Emergency physicians are frequent providers of Indigenous health. Emerging evidence suggest implicit bias to be a contributor to health disparities affecting Indigenous Canadians. This presentation explores the impact of implicit bias as well as strategies to mitigate its adverse effects in the Emergency Department.
A big thank you to our former UBC Abbotsford-Mission Family Medicine resident, Dr. James Liu, for posting your presentation and sharing your work! And thank you to Dr. John Pawlovich for forwarding the link!
Who do you teach?
Anyone who will listen! I would teach my kids more but they’re adults now and are sometimes less inclined to listen…actually I have learned that it’s not much good to teach all the time. I do enjoy teaching residents, colleagues, and coworkers, and most of all I teach patients, all day, every day at work.
What inspired you to teach?
My profession has taught me a lot. I think, like most people who have a fair bit of experience, I have something to give. Teaching one patient can make a big difference to that person but teaching a resident could have generations of impact!
Who is one educator that had a significant impact on you? What did s/he do that was so effective?
My dad was a teacher. I think I caught his passion for teaching. Dr. Ed Korchinski was my favorite preceptor. Nothing phased him. He was always steady, wise, and supportive.
How do you establish and maintain a good working relationship with your resident?
Definitely the most important thing is to be interested in who they are. Respecting them should follow naturally. Of course you will uncover learning needs, but find out what their felt needs are, and address those.
What do you predict will be our biggest medical advancement in the year 3000?
I have no idea what that year will entail! But long before then, we will be treating conditions genetically. I’m pretty sure most traces of today’s medicine will be unrecognizable. Somehow patients will still need to be known and cared for; I don’t think you can have genuine movement toward health without that.
“The provision of care in alternative locations or after hours, and participation in on-call rota declined in BC from 2006 through 2012. The decline of care provided in patient homes and long-term care facilities is of particular concern given that an increasing proportion of the population will be moving into age groups where visits in these locations is important for quality primary care. It is also of note that these declines occurred in the context of substantial financial incentives.”
To be eligible for one of the medical student awards, please note that a nominator is required – this may be a family physician, fellow student or resident. Submissions for 2019 are due by July 31. Please use our online form to nominate.
Hope you are well! I know many of you are in the midst of preparing and practicing for your exams. The strategy I used to successfully tackle tests involved planning and distributing content over a series of months in digestible, bite-size chunks. I used my weekdays to introduce new content and my weekends for reviewing topics that week and the week before. At the end of the month, I addressed the gaps and questions that emerged.
These monthly calendars were posted on my refrigerator to remind me of what I needed to cover and to provide my family with a sense of my journey. Gold stars were put on the days that I achieved my goal and this helped me in visually tracking my progress.
Group study was particularly important as it gave my team the opportunity to discuss conflicts in information, rehearse our oral exam responses, test our knowledge, and share additional resources. Working in a team also provided a source of motivation and encouragement.
When I think about your content, such as the 99 topics, I might approach it like this:
Learning scientists refer to these strategies as spaced learning, microlearning, and spaced repetition and they’ve been fairly successful methods for medical students (see The New Way Doctors Learn). Research indicates that people retain information, score better on exams, and modify behaviour using spaced learning/repetition. For more on the concept, watch the 5-minute video below:
What we know about the brain is that it’s hardwired to forget. Spaced repetition, in conjunction with testing/active retrieval, appears to work best in addressing the cognitive, behavioural, and emotional components of learning. In addition, it helps in developing one’s situational awareness. The brain is poor at self-assessment and testing provides that external feedback mechanism that informs us of our gaps and strengths.
Regarding your material…The Review Course in Family Medicine recently updated their CCFP free study resources for the SOO and SAMP. You may also want to read the BCMJ’s Ready of Not for the CCFP Exam by Drs. Paul Dillon and Simon Moore. Listed below are resources they’ve identified:
Finally, consider using Honnold’s method for your exam preparation: surround yourself with the right people; practice, repeat, and test yourself until you’re comfortable with the material; mentally rehearse the experience; focus on what you need to do for success; find a confidence builder; work through your fear; and then on exam day release the stress and anxiety and immerse yourself in the experience.
You got this! If you need to talk, call me. I’m here for you. Always.
“What distinguishes pi from all other numbers is its connection to cycles. For those of us interested in the applications of mathematics to the real world, this makes pi indispensable. Whenever we think about rhythms—processes that repeat periodically, with a fixed tempo, like a pulsing heart or a planet orbiting the sun—we inevitably encounter pi.
….pi is intimately associated with waves, from the ebb and flow of the ocean’s tides to the electromagnetic waves that let us communicate wirelessly. At a deeper level, pi appears in both the statement of Heisenberg’s uncertainty principle and the Schrödinger wave equation, which capture the fundamental behavior of atoms and subatomic particles. In short, pi is woven into our descriptions of the innermost workings of the universe.” More on Why PI Matters by Steven Strogatz.
And to those who want to make pie to celebrate the occasion…check out the recipe above!
“On nights when I see my wife and daughter together, dancing across our living room floor, Beyoncé on the speaker and my baby leading the choreography, I’m almost brought to tears. It’s not that every small moment is now overflowing with emotion — I’m just more present while deciding on a board game to play or what takeout to order, less distracted, less focused on what’s happening tomorrow, or how dominant I am in a game of Uno.
I’ve given myself permission to feel it all, every single emotion. The good and bad alike. My own personal narrative has always been one of overcoming adversity and remaining strong for those around me. I still am, but I am also able to admit that sometimes I’m scared.” Trymaine Lee on My Life After a Heart Attach at 38 via The New York Times.
Eiko Ojala designs the most wonderful paper illustrations! His recent editorial illustration showcased above accompanied Lee’s NYT article. Eiko’s latest work focuses on the mind and body. You can view more of his brilliant creations here and here.
Visual communication is incredibly powerful and often a cathartic process for the illustrator. Dr. Mike Natter’s work in Progress Notes: Cancer (seen above) captures the tension and struggle he’s experiencing in delivering bad news. Patients are also increasingly using visual communication to explain their symptoms and diseases to their doctors. “Show, don’t tell: How visuals improve healthcare visits” describes how imagery is employed to describe and document the patient’s journey.
It was interesting to note in the article that EMR systems are expanding in their ability to include photographs and paper drawings (thanks to dermatologists and surgeons). Furthermore, OurNotes is an initiative recently launched “letting patients, caregivers, and providers jointly create clinical notes and care plans within the shared electronic health record.”
For those interested in using visual communication tools with their patients, drawMD is a free app that you can download and test!
“What we are seeing is that technology can be used to help patients be more autonomous and to improve their health in partnership with their clinical teams. These benefits can be achieved at home but also inside the hospital where patients have a great desire to directly manage their room environment and access to information that impacts their medical care.”
Chris Longhurst, MD, Chief Information Officer and Associate Chief Medical Officer at UC San Diego Health