Building a House, Creating a Home

By Matthew Schreier

“There is nothing more important than a good, safe, secure home.”
~Rosalynn Carter

Food, water, shelter, education.

These facets of a healthy, safe lifestyle are seen by most of us as a basic human right.  It is in their steady presence that we are able to pursue our goals of personal growth, intellectual achievement, and career success.  For people in many parts of the world, however, it is in the acquisition these basic rights that they must focus the bulk of their energy.

For one week of this summer, six fellow medical students, one physician, one bioethicist, one firefighter, one dean, and I had the opportunity to travel down to Belize and help a family build themselves a shelter.  Estrella, the woman for whom we would be building a house, lived in a house with her son and mother that had all the components of a home: photographs, decorations, a pair of adorable dogs, and one of the strongest family bonds I have experienced.  The structure of the house itself, however, was a bit less faithful, with the foundation sinking and the floor caving in to the moisture. The shelter that this family deserved was giving out on them, so together with Hand-In-Hand Ministries, we were to come down and assist them in building a new one…

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The Value of Reflection in Clinical Teaching

By Patricia Stubenberg

“No words are ofterner on our lips than thinking and thought.”  – John Dewey

The teaching physician has opportunities for personal and professional growth through reflection and revisiting not only their own experiences in training and practice, but also their role as clinical teachers with medical students and residents.  Studies on reflection in teaching are abundant including, Freese’s work on Reframing One’s Teaching1, Dewey’s Art of Reflection2, and the theoretical underpinnings of reflective engagement, metacognition, and transformative learning.  The literature on reflection in clinical teaching is expanding through scholars including, Irby et al.3 and Sanders4.  This essay offers perspective on the value of reflective activity to advance medical education in training the next generation of physicians…
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Learning to Love Improvement Work: The Key is in the Relationships

By David C. Leach and Paul B. Batalden

Thomas Merton once asked his novices: “What was Adam’s sin?”  He then answered his own question by saying: “It was that he wanted to do good.”  The knowledge obtained from eating the fruit of the tree of the knowledge of good and evil, coupled with the serpent’s seductive approach announcing that now he could be really good and show God his abilities introduced Adam to pride.  Instead of being nurtured by his relationship with God he settled for self-sufficiency and we all know the result…
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My Patient

By Suzanne Minor

The student used the phrase “my patient” six times during the brief patient interaction: “I don’t like my patients to not exercise.”  “I like it when my patients eat healthy.”  “I like it when my patients take their medications” and so on.  Many students use this phrase occasionally, but this was striking.  I wondered what his motivation was.  Was he nervous?  Or did he think the patients were his?  After the interaction, I debriefed with him, asking him what went well and what he could improve. He did not bring up his use of “my patient” so I did.  He was unaware of his saying “my patient” and could not reflect on why he was doing so.  I asked him what he thought this phrase might mean to the patient.

“The patient”, he queried, “what does that have to do with it?”  I was frustrated, somewhat aghast that this third-year student, steeped in patient-centered interviewing throughout his first two years of school, missed that the patient had something to do with their own care and that the phrase “my patient” might claim ownership of another person or their attributes, such as soul, physical being, or responsibilities…
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Learning Anatomy: Between Fear and Reality

By Wessam Ibrahim

Learning Anatomy is a journey.  All medical students have some memories about their anatomy courses; some have good memories and some don’t.

It’s October 1995.  I was a first-year medical student at my medical school in Egypt.  I had never seen a corpse except in horror movies.  I was so scared and I really thought that those bodies weren’t real. The instructor started “Well, who would like to start dissection?”  I whispered to myself this guy must be crazy.  He continued: “You guys have to do it”. OMG, I guess I will have to cut that dead body. Surprisingly I volunteered.

Years were going so fast.  I graduated from medical school and decided to have anatomy as my career.  How did I do that? Again, I don’t know; but I know that I am so passionate about teaching medical students and my utmost joy is to see them succeed in medicine…
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Self-Reflection Through a Glass, Darkly

By Josh Hopps

It is the end of the USMLE Step 1 exam season in undergraduate medical education.  If UME is a solar system, Step 1 is the sun, irradiating and superheating some, leaving others cold and frozen out, and supporting life for those who thrive in intense and constrained circumstances.  Its enormous gravity pulls students toward it at the cost of medical school grades, well-being, and finances1, and impinging on medical schools’ autonomy in determining their UME curricula.  Students whose single-minded purpose for years was getting into medical school very quickly shift their focus to the Step 1 exam because of its outsized emphasis in the residency selection process2.   In years past the Step 1 conversation began at the beginning of the second year of medical school or at the end of the first year for an ambitions few.  Students now ask about First Aid for Step 1 before they’ve even matriculated…
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Medical Education Research and IRB Review

By Emily Anderson

Medical school curricula now emphasize evidence-based medicine.  We also need to prioritize evidence-based educational strategies.  There are some great educational innovations happening at our medical school, but too few publications highlighting these.  Conducting research on medical education faces many barriers, not least of all, lack of funding.  Publication in any peer-reviewed academic journal usually requires some evaluation data; to get in a top-tier journal, you need solid research methodology, clearly defined outcome measures, and sufficient sample sizes.  Medical education journals are notorious for rejecting small pilot studies, which is discouraging.  Perhaps even more daunting are the Institutional Review Boards (IRBs).  Studies indicate that medical education researchers face challenges in IRB submission and review (1,2).  Unfortunately, we often end up implementing new programs – and maybe even doing a solid program evaluation – but never sharing what we’ve learned with colleagues outside our own institution…

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