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…
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We are taking this opportunity to showcase a few excellent posts from the year gone by. We invite you to check out these highly popular essays.
Mary Boyle, MD, “The Invitation”: A poem and reflection about a patient as teacher
Guadelupe Garcia McCall, “Popocatepetl and Iztaccihuatl”: A poem about romance, illness, and death.
Amy Blair, MD, “Ideals and Inadequacies: Living the Physician’s Vocation.”
With the holidays upon us, we are taking this opportunity to showcase a few excellent posts from the year gone by. We invite you to check out these highly popular posts.
Darrell G. Kirch, MD, “Educating for Resilience and Humanism in an Uncertain Time.”
Hedy Wald, PhD, “Becoming Zusha: Reflecting on Potential in Medical Education and Practice.”
Sunny Nakae, PhD, “Presence and Vulnerability in Medical Education.”
By Mark Kuczewski
University and college administrations have shown laudable leadership since the election in offering support to their students who feel under threat. The strongest and most explicit statements have been in regard to undocumented students who have benefited from the Deferred Action for Childhood Arrivals (DACA) program. As the almost 800,000 persons of DACA status could be sent back “into the shadows” by the next president, numerous universities have made statements elaborating the steps they will take to protect these students and supply them with legal and social support services. [1,2]
Furthermore, many other students including persons of color and students from the Muslim and Jewish faith traditions also are encountering increased interpersonal hostility and they fear potential discriminatory policies such as the rumored “Muslim registry.” As a result, many universities and colleges have done a variety of things to support them including offering discussion forums and creating “safe spaces” where students can express their concerns without debate. But many educators wish to know what they personally can do to help. Let me offer a few suggestions…
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By James Smith
As we navigate current and future health care transitions, I am skeptical that our conventional understanding of medical professionalism will assist us. We have defined and organized medical professionalism into list of codes, behaviors, and collective “group-think” to serve as an aegis to transient threats to the central role of the medical practitioner in historic and contemporary healthcare. Or at least physicians have. Professionalism, as a movement in medicine, arguably had its inception in this country with the organization of the American Medical Association (AMA). The AMA’s initial agenda included a proprietary defense to the threat of “irregular” practitioners—those from alternative medical education pathways. The central role of physicians in modern healthcare has been eroded by payers, the government, and the healthcare systems in which physicians find employment. Or so physicians think. In response, physicians have conveniently deployed “professionalism” as a shield against these threats, and the general threat of commercialism in medicine.1 Furthermore, professionalism has been nuanced, expanded and rolled out as a discipline to be taught in medical education in order to protect and retain a collective identity, resistant to oversight or intrusive engagement from the outside. The self-serving nature of the call for renewed professionalism and its incorporation into medical education is thinly veiled by the allure (and illusion) that it may actually be effective. All we are accomplishing is the depersonalization the very nature of the relationship between healer and patient upon which we “profess” our social vocation…
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By Tim Lahey
Two days ago, Jimmy stuck a used needle into the soft skin of his forearm, and released 20 milligrams of black tar heroin and a bolus of bacteria into his blood.
The bacteria floated from vein to artery as he nodded, eventually sticking themselves to the ragged edge of his aortic valve. There they multiplied and burrowed until each systole whipped a two-centimeters of snot back and forth in his atrium.
Fevers came first, which Jimmy ignored while buying more black tar at a rest stop on I-91. A day later, little red stigmata appeared on the palms of his hands as plugs of snot lodged in small vessels there.
When he couldn’t breathe, Jimmy went to the ER. My medical student and I met him there as he shook in bed. A snarl of IV lines snaked under the covers.
Jimmy gave one-word answers to my questions, and did not open his eyes…
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By Laura Vearrier
Americans check their phones an average of 46 times per day, (Eadicicco 2015) and they do so no matter what they are doing, including while driving, while at church, during sex, or out to dinner. (Rodriguez 2013) Are healthcare providers any different? In a survey of medical students, 46 % reported texting, checking email, or making a call on their personal devices during a patient encounter, and 93% had seen a senior resident or attending do so. (Tran et al. 2014) The answer to this problem is not as simple as turning off the device. Improvements to medical care afforded by personal devices include efficient access to electronic text books, up-to-date literature, medical apps such as dosing calculators, and improved provider connectedness, among others. The flip side is that the inevitable distraction created by smartphones creates a threat to professionalism in healthcare…
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