The stories we tell…

I’ve been thinking a lot about stories lately.

It’s partly because of an independent study I’m completing at the Queen’s Faculty of Education on narrative inquiry. It’s partly because I’m increasingly conscious of several aging family members whose stories I want to record—and of other members whose stories have been lost. It’s partly because I’ve watched some excellent biographical documentaries on Netflix recently. It’s also partly because I just love good stories.

As an educator, I embrace stories and that’s easy to do since we’re surrounded by stories: The stories we tell. The stories we hear. The stories we learn—and learn from.

We all have stories we’ve seem to have known forever that we know we will share and pass along. This is because stories are personal, usually relatable, and “knowable”—it’s a way to memorize without strict rote memory.

We tell stories to impart lessons, to entertain, to remember. And sometimes all three.

Like the story I tell of leaving a political science essay to the last minute when I was in my second year at the University of King’s College. The one I stayed up until 3 a.m. writing, then got up at 5 a.m. to type it (on my electric typewriter, no personal computers in those days). It was on the Cuban Missile Crisis. Except in my sleep-deprived state, I didn’t type it that way. Instead, I wrote of the Cuban Missal Crisis.

And my professor circled “missal” every single time it appeared through the paper. (Which was a lot). I respected this man profoundly and his was my favourite course. I was mortified when he returned the papers and I saw all the  circles (every single time). Still, he gifted me with a B+ (which was rare for him), so the content, if not the spelling, was fairly sound.

Why do I tell this story? (1) It’s kind of funny. (What would a Cuban missal crisis look like? Too many prayer books? Too few? Typos within them?) (2) It cautions against procrastination. (Which is why I shared it with my daughter when she started university and use it to remind myself, constantly). And (3) it advocates good proofreading – which we should all do, all the time. Plus, it’s relatable to many who have “pulled an all-nighter” who nod and smile through the telling (or reading) of this anecdote.

Medicine, and medical education, relies heavily on stories. Every medical encounter I’ve had as a patient has started with my story – what brought me there. Taking patient histories is one of the first clinical skills our students undertake.

What are case studies if not stories? Some are bare bones, some rich and colourful in detail. Like patients. Like people. We can’t see (or read) all, but we can see (read) enough. Stories are entrées into another person’s life, their point of view, the path they are on.

What goes into a good story? There’s characters, and place, and time, and plot – something has to happen. And woven into this, deliberately or incidentally, is meaning.

Stories can be loud “A-HA!” moments, or a gentle unfolding. They can be meandering streams-of-consciousness (perhaps a bit like this blog post), or a clear, linear narrative. Or something in between.

The best stories are conversations. What are the stories you tell? What stories will be told about you? As a student, as a teacher, as a person?

Do you have a story you want to tell related to medical education? Drop me a line at theresa.suart@queensu.ca – it may fit here in our Guest Blogger posts.

What stories do you want to tell?

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Poetry, journalism, and a Pepsi commercial… or, a meandering parable about balance

I started writing poetry again recently. I do this, then abandon it, then reclaim it at various intervals. I’m always better with it.

This may seem to have very little – if anything – to do with medical education. And, you’re right in one sense. Join me on a little self-indulgent meandering to get to my point.

As I write this, it’s Thanksgiving Day – a day when people traditionally reflect on their blessings and things they’re grateful for. And, I’m on the cusp of a milestone birthday, so perhaps that has made me more introspective than other weeks, when I write about course evaluations and how we value them (we do!), or team-based learning and how it contributes to long-term learning and understanding more than straight lectures (it does!), or ways service-learning contributes to both social accountability and professional development (yes!). So, I find myself thinking about poetry.

On the road to becoming any professional – and medicine is no exception – we ask people to shed a lot of things along the way.

We ask people to shed attitudes that aren’t aligned with their goals. To ditch beliefs that aren’t compatible with where they’re going. To replace erroneous information or practices with those that are proven to be more valid.

The profession of medicine itself demands other things – things I watch colleagues work through and cope with – long days, longer nights, emotional and physical demands they may never have imagined at the start of their careers.

Because, really, none of us truly ever know what we’re getting into.

All of this coalesces in a kaleidoscope of who we were and who we are and who we will be. The parts and colours shifting as the years turn.

My first career was in journalism. In the spring of Grade 12, I was accepted into the four-year Bachelor of Journalism program at the University of King’s College. They only accepted 35 students a year, out of nearly 1,000 applicants, so this was exciting! As parents are wont to do, my father, an English teacher, mentioned my acceptance to a colleague he saw at a conference. That colleague was the late Don Murray, then a professor of Journalism at the University of New Hampshire. Professor Murray later sent me a number of articles and a book on journalism (that I still have and use to this day), but he passed along advice through my father that was even more valuable.

“They’re going to teach her how to write a certain way,” he said. “And that’s important, and she needs to do that. But tell her not to give up her other stuff. She needs to keep doing that, too. It will make her a better writer.”

I haven’t always adhered to that advice, but over 32 years after first hearing it, I know its value. So I put pencil to paper to work out ideas, and thoughts, and metaphors. But, really, I’m claiming a part of myself I refuse to shed. It’s something I need to keep to be me. To be better.

Are there things you’ve accidentally shed along the way that you didn’t need to? Are there parts of you you’d like to reclaim, to give you that edge, that solace, that space to be you, preserved in the full person you want to be?

As I write this, I’m reminded of the 2004 diet Pepsi “old van” commercial… where a thirty-something dad is asked if there’s anything else youthful he’d like to experience and he says his old van. He then imagines his 1980s-era rocker painted van and what driving that in his current life (like dropping his kids off at school) would be like (not good!). Then he drinks his can of pop and is happy with that.

Some things can’t – and likely shouldn’t – be reclaimed. But if there’s something like poetry, or running, or music, or nosing around in antique shops, or reading trashy fiction (however you define that), or some other seemed-not-that-important-at-the-time thing that you miss about being you, consider ways to recapture that. And fit that “old” part amongst the newer parts.

Just maybe not that van.

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Improving your medical teaching practice one minute at a time

Making changes in how we do things can seem overwhelming – whether these are personal wellness habits, work habits, or teaching practice habits. In the face of a huge list or a major innovation it can seem easier to throw in the towel before you begin.

Sustaining change means adopting new practices and habits that you can stick with.

I recently took a six-week online fitness course that focused on these types of incremental changes. The course is designed for working and stay-at-home moms and recognizes that everybody is really, really busy. Our first challenge was to pick a new habit to adopt that could be easily incorporated into our regular day (I chose skip the elevator—take the stairs). Another challenge was to adopt a one-minute daily task and stick with it – because, as the course leader pointed out: everybody has one minute. I (finally) started doing daily balancing exercises for my multiple-injury-damaged ankles. I’m five weeks in on that new daily one-minute habit, so I think it’s going to stick.

Along the way, I started thinking about one-minute habits and how this could apply to medical education. So here’s my challenge to those looking to improve or change their teaching practice:

Think of one thing that you can do in one minute (a day, or one minute at a time) that could improve your work in medical education. Adopt that one-minute habit. Here are some suggestions:

  1. Immediately after teaching, take ONE MINUTE to jot down quick notes on what you want to change the next time you teach. Do it right after your session, or you may forget what it is.

  2. Create a Med Ed “feel good file” in Google docs or another electronic format (this might take more than a minute): put in things like great feedback fro course evaluations, notes to yourself when something went really, really well with a class or a clerk, notes on teaching things you’re really proud of. If you’re having a bad (teaching) day, pull up the file and take ONE MINUTE to remind yourself of the good things you do as a medical educator.

  3. Reserve the last minute of class, seminar, or rounds to get two-sentence student feedback on index cards – what’s their top take-away from your session/seminar/rounds and what’s their muddiest point right now? Have them take ONE MINUTE to give you this feedback. Over the next week, take ONE MINUTE a day to read through some of the cards. Use the feedback to inform changes to your teaching or to shape a follow-up session.

  4. If you’re logged into MEdTech, take ONE MINUTE to annotate your session objectives on MEdTech. You likely already have these objectives in your PowerPoint slides, so you can just match them up to the assigned ones. (If you have multiple objectives, use your ONE MINUTE to do what you can now!)

  5. Start a teaching ideas journal (could be a notebook, or a word file, or the Notes app on your smart phone). After you’ve read a journal article, or talked with a colleague, or attended a workshop, take ONE MINUTE to write down ideas for how to incorporate this new information into your teaching

  6. Email or phone me and ask for help. No, seriously, do this. True story: While I was writing this post, a faculty member called and said: “Do you have one minute right now for a question?” We might not solve your challenge in a ONE MINUTE phone call, but if not, we can set a time to get together.

Sure, you could take more time on some of these ideas — but not at the expense of feeling overwhelmed by “one more thing” on a big project to-do list. Also, remember, these are suggestions to select from. Don’t take on all of them, because that has potential to turn into an overwhelming, throw-away plan. Pick one or two, or create your own. Because everyone has one minute.

 

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Five things attending a gaming expo reinforced about medical education

It’s March Break in much of Ontario – including for UGME students and faculty at Queen’s School of Medicine – so I found myself at “EGLX” in Toronto with my 13-year-old son. Billed as “Canada’s Largest Video Game Expo” the three-day extravaganza included virtual reality, cosplay, exhibitors, panels, artists, a giant Nerf battle, and various and sundry gaming competitions. Given that the height of my gaming career was “VICman” (a Pac-Man knock-off by Commodore back in the early 1980s) and playing a mean game of Tetris (so, translation: Worst. Gamer. Ever.), this is perhaps one of the last places anyone would expect to find me. However: moms do stuff. (Dads do, too. My husband valiantly went to TWO days of it). In this and other unfamiliar territory, medical education is rarely far from my mind. Here are five things the expo reinforced about Med Ed:

  1. Be open to new experiences

VR is cool, but the set-up takes some getting used to for it to work well.

This one works for both teachers and students. Whether it’s tackling a new subject or trying out a different teaching or assessment method, it can pay off to be brave and just dive right in. While I’m not a gaming convert, EGLX gave me a new view to some of my son’s interests and showed the breadth of the industry. When we do the same thing over and over again, we can get trapped in our own “bubble” of experiences and not realize what else is out there. There’s value in new perspectives.

  1. Learning works in multiple directions

I’m used to being in the role of educator – both as a parent and at work, where I’m mostly behind the scenes in the planning stages. It’s important to remember that learning isn’t mono-directional. At the expo, I was the rookie, and my kid the mentor. (And my husband, the trade-show veteran, was the navigator). In medical education, learning comes from our faculty, our students, allied health professionals, our patients and their families.

  1. Technology is cool

More pedaling = more power

What starts as games can turn into tools and vice versa. Some of the virtual reality stuff at the expo was pretty cool (fly like Superman, anyone?) and, for parents, the cycle-to-power-the-game stuff never gets old. (Just when am I going to be able to buy one?). Likewise in the classroom and clinics – what’s the next good thing to enhance learning?

  1. Celebrate accomplishments

One whole segment of the expo featured projects by students at Sheridan College. While this, of course, served to promote the programs at the college, it also gave students well-deserved recognition for hundreds (thousands) of hours of work, problem-solving, and creativity. Sometimes the accomplishments of our students and faculty become routine to us – we need to take time to showcase and celebrate the great things we’re doing.

  1. If something doesn’t work the first time, try something else.

My son wanted to meet some of the YouTube gaming celebrities. (Yeah, I learned this is a thing). Our first day there, we were waiting in a very long line that was moving about one person every five or six minutes. I counted those ahead of us, did some math and figured we’d be there for about 2.5 hours before we hit the front of the line. We ditched the line and went to an awesome ribs place for supper instead. The next day, my son and husband went to one of the YouTube gamer panels, left strategically early, and landed second in line. Likewise in Med Ed, sometimes we introduce innovations and don’t get them quite right. We need to step back, figure out what went wrong, and go at it a different way.

Next week: Five things about medical education reinforced by the multiple shoe stores at the Vaughan Mills Mall. (Just kidding…. Maybe).

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Five ways being a Geneticist helped me improve my teaching skills

By Andrea Guerin, Year 2 Director and Clinical Geneticist

Dr. Andrea Guerin

When growing up, the career choices offered are often dichotomous, do you want to be a lawyer or a firefighter, nurse or entrepreneur, doctor or teacher? In reality, most jobs are a blend of a few different skills. In medicine, doctors can be scientists, can run a business, and for most of us, being a teacher is a large part of our job. At first blush, being a Geneticist and a teacher doesn’t seem to have much in common, but my training in Medical Genetics has significantly influenced my role in education. Here are five examples I’d like to share:

  1. Words matter

Geneticists are wordsmiths. Language is very highly selected, “cause” not “reason”, “typical” not “normal” and “chance” not “risk”. The language I use with my patients is specific and inclusive, positive and hopefully, precise. Words are important, to convey meaning without an agenda, to educate without prejudice. I use the same thought in the classroom. I am mindful of the implicit biases that can be drawn from words. Words are powerful and their power needs to be recognized and headed.

Medicine is learning a new language. So is education. I’m not going to lie, I had never designed a small group session before coming to Queen’s and I certainly did not know what a Directed Independent Learning event was. When I came, I was disoriented, DILs, SGLs, RATs, GTAs. The terminology was overwhelming. But, like learning the language of medicine, I learnt the language of education too. We’ve added a few more in the past year in undergraduate medical education CBME, EPA, with only more to come.

  1. Technology is forever changing, but good ideas stand the test of time

When I started my residency 10 years ago the understanding of genetic testing was very different. Many tests were not available. Testing was laborious, going from gene to gene, with months of anxious anticipation in between. Now, a decade later, I can order a test that looks at all the necessary genes of the body that have a purpose. Results can be available more quickly. Interpretation is more of a challenge, as we learn more, it becomes more evident the gaps in our knowledge and tying findings to patient symptoms can be a challenge. The concept of having parents and environment contributing to the health of the child is an old one, with influences from Ancient Greece to India. This testing is a reinvention of an old idea — we have only identified the individual factors (genes) that support what has been seen for thousands of years.

When I went to medical school, problem based learning was new. Powerpoint was a staple of lectures. There were almost no laptops. We would never have thought to work in groups while in the same classroom. That was an activity reserved for afternoon sessions, segregated into rooms under the watchful eye of a faculty facilitator. Marks were given from formal assessments, not team assignments or readiness assessment tests. That’s not to say assessments were not happening, they were just less formalized. It was a gut feeling. Did the clinical skills tutor think you were professional? Did the small group facilitator see that you participated? Now, assessments, both summative and formative are happening all the time. The actual process has become more concrete and transparent, but the idea has not changed.

  1. It’s all developmental

Genetics is  one of only a few specialties where the patient population spans from before cradle to grave. When I see a patient with a concern, I endeavour to find out when it started. An understanding of development, both physical and emotional, is key to my practice. You must walk, before you run.

Education is no different. The expectation must be adjusted to where the student is in their education journey. It’s okay to not know the differential in the first year, but in fourth year, students must be equipped with the knowledge and expertise to generate a differential and initiate management. Expectations need to match where the learner is, just like my patients.

  1. No person is an island

Genetics is a team sport. In clinic, amongst clinician and researchers spanning the province, country or world, we work together to solve diagnostic mysteries and provide good patient care.

Education is the same. Teachers, admin support, education support, technical support and student support and feedback are essential to the teaching process. Behind every teacher, there is a team supporting them in their journey.

  1. Comfortable with the uncomfortable concept of unknowns

After years of education, I will never be done learning. There is always more to learn, and no physician, despite years of practice and experience knows everything. When I counsel patients I always raise the possibility of an unknown. A confusing result, a question left unanswered. There is no crystal ball.

Education continues to surprise me, but I am open to the concept of something new, unknown. Can we produce excellent physicians using different teaching methods? Of course we can. Each of my colleagues had different curricula, different forms of instruction. There is more than one way to teach — the “best way” is still unknown.

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Five great reasons to attend medical education conferences

This weekend many involved in undergraduate medical education at Queen’s are heading to Montreal for the annual Canadian Conference on Medical Education (CCME). From faculty, to students, to administrative staff, we’re attending as presenters, workshop facilitators, and in several other roles.

As described on its website, CCME is the largest annual gathering of medical educators in Canada. Attendees include Canadian and international medical educators, students, other health educators, health education researchers, administrators, licensing and credentialing organizations and governments. The goal is to “share their experiences in medical education across the learning continuum (from undergraduate to postgraduate to continuing professional development).”

This year’s conference in Montreal from April 16-19 is hosted by the University of Sherbrooke (other partners are the Association of Faculties of Medicine of Canada (AFMC), the Canadian Association for Medical Education (CAME), The College of Family Physicians of Canada (CFPC), The Medical Council of Canada (MCC), and The Royal College of Physicians and Surgeons of Canada (RCPSC).)

With the theme is Accountability: From Self to Society, the program includes workshops, posters, oral presentations and plenary sessions designed “to highlight 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.”ccme theme

Here are five good reasons we take the time from busy spring schedules to take part in this conference:

  1. To present innovations in medical education at Queen’s: We’re doing some great things here at Queen’s and it’s great to share these successes. From early-adoption of the flipped classroom to our First Patient Program, to our Accelerated Route to Medical School – CCME gives a forum to celebrate what we’re doing well.

  2. To learn from colleagues from other Canadian and international medical schools. While we share our innovations, it’s equally beneficial to learn from our colleagues at other schools. We don’t always have to reinvent the wheel.

  3. To wrestle with common issues and gain comfort from being in the same boat. There’s a synergy in working together to sort out challenging issues in medical education.

  4. To network with colleagues from across the country and around the world – this is closely related to both #2 and #3 – networking may not be about a specific challenge at a specific time, it’s making connections with like-minded individuals involved in similar circumstances.

  5. And the food. OK, so this might not be a “good” reason to commit to attend a conference, but it’s certainly a fun part of it. Combining #4’s networking with colleagues with exploring local cuisine is an added bonus.

If you can’t attend this year, consider it for next time. Also, explore conference options closer to home. Our own Queen’s Faculty of Health Sciences Celebration of Teaching, Learning and Scholarship is coming up on June 15.

 

 

 

 

 

 

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