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.

"At the Most Important Crossroads in our Life there are No Signs"

 From the 3/5/2021 newsletter

Perspective/Opinion

"At the Most Important Crossroads in our Life there are No Signs"

 

by Linda Menck, MA

 

Linda Menck, a faculty member in the Kern Institute’s KINETIC3 program, talks about how she employed the entrepreneurial mindset to recast a communications course at Marquette from a tired offering to a creativity powerhouse…

 

After seventeen years of teaching at Marquette University I found myself at the crossroads. My teaching career felt like the plot of the film Groundhog Day. 

 

As a professional faculty member in the Diederich College of Communication, I was assigned to teach the same classes every semester. It was like eating the same breakfast cereal every morning. While students in my classrooms changed, course content remained the same. 

A course I regularly taught was Introduction to Visual Communication (COMM 2100). This was a required course for all majors in the College of Communication but was demoted to an elective after a college core curriculum review. 

I remember thinking this course was destined to die, and the cause of death would be low enrollment. Students with majors in engineering, the sciences, and business administration had no desire or need to learn theories of visual communication or memorize dates and definitions of major art movements. 

This became a personal and professional prefect storm that ultimately motivated me to disrupt and transform my teaching. Consistent with my character, I didn’t ask for permission, but I knew it was time to redesign COMM 2100, and the redesign would need to be of epic proportion. At the foundation of the redesign would be personal passions, what I knew best, and essential skills research indicated our students needed to practice and become capable of applying.

I gathered my markers and faced the whiteboard to mind map my new course. “Mind mapping” is a visualization method I use and teach to promote and practice divergent and disruptive thinking. The central topic of my mind map was COMM 2100 REDESIGN and the initial major branches or connections were creativity, communication, and innovation. 

From the initial branches, twigs began to grow fast and furious. They included entrepreneurial mindset, defining and exploring creativity, building creative confidence, methods for creative problem solving, human-centered design research methods, inclusive and design thinking, disruptive innovation, and the power of storytelling and visualization to present innovative ideas and solutions. 

There were other crucial components to ensure the course would work. It had to be hands-on and grounded in active learning. This meant identifying an environment designed to untether learners from desks. The course needed to be experiential and focused on challenges in our community and the world. Finally, the content had to be collaborative in nature and applicable to students from diverse majors with a variety of skillsets. While planning it became evident this was a red-hot challenge with a whole mess of opportunity. Flying under the administrative radar screen, I created  content, rewrote the course description, objectives, and learning outcomes, and then settled on a new name for the course. Finally, it was time for the reveal. In the Fall of 2014 my new Creativity, Communication, and Innovation course was ready to be put to the ultimate test and judged by the harshest critics, our students. This was my field of dreams. I built it, but would they come? 

Course registration for the semester began and I waited and watched. The result was shock and awe. Within the first two days of registration both sections of the course filled to capacity.

The course continues to thrive and grow. Over time, it has evolved into a course that fulfills a requirement in our University’s new core of common studies, continues to push students out of their comfort zones, and builds their creative confidence. 

When I arrived at the crossroads, I chose to take the transformative route but I never traveled alone. My journey took me across campus to the Opus College of Engineering and the Kern Engineering Entrepreneurial Network (KEEN). I was welcomed, supported, and taught how to integrate entrepreneurial minded learning into my courses with a framework grounded in curiosity, connections, and creating value. 

Continuing on the road led me to MCW and the KINECTIC3 Teaching Academy. You, too, welcomed me. Collaborating with members of the KINETIC3 Advisory Committee to design and teach bootcamp workshops is an exciting new challenge. Your ongoing support transforms me with character, caring, and competence and keeps me from returning to the crossroads. 

The title of this piece is from a quote attributed to Ernest Hemingway. 

Linda E. Menck, MA, is a Professional in Residence in Strategic Communication in the Diederich College of Communication at Marquette University. She is a member of the KINETIC3 faculty. 

Teaching About Implicit Bias in the Classroom

 From the 3/5/2021 newsletter

Perspective/Opinion

Teaching About Implicit Bias in the Classroom

 

by Sandra Pfister, PhD, and Kerrie Quirk, MEd

 

Dr. Pfister and Ms. Quirk describe the course they co-lead in the KINETIC3 program which helps faculty recognize and mitigate their implicit bias when teaching...

 

The definition of implicit bias is: “the attitudes or stereotypes that affect our understanding, actions, and decisions in an unconscious manner.” Let's use a True/False question to see what you think: True or False? I have no implicit bias.  Correct answer: FALSE. Every one of us has implicit bias because that's a function of how our brains work. What happens when implicit bias takes over when we are teaching? Maybe you say that women don't have heart disease. Not said with intention, but isn't heart disease a man's disease? Or when teaching about skin disease, maybe you only show images from white patients. Not done with intention, but maybe because those were the same images used when you were a student.

Using a combination of didactics and active learning, our KINETIC3 course is structured to allow participants to explore their own implicit bias. Prework is to take the Implicit Association Test (IAT). IAT begins to connect learners with attitudes and beliefs they may not know they have (unconscious or implicit bias). The IAT website gives this example: "You may believe that women and men should be equally associated with science, but your automatic associations could show that you (like many others) associate men with science more than you associate women with science." Each KINETIC3 learner is given the opportunity to discuss their own experience with the IAT. 

This course also offers a more in-depth discussion on the meaning of implicit bias, and we delve into the role of the brain. Think FAST. Think SLOW. Think FAST involves those parts of our brain outside of conscious awareness. For example, let's say you stop your car at a red light. When the light turns green, you know to go. This mental association requires no conscious or effortful thought. In contrast, Think SLOW is the brain's conscious processing. It's what we use for mental tasks that require concentration, such as a taking an exam. Together, Think FAST and Think SLOW parts of the brain help us make sense of the world. But it is also the Think FAST parts of our brain that contribute to unconscious bias. This session looks at times when unconscious bias is activated in our brains and shows up in our teaching (when we are rushed, when we are fatigued, or when we are unprepared) and offers strategies to help. We also show a video clip from a PBS special to highlight how medical education has contributed to systemic racism and the role of institutions in contributing to implicit bias. Through small group break-out rooms, learners are given the chance to reflect on their own role as medical educators to ensure a diverse and inclusive representation in clinical case-based material.

This KINETIC3 course aligns with a Kern Institute Transformational Ideas Initiative (TI2) project led by Kerrie Quirk to design a reflection check list for faculty to assess the clinical cases currently being used in the preclinical curriculum. The project is called Identifying Bias in Classroom Clinical Cases: A Structured Approach to Make Clinical Cases More Diverse and Inclusive. Since no KINETIC3 course is complete without a chance to spin the Character Wheel, we end the session with discussion on how specific character traits can play a role in mitigating our own implicit bias. 

Sandra Pfister, PhD, is a Professor in the Department of Pharmacology & Toxicology at MCW. She is a member of the Faculty Pillar of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education. 

Kerrie Quirk, MEd, is a Program Manager in MCW’s Office of Educational Improvement.

Love to teach and recognize that learning is what really matters!

 From the 3/5/2021 newsletter

Director’s Corner

 

 

Love to teach and recognize that learning is what really matters!

 

By Adina Kalet, MD MPH

 

 

In this issue of the Transformational Times, we celebrate the Kern Institute’s KINETIC 3 Faculty Development program. Dr. Kalet thinks about how engaging with a faculty development “Community of Practice” transformed her from just another good teacher into an educator ...

 

 

I have always loved to teach. Ask my little brother about the forced spelling lessons when he was a toddler. In high school and college, I taught dance to peers and little kids at a day camp. But it was not until I became a clinical teacher that I realized that it was not enough to just love to teach. If we want to educate masterful physicians, we needed to focus on learning.

  

One night as an Intern …

 It was the dead of winter. Mr. M was admitted to my care for hypothermia and impending delirium tremens, a life-threatening consequence of alcohol withdrawal.  Joe, “my” medical student, followed me to the ER. As expected, Mr. M smelled rank and was talking gibberish (confabulating), his eyes were bright yellow where the “whites” should have been (icterus). Vitamins had been given to stave off a full-blown encephalopathy, and the first of many milligrams of Librium were already flowing into his veins along with warmed fluids. Blood was drawn and sent to the lab. The ER nurse had donned protective gear ready, on my say so, to give Mr. M a warm water bath that would not only warm him up but also wash away the dirt caked most prominently on his feet and to treat the overwhelming case of pediculosis capitis (“head lice”). As I engaged with his incoherence and gently examined Mr. M, I sensed Joe drift as far away from the bedside as he could possibly get. I was miffed that he did not show greater interest.

 Later in the evening, after ensuring that the now fresh-smelling, no longer tremulous, Mr. M had a close-to-normal body temperature, Joe and I sat side-by-side in the Doctors Station. I wrote the admission note and orders, reviewed Mr. M’s extensive medical chart, and pondered the deranged blood chemistries, his chest X-ray and the ECG. Typically, medical students overflow with questions; Joe, oddly, showed little interest and sat quietly while I worked.

 Irritated with his passivity yet wanting to wake his curiosity to the wonders of medicine, I decided to do some “teaching.” I walked to the green board, took up the chalk, and began a wide-ranging lecture. I discussed alcohol as a direct and indirect toxin, with acute and chronic manifestations in every organ in the body. I “pimped” Joe on the physical exam findings and labs which he dutifully reported. I pressed him to discuss why Mr. M was irritable but still charming even while his words did not make much sense. I pushed on. Why does he have yellow skin, tremors, an enlarged heart, a huge belly, but skinny limbs? Why does he have few red blood cells in a wide range of sizes, altered liver function in that particular pattern, and the irregularly irregular cardiac arrythmia? And finally, Why does he have this the remarkable number of ER visits, abominable hygiene and nutrition, no home, no money, no family? 

 After reveling in a medical textbook’s worth of physiology, toxicology, neurology, psychology, pathology, and dermatology – all knowledge relevant to Mr. M’s care - I plopped down in the chair. Joe was clearly impressed. I was jazzed, astonishing even myself with how much I could recite with great enthusiasm and passion.

 It was a fun, self-satisfying performance but, I know now, that did not make it a great education.

 

Why not? First of all, I never stopped to assess what Joe already knew, what he felt, or what he made of the whole experience. I did not discern if he would walk away from my lecture being any more able to care for patients like Mr. M who disgusted or frightened him. Did he now understand how to approach difficult patients emotionally and intelligently? Would he deal with them employing care, competence, and compassion? I had no idea.

 In addition, I neither tried to understand why Joe was so passive about learning, nor did I have a clue how to help him become a more the engaged and motivated learner.

 The next day, it dawned on me that Joe likely had a powerful emotional reaction to Mr. M. Did he recognize a loved one or himself in the end stage alcoholism? I did not know. Did he question his ability help in the face of such suffering? I never asked. If true, then he could have left that evening emotionally overwhelmed, questioning his career choice. 

 As a result, it is possible that my “performance” lecture had the opposite of my intended effect; rather than filling him with knowledge, I might have left him intimidated and less confident. Although Joe might have given me a glowing evaluation based on the attention I gave him (not a bad thing), I realized that, in the long run, I might have failed him.

 

 The road to becoming an educator

 After that evening, I became much more interested in becoming a better educator. Being an educator would require me to both know a great deal, but also know how to share that knowledge effectively. Although I still cared about what I taught the students, I wanted to be able to ensure they would and could learn.

 It was then that one of my mentors sponsored me to attend a weeklong faculty development program for medical educators. We worked in small groups co-creating active learning tasks (e.g., role plays, bedside rounds, reflection writing, and dialogue) and engaging in facilitated “personal awareness” groups.  I shared the story of my experience with Joe, and we role played alternative versions of that “lecture.” This was a profound experience which prepared me to return to residency as a much more effective educator.

 Ultimately, I joined the Facilitators-in-Training (FIT) program of the Academy of Communication in Healthcare (ACH). A senior member of the ACH faculty served as my “Guide.”  In monthly meetings, she coached me to identify my own learning goals and strategies. Together, we facilitated small group learning at national faculty development courses where I honed my skills with her feedback. We worked together for almost seven years, at which point I went on to serve as a guide to others.

 For over thirty years, ACH had created a community of medical educators who share a passion for communication skills training in medical education. ACH members have created innovative curriculum at many institutions and healthcare systems, conducted key scholarship, published a newsletter, a journal, and textbooks, and continued to conduct faculty development.

  

The value of Communities of Practice (CoP) in medical education; Creating concentric circles

 Most faculty development activities in medical schools consist of lectures or one-off workshops. This strategy simply does not work. Instead, experts suggest that it is best to build a community of practice (CoP) situated in an authentic workplace (See “For Further Reading” at the end of this article or click on the article links: O’Sullivan and de Carvalho-Filho.) A CoP is a group of people who "share a concern or a passion for something they do and learn how to do it better as they interact regularly.”

 CoPs are based on learning theories first proposed by cognitive anthropologist Jean Lave and educational theorist Etienne Wenger who were studying what makes apprenticeships powerful learning experiences. At their best, apprenticeships are complex sets of social relationships in the context of a community which creates a living, dynamic curriculum. CoPs are organized in concentric circles with those most intensely involved and experts at its center. Novices initially participate in the periphery, sometimes simply “lurking,” while listening in without engaging. Facilitators actively communicate with and invite in those peripheral participants. Learning happens at all levels of the organization through structured coaching relationships among individuals. Learning is, however, most intense as individuals engage more and move toward the center of the CoP.  This is one of my favorite learning theories, because it provides evidence to guide the growth of our faculty development practice in the Kern Institute.

  

KINETIC3 and the road to developing MCW’s CoPs

The essays in this issue demonstrate the many ways in which the KINETIC 3 program has established and is enriching a Faculty Development CoP at MCW.  By attracting committed, passionate medical educators to engage together in shared learning and practice, we are building capacity to enhance the learning environment for all our students. We continue learning as we tie ourselves together in learning relationships around our shared work.

 While there are basic “teaching skills” components to the KINETIC3 offerings, the members of the Kern Faculty Pillar, under the Direction of Dr. Alexandra Harrington, are building the skills of faculty that improve teaching performance and develop impactful, life changing educators. KINETIC3 graduates are already sharing their skills with colleagues, creating eddies that will become the concentric circles of our own Communities of Practice.

At the Kern Institute, we hope every faculty member will consider applying for the KINETIC3 program during their career. As faculty, we all hope to be the best educators we can be as we share our knowledge and passions. Only then will we engage, prepare, and support every student, even the ones like Joe, who passes through our doors.

 

 

For Further Reading:

O'Sullivan, Patricia S. EdD; Irby, David M. PhD Reframing Research on Faculty Development, Academic Medicine: April 2011 - Volume 86 - Issue 4 - p 421-428 doi: 10.1097/ACM.0b013e31820dc058

de Carvalho-Filho, M. A., Tio, R. A., & Steinert, Y. (2020). Twelve tips for implementing a community of practice for faculty development. Medical Teacher, 42(2), 143-149.

 

 

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.