Harvard Macy Community Blog

Fostering the ongoing connectedness of health professions educators committed to transforming health care delivery and education.

What is the Silent Scream that Disrupts a Culture of Safety?

Like a tree that falls in the woods, yet no one hears it; a silent scream is the muting of voices and rejection of alternative perspectives to maintain a single monolithic reality.                                 K. Beard

Several years ago, I visited a family member who had undergone a partial nephrectomy. As I entered Randy’s (fictitious name) room, I immediately saw what I interpreted to be signs of distress. Randy’s mouth was open, yet he uttered no words. His eyes had a fixed downward gaze, and his facial expressions portrayed a hint of fear that coalesced with discomfort. The image, coupled with the rapid yet shallow rise and fall of his chest, pushed me out of my comfort zone. Was I interpreting these cues correctly? I whispered, “Are you ok?” Randy’s response solidified my suspicions.

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#MedEdPearls April 2018 - 21st Century Scholarship from #theCGEA

#theCGEA 2018 conference in Rochester Minnesota was hosted by @mayoFacDev. There were schools like @OhioStatemed and scholars like @stanhamstra. Publications @JournalofGME, @MedEdPORTAL and @TLMedEd were represented, editors like @anna_cianciolo and @debsimpson3  participated.
 
The first 279 characters of this #MedEdPearl demonstrate the proliferation of social media in medical education #SoMe. During these times of unfavorable news about social media one pearl was reiterated by #SoMe scholars  like Daniel Cabrera (@CabreraERDR) and power users like Gary Beck Dallaghan (@GLBDallaghan) at @theCGEA:
 
Whether your interest is teaching, research or patient education, determine your purpose and intended audience before using social media.  Let your goals drive your decisions about platform, strategies and connections.
 
The University of Nebraska Medical Center hosts a blog with several useful articles about #SoMe at https://connected.unmc.edu/category/social-media/    It includes a quick start, Lingo, Tips to Grow Your Twitter Followers, Common  Mistakes, Tweet Chats, and the power of using twitter at conferences.
 
Share the #SoMe resources do you recommend at #MedEdPearls
 
Larry Hurtubise @hur2buzy and  
Linda Love @2LindaMLove
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Reflection on March 2018 HMIchat on Health Equity

This blog reflection is co-authored by Mobola Campbell-Yesufu and Christina Cruz

The March #HMIchat focused on health equity and social determinants of health. We kicked off the first synchronous hour with excited and engaged health professions educators sharing what health equity means to them. Over the course of the next 23 hours, including both synchronous sessions, we shared our experiences, challenges and future directions in teaching health equity. With almost 100 participants sending 500 plus tweets on this topic, we amassed a veritable treasure trove of teaching pearls during the chat. Here are the highlights:

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Burnout: Addressing the epidemic in Medical Trainees

Burnout is a serious epidemic affecting medical students, residents, and practicing physicians. This past January, Mohammad Zaher authored an insightful blog discussing the current state of well-being in health care. This current blog will build on these ideas with a focus on medical trainees. In addition, I will discuss practical solutions that can be implemented at your institution to improve trainee well-being.

Burnout is defined as a work related syndrome of depersonalization, emotional exhaustion, and decreased sense of personal accomplishment. Studies have shown that burnout begins in medical school, and intensifies during residency. Furthermore, approximately 50% of practicing physicians meet criteria for burnout. Burnout has grave personal consequences for medical trainees, including decreased quality of life, higher rates of depression, and suicidal ideation. Professionally, burnout affects patient safety, physician turnover, and patient satisfaction. Given these undesirable outcomes, increasing efforts to target burnout and improve physician well-being are an important focus at many training programs. Experts and evidence have suggested a combination of individual and organizational approaches to target burnout. Read on to explore the problem of burnout in medical trainees and get ideas about interventions you can implement at your own institution.

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Exploration of Program Director Perspectives on Core EPAs for Entering Residency

This blog was co-authored by Gary L. Beck Dallaghan, Ph.D. and Michael Ashley, B.S.

In 2014, the Association of American Medical Colleges issued recommendations for essential activities every graduating medical student should be able to perform unsupervised. The guiding principles underscoring the development of these skills included patient safety and enhancing confidence of stakeholders regarding new residents' abilities. These activities are meant to be a foundational core and should complement specialty-specific competencies.

Englander and colleagues mirrored their conceptual framework of the core entrustable professional activities for medical students on that being used by residency training programs. This entailed systematically reviewing published graduation requirements, program director expectations for entering residents, and tasks residents perform without supervision. This helped them develop 21 distinct entrustable professional activities (EPAs) that are considered observable and measurable units of work that represent a variety of competencies expected of medical professionals. More than 100 unique educators representing the continuum of medical education settled on the 13 current EPAs.

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