“Yes, and…”: How Improv Techniques Enhance Medical Training

From the 4/9/2021 newsletter

Medical Humanities Perspective/Opinion

“Yes, and…”: How Improv Techniques Enhance Medical Training

Erica Chou, MD and Sara Lauck, MD

Drs. Chou and Lauck discuss the parallels between interpersonal interactions in theater improv and at the bedside. Improv offers a way to hone critical clinical skills …

Attunement, affirmation, and advancement. These are the core skills of improv, and of all interpersonal interactions. Attunement means to be present and focused, deeply listening. Affirmation is to acknowledge the other person's truth and to find common ground, even at times of disagreement. Advancement uses that common ground to move the conversation and interaction forward. In short, these skills embody the “yes, and” tenant of improv. 

These same skills are essential in the practice of medicine. Good communication with patients, families and healthcare team members requires active listening and adaptability. A quality of empathy is recognizing others’ perspectives as their truths. Listening, acknowledging, and responding productively are the foundation of creating psychological safety on a team. The relevancy and applicability of improv in healthcare is where medical improv comes into play. 

Here’s an example of Medical Improv

Medical improv is the adaptation of theater improv skills and principles to the healthcare setting. It is a type of experiential learning, where learners participate in improv exercises and then debrief afterwards. While the exercises themselves teach learners to be spontaneous and think on their feet, it is the unpacking of their actions, behaviors and feelings during the exercises that allows learners to reflect and make connections to medicine and other aspects of their lives. 

An example is an exercise called Word at a Time Story. In this exercise five to six people stand in a line. They are given the title of a story and asked to make up a story together where each person says one word at a time. This exercise is incredibly challenging. The natural tendency is for everyone to think of their own story and to try to plan what word they are going to say when it is their turn. But then the sentences that are created make no sense grammatically and the story does not come together. To be successful with this exercise, participants need to focus, be present and listen intently; and if they do these things, then they can trust that when it is their turn to speak, they will say a word that aligns and advances the story.  

How does this relate to medicine?

These same skills can be applied when obtaining a patient history. Rather than approaching the patient encounter with a list of pre-prepared questions to ask, students learn with medical improv to listen and respond to their patients, and to embrace the path the conversation takes.

After attending the 5th International Medical Improv Train-the-Trainer Workshop in 2018, we developed a two hour-long medical improv workshop based on Katie Watson’s Playing Doctor course at Northwestern University Feinberg School of Medicine.2 Our workshop includes the above exercise, as well as several other improv exercises that explore the concept of “yes, and,” emotions, leading/following, and status. We have presented our workshop for a variety of different audiences, including high school, undergraduate and medical students, residents, faculty, staff and interprofessional teams. 

Please contact Erica Chou echou@mcw.edu or Sara Lauck slauck@mcw.edu if you are interested in having a medical improv workshop for your learners, section or team. 

For more reading

Belinda Fu (2019) Common Ground: Frameworks for Teaching Improvisational Ability in Medical Education, Teaching and Learning in Medicine, 31:3, 342- 355, DOI: 10.1080/10401334.2018.1537880 

Katie Watson (2011) Perspective: Serious Play: Teaching Medical Skills with Improvisational Theater Techniques, Academic Medicine, 86:10, 1260-1265, DOI: 10.1097/ACM.0b013e31822cf858

Erica Chou, MD is an Assistant Professor of Pediatrics (Hospital Medicine) at MCW. She is a member of the Curriculum Pillar of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education. 

Sara Lauck, MD is an Assistant Professor of Pediatrics (Hospital Medicine) at MCW and the Pediatrics Clerkship Director.

Building a New Curriculum for MCW

From the 4/2/2021 newsletter

Director’s Corner

Building a New Curriculum for MCW

Adina Kalet, MD MPH

Dr. Kalet focuses on how we must change our educational strategies to achieve the most important work we have as educators: To prepare medical students to become caring, character-driven physicians that can manage a rapidly expanding knowledge base in rapidly evolving health care systems …

As you will read in this week’s Transformational Times, MCW Academic Affairs has been engaged in a process of reimagining the medical school curriculum. 

This has been an almost two year-long, deliberative, and creative process. As part of the comprehensive Liaison Committee of Medical Education (LCME) self-study we do every eight years for reaccreditation, MCW launched small group curriculum conversations. Robust discussions in key stakeholder working groups were bracketed by two full-day retreats. We defined key curricular principles and outlined a new three-phase structure and its predominant instructional designs (case-based sessions, spiral weeks, etc.).  This is important work and no small task. 

I have also been told that MCW has had both successful and unsuccessful experiences with curriculum reform in the past. We are not alone in this, Yet, I have participated in a number curriculum renewal cycles in medical schools around the world. I can attest that our approach has been well managed. The process and outcomes have been inspiring and the team has embraced a road-tested model for organizational and curriculum change to guide their work. The principles and concepts are evidence-based and well understood. There is a nice balance between ancient wisdom (e.g., “learning from patients”) and newer ideas (e.g., Programmatic Assessment of Master Adaptive Learners). 

It seems as though everyone is reforming their curricula (again)

The LCME began accrediting US medical schools in 1942. Since then, most US medical schools have engaged in significant changes in their curriculum about every ten or so years. Lately, the frequency of major curricular updates has been accelerating toward   but has not yet arrived at   a robust continuous quality improvement process. 

In 2018, only 15% of US medical schools were either not planning or had recently implemented a major curriculum change. 35% were in the planning phase and 31% in the implementation phase of a major curriculum reform. The majority of the schools engaged in curriculum change were deliberately moving away from the early 20th century Flexnerian “2 + 2 model,” with two years of predominately pre-clerkship basic sciences followed by two years of immersive clinical experiences. On the whole, they were moving toward more integrated models where students spend less time in classrooms and more time learning the foundational sciences while mastering the cognitive aspects of clinical work. 

Curricula were forced to change as hospital practices changed

This is not a revolution, but more of an evolution. Change, however, has been slow in coming. Why is this? Plenty of schools have attempted the switch. There is ample evidence that students learn best in well-integrated curricula with early and rich exposure to the real-world applications (e.g. written cases, simulated cases, early actual patient experiences). Students demonstrate knowledge and skills when held to very high standards and cultivate their developing medical identities while supporting their well-being as future physicians. 

Change is hard because, traditionally, medical educators have been “curriculum agnostic.” When I was a resident, Saul J. Farber was both our the chair of the department of medicine and dean of the medical school. He was an absolute legendary bedside teacher who was fond of saying that the formal curriculum was irrelevant. He believed that the most important thing we could do as a medical school was choose the right “kids” and then engage them (he said, “throw them”) into caring for patients in our large inner city, safety net hospital. 

For his time, Dean Farber was not wrong, but he wasn’t right, either. In his era   what we often referred to tongue-in-cheek as, “the days of the giants” (he was chairman of medicine for thirty-two years, after all!)   people were hospitalized for weeks at a time while they underwent diagnosis and treatment.

This pace was slow enough that students and teachers could spend a great deal of time together with patients, eliciting their histories and conducting detailed physical exams and bedside maneuvers. The students in that generation before mine witnessed the “natural course” of disease processes, and were able to then spent hours in the hospital library, the laboratories, and reading rooms, reviewing radiological images and having midnight meals where cases were discussed in detail. Using a slow, deliberate, iterative process, their role models showed the students how to integrate all the material and choose courses of action. 

This held true for surgical specialties, as well. Patients who were to undergo an operation were routinely admitted to the hospital the afternoon prior to their procedure. This allowed enough time for them to undergo work-ups by the junior medical student, the senior medical student, the intern, and the surgical resident ahead of time. Postoperative patients stayed in the hospital for weeks prior to the development of rehabilitation centers and long-term care facilities. 

In that earlier era, many teaching hospital physicians also conducted basic science research. It was common (even into my era) that students would walk to the clinician-scientist’s lab to discuss the relevant physiology, microbiology or biochemistry and receive a quick “chalk talk” about the scientific principles underlying their patients’ condition and treatment. 

By the time I was a resident in the early 1980s, the pace of hospital work had revved up, and patients were either very acutely ill or hospitalized very briefly. Most diagnoses and therapeutics moved outside of the inpatient setting and, therefore, outside the view of most medical students. Science was conducted at a distance from the clinical environments. Fewer and fewer scientists were clinicians and fewer clinicians did science. To ensure adequate preparation for practice, medical schools were forced (they were reluctant at first) to create ambulatory care experiences for students and residents. This was only one of many major shifts in medical school curricula. 

Some new and some old elements will create a relevant curriculum for the new healthcare environment

Hospitals now run 24/7/365 and stress the constant downward pressure on “length of stay.” While hospitals are exciting, most medicine is practiced in clinics and community settings. New sciences have become critical to being a physician.  We are constantly struggling to keep our educational structure, content, process and outcomes relevant.  

At the same time, medical school curriculum requirements have become more and more structured and complex. Dean Farber would be aghast. Where are those “midnight meals”? Where is the time to learn through discussing cases and sitting with patients and families? It all seems hopelessly romantic and out of touch with modern reality. But I think we do better by holding firm to core principles and innovating. 

So, what are the non-negotiables elements as we move forward? 

We can protect the “baby” (integrative learning processes essential to becoming a physician) as we consider “spilling out the bathwater” (experiences that don’t lead to deep learning). 

First, we have to build curricula around the knowledge that a physician’s most profound and long-lasting learning occurs while thinking about and interacting with patients. Second, we must recognize and support great teachers who care about learning, are knowledgeable, remain optimistic, and know how to motivate. Third, we must set and hold everyone to measurable high standards. 

This is where Dean Farber got it right. Take excellent, motivated students and mix them up with great teachers with a range of content expertise and provide them with endless “clinical material” against which to demonstrate their growing mastery. Voila! Medical education alchemy. 

Engaging and caring for our stakeholders

Based on educational research and our desire to create new, vibrant approaches, we believe that a strong medical school curriculum will enable groups of students and faculty to learn by puzzling together through a wide range of cases. That is our goal. 

As we create the new educational environment, the students who are still in the current curriculum will need to be cared for and educated. They will be invited to engage in the planning for, and piloting of, new curricular and assessment elements. If we do this right, our students will be the main beneficiaries, yet some will likely feel and express discontent. 

Faculty will need to take new roles, learn new skills and feel like novices again. We will need to work closely with small groups of students across many content domains outside of our own content expertise. We will have more interaction and, therefore, more collaboration between scientists and clinicians. Those of us who are excellent lecturers will lecture on topics best communicated that way. The rest of us will learn new ways. This will be difficult for some. 

The bumps in the road will be smoothed out by working together

Like all medical schools, MCW is a complex organization with many missions and complex governance. We will need both design and change strategies as we anticipate and prepare for predictable challenges both within and without.

A strong leadership team and communication plans are emerging.  Creating and implementing a cutting edge, locally relevant curriculum will take significant effort, cooperation, forbearance, respectful debate, a wide range of expertise, and extraordinary program management skills. While I hope we will be doing a lot of celebrating, I also know this will we stressful. 

The Kern Institute will be there to support faculty development, administrative savvy, and complex and integrated assessment. In a few years, we will have the infrastructure in place to continually improve the curriculum so that future changes will be incremental rather than revolutionary. 

I believe we are long overdue for an upgrade and that the time is now. Even Dean Farber would likely see the wisdom in that.

Adina Kalet, MD MPH is the Director of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education and holder of the Stephen and Shelagh Roell Endowed Chair at the Medical College of Wisconsin.

The news from Atlanta this week is horrifying

From the 3/19/2021 newsletter

The news from Atlanta this week is horrifying.

A gunman took the lives of eight people, six of whom were Asian women. This has been one among many recent hateful crimes that have terrorized the Asian American community. Every one of us at The Kern Institute expresses our unconditional support for this community, and we want to express our love and concern for MCW’s Asian students, trainees, faculty and staff during this acutely difficult time. We continue to invite dialogue about racism, discrimination, character, caring, compassion and medical education because we understand that it is only in bringing these discussions into the light that we might learn from one another and be a part of changing our profession and our world for the better. 

Shared Change is a Rigorous Process

From the 4/2/2021 newsletter

Perspective/Opinion

Shared Change is a Rigorous Process

Jeffrey Amundson, PhD, Travis Webb, MD, MHPE, Amy J. Prunuske, PhD, and Adina Kalet, MD, MPH

The team describes the development of the curriculum transformation working groups, reports on their recent activities, and looks forward to the Human-Centered Design approach that will clarify and accelerate the curriculum redesign …

 

Change is hard.  However, when change is a shared experience, many of the stakeholder concerns and expectations can be attenuated by communicating and demonstrating conscientious and prudent planning.  The process of curriculum change is a large-scale change that requires thoughtful organization of various stakeholders into manageable and effective teams.  

MCW is currently transforming our traditional 2 + 2 curriculum into one that integrates foundational science with clinical knowledge and skills through case-based, inquiry focused, individualized learning with an emphasis on inclusion and wellness.  To achieve this transformation, various change management strategies have been used including Kotter’s 8 Step process of change and components of Implementation Science to create a rigorous process of communication and structuring with stakeholders. 

Envisioning and building the team 

A common starting point in most models of change management is to communicate a vision of the most important reasons for change. In Kotter’s 8 Step process and similar models (e.g., ADKAR), shared vision is the foundational concept for change. 

This first step at MCW began when all course directors, chairs, education deans from all campuses, Curriculum and Evaluation Committee (CEC) members, selected education staff, and student representatives from all campuses were invited to a Curriculum Exploration retreat held on October 2, 2019.  This involved approximately 100 stakeholders who began an iterative process that developed principles to provide a foundation for medical school curriculum redesign at MCW.

The next step was to create a team of representative stakeholders responsible for coordinating and guiding teams through effective communication and activities. The Curriculum Exploration Steering Committee became this coalition, and included basic science and clinical chairs, course directors, administrative leaders, and Curriculum and Evaluation Committee (CEC) representatives. These same individuals were dispersed throughout the subcommittees to promote contiguity for effective communication and activities. Please see the steering committee and subcommittee rosters at the end of this article. 

Exploring the five principles

After ratifying the new curriculum principles, the steering committee charged subcommittees of key stakeholders to consider how to implement these principles into a comprehensive curriculum considering the complexity of the three-campus institution. Subcommittee members were recruited via email, InfoScope postings, and verbal communication. The kick-off meetings of the “Principle Groups” occurred September 9th and 10th, 2020.

A Principle Group subcommittee took charge of each of the following: 

• Principle 1: Integration of foundational and clinical science learning throughout all years of curriculum.
• Principle 2: A systematic approach and focus on assessment that drives learning and assures that students achieve desired competencies.
• Principle 3: Individualized approaches to learning that are ultimately tailored to student interest and career goals.
• Principle 4: A student-centered, inclusive culture with a focus on wellness.
• Principle 5: An evidence-based instructional approach that is inquiry driven and utilizes active learning.

The subcommittees provided monthly progress reports starting in September 2020 which culminated in final reports on January 1, 2021 (a link to the five principle group reports is available here from an MCW computer or through InfoScope). Additionally, as Lindsey Bowman, Senior Administrative Assistant for Curriculum noted, the guiding coalition efforts were a standing CEC agenda item during the 2020-2021 academic year. These updates provided opportunities for discussion at seven curriculum meetings over the 2020-21 academic year. The coalition communicated monthly with the CEC, its M1-2 subcommittee, its M3-4 subcommittee, and the executive committee. In addition, there were also quarterly meetings with the Directors of Medical Student Education, the M1-2 Course Directors and Coordinators, the Advanced Clinical Experience Committee, and the Clerkship Directors.  It is important to emphasize most of this rigorous process was undertaken while adapting to the impact of the pandemic.  

These individuals have done an outstanding job through the first steps and generated numerous short-term wins (another common component of “models of change”), including formulating a set of design principles from the final Principle Group reports (i.e., Core Content, Instructional Approaches, Assessment, and Faculty and Student Support).  These principles served as the next piece of the process to create a larger team of volunteers.  Additionally, as in many models of change, the next steps will include establishing reasonable targets and, in MCW’s case, using competencies, learning objectives, and suitable governance frameworks to reduce barriers for stakeholders to work across silos.  

The next steps

The next stakeholder teams will clarify medical school learning objectives around: 

• Patient Care and the Health Care System
• Knowledge for Practice
• Communication 
• Personal and Professional Identity 

In models of change, this represents the transition from preparation to initiation of change.  

Importantly, these proposed changes rely heavily on stakeholder input so stakeholders can learn from mistakes and adjust the process as it moves from planning to implementation (as well as adjusting during implementation).  

MCW, with help from the Kern Institute’s Human Centered Design Lab, will capitalize on this input in the next steps.  Human-Centered Design is a team-based approach to problem-solving that uses empathy to develop a deep understanding of any problem.  This allows the problem to be clearly articulated, paving the way for the brainstorming of solutions, followed by prototyping the solution that is most impactful.  This will lead to a process of continuous and intentional short-cycle iterative improvement to the solutions design. 

Much work is yet to be done, and we hope that all faculty, staff, residents, fellows, and students will engage in this exciting process to achieve sustained acceleration (a very important component of change). Given the efforts put forth so far and with a continued rigorous process, the shared experience of change can achieve a fruitful transformation.

Jeffrey Amundson, PhD is a Postdoctoral Fellow in the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education. Travis Webb, MD, MHPE is a Professor in the Department of Surgery and Associate Dean for Curriculum at MCW. Amy J. Prunuske, PhD is an Associate Professor at MCW-Central Wisconsin. Adina Kalet, MD, MPH is the Director of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education and holder of the Stephen and Shelagh Roell Endowed Chair.

COMMITTEE AND SUBCOMMITTEE ROSTERS

Curriculum Exploration Steering Committee:  

Amy Prunuske, Travis Webb, José Franco, John Hayes, Alexandra Harrington, Malika Siker, Jonathan Marchant, Bill Hueston, Matthew Hunsaker, Lisa Dodson, Adina Kalet, Jon Lehrmann, Marty Muntz, Melinda Dwinell

Subcommittee Members (Faculty and Staff):

Jennifer Hinrichs, Joe Budovec, Marty Muntz, Mindy Dwinell, Jonathan Marchant, Craig Hanke  Sandra Pfister, Lisa Cirillo, Joe Brand, Hershel Raff, Steve Hargarten, Bipin Thapa, Beth Krippendorf, Marika Wroszek, Teresa Patitucci, Allen Last, Craig Young, Jeff Fritz, Maria Hintzke, Megan Waelti, Terra Pearson, Kathlyn Fletcher, Karen Marcdante, Brian Lewis, Lisa Dodson, John Meurer, Monica Shukla, Kerry J. Grosse, Catherine Thuruthumaly, Ankur Segon, Alan Bloom, Ellen Schuman, Karin Swartz, Carley Sauter, Leslie Ruffalo, Robert Treat, Erin Green, Mary Ann Gilligan, Tavinder Ark, José Franco, John Hayes, Paul Knudson, Elizabeth Hopp, Bill Hueston, Jules Blank, Roy Long, David Brousseau, Pat Foy, Kathleen Beckmann, Brian Law, Jordan Cannon, Johnny Neist, Dan Stein, Jon Lehrman, Malika Siker, Cassie Ferguson, Himanshu Agrawal, Theresa Maatman, Kurt Pfeifer, Kristina Kaljo, Linda Meurer, Anita Bublik-Anderson, Becky Bernstein, Jean Mallett, Adrienne German, Nicholas Yunez, Travis Webb, Ali Harrington, Ashley Cunningham, Amy Prunuske, Patrick McCarthy, Adina Kalet, Ellen Sayed, Ashley Zeidler, Art Derse, Jacob Prunuske, Erica Chou, Megan Schultz, Jay Patel, Joe Barbieri, Curt Sigmund, Matt Hodges

Subcommittee Members (Students):

Kelli Cole, Mario Castellanos, Marko Ivancich, Chase LaRue, Taylor Brockman, Haley Pysick, Gopika SenthilKumar, Alec McCann, Colton Brown, Emily Nordin, Jess Sachs, Connor McCarthy; Syndey Newt, Emily Schaefer, Phil Hartfield  

Recruitment Season 2021: It’ll all be Worth it!

 From the 3/19/2021 newsletter

Perspective/Opinion

Recruitment Season 2021: It’ll all be Worth it!

Camille B. Garrison MD

Dr. Garrison describes how the Ascension Columbia St. Mary’s Family Medicine residency program adapted to the need for virtual interviews as they recruited their next cohort of residents, relying on social media, entertaining videos, and human interaction …

I had all the right people in place. From the perfect faculty leading the recruitment committee, the most enthusiastic residents set to attend our much-anticipated summer and fall recruitment fairs, the administrative team set with our new interview schedule, and an opportunity to pilot our new ranking system. I remember the heavy feeling of desperation that came over us when we heard that recruitment season and interviews would be transitioning to all things virtual. But once we got over the initial shock of what this would mean for our program, our team became energized and got to work. 

It was refreshing to have residents, faculty and administrative staff who were undaunted by the unknown, as COVID-19 likely prepared us for this moment too. We only had four months to prepare as our first recruitment event would take place in July, so we started to brainstorm which issues to tackle first: website edits, videos, social media and interviewing platforms, recruitment fair participation, visiting students, audition rotations, and finances. Looking back, this was a pretty significant list of issues, but all of the planning and effort that went into each of these areas has truly proven fruitful even without knowing the results of this year’s Match and, for that, I’m grateful.

As Program Director, I know that we have awesome faculty who teach Family Medicine excellently. I also know that we serve an amazing, underserved community and that we meet the community’s needs through clinical care and resident education. We also have a strong reputation of providing high quality care to our patients and their families. I felt like those qualities would not be that hard to convey to potential applicants in virtual format, even after all that the pandemic had brought to us. But the one thing that I was worried about not being able to convey adequately was the sense of family that people feel when they are at our program. 

When I was a medical student, I decided on Family Medicine after I rotated with our program in my fourth year. I remember sitting in rounds one day thinking, I could work with these people! It was the people who helped me see my calling in Family Medicine. It was the people who served as perfect role models for the type of physician I wanted to be. For me, the people included residents, faculty, clinic staff, administrative staff and the patients;  they are “the thing” that makes the program what it is and I wanted to let applicants know this before the interview day. Our goal was to effectively get people to sense “that thing” that I felt when I first came into contact with our program years ago. 

So, we decided to do what we did best, which was to be ourselves as we introduced people to our family. From the quirky, “80s-inspired public service announcement style” clinic tour to the Instagram page created and maintained by select residents, highlighting our team members and their favorite things. Our social media platforms helped us introduce people to our patient population and frequently displayed our commitment to social justice in light of current events. I, along with several residents, spent a lot of time talking with potential applicants during recruitment fairs and scheduled WebX meetings thereafter. We worked closely with our sponsoring institution ensuring that we would have a more professional video to introduce applicants to our hospital wards and clinical faculty, and that our website would be attractive and more appealing than our competition. We worked hard! We banded together as good families do. We were innovative problem solvers and had fun doing it. 

I truly believe that, this year, we interviewed more candidates who were genuinely interested in our program and our offerings and who had already done their research on us. Many of them spoke of how much they appreciated the details we put into our website and were able to vocalize those key details about us during their interviews. It was also great to hear that many of them loved that quirky, 80s-inspired video. Many applicants visited our social media platforms and were able to see the diversity within our program and surrounding community. I believe that the type of candidates we interviewed really seemed to have similar passions and interests which aligned well with our mission and commitment to Family Medicine. 

Overall, my goal is to always recruit individuals who have “that thing” that I was first attracted to when I was a student rotating at our program so I look forward to seeing who will join our team this year. This truly was an exciting recruitment season and I can’t wait until Match Day!

Camille B. Garrison MD is an Associate Professor in the Department of Family and Community Medicine at MCW and residency program director for the Ascension Columbia St. Mary’s Family Medicine Program.

Work and Career in that Order: Residency is Just the Next Step in the Life of a Physician

 From the 3/19/2021 newsletter

Director’s Corner

 

Work and Career in that Order: Residency is Just the Next Step in the Life of a Physician

 

By Adina Kalet, MD MPH

 

Dr.Kalet celebrates Match Day 2021 by exploring how residency, as difficult as it can be, offers opportunities for growth and a path to a rewarding career …

 

Later today, more than 48,000 medical students will find out where they will begin residency training in July.

While the numbers vary, about half of students matched to their top choice, and about two-thirds to one of their top three. About 5% of all applicants did not match and have spent the week working with deans and faculty to “scramble” into open slots. There will be disappointments and not everyone will be thrilled.

In normal times, MCW-Milwaukee would be hosting our 200 students, their families, and their friends in an Alumni Center celebration with balloons, short speeches, finger food, intense excitement, and identical “I MATCHED!!!” t-shirts. Even still, today’s celebration and energy will be shared on social media and over the internet when, at 12:00 noon EDT, students open the e-equivalent of an “envelope” and learn for the first time to which program they have matched.

Today is one of the most significant watershed moments in each of their lives. They will, finally, be able to glimpse more clearly the outlines of their future selves.

 

The importance of “place” in residency training

Where a physician trains does matters. Residency takes each young physician to a city or town where they are committed to stay for a while and, although it varies by specialty, over 50% of physicians end up practicing in the state where they complete training. The shared experience of residency builds profound and lifelong friendships forged during long nights-on-call and the intellectual, physical, and emotional challenges inherent with the transition from medical student to practicing physician. Clinical “habits” are formed and imprinted for a lifetime.

I am amazed how intense the experiences I had during my own residency remain. While I have not drawn blood cultures, done a lumbar puncture, or placed central intravenous line in the subclavian vein in three decades, I still recall the rhythm of each procedure, the proper aseptic techniques, the positioning of the patient, the feel of the cannulas and needles, and the proper documentation. My fingers remember the sensation of the needle overcoming resistance, piercing the skin, and finding the proper space. During my residency, I learned to rehearse “delivering bad news,” and still do so as I walk toward a difficult conversation. Facing an emergency, I still summon courage the same way I did when I was wearing the “code beeper” and running toward, rather than away from, the crisis. Always take the stairs. Never wait for the elevator. Hope the nurses are already there with the cart. Will the medical student by my side be ready to do chest compressions? I learned to be ready when I arrived. 

 

Looking for meaning during residency training

Some things have changed about the match since I was in medical school. While many of my classmates in the early 1980’s applied to only one type of residency, a sizable minority listed more than one type of program on their match lists, allowing the algorithm to determine whether they would end up as an internist, pediatrician, dermatologist, or orthopedist. I share this because I now know how this approach worked out. These peripatetic students understood something the rest of us did not, and here is the lesson: It is much more important to choose what kind of career you want to have, than which clinical discipline or “tribe” you seek to join. They understood that there are, for most of us, many paths to a satisfying life as a physician.

Here are some examples. One friend knew she wanted to spend her career in women’s health, so she applied to and ranked OB/Gyn, family medicine, and internal medicine programs. Another close colleague, hoping for a quiet, suburban, “Marcus Welby” type of practice, applied to both family medicine and internal medicine. They let the match decide their specialty, knowing that each path would lead to their goals. Other classmates were so committed to where they wanted to live that they applied to several different specialties in the same city, believing that the type of residency was secondary.

This type of flexibility seems very old fashioned now and there are reasons for this. Over the past decades, for example, the increase in medical school graduates has far outpaced the increase in first-year residency positions, placing an intense “What if I don’t match?” pressure on students that we never experienced. Today, certain clinical fields are so competitive that students feel the need to plan far ahead, take time off to complete specialty-focused research, concentrate on doing things that will make them more attractive for the few spots, and audition extensively. Back when each residency program had its own pen-and-paper application form, we applied to ten or so institutions and ranked five to eight. These days, the number of electronic applications submitted by each applicant continues to climb, and it is not unusual for a medical student to apply to over sixty programs hoping for a handful of interviews. Different times, for sure. But instructive. Life as a physician has always been a journey with many choices, and residency is just the next step after medical school.

 

“Careers are made in retrospect”

Most of us can look back and see the paths we took, the opportunities we seized, and the roads not taken. But discerning the path that still lies ahead of us is impossible. It is rare to meet someone who, in retrospect, knew where they were going from the very beginning. Nearly half of the students who match today are entering different fields than they had envisioned for themselves when they started medical school. As many as 20% of residents switch fields before the end of their training. Mid-career physicians often retrain into new clinical specialties, seek advanced education, or pursue mid-career fellowships in a wide range of areas.

My woman’s health friend, for example, ended up happily doing groundbreaking immigrant health research. “Marcus Welby” is now a professor and urban health services researcher. Even though they did not end up where they might have predicted, their training gave them the flexibility to build satisfying and meaningful careers.

This is really good news. It means we can each feel free to be fully in the present. With reflection, mentorship, and opportunity, we can redirect our work. As the ancient Greeks advised: Know Thyself. Then move in that direction.

The wonder of a career in medicine is its flexibility and ever emerging opportunities. So how do we make good choices?

 

Residency is a learning experience, but it is also a job. Some advice …

Find work that matters. Look for the aspects of your new careers that intrigue you and get you out of bed in the morning. As novice physicians, you will learn about yourselves and your patients as you engage with both the well and the chronically ill. You will learn to prioritize and lead teams as you work through the daily tasks and confront the patients who decompensate in front of you. You will perform procedures that require significant manual dexterity and employ advanced technology. You will engage with colleagues, team members, and communities. You will collect and analyze data, peer through microscopes, study the results of sophisticated analyzers, and seek the truth and beauty hidden in a radiologic image. You will deal with unimaginable ambiguity. Learn to think, to feel, and to engage at various paces and rhythms — optimally, for your entire professional lifetime.

Take time to reflect and grow. Listen to others as they help you discern how your work impacts you. Find ways to stay well even as you do the hardest work in your life.

 

Residency is only one step on the path to a career

Training is extremely hard, and it can become a life of one challenge after another. Yet, as residents touch the lives of patients, learners, colleagues, friends, family, and the community, opportunities for growth, character development, and changemaking present themselves. Some residents will avoid these occasions while others will seek them out. To some, the work of residency will drive them forward into rich careers, dictating their goals and what they work on. For others, the opportunities will fade into the background while they are “busy making other plans.”

This is what continues to astonish me. While residency is an overwhelming experience, there are those who take full advantage of its opportunities. They learn early that training is only one step toward a career that will take unexpected twists along the way. As faculty, we must recognize their sacrifices, yet help them stop and consider: What do you want to be able to say you have done? How will you know you have done it, influenced others, engaged in those conversations, made the world just a little better? How might I help?

 ___

The next group of residents will arrive soon. This week’s Transformational Times celebrates the agility, flexibility, and compromise inherent in recruiting the next cohort of residents during a pandemic. In this issue, you will read about how our MCW community of residency program directors, students, and residents have faced and embraced the special challenges this COVID-19 year. Airports, hotels, and long visit days filled with hospital tours and interviews were replaced with Zoom interviews, “1980’s style” videos, social media blitzes, all produced to give the potential residents a “feel” for the culture of the programs.

And there have been upsides! Programs saw the numbers of applicants increase. There was a more diverse applicant pool. Web pages were spiffy, social media campaigns were buffed, and all hands were on deck as residents showcased their program’s camaraderie and the wonders of living in Milwaukee. In some ways more exhausting (zoom fatigue) and in some ways more intimate, faculty and applicants got to see each other’s home offices and meet the family dog. No cheese curds, brats, and beer; instead, there were suit jackets, a clean shave, and a new house plant along with scrub pants and sneakers.

Creativity overflows. This is an important moment. Let’s take advantage of it.

 

 

Adina Kalet, MD MPH is the Director of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education and holder of the Stephen and Shelagh Roell Endowed Chair at the Medical College of Wisconsin.

Interviewing for Fellowships - My 2020 Experience

 From the 3/19/2021 newsletter

Perspective/Opinion

Interviewing for Fellowships - My 2020 Experience

David A. Campbell, MD - Department of Otolaryngology and Communication Sciences

Dr. Campbell, who will complete his otolaryngology residency in June 2021, talks about some of the plusses and minuses of interviewing for fellowships during the COVID-19 pandemic … 

“Please tell me you’re not in Atlanta yet!” 

It was March 12, 2020, the day before my first fellowship interview. In the days preceding, interviews dropped off the calendar one by one as travel restrictions tightened and hospital campuses closed their doors to non-essential workers. Some programs switched directly to virtual interviews, while others were hopeful they could have applicants in person by May or June (a wildly optimistic prospect, in hindsight). The Atlanta program finally shut their campus down and the coordinator was frantically trying to stop applicants from getting on flights. After being through medical school and residency interviews, I knew this would be very different. However, as I worked through nineteen virtual interviews spanning five months, I did find some surprises along the way.  

The first thought was how disappointing it was to be unable to visit the cities and hospitals I’d potentially be spending a year at. A very close second thought (in reality, probably a simultaneous thought) was how much money I’d save. Already, credit card bills were piling up and vacation days were evaporating. It was becoming clear that physically getting to 19 interviews was likely going to be impossible. However, on the virtual interview trail, I could attend a morning interview in Florida, an afternoon interview in California, and an evening Zoom social event in New York, all without leaving my apartment or spending a dime. Some programs scattered interviews over several days, meaning I could duck into a hospital workroom for 15 minutes at a time, using no vacation days at all. I’ll admit I did several interviews between cases wearing a suit coat and scrub pants.

Some aspects of the virtual process weren’t immediately obvious. One significant drawback was not meeting the other applicants. Otolaryngology is a small enough specialty that during the residency interview trail, applicants tend to run into each other several times. In the process of comparing notes on past and future interviews at social events or making small talk on the 10th hospital tour, many of us formed connections that only grew as we found each other at conferences throughout residency and will continue to grow as we move through our careers. The graduating ENT class of 2021 got to meet each other during the interview trail of 2016. Now, as I was virtually interviewing to enter the even smaller community of Head and Neck Surgical Oncology, I realized I was missing out on the opportunity to meet my soon-to-be colleagues. 

There were also some unexpected advantages to virtual interviews. As interviews approached, there was concern if programs and applicants could get to know each other as well on the virtual platforms. Similar to the residency match, the 10-to-15 minute interviews themselves are incredibly important for both applicant and program. A single awkward interaction vs. a meaningful connection can have huge impacts on how applicants and programs rank each other. Of course, there were the expected technological hiccups with lots of “I can hear you. Can you hear me?” However, I had several interviews that felt easier because they were virtual. While many physicians interviewed from their offices, I spoke to several world-famous Head and Neck surgeons from their homes. One particularly well-known surgeon was arriving home from work as the interview started. He greeted and introduced me to his wife and showed off the view from his yard (“This could be the type of view you get if you move here!”). From the applicant side, rather than being led into an office at an unfamiliar hospital after sleeping in a hotel bed, I was often interviewing from my apartment with my cats napping on my bed that was just steps away. While some ability to connect was undoubtedly lost with interviews being virtual, my guess is that both parties being in a familiar setting facilitated easier connections in a different way that would not have been possible in-person.  

I’ve heard the sentiment over and over that virtual interviews could never replace in-person interviews. In many ways, I agree with this. However, it was refreshing see people finding new ways to connect with each other when the world was turned upside down.

David A. Campbell, MD is a PGY5 in the Department of Otolaryngology and Communication Sciences at MCW. He will spend the 2021-2022 academic year as the Head and Neck Oncology - Microvascular Reconstructive Surgery Fellow at the Icahn School of Medicine at Mt. Sinai in New York City, a town which he has never actually visited. 

The Transformational Times First Anniversary "Best Essays"

 From the 3/12/2021 newsletter

The Transformational Times First Anniversary "Best Essays"

These are the most read, most important, and most popular essays, poems, and reflections from our first year. They are all on the blog, so feel free to use the "SEARCH THIS BLOG" box in the right hand column to find and explore each of them. 

The Transformational Times has a Birthday and I have an Insight

From the 3/12/2021 newsletter

Editor’s Corner

 

The Transformational Times has a Birthday and I have an Insight

 

Bruce H. Campbell, MD FACS

 

In this Anniversary Issue, we reprint some of the most important and popular essays published during the first year of the Transformational Times. Dr. Campbell, Editor in Chief of the newsletter, reflects back on its origins in March 2020 and believes it will offer a blueprint for the transformation of medical education and the culture of medicine for the coming generation …

 

This newsletter has been around for one year. Safe to say, more than a few things have changed over the months.

In March 2020, in-person classes were being cancelled, medical students were being sent home from their clinical rotations, and the pandemic was starting to become real. On March 16, Dr. Adina Kalet, Director the Kern Institute, presented her vision for a weekly email that would offer support and information to MCW and the wider community. She invited several of us to address a variety of topics, asking us how we might:  

• Keep students connected now that they had been forced off-campus
• Understand what Caring and Character look like during a public health emergency
• Explore how faculty and staff are affected by the ethical issues inherent in balancing work, coronavirus exposure, family upheaval, PPE shortages, and child rearing
• Support the “worried well”
• See how the pandemic might reactivate old wounds
• Find ways to best engage our audience
• Discover what “transformation” looks like when everything is disrupted, and how we should take advantage of this disruption to reinvigorate medical education

We had no idea how to tackle Dr. Kalet’s challenge. On top of it, we all had day jobs and none of us had ever attempted to mount a weekly newsletter. Would we take on the challenge? Sure, we said. What could possibly go wrong?

So, the Transformational Times was born. That Monday meeting led to a newsletter the following Friday. And every Friday since.

 

What we brought to the Transformational Times

We experimented. We learned. We pledged to keep the content relevant, surprising, honest, and edgy. We started this blog to archive many of the essays. Over the subsequent months, we expanded our efforts:

• We requested essays and poetry that addressed reactions to George Floyd’s death, shining lights on systemic racism and the impact of the Black Lives Matter movement.
• We offered platforms for voices we believed were not widely amplified, including students, residents, staff, nurses, persons of color, women, persons identifying as LGBTQ+, and native Americans.
• We published pieces that offered clarity even as polarization threatened the fabric of democracy.
• We included first-person struggles with failure, stigma, mental health issues, and burnout.
• We celebrated the service of military veterans.
• We brought in voices from the regional campuses.
• We added student associate editors to recruit writers, develop poetry and visual arts columns, create content, and be social media experts.

In the process, we aggressively began including the projects and missions of the Kern Institute. The institute’s thought leaders, program participants, and consultants shared insights on many topics, including visual thinking strategies, remediation, medical education transformation, entrepreneurial mindset, entrustable professional activities, educational measurement science, mentorship, mattering, practical wisdom, and professionalism.

Overwhelmingly busy people create our content, and we have been gratified by their willingness to share stories on deadline. We are also very grateful to our readers; of the 6000 who receive this email every Friday morning, over 30% open one or more of the articles. We appreciate the feedback, as well.

 

What the Transformational Times has taught me

Our MCW, Kern, and KNN world is remarkable. I now have even more respect for the accomplished and delightful people with whom we share this space. I have garnered new insights into the extra burden older, male, white folks like myself place on people who identify as “other.” I have been astonished by the maturity and skill of the youngest members of our community. I have seen how concepts such as mattering and the entrepreneurial mindset will soon change how medical educators approach everything they do.

Each week’s issue makes me wonder what will emerge from the ashes and chaos of the past year. The pandemic and social upheaval offer unique opportunities to innovate, lead the way, and develop new paradigms that can guide young adults from being premedical students through the phases of training to becoming character-rich, caring, and healthy practicing physicians and medical educators. By reading the Transformational Times, readers catch hints of what that change looks like.

The Kern Institute was established to “transform medical education.” This past year has transformed medical education and everything else in our worlds.  Editing the newsletter has allowed me to glimpse a better path. If everything returns to the old, comfortable status quo when the masks come off, the classrooms and labs reopen, and the pandemic recedes, we will have lost.

Having read every single article over the past year, I should have insight into all of the topics Dr. Kalet listed during our inaugural meeting last March. And, of course, I do not. But, thanks to the amazing opportunity that being editor has provided, I have learned much, become an optimist, and have glimpsed the future.

 

 

A special thanks to all of our contributors! The newsletter would not exist without the hard work of (drum roll…) Production Editor Julia Schmitt and the rest of the editorial team: Kathlyn Fletcher, MD MA, Adina Kalet, MD MPH, Wendy Peltier, MD, Michael Braun, PhD, and medical students Olivia Davies, Scott Lamm, Eileen Peterson, Sarah Torres, and Anna Visser. You are each amazing!

 

Bruce H. Campbell, MD FACS is a Professor in the Department of Otolaryngology and Communication Sciences and in the Institute for Health and Equity (Bioethics and Medical Humanities) at MCW. He is on the Faculty Pillar and is Editor in Chief of the Transformational Times newsletter for the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education.

Setting the Expectation for a Growth Mindset in KINETIC3’s Excellence in Teaching Track

From the 3/5/2021 newsletter

Perspective/Opinion

Setting the Expectation for a Growth Mindset in KINETIC3’s Excellence in Teaching Track

 

by Alexandra Harrington, MD

 

Dr. Harrington shares that character development in adults seems dependent on having a growth mindset, a frame of mind adopted by the Kern Institute's KINETIC3 Teaching Academy...

As I reviewed the results of my Values in Action (VIA) character strengths survey, I noted the ‘top 5’ of honesty, judgement, love, perseverance and fairness, but was naturally drawn to those strengths ranked at the bottom, self-regulation, social intelligence, and spirituality. For those unfamiliar with this survey, it is a free survey (available at viacharacter.org)- that all KINETIC3 learners take prior to our first course- that ranks your character strengths based on your answers to a series of questions. Can I better control my emotions and reactivity? How do I improve my interpersonal relationships? These questions and other related ones had me reflecting on my mindset. With a growth mindset, I certainly could practice better self-control, but not with a non-acknowledging, resistant fixed mindset. Character development in adults seems dependent on having this growth mindset.  

A growth mindset is defined by Dr. Carol Dweck as the belief that talents and skills can be developed in oneself and/or others. We have adopted this frame of mind in the KINETIC3 program and have set the expectation for having a growth mindset with respect to teaching in the Excellence in Teaching Track. Our learners are asked early in the program to reflect on previous teaching evaluations. We ask learners to share their positive evaluations and reflect on growth opportunities. Then, we ask learners to share any negative feedback on their teaching and again reflect on growth opportunities. We try to explore those opportunities, even if the negativity of the evaluation seems like Jimmy Kimmel’s mean tweets! KINETIC3 learners are given time to reflect substantively on their teaching and character strengths and opportunities for improvement and commit to working on those growth fronts during their coached teaching observations. 

“We’re all a mixture . . . it’s true that you can have a fixed mindset in one area and a growth mindset in another and that it’s a spectrum, not a dichotomy,” Dr. Dweck tells us in a videoed interview that we watch in KINETIC3 (https://www.youtube.com/watch?v=-71zdXCMU6A&feature=youtu.be). 

Learners are asked to reflect and share stories wherein they had a fixed mindset and then situations in which they have had growth mindsets. And as Dr. Dweck advises, we ask learners to reflect on the triggers of the fixed mindset. What puts you in the fixed mindset in that moment? The goal in this exercise is to identify the trigger in hopes of avoiding the rigidity in the future. We stretch our learners to mentor themselves hypothetically then towards a growth-minded belief if they encounter similar scenarios in the future. Lastly, we share examples of fixed and growth mindsets related to our previous educational experiences, such as disregarding student evaluative feedback (fixed) and trying a new active learning exercise (growth). It is imperative we recognize that in the teacher-student relationship, our mindset may influence our learners’ mindsets (and vice versa!).

Alexandra Harrington, MD, MT (ASCP), is a Professor of Pathology and Director of Hematopathology in the MCW Department of Pathology. She serves as Director of the Faculty Pillar and the KINETIC3 Teaching Academy within the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education.

Entrepreneurially-Minded Learning and Teaching: A Core Element of KINETIC3

 From the 3/5/2021 newsletter

Perspective/Opinion

Entrepreneurially-Minded Learning and Teaching: A Core Element of KINETIC3

 

by Bipin Thapa, MD

 

Dr. Thapa provides an overview of what the KINETIC3 program hopes its participants will learn about the Entrepreneurial Mindset …

 

Teachers and educators do different things, but how often do we stop to consider and “What is the value of what I am doing?” or “What exactly are we trying to create?”

We need to think differently if we are to address these questions.

In medicine and education, we shy away from terms like, “Entrepreneurship” because of the incorrect assumption that entrepreneurs focus solely on monetary profit. But entrepreneurship is more than that. It encompasses ways of creating anything of “value” – and can concentrate on things such as services, scholarships, processes, and quality improvements. It can even focus on experiences.

Academic Entrepreneurship creates sustained value in multiple dimensions that are financially and/or logically stable. It is competitive in the “marketplace”; the “market” here reflects a broader platform that includes, but is not limited to, scientific and peer-reviewed venues. Entering this market requires an Entrepreneurial Mindset (EM). EM is, in essence, a collection of mental habits like attentiveness toward opportunities, focus on their impact, and intent to create value. This learned set of values offers a way of thinking about the world and acting upon what we see. EM empowers the practitioner to question, adapt, think differently, and make positive change; it equips one to identify opportunities and create value in any context.

By building on work borrowed from our Kern Engineering Entrepreneurial Network (KEEN) colleagues, we are deliberately creating an entrepreneurially minded learning and teaching culture in the KINETIC3 program. Our teachers and educators start from the big ideas of why our learners need to learn something and then move to what they need to ask to answer the more important questions. We push them to discern how best they can accomplish the goals. We want them to focus on learning objectives that reflect the tandems of mindset and skillset. That is another offer of value. Our instructional methods must be inclusive and respectful of the differing learning styles of our learners; this is critical to excite every learner. Finally, our assessment methods must be practice-relevant, as we know that assessment drives learning. 

The diagram shows the big picture of how the Entrepreneurial Mindset guides the process from identifying big picture themes through instruction to assessment. 

We believe that by training entrepreneurially minded faculty, we will promote long term institutional change. Having a significant number of KINETIC3 alumni teaching students and residents with techniques built on the Entrepreneurial Mindset, can lead to “good” disruption and new ways of developing identity formation. 

Bipin Thapa, MD, MS, FACP, is an Associate Professor in the Department of Medicine (General Internal Medicine) and Assistant Dean of the Clinical Science Curriculum at MCW. He is a member of the Faculty Pillar and of the KINETIC3 Steering Committee of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education. 

Social Connectedness and KINETIC3 Medical Educator Track

 From the 3/5/2021 newsletter

Perspective/Opinion

Social Connectedness and KINETIC3 Medical Educator Track

 

 

by Jeffrey Amundson, PhD, Tavinder K. Ark, PhD, and Alexandra Harrington, MD

 

Drs. Amundson, Ark and Harrington share how the KINETIC3 program is producing valuable data for program assessment and publication, but more importantly it is providing opportunity for a mediator of flourishing to exist and develop...

 

It may seem obvious that social connectedness is important, however, understanding its impact in particular environments allows individuals to leverage its benefits to build character and promote flourishing. Moreover, when we think of social connectedness, we often define it in superficial terms as social networking or creating a circle of friends, family, and colleagues. However, we seldom consider the depth of how impactful such connection can be, especially at work. That is, we might only think of work relationships as ways to get ahead, but upon digging deeper into these connections one begins to see the real value. For example, social connections play an important role in professional development and the co-construction of knowledge, by shaping an individual’s access to valuable information, guidance, and overall support. (Baker-Doyle, & Yoon (2011); Wasserman & Faust (1994). 

What does this mean for medical education? 

 The culture of medical education emphasizes productivity and demands excellence given the seriousness of the potential impact on the eventual practicing physician and patient. The stress of this environment can be mediated by social connectedness. That is, if faculty have more connections and more meaningful connections, then their ability to flourish and in turn help emerging physicians flourish is more accessible (Happiness Is 'Infectious' In Network Of Friends: Collective -- Not Just Individual – Phenomenon, 2008; Mere Belonging: The Power of Social Connections., 2012; Learning in Faculty Development: The Role of Social Networks, 2020). 

What we found 

 Social network analysis (SNA) has been used variably in faculty development efforts in medical education to assess effectiveness of learning about teaching, but prospective data from formal programs is minimal. We developed a SNA to understand how social connections emerge, develop, and add value to the learners in our faculty development program for medical educators (Kinetics3). Prior to a workshop on building professional networks at our institution, participants completed a SNA exercise. Participants were asked to sketch the direction (unidirectional- one-way value relationship vs. bidirectional- value provided for both parties) and strength (1-weak/low value, 2-moderate, 3-strong/high value) of relationships to individuals and organizations in and outside of our institution, as they relate to their existing academic educational networks. Text box descriptions of the relationship(s) were encouraged. Individuals were also asked to sketch future connections they hoped to foster over the program duration (dotted lines). For our enrolled participants, the strength of their relationships related to education was dependent on the type of relationship (organization vs. individual). Specifically, faculty rated their unidirectional relationships highest from organizations and lowest from individuals. This suggests that junior faculty use of organizational expertise and resources may be more impactful than any given individual. We plan to monitor faculty SNAs after several curricular interventions in the program as an outcome metric to understand if our faculty development program influences the strength and diversity of connections to people and organizations involved in the educational mission. Junior faculty in our faculty development program tend to have stronger baseline relationships with organizations than individuals for educational-related activities at our institution. This data is unique in the faculty development literature and suggests that our program’s mentorship component and the influence of individual program instructors have the potential to fill voids in faculty relationships early in their careers. Additional network analyses by our faculty will provide data on how connections and community of practices evolve in an academic faculty development program.

KINETIC3 Medical Educator Track and Social Connectedness While what we found is only a part of the story on social connectedness and adds to our overall understanding of such constructs, the real value lies in how the process of experiencing the KINETIC3 program can foster these connections. That is, the process of the KINETIC3 program exists through planning for a capstone project and participating in workshop activities. Planning for the capstone meetings involves identifying mentor(s), collaborators, and working with members of a cohort. Once mentors and collaborators have been identified one is trained in empathetic interviewing to develop networking skills. During workshops leading up to and including identifying mentor(s) and collaborators there are activities to promote thinking about connecting with people. For example, in addition to the social connectedness study mentioned above, a barriers and potential solutions for the capstone activity was implemented that required identification of individuals one would connect with to help solve barriers to the progress and completion of the project. 

The KINETIC3 program is producing valuable data for program assessment and publication, but more importantly it is providing opportunity for a mediator of flourishing to exist and develop. 

Jeffrey Amundson, PhD, is a Postdoctoral Fellow in the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education. Tavinder K. Ark, PhD, is an Assistant Professor and Director of the Data Lab in the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education. Alexandra Harrington, MD, MT, (ASCP), is a Professor of Pathology and Director of Hematopathology in the MCW Department of Pathology. She serves as Director of the Faculty Pillar and the KINETIC3 Teaching Academy within the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education.