Technology Meets Humanism: #AAMC13-Style

Sunday, November 3, 2013, certainly did not disappoint at the AAMC 2013 meeting in Philadelphia.  I had the opportunity to attend many great sessions.  This blog will touch on two of them.

Digital Literacy

The session on digital literacy was as engaging as any I’ve ever attended.  The speakers brought cases from real life to discuss with the participants.  Table exercises provided the substrate for meaningful interaction among people who literally met two minutes ago.  There were some quotes that hit home for the audience.  All come from the speakers, Bryan Vartabedian, Neil Mehta, Warren Wiechmann, and Jennifer Salopek.

“Every provider should be prepared to deal with unsolicited requests via digital media.”

“On public platforms, physicians are under no obligation to respond to solicitations from prospective patients.”

“Patients put their trust in us, and it is our obligation to educate them in real and digital environments.”

“We are in the age of the public physician.  We need to function in this new environment.”

This session really hit home for me, as I realized that there are great folks studying this new field, which itself is moving as fast as a teenager’s thumbs on a smartphone texting a friend!

The group launched an extremely helpful resource toolkit for digital literacy, found here. This toolkit is a work in progress, but marks an important step for those educators who need help in teaching the future generation.

How Doctors, Nurses and Consumers Can Make One Another Better

This session was a real treat, as the speaker was Anna Quindlen, the Pulitzer Prize-winning author.  She spoke with no slides whatsoever (what a concept at a medical conference!).  However, one could hear a pin drop in the room (which required an overflow room to accommodate all those who wanted to hear her speak).  Anna spoke from the heart about real-life interactions with the medical profession, some of which shed a light on the humanism that still exists in medicine, and others which provided, well, simply put, an “opportunity for improvement” regarding communication interactions with patients and families.  Given my interest in using emerging technology in medicine and medical education, I really loved these comments (paraphrased here):

 “There is no technology that can take the place of humanism; despite technological advances, human touch is more necessary than ever before.”  

And this one, reflecting on her own work as a writer, was truly profound: 

“In the drama of my own body, I have become both the story and the reporter.”

I think the session can best be summed up from this statement by the moderator, Richard Levin: 

“We must keep the ‘care’ in healthcare.”  

Yes, we must!  Anna, thank you for sharing your stories with me and so many others.

I think these two sessions provided a perfect intersection between the need to “push technology” while still “going back to the basics” of humanism in medicine.  Lest those who feel technology is obliterating the human connection, I would tend to disagree: the lunchtime discussion with the digital literacy speakers demonstrated to me that we can have both humanism AND technology together. 

Yes, we can have our cake AND eat it too!

#AAMC13: Saturday November 2, 2013 Reflections

It is currently the first night of my time in Philadelphia at the 2013 AAMC meeting.  I’ve only been here a little over 24 hours, but today has just been phenomenal for thinking about the future of medicine and medical education.  This blog is a few reflections from the day.  There were many other sessions that I attended, but these are some key elements from a few of the sessions that had a great impact on me.  The credit truly goes to the speakers whom I heard discuss these topics.

CME (Attribution: David Price)

The old way of thinking about CME is this: a “credit” required to justify “widgets” of learning.  This is shifting to a new CME/CPD model: aligning education with the gaps/needs of our communities.  In this new model, we can study why things work or don’t work.  For example: Does it work?  Can it work in real life?  How/why does it work?  Does it work better/cheaper?   What I think the challenge will be is finding the linkage to determine how the education is created, disseminated and implemented across health care systems.

Teaching Costs of Care/Value in Health Care (Attribution: Chris Moriates, Vineet Arora, Neel Shah)

The ABIM Foundation created a wonderful program as part of the Choosing Wisely Campaign which was a competition for programs/schools to present educational innovations to teach this important topic.  The criteria for this necessitated that the innovations be FINER: Feasible, Interesting, Novel, Ethical and Relevant.  Ultimately, interventions needed to address “COST”: Culture, Oversight, Systems Change, and Training.  3 speakers from different institutions highlighted their innovations, which demonstrated a variety of techniques to tackle this critical component of health care. My take home is that the health care providers have an obligation to our patients and society to tackle the issues of health care costs stemming from the unsustainable strain that these costs are putting on society.  This program showcases the fact that medicine as a field, under the leadership of the ABIM Foundation, is not pointing fingers at others (insurance companies politicians, or lawyers, for example), but rather is looking introspectively at how can we make a difference in addressing the cost issue.  The issue is real, but we are no longer burying our heads in the sand.

The Future of Medicine and the Need for More Residency Training Positions

I had the fortune of having dinner with our Associate Dean for Medical Student Affairs and 3 medical students from the IU School of Medicine.  We all reflected on the day, and what we all can take from the conference so far.  One big theme from that discussion is that advocacy is alive and well in the current generation that is going through school and training now.  Advocacy can take many forms, such as helping the disenfranchised, educating patients and families about the importance of vaccines, and/or even lobbying Congress to secure more positions for residency training.  The future of health care needs more physicians: medical schools have responded by increasing enrollment (and adding new schools), but the “bottleneck” is truly at the GME level.  In order to alleviate this, the number of residency positions need to increase.  This is not just a way to help students secure a residency position, but is the ultimate path towards addressing societal need for more health care providers.

Thank you, AAMC, for a wonderful first day of learning, camaraderie, discussion and interaction.  I look forward to the next few days as well!

Reflections on #AIMW13 and the APDIM Fall Meeting

I just finished a wonderful two days at the Academic Internal Medicine Week meeting in New Orleans.  This is a meeting bringing together organizations involved in internal medicine education and leadership, including, among others, the Clerkship Directors in Internal Medicine, and the Association of Program Directors in Internal Medicine.  It is this latter group to which I belong, and, as usual, this meeting did not disappoint.  I was not able to attend the entire meeting, but was present for the last two days.  Here are my brief thoughts on this meeting from those sessions I attended.

Direct observation has definitely come front and center as an important component of training.  Not just an an assessment tool OF learning, but rather as assessment FOR learning.  It needs to be the culture that we regularly observe trainees in their direct interaction with patients (akin to playing the piano: my teacher was there right next to me the entire time, giving constant feedback when I was doing something wrong or had held my fingers in the incorrect position!).

I attended a session on a writer’s club to improve scholarly output.  This session really was riveting for those who attended.  Probably the best discussion was on the fact that scholarly output does NOT have to be ONLY the peer-reviewed publication (although that certainly is excellent!).  Rather, we should consider other products which still demonstrate a scholarly approach.  Those products might include writing a policy, disseminating a curriculum, or creating a tool that others can use for evaluation purposes.  A phenomenal example of how to consider this (focusing on the scholarship of education) is this toolbox from the AAMC MedEdPortal on evaluating educators.

I also attended a great session by colleagues from the U of Cincinnati and Nebraska on considering tools that we ALREADY use to report the Next Accreditation System Milestones.  This session created my “A-HA” moment for how educators might look at Milestones and Entrustable Professional Activities.

The next day, I was on the docket with others focusing on innovation in resident ambulatory experiences.  I had the privilege of discussing our residency experience with teaching quality improvement to trainees.  Other leaders discussed “X+Y scheduling”, to help improve resident interest in doing primary care, ways to teach Evidence-Based Medicine in the ambulatory arena, and experiences in residents having a second continuity clinic with primary care physicians (known in their program as “Second Site”).

In the final plenary, on one of my favorite topics, utilizing emerging technology in medical education, four different programs discussed their experiences with what they were able to accomplish.  One was a current fellow who himself created a smartphone app focusing on evidence-based management of patients admitted/observed for chest pain.  The app link is found here (only available on iOS devices).  Another speaker taught us basics of using Podcasting for medical education, and two others demonstrated the use of iPads in medical education and how others might consider using tablets for that purpose.

For anyone interested, the presentations mentioned above, as well as all of the presentations that were loaded up, can be found here.

All in all, it was a phenomenal conference for me to attend.  Lots of great tweeting was done, as the conference encouraged the Twitter hashtag #AIMW13 for connections via this microblogging social network.  If you are interested, please see my tweets from 10/5/13 and 10/6/13, which were mostly dedicated to the content of this conference.

As a last note, I want to thank the incredibly professional staff of AAIM for hosting a phenomenal meeting, and especially the security staff of the Hilton Riverside in New Orleans Hotel for finding my misplaced keys!