Each year in Telluride, we kick off the week’s conversation on open and honest communication in medicine by showing the Lewis Blackman Story. For the 10th year in a row, Helen Haskell, Lewis’ mom, was part of the Telluride faculty and for the third year, led the post-film discussion along with Telluride Patient Safety Student and Resident Summer Camp founder, Dave Mayer MD. Many of the resident scholars commented on the various levels of communication failure that occurred during Lewis’ care. Doctor to patient communication, provider to provider communication, power gradient communication challenges–it has been clear for some time that being uncomfortable communicating with anyone in the circle of care to patients puts the patient, and also caregivers, at risk. Lewis’ case is an unfortunate example of what goes terribly wrong when open, honest communication is not valued in a health system.
For those of you who haven’t heard Lewis’ story–he is someone you would have loved to have met. He would be 28 years old this year had his path not crossed that surgical suite almost 14 years ago. An actor, a scholar, an athlete — a lover and friend of the underdog–Lewis was the teen you hoped your kid was hanging out with when you weren’t around. By all accounts, Lewis’ was poised to do wonderful things and he left his mark on life early through his caring, thoughtful nature, a witty sense of humor, a loving son and brother, and now an inspiration to many of us trying to make care safer for patients today. He is one of many who serve as an example of continued and senseless loss in our slow movement toward zero preventable harm in healthcare. We need to decide today, that it’s time to take action in new ways to prevent the same stories from repeating.
For example, what can we do to improve our professional communication skills among healthcare teams so that we ensure families like Lewis’ do not suffer a similar loss? So that good, conscientious caregivers are not put through the traumatic experience of harming a patient out of fear of speaking up in a toxic culture? Which medical education programs are stepping up to incorporate interpersonal communication skill building into their core curriculum from the first day of medical school? Please share best practices in teaching medical and nursing student communication, and start an open conversation about better ways to teach communication to care providers at every level.
Healthcare today is a wide open canvas, and technology continues to open doors for entrepreneurs, the tech-savvy young and old from any industry, and those whose immediate need for a solution is far greater than any competing agenda. Steve Gleason, ex-New Orleans Saints football player hit with the same life-altering illness named after the great Lou Gehrig (amyotrophic lateral sclerosis, or ALS), is getting on with the business of living thanks to a spirit that refuses to quit, a social support network without limits (they carried him to the top of Machu Picchu) and companies like Microsoft. A reminder that the sky really is the limit when the heart and mind remain open.
What do Star Trek, Motorola, Stephen Spielberg, Minority Report, Raytheon, @ElonMusk, @JonFavreau, and Iron Man (the movie) have in common? All are examples of how science can influence fiction, and fiction can influence science.
@RobertWong, a graphic designer by training and a driving force behind Google Creative Labs, tells the story of how art, technology & design lovers come together with engineering experts to create the future. Think Google Glass, cell phones, tricorders and more–What a way to kick off 2014!
For those interested, Wong also hosts a Future of Storytelling Virtual Roundtable Speaker Series weekly on Wednesdays, 12:30pm ET. Click here for more information.
This year’s annual AAMC meeting is in full swing in Philadelphia, and you can join the conversation on Twitter via hashtag #AAMC13 to see highlights. The theme for 2013 is The Change Imperative and the meeting agenda, which runs through Wednesday, includes the following speakers who will without a doubt engage audiences in thought-provoking sessions on what the future of medicine and medical education will look like:
- Darrell Kirch, AAMC President kicked off plenary sessions Saturday, 4pm to discuss Our Moment of Truth
- Ian Morrison, Healthcare futurist and author, shared “his perspective on the rapidly changing landscape of health care, the impact of the Affordable Care Act on academic medicine, and how our community might leverage changes in the marketplace to help shape the future of medicine” on Sunday morning
- Anna Quindlen, Pulitzer Prize winning journalist and author, was scheduled for Sunday morning to discuss, Health Care in an Information Age: How Doctors, Nurses and Consumers Can Make One Another Better
- Daphne Koller, Professor of Computer Science, Stanford University and Co-Founder/Co-CEO, Coursera, discusses Exploring Changes in Education: Is Academic Medicine Ready for MOOCs? (Monday, Nov. 4th, 4pm)
- Adam Grant, Professor, The Wharton School of Business, University of Pennsylvania and author, Give and Take: A Revolutionary Approach to Success, will speak on Embracing Changes in Culture: Driving Organizational Success by Building a Culture of Contributors (Tuesday, Nov. 5th, 4pm)
For final program, click here.
On Tuesday, November 5th, winners of the AAMC “Light-years Beyond Flexner: Academic Medicine in 2033” video contest will also be announced. Medical schools were invited to create a 2-minute video envisioning what US medical schools will look like in 2033. Following is one example from Baylor University who believes three areas of competency physicians of the new age will need to be well versed in are: 1) Network awareness; 2) Information management, and; 3) Digital content creation. Finalists include:
- Eastern Virginia Medical School
- Meharry Medical College
- Temple University School of Medicine
All submissions can be viewed here.
In May of 2012, Chip Heath (Made to Stick) and Charles Prober MD at Stanford University School of Medicine co-authored a NEJM perspective, Lecture Halls Without Lectures–A Proposal for Medical Education, positing that lecture time is wasted time, and that a more dynamic content delivery medium should be explored. Today, Prober and Sal Kahn, of Khan Academy, are now teaming up to experiment with exactly that concept by “flipping” the med school classroom, according to a September 9, 2013 Inside Higher Ed blog post, Flipping Med Ed:
Khan and Prober present a three-step road map: First, identifying a core curriculum with concepts and lessons that can be taught through…short, focused video clips…then, changing static and poorly attended lectures into interactive sessions where students can practice that curriculum; and finally, letting students explore their passion…early on in their med school careers.
As Khan Academy moves toward delivering lessons for medical students, Khan is engaging experts in the field to help create content. He believes that a ratio of 1:299, lecturer to student, only captures the knowledge of one person in the room. When everyone in the classroom is allowed to weigh in, the content, and learning, take on new life. An example of a Khan Academy lesson on antibiotics follows:
Stanford is also working on interactive learning initiatives to support medical educators who would like to explore new ways of delivering traditional curriculum. See more at Stanford Medicine Interactive Learning Initiatives, and stay tuned, as we will continue to share more on the innovations coming your way in medical education.
The American Medical Association (AMA, @AmerMedicalAssn) has announced the final 11 medical schools that will receive funding as part of its Accelerating Change in Medical Education initiative. The goal of the initiative is to transform the way future physicians are trained. Following is a short video clip which provides insight into the program.
Here are short summaries of proposals submitted by the winners for innovation in medical education:
Indiana University School of Medicine
The proposal seeks to create a virtual health care system (vHS) and a teaching electronic medical record (tEMR) to teach clinical decision-making and ensure competencies in system, team and population-based health care skills. The tEMR will be a clone of an actual clinical care EMR, populated with panels of patients for students to manage with information gleaned from de-identified actual patient data…(for more information click here)
Mayo Medical School
This proposal will create an innovative educational model based on the science of health care delivery to prepare students to practice within patient-centered, community-oriented, science-driven collaborative care teams that deliver high-value care. The “science of health care delivery” curriculum’s experiential learning program will focus on how interprofessional teams, patients, communities, public health resources and health care delivery systems can impact patient care, health outcomes and cost…(for more information click here)
Oregon Health & Science University School of Medicine
The proposal will develop and implement a learner-centered, competency-based curriculum that enables medical students to advance through individualized learning plans as they meet pre-determined milestones. A portfolio-based system will track milestone achievement and clinical experiences. Faculty will develop innovative methods for teaching and assessing critically important skills related to informatics, quality science and interprofessional teamwork…(for more information click here)
The Brody School of Medicine at East Carolina University
The proposal will implement a new comprehensive core curriculum in patient safety for all medical students. The proposal will feature integration with other health-related disciplines to foster interprofessional skills and prepare students to successfully lead health care teams for systems-based health care transformation. One component of the proposal will be a “Teachers of Quality Academy” to help faculty develop the skills necessary to practice and teach this new curriculum…(for more information click here)
The following schools are the remaining 7 winners:
- NYU School of Medicine
- Penn State College of Medicine
- The Warren Alpert Medical School of Brown University
- University of California, Davis School of Medicine
- University of California, San Francisco School of Medicine
- University of Michigan Medical School
- Vanderbilt University School of Medicine
From the AMA’s recent press release, it is encouraging to note that of the 141 eligible medical schools, more than 80 percent (119) submitted letters of intent outlining proposals. From their PR department: In March, 28 individual schools and three collaborative groups of schools were selected to submit full proposals before a national advisory panel worked with the AMA to select the final 11 schools. For more information about the initiative, visit www.changemeded.org.
If interested, additional comment and coverage can be found at MedCityNews, What Does the Future of Medical Education Look Like?
By Guest Author, Sarah Easterling, Telluride Patient Safety Roundtable Health Science Attendee, 2013
-Previously posted on Transparent Health
As it was, I didn’t feel great about my time as a defense attorney. I enjoyed being a lawyer in the most utopian sense of the word: I enjoyed being an advocate and an adviser to healthcare professionals. I didn’t enjoy hanging a plaintiff’s dirty laundry out to dry. I didn’t enjoy burying someone in motions to buy time or meet my billables. I didn’t enjoy working at a law firm.
I got out of litigating because my work didn’t mean anything. By the time I was involved, something had already gone grievously wrong, and someone was angry (and injured) enough to bring suit. I worked the case to a resolution, but that didn’t mean anything either. I billed the bejesus out of it, distributed the insurance money accordingly, and went about my day. I always wanted to go back to the hospital or the provider and say, “Let’s make sure this never happens again!” But, it wasn’t my place. Three years ago, I was fortunate to be in touch with Dr. McDonald who advised that if I wanted to make a difference in a risk management/patient safety capacity, I should go to nursing school.
And now, here I am. One week away from my NCLEX, and two weeks from working in the risk management department I’ve admired for years. After my first day, I was excited to be here, despite feeling winded after three flights of stairs. After yesterday, I couldn’t be more ready to start working next month. I still maintain that at some level, I helped healthcare providers at a time of personal crisis. But now I also see what I might have unintentionally done to families, and I wholeheartedly apologize for that.
The Telluride Patient Safety Educational Roundtable (#TPSER9) is giving me a new perspective. Patients and physicians are no longer plaintiffs and defendants. I work as an advocate and adviser to both: By working directly within healthcare (and not as outside counsel), I will educate providers on why transparency is crucial, support providers when they are hesitant about disclosing, and maintain open lines of communication with patients.
June has always been a very exciting month for me. For the last eight years, Tim McDonald and I have journeyed west to Telluride, CO, a beautiful mountain town known by many for its skiing than summer activities. For those outside CO, Telluride may be one of the best kept secrets around. We often choose to take the scenic six hour journey from the Denver airport to Telluride each June, making our way up the mountain to run our annual Telluride Patient Safety Roundtable and Summer Camps, and to be reminded of the power of the peaceful surroundings we will be teaching in for the next 2-3 weeks. Over the years, people have asked me “Why Telluride?” My response has always been the same – “Why not?” Be it the “old west feel” of the town, or the magic that happens at an elevation of 9,600 feet, Telluride has always been a learning mecca for us.
Nana Naisbitt, Executive Director of Telluride Scientific Research Center (TSRC) and her son Rory, have been wonderful to work with through the years. TSRC hosts about 24 scientific programs each summer. The smaller, roundtable format we use is designed to foster creative thought and consensus building through lively conversation in a relaxed and informal setting. This format attracts patient safety leaders from around the world to Telluride each summer to “break bread” and share ideas on current issues and challenges. Because of this unique venue, a lot of discovery and sharing of ideas happen on the walking paths, hiking on the mountain trails, in a coffee shop, or over a glass of wine.
Through the generous support of The Doctors Company Foundation (TDCF), COPIC, Committee of Interns and Residents (CIR), Mag Mutual and MedStar Health, over 100 health science students and resident physician leaders will be attending one of three, week-long Telluride Patient Safety Summer Camps this summer. The first two weeks will be in Telluride and a third week in Washington DC later this summer. Numerous health science students and resident physician leaders from across the country applied for one of the summer camp opportunities.
Our objectives for the Patient Safety Summer Camps are the same each year:
- To identify and help develop future healthcare leaders and champions in patient safety, transparency and open, honest and professional communication between patients, families and caregivers.
- To develop a growing number of Patient Safety Summer Camp alumni that serve as role models and mentors to (a) health science students and resident physicians at their respective medical centers and health systems, and (b) health science students and resident physicians enrolled in future Patient Safety Summer Camps.
- To create a social networking community where Patient Safety Summer Camp health science students, resident physicians and past alumni can interact with international leaders in patient safety, education and patient advocacy on issues pertaining to patient safety, transparency and open, honest and professional communication between patients, families and caregivers.
- To help create risk reduction and quality improvement collaborative projects between Patient Safety Summer Camp alumni, faculty and patient advocates that are implemented within the Patient Safety Summer Camp alum’s institution and beyond.
Next Monday, many wonderful and highly committed patient safety advocates and leaders will once again convene in Telluride to continue our mission of “Educating the Young”. The first week, we will have twenty-nine resident physicians, future physician leaders from across the country, immersed in learning about transparency, patient safety, and patient partnership. It truly is an amazing experience that always leaves me energized for months to follow.
The @Edutopia Big Thinker Series presents Katie Salen, Executive Director of the Institute of Play, and Professor in the School of Computing and Digital Media at DePaul University. From the Institute of Play website, Katie:
- Has co-authored or edited several books, including Rules of Play, a textbook on game design, The Game Design Reader and The Ecology of Games: Connecting Youth, Games, and Learning
- Was co-lead designer on Gamestar Mechanic, an award-winning online game with built-in game design curriculum
- Has been involved in the design of slow games, online games, mobile games and big games in the commercial and independent games sectors around the world
The overarching theme from her short video below is that games provide excellent learning environments by allowing for collaboration, team building, exploration of identities, and also a forgiving space where students have the ability to take risks and fail. There is a growing movement toward using these playful environments to uncover the needs of a future yet to be defined in many industries.
Much of medical education has traditionally been the antithesis of this new order for education — where collaboration, continuous exploration and discovery are just as valuable as having what is believed to be the “right” answers for today. Will health sciences schools be willing to adopt a new culture of learning? Are some already doing so? Please share!