Family Medicine Residency Site: Abbotsford-Mission

“Over the last half century, Systems Theory has spread across disciplines, from psychology to engineering. By the 1980s and ’90s management science began to apply Systems Theory broadly. Application of this theory rests on the assumption that most individuals strive to do good work, but that they are acted upon by diverse influences, and that functional and efficient systems not only account for, but also embrace, these influences. Causal Analysis based on Systems Theory asserts that when errors occur, one ought not focus solely on individual failings, but on the surroundings that allowed such events to transpire. It further asserts that outcomes can be influenced by smart interventions, developed after studying common patterns and behaviors across time.”

Dr. Brett Anderson on Improving Healthcare by Embracing Systems Theory.

Anderson, B. (2016). Improving healthcare by embracing systems theory. The Journal of Thoracic and Cardiovascular Surgery, 152(2). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4947551/

The HoloBrain is an interactive, augmented reality app that helps students understand the architecture of the brain. Since this video was released, Dr. Krebs has tested the app on students to determine its impact on learning. Here are the results! Also, they’ve taken this platform to launch Holobrain in Webvr that “aims at delivering a similar experience to a wider audience. Using a web app we are able to network more HoloBrains to each other, in the hopes of eventually making this a tool used to teach large classes. The tools used in this project are AFrame for building a VR experience using just Javascript and HTML, and Blender and Amira for segmentation of MRI scans and production of the 3D models.”

It’s interesting because over the course of the past few months that I’ve been researching the medical/clinical learning setting, it’s virtual, augmented, and mixed reality learning environments that elicit student responses such as “This is fun! This is cool!” (see The APPLE Project, p. 606, of Creating Innovative Models of Clinical Nursing Education). Also, I’ve noted that “the fun” translates to greater engagement, collaboration, and integration of information. It’s fantastic that there are medical/clinical educators and administrators willing to challenge the antiquated content delivery process that academia has used for decades.

It’s also about time we change it up and recognize that fun and play are essential to learning…even in college! Play encourages risk and failure and that safe space allows learners to challenge themselves. Many of these platforms also provide instantaneous, constructive, and specific feedback on performance as opposed to “Read more around…”

We grow from being attended to and nurtured. If alternative methods to learning support this then we should consider how to best incorporate these technologies to supplement our medical and clinical education models.

For more on the Holobrain and Dr. Claudia Krebs work, click here.

Warm regards,

Jacqueline

Congratulations to all those that received the Certificate of Merit Award by the Canadian Association for Medical Education (CAME)! The award recognizes and rewards faculty members who are committed to medical education in 17 medical schools across Canada. A special congratulations to our UBC Department of Family Practice physicians Drs. Maria Hubinette and Beth Watt for your leadership and dedication to excellence! More here!

We are excited to announce that a date has been set for Okanagan Orchards 2019! Join us at the fabulous Hotel Eldorado on the edge of Lake Okanagan for this Faculty Development and Appreciation Event!

This Faculty Development event is open to all preceptors and faculty from across the province! We will have a half day of workshops, followed by some options for outdoor activities in the afternoon (wine touring, cycling, paddle boarding, etc), and will wrap up with an Appreciation Dinner in the evening. It’s a great opportunity for some networking and support, and we have a lot of fun too!

A $250 travel reimbursement will be available to eligible preceptors from out-of-town. There are a set number of guest rooms held at Hotel Eldorado in Kelowna, so booking early is recommended.

Please contact me directly for more information, and we will send further details, including a registration link, as they are confirmed. Feel free to share this with colleagues at your site.

We look forward to seeing you in June!

Greetings! This month’s Journal Club is a debate on Opioid Standards. Please take some time over the next couple of weeks to prepare your team and arguments. Please make your final team member selections by January 14th. See the following documents as reference:

• Safe Prescribing of Opioids and Sedatives FAQs via College of Physicians & Surgeons of British Columbia
• Will the new opioid guidelines harm more people than they help? Yes (via Romayne Gallagher and Lydia Hatcher)
• Will the new opioid guidelines harm more people than they help? No (via Nav Persaud)

Format will be as follows:

• Opening statement: 10 minutes
• Confer with team: 10 minutes
• Rebuttal: 5 minutes
• Confer with team: 5 minutes
• Closing statement: 5 minutes
• Judges: Include faculty and clinical staff. We will debate for 5 minutes to determine the winner.
• Total time: 70 minutes

Traditionally, we like to include a few additional challenges and opportunities to score extra points. Scoring will be as follows:

• Winning opening statement: 10 points
• Debating while standing on a BOSU (What is a BOSU?):
  • 1 point / minute (soft side)
  • 2 points / minute (flat side)
  • If you do it on one leg, the points will double
  • 5 points / minute if you can handstand it!
• Winning rebuttal: 10 points
• Winning closing: 10 points
• Overall winner: 20 points
• Teammate not showing up (without a reason): MINUS 10 points
• Teammate late (without a reason or with no text to Dr. Liu explaining why): MINUS 5 points
• Going overtime (each 30 second block): MINUS 1 point

WINNING TEAM receives:
A dessert with their team name emblazoned on it at the next Journal Club or I’ll make you homemade ice cream and you can design the flavour! Your choice!

A big thank you to Dr. Liu for creating such an engaging and interactive Journal Club session!

Good luck!

Warm regards,

Jacqueline

“If patients are going to Google their condition anyways, shouldn’t they have access to the same quality information that doctor’s have?”

Dr. Lina Colucci on The Secret “Google” Used by Doctors and Unknown to Patients.

For those interested in perusing some of the medical references, apps, and learning materials used by our Residents, please visit Resources & Recommended Readings.

More on this important topic:

• Finding reliable health information online via John Hopkins Medicine.
• Quality of patient health information on the Internet: Reviewing a complex and evolving landscape via Australasian Medical Journal.
• The quality of health information on the internet via BMJ.
• Defining information quality into health websites: A conceptual framework of health website information quality for educated young adults via JMIR.
• Google aims to stop terrifying you with its responses when you search medical symptoms via Washington Post.

Residents! This topic would make for a great PIP or Scholar project!

Warm regards,

Jacqueline

“Because when we create — whether it be a podcast, blog, vlog, side business, book, or whatever — we regain our autonomy. Regaining autonomy is something we all are craving in today’s confusing healthcare landscape. This allows us to connect, collaborate, contextualize, and amplify at scale.”

Dr. Neel Desai on How Do We Prevent ‘Burnout’? Create! via The Happy Doc Podcast (Thank you to our Dr. Brenda Hardie, UBC Clinical Assistant Professor & Faculty Development Lead, for the forward! Love it!)

Just going to add a little jam to it now…

Peace,

Jacqueline

“The soul of medicine is seen in the clinical encounter with the patient who, having become ill, presents to the physician asking for help and where the physician responds, using all of the skills and knowledge she has accumulated, in attending that patient within a context of ethical relationship, equality and mutual trust.”

Miles, A., Elliott, J., Caballero, F. (2015). Towards a person-centered medical education: challenges and imperatives. Educacion Medica, 16(1).

“In health we saw a shift from traditional doctor-centric to managed care and evidence based medicine. Realizing that only 20% of health depends on health care services, while 60% depends on social, environmental and behavioral factors, major health system innovators like Kaiser Permanente have begun to refocus from pathogenesis (focusing on the 20%) to salutogenesis (to also focus on the 60%) by strengthening the sources of health and well-being in communities. As the mainstream health organizations have been moving into 2.0 (evidence-, standards-, and science-centric), we have seen the more innovative health care providers shift to organize around the actual patient journey (3.0). While that patient-centric way of delivering health care services is moving more mainstream, we see yet another frontier of health innovation at the horizon: a system that strengthens the sources of well-being both individually and collectively (4.0).”

~ MIT Senior Lecturer Otto Scharmer on the future of health via 4.0 Lab: Inventing the Future of Food, Finance, Health, Ed, & Management

For those interested in learning more about the salutogenic model:

• The Application of Salutogenesis in Hospitals.
• Keeping Doctors Healthy: A Salutogenic Perspective.
• The Salutogenic Model of Health in Health Promotion Research.
• The Relevance of Positive Approaches to Health for Patient-Centered Care Medicine.
• Salutogenesis: The Defining Concept for a New Healthcare System.

What will Health 4.0, 5.0, and 6.0 look like in British Columbia? How can we utilize technology to support the 60% (social, environmental, and behavioural factors)? How can our medical education system prepare learners to contribute to the design and implementation of the models that they will work and live in?

Off the top of my head, it would be interesting to install a university-community health liaison office that bridges the social and intellectual capital in both spheres and initiates partnerships to specifically address the vitality, health, and wellness of our shared ecology.

Warm Regards and Happy New Year!

Jacqueline

#salutogenesis #medicaleducation #universitycommunityhealthpartnership #sharedecology

From our team to yours,
We wish you a Healthy and Happy New Year!