Finding Flow

“Be like water making its way through cracks. Do not be assertive, but adjust to the object, and you shall find a way around or through it. If nothing within you stays rigid, outward things will disclose themselves.” ~ Bruce Lee

Greetings and hope you are well!

Many of you are just completing your first month of residency and over the past few years some have described the experience to me as drowning, overwhelming, isolating, and stressful. On the whole, these rotations are intensive, brief learning submersions where one is dipped in a culture and way of practice that can often feel foreign and unknown. These “sink or swim” experiences are limited and before a resident can really grasp and acclimate to the learning context they’re moved on to the next rotation.

So, I want to encourage you to check out Martin et al. (2017) Exploring the Experience of Residents During the First Six Months of Family Medicine Residency Training. The article highlights key changes in the transition from medical student to resident and may help in articulating and pinpointing the stress. For example, as one resident from the study explains, “There is an underlying concern that the patient is going to die if I don’t get the diagnosis right.”

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The program’s expectations around knowledge base, practice management, and ability to form and nurture patient relationships have jumped a massive notch. The article offers ideas about acclimating to this new role and building confidence in your environment.

Another read you may want to check out is Flow: The Psychology of Optimal Experience by Mihaly Csikszentmihalyi. I ordered this book for our Preceptors and I believe it currently sits in our Site Library Office so ask Ann for the copy 🙂. I’m particularly fond of this quote:

“Contrary to what we usually believe, moments like these, the best moments in our lives, are not the passive, receptive, relaxing times—although such experiences can also be enjoyable, if we have worked hard to attain them. The best moments usually occur when a person’s body or mind is stretched to its limits in a voluntary effort to accomplish something difficult and worthwhile. Optimal experience is thus something that we make happen. For a child, it could be placing with trembling fingers the last block on a tower she has built, higher than any she has built so far; for a swimmer, it could be trying to beat his own record; for a violinist, mastering an intricate musical passage. For each person there are thousands of opportunities, challenges to expand ourselves.”
~ Mihaly Csikszentmihalyi

These rotations, if framed as opportunities, have the potential to expand oneself and to further develop the intrinsic reward system that pushes us past the reluctancy, resistance, and stress of learning something new.

Warmly,

Jacqueline

#WeAreInThisTogether #DesigningTheOptimalExperience #ChangingTheContentsOfConsciousness

Resources:

Martin D, Nasmith L, Takahashi S, Harvey B. Exploring the experience of residents during the first six months of family medicine residency training. Canadian Medical Education Journal 2017; 8(1): 22-36.

The Other Side of Being First

“The day I received my medical degree, it was a watershed day of my life. A day to celebrate the achievements of those in our graduating class and a day to start examining the failures of the country in which we had done it.” ~ Dr. Nadine Caron

“Dr. Nadine Caron is the first female Indigenous graduate of the University of British Columbia’s School of Medicine, and the first female Indigenous general surgeon in Canada. Nadine asks us the question, is being the first always good. Recorded at TEDxUNBC in Prince George, BC. Dr. Caron asks us to look at the implications of what it means to be the first person to achieve something.”

Learn more from Dr. Caron on The Other Side of ‘Being First’ via UBC Faculty of Medicine’s Centre for Excellence in Indigenous Health.

#UBCSchoolOfMedicine #DrNadineCaron #TheSilenceOfBeingFirst

Prioritizing Well-Being

NicolaSturgeon_2019T-embed.jpg“You know, what we choose to measure as a country matters. It really matters, because it drives political focus, it drives public activity. And against that context, I think the limitations of GDP as a measurement of a country’s success are all too obvious. You know, GDP measures the output of all of our work, but it says nothing about the nature of that work, about whether that work is worthwhile or fulfilling. It puts a value, for example, on illegal drug consumption, but not on unpaid care. It values activity in the short term that boosts the economy, even if that activity is hugely damaging to the sustainability of our planet in the longer term.
….
I started with Adam Smith and ‘The Wealth of Nations.’ In Adam Smith’s earlier work, ‘The Theory of Moral Sentiments,’ which I think is just as important, he made the observation that the value of any government is judged in proportion to the extent that it makes its people happy. I think that is a good founding principle for any group of countries focused on promoting well-being. None of us have all of the answers, not even Scotland, the birthplace of Adam Smith. But in the world we live in today, with growing divides and inequalities, with disaffection and alienation, it is more important than ever that we ask and find the answers to those questions and promote a vision of society that has well-being, not just wealth, at its very heart.”

~ Nicola Sturgeon at TEDSummit 2019 on Why Governments Should Prioritize Well-Being
#TheWealthOfNations #Wellbeing #NicolaSturgeon #Scotland

Leadership & Technical Expertise

“First, when we teach people about leadership, we need to be more explicit that domain expertise matters. Just because a person is successful at running one kind of organization does not mean that they are likely to have the same degree of success running an organization with a different mission. Second, when we train people to take on leadership roles, we need to give them practice solving domain-specific problems so that they can prepare to integrate information in the arena in which they are being asked to lead. For example, it isn’t enough just to teach people about how to resolve generic conflicts between employees, we should create scenarios derived from real cases so that people have to grapple with all of the ambiguities that come from the conflicts that arise within particular industries.”

More on Can You Be a Great Leader Without Technical Expertise? (2017) by Dr. Art Markman via Harvard Business Review.

#Leadership #Medicine #HBR #ArtMarkman

Qui Dat Videre Dat Vivere

Arabella Steinbacher & Akiko Suwanai – J. S. Bach : Concerto for Two Violins

“During the last year of his life, Bach’s vision became so poor that he decided, after persuasion by his friends, to have his eyes operated on. Two operations were performed in 1750 by the traveling English ophthalmiater ‘Chevalier’ John Taylor (1703 or 1708-1772), who happened to be in Leipzig.

Taylor had completed a surgical training in England; he also attended lectures by Hermann Boerhaave in the Netherlands and learned the art of couching from Jean Louis Petit in France. After his training, Taylor started practicing in Switzerland, where he blinded hundreds of patients, he once confessed. During his working life, he spent most of his time traveling around in a coach painted all over with eyes and the words qui dat videre dat vivere (giving sight is giving life). His travels took him over the greater part of Europe and beyond, to Russia and Persia, where even kings and emperors were among his patients. More than once he was robbed and almost killed during his travels. Taylor knew a lot about ophthalmology and left scientific articles in several languages. He was the first to describe keratoconus, which he also illustrated in a recognizable way. In the surgical approach to strabismus by means of cutting an eye muscle, he was ahead of his time. This made Taylor a rare combination of a man of serious science and a charlatan in daily practice.”

More on The Eyes of Johann Sebastian Bach (2005) by Dr. Richard Zegers via JAMA Ophthalmology.

#ClassicMonday #JohannSebastianBach #JohnTaylor #Myopia

Partnering with Patients

authentic engagement.jpegBC Patient Safety & Quality Council published “How to Partner with Patients Authentically” to encourage patient engagement and collaboration among physicians, patients, family members, and caregivers.

“The guide covers the essentials of authentic patient engagement, including key concepts around why it’s important to involve patients and how doing so improves the patient experience. You’ll learn how to connect with the right patient partners, involve them directly in quality improvement processes and engage with them authentically. The guide also explores concerns such as overcoming challenges in patient engagement and avoiding tokenism.” Download here.

(Thank you for sharing Dr. Christie Newton!)

#PatientSafety #PartnerWithPatients

CHES: Articles of Interest on Medical Education

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CHES recently distributed a collection of medical education article abstracts to members! “We thank Dr. Gisèle Bourgeois-Law who has created these summaries for the education community at the Island Medical Program. While these articles have a medical education focus, we are using this opportunity to explore the value of such an initiative to our larger CHES community. Article themes include topics such as: feedback and mindfulness, those by local/BC educators, those relevant to a distributed medical program, and those with new ideas. Our aim is to include a variety of quantitative and qualitative research articles, review articles, and concept articles, some of which contain an interesting editorial or commentary. This summary is not meant to be comprehensive, nor to include everything of potential interest.

If you would like to nominate an article for future inclusion or have any questions, please email us at ches.communications@ubc.ca.”

#UBC #CHES #MedicalEducation #July2019

AMEE Webinar

The next International Association for Medical Education (AMEE) webinar is coming up!

This free webinar forms part of a guest blog by Professor Stewart Mennin on the topic ‘Tame your Wicked Issues in medical education: What has you stuck? How to get unstuck with Adaptive Action’  Tuesday 30 July 2019 at 14:00 (2pm) BST/UK. 

As of 2019, the AMEE webinar series will be entirely free and you can access the webinars by joining here when it begins.

Due to limited space it is advisable to join on time as AMEE cannot guarantee entry to webinars.

For further information regarding AMEE’s webinars please email mededworld@dundee.ac.uk