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Get Involved in Medical Education: Part II
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Get Involved in Medical Education: Part II
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2022-09-15T00:00:00.0000000
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[Dr. Smith] Welcome back to Run the List, a medical education podcast in partnership with McGraw Hill Medical. Our host are Dr. Navin Kumar, Dr. Walker Redd, Dr. Emily Gutowski, Dr. Joyce Zhou and myself, Blake Smith. As a quick disclaimer, this podcast is meant for informational and educational purposes only, and should not be understood as medical advice under any circumstances.
[intro music] [intro music] [intro music] [Dr. Smith] Welcome back to the second part of this two-part series on medical education where we're talking with the co-host and founder of Run the List podcast, Navin Kumar, who, if you didn't hear it in the first part, is an attending gastroenterologist at Brigham and Women's Hospital, an associate medicine clerkship director at the Brigham and MedEd extraordinaire.
So I'll just recap part one which to me in the student phase of medical education was filled with pearls. Navin talked about kind of starting early and it's never too early to start medical education. He went through an anecdote of a student of his that identified a need and took a real grassroots approach amongst her class to do some research on that need and proposed an innovative curriculum in order to kind of imbue the clerkship year with a global health component which was awesome.
And so if you didn't catch that go back to part one of this series. The second pearl was just saying yes to opportunities that come your way that will then allow you to become more involved in medical education, and people might start to seek you out for it for having kind of that entrenched role in MedEd. Practice makes perfect and being able to practice the teaching that you've prepared so well for will allow you to become a better and more effective educator.
And lastly, just embracing the fact that there's a lot of formal and informal teaching in MedEd. Whether that happens in the classroom, at the bedside, in the break room. And reserving five minutes upfront for teaching, as Navin did as a resident, is a way to get kind of a blend of informal and formal teaching as part of his daily practice. So now in the second part, I think we're going to want to focus more on later trainees and even early faculty.
We have a lot of listeners in kind of every stage of training, and so I think this will be really helpful for those upper trainees to hear from you, Navin. From your own experience, how were you able to continue this momentum you had that you spoke about as an upper medical student and a resident into your fellowship and early attending years?
[Dr. Kumar] All right, excellent question, Blake. And so, you did a really nice job of talking about informal versus formal teaching. And so now we're thinking about those individuals who are in their fellowship stage or early faculty stage. And so my tip here, so we'll do tip number one for this part two of our podcast series on medical education is to take on formal roles. Now it's time, right?
You're further along in your training, you are increasing your distance from when you were a student and you're getting closer to either already being a faculty member or actually finishing fellowship and starting your first job. So this is a time to build up your educational portfolio. And the way I like to think about it is you want to diversify what you teach for a variety of reasons.
One is that you'll become a better teacher. If you're teaching in different settings, different content, you yourself will become a better teacher because you're having to adjust to a different body of knowledge. The second is that it will show well on your educational CV The second is that it will show well on your educational CV that you're able to be flexible and teach in many different roles which is very important once you start looking for leadership positions because to actually lead a course, you have to have knowledge of how to teach effectively within that course.
And many of our courses for good reason employ different techniques of teaching, right? There's lecture, there's small group, there's bedside. So really important to start developing those skills. So what this looks like more tangibly is that, there's clinical skills courses and these are generally for earlier first and second year medical students. And within those courses, you can be a preceptor who helps guide students at the bedside through the physical exam, history obtaining from the patient, presenting the findings of history and physical presenting the findings of history and physical in a formal manner.
There are small group courses at the medical schools within the specific organ-based pathophysiologic areas of the topic. And so me as a gastroenterologist, as a fellow in gastroenterology, I spent a lot of time teaching during the GI pathophysiology course to gain that experience. And then there's also the opportunity to lead small lectures within internal medicine if you're in internal medicine, or any residency, there's opportunity to teach within the curriculum that's actually put forth for the residents.
So there's a lot of different ways to get these teaching opportunities and experiences. And one pearl I want to leave early on in this talk is the importance to you of saving any evaluations you get is the importance to you of saving any evaluations you get of your teaching in a course. It will help both for your own growth to see what areas of teaching you are actually quite effective in and then what areas you need to work on, but then also later down the road, and this will become more like- The importance of promotion within an academic institution I think everyone has a different take on it, but if you happen to become motivated to move along the different tiers of promotion in an academic institution, it really helps to have these learner evaluations as supporting all your efforts within the teaching arm of that institution.
[Dr. Smith] Thanks for those tips and kind of those bullet points of formal roles you could take on in your kind of upper residency fellow years even as an early attending. One of the coolest things about medical education is that, and almost one of the more fun things is when you could have a lecturer in your classroom that you then get to see in the OR later on during your clinical years or a fellow that's teaching you about cirrhosis and then you see them on the wards or you're then teaching them if you will, by giving them a history about the patient on the wards.
And so, it's kind of this two-way street of formal and informal teaching and different roles as you advance in your medical career. [Dr. Kumar] Yeah, and I'll just add also that what's a really nice byproduct of doing all this teaching is that you learn how to explain things in very simple ways that ultimately your patients understand. And so, it's so funny I'm like now, I'm a good few years into being an attending, and I find that a lot of my time seeing patients is spent educating them on their condition.
And so if you become a more effective teacher, you'll just find that naturally you can explain disease processes and treatment options in a way that patients understand really well. And that's the bottom line, right? Like ultimately we all want to just become really great clinicians and just think about education as a way to get there also. [Dr. Smith] Yeah, definitely.
I'm just in my head playing out how you would explain ERCP and MRCP to patients, but I'll save that for another pod. [Dr. Kumar chuckles] [Dr. Smith] You mentioned in the first part of this how you as a student took on a medical education role and found mentors yourself and then you went through this anecdote where you had a student who was your mentee, and almost how you're now peers with the medical educators that you learned from that were mentors of yours.
Could you kind of talk about the role of mentorship in medical education and how you find a mentor as a student or even as a fellow? [Dr. Kumar] Yeah, great question. So mentorship is really key in anything we do, but I think it's very important in medical education. When I first started I thought, okay, you only need a mentor if you're ultimately going to pursue a research career and you're going to be in the lab or you want to join a research group, that's naturally where the mentors live, but I soon learned that that is not the case and really anyone who wants to succeed in their career needs a great mentor who is looking after them, because a mentor can do a lot of things.
A mentor in medical education can connect you with teaching opportunities that they hear of. Oftentimes this happens where I cannot teach because I just don't have the time or I don't have the availability on that day, but I will let the person who's offering the opportunity know that I actually know a student or I know a resident, or I know a fellow who would love to teach. And so I can connect them and present them with these opportunities that they should then say yes, right?
We talked about that earlier, say yes. Okay, the second thing a mentor can be is a role model for seeking out a career in that path of medical education. I think I have a lot of mentors who I look up to, and it's just really fun to hear about how they arrived at their current state of being a leader in medical education and taking lessons that they learned along their way that I can apply to my own career for getting to where I want to be.
Mentors in medical education are really great for observing your teaching skills. I think all of us who are interested in medical education want to help our mentees become better teachers. want to help our mentees become better teachers. And what better way to do that than have your mentor actually watch you teach and give you feedback on your skills? I remember I had someone do that for me when I was an early educator, I had just finished residency and I was paired to help direct a course where I was very junior, but I was paired with someone who was actually quite senior, and we had a great relationship where he would put me at the front of the class and have me take the opportunities to teach as much as possible.
And he was in the back observing, taking notes and then we would discuss afterwards about how my teaching went. And then lastly and we'll get to this in the next section is that a mentor in medical education can also potentially serve as a research mentor if they have that capability as well and that's a really great thing to have also. [Dr. Smith] Yeah, I like that in the beginning you mentioned how I think the initial take that students might have is that mentors are more reserved for the lab and even scholarship the same where the goal of research tends to be publishing as kind of academic currency whereas in teaching, maybe it's kind of those informal conversations you have in the break room or with your patient, but there's also another side to it as you were alluding to that there is kind of a scholarship component to medical education as its own discipline in an outright way.
So what's your approach to scholarship in medical education and how that involves the mentors you mentioned or seeking out mentees to kind of help you on a research project in medical education and everything therein? [Dr. Kumar] Awesome. So if my first tip was to take on formal roles, I'd say my second tip now is to strive hard to be scholarly. And this all starts with finding a mentor who can really help you with your medical education project to get it to a point where it is true research and can be published in a peer reviewed journal.
And I think one point I just want to make is that what I realized as I moved through my career, that you very well may need multiple mentors. It's hard to find one mentor who fulfills all the different things you need. And I think that's especially true in medical education because you may have a mentor who is an incredible educator, who has just the best teaching skills, but for better or worse, just never became interested or had the opportunity to publish.
And so that mentor may be the person you go to to enhance your teaching skills, but then you may find another mentor and sometimes this happens where I think particularly medical education research, this mentor may not actually be a clinician, they may be more of a research scholar. And they can be a research mentor who in combination with your teaching mentor you can make a great team that will help support your medical education research.
So again, it starts with finding a mentor but be flexible, know that you may not find a mentor who fills all the things you need, you may need to combine mentors to achieve what you need. And then as part of being scholarly, we talked about it in the prior episode about finding the gap and trying to fill that gap within a curriculum and innovate, but also take the next step and publish.
It absolutely takes more effort to take a scholarly approach to whatever innovation you're presenting. You know, you have to think out what the study design is, you have to go through an IRB process, you have to collect the data, you have to write it up, absolutely takes a lot more time, but I personally think it's really worth it. For one, this is true academic currency is publication, and so, it will help for your own promotion if that's, again, something that you are motivated by to have your work published, but another really important reason is that it helps you disseminate your work.
And so, by engaging in the scholarly process of trying to publish your work, you can then share your innovation to a much larger audience than your local institution where you're doing your project. And then the third part of being scholarly is gaining skills in medical education research. You will, if with a good mentor, you'll start to naturally inherit some of these skills by just the conversations and seeing how your mentor approaches projects, but there's also formal ways to gain skills in medical education.
And I think this again becomes more of an opportunity for the stage of training we're talking about now when you're in your fellowship or early faculty positions. So these opportunities are medical education fellowships that a lot of institutions now have. There are medical education grand rounds that you can be a part of as well as potentially present at. And then there's a whole host of CME, continuing medical education courses that specifically target medical educators.
The Harvard Macy Institute has a wealth of programs that are really, really great. And I'm sure there's many other CME courses outside of the Harvard Macy as well where you can really expand on your skills and receive formal training in medical education. [Dr. Smith] Yeah, I think seeing kind of medical education formalized in that way through CME, through fellowships, through just the papers that are published, it's so cool to see it kind of as a discipline be solidified in that way.
And it's the analogy that you were making before between research and medical education, and it also applies where in research if you're interested in T cell immunology and you're working on it every day, then you want to publish that to become part of this generalizable knowledge for the community. And the same is to be said about medical education where if it's something that you're passionate about or it's something that you're trying to innovate on, you want to share those findings with people.
And so, if it takes a little bit more work as you were saying with the IRB approval process, or even just study design and writing it up, it becomes worth it because it adds to that body of literature supporting the approach you're taking to medical education. So I really resonate with that point, Navin. You kind of started to allude to it with CME at the end there, but what's been the role of digital education, you know, podcast, social media in all of this for medical education?
And maybe talk about kind of where you started versus now, which is not to age you in any way but it's more just even with COVID in the last couple of years, the pandemic has really accelerated digital education in my mind, digital medical education, sorry. So maybe take us on kind of a timeline in your mind of how it's gone. [Dr. Kumar] Yeah, it's funny. I think there's been so much development in this space that I think my big point here is that us educators need to know how our learners are engaging with these new resources.
It's a disservice if we say that, oh, we're too old to be going on social media, right? Or it's going to be too hard for us to start. We really need to do it because that's how our learners are learning, and there are so many benefits to becoming involved in this digital education space. And I'm saying this from my perspective, I'm generally a slow adopter.
I like routine, I like knowing what I know. And Facebook started in my dorm when I was a sophomore And Facebook started in my dorm when I was a sophomore and it took me several years to actually join. And same thing with Gmail, like that was kind of my generation, we were in college when all these things came out. And I've learned that it makes much more sense to just get involved sooner rather than later so that you can become comfortable in the new medium and actually become effective using these resources.
So I think MedTwitter obviously is a huge part of what we're talking about right now. And again, I just want to reinforce that we all should be taking advantage of this opportunity to reach learners who are otherwise unreachable to us, right? Like we may be teaching really effectively in our own local institution, but there are so many more learners out there who could potentially benefit from what we have to share as well.
So getting involved in MedTwitter if you haven't before, I mean, it does take some activation energy and some research on your own part to start getting involved by just seeing what other people are doing, but I think like three ways to do it to get involved in MedTwitter to start by posting teaching infographics. So if you teach, let's say, you teach on a topic for the residents and you have a summary image that kind of captures everything that you just taught during that 30-minute session, you can just go ahead and post that on Twitter and share it with obviously citing any work that you brought into your infographic but share it with a larger community.
Another thing that I'd like to do, and it takes time and so I haven't been able to do it as regularly is doing a tweetorial on a clinical topic. What I like to do and it's something I've learned is to squeeze out as much as possible from a teaching opportunity as I can. So what this means is if I'm going to go teach about let's say my favorite, small intestinal bacterial overgrowth, SIBO, getting a lot of attention these days, if I do a 15-minute teaching for my fellows, I then will turn that teaching into a tweetorial I then will turn that teaching into a tweetorial and I'll break it down into its core topics.
And I'll do a tweetorial about 8 to 10 tweets that basically runs through all my teaching points in that session. I find, honestly, it's a great way to gain I think some traction on something like MedTwitter, because I think tweetorials that are done well, generate great engagement and also more followers, but also I think it improves your ability to teach because you are really trying to be as succinct as possible and logical as you are going through tweet by tweet the teaching topic.
So I love doing a tweetorial and also pairing it with a didactive I just made so that I'm getting kind of a two for one there. And then lastly, we talked earlier about the importance and Blake, you really summarized this nicely about pursuing research so that you can disseminate more widely and MedTwitter is a great, great way to do that, where you can share your medical education research project, link it to the original article and then do a short tweetorial where you go through what you did and what you're able to achieve.
[Dr. Smith] Yeah, I think you touched on it nicely about MedTwitter being kind of this centralized place for where news break fast and that's world news but also just medical education papers and kind of even pre-prints, but also where a lot of teaching goes down and sharing of infographics and sharing of kind of chalk talks from that day. It's funny because it also ties into what you were saying earlier about how you would teach five minutes every day as a resident and how you could just kind of formalize that or turn that talk into an 8 to 10 tweet tweetorial kind of with minimal effort and just the character limit of Twitter just makes it harder but easier- It makes you a more effective teacher like you were saying.
So if anyone hasn't seen the SIBO tweetorial that Navin is mentioning from last year, I mean, it took off, it was viral. It's a masterclass in how to do a tweetorial. So we'll link it to this episode because I think it's from one of our own and it's extremely well done. [Dr. Kumar] That's hilarious, Blake, thank you. And one thing I forgot to mention as we talked about MedTwitter is obviously what we're doing right now which is podcasting.
Podcasts are now a huge part of digital medical education, and for me I first got involved when I was a fellow and I was asked to be a discussant for a medical education podcast. And I mean, it was like a throwback to when I was a third year medical student thinking about teaching in front of my team. Initially, I was like very stressed out about this idea of me being an expert coming on to a podcast to discuss a topic when I'm just a fellow.
And I think I did have some hesitancy initially but then I remember that yes, one of my tips is to say yes and so I went for it. And again, it did require a lot of work, but it was such a great decision because I gained confidence in my ability to actually be on a podcast. And then once I started like looking at the landscape and thinking about what's out there and how I wanted to more effectively reach learners of the stage of our audience, I saw there was a gap and just like things came together between with Walker Redd and Emily Gutowski early on and how we started out doing this podcast like literally it was essentially a closet, right?
It had glass doors, but it was essentially a closet. And how far we've come thanks to you, Blake and Joyce joining the core team and all the other students who helped us along the way. I just feel so proud of what we've been able to achieve. And I think a lot of people out there think about starting a podcast of their own and it's certainly a worthy endeavor, but also I think before diving into something like that, you have to do your needs assessment and see what's out there.
And if your podcast is going to bring something new that hasn't been done before and if there is not a huge gap but there are some areas that you like to discuss another way to do this is to reach out to podcasts that are already established and seeing if you can do a few series of topics with a podcast that's already been up and running. [Dr. Smith] Yeah, I like that.
And it's nice that the first part of this series really bleeds into the second one. It's not really dichotomized because you just said that you say yes even in your current stage of training. You practice what you preach and kind of collaborating with others on an endeavor that you did a needs assessment and then collaborating with others to fulfill that in the form of a podcast is you doing medical education just like you were doing as a student, constantly innovating and continuing to teach us but kind of all our listeners from all over the world.
So I think that's a good stopping point. We could keep asking you more questions because of your wealth of knowledge on this subject, but Navin, as you did with the last episode, could you summarize some pearls for the later trainees, early faculty that either were involved in medical education as students like yourself or even just got to it late, ways to really be entrenched in the current wave of medical education?
[Dr. Kumar] Absolutely. So tip number one again is to take on formal roles and try to do roles that force you to teach in different ways so that you can really diversify your educational portfolio. Number two, we spent a lot of time on this about being scholarly and how that really starts with finding a mentor or mentors to help you turn your medical education project into something that is potentially publishable in a peer reviewed journal.
And then the last tip that I'll just share is this need to find your people. And what I mean by that is try to find committees that are focused on medical education. This can be done both locally within your own hospital institution or med school, but also nationally within the clinical society that you're a part of. For me I've found this within, it's really great, there's the American Gastroenterological Association and within the AGA, there's a community of educators.
And so I've joined that community and it's a great way to find like-minded individuals who are doing similar work, but not necessarily at your own institution. And before we wrap up, I just need to give some feedback because, Blake, I thought you did such an excellent job as a host. I love how you summarize the teaching points as we move through these podcasts, we need to get you hosting it more often because you do such a great job with this.
[Dr. Smith] Thank you, Navin. Constantly learning and innovating from mentors like you. And again, if you haven't checked out the SIBO tweetorial, you should, so we'll link it in the show notes. Thanks again for listening to another episode of Run the List. [outro music] [outro music]