#27 Pearls from the Alliance of Academic Internal Medicine AIMW23: Escape Rooms, Racism in MedEd, Coaching, & More

April 21, 2023 | By Era Kryzhanovskaya

Audio

Download the Transcript

Part 2 with Drs. Josh Onyango and Noble Maleque

We get to sit down in person with Drs. Josh Onyango and Noble Maleque to share our favorite pearls from the AIMW23 conference in Austin, Texas. We discuss Dr. Utibe Essien’s Plenary on race in medicine, escape rooms in medical education, the role of coaching, how to support learners who take leave, and how to use podcasts in your teaching. Even if you didn’t get to attend this year’s Alliance for Academic Internal Medicine #AIMW23, you’ll get to share in the wisdom!

Claim free CME for this episode at curbsiders.vcuhealth.org!

Website | Instagram | Twitter | Subscribe | Patreon| thecurbsidersteach@gmail.com | Free CME!

Show Segments

• Intro, disclaimer
• Dr. Onyango one-liner 
• Takeaways from Dr. Utibe Essien’s plenary
• Dr. Maleque one-liner
• Escape Room for clinical reasoning
• Juggling Hats workshop
• Supporting residents who take leave
• Podcast integration into medical education 
• Pearls for being at AIMW23
• Take home points
• Outro

Alliance for Academic Internal Medicine, Academic Internal Medicine Week 2023 (AIMW23) Pearls Show Notes

A Opening Plenary: History has its Eyes on You: Race and Justice in Academic Medicine  

Presented by Dr. Utibe Essien

Our guest, Dr. Onyango, notes that while we commonly discuss racism’s impact on clinical outcomes, we often forget the role of discrimination in medical education – whether in recruitment, retention, and the content learners are regularly exposed to. This plenary was a call to action on what we can do to make education spaces more equitable. Race and discrimination are complex, systemic issues, and individuals often feel overwhelmed with what can be done to enact change. Drawing on Dr. Essien’s description of the leaky pipe theory which drives the loss of diverse members from our medical (education) community at different levels (application to medical school, graduation from residency, acceptance to fellowship, etc.), we can consider on the individual level what we’re doing to “patch up” that leaky pipe and attempt to address racism. Where are the diverse candidates “leaking out” of our academic medical space? What can I do to retain some of these individuals? What can my institution do to support these candidates? 

See our upcoming episode with Dr. Utibe Essien in which we discuss networking in medical education and also dive more into his plenary on race in medicine.

Operation Diagnosis: Applying Virtual Escape Room Construct to Clinical Reasoning Education 

Presented by Drs. Sharp, Cox, and colleagues

Our second guest, Dr. Maleque, guides us through his take home points on the power of gamification (taking educational content and introducing a gaming element) as it applies to teaching and assessing clinical reasoning. 

Tips on how to use an escape room to think about clinical reasoning:

1. Select a clinical case.
   1. Identify what type of question is being asked. Diagnostic reasoning question? Management reasoning question? Or both? 
   2. Who are the learners – undergraduate or graduate medical education trainees? 
   3. Consider your educational elements – how much time is there for delivery, what is the complexity of the case, are you covering new material or reinforcing known content?
2. Create the virtual room or puzzle box (think about the movie, Glass Onion).  Divide the content into the context (“the story” or discovery points like the history, vital signs, physical exam, and laboratory data) and the teaching points (the “puzzle building blocks” or the differential diagnosis, therapeutic interventions, and interpretation of the laboratory tests).  
3. Create an “escape” or end of the case section.  The team led by Drs. Sharp and Cox recommend using multiple parts that must come together for this “escape” ending. 

Dr. Maleque considers applying the escape room model or gamification to teaching situations like reviewing cost conscious care or working through an undifferentiated clinical problem.  For example, in a case of chest pain, where there may be many possible diagnoses, learners could work through a puzzle that shares likelihood ratios about historical clues (i.e. exam findings and/or laboratory data) to get to a diagnosis of pulmonary embolism. The Escape Room idea can also be reframed as a team-building event where trainees can learn together in a safe space while attendings observe how learners think, react, and work through clinical problems. Escape rooms also offer the opportunity for individuals to show their work as well as identify what their growth edges are. 

Juggling Hats: How to Rock Every Role You Play as a Medical Educator

Presented by Drs. Mann and Fainstad

A medical educator wears a lot of hats including evaluator, teacher, friend, mentor, and/or coach. It is important to recognize which hat you are wearing when speaking to an individual in order to appropriately and effectively help them. Organized by two certified coaches, this workshop placed a lot of emphasis on the role of medical educator as a coach.  

Coaching requires that you guide the individual to utilize or find their own wisdom. Instead of sharing pearls or filling gaps, you as the coach are on the journey with the individual directing them on their already chosen path. To separate coaching from mentoring, Dr. Onyango compares coaching to motivational interviewing in which the coach helps the learner set goals and establish the path they want to take to achieve those goals. Traditionally, physicians are trained to tell people what to do and how to do it. This practice does not work well in a coaching situation and may deprive the learner of the benefits of going through the process themselves. It is important that both the coach and coachee understand the expectations of the coaching relationship. 

Coaching has taken medical education by storm. Recent literature quoted in the workshop suggests that coaching leads to increased trainee success, decreased burnout, decreased imposter syndrome, increased quality of life, and greater access to mental health resources (Dyrbye 2019, Palamara 2018, Fainstad 2022).

When life gets in the way: helping support residents who need to take leave during residency

Presented by Drs. Borgatta, Hartz, Weigel, and White

This very practical session, geared toward chief residents, highlighted the importance of being familiar with your institutional policies about leave, sick time, parental leave, and FMLA to ensure learners get the time and support they need during personal life events. This session highlighted similar points made during our Curbsiders Season 2 episode with Dr. Lisa Meeks around supporting learners with disabilities. It is important we shift our medical culture to support trainees who may need time off and advocate for a system that supports all learners in the health professions.

(Ear)Budding Potential: integrating podcasts into medical education

Presented by Drs. Kryzhanovskaya, Heublein, Onyango, Gielissen 

The duo from Curbsiders Teach teamed up with the Yale crew behind Primary Care Pearls Podcast (Drs. Onyango and Gielissen) to share the power of podcasts and digital tools for medical education along with innovative ways to integrate them into teaching. One way to use a medical podcast for teaching includes using a flipped classroom model. The presenters recommended having learners either listen to a podcast before a session, hear a podcast and then follow up with a written reflective exercise, and/or use a jigsaw approach where learners may listen to the same podcast but different excerpts or have different primers prior to listening to the excerpt. After the learners listen to the podcast, they can come back together to share pearls in a large group setting. 

Obstacles to integrating medical podcasts into educational content include the preparation required by both the educator and learners for a flipped classroom setting. Another challenge is the use of podcasts by educators who are not as familiar with this medium. Co-learning and co-creation of the instructional content with the learners who are consuming the digital medical education (bi-directional learning; near-peer teaching) can help. 

Links

1. Primary Care Pearls Podcast a Yale Internal Medicine podcast showcasing patient voices when discussing clinical topics.  New season coming 2023!

Goal

Listeners will be served delicious knowledge food from #AIMW23.

Learning objectives

After listening to this episode listeners will…

1. Review key academic internal medicine (AIMW23) practice-changing pearls.
2. Receive updates on medical education and pearls for clinician educator careers.

Disclosures

Drs. Maleque and Onyango report no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

Onyango J, Maleque N, Heublein M, Kryzhanovskaya E. “#27 Highlights and Pearls from the Alliance of Academic Internal Medicine AIMW23, part 2: Escape Rooms, Racism in MedEd, Coaching, & More” The Curbsiders Teach Podcast. https://thecurbsiders.com/teach. April 21, 2023.