Remembering the Earliest Days of the Pandemic: The Institute Responds to Times of Transition

From the April 24, 2020 issue of the Transformational Times

Remembering the Earliest Days of the Pandemic: The Institute Responds to Times of Transition

Adina Kalet, MD, MPH

This April 2020 essay was originally published six weeks after classes shut down at MCW. Despite the unknown risks, our physicians, nurses, and front line workers stayed on the job. 

During the very earliest days of the COVID-19 pandemic, we were all scared for our lives; the danger was very, very real and the future was uncertain. Despite this, the Kern Institute's leaders and educators shifted the Institute's focus to make certain students were supported and prepared. As you read, recall those days when we worried about the transitions and the future. 

In the coming months, the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education will transition again. Those of us associated with the Institute hope that whatever iteration emerges will continue to provide a sustained, innovative, and character-driven platform that influences the future of health sciences education. 

 

The COVID-19 pandemic has hit our economy hard. On our own campuses, saving and protecting lives has caused unprecedented revenue shortfalls within our community, to our hospitals, and to the Medical College of Wisconsin. Ironically, just when health care provision, education, and research are needed most, our work is threatened. Those on the “front line” of the pandemic deserve hazard pay for taking on risks for the rest of us, yet our staff is facing salary reductions and furloughs. 

Along with many of our peer institutions, MCW is implementing a financial austerity plan. We have hit a very rough patch and more changes are coming. Our futures are uncertain. People are scared. In this context, the Kern Institute is working to be good citizens by aligning emerging needs with our resources.

There can be opportunity in adversity

Historians point out that even devastating crises offer opportunities to societies. We have already seen unprecedented innovations in the face of immediate problems. Unable to deliver required clinical rotations, faculty and students are co-creating ways to fill curricular gaps through telehealth and service learning. New levels of collaboration and cooperation among medical schools and with accreditors have broken-down traditional silos, suddenly changing systems and shifting long-held policies. 

We must leverage these transformative opportunities for the better. If we work together to retain our senses of mission, purpose, and meaning, we will increase our individual and organizational well-being and resiliency. 

Pivoting what we do, yet remaining thoughtful

In our pre COVID-19 lives, the Kern Institute had been working to clarify our philosophy of medical education transformation. We referred to this as our “topology of transformation,” seeking to best understand why we are doing what we are doing. By thinking, dialoging, reading, and writing, we wrestled with uncovering which experiences are essential as a student transforms into the “good physician.” Then, and only then, would we allow ourselves to talk about the instructional or pedagogical evidence that drives the design and implementation of programs that achieve this transformation. For most of us, especially impatient physicians, it takes discipline not to jump into the “doing” too soon.

Suddenly, COVID-19 accelerated our work

Plato is credited with the phrase, “Necessity is the mother of invention,” sometimes translated more literally as, “Our need will be the real creator." While I prefer the more feminine flourish, now is the time when innovation is needed most. Over the past few weeks, Kern has pivoted to assist MCW’s rapidly transforming educational programs in response to immediate needs and we are designing ways to streamline and sustain the best of these changes. 

We are collaborating with partners in Academic Affairs and Student Affairs to support well-being, prepare students to meet their graduation requirements, provide meaningful clinical experiences, sustain and strengthen MCW’s long-term investments in diversity and inclusion, and speed the design and implementation of a dynamic, state of-the-art fully virtual curriculum.

Some things are the same in both 2020 and 2024

These are historic times globally and locally. As we adapt our educational work to the new reality, we will study the outcomes, learn from our successes and shortcomings, and look for the new topology of transformation. 

The essay was originally published on April 24, 2020 as, "Transforming Educational Strategies on a Dime."

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.

MCW's Seventh MedMoth Storytelling Evening

  

MCW's Seventh MedMoth Storytelling Evening

MCW MedMoth, a student-initiated and student-led storytelling event, was held on November 30, 2023. Over 100 appreciateive listeners came to support the ten storytellers as they shared tales on everything from the lifelong scars left after shoplifting to lessons learned from running a food pantry program to a death in the ICU. 

Some of the stories will soon be featured on the Medical Education Matters podcast. 

Thanks to the Kern Institute, the Kern Family Foundation, and the Charles E. Kubly Foundation for support of MCW MedMoth over the past four years. These events reflect human centered design principles and character. MedMoth supports students, staff, faculty, and health care professionals in human flourishing and resilience.

Big props to the MedMoth team: MCW students Meg Summerside, Linda Nwumeh, Amber Bo, Meghan Schilthuis, Corey Briska, and Maya Martin, and to Kern faculty/staff Shannon Majewski, Devarati Syam, Adina Kalet, Bruce Campbell, and Cassie Ferguson. 

Look for the next MCW MedMoth evening in Spring 2024!

My Night in the ED: Treating My Community During a Mass Casualty Incident

 From the December 17, 2021 issue of the Transformational Times

My Night in the ED: Treating My Community During a Mass Casualty Incident

On November 21, 2021, Evan Gibson was a third-year medical student at the MCW-Milwaukee campus. He was working a shift in the ED that evening when Froedtert Hospital and Children’s Wisconsin ran a mass casualty incident in response to the Waukesha Parade Tragedy. 

In this "Take 3" exchange published two weeks after the event, he answered three questions on his experience working a mass casualty event from his perspective as a medical student…

Transformational Times: What emotions did you experience hearing about the incident/treating the patients?

Evan Gibson: Fear was the first emotion that I experienced, which surprised me as I worked in EMS for multiple years and experienced challenging situations. I think that framed the seriousness of the incident for me. I have fortunately never been a part of a mass casualty incident and wasn’t sure what experiences were going to come in the following hours.

As I’m from Southeastern Wisconsin, I was also fearful that I might know a patient that came in. There is quite a difference between a friend texting you to ask what they should take for their cold vs. treating them (or their family) for a life-threatening injury.

Transformational Times: How did you harness your fear in the moment? What advice did you receive from fellow students or physicians prior to the arrival of the patients?

Evan Gibson: Fortunately, Dr. Jason Liu, who is an expert in Disaster Management, came to the ED after hearing of the event and helped lead the response. He reminded us that “the pathology is the same,” and this was a calming message for me. It reminded me that these individuals would be no different than the previous patients that have presented to the trauma bay and helped ground me.

Transformational Times: Did you notice any characteristics or traits that the Froedtert Hospital/Children’s Wisconsin-Milwaukee Hospital workforce demonstrated that stood out to you?

The dedication of everyone stood out most to me. There were multiple nurses, techs, and physicians that came to the ED or called in asking how they could help even though they were not scheduled. Everyone wanted to help their community in any way they could. The swiftness and preparedness of the nursing staff stood out to me as well. They quickly moved patients to the floor and made sure that there were plenty of rooms available within the ED. Everyone appeared prepared and eager to run a smooth mass casualty

Evan Gibson, MD, graduated from MCW in 2023. He is currently a PGY1 in Emergency Medicine at the Medical College of Wisconsin.

Gratitude: A Practical Application

 From the November 18, 2022 issue of the Transformational Times (Gratitude)

Gratitude: A Practical Application

Kathlyn E. Fletcher, MD, MA

Dr. Fletcher and Luke make a discovery together.

Me: “What are you grateful for today?”

My 12-year-old son, Luke: “That everyone was here today. My basketball games. And making tortillas with you.”

This is the nightly ritual that we have observed almost without fail since mid-winter 2021. I think it turned his life around; but let me take you back to the preceding months and you can judge for yourself.

We had endured most of the first year of COVID, like everyone else in the world. There was talk in the media of how the pandemic was impacting children, making them more anxious and worsening behavior. Maybe that was the explanation, but honestly, this storm had been brewing before COVID: My beautiful 10-year-old boy had become completely negative. He was certain that every activity on the horizon would be terrible, even the ones that he always objectively enjoyed (e.g., baseball practice). Every conversation we had was about his discontent. Nothing would placate him. Nothing brought him happiness. School was terrible. He didn’t like his teacher. His friends were never available. The list was endless and bleak.

On February 2, 2021, I took the day off to visit my sister in Lake Forest, IL. We had a lovely day. She made me a beautiful and delicious lunch, and we went shopping. 

As I drove home in the dark, it was freezing outside. Tiny snow flurries dusted the windshield on the lonely stretch of the interstate between the Wisconsin-Illinois border and the south Milwaukee suburbs. I turned on a podcast to pass the time. I don’t listen to a lot of podcasts, and I had never listened to Oprah’s before. I don’t know why I chose to listen to Oprah’s Super Soul episode called Grace and Gratitude, but something drew me to it that night.

At some point in the podcast, they discussed the study that showed that by writing down what you are grateful for every night, one can move from being pessimistic to mildly optimistic in three weeks. Right then and there, I made a Groundhog’s Day resolution: Luke and I were going to each say three things that we were grateful for every night for three weeks and then I would re-evaluate. 

It was a little rough at first. 

Luke: “Can’t you just tell me what to say?”

Me: “No.”

Some nights, the only things he was grateful for were breakfast, lunch, and dinner. But at least he was saying something. After a week or so, he asked me if I wanted to say a prayer after our gratitudes. Hmmm. That seemed promising. We persevered through three weeks, and then it was a habit.

I am not sure exactly when things changed, but after a month or so, he wasn’t actively resisting all new activities. A few weeks later, he would remind me if we hadn’t said our gratitudes before we started to read a new chapter in the Chip Hilton book we were sharing. Now, he still doesn’t like school, but we don’t discuss it every day. He walks into new situations with (mild) optimism. He has found a way to be comfortable in his skin and happy in his life.

A lot of other things have gotten easier as the early COVID restrictions have lifted but, again, this change in his outlook predated that one. It’s not scientific, but life is better, and gratitude was the major change. While I was open to the idea before, I am now a complete believer. 

In May 2022, a year and a half into the experiment, Luke got COVID. Isolated in his room, we couldn’t do our usual ritual, so he FaceTimed me at bedtime. “Can we do our gratitudes, Mom?” 

#winningthegame

Kathlyn Fletcher, MD, MA, is a Professor in the Department of Medicine at MCW. She is the program director for the Internal Medicine residency program and the co-director of the GME pillar of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education. She is an editor of the Kern Transformational Times.