching of clerks.
For more information and to register, click here.
- Credits for Family Physicians: This Group Learning program meets the certification criteria of the College of Family Physicians of Canada and has been certified by Queen’s University for up to 5 Mainpro+ credits.
- Credits for Specialists: This event is an Accredited Group Learning Activity (Section 1) as defined by the Maintenance of Certification Program of The Royal College of Physicians and Surgeons of Canada, and approved by Queen’s University, You may claim a maximum of 5 hours.
- Credits for Others: This is an accredited learning activity which provided up to 5 hours of Continuing Education
Applying decluttering principles to learning event planning
My family and I recently relocated from a 2300-square-foot, five-bedroom house to an under-1100-square foot, three-bedroom townhouse to be closer to my son’s school and my office at Queen’s. This has required divesting ourselves of a great many belongings. Some things were easy (no more guest room = get rid of bedroom suite of furniture), but now we’re down to what home organizers call decluttering.
Near the beginning of my downsizing project, a colleague passed along a copy of one such book, Marie Kondo’s The Life-Changing Magic of Tidying Up: The Japanese Art of Decluttering and Organizing. (Yes, there was some irony in acquiring a new book when I was purging others, but that’s another story).
In this bestselling book, Kondo sets out principles for determining how to declutter. Since I’m immersed in decluttering (and unpacking can be a mind-numbing task) I started thinking about applying Kondo’s principles to learning events.
Decluttering principle: Uncover what you want your space to be
Learning Event translation: Uncover what you want your learning event to be
What underlies this principle is visioning: think about what it is you want your learning event to look like before you start making changes. What do you need and want to accomplish in your 60- or 120-minute session? What are your assigned learning objectives? Keep in mind this planning cannot be a solo activity as your events are connected to others – course directors need to balance topics and learning event types throughout a course, so check in with anyone impacted by changes you’re thinking about making. Do you want to add interactive components? Revise case studies? Improve group work? Streamline the order of MCC presentations?
Decluttering principle: Only keep those items that give you a “spark of joy”
Learning Event translation: Only keep those activities that spark learning
Take a good look at the activities and materials you’re using in your learning event: are these aligned with your objectives? Do they provide meaningful learning for your students? Are the points clear? How many cases are you using? Would it be better to have three well-constructed, in-depth cases, or the five you’re currently using? Are you being deliberate in what you’re including, or just force of habit?
Decluttering principle: Have a designated place for everything
Learning Event translation: Have a designated time for everything
Consider making a timeline plan for your learning event to keep everything “in its place.” This doesn’t have to be rigid to the last second, but can help keep things on track. If you have an outline that includes each topic or case, discussion/question time, breaks, wrap-up/summarizing time, it will help keep you on track and ensure finish on time. It also helps let you know when to wrap up discussions (no matter how interesting) to move onto the next important point.
* * * *
Not everyone can – or should – dive into decluttering their home (see this New York Times opinion piece which argues very clearly that there’s class politics involved in the decluttering movement). Likewise, not every learning event is in need of decluttering. However, if you’re frequently going over time, or find that you’re not meeting the learning objectives you have, or you’re just generally dissatisfied with your teaching sessions, decluttering may be a place to start.
One caveat: Decluttering can’t be done in a vacuum – either at home or for a learning event. For every fan of Kondo’s work, there are partners, children and other relatives who complain (rightly) that stuff they needed, wanted or sparked joy for them has been summarily tossed by an obsessive tidier. If you’re interested in decluttering your learning events on a larger scale (for example, does this MCC presentation even belong in my session?), that necessitates conversations and cooperation with your course director and fellow instructors and I’m happy to pitch in, too.
On boy doctors, girl doctors, and advocating for my son
“I hope it’s a boy doctor.”
It was the spring of 2014, and I was walking with my then-10-year-old son from our car to our family health team’s office. Our doctor is part of the Queen’s Family Health team, so we often see residents rather than our assigned physician. For this reason (and because I don’t ask about the schedule when I book appointments), we don’t always know the gender of the person who’ll be providing care on a specific day. (We can always ask to see our doctor, however, I’ve never done this. I’ve always bought into this model of medical education – even before I started working as an educational developer in the undergraduate medical program).
It had never mattered to my son. Until that day in April.
We were heading to an appointment about recurring rectal bleeding. He had first presented with this on New Year’s Day. The digital rectal examination at the child out patient clinic the next day was an uncomfortable experience that he now refers to as “the butt thing”.
If they’re going to do “the butt thing” again today he wants a boy doctor, he said.
“You know,” I said, matter-of-factly (or at least I attempted to be matter-of-fact), “at the Med School where I work they teach boy doctors and girl doctors all the same things. They all learn how to look after everybody.”
“Yeah, I know,” he said. “But if they do the butt thing, I want a boy doctor.”
My son has autism. He’s seen multiple physicians, therapists and interventionists in his short life. Until this point, he had never commented on their genders. This was a new request. I had until his name was called to sort out for myself what I would do.
There was a flurry of news reports the previous fall, in October 2013, about whether patients should have the right to choose their physician based on race, religion or gender. (See here and here for some of this coverage). The news hook was a position statement by The Society of Obstetricians and Gynecologists that argued its members should resist such requests in emergency and other after-hours situations.
Perhaps because the articles were focused on obs/gyn, much of the commentary that followed focused on women, immigrants, and others with religious concerns. I can’t recall any discussion about children and their preferences in the gender of a treating physician. Until that day in 2014, I’d never given it any thought myself. My kids have been “stuck” with whichever family physician I’ve found for us.
Until my son’s request for a “boy doctor.”
Is this a reasonable request? Is my job as his mother to convince him that physicians of either gender will provide him with great care and that he should feel comfortable with either gender? Or is my job to talk with the clinic staff, explain his concerns, and ask to see a male doctor on duty that day?
The resident we were scheduled with that day was, indeed, the “boy doctor” so I was let off the hook of having to ask to have the attending (male) physician replace the other (female) resident. As a woman, as an educator, I’m uncomfortable with the idea of that conversation. As a mother and my son’s advocate, I think it’s something I would have had to do to support him in his request for a “boy doctor” for this invasive examination.
While I was happy to be off the hook that day, I have yet to resolve this conundrum. Is it reasonable for patients (or parents of patients) to make such requests? If gender requests are OK, are other requests OK, too — race, religion, age? Are children a special case?
In my role as an educational developer, I take these mental musings further: What does this mean for medical education? Do our students need special instruction on how to address these patient concerns? Would I have more or fewer reservations speaking up on this for my child if I weren’t involved in medical education? Are there other parents who feel they can’t bring things like this up for other reasons? Is this a problem? How can this be addressed?
These are questions I’ve continued to wrestle with and I suspect I will for a long time. What do you think?
Recognizing our Course Directors
“The People Who Make Organizations Go – or Stop” was the intriguing title of an article that appeared in the Harvard Business Review in 2002, authored by management experts Rob Cross and Laurence Prusak. In it, they describe the key people and largely informal networks that are necessary to the functioning of any organization, regardless of its purpose or product. They make the point that the success or failure of organizations can usually be attributed to the effectiveness of a group of key people they refer to as “central connectors”. In their own words:
“In most cases, the central connectors are not the formally designated go-to people in the unit. For instance, the information flow… at a large technology consulting company we worked with depended almost entirely on five midlevel managers. They would, for instance, give their colleagues background information about key clients or offer ideas on new technologies that could be employed in a given project. These managers handled most technical questions themselves, and when they couldn’t, they guided their colleagues to someone else in the informal network—regardless of functional area—who had the relevant expertise. Each of these central connectors spent an hour or more every day helping the other 108 people in the group. But while their colleagues readily acknowledged the connectors’ importance, their efforts were not recognized, let alone rewarded, by the company. “
In a medical school, these critical central connectors are called Course Directors. They are the folks with the practical knowledge, functional relationships and, importantly, “street cred” required to translate the high level educational goals of our program into the multiple packets (courses) of education that, in aggregate, will come together to produce the fully formed graduate, ready for residency and great things beyond. Their job is basically to take a subset of the overall program objectives that are assigned to them by the Curriculum Committee, and develop the multiple components of teaching and assessment designed to ensure our students achieve the objectives. In doing so, they must engage and coordinate the efforts of their professional colleagues, other members of the educational community, educational specialists and our administrative support staff. By effectively orchestrating all these efforts, guided by the “score” provided by the curricular framework, they develop an effective and coordinated educational experience for our students. They are truly “connectors” as described by Cross and Prusak. They are absolutely indispensible to the success of the program.
Last week, we recognized the contributions of four of our Course Directors who are moving on from those roles, three of whom are retiring. Fittingly, students, representing those who had benefited so greatly from the efforts and dedication of these remarkable people, provided the tributes. In their words:
Elisabeth Merner, Meds 2019, speaking on behalf of Dr. Jennifer MacKenzie:
It’s a pleasure to thank Dr. Mackenzie for all of her work as the inaugural Co-Director of the QuARMS program on behalf of the QuARMS students.
Most people have heard of the QuARMS program, but very few people understand the QuARMS vision as well as you do, Dr. Mackenzie. From the very beginning of the program, you helped to deepen students’ understanding of the role of the physician, the qualities of a leader in the medical community, and the values and ethics that are to be upheld in medicine.
For some, it would be daunting to teach these topics to a group of teenagers, but you were more than ready for the challenge. Your passion for education and innovation has been clear to all of us. We appreciate the fact that you attended every single three hour Wednesday session for the first two years of the QuARMS program. Honestly, with young adults of your own, we would have understood if you claimed that you had administrative duties to perform and missed out on one or two of the sessions – but you were there, leading by example.
We also recognize your role in designing the QuARMS curriculum, which is unlike any other program in Canada. Through service-learning projects, you helped students to understand the importance of social accountability within the medical profession. You also led a transformation in how students think about volunteer work. Your vision and your values have shaped the QuARMS program. Thanks to you, service-learning projects have now become a much more important part of our medical school here at Queen’s.
On behalf of four generations of QuARMS students, we want to thank you, Dr. Mackenzie, for your tireless dedication to the development of the QuARMS program and to shaping our lives, both as future professionals and as mature students.”
Jeff Mah, Meds 2019, speaking on behalf of Dr. Conrad Reifel,
Let me start off by saying, anatomy is one of the most overwhelming topics in medicine. From head to toe, there is a seemingly endless number of muscles, bones, nerves, blood vessels and organs that each serve a specific purpose and thus need to be learned. Needless to say, without a good teacher, this subject can be very difficult to master.
At Queen’s, we have been extremely fortunate to have had Dr. Conrad Reifel as an anatomy instructor for the last 43 years. Over his time here, Dr. Reifel has guided thousands of medical students through the vast, unfamiliar world of gross anatomy and has done so with patience and commitment. What I always appreciated about Dr. Reifel was his ability to take an area of the body that is incredibly complex and systematically break it down so that by the time he finished talking, it seemed quite manageable.
Dr. Reifel also has a fantastic ability to keep a class engaged even when teaching a somewhat dry topic with his unique sense of humour and vast repertoire of personal anecdotes. I’ll never forget Dr. Reifel, standing at the front of the class with his arms outstretched using his own body to demonstrate the anatomy of the uterus. While the memory of that lecture does conjure up some odd images, I’ve never had trouble visualizing the uterine anatomy since then.
Dr. Reifel, on behalf of the medical students of Queen’s University, past and present, thank you for the decades of excellent instruction. Please know that you are respected and loved by the students you have taught and have positively impacted the lives of so many. You will be truly missed and we wish you all the best in your retirement.
Calvin Santiago, Meds 2018, speaking on behalf of Dr. Lewis Tomalty
Dr Tomalty has been teaching in the Mechanisms of Disease course since 2010 and took over as Course Director in 2012. In this role, Dr. Tomalty worked tirelessly to make improvements to the course. He attended all the MoD lectures and met weekly with the class curricular reps. He set up consultations with students and faculty, organized a strategic planning curricular retreat and established a framework to link together a diverse range of subjects including pathology, immunology, microbiology and infectious disease.
In addition to his role as Course Director for the Mechanisms of Disease Course, Dr. Tomalty also previously served as Vice Dean of Medical Education for the Faculty of Health Sciences and is the current Chair of the Course and Faculty Review Committee. As well, Dr. Tomalty is heavily involved in global health initiatives and provides his consultation services on infection control in Mongolia.
On a more personal note, and speaking on behalf of the many students who have had the privilege of knowing him over the years, I have found him to be an absolute pleasure to work with. Even in his last year as the Course Director, he still met with the curricular reps on a weekly basis to discuss ways to fine-tune an already well-received course. I know from their stories that they looked forward to these meetings with Dr. Tomalty, calling it their weekly “T-Time”. To quote another student, he is the “bestest, most efficient chair of a meeting ever.” I look to him as an exemplary role model of a leader and educator and as an inspiration for stylishly funky socks.
Dr. Tomalty, thank you so much for your leadership as Course Director and I wish you all the best in your future endeavours.
Kate Rath-Wilson, Meds 2019, speaking on behalf of Dr. Chris Ward
Dr. Chris Ward was one of the inaugural course directors for our new curriculum when it was introduced in 2009, and was responsible for developing and consistently aiming to improve the Normal Human Function course in Term 1. He has coordinated multiple faculty members, built a strong curriculum for the course, been part of the initiative to bring in Drs Moffatt and Parker to apply physiology to cases (which has added immeasurably to our learning), and helped to build introductory physiology modules for students struggling with physiology. This led him to be asked to join many, many, many UGME committees, including (but not limited to) the Curriculum Committee, The Teaching, Learning and Innovation Committee, and the Student Assessment Committee – currently, Dr. Gibson believes this to be a record for any one course director. He was instrumental in preparing our brief for the CACMS/LCME accreditation, reviewing all the sections that pertained to foundational science and its impact across the curriculum. Dr. Ward is known at Curriculum Committee for being the person to move that the meeting be adjourned! It started with only a few times, but now we look to him for this and he’s become everyone’s favourite motion-maker!
As a medical student, I have not had much of a chance to get to know Dr. Ward personally. His name will always be associated with hypovolemic shock for me – which some may deem as unfortunate but I think is one of the highest honours a teacher can be granted. He elucidated complex cardiac physics with clarity and patience, and acted as a model to the other professors in his course. He expertly managed a complex course, juggling the schedules of many faculty members and even more stressed out A-type students.
Dr. Ward has worked tirelessly behind the scenes to build our medical curriculum from the bottom up. This is a position that often lacks glory and recognition. We owe Dr. Ward a lifetime’s worth of thanks. The positive impact he has had as director of the Normal Human Function course on his colleagues and his students is immeasurable, and we thank him today for his contributions to the foundational medical knowledge of hundreds of medical students and wish him all the best for his future work.
Let me add my thanks and personal appreciation to those of our students. I’d also like to acknowledge the ongoing efforts of all our Course Directors, who carry out their roles so effectively and provide those key “central connections” so essential to our program.
All photographs by Lars Hagberg
Anthony J. Sanfilippo, MD, FRCP(C)
Undergraduate Medical Education