PANDEMICS JUXTAPOSED

From the 6/19/2020 newsletter



PANDEMICS JUXTAPOSED



Sherry-Ann Brown, MD, PhD, FACC, FAHA

Many of you are wondering about what I as a leader in various ways am thinking about the racial pandemic, juxtaposed with the coronavirus pandemic.

In the coronavirus pandemic, I had been starting my emails with something like, “I hope you have been able to stay well during these unprecedented times.”

This morning, I started to write an email to a group of people. At first I typed, “I hope you are well.”

Then I deleted that and started over. And then wrote, “I hope you are sorting through these multiply tumultuous times.”

I deleted that too, and skipped that intro altogether, and instead decided to share it with you all.

Let me tell you why. You should already be able to figure this out, but let me walk you through it.
Here it is.

Plainly and simply.

I hope you are NOT well.

I hope you are not OK with seeing what is going on in the world around you. I hope you are not OK with the global ignorance we have as people. I hope you’re not OK with the complacency with which we live our lives.

I hope you are NOT well.

I hope that your heart has been breaking inside due to centuries and decades of injustice.

I hope your well being has been ruffled knowing that all are NOT well.

That all is NOT well.

We all agreed that as a society the goal is to be well.
However, the goal we should desire is for all to be well.

We cannot be true to ourselves until we honestly recognize that all are not well until the futures of our black men, women, boys, girls, and babies in this country and around the world are well.

Until then, how can you be well?

Together, in community, how can we be well?

We can be well when we start to admit that we are not.

We can be well when we commit to open dialogue and truthful conversation about race.

We can be well when we recognize our ineptitude as a society at understanding and addressing what ails us.
We can be well when it finally legitimately rings true that all men, women, boys, girls, and babies in the United States are indeed understood, recognized, perceived, and treated as equal.





Sherry-Ann Brown, MD, PhD, FACC, FAHA is an Assistant Professor of Medicine (Cardiology) and the Director of Cardio-Oncology Program at MCW. She is a physician, scientist, poet, and author.

“What part of your character are you working on today?”

From the 6/19/2020 issue

“What part of your character are you working on today?”



Alexandra Harrington, MD, MT (ASCP) – Director of the Kern Institute Faculty Pillar

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Here was the ice breaker used in a virtual education workshop I attended last week:

"What part of your character are you working on today?”

Without missing a beat, one participant, an elementary school educator, reflected on her character strength of “Perspective” and how moving all of her students’ home-schooling instruction online had challenged her patience. Several others gave the same answer: Perspective. According to the Values in Action (VIA) Institute of Character (viacharacter.org), “Perspective,” or the ability to see the big picture, is one of the twenty-four character strengths valued across cultures. Even though I am usually not fond of ice breakers, I loved this activity.



We were participating in a break-out group from a larger Kern Family Foundation Partners in Character and Educational Leadership (KPCEL) gathering. Over the course of a year, we were brought together – initially in Boston only a few blocks from Fenway Park and then remotely – by the Kern Family Foundation to learn change management and share best practices for character education. Most of the participating programs were from the K-12 world but undergraduate and graduate programs were represented, as well. This talented group, along with its facilitators, lives and breathes character education in their classrooms and programs. I was surrounded (albeit in Hollywood-Squares-style) by character-literate educators who were so impassioned by their work on behalf of their students and society, that they themselves could easily identify character growth opportunities on the spot without hesitation. This was Dr. Carol Dweck’s growth mindset in action.



Take home points for medical education


We can learn much from the K-12 community that applies to medical schools. In child and adolescent education, character education is defined by Dr. Marvin Berkowitz as “the intentional attempt in schools to foster the development of students’ psychological characteristics that motivate and enable them to act in ethical, democratic, and socially effective and productive ways.” Public and private elementary and secondary schools have adopted character education curricula for decades, and effective strategies for character education are available. These are terrific resources.



Having been part of convenings, I have learned some high-level lessons from our colleagues:

• “Start with the adults,” and “the adult culture matters.” In elementary and secondary schools, this refers to the teachers, counselors, and administrators. In the medical school environment, this means that we must engage with our faculty to promote character education, so that everyone recognizes their critical role in the development of our learners.

• Character education must be enculturated into the learning environment and prioritized by executive leadership.

• It is a false dichotomy to believe that character excellence and academic excellence are mutually exclusive. Both can exist successfully.

• Character education is iterative. Some things will work but expect others to fail. Keep your eye on the desired outcome.

• The goals of character education are to develop persons of good character who are their best selves and to positively influence our communities and society towards a better direction.

Next steps


So, what does this mean for our adult medical school learners? Unlocking this question has been our Kern Institute charge since we began this work. We have learned a lot from content experts in the character field and from our own experimentation at MCW. We have explored how character development intersects with professionalism, medical ethics, and professional identity formation. Additionally, I suggest we consider exploring well-being, communication skills, emotional intelligence, systems-based practice, leadership, and self-management as components of character development in medicine. Current events and the resulting rich dialogue around inequities have helped me recognize that patient and community advocacy is a critical opportunity for all of us as we develop our civic virtues.



“I’m working on my bravery these days,” I answered when I was called on for the ice breaker. “I want to be a leader that speaks up when it’s hard to and challenges things that may not be so easy to challenge.” I talked about the racial and gender inequities pervasive in our culture. The VIA Institute on Character defines bravery as facing your challenges, threats, or difficulties by valuing a conviction and acting upon it.


So, I ask you, “What part of your character are you working on today?”


You can take the free VIA Character Survey to determine your own top character strengths by clicking here.



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 of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education.

Kern Institute for the Transformation of Medical Education is Not a “Black Box”!

From the 6/19/2020 newsletter

Kern Institute for the Transformation of Medical Education is Not a “Black Box”!


Adina Kalet, MD MPH



In this week’s Director’s Corner, Adina Kalet implores you all to read the entire issue “cover to cover” to both engage in the urgent conversations of the moment and find out what the Kern Institute is doing to transform medical education …

I met sixty MCW folks over the course of three recruitment visits while I was being considered as the Director of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education. I was intrigued by this remarkable and unique leadership opportunity but still wasn’t certain that the potential accomplishments of the position would be worth the personal risks I would take.



I had done my homework. I had heard the skepticism over what the Kern Institute was trying to accomplish (“black box,” “cash cow”). I had listened to the questions about whether or not the Kern Institute would be worthy of the investment made by the Kern Family Foundation. I was aware of the MCW community’s uncertainty if it would be able to live up to the high expectations.



Then, a senior MCW leader (who shall not be named to protect the innocent!) asked me point blank, “Why would you take a job where you have all this responsibility but no authority?” I let out a short laugh at his stunning question. After all, what was he implying? That a well-funded institute with a critically important mission would have “no authority”?



The gauntlet had been thrown! I cannot remember exactly what I said, but I hope I answered, “Because, I want to work with people who are so passionate about the potential for medical education that they are willing and eager to do difficult, transformative work.” In that moment, I made my choice. It is a curse! I can never walk away from a challenge.



You see, eighteen months ago, the Kern Institute was mostly pure potential energy. There was the lofty triple aim framework of Character, Competence and Caring. Cheryl Maurana, Kern’s inaugural, reliable, and effective leader, had assembled a team of five remarkable Pillar Directors, twenty-four talented faculty members, a small but well-prepared staff, six medical school partners, and what seemed like plenty of resources. Things were poised to take off.



We have accomplished much in the past months. The current challenges have, if anything, sharpened our focus and our message. The tide is turning.



For those of you who are still dubious or unclear about the Kern Institute’s work, I invite you to read this week’s (and each successive week’s) issue of the Transformational Times in full. Check our archives. This is Issue Sixteen of the Transformational Times. Engage with us in transformative conversations, bring your ideas, and challenge us to do even better work. Click on “Letter to the Editor” button and share your thoughts. 



We have all been sheltering-at-home for three months. This issue is published on Juneteeth, twenty-five days after the murder of George Floyd. We have been learning from almost four weeks of diverse, antiracism protests that have grown organically in both large and small communities all across our nation. These are dynamic times. Simultaneously, the Kern Institute’s work is in full gear. Read, react, submit. Engage with us! Here is my advice:

• This week, consider submitting a “Letter to the Editor” reflecting your response to the prose poem by Dr. Sherry Ann Brown, Director of Cardio-Oncology Program, as she “plainly and simply” hopes “you are NOT well.”

• Send us your thoughts on medical student Scott Lamm’s question, “Can We Agree This Is a Problem?” when anti-racism is not ingrained in our early education, leaving adults struggling to rapidly incorporate new ideas and change lifelong habits.

• Notice how Lara Voigt, MD, Associate Director of the Bedside Procedure Service and brand-new mother demonstrates the conscious antiracism process white people like her must do if we want to become good parents to humans born into this moment in history. What does that make you think about? How does it make you feel?

• Alexandra Harrington, MD, Kern Faculty Pillar Director wonders “What part of your character are you working on today?” She gracefully accomplishes the difficult task of clearly defining character education and sharing some critical lessons learned from K-12 educators at a national conference. She says, “I’m working on my bravery these days … I want to be a leader that speaks up when it’s hard to and challenges things that may not be so easy to challenge.” What are you working on? What might you want to do differently today?

• Think deeply about how our mind sets need to change as you read the “Call to Action” from Cassie Ferguson, MD, Kern Student Pillar Director, as she asks us to begin “Rethinking Remediation at MCW” using an equity lens and systems-level approach to ensure every student is treated fairly and that we don’t needlessly activate internalized biases that cause pain and doubt.

• Look over the list of projects that the Kern Institute is funding though this year’s TI2 mechanism that address the campus climate for underrepresented minority (URM) students in the essay by Chris Decker, MD and Julia Schmitt. Where might you make a connection and be part of the change?

• And finally, consider the transformative impact of the answer to the question “Why is the Kern Institute’s Medical Education Data Scientist Smiling?” Wouldn’t you be smiling if you, like Tavinder Ark, PhD, Director of the brand new Kern Medical Education Data Science Laboratory, could do meaningful, rigorous, convincing work you love with people who are on a mission to educate the next generation of health care professionals.

Who says we don’t have the “authority” to transform medical education? We are passionate to be part of the change. If not us, then who?





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.

A Personal Call to Action

From the 6/12/2020 newsletter


A Personal Call to Action


Kathlyn E. Fletcher, MD, MA - Internal Medicine Residency Program Director

“With malice toward none; with charity for all; with firmness in the right, as God gives us to see the right. Let us strive on to finish the work we are in; to bind up the nation’s wounds; to care for him who shall have borne the battle, and for his widow, and his orphan – to do all which may achieve and cherish a just and a lasting peace, among ourselves, and with all nations.”

Thus ends Abraham Lincoln’s second inaugural address. The speech was given as the Union was close to winning the civil war, much of the country (particularly the South) was in ruins, the country mourned over 620,000 lives lost to battle and disease, and just weeks before Lincoln would be assassinated by John Wilkes Booth. This speech is beautiful in its brevity and prescient in its call to action.


With George Floyd’s senseless and violent death, we see yet another stark example of structural racism. Like Lincoln’s second inauguration, this moment in our history presents a call to action. In this moment, action can be large or small. In this moment, action can be public or personal. In this moment, action can be a quiet commitment or a loud chant. But action is required by each of us who wishes to “bind up the nation’s wounds.”


In a recent New York Times column, David Brooks suggested that great leaders are able to use lessons from history and the humanities to guide their responses to crisis. He says that such leaders:

"...were educated under a curriculum that put character formation at the absolute center of education. They were trained by people who assumed that life would throw up hard and unexpected tests, and it was the job of a school, as one headmaster put it, to produce young people who would be ‘acceptable at a dance, invaluable in a shipwreck.’”

He goes on to say that we need our leaders to draw on both science and the humanities during crises like those we are facing:

“Right now, science and the humanities should be in lock step: science producing vaccines, with the humanities stocking leaders and citizens with the capacities of resilience, care and collaboration until they come. But, instead, the humanities are in crisis at the exact moment history is revealing how vital moral formation really is.”

I believe that we can reintroduce the humanities into our lives and become the leaders that David Brooks is describing. Many of us have liberal arts backgrounds already. For those who do not have a humanities-based education, it is not too late. I didn’t even read Pride and Prejudice until I was in medical school or To Kill a Mockingbird until residency.


In that spirit, we offer this opportunity to reflect on Lincoln’s words and join a discussion in our community about what we can do to make our offices, our committees, our divisions and departments, our institution, our city, and indeed our country a place of “a just and a lasting peace” for all people. I, for one, plan to start with a commitment in the spirit of MCW’s #IWill campaign. I will notice microaggressions in my sphere. I will call them out. I will listen more.


I will make mistakes, but mistakes will not stop me from trying to do better. Sometimes I will lead; sometimes I will follow. I will bring along as many people as I possibly can on the journey to create lasting peace for all people.



Kathlyn E. Fletcher, MD MA is a Professor and Residency Program Director in the Department of Medicine at the Medical College of Wisconsin. She is a member of the Curriculum Pillar of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education.