By Jeffery D. Fritz, Sandra Pfister, Diane Wilke-Zemanovic, Sally Twining and Jose Franco.
Can we incorporate into the curriculum a quick and easy way to promote awareness and the practice of wellness by both medical school faculty and students? At the start of the fall 2017 term, course directors overseeing first- and second-year pre-clinical instruction at the Medical College of Wisconsin encouraged each faculty member to develop a simple communication slide. These instructors were asked to include an introductory slide noting their practices of wellness to be shown at some point in their instructional block. The exact content of this slide was not prescribed; however, all participants were encouraged to include images and personalize the content to the degree that they felt comfortable. Given the magnitude of this initiative – it would involve over 300 different faculty members and reach over 500 first and second year students across three campus locations – it was hoped that voluntary participation by faculty would be sufficient to would significantly enhance student and faculty awareness and practice of wellness/wellbeing.
Faculty participation across the 13 pre-clinical first and second year courses was surveyed throughout the academic year by reviewing the recorded sessions for inclusion of the introductory wellness content at any time during the session.Read More »
By Kihyun Kwon
It was an eventful start to the morning. My attending saw the first patient, who voiced murder ideation towards her unfaithful husband. I imagined myself being taken aback in a troublesome situation like that. I was still in a state of shock when my patient arrived. The clinic schedule had no regard for my emotions and gave me the most difficult patient I ever came across.
The nurse came back shaking her head and said, “The patient will not talk or make any eye contact.” The preparation notes I took earlier said she was a college student with Autism spectrum disorder, depression and anxiety. Never having had any interaction or personal experience with autism, I was nervous. My attending offered to see the patient with me, but I took the initiative to interview by myself. The patient was lying on the examination table playing on the phone while her mother greeted me. I introduced myself to the disinterested patient; I was utterly ignored.
I asked the mother about the patient’s history.
“How has she been doing?”
“Have her symptoms improved?”
Talking about the patient in her presence without actually conversing with her felt awkward. Answers that the mother gave seemed impersonal, and I could not empathize with the information especially with the patient being engaged in her phone.
I wasn’t sure if it was out of annoyance, or concern, but I started directing questions toward the patient.Read More »
By J.M. Monica van de Ridder
Teaching is something that I have been doing for over 20 years. So, in general, I don’t worry about it. I think I know what works and does not work.
Things were very different for me this time. I was worried, and I felt very much out of my ‘comfort zone’ almost in my ‘panic zone’ (Brown, 2008; Palethorpe & Wilson, 2011). I had developed an intersession for M1 and M2 medical students on how to optimize their learning processes in the clinical setting through goal setting, self-regulation, receiving and seeking feedback. The content on feedback I am familiar with, from goal-setting and self-regulation, -I assume- I know more than average.
I tried to discover my fears. What is worrying me?Read More »
By Shoshana B. Weiner
“4 ounces water every mile, half an electrolyte ‘gu’ pack over 2.5 miles, ¼ energy bar every 6 miles.” AKA how did you manage training for a marathon while in medical school? The simple truth: I decided to run a marathon so I did. Longer story: months of rigorous training, more moments of doubt than I care to recall, and insights already positively impacting my medical training.
Training for and running a marathon is a time-intensive commitment of physical and mental endurance. Age-old lessons of “you can accomplish anything you set your mind to; hard work pays off” hold true and gained new meaning for me. Read More »
By Shannon Tapia
My husband the Anesthesiologist came home one evening solemn, affected, not himself. His patient died in the recovery room. It was sudden, unexpected for my husband, and despite the team’s swift efforts and perfectly executed code, the patient died anyway. It’s relevant to note that his patient was an almost 90 year old man with significant Congestive Heart Failure, probably Chronic Kidney Disease, and complete occlusion of one of his carotids who sustained hip fracture and thus required the surgery to pin his hip for both healing but also comfort. This is the ultimate Catch 22 in medicine (or at least in Geriatrics). Someone who really should not be having Anesthesia or surgery due to their life-threatening chronic medical conditions has an accident and now requires a surgery to make their remaining life bearable. My husband and the surgeon delivered the bad news together, and as the patient’s wife understandably fell apart, my husband cried in front of patients (family) for the first time, ever. As we processed this together, he asked me, the Geriatrician, “How do you deal with death all the time?”
I won’t pretend to have all the answers. However, I don’t think my husband or any doctor is alone in needing help or any tips at coping with death. So here are some ways this mother, family physician now Geriatrician copes with death, an ever-present part of Geriatric medicine…
Read More »
By Hedy S. Wald
Lean machine of prose, stripped down to the essence, and a power-packed way to care for the caregiver… this was my experience of the 55-word story genre1 at a writing seminar.2 While I had some experience writing haiku, I was generally accustomed to reflective narratives3 as “story” so was nothing short of surprised when a compact 55-word prose “small jewel”2 about a patient who touched my heart and soul spontaneously emerged onto the paper. It chilled me to the bone and warmed my heart. I was asked to read it aloud for the attendees – the hush afterward was a moment of sacred silence…
Read More »
By Meaghan P. Ruddy
Paying attention to the wider trends in medical education recently makes it difficult to miss the growing voice of Pamela Wible, MD and her crusade to end physician, resident and medical student suicides. One premise of her argument is that all the language around burnout and resilience misses the point. The point it misses? This demographic is suffering from abuse.
I tend to agree. To this I would add that the result is not burnout but the closely related state of grief…
Read More »
By Michael P. McCarthy
The New Year offers a clean slate, a welcome opportunity to try something new. Given the title of the blog, Reflective MedEd, I would like to offer a way of refocusing and reorienting oneself through reflecting on the experiences of the day. As Hedy Wald described in her blog post, reflection enhances a variety of skills that are essential for continuing professional identity formation for medical students, educators, and practitioners alike. The process of the examen serves as a way to reflect by reviewing hour-by-hour the events, circumstances, and experiences of the day…
Read More »
By David Leach
On March 1st my aortic valve was replaced. I received extraordinary care, was discharged on the third postoperative day, and am doing very well. When I arrived from the operating room to the intensive care unit I had an endotracheal tube, two chest tubes, an arterial line, a jugular vein Swan-Ganz catheter, two 14 gauge intravenous lines, a urinary catheter, various chest leads monitoring my heart rhythm, a pulse oxygen monitor and I have rarely felt better. In fact I was filled with joy. The Society of Thoracic Surgeons rates the 1300 plus cardiovascular surgery programs in the U.S. and I was happy to discover that my local thoracic surgery program was highly rated. I was grateful to have a disease that was fixable and a surgeon who knew how to fix it. I was also terrified at what I would have to go through to get it fixed. I did not anticipate joy…
Read More »
By Karen Spear-Ellinwood
I began professional life as a lawyer, representing people accused of violent crimes, most having failed to graduate high school, if they made it there at all. I realized that while a lack of education accounted for a great deal of crime, the more dangerous affliction was a failure to reflect before acting.
After 13 years, I became an educator. I started in middle school. I constructed debates on history, legal and social issues, on weighing the potential harm of perceived ills and their perceived remedies. The sorts of subjects that forced reflection and self-awareness.
I told my eighth graders that lawyers never make decisions without reflecting on what’s likely to happen and what might happen. Lawyers had to know the law and they had to figure out how to apply it, sometimes while encountering unanticipated circumstances. I assigned these eighth graders to argue the side of the debate with which they vehemently disagreed. They had to stretch their perspective, I told them. See this issue from someone else’s perspective to reconsider their own position. They might not change their mind but they would understand the issue and themselves better…
Read More »