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.