Sunday, August 23, 2015

#ITeachMedicine

I have mentioned for several years now how social media has been able to impact how I teach, and how others learn in medicine.  It has been an incredible journey to see, as I have met many folks virtually whom I would otherwise never meet.

It is also amazing how quickly information can be spread via social media.  Sometimes, this can be bad, but other times, it can be very good.  A great example of advocacy within medicine began earlier this month, with a tweet from a surgeon-in-training, Dr. Heather Logghe (@LoggheMD).  A blog which began this campaign describes early successes.  This campaign continues to grow, and has amassed an incredible number of tweets and impressions.  It is so refreshing to see stereotypes broken down, and to see the human side behind these incredible physicians.  I've never met Heather, but as a residency program director, I am impressed!

I got to thinking: the #meded hashtag (for medical education) has really taken off over the past few years due to my colleague, Dr. Ryan Madanick from the University of North Carolina, and includes a weekly tweetchat and many other tweets at any time.  #meded has even been described in the peer-reviewed literature (here and here).  How about highlighting some of the amazing medical educators out there who enjoy teaching medicine (at any level)?


So here goes: #ITeachMedicine is starting today with this blog.  Please distribute to all of those dedicated teachers who make medicine and the teaching of and within it a wonderful profession! I am a #meded ‘er, and #ITeachMedicine !!

Saturday, August 22, 2015

Etiquette for Live Tweeting at Conferences

Recently, I published a paper on the topic of “Tweeting the Meeting”, along with Dr. Janine Zee-Cheng.  In that paper, we briefly discussed the topic of etiquette with respect to tweeting during conferences.  I came across this piece from a few days ago in Nature about conference tweeting.  The blog piece describes two options for the “default” at meetings.  Should the default be that tweeting is allowed (unless the speaker explicitly asks attendees not to) or that tweeting is NOT allowed (unless the speaker gives explicit permission to do so)?  I am not sure of the right answer for this, but given how common this has become, I believe that conference organizers should actively discuss this option when planning meetings, and make the default answer explicit as possible.

A problem might ensue when the default is that it is allowed, but individual speakers who know very little about Twitter are upset when they find their content disseminated via this social network.  It begs the question that guidelines or policies really should be created and disseminated to potential presenters at the time that those presenters submit their abstracts.


I wonder how many scientific associations have formal policies about this topic, and if they do, how is that policy disseminated prior to meetings?  Maybe this is an area ripe for more research, and one that should be discussed among those who plan scientific conferences.

Saturday, August 15, 2015

Learning Theory and Social Media

I read this really interesting piece on learning theory for medical educators interested in the use of social media.  The authors hint that it is really important for educators to consider an understanding of learning theory when integrating social media into the learning process.  I agree wholeheartedly for many reasons.  

First, after having given a recent grand rounds (to two separate audiences) on the topic of learning theory in medical education and how technology can help, I feel that it is very important to reflect on these theories for a better understanding of why learners use (or don't use) social media and other emerging technology.  Communities of practice (CoPs) are a great way to bring groups of people together around a common theme, and virtual/electronic CoPs are catching on in medicine and medical education.

Second, it is important, as the authors mention, to consider connectivism and constructivism as key theories behind why some learn with social media (and may prefer to learn via such tools).  Using constructivism, learners should be reflective, and the teacher needs to adopt a facilitative approach (instead of being an "expert").


For the educators out there who are integrating social media into your learning methods, which theory or theories reflect why you use social media or how your learners use social media?

Wednesday, July 22, 2015

CME, Industry and Outcomes

Recent medical literature describes the challenges of demonstrating the impact of CME on physician learning (with a focus on the lack of impact), and the need to reform the current system.  Writers suggest that it really is not having the impact that it should, given the financial resources provided.  Others have questioned how it is funded, suggesting that it may be biased given the resources provided by industry, and that it should be changed. 

While I admit my own bias as an Associate Dean for CME for a major medical school, I feel that it is important to study the peer-reviewed literature to best understand this important topic.

First, is the industry influence really that significant?  A piece by Cervero discusses this, and found limited evidence of the impact of industry influence on CME.  In the recent ACCME 2014 report (Table 8), only 11% of accredited CME received commercial support from industry.  My interpretation of this is that the commercial support is certainly not an overwhelming part of CME programs (our own institutional data would definitely mirror this finding).

Second, what is the real impact of CME?  The same above author recently published a piece in JCEHP (full disclosure: I am the social media editor for this journal, but was not involved in any way in the creation, revision, or decision to publish this manuscript) that concluded that CME can indeed impact patient outcomes and physician behavior (the former more than the latter).

Third, improvements in how CME is disseminated should occur.  Within this realm, patients should be included, and interprofessional learning should occur in team environments; this is highlighted by the new President and CEO of the ACCME, Dr. Graham McMahon, in a Viewpoint piece in JAMA that came out online earlier this week.


So where should we go from here?  I think there are several things we can consider.  Most importantly, physicians and other healthcare providers should continue to learn in order to provide optimal care of their patients in a changing environment; CME is one way to aid this learning.  Those in the field have been thinking about how to restructure it for many years and have made major strides in focusing on quality improvement.  Second, we should also consider learning healthcare systems as a way to promote learning for those who provide care for patients.  Lastly, we should be diligent about using technology to make our learning more effective.  Examples include online journal clubs and virtual communities of practice.  Given the complexities that abound in medicine in the current environment, anything that can make the process of learning how to "keep up" and best care for our patients easier should be welcomed.  

Tuesday, July 14, 2015

Learning Theory vs Learning Approach

I had the privilege of giving a grand rounds presentation recently on the topic of lifelong learning in healthcare.  In the presentation, I discussed how adults learn within medicine, and reviewed literature on "adult learning theory".  Malcolm Knowles wrote extensively on the topic of Adult Learning, creating "principles of adult learning" also coining the phrase "andragogy" (as opposed to "pedagogy").

Others have questioned the concept of Adult Learning Theory, and have evidence to suggest that having one learning style is a misnomer.  In fact, an article this month suggests that, at the undergraduate medical education level, we should consider a focus on learning approach rather than teaching to a specific learning style.  Learners may not learn optimally with their self-proposed best learning style, and it is hard to say that a learner can learn with only one particular style.  See here http://www.danielwillingham.com/learning-styles-faq.html  for a great review of this.

So what should educators do, given this dichotomy?   Should we focus on the content and a delivery style that "meets the needs of today's learners"?  Should it be about teaching the content to the learners, and nothing more?

In clinical medicine, where I spend most of my time, I do think it is critically important to focus on not just the content, but also the context in which that content is delivered.  Learning environment, sometimes referred to as learning climate, is critical to making the learning process successful.  It is the backbone upon which is built the process where ideal learning can take place.  Given the IOM description of the Learning Healthcare System, this is essential.  After all, where there is a healthy learning environment, there is an opportunity for all to learn with and from each other in order to provide the best care of the patients for whom we are privileged to care.

Thursday, June 25, 2015

Demonstration of "Tweeting the Meeting"

I had the privilege of writing a paper recently with Dr. Janine Zee-Cheng on Live Tweeting in Medicine: 'Tweeting the Meeting', which came out a few months ago (and allows free open access to all articles through the end of June, 2015).  In it, we highlighted the importance of lifelong learning through the use of Twitter at conferences.  I also encourage a quick read of this other great piece giving suggestions on how to live tweet in conferences.

Dr. Zee-Cheng, a pediatric critical care physician from my institution, is giving a presentation on a social media-related project she did as part of her fellowship, at a conference currently going on this week in Chicago.  The hashtag is #smaccUS (to reflect social media and critical care).  I highly encourage those who are reading this blog now to check out the tweets from this conference.  The discussions, on a variety of topics, are truly epic, and range from general content in the management of critically ill patients, to the emotional side of medicine, to introspective reflection about one’s practice, to frank humor.


While I am not at the conference (we are orienting new incoming interns to begin their clinical duties), I have learned so much from reading tweets from participants.  I encourage all interested in this topic, and literally, medicine in general, to check out the #smaccUS hashtag—you will not regret it!

Thursday, May 28, 2015

Social Media in Medicine: Lifelong Learning for All Through Free Open Access

I recently posted about online resources for lifelong learning.  This is a very important topic as emerging technology continues to be a part of medicine.  Just last month, I was privileged to be an author for one article on Live Tweeting in Medicine, within an entire issue of a medical journal focusing on social media.  The guest editor, Dr. Meg Chisolm, has worked with the journal, International Review of Psychiatry, to make the entire issue free open access from now until the end of June 2015.  This is extremely exciting as it makes available to all some wonderful reviews of social media within medicine in a variety of contexts.  I encourage you to take advantage of reviewing these articles, and saving them as resources.  The link to the entire issue of the journal (with free access to all articles full-text through June 2015) is here

In addition, a Twitter chat discussing pertinent issues of social media in medicine, under the hashtag #nephJC will take place on June 16, 2015 at 9 pm EST, and again at 8 pm GMT on June 17, 2015 (as a time more conducive for our colleagues in Europe/Africa).  Many of the authors from this issue will be tweeting in during that discussion.


This is a leading example of sharing materials for lifelong learning for all.  Please share via social media to demonstrate the impact that social media can have!