26 Random....

For the past several days, I have struggled with the horrible events of last Friday, December 14, 2012.  A shooter entered an elementary school and shot 6 teachers and 20 first graders.   As a parent and grandparent, as a professional, and as someone who hates guns, this one has been hard for me.  The images, indelibly imprinted in my psyche, are terrifying and sad.  

The media has conjectured extensively about the increased possibility of gun control legislation, as well as the flaws and possibilities of the mental health system.  They have also  revealed a new debate as to whether principals and teachers should be armed.   The shooter's mother, also a victim, has been portrayed in sensational ways (survivalist, gun maven, troubled) and a heroine (mother of a son with many challenging behaviors, unable to access needed services).   There is much conflict in each of these discussions.  Now, our society can add epidemic violence to some of our other woes:  the looming fiscal cliff, wars abroad, and  health care reform    Perhaps it is good that it this new "worry" has moved up on the list that politicians, neighbors, and various advocacy groups can argue about.   The combination of the realities of the events of last Friday and the debate that has followed has dampened my holiday spirit, and that of many others around me.  

And then this morning, my wife shared something with me.   Former NBC Today Show host Ann Curry has started a website/twitter feed:  Inspired to Act: #26 Acts of Kindness:  

Curry's message is asking others to join her in committing to 26 random acts of kindness to honor the Newtown children and adults who were killed.  I read down the page, which provides some opportunity to respond and hundreds of people have indicated what they have done, little things and big things, to memorialize the victims and to move forward.   To be honest, reading these "tweets" humbled me.  While I have been focusing on the hopeless sadness of the situation, thousands of others have been doing good things, big and little.   There are notes of Christmas miracles, Jewish mitzvahs, generous donations, letters of apology, and thank you notes to first responders.

It is right to be sad and angry over such "random" violence.  It is not likely that 26 acts of kindness by many will stop the next crazy killing spree.  Our legislators, scientists, the education system, and the health system will have to struggle with this epidemic for a long time.   In the meantime, doing something positive and kind has the potential to communicate what is healthy and hopeful during this most difficult period.  So, I am starting my holiday list late this year.  This year, my holiday to do list focuses on 26 random acts .I want to respond to Ann Curry's little message.  My response won't change the world, it won't change the grief of the sorrowful survivors in Newtown, and it certainly won't change the likelihood that there will be another random killing in the future.  My reason for doing it is selfish.  It will change me, lift my spirits, and might help someone that I work with or someone in my family or someone who needs a little lift.

I hope that this holiday that everyone in the Institute community and your families, have a safe, healthy, happy and wonderful break.  I hope that every one of our students knows that we care about them and their success and that we look forward to seeing them in January.  I hope that every faculty member and staff member at the IHP knows that what we do changes the face and the future of health care-one student at a time.   I also invite everyone to read the "Inspired to Act" site and then join in with 26 big or little random acts.  Do it for yourself.

Best wishes for a wonderful holiday! Peace.

PS-Feel free to list some of your random acts on the blog response below!  Think of the effect!  26 random acts x 1200 students+ (200 faculty and staff) =36,400.  That's big!

Cutting Edge Interprofessional Education



PT, Nursing, and CSD  students share lunch and patient reflection time after a "shift" on the MGH  Interprofessional Dedicated Education Unit



Last Friday I had the opportunity to spend time with several students, clinical faculty members, and preceptors at the Mass General on Ellison 8.  There, each week, an interprofessional group (Nursing, DPT, CSD) students spend time together caring for patients, learning about the work of each of our disciplines, experiencing day long observation of the top notch professional acute care at the MGH, and then spending an hour together reflecting on what the significant learnings were that occurred on that day.

I was able to see a bit of the action that occurred on the floor,but spent more time in the debriefing session at the end of the day.   One of the first observations that I made was that it was difficult to tell what discipline students represented.  They were so sophisticated about the patients that they presented that each one knew the clinical, social, functional, and practical concerns for each patient.   The speech-language pathology students discussed the patient's physical concerns, the physical therapy students were able to talk a lot about communication and swallowing, and the nursing students were remarkably knowledgable about the patient's functional and social situations.   Each student was highly engaged in the discussion and expressed great concern about the needs of the patients from a health perspective, but also from the perspective of future needs, affordabilty of care, and family needs.  

Having had the chance to observe this highly innovative educational pilot was a gift for me.  We are so fortunate to be in a setting where these types of activities are embraced and where our Mass General colleagues are so willing to go the extra mile to make this experience successful and outcomes driven.  We need to continue to find opportunities to develop patient centric teaching and learning situations for all our students!   These opportunities will be transformative in the future of health care!

Thanks Veterans

It is that time, once again, when we honor Veterans.  These people who have served our country deserve special thanks and appreciation from all of us.

We are especially proud and grateful for those members of the IHP community-faculty, students, alumni, and staff who have served in the armed forces.   Many of these individuals have served as health care providers in the service.

Please join me in saying thanks to this special group of people!

Fantastic Gala 2012

Last night, the Institute’s annual gala  (35^th birthday celebration!) was held at the Renaissance Hotel in Boston’s Innovation District, the seaport.  The venue was beautiful.  As always, friends of the IHP filled the room.   Old friends found each other, student scholars were recognized, fantastic staff members made the evening sparkle, there was a lovely dinner.   Even though much of the pattern was the same as in previous years, each gala has a unique story to share or a unique focus.   For last night’s event, several unique features come to mind.

First of all, the key video presentation focused on recent alum Heather Quirk (SON, 2012) and her remarkable story as a young widow, nursing student, parent, and marathon runner.   She represents a uniquely remarkable young woman, who like many of our students and alums have sacrificed and risen above many hurdles to move into their life’s work.    As notable as Heather’s story was her eloquence and graciousness when she thanked those present for their generosity in behalf of all the students who need financial support.  

Second, President Bellack and Board Chair George Thibault praised the start-up of two new academic programs, the MS in Health Professions Education and the PhD in Rehabilitation Sciences, both which have launched in the past few months.   In addition, three of our new faculty researchers were present and were honored.  Drs. Lisa Wood, Tiffany Hogan, and Jordan Green will be part of the Institute’s next chapter of successful contribution to health care transformation.  

And then Trustee Ari Buchler announced the opportunity to participate in an auction to raise money to support students.   Long time friend of the Institute, Sumner Brown had challenged those present to increase their donations by indicating he would add to his already generous gift if over $50000 was raised.   The effect was impressive.   In a few minutes, over $90000 was raised to support students at the Institute.   This amount almost tripled the activity of previous years.  Amazing.

As the Institute celebrates its 35^th Birthday, it is fantastic that the wonderful event held last night could honor our work, support our students, look forward to new programs and people, and generate significant financial support for our important mission.   I am grateful to be part of such a remarkable institution.

If you happened to miss the gala and would like to see a video about the Institute's legacy of giving, be sure to check it out:www.mghihp.edu/about-us/ways-to-give/investing-in-the-future.aspx.

Another (Baby) Day at The Institute

Oh Baby! Friday, September 27 was another landmark day for the entry level graduate students at the Institute. The Institute’s annual Baby Day was held for the first time at our newest facility at 2 Constitution Center. Started several years ago by great leaders in the Department of Physical Therapy, Baby Day has become a true interprofessional learning adventure for many, many students. Having the new facility allows more babies and more students and faculty to participate.

Baby Day involves inviting parents to bring in infants and toddlers for observation/assessment and interaction with our students in Nursing, Physical Therapy, and Speech-Language Pathology. For many entry level students (most began their studies less than a month ago), this is a first exposure to typical children and their parents. Watching them crawl, talk, roll over, cry, interact with parents, and explore the environment are fundamental features for assessment of health, development, communication, and motor skills.

Dr. Laura Plummer (SHRS, PT) is responsible for the overall organization of the event, which involves over 150 students, faculty, clinical instructors, and plenty of children and their families. The story as I tell it, reads back to me “another nice thing that the IHP does, “ but doesn’t read as “breakthrough or earth shattering.” It is the back story and the experience that gets my attention and I hope you will think about it.

The Institute works hard to create an interprofessional narrative and to talk about the ways that our students can (must?) learn together and that our faculty must learn to teach together and to teach across disciplinary boundaries. Last month we offered the first ever community service day, allowing students to work side by side to help out the neighborhoods closest to our school. This past Friday, walking around the learning spaces at 2 CC, here is what I observed:

• Interdisciplinary groups of students huddled together in groups of 15 or so, sitting on the floor, and watching faculty members and Clinical Educators interact with little children;

• Students focused, almost laser focused, on observing, documenting, and clarifying what they were learning in a completely safe, IPE environment;

• Faculty members giving up a Friday morning to provide an integrated learning experience for students from all of our programs;

• These same faculty members teaching students by asking for observations and interpretations;

• Most impressive, faculty members from one discipline, informing students from other programs about key observations that they make for purposes of referral or enhancing their own practice.

• Happy parents watching their child interact with a group of remarkable students; and gaining confidence in the next generation of providers of care.

Baby Day was a great day. It was fun and rewarding to see the activities, the teaching, and the learning that was being accomplished in this most impressive space. Our graduate students at the Institute are experiencing a truly remarkable opportunity and this will continue to expand and grow.

Opportunities such as Baby Day, the Community Service Day, and our upcoming Interdisciplinary Lecture occur because faculty leaders choose to go the extra mile to make vital learning work well at the IHP. All I can say is THANK YOU to Anne and to all who made this happen. And also I say, “Oh Baby.”

What's Better Than a Sunny Day in Boston?

 

Lost and Found: In memory of Lena Sorensen, PhD, RN

       Just two weeks ago, we learned that Dr. Lena Sorensen our colleague, faculty member, teacher, and friend passed away after a very brief illness. We were sad to lose this Institute leader, but relieved to know that her suffering was not lengthy and that she was with her long time partner, Alice Friedman. Expressions of disbelief, grief, and loss have been intermingled with interesting and uplifting stories of Lena’s talents, her passion for her work and her students, and her commitment to connecting patients and providers via technology. Lena had an interesting career, serving several different academic institutions and clinical settings. She was an early adopter of technology advances and pushed to make connections happen that could benefit patients and providers, especially nurses. At the Institute, Lena taught courses in informatics and research, supervised many student projects, and expressed constant delight at her work with her close colleagues in the DNP program, CIPSI, and the School of Nursing. I had the opportunity to work closely with Lena while she served as Chair-Elect and Chair of the Faculty. She worked to bring attention to collaboration around governance, to launch and support a new faculty rank and promotion system, and to include the faculty in important decisions and actions. Lena was also connected with many colleagues in the community. I won’t pretend to know them all but I know that her collaborations with Jeanette Ives-Erickson and Patient Care Services at Mass General and her work with the Center for Connected Health were central to her personal and professional mission. One of her great “moments” of the recent past was when she was invited by Joe Ternullo of the Center for Connected Health to introduce the Prince of Denmark at last year’s Connected Health Symposium! She laughed so much describing all of the ways that the CCH team tried to handle her comments and to reduce the probability that Lena’s natural spontaneity might cause any diplomatic problems! They should have known that Lena’s spontaneity was far from controllable.

     A few years ago, Lena initiated a new way to simulate clinical interactions and education via the virtual world of “Second Life.” Lena and her students struggled through various iterations of the IHP “island”, discovering ways to make their avatar real (or at least have normal clothing), and to explore in a very safe manner some of the complex interactions that occur between patients and providers. Lena was so proud of her “second life” world and the way that her students grumbled at the beginning of the term about having to use this new cumbersome technology and subsequently celebrated their accomplishments at the end of the term. This is the classic continuum of learning-discovery, frustration, deeper exploration, mastery, confidence, competence. Lena celebrated this continuum and I will remember her for these contributions and many more. I think it is somewhat symbolic that her work will live on in something aptly named “Second Life.” I think that you will join me in “finding” Lena there in the virtual world that she helped design.

     The IHP community will gather for a memorial tribute to Lena on September 27 at 5 pm in the beautiful student lounge in 2 Constitution Center. I hope that the whole IHP community-staff, faculty, students-will join us in honoring Lena at that time.

MEMORIAL SERVICE

DR. LENA SORENSEN

SEPTEMBER 27, 2012

5 PM

2 CONSTITUTION CENTER, STUDENT LOUNGE

Third Base: Why do I care so much about Interprofessional Education (IPE)?

Blog Prepared by Dr. Bette Ann Harris

This is the third in a series of submissions this year concerning the Institute opportunity for a "triple play."   Earlier this semester, blogs have been presented about active learning  and inclusive excellence.  The final home run in this series comes from Dr. Bette Ann Harris.  Bette Ann (BA) has the distinctive historical role of being the Institute's very first graduate!   She is now completing 35 years of affiliation with the IHP.   Her history here includes leadership roles  in Physical Therapy, as a Dean, and most recently Associate Provost.   A common theme through her leadership experience has been that of Interprofessional Education.  As the interim Director of CIPSI she has been able to fulfill this long-time passion in interdisciplinary education.   BA will retire from her post in the Provost office in two weeks.    It is wonderful that she has chosen to share with us her rationale for her passion in interprofessional education.  Thanks BA for thirty five great years!

Since the Institute’s inception, interdisciplinary education has been a core value.

Why? We all knew empirically that collaboration and team work worked...many of us who were part of the early days at the Institute had experienced first hand how working together as a team not only improved patient outcomes but created a strong sense of community that together we can make a difference….fast forward to today…it’s still a work in progress but we are gaining on it!

The concept of Interprofessional Education (IPE) has been around for a long time and if you take the time to go back through the literature, you will find a call for educating health professionals together as early as the 1960s citing many common core competencies that apply to all health professionals from beginning skills such as communication, patient safety, culturally competent care to the more complex activities such as leadership, research and clinical decision analysis. Where IPE seems to break down, is how best to teach these skills. (OK, this is blog so I am not going to go into all of the details, but if you are interested in increasing your understanding of the pros and cons of IPE, please refer to the list of references at the end of this article)

In recent years, there has been much more buy-in as to the need for IPE, including incentives for working as a team. For example, many funding agencies, including the National Institutes of Health (NIH) now require that many grant proposals have an interprofessional team of collaborators as well as third party payers of health care. Also, students are demanding more interprofessional opportunities, as they rally together over common health care problems such as health disparities and social justice. In November 2010, there was a wonderful conference at Harvard Medical School that coincided with the seminal Lancet Report: Health Professionals for a New Century: Transforming Education to Strengthen Health Systems in an Interdependent World. Educational leaders from all over the world passionately cited their own experiences with IPE – from collaborations in the field to core curriculums. During one of the questions and answers sessions, a very articulate HMS medical student embraced the need for more interprofessional educational experiences. Like others, he went into health care because he wanted to improve the health and quality of life and make a difference. However, he felt that in an effort to socialize him to his profession, “the passion was beaten out of him” and he should be a physician first, then a humanitarian. From the applause in the room, it was clear that others felt the same way…we need to all focus on the outcome, and recognize each of us from the various professions, do bring a unique set of skills and expertise to the table, but the common goal is the same…to improve the health and well being of those we serve. Much of what we do does cross professional boundaries and if you examine the accreditation standards from the respective disciplines, many of the standards are exactly the same especially around ethics, research, professional behaviors, quality patient care, safety, evidenced based practice, etc, etc. The challenge in education is how to create a curriculum that creates a balance of interprofessional experiences (with core coursework, clinical experiences, activities) with professional specific content so we can graduate students prepared to meet the challenges of health care in the 21st century. No one said it was easy and the Institute is not alone in trying to figure out how to do this effectively and efficiently.

The Institute strives to become a leader in interprofessional education and as a commitment to this vision, the Center for Interprofessional Education and Innovation (CIPSI) was created on January 11, 2011. CIPSI is now the home for several academic programs open to all health professionals including: Health Professions Education, interprofessional content courses (known as HP), the newly established PhD in Health and Rehabilitation Sciences and the Prerequisites for the Health professions courses for those students interested in entering the health professions. CIPSI is also a place where faculty come together to discuss interprofessional curricula opportunities, launch new interprofessional activities, brainstorm innovative ideas and the center serves as a two-way bridge between our schools to move interprofessional opportunities forward. CIPSI is not the only place where interprofessional education takes place and there are exciting new opportunities for students such as the Dedicated Educational Unit (DEU) which was initiated by the School of Nursing and the School of Health and Rehabilitation Sciences. CIPSI, like the rest of the Institute, wants to be known as innovative, creative and to quote Clayton Christensen, disruptive!
As I end my tenure as Associate Provost for Academic Affairs on June 20 and head towards retirement on January 1, 2013, I find myself reflecting on how much the Institute has accomplished over the first 35 years. I am proud to be part of the journey and plan to spend more time working in collaboration with other health professionals (and other disciplines) both on my clinical research and in developing rehabilitation training programs in underserved communities.

Like the Institute, interprofessional collaboration is a core value of mine.


References

Health Professions Education: A Bridge to Quality Ann C. Greiner, Elisa Knebel, Editors, Committee on the Health Professions Summit. ISBN: 0-309-51678-1, 192 pages, 8 1/2 x 11, (2003) This PDF is available from the National Academies Press at: http://www.nap.edu/catalog/10681.html


Core Competencies for Interprofessional Collaborative Practice, Sponsored by the Interprofessional Education Collaborative. Pre-publication recommendations to support activities for the Team Based Competencies Conference, February 16-17, 2011, Washington, DCIPE. PDF is located here: https://www.aamc.org/download/186750/data/core_competencies.pdf

Frenk J, Chen L, Z, et.al: Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. www.thelancet.com Published online November 29, 2010 DOI:10.1016/S0140-6736(10)61854-5. PDF is located here: http://www.mededconference.ca/documents/CommissionReport_000.pdf

Harris, BA: The 2006 Pauline A. Cerasoli Lecture – Interdisciplinary education: what, why and when. Journal of Physical Therapy Education, Vol 20, no. 2, fall 2006, 3-8. PDF is located here: http://cedric.mghihp.edu/v3/dlefile/getfile?id=8538203610282835


What is interprofessionalism? http://highereducationresources.atspace.com/interprofessional.htm

Growing by One Degree....

It's final! We have been notified by both the Massachusetts Board of Higher Education and also the New England Association of Schools and Colleges that we are approved to grant the degree, Doctor of Philosophy in Rehabilitation Sciences.   This is a true mark of the Institute's commitment to fulfilling the vision of our Founders and to the work of so many who have led us to this point!  Congratulations especially to Dr. Robert Hillman, Associate Provost for Research, to the Institute's Research Committee, and to the long list of faculty and staff who have worked to make this day a reality. 

So, now that we have been notified that we can award the degree, what happens? 
1.  We will begin to market and recruit for a small entering class for Fall 2012.
2. We will begin to create the schedule of courses and the plan for advising for the new cohort.
3.  We will work with our partners at Spaulding and Mass General, as well as within the IHP, for part time clinical  appointments for our students.
4.  We will work with our friends in the Department of Communications and Marketing to come up with creative ways to notify the academic community of our new program!
5.  Students will come.
6.  An increased focus on research will be experienced at the Institute.

Why is this significant and important?  The Institute now offers a full complement of academic degrees at the graduate level.   We offer professional (practice based) doctoral degrees in Nursing and Physical Therapy; the MS in Communication Sciences and Disordersand in Phyiscal Therapy.  Adding the Doctor of Philosophy aligns us with other top notch programs in our disciplines.

Look for a new blog posting soon, with more details and descriptions.  In the meantime, please thank your colleagues who worked on this and "smell the roses."  The addition of the PhD in Rehabilitation Sciences is a remarkable and laudable accomplishment in our history.  Feel free to brag shamelessly for at least a couple of days or so!

Second Base: Diversity, Competence, Disparities

This is the second article in a series about  subjects which have been on the collective minds of the Office of the Provost, the leadership and Board, and the community at large:  active learning, diversity, interprofessionalism.   Thanks toDr. Lynn Foord for her contribution from last month regarding active learning.  I have chosen to steal back the blog for this edition and to focus on the issue of diversity and health disparities. Alex Johnson

The Institute is in need of diversity that reflects the perspectives of the communities we serve.  Diverse students and faculty bring their unique and relevant experience to the forefront of our minds.   From dealing with individuals whose experience is different than our own we learn to listen openly, we learn to think in a non-judgmental manner, and we learn empathy.     More important, we also learn to be understood and misunderstood and how to explain ideas, diagnoses, and recommendations in a manner that is respectful and helpful.   We learn to clarify and explain with an eye toward the needs of another person or group of people.

1.  A Diverse Community Builds a Narrative

When we speak about diversity, do certain images come to your mind?  When I hear the term “diversity” images of race and language jump into my consciousness.   I work to stretch to think of diversity to include every aspect of our community and the unique cultural, social, linguistic features that are associated with the experience of another person.    Thus, a “perfect Institute” would be open to people from various social strata.   We would have strong representation from those communities that are highly underrepresented in the professions of nursing, physical therapy, and speech-language pathology.   The male voice would be more present and visible among faculty and students.   We would continue to expand discussion and provide positive visibility for LGBT students.   We also would welcome and honor every religious and political persuasion.   But assuring balanced representation by these labeled categories does not lead to cultural competence; rather this balance is just the first step.   Assuring a very heterogeneous student body and faculty insures that a voice will be present to tell important cultural and social stories that are critical to the health of the community.

2. Professional Competence Always Includes Cultural Competence.

Cultural competence goes far beyond consideration of labels.  In fact, labeling itself develops a form of bias and judgment.  What will it take for us to think of each person as a potential-filled opportunity for health and success?    What will it take for us to see communities and cultural groups as opportunities for learning, exchange, and health?  In our own work at the Institute, we often use examples of skin color, accent, or attitude as examples of why we need to be culturally competent in our service delivery.    Can I assess the skin integrity of an individual with brown or black skin?  Can I assess the communication abilities of someone who uses English as a second language (or not at all)?    Do I understand the attitudes about health and family in people from another country than my own?    These represent some fundamental examples of thinking with competence about our clients/patients.   They underestimate, however, the depth and importance of the need.    These most obvious examples are trite and are overused.  By working with our patients to understand their social, cultural, language, or religious values and uniqueness, we can come to see the complexities of their illness or disability in a new light.   When we make appropriate decisions based on these complexities and realities, as well as the reality of the patient’s condition, then we are competent.    Cultural competence IS competence. 

3.  Health Care Disparities Need our Immediate Attention

And what about health disparities?   It is well known that certain groups and populations have received less comprehensive service than others in the health system.   Many of our faculty members, experienced health professionals, have worked in community health centers or urban hospitals where care is rationed quite differently than in more economically advantaged settings.   We know that our country has a huge population of underinsured individuals.    I recently spoke with a friend, who has been unemployed for some time.  She has been paying her own insurance rates for her family----over $800 per month.  For this, she receives comprehensive coverage with an annual $10,000 deductible.    So, if she spends $10,000 in total for prescriptions, office visits, hospital or emergency admissions then she can be reimbursed for her care.    On the other hand, most of us with “good” insurance are paying far less for insurance because our employer purchases our insurance.  We might pay $10-20 for a co-pay for our prescriptions and visits.  All major medical tests and procedures are covered.  This is the best example that I can think of for a disparity.    By virtue of where I work I am advantaged in my health care.   I (and most of you) don’t have to make the difficult decision to choose between care and other “luxuries.”   Disparities extend far beyond these economic situations.    We also know that providers make unconscious decisions based on race, gender, sexual identity, age, and so forth.   Disparity needs to be addressed at a personal (reduce the bias),  policy (create equal access to care), and advocacy (educating the public and those who govern) level.    Our students need the expertise (competence) to address these disparities at each of these levels.

In conclusion, diversity is desirable for the Institute because it advantages our thinking, our experience,  and our understanding of each other.    Cultural competence, one feature of excellent professional skill and knowledge, is a goal for everyone in the IHP community-faculty and students.   Awareness of disparity and the mechanisms that cause it are critical to effective delivery of health and rehabilitative services for the future.  We need to prepare leaders in reducing these disparities.  

First Base: Active Learning by Lynn Foord, PhD

Note:  This is the first in a series of follow-up comments to last month's blog (Looking for the Institute's Triple Play: Get your Eye On the Ball).  I asked our new Director of the Prerequisites Program, Dr. Lynne Foord, to give some thoughts about Active Learning and its role at the Institute.  Read on and you will  know a bit more about active learning and its importance as one of the many dimensions for teaching and learning at the IHP!  Alex Johnson, Provost

Lynn Foord, Ph.D.

Many instructors of late have begun to consider transitioning all or part of their class time to active learning . There are lots of interpretations of active learning; all value some means of putting the learner in charge of his/her learning. Unfortunately, some interpret this to mean that faculty then simply provide or refer to resources and step away. In actuality, the instructor never steps away, only steps into a role larger than that of repository of information (“Sage on the Stage”) to apply her/his expertise and experience to the design of learning experiences for the students (“Guide on the Side”).

What will transition to active learning mean in practice?

Richard Thornburg (1996) in Campfires in Cyperspace proposes that we can think of learning happening through a combination of four different environments. The Campfire is the one-way delivery of information from a respected sage. The Watering Hole refers to the informal peer discussions that happen outside of the Campfire (or classroom). The Cave refers to the time when we reflect about what we have learned. Life is, well, life—when we apply what we know in actual practice.

This model seems ideal for health professions education. We all know that our students need access to the essential foundational information found in texts and articles and at Campfires. Equally they need to be able to learn from interactions in the health care community with peers, patients, families. And throughout they need to be able to think critically about their options and choices to be able to apply their knowledge and skills in uncertain, complex clinical situations.

Innovation is at the core of the IHP Strategy Map. Innovators don’t start from scratch; rather, innovators look between the past, the present and the future and develop new ways to use familiar resources. So how can we use our current resources in designing learning experiences that will successfully prepare our students not only to perform well in their academic and clinical education, but to continue to learn and grow throughout their professional practice?

I keep coming back to Thornburg’s model. Our faculty bring expertise, knowledge and wisdom to their courses—we need to be sure that they are available for Campfires at the right time in each course.

But let’s not stop there—let’s free up the faculty to also allow them to create Watering Holes where they can share their expertise in learning activities in which students to engage actively with the material. Some obvious examples of Watering Holes are discussions, “think-pair-share” activities, role plays, debates, case analyses, and simulations.

Consider also how we can encourage our students to use Cave Time to critically reflect upon what they have learned and visualize what they can do with their knowledge and skills? At a recent symposium on teaching at Harvard, the speakers talked about “Flipping the Classroom” presenting a challenging, authentic problem to students for critical reflection. Class time then is constructed to do what used to be homework: to explore, examine, consider the problem in authentic ways (“how would you use this in the clinic?”)by interacting with other students, and with guidance from the instructor who shares his/her experience and expertise.

The transition to active learning involves doing what we are already doing—just differently. We are fortunate here to have resources as we make the transition: Instructional Designers, our Librarian; our colleagues who have taught in 2CC, in the simulation labs, in small groups and in large classes.

We are, after all, learners as well as instructors ourselves. If we practice active learning in all of Thornburg’s environments, we can bring those experiences as well as our clinical experiences, expertise, and judgment to our students.
_________________

Berret, D. (2012) How Flipping the Classroom can improve the traditional lecture.  The Chronicle of Higher Education http://chronicle.com/article/How-Flipping-the-Classroom/130857/ Accessed March 7, 2012Lambert, C. (2012) Twilight of the Lecture.  Harvard Magazine http://harvardmagazine.com/2012/03/twilight-of-the-lecture  Accessed March 7, 2012

Thornburg, D. (1996) Campfires in Cyberspace. San Carlos, CA. Starsong Publications.

 

Looking for the Institute's First Triple Play: Get Your Eye on the Ball!

The Boston Red Sox are in Florida for their spring training.  They are making preparations for the 100 year anniversary of their home,  Fenway Park.     While they are focusing on this important celebration, we all know that their “eye is on the ball.”  They are looking ahead to doing everything that they can to win the upcoming season.     Attention to the birthday event inspires and brings attention to their story.   Simultaneous attention to the coming baseball season is what it’s all about.  The history, the party, and the story of what has come before inspire the next step.   This history lifts up the season!

This Red Sox story is a model for where we, the MGH Institute of Health Professions, are headed.  This year, 2012, is the 35^th anniversary of the Institute!  During the fall term we will celebrate this important birthday for the IHP!   At the same time three important themes are emerging as being distinctive and important areas of focus for our future.    These include Interprofessional Activity and Competence, Inclusive Excellence and Multicultural Competence, and Active Learning as foundational to entry level education.      In the coming weeks, this blog will focus on each of these themes in more detail.   

Interprofessional Teaching and Learning: Interprofessionalism  has a long history at the Institute.   When our founders described the Institute in their original planning, it was this concept of health professionals working together that was at the forefront of their thinking.  As the Institute changed locations (four times?), grew in size from a few students to now almost 1200, and added and subtracted programs of study it was this interprofessional concept that has been central to the thinking.     In the 1970s and 1980s, there was not much national attention on health professional education and so the Institute was one of the few organizations with a deliberate commitment to the topic of interprofessional studies.    Today, we have a new Center for Interprofessional Studies and Innovation that will soon be the home for two new interprofessional academic degree programs and also for our prerequisite courses.  We have launched, with our partners at Mass General, a new interprofessional dedicated education unit, where a small number of our entry level students from all of our disciplines learn together and from each other.   We are beginning to plan for a new multidisciplinary community focused clinical model.   These “real world” opportunities are reinforced by the monthly Schwartz Rounds, the annual Interdisciplinary lecture,  common coursework in ethics, and our new “Changing Courses II” teaching fellowship.  

Inclusive Excellence and Multicultural Competence:    Inclusion of historically underrepresented groups  in the health disciplines and competence in delivering care to everyone continues to be a major national, local, and Institute theme.   Our disciplines continue to have broad underrepresentation by ethnic, racial, and linguistic minorities.   Health disparities are well documented in the way that the poor and certain minority groups benefit from the health system.   Issues of mistrust, under-and over-diagnosis of health problems,  low health literacy, and access based on social and economic status  continue to reduce quality and outcomes,  drive cost to an unaffordable level, and also to drive critically important moral and ethical questions.     The Institute’s Diversity Committee led by President Bellack,  has developed a model of inclusive excellence and a set of expectations regarding our progress in welcoming a diverse group of faculty members, students, and staff.    Equally important, the committee has  provided guidance regarding the competencies that are expected from every IHP graduate!     

Active Learning and Entry Level Education:  Development of critical thinking, problem-solving, case studies, critical observation, and reflection are well documented approaches to successful adult learning.    These active approaches need to be intertwined with sound theoretical, principled content knowledge.    In traditional graduate education, the approach has been to present the latter (content knowledge) first in lectures and readings, provide some critical reasoning tasks in exams and occasional discussions, and to leverage the more “active” components to practicum or other field experiences.    As we realize that the potential content for almost any of the content matter that we teach is limitless; that the old strategies for learning that focused on memorization and repetition do not produce sustained access to information; and regardless of what we teach today, the shelf life of content is quite short.     Our Committee on Teaching Excellence (CTE) has active learning on their agenda and continues to make information available to us that informs and drives our competence in this arena.    Our instructional support group in Instructional Design, Information Technology, and Library are working together to support our educational efforts.  Most notable, last month the Institute opened remarkable new space designed for active learning at 2 Constitution Center. 

So, these three key themes are in our focus for the coming years.  Our eyes are on the ball.   As we look to our 36^th year we need to perfect our ability to teach and learn together in an interprofessional context, while maintaining distinctive and excellent disciplinary knowledge.  We all need to be sure that every student feels welcomed, served, supported, inspired, and enhanced by his or her experience at the MGH Institute.   We need to also be certain that when an entry level student graduates from our programs that they know how to care for those who come from a variety of cultures and backgrounds, especially the poor or otherwise disadvantaged.   And we need to engage in ongoing discourse about how we will teach  using the best methods to improve learning and ultimately to impact practice.

Over the next several weeks, this blog will include a bit more in-depth information about each of these topics.   I am inviting some of our colleagues to write guest contributions on each of these topics.  My hope is that this work can provide an important framework that benefits your teaching and scholarship.

Keep your eye on the ball!