Academy Insights Vol. 6, No. 2

Medical Education Career Night- An Inaugural Event By Zoe Gottlieb

On an evening in March, HMS students in years 1-4 and faculty members across several fields at five of Harvard's teaching hospitals gathered in the Minot Room of Countway Library for the first ever Medical Education Careers Night. Hosted by the Medical Education Student Interest Group, the event sought to connect medical students with faculty whose careers have involved work in the field of medical education. Roughly 65 guests attended the event; the 25 faculty guests included internists, pediatricians, family practitioners, surgeons, OBGYNs, psychiatrists and researchers. All were eager to share how their interests in medical education evolved and how they have integrated teaching into their careers. PICTURE: RIGHT TO LEFT Medical Education Student Interest Group Co-Chairs ZOE GOTTLIEB

HMS-4, HOLLY GOODING, M.D. After a warm welcome from Academy Director Dr. Richard Schwartzstein, faculty members sat at tables according to their main area of focus as medical educators-undergraduate medical education, graduate medical education, medical education in a surgical field, medical education research, and medical education and advocacy-and had the opportunity to interact with all student guests in a "speed dating" format. Students spent roughly 10 minutes at each table before moving along to the next group, allowing them to have individual conversations with faculty guests in a variety of roles. "Attending the event reminded me of the first time I went to a dim sum restaurant-I didn't know what to expect coming in, but I ended up taking a piece of everything and left feeling very satisfied," Sean Fletcher, MS1, reflected. "The 'speed dating' aspect of the event was ideal for me because I didn't know what I would be most interested in, and I only wish that I could have had more time at each table." As the event came to a close, Dr. Edward Hundert, Dean for Medical Education, shared with everyone a favorite aphorism from his own mentor, Dr. Daniel Federman. "To be a great clinical teacher, you have to do three things: Think out loud, stick to the basics, and be kind." The event received very positive feedback from both students and faculty guests. "Having the

opportunity to learn from many of our best teachers, mentors, and role models about how they became involved in medical education was a true privilege," said Laura Chiel, MS4. "This event gave me a better understanding of the variety of career paths that can [involve medical education]. I left the event feeling inspired and motivated to further pursue my interests in [the field]."

Achyut Patil, MS1, felt similarly. "[This event] was by far the best of its kind that I've been exposed to so far. Being able to see the entire spectrum of the field of medical education taught me more about my potential careers in medicine than did years of researching before medical school." Mr. Patil also noted the importance of having this type of event early in medical school. "Having the event during first year is critical - as I interact with educators for the rest of medical school, I will have a much better idea of how to engage them with my interest in education." Fellow first year Sean Fletcher agreed. "It was definitely helpful to attend the event as a first year," Fletcher said. "At HMS we often hear about all of the exciting opportunities we have, and events like the Med Ed Careers Night really facilitate our taking advantage of those opportunities."

Graduating students also found that the event helped them think about their own career development as they move forward with residency and beyond. "It was wonderful to chat informally with faculty members who were instrumental in my own development as a soon-to-be physician," said Molly Brett, MS4. "I am starting my training in Internal Medicine in a few short months, so I found it particularly valuable to discuss strategies for developing as an educator during the hectic years of residency. This event made it quite clear that many of the faculty in attendance considered their involvement in medical education to be the most fulfilling element of their careers in medicine."

Wes Brown, MS4, echoed these sentiments. "As I approach my final year of medical school, I've begun to wonder how top-notch HMS professors found their calling in education," he remarked. "The Med Ed Careers Night was the first time I was exposed to medical education as a career option outside the standard curriculum. The event gave students an opportunity to ask curious questions, and professors were entirely candid with their responses. Overall, it gave interested students the opportunity to ask 'what does it take' and 'how do I get there' in a relaxed environment."

In addition to receiving such positive feedback from student guests, faculty attendees also felt that the event was a great success. In particular, many noted that the structure of the event was particularly effective in exposing students to a wide variety of potential careers in medical education. "One of the wonderful things about medical education is the wide range of educational opportunities and venues for teaching, resulting [in] career paths that are unique to each individual educator," said Dr. Chris Smith, Co-Director of the Rabkin Fellowship in Medical Education and Director of the Internal Medicine Residency Program and Clinician Educator Track at Beth Israel Deaconess Medical Center. "While this variety is wonderful and stimulating, for someone starting his or her career in medical education, this uncertainty can also be quite daunting. The Medical Education Careers Night was an outstanding opportunity for young medical educators to meet with medical education leaders from many clinical and educational realms to learn about their own career paths. The advice garnered from these discussions and the relationships formed from this session will hopefully help to create new pathways in medical education for the students who participated."

Dean Hundert also commented on what a memorable event it was for many of the faculty as well as the students who attended. "There was a wonderful 'buzz' as the students circulated among the tables, where we all got to share our experiences and inspiration," he said. "I left with great confidence that the future of medical education will be in the best of hands!" The event will hopefully be the first of many aimed at connecting medical students with faculty mentors in medical education.

Congratulations to the 2015 Charlie Hatem Award Recipient:

Hope Ricciotti, MD Associate Professor of Obstetrics, Gynecology and Reproductive Biology

Head of the Department of Obstetrics, Gynecology and Reproductive Biology at Beth Israel Deaconess Medical Center

Dr. Hope Ricciotti is the Chair and Residency Program Director in the Department of Obstetrics and Gynecology at Beth Israel Deaconess Medical Center, and an Associate Professor of Obstetrics, Gynecology, and Reproductive Biology at Harvard Medical School. She rose internally in the Department of Obstetrics and Gynecology to her current role as Department Chair, with prior roles as Division Director, Vice Chair for Education, and Vice Chair. She practices obstetrics and gynecology at Beth Israel Deaconess Medical Center in Boston, MA. At Harvard Medical School, Dr. Ricciotti is Co-Chair of the Resident as Teacher Interest Group for the Academy, and a member of the Curriculum Committee and Faculty Council. Her academic interests include resident-as-teacher and leadership training programs, culture in academic medicine, and simulation for training medical students and residents. Her clinical interests are focused on reducing health care disparities in women's health, and include obstetrics, advanced contraception, and preventive women's health care. She has published several important manuscripts in the medical literature, including the innovative use of open space for enhancing the culture of academic medicine (Academic Medicine, 2014), the disparity in representation of women in department-based leadership roles in obstetrics and gynecology (Journal of Obstetrics and Gynecology, 2015), and the objective structured teaching evaluation (OSTE) for training residents as teachers (Medical Teacher, 2012).

Five Faculty Members Selected as HMS Academy Fellows

in Medical Education

Five faculty members have been awarded the Harvard Medical School Academy Fellowship in Medical Education for the academic year 2015-2016. This endowed, competitive program seeks to develop and enhance the fellows' analytical skills as medical education researchers and teaching skills as medical educators. Each fellow applies with a project to be completed during the fellowship year which is designed to contribute to the quality of medical student education at HMS. Fellowship seminars meet at least twice per month with the Director of the Academy Fellowship, David Hirsh, MD to discuss topics related to curriculum development, educational research and program assessment, the application of adult learning theories, and the enhancement of teaching skills needed for both lecturing and small group teaching. In addition, each Academy Fellow completes a fellowship project over the course of the year. Projects focus on curriculum development, faculty development, assessment of learners, and outcomes research. The selection process seeks faculty whose proposed projects will contribute to the education of Harvard medical students through curriculum innovation, outcomes assessment, faculty development, or enrichment opportunities. Upon completion of the program, fellows present their work at HMS Medical Education Day. Graduates have led significant curricular and programmatic changes and served as education leaders in the HMS community and around the world. Dr. Hirsh commented "The HMS Academy was delighted with the high quality work of the faculty who applied, the energy and creativity of the applicants, the meaningful projects they proposed, and the committed mentors who support them." "Each of the fellows' projects has the potential to make a real impact on the continuous improvement of teaching and learning at HMS and our affiliated hospitals," said Edward M. Hundert, MD, the Dean of Medical Education. Academy Fellowships are made possible through generous contributions to the Morgan-Zinsser, Curtis Prout, Eisenberg Family, and Susan and James Jackson Academy Fellowship Funds. The Harvard School of Dental Medicine is also sponsoring one Academy Fellow.

Congratulations to the following Academy Medical Education Fellowship Recipients:

Fellowship Overview:The Academy Fellowships in Medical Education provide educators with dedicated time to develop the expertise and skills needed to advance academic careers in medical education and medical education research.

Gaurab Basu, MD, MPH Curtis Prout Academy Fellowship in Medical Education

Instructor in Medicine, Cambridge Health Alliance, Harvard Medical School Project Title: Evaluation Agenda for Research Based Health Advocacy Curriculum

Kathryn Butler, MD

Morgan-Zinsser Academy Fellowship in Medical Education Instructor in Surgery, Massachusetts General Hospital, Harvard Medical School

Project Title: Validity and Feasibility of an OSCE for Student Assessment on the Surgical Clerkship

Jeffrey Linder, MD, MPH, FACP

Curtis Prout Academy Fellowship in Medical Education Associate Professor of Medicine, Brigham and Women's Hospital, Harvard Medical School

Project Title: Development and Evaluation of the Pursuing Inquiry in Medicine Course and the Scholars in Medicine Graduation Requirement

David Sloane, MD, EdM

Morgan-Zinsser Academy Fellowship in Medical Education Instructor in Medicine, Brigham and Women's Hospital, Harvard Medical School

Project Title: An Investigation of Health Theories

Lisa Thompson, DMD

Instructor in Oral Health Policy and Epidemiology, part- time, Harvard School of Dental Medicine

Project Title: The Development and Assessment of Curriculum for an Inter-professional Community-based Clinical Activity in Geriatric Oral Health for Medical, Dental and Nursing

Students

Peer Observation of Teaching Interest Group

The HMS Academy's Peer Observation of Teaching Interest Group is co-chaired by Dr. Susan Frankl and Lori Newman, MEd. The primary goals of the Interest Group are to develop a culture of teaching improvement across HMS; provide individualized faculty development for those involved in teaching at the UME, GME, and CME levels; and generate community-wide conversations about best teaching practices. To assist HMS with its efforts to cultivate use of interactive teaching strategies that foster active learning and encourage critical thinking and reflection, during AY2014 the Interest Group focused its attention on exploring and gaining a better understanding about the flipped classroom

method. While there are many ways to "flip a classroom," a unifying characteristic of this approach is to move "information transfer" activities to student preparatory time, so that in-class time allows students the opportunity to analyze, synthesize, evaluate, and apply knowledge - all while a faculty member is present. Faculty, in turn, are able to step away from the podium and provide individualized instruction through increased educator-student interactions and continuous feedback. To identify various flipped classroom approaches used at HMS, Dr. Richard Schwartzstein allowed our interest group to observe the Spring 2014 Integrated Human Physiology (IHP) course in which faculty deliberately used interactive and flipped classroom techniques during their large group discussions. As a result the Interest Group members conducted 22 observations of the IHP large group sessions. From these observations, a number of criteria were identified as vital to the essence of a flipped classroom experience, including:

A collaborative learning environment Student preparation and readiness Appropriate sequencing, timing, and flow of class activities Instructors' use of questions and active learning techniques Instructors' promotion of critical thinking Student engagement, collaboration, and participation Instructional interplay among multiple faculty members

Once we had gathered and analyzed this information, at the start of AY15, we were ready to begin designing a peer observation of flipped classroom teaching worksheet - one that we named "Case-based Collaborative Learning" or CBCL. We then used a modified Delphi method (an iterative, consensus-driven process) to determine the essential criteria to include in the worksheet. In addition, we gave careful consideration to the criteria's wording to ensure that we best captured the demonstrable behaviors an observer might expect to see during a CBCL-structured teaching session. After three Delphi rounds in which interest group members vetted their opinions about each criterion, we devised a CBCL worksheet with 8 observable criteria. For each criterion, we included numerous examples to best elucidate each behavior. Moreover, the group devised a separate "Elements of Effective Instruction" to accompany the worksheet as they felt it was necessary to reinforce the understanding that all successful teaching efforts stem from community-based, agreed-upon instructional standards. CBCL criteria are well grounded in the group's observation of the AY2014 IHP course and include items such as: Uses a variety of learner-centered activities to engage students in the application, transfer, or generation of knowledge and Co-teaches with other faculty in a coordinated and collaborative manner. An example of a fully-described criterion is as follows: Prompts deeper learning by using one or more of the following strategies:

Uses higher-order questioning or asks questions such as "Why?" "What if?" or "Why does this matter?" to further students' understanding and critical thinking

Asks students to clarify, elaborate further, or reason through their responses Alters case or question to see if students can apply their knowledge to different situation Challenges students' existing ways of thinking or points out exceptions to the rule

Now that the Interest Group has drafted the CBCL observation worksheet, we have entered the pilot phase of the process. At this time, we have begun to watch videotaped examples of CBCL to determine if we have captured common behaviors and begin to test whether we are able to produce reliable results when we each use the worksheet to observe teaching. At the same time, we have decided to create an accompanying compendium for the worksheet to help guide peer faculty when conducting CBCL observations. We hope to present a final version of the CBCL observation worksheet by the close of the academic year and to share the compendium with the faculty during the late fall of 2015. We foresee training faculty to use the worksheet and compendium to begin peer observation of the pre-clinical courses in the spring of 2016.

Congratulations to the following Fellows in Medical Education Research

Fellowship Overview: This program will prepare fellows to apply social science research methods to educational issues in medicine and health care. Through lectures, discussion, in-class practice, and projects, fellows will gain familiarity with a range of social and behavioral approaches to studying medical education and evaluating psychoeducational and behavioral interventions, with an emphasis on interview and survey research methods.

Xiaodong (Phoenix) Chen, PhD Instructor in Surgery, Brigham in Women's Hospital, Harvard Medical

School Project Title: Exploring effective educational interventions to improve

residents' autonomy in the operating room in Surgery and OB/GYN

Cindy Ku, MD Instructor in Anaesthesia, Beth Israel Deaconess Medical Center,

Harvard Medical School Project Title: MINTOR: Measuring Intubation in the OR

Margaret Hayes, MD Instructor in Medicine, John Hopkins University -School of Medicine

Project Title: Improving End-of-Life Care in the ICU

Daniel Saddawi-Konefka, MD Instructor in Anaesthesia, Massachusetts General Hospital, Harvard Medical

School Project Title: The Combined Effects of Retrieval-Based Learning and Mental

Contrasting with Implementation Intentions on Self-Directed Resident Learning

Who's Who in the Harvard Medical School Academy

Brian Nahed, MD Dr. Brian Nahed specializes on brain tumors (glioblastoma, gliomas, metastatic brain tumors, and meningiomas) as well as Spinal Disorders. He was born in New York. He attended University of California at Los Angeles where he majored in Neuroscience, graduating Phi Beta Kappa. He attended the Yale School of Medicine where he was awarded the Doris Duke Clinical Research Fellowship to study the genetics of intrancranial aneurysms. He completed internship and neurosurgery residency at the Massachusetts General Hospital. He was a postdoctoral fellow in the laboratory of Drs. Daniel Haber and Shyamala Maheswaran. Dr. Nahed joined the MGH Department of Neurosurgery and the Brain Tumor Center in 2011. He is an assistant professor and teaching faculty member of Harvard Medical School. Dr. Brian Nahed's research focuses on circulating brain tumor cells and metastatic disease. In collaboration with Drs. Daniel Haber and Shyamala Maheswaran, Dr. Nahed's research has received several grants and awards and has been presented at national conferences. Dr. Nahed is actively enrolling patients

with brain tumors into his research study. Dr. Brian Nahed is an active member of the American Association of Neurological Surgeons, Congress of Neurological Surgeons, and serves on national committees for the Tumor Section and Council of State Neurological Surgeons. He is serves as a neurotrauma consultant for the National Football League (NFL)

Kimberlyn Leary, PhD, MPA Kimberlyn Leary is an associate professor of psychology at the Harvard Medical School and chief psychologist at the Cambridge Health Alliance. She is also a faculty affiliate at the program on negotiation at Harvard Law School and a senior policy advisor at the White House Office of National Drug Control Policy. Leary began her career as a clinical practitioner focused on improving access to diverse communities. Her early work on "negotiated transactions" in psychotherapy expanded to broader research on negotiation and conflict management. Leary's global work on conflict negotiations includes studying "critical moments" in mediations to end armed conflict in Southeast Asia and researching social enterprise ventures in the Middle East. She teaches courses on leadership and conflict transformation to undergraduates at Harvard College, on advanced negotiation and mediation to senior executives at Harvard Law School, and on physician-community engagement and the doctor-patient relationship at Harvard Medical School. In her work as chief psychologist at the Cambridge Health Alliance, Leary directs the division of psychology and its training programs to deliver culturally sensitive care supporting the hospital's primary care centers, specialty mental health, and acute emergency services. This work includes facilitating partnerships with community agencies, law enforcement, and school systems and assisting with the health system's transformation to becoming an accountable care organization. Leary received her BA from Amherst College, her MPA from the Harvard Kennedy School, and her PhD in clinical psychology from the University of Michigan. She received additional postgraduate training as a psychoanalyst. For the past four years, she was the scientific program chair of the American Psychoanalytic Association.

The Shapiro Institute for Education and Research at HMS and BIDMC is pleased to announce the

Rabkin Fellows in Medical Education for 2015 - 2016

The Rabkin Fellowship in Medical Education was established in 1998 to provide faculty with an opportunity

to develop the expertise and skills needed to launch or advance academic careers in medical education and/or academic administration.

Asha Anandaiah, MD

Pulmonary Beth Israel Deaconess Medical Center

Glenn Gaviola, MD Radiology

Brigham and Women's Hospital

Mary Jane Houlihan, MD Surgery

Beth Israel Deaconess Medical Center

Alan Malabanan, MD Endocrinology

Beth Israel Deaconess Medical Center

Heather Vestal, MD Psychiatry

McLean Hospital

Ariel Winn, MD Pediatrics

Boston Children's Hospital

Please join us in congratulating our colleagues on this wonderful opportunity!

Upcoming Academy Events: Medical Education Grand Rounds: Designing a Post-Clerkship Curriculum for Pathways: Creative Ideas and Best Practices- RSVP

Edward M. Hundert, M.D, Dean for Medical Education, Harvard Medical School Bonnie M. Miller, M.D., Senior Associate Dean for Health Sciences Education and Associate Vice-Chancellor for Health Affairs, Vanderbilt School of Medicine

Friday, May 1, 2015- 7:30-9:00AM TMEC 227 The launch of the Pathways curriculum this summer will make possible a completely new approach to the post-clerkship curriculum at HMS. With 19 months between the end of the PCE and graduation, novel opportunities can be considered for integrated science courses as well as new approaches to clinical electives and sub-internships, scholarly research, and more. In this session, Dr. Hundert will introduce some ideas for discussion about how HMS might consider the planning for the post-clerkship curriculum, and Dr. Miller

will describe the approach that Vanderbilt School of Medicine has taken, having moved their core clerkships to year two to create this same opportunity. Participants will be encouraged to ask Dr. Miller about details of the Vanderbilt experience and to give Dr. Hundert input on how HMS should move forward in designing years three and four of Pathways. Inter-Hospital Collaborative: Advancing consultative medicine through teaching- RSVP Eli Miloslavsky MD, Instructor in Medicine, Massachusetts General Hospital Jakob McSparron MD, Instructor in Medicine, Beth Israel Deaconess Medical Center

Wednesday, May 13, 2015 - 4:15-5:30 pm TMEC 250 The presenters will explore the teaching interaction between residents and fellows in Internal Medicine and describe interventions to improve this interaction. Academy Symposium: The Many Flavors of Scholarly Writing: Possibilities and Practicalities-RSVP

The Doctor as Writer Atul Gawande, MD, MPH, Professor of Surgery, HMS, Professor of Health Policy and Management, HSPH Thursday, May 14, 2015 1:00-3:30PM This mini-symposium by the HMS Academy Workgroup on Writing for Scholarship will discuss multiple avenues that are available for scholarly medical writing in addition to writing scientific articles for peer-reviewed journals. The symposium will feature a Keynote Address by Dr. Atul Gawande who will discuss his career in medical writing and the approaches physician-writers take to writing for general audiences. The Keynote will be followed by four concurrent workshops on 1) writing and editing textbooks, 2) common ethical issues in medical/scientific writing; 3) practical ways to overcome common writing challenges to develop a successful writing strategy, and 4) writing grant proposals. Medical Education Grand Rounds: For Modern Pedagogy, Do We Lecture or "Flip"? And How? An Exercise and Analysis of Animating the Classroom- RSVP David Hirsh, MD, Associate Professor of Medicine, Associate Director of the HMS Academy Friday, June 5, 2015- 7:30-9:00AM TMEC 227 What can moral philosophy teach about modern pedagogy? As education planners increasingly design time in class to be active, participant-oriented, iterative, developmentally-aligned and effective, the requirements of teachers are changing. To stretch participants' pedagogic abilities and orientation, this session will engage the participants in a dynamic live-exercise in moral philosophy. Thereby, learners will take part in, consider, and assess aspects of dynamic pedagogy that they might apply in their contexts. Just as serving patients is ultimately a "moral practice," so, too, will be this session...

New Medical Education Pubmed Citations from Academy Members Please note that we use an automated search system to identify new pubmed-cited medical education literature. If we have missed a medical education paper you have published, please let us know. Also, please let us know if you have published medical education materials on MedEdPortal or other sites.

Bijol V, Byrne-Dugan CJ, Hoenig MP. Medical student web-based formative assessment tool for renal pathology. Med Educ Online. 2015 Mar 31;20:26765. doi: 10.3402/meo.v20.26765. eCollection 2015. PMID: 25833824 [PubMed - in process]

Briggs A, Raja AS, Joyce MF, Yule SJ, Jiang W, Lipsitz SR, Havens JM. The Role of Nontechnical Skills in Simulated Trauma Resuscitation. J Surg Educ. 2015 Mar 26. pii: S1931-7204(15)00036-7. doi: 10.1016/j.jsurg.2015.01.020. [Epub ahead of print] PMID: 25817012 [PubMed - as supplied by publisher]

Dworetzky BA, Peyre S, Bubrick EJ, Milligan TA, Yule SJ, Doucette H, Pozner CN. Interprofessional simulation to improve safety in the epilepsy monitoring unit. Epilepsy Behav. 2015 Mar 23. pii: S1525-5050(15)00025-6. doi: 10.1016/j.yebeh.2015.01.018. [Epub ahead of print] PMID: 25812939 [PubMed - as supplied by publisher]

Roberts LW, Maldonado Y, Coverdale JH, Balon R, Louie AK, Beresin EV. The critical need to diversify the clinical and academic workforce. Acad Psychiatry. 2014 Aug;38(4):394-7. doi: 10.1007/s40596-014-0175-y. Epub 2014 Jul 3. No abstract available. PMID: 24989990 [PubMed - indexed for MEDLINE]

Iyer SV, Dutton CR. Screening for Intimate Partner Violence in an Outpatient Gynecology Clinic Setting [191]. Obstet Gynecol. 2015 May;125 Suppl 1:63S-64S. PMID: 25930525 [PubMed - as supplied by publisher]

Schapira L. Communications by Professionals in Palliative Care. Clin Geriatr Med. 2015 May;31(2):231-243. doi: 10.1016/j.cger.2015.01.005. Epub 2015 Feb 26. Review. PMID: 25920058 [PubMed - as supplied by publisher]

Schwartzstein RM. Getting the right medical students--nature versus nurture. N Engl J Med. 2015 Apr 23;372(17):1586-7. doi: 10.1056/NEJMp1501440. No abstract available. PMID: 25901425 [PubMed - indexed for MEDLINE]