WEBVTT

1 "Mulla, Zuber" (1314477312)
00:00:46.890 --> 00:00:51.600
Good afternoon. I'm Zubair mala with the office of faculty development.

2 "Mulla, Zuber" (1314477312)
00:00:51.600 --> 00:00:54.630
Welcome to our need to know in undergraduate.

3 "Mulla, Zuber" (1314477312)
00:00:54.630 --> 00:01:01.050
Medical Education series, it's my pleasure to introduce today's esteemed speakers.

4 "Mulla, Zuber" (1314477312)
00:01:01.050 --> 00:01:06.300
Doctors Richard Brower Rebecca Rebecca compass and Kurt far.

5 "Mulla, Zuber" (1314477312)
00:01:07.350 --> 00:01:12.720
Dr, El Paso vice president for academic affairs.

6 "Mulla, Zuber" (1314477312)
00:01:12.720 --> 00:01:15.870
And he's associate professor of neurology.

7 "Mulla, Zuber" (1314477312)
00:01:17.040 --> 00:01:21.810
Dr, accomplish is a system professor of medical education and our foster school of medicine.

8 "Mulla, Zuber" (1314477312)
00:01:21.810 --> 00:01:25.950
She is a family physician and director of the medical skills. Course.

9 "Mulla, Zuber" (1314477312)
00:01:25.950 --> 00:01:37.020
And Dr far is professor of medical education and specialized in cell and molecular biology here at the foster of school of medicine. He also serves as a college mentor.

10 "Mulla, Zuber" (1314477312)
00:01:37.020 --> 00:01:43.290
Before we get started, I wanted to bring your attention to the and see any disclosures.

11 "Mulla, Zuber" (1314477312)
00:01:43.290 --> 00:01:51.270
That are displayed here, turn credit. Excuse me? You have to be present for at least 75% of this session.

12 "Mulla, Zuber" (1314477312)
00:01:51.270 --> 00:01:55.710
And to earn the nursing credit, you must attend the entire.

13 "Mulla, Zuber" (1314477312)
00:01:55.710 --> 00:01:59.910
Session 1. welcome to our 3 presenters. The floor is yours.

14 "Mulla, Zuber" (1314477312)
00:02:00.930 --> 00:02:04.110
Hello.

15 "Brower, Richard" (3902980608)
00:02:04.110 --> 00:02:17.820
Thank you, I guess since I'm presenting the 1st few slides, I'll just mention that these are our objectives for the session and I'll start with the the 1st, 1 of these. So, next slide.

16 "Brower, Richard" (3902980608)
00:02:17.820 --> 00:02:31.020
So, I'm going to discuss the background of the foster school of medicine and look at some of the program data. Um, that I hope will inform a, a discussion about.

17 "Brower, Richard" (3902980608)
00:02:31.020 --> 00:02:40.380
How we can, uh, develop and maintain a positive learning environment, uh, here at the foster school of medicine. So, next slide.

18 "Brower, Richard" (3902980608)
00:02:41.400 --> 00:02:47.730
So, by way of background, um, the foster school of medicine was among this, uh.

19 "Brower, Richard" (3902980608)
00:02:48.145 --> 00:03:02.545
Group of 6, new me accredited medical schools. Um, back in that era from 2000 to 2008. basically the 1st, cluster of new schools to open since, uh, 9,982. open since uh nine thousand nine hundred and eighty two

20 "Brower, Richard" (3902980608)
00:03:03.355 --> 00:03:15.835
In the background, there is important, because in the late twentieth century, there was a lot of, uh, smoldering dissatisfaction with the healthcare system and with medical education, uh,

21 "Brower, Richard" (3902980608)
00:03:15.865 --> 00:03:21.535
resulting in major policy reports both in the UK.

22 "Brower, Richard" (3902980608)
00:03:21.810 --> 00:03:34.645
And in the United States, through the National Academy of medicine, uh, and some major publications regarding, um, the status of both the health care system in the United States and medical education,

23 "Brower, Richard" (3902980608)
00:03:35.035 --> 00:03:41.005
and then within the medical education community, there was an increasing awareness of, um.

24 "Brower, Richard" (3902980608)
00:03:41.550 --> 00:03:45.180
Issues with with content bloat.

25 "Brower, Richard" (3902980608)
00:03:45.180 --> 00:03:58.435
Cast of curriculum based and old pedagogical models, a lack of content addressing the healthcare disparities and social determinants of health and, uh,

26 "Brower, Richard" (3902980608)
00:03:58.465 --> 00:04:02.335
the social mission of medicine and health care in general.

27 "Brower, Richard" (3902980608)
00:04:03.145 --> 00:04:06.415
And there were some early movements, uh,

28 "Brower, Richard" (3902980608)
00:04:06.415 --> 00:04:20.995
in the 80 s and 90 s with curricular change and accreditation reform that informed the development of new schools and led to essentially a whole bunch of new schools, uh,

29 "Brower, Richard" (3902980608)
00:04:21.025 --> 00:04:22.585
since the 1st, 6.

30 "Brower, Richard" (3902980608)
00:04:22.670 --> 00:04:35.955
That I mentioned 24 additional schools, all trying to try to jump ahead of this curve kind of address the issues that were brought up by the policy reports in the, in the late twentieth century, um, around 2000.

31 "Brower, Richard" (3902980608)
00:04:35.955 --> 00:04:42.645
uh, and then also try to address the pedagogical and content. and content

32 "Brower, Richard" (3902980608)
00:04:43.055 --> 00:04:57.725
Uh, management issues and medical education and and that's really where, um, we were at the beginning days, formulating the curriculum for the Paulo foster school of medicine. Uh, so onto the next slide.

33 "Brower, Richard" (3902980608)
00:05:00.029 --> 00:05:09.564
So, in that process of trying to move ahead to more active and integrated forms of instruction,

34 "Brower, Richard" (3902980608)
00:05:10.674 --> 00:05:19.944
the Paulo foster school of medicine and adapted a clinical presentation based undergraduate, medical education curriculum, this was originally developed at the University.

35 "Brower, Richard" (3902980608)
00:05:20.684 --> 00:05:23.744
Calgary, you can read the information there.

36 "Brower, Richard" (3902980608)
00:05:24.043 --> 00:05:35.714
Um, but it was, uh, um, and then attempt to develop essentially a systems based model around, which you could, uh, wrap.

37 "Brower, Richard" (3902980608)
00:05:37.464 --> 00:05:50.004
Or contemporary approaches to education and address some of the content integration issues that were broadly affecting medical education, uh,

38 "Brower, Richard" (3902980608)
00:05:50.034 --> 00:05:55.944
for those of you who are relatively new to the institution by way of kind of historical background. This idea was.

39 "Brower, Richard" (3902980608)
00:05:56.029 --> 00:06:00.839
This curriculum was brought to the campus by Robert.

40 "Brower, Richard" (3902980608)
00:06:01.254 --> 00:06:10.854
Uh, and, uh, supported by Dave steel and Brian Tobin kind of the 3 horsemen of the curriculum presentation curriculum here back in the day.

41 "Brower, Richard" (3902980608)
00:06:11.274 --> 00:06:20.814
Uh, also, 1 of the initial founders of the clinical presentation based curriculum in Calgary. Dr Mandan served as a consultant during those early.

42 "Brower, Richard" (3902980608)
00:06:20.839 --> 00:06:25.229
The days, um, so on to the next slide.

43 "Brower, Richard" (3902980608)
00:06:26.759 --> 00:06:37.109
So, the underlying theories of that curriculum, and these same ideas that we were attempting to incorporate into the development of the foster curriculum.

44 "Brower, Richard" (3902980608)
00:06:37.109 --> 00:06:41.819
Were these ideas that, you know, if you're going to, if you're going to develop.

45 "Brower, Richard" (3902980608)
00:06:41.819 --> 00:06:53.814
Um, experts in diagnostic reasoning, you need to start teaching them early that that expertise is very much domain specific and if you make it opaque and dress it up as, uh,

46 "Brower, Richard" (3902980608)
00:06:53.814 --> 00:07:01.794
Here's a bunch of basic science and we're gonna give you an opaque, essentially, opaque method like, uh, differential traditional differential diagnosis.

47 "Brower, Richard" (3902980608)
00:07:01.819 --> 00:07:09.929
This is you basically squelched that learner engagement in in early diagnostic reasoning. Um.

48 "Brower, Richard" (3902980608)
00:07:09.929 --> 00:07:22.829
It also, uh, by going to a clinical presentation model, uh, it allowed us to address the complications that you get into with trying to teach all diseases.

49 "Brower, Richard" (3902980608)
00:07:23.664 --> 00:07:34.794
Systematically or, uh, you know, all biomedical science knowledge, and then have to rearrange it around clinical problems.

50 "Brower, Richard" (3902980608)
00:07:35.454 --> 00:07:42.414
The idea was was basically to integrate diagnostic reasoning around the.

51 "Brower, Richard" (3902980608)
00:07:42.829 --> 00:07:53.609
Ways and people way in which patients, uh, present with illness as the basis for organizing CIS, integrated systems based content um.

52 "Brower, Richard" (3902980608)
00:07:54.054 --> 00:07:55.314
Go on to the next slide.

53 "Brower, Richard" (3902980608)
00:07:57.714 --> 00:08:11.604
So, in a nutshell, and I'm going over essentially a lot of information very quickly, because we want to get to the data and talk about where we are with the learning environment. Um.

54 "Brower, Richard" (3902980608)
00:08:11.909 --> 00:08:22.794
What we were attempting to do was to settle into our curriculum, build into our curriculum, this idea of learning medical students,

55 "Brower, Richard" (3902980608)
00:08:22.794 --> 00:08:31.344
learning scientific knowledge in the context of its intended application and diagnostic reasoning to provide that.

56 "Brower, Richard" (3902980608)
00:08:31.909 --> 00:08:34.784
Instruction in an integrated way, uh,

57 "Brower, Richard" (3902980608)
00:08:34.814 --> 00:08:47.594
wrapped around common clinical presentations that allows us to link this basic science content with the diagnostic content with basic clinical skills doctoring skills and also, uh,

58 "Brower, Richard" (3902980608)
00:08:47.624 --> 00:08:51.884
social aspects of medicine to really encourage active learning.

59 "Brower, Richard" (3902980608)
00:08:51.909 --> 00:09:01.019
Strategies and the rest of those items that you see there um, and.

60 "Brower, Richard" (3902980608)
00:09:02.334 --> 00:09:16.104
There was definitely a spirit of innovation and rapid change and kind of, uh, move fast and break things, kind of, uh, approach to the implementation of the medical school curriculum.

61 "Brower, Richard" (3902980608)
00:09:16.764 --> 00:09:20.994
And I, I think there was also a very tight group of people.

62 "Brower, Richard" (3902980608)
00:09:21.019 --> 00:09:33.629
Um, recruited specifically for this mission and students that were recruited with that thinking in mind and with that will move on to the next slide.

63 "Brower, Richard" (3902980608)
00:09:35.279 --> 00:09:50.094
And I want to talk a little bit about the data that we have with, uh, students satisfaction. And, uh, and their sense of the various function, how they relate to the various functions of the school over time.

64 "Brower, Richard" (3902980608)
00:09:50.634 --> 00:09:54.954
And to me, this is, uh, this is interesting stuff. And I'm largely going to base.

65 "Brower, Richard" (3902980608)
00:09:55.169 --> 00:09:59.009
My remarks on what's called the, uh, uh.

66 "Brower, Richard" (3902980608)
00:09:59.009 --> 00:10:13.014
Association of American colleges, graduation questionnaire. So this is a questionnaire administered to all, uh, graduating medical students at all. Elsie accredited schools. It's not compulsory. It's optional.

67 "Brower, Richard" (3902980608)
00:10:13.014 --> 00:10:18.504
So there is a response rate, uh, issue with it.

68 "Brower, Richard" (3902980608)
00:10:19.009 --> 00:10:24.209
In general, most schools encourage participation and response rates are high.

69 "Brower, Richard" (3902980608)
00:10:24.894 --> 00:10:35.394
At the bottom of the slide, you can see the years and you can see the number of graduates we had, uh, with the letter g. like, for 2014 we had 53 graduates, we had 49 respond to the graduation questionnaire.

70 "Brower, Richard" (3902980608)
00:10:35.394 --> 00:10:43.884
Um, so that kind of frames the response rate issue and you can see our data at the top with the. at the top with the

71 "Brower, Richard" (3902980608)
00:10:44.209 --> 00:10:47.219
Line being the national data.

72 "Brower, Richard" (3902980608)
00:10:47.219 --> 00:10:52.889
National data and the red line being, uh, the foster school of medicine.

73 "Brower, Richard" (3902980608)
00:10:52.889 --> 00:10:57.419
Uh, and if we look at, um, this.

74 "Brower, Richard" (3902980608)
00:10:57.419 --> 00:11:04.919
Pivotal or framing question overall I am satisfied with the quality of my medical education.

75 "Brower, Richard" (3902980608)
00:11:06.024 --> 00:11:17.274
I think it's reasonable to say that we have done quite well from our founding kind of opening our doors. The data doesn't go all the, all the way back. We didn't graduate students until 2013.

76 "Brower, Richard" (3902980608)
00:11:17.274 --> 00:11:24.744
uh, but if we look from 2013 going forward for several years, we were pumping along with very high. were pumping along with very high

77 "Brower, Richard" (3902980608)
00:11:24.919 --> 00:11:39.029
Satisfaction rates, uh, and then things began to wobble and if you kind of take from 2018 on, we've had, um, a steep decline.

78 "Brower, Richard" (3902980608)
00:11:39.029 --> 00:11:51.089
Especially, uh, compared, you know, uh, especially concerning in comparison to the national data, uh, since that point. And so, uh, it, it.

79 "Brower, Richard" (3902980608)
00:11:51.089 --> 00:12:04.199
It causes us to pause and consider WH, what is what is happening and especially what is happening happened since about 2018 2019.

80 "Brower, Richard" (3902980608)
00:12:04.199 --> 00:12:17.754
And if you can go on to the next slide so Here's some additional questions that I think are, uh, pivotal in terms of thinking about the broad swap of,

81 "Brower, Richard" (3902980608)
00:12:17.784 --> 00:12:24.174
of how students perceive their learning environment. My medical school has done a good job of foster.

82 "Brower, Richard" (3902980608)
00:12:24.199 --> 00:12:36.974
During and nurturing my development as a future physician and again, um, I've, I've to to save space and time we had high response rates. And and then you come into 2017, 2018, steep decline. Um.

83 "Brower, Richard" (3902980608)
00:12:36.974 --> 00:12:40.934
thousand and eighteen steep decline um

84 "Brower, Richard" (3902980608)
00:12:41.249 --> 00:12:52.529
My medical school has done a good job of fostering and nurturing my development as a person kind of that more general remark as opposed to my, my development as a future physician. Um.

85 "Brower, Richard" (3902980608)
00:12:52.529 --> 00:12:59.069
Somewhat to similar, uh, precipitous decline, um, keep going.

86 "Brower, Richard" (3902980608)
00:12:59.964 --> 00:13:10.674
Next slide and then we can look at this isn't looking specifically at curricular things. I think curriculum is a big part of the students experience.

87 "Brower, Richard" (3902980608)
00:13:11.154 --> 00:13:18.624
And I can say that the data that we have for the curriculum largely parallels what we're seeing for the overall perception of students.

88 "Brower, Richard" (3902980608)
00:13:19.069 --> 00:13:22.139
Um, if you parse it out, um.

89 "Brower, Richard" (3902980608)
00:13:22.139 --> 00:13:32.729
There are some bright spots and specific elements of the curriculum medical skills instruction being 1 and, uh, on the clinical side, uh, emergency medicine has.

90 "Brower, Richard" (3902980608)
00:13:33.204 --> 00:13:46.944
Largely maintain positive reviews, but for the most part, um, the curricular elements have have mirrored that overall data and then we can look at some of the other supportive aspects, uh, related to, uh,

91 "Brower, Richard" (3902980608)
00:13:46.974 --> 00:13:50.334
career planning services. You can see similar trends.

92 "Brower, Richard" (3902980608)
00:13:51.899 --> 00:14:03.594
And then the next slide, um, here, we have satisfaction with the functions of the, uh, uh, office of medical education, our, uh,

93 "Brower, Richard" (3902980608)
00:14:03.594 --> 00:14:11.814
school or in in the specific contents of this survey. It's things attributed to the, the education.

94 "Brower, Richard" (3902980608)
00:14:11.899 --> 00:14:13.409
Dean's office.

95 "Brower, Richard" (3902980608)
00:14:13.409 --> 00:14:17.789
And again, um, things, uh, maybe.

96 "Brower, Richard" (3902980608)
00:14:17.789 --> 00:14:23.999
Looked a little strong coming into 2018 and 2019, but then precipitous.

97 "Brower, Richard" (3902980608)
00:14:23.999 --> 00:14:27.239
Um, decline, um.

98 "Brower, Richard" (3902980608)
00:14:28.164 --> 00:14:37.494
Next slide and then here are, uh, additional data points relating to student support services.

99 "Brower, Richard" (3902980608)
00:14:37.494 --> 00:14:47.214
So we're here, we're talking about things like academic counseling, faculty, mentoring, financial aid, uh, debt, management, personal counseling.

100 "Brower, Richard" (3902980608)
00:14:47.239 --> 00:14:50.579
Um, student, um.

101 "Brower, Richard" (3902980608)
00:14:50.579 --> 00:14:54.239
You know, tutoring and, uh.

102 "Brower, Richard" (3902980608)
00:14:55.464 --> 00:15:08.034
I think by now, you can sense that there's this general trend that's, uh, developed since 2018. it's very data driven. Uh, and there's more data points, right? So this is all graduate opinions.

103 "Brower, Richard" (3902980608)
00:15:08.034 --> 00:15:14.214
So it's sort of a summative assessment that students reveal. that students reveal

104 "Brower, Richard" (3902980608)
00:15:14.504 --> 00:15:28.964
Through their responses to the survey in the months, uh, just proceeding their graduation uh, just the other day we got the, uh, most recent data from what's called the double AMC survey,

105 "Brower, Richard" (3902980608)
00:15:28.964 --> 00:15:33.854
which is our current 2nd, year students opinions.

106 "Brower, Richard" (3902980608)
00:15:34.944 --> 00:15:48.954
And it's from the, uh, the fall terms. So fall of 2022, but our current 2nd, year students, and we can see still, um, that we're, we have trouble coming along the pipeline.

107 "Brower, Richard" (3902980608)
00:15:48.954 --> 00:15:53.634
And, and the evidence that these trends may. that these trends may

108 "Brower, Richard" (3902980608)
00:15:54.794 --> 00:16:04.574
If we think about teaching out that group, and I'll just say that the analysis on that is very preliminary and early, but only 53% of those 2nd,

109 "Brower, Richard" (3902980608)
00:16:04.574 --> 00:16:14.114
year students indicated that they were either satisfied or very satisfied with their medical education. Uh, and, uh, very, very. very very

110 "Brower, Richard" (3902980608)
00:16:14.139 --> 00:16:15.929
Low and.

111 "Brower, Richard" (3902980608)
00:16:15.929 --> 00:16:20.999
Uh, in terms of benchmarking, compared to national, uh, data.

112 "Brower, Richard" (3902980608)
00:16:21.354 --> 00:16:31.044
So, we've clearly got some issues, uh, to discuss related to our learning environment, as reflected by, uh,

113 "Brower, Richard" (3902980608)
00:16:31.074 --> 00:16:40.584
students satisfaction with a broad swap of services and interactions they have with various components of the school from faculty.

114 "Brower, Richard" (3902980608)
00:16:40.999 --> 00:16:46.559
Tutoring mentoring, um, and and student services.

115 "Brower, Richard" (3902980608)
00:16:46.559 --> 00:16:51.419
And I would move on from here to the next slide.

116 "Brower, Richard" (3902980608)
00:16:51.864 --> 00:17:05.244
Uh, and just reflect a little bit, uh, if you look at the timing of the decline, um, and you look at our history, as I tried to touch on briefly, at the very beginning, you know, we got started, uh,

117 "Brower, Richard" (3902980608)
00:17:05.274 --> 00:17:11.274
opening the doors in the fall of 2009. graduated our 1st class and, uh. class and uh

118 "Brower, Richard" (3902980608)
00:17:11.419 --> 00:17:15.179
Um, uh, 2013.

119 "Brower, Richard" (3902980608)
00:17:15.179 --> 00:17:21.809
Um, and went through our 2nd, full accreditation survey with the.

120 "Brower, Richard" (3902980608)
00:17:21.809 --> 00:17:31.314
In the fall of 2017, uh, and it was all about solidifying our model, securing our model reinforcing our model.

121 "Brower, Richard" (3902980608)
00:17:31.614 --> 00:17:41.214
And it was all largely with the same Co still largely with the same core of leaders and most of the. most of the

122 "Brower, Richard" (3902980608)
00:17:41.809 --> 00:17:46.619
Founding core faculty, we're still around, um.

123 "Brower, Richard" (3902980608)
00:17:47.124 --> 00:18:00.234
As we look at what's happened since then we've had multiple multiple turnovers in the office of student affairs leadership, multiple turnovers in the office of curricular affairs, or medical education leadership.

124 "Brower, Richard" (3902980608)
00:18:00.654 --> 00:18:06.114
Uh, we've had, uh, the transition from the founding, uh, associate dean for admissions.

125 "Brower, Richard" (3902980608)
00:18:06.619 --> 00:18:16.154
To a new associate dean for admissions, uh, less directly related to curriculum and student experience, but still part of our environment.

126 "Brower, Richard" (3902980608)
00:18:16.154 --> 00:18:26.534
We had a turnover in clinical affairs uh, and, uh, also multiple changes in the financial leadership of the institution as well as.

127 "Brower, Richard" (3902980608)
00:18:26.619 --> 00:18:40.829
School, um, at the same time faculty size and structure, um, hasn't, uh, grown in direct proportion or, or, um, even the.

128 "Brower, Richard" (3902980608)
00:18:40.829 --> 00:18:50.844
Um, in relative terms, uh, to our student expansion, uh, we've also gone through a,

129 "Brower, Richard" (3902980608)
00:18:50.874 --> 00:19:00.534
an evolution from a medical school based branch of the health science center, and Lubbock to an independent health science center with a reorganization of.

130 "Brower, Richard" (3902980608)
00:19:00.829 --> 00:19:12.704
The services that used to be centered around the medical school and are now essentially at the institutional level, and we're going through a lot of both institutional growth and growth of the medical school class.

131 "Brower, Richard" (3902980608)
00:19:13.244 --> 00:19:20.084
Um, after our last full accreditation survey, there was also an interest in introducing some major curricular changes.

132 "Brower, Richard" (3902980608)
00:19:20.339 --> 00:19:33.204
And we've been hit by a pandemic so I, I think we have a a unique set of circumstances that have, uh, put our learning environment, uh, uh, in a very challenging spot.

133 "Brower, Richard" (3902980608)
00:19:33.474 --> 00:19:36.504
And, uh, uh, I'll, I'll, uh.

134 "Brower, Richard" (3902980608)
00:19:37.554 --> 00:19:51.264
I'll, uh, decide at this point and let Dr compost and far tell us how to fix this problem. And, and I'm, I'm, I'm joking in the sense of obviously we all are interested in fixing this.

135 "Brower, Richard" (3902980608)
00:19:51.264 --> 00:19:53.244
But, uh, I think it's a.

136 "Brower, Richard" (3902980608)
00:19:53.669 --> 00:19:59.969
Uh, it's s, disseminated responsibility across across the institution, so thanks.

137 "Rebecca L Campos MD" (3376588800)
00:20:03.509 --> 00:20:08.549
Thank you for that as we transition from learning about our own curriculum.

138 "Rebecca L Campos MD" (3376588800)
00:20:08.549 --> 00:20:15.989
Evolution to the components that form the learning environment, both formally with the defined purpose, but also.

139 "Rebecca L Campos MD" (3376588800)
00:20:15.989 --> 00:20:21.179
That which develops on its own independently, whether with the intention or not.

140 "Rebecca L Campos MD" (3376588800)
00:20:21.179 --> 00:20:27.239
But this applies to all health care learners of all the schools as well.

141 "Rebecca L Campos MD" (3376588800)
00:20:28.919 --> 00:20:34.019
Then we talk about the role of medical education, although the focus for today, we want to.

142 "Rebecca L Campos MD" (3376588800)
00:20:34.019 --> 00:20:37.109
Emphasize the undergraduate medical education.

143 "Rebecca L Campos MD" (3376588800)
00:20:37.109 --> 00:20:40.919
Um, but because we, we're looking at a type of apprenticeship.

144 "Rebecca L Campos MD" (3376588800)
00:20:40.919 --> 00:20:47.549
Um, it's hard to silo that and incorporate both the undergraduate and graduate medical education component.

145 "Rebecca L Campos MD" (3376588800)
00:20:47.549 --> 00:20:52.079
From a traditional apprenticeship we go from and on the job learning from an expert.

146 "Rebecca L Campos MD" (3376588800)
00:20:52.079 --> 00:20:56.489
Uh, where we have a physical craft that we practice, and then it ends with an expertise.

147 "Rebecca L Campos MD" (3376588800)
00:20:56.489 --> 00:21:04.829
Here we look at more of a cognitive apprenticeship where now we're looking at the internal thought process development, the clinical reasoning as well.

148 "Rebecca L Campos MD" (3376588800)
00:21:04.829 --> 00:21:15.509
So, there's both the observation, but now more coaching and growth within that layer of knowledge. And so here we can even divide that further to looking at a preclinical component where we have a very.

149 "Rebecca L Campos MD" (3376588800)
00:21:15.509 --> 00:21:25.619
Safe controlled learning environment, whether that's in lectures or simulations, standardized patient cases the way we would design those cases to be.

150 "Rebecca L Campos MD" (3376588800)
00:21:26.124 --> 00:21:38.604
And the objectives that we want to have that hit, but then we also have a degree of optional activities. And 1 example is the lectures become optional. And attendance is 1 factor that we've looked at.

151 "Rebecca L Campos MD" (3376588800)
00:21:39.204 --> 00:21:42.234
Then we transition to clerkship versus clinical.

152 "Rebecca L Campos MD" (3376588800)
00:21:42.509 --> 00:21:45.659
Where we see that both in medical school and.

153 "Rebecca L Campos MD" (3376588800)
00:21:45.659 --> 00:21:48.899
Residency even in our other schools as well.

154 "Rebecca L Campos MD" (3376588800)
00:21:48.899 --> 00:21:54.599
Now, we have more of a patient of the unknown what your patient comes in with different pathologies.

155 "Rebecca L Campos MD" (3376588800)
00:21:54.599 --> 00:22:07.199
Less controlled, you also have different faculty your learning from so you have different levels of expectations and variables there. And now you also have to deal with patient expectation or more than just your objective.

156 "Rebecca L Campos MD" (3376588800)
00:22:07.199 --> 00:22:11.969
And structured goals within the course, and things can become more vigorous.

157 "Rebecca L Campos MD" (3376588800)
00:22:11.969 --> 00:22:15.239
Yeah, and now they're all required next slide please.

158 "Rebecca L Campos MD" (3376588800)
00:22:16.349 --> 00:22:29.879
So, we see where medical training in 1 quote that I'd like to reflect on, is that medical training is not just learning about becoming a physician. It actually involves also learning how to cease becoming a late person.

159 "Rebecca L Campos MD" (3376588800)
00:22:29.879 --> 00:22:40.529
Which is something that we're trying to guide our learners within. So when we're looking at the phases of learning that we see, we have your 1st stage of your knowledge acquisition.

160 "Rebecca L Campos MD" (3376588800)
00:22:40.529 --> 00:22:44.009
Which can also be known within, like the right um.

161 "Rebecca L Campos MD" (3376588800)
00:22:44.009 --> 00:22:49.679
Pattern of growth as a reporter positioning to the articulation of our findings.

162 "Rebecca L Campos MD" (3376588800)
00:22:49.679 --> 00:22:54.539
The problem the organization of approach, and that's the interpreter state.

163 "Rebecca L Campos MD" (3376588800)
00:22:54.539 --> 00:23:02.189
And then we also have our clinical reasoning and our problem solving and unique to our integrated curriculum.

164 "Rebecca L Campos MD" (3376588800)
00:23:02.189 --> 00:23:07.799
This is already introduced early and so here we are having an early approach to the problem.

165 "Rebecca L Campos MD" (3376588800)
00:23:07.799 --> 00:23:15.059
The investigation, uh, the planning of that as well as the comprehensive approach to developing a treatment plan.

166 "Rebecca L Campos MD" (3376588800)
00:23:15.059 --> 00:23:23.519
Or even a further workout plan, and now we're going to a manager phase in the right process. Um, and then lastly, we have more independence.

167 "Rebecca L Campos MD" (3376588800)
00:23:23.519 --> 00:23:26.759
That includes more management ownership.

168 "Rebecca L Campos MD" (3376588800)
00:23:26.759 --> 00:23:32.729
Or the leader and the educator, which is the last of our rhyme analogies. So we go from the reporter.

169 "Rebecca L Campos MD" (3376588800)
00:23:32.729 --> 00:23:46.739
The interpreter, the manager and the educator, and in this, we have a process that our students transition from from that observation role now, more to the ownership of patient care, and we want them to own their patient and to know their patient.

170 "Rebecca L Campos MD" (3376588800)
00:23:47.544 --> 00:24:02.154
Next slide please. So, when we talk about settings in the environment to be more cohesive and more encouraging to learning a multitude of large ranges of types of definitions, used for defining these.

171 "Rebecca L Campos MD" (3376588800)
00:24:03.204 --> 00:24:13.554
I call them the ingredients, but for today's purposes, I'm trying to just focus on some of the ones that we would like to emphasize hopefully more related to our organization in our environment.

172 "Rebecca L Campos MD" (3376588800)
00:24:14.454 --> 00:24:19.824
So, within these within health care, we'll go ahead and start to, um.

173 "Rebecca L Campos MD" (3376588800)
00:24:20.129 --> 00:24:27.749
They find some of these next slide. Please. So, 1st, is the form of curriculum as we've just heard there's our formal.

174 "Rebecca L Campos MD" (3376588800)
00:24:27.749 --> 00:24:32.579
Approach or integrated curriculum with didactics, we have identified objectives.

175 "Rebecca L Campos MD" (3376588800)
00:24:32.579 --> 00:24:41.549
We have defined materials that students need to review and learn. We have some changing and innovative adjustments to the pedagogy of the science and the medicine.

176 "Rebecca L Campos MD" (3376588800)
00:24:41.549 --> 00:24:46.889
As well, as the bedside approach to the patient that we're introducing early on with the integrated.

177 "Rebecca L Campos MD" (3376588800)
00:24:46.889 --> 00:24:51.839
And we can find out our outcomes with that buyer summative and, um.

178 "Rebecca L Campos MD" (3376588800)
00:24:51.839 --> 00:24:55.049
Are included formative testing that we also have had.

179 "Rebecca L Campos MD" (3376588800)
00:24:55.049 --> 00:24:59.669
We can find an end end point to the success of our approach in that curriculum.

180 "Rebecca L Campos MD" (3376588800)
00:24:59.669 --> 00:25:05.999
Next slide and here now we go into the informal curriculum so, um.

181 "Rebecca L Campos MD" (3376588800)
00:25:05.999 --> 00:25:12.539
I'm defining this and carving out this a little bit different than some of the ingredients that many might recognize.

182 "Rebecca L Campos MD" (3376588800)
00:25:12.539 --> 00:25:23.909
Also refer to for the hidden curriculum, but here, I want to focus on the social interaction specifically between the learner and the faculty and that may be 1 area that needs to be, um.

183 "Rebecca L Campos MD" (3376588800)
00:25:23.909 --> 00:25:32.129
Something we look at further, you know, as Dr Brian mentioned, we have growth and we have different areas of innovation and growth within our schools.

184 "Rebecca L Campos MD" (3376588800)
00:25:32.129 --> 00:25:40.139
But we also have not the same amount of growth in our faculty numbers and that socialization is important.

185 "Rebecca L Campos MD" (3376588800)
00:25:40.139 --> 00:25:49.229
You know, here, I, I would say that that socialized socialization in this medical world. It's a process by which people the values, the attitudes.

186 "Rebecca L Campos MD" (3376588800)
00:25:49.229 --> 00:25:53.309
The interest and the skills as well as just not just the knowledge.

187 "Rebecca L Campos MD" (3376588800)
00:25:53.309 --> 00:26:00.839
But, in short that culture that we're trying to develop and grow in, and that's for those, I want to be learning those. Um.

188 "Rebecca L Campos MD" (3376588800)
00:26:00.839 --> 00:26:05.729
Factors in the groups of which they are, or in this case, which they want to become a member of.

189 "Rebecca L Campos MD" (3376588800)
00:26:05.729 --> 00:26:09.599
And the bring up from faculty next like this.

190 "Rebecca L Campos MD" (3376588800)
00:26:10.679 --> 00:26:14.159
So, looking back at our ingredients and the 1 to highlight the most.

191 "Rebecca L Campos MD" (3376588800)
00:26:14.159 --> 00:26:20.819
Is in this curriculum and that culture of learning that we need to be aware of, especially based on some of the.

192 "Rebecca L Campos MD" (3376588800)
00:26:20.819 --> 00:26:28.859
Finding that we see in these surveys, is there more to just the curriculum objective part but also to the culture that established within, that.

193 "Rebecca L Campos MD" (3376588800)
00:26:33.449 --> 00:26:41.909
So, here, we might actually recognize this more as the implicit learning or that fitting curriculum. Um.

194 "Rebecca L Campos MD" (3376588800)
00:26:41.909 --> 00:26:49.919
Although it was 1st, recognized in the 9,960 s and it hasn't been called different things from the implicit learning and curriculum.

195 "Rebecca L Campos MD" (3376588800)
00:26:49.919 --> 00:26:54.149
Um, they can shadow, it was another term I had come.

196 "Rebecca L Campos MD" (3376588800)
00:26:54.149 --> 00:26:59.489
A more recently and about 994 1 of them were referenced articles by.

197 "Rebecca L Campos MD" (3376588800)
00:26:59.489 --> 00:27:07.649
As you use the term hidden curriculum in, in addition to the relationship of what is.

198 "Rebecca L Campos MD" (3376588800)
00:27:07.649 --> 00:27:14.939
My observation from our learners and the way faculty approach and deal from their day to day tasks.

199 "Rebecca L Campos MD" (3376588800)
00:27:14.939 --> 00:27:19.079
As well, as the ethics and other areas that need to be done.

200 "Rebecca L Campos MD" (3376588800)
00:27:19.079 --> 00:27:28.739
But the key thing here is what is important is it driven by the learner by the faculty or board that by the organization? Ideally, a good level of all. 3.

201 "Rebecca L Campos MD" (3376588800)
00:27:28.739 --> 00:27:34.979
Um, it's a means of how we inherit and pass on the standard of the profession and medicine.

202 "Rebecca L Campos MD" (3376588800)
00:27:34.979 --> 00:27:39.269
To our future physicians or future nurses and dentists as as well.

203 "Rebecca L Campos MD" (3376588800)
00:27:39.269 --> 00:27:45.809
We also inherit and pass on the ethics, the moral and the behavioral standards in the advocacy.

204 "Rebecca L Campos MD" (3376588800)
00:27:45.809 --> 00:27:50.369
So, to speak of that bedside manner of how to approach our patients.

205 "Rebecca L Campos MD" (3376588800)
00:27:50.369 --> 00:27:54.569
Um, so here the learner has to then decide and choose.

206 "Rebecca L Campos MD" (3376588800)
00:27:54.569 --> 00:27:59.129
Whether they're going to emulate unconsciously or consciously. Um.

207 "Rebecca L Campos MD" (3376588800)
00:27:59.129 --> 00:28:04.289
What they've seen is a responsive faculty or other team members in healthcare.

208 "Rebecca L Campos MD" (3376588800)
00:28:04.289 --> 00:28:10.199
When they have to deal with some of that ambiguity of medicine or the.

209 "Rebecca L Campos MD" (3376588800)
00:28:10.199 --> 00:28:19.199
Types of responses that they see of faculty and others to certain situations or individuals. And if they're going to be incorporating that into their own.

210 "Rebecca L Campos MD" (3376588800)
00:28:19.199 --> 00:28:22.829
Practice in their medicine next night.

211 "Rebecca L Campos MD" (3376588800)
00:28:24.209 --> 00:28:35.484
So there's a very new, um, article that came out, just, uh, within the last 2 months of 2023 and in this 1, it was actually a different take on the hidden curriculum, but looked more at the faculty aspect.

212 "Rebecca L Campos MD" (3376588800)
00:28:35.484 --> 00:28:44.124
And so they did define them with some student domains in the structure of this curriculum, or the framework of how. the framework of how

213 "Rebecca L Campos MD" (3376588800)
00:28:44.209 --> 00:28:57.974
Of how teaching happens and so unfortunately a lot of them were kind of on the negative perspective, and we'll see a little breakdown on that from the faculty standpoint, but these are really good categories to look at when we're defining that learning environment.

214 "Rebecca L Campos MD" (3376588800)
00:28:58.304 --> 00:29:02.054
Uh, so the 1st, 1 would be the motivational and psychological sphere.

215 "Rebecca L Campos MD" (3376588800)
00:29:04.169 --> 00:29:10.949
The motivation on psychological sphere. So there we would define that is the value, the attitudes beliefs that are unintentionally transmitted.

216 "Rebecca L Campos MD" (3376588800)
00:29:10.949 --> 00:29:22.049
Uh, from the teachers, uh, by the behaviors of others, then we have the interpersonal and social, and this would be, um, individuals would interact with the beliefs.

217 "Rebecca L Campos MD" (3376588800)
00:29:22.049 --> 00:29:26.939
Um, and that establish relationships within those learning environments and ways that she.

218 "Rebecca L Campos MD" (3376588800)
00:29:26.939 --> 00:29:32.309
Uh, that shape how teaching duties can be performed in the delivery and those modalities.

219 "Rebecca L Campos MD" (3376588800)
00:29:32.694 --> 00:29:44.064
The next 1 is the institutional and organizational sphere where rules policies and procedures that teachers are expected to follow within the institution. And that way.

220 "Rebecca L Campos MD" (3376588800)
00:29:44.064 --> 00:29:49.374
Those have to be the framework of how some of this educational material developed and delivered.

221 "Rebecca L Campos MD" (3376588800)
00:29:49.679 --> 00:30:02.789
And then the last is the contextual and the cultural part and so here, we're seeing the norms and the assumptions as well as the expectations that are held by others and how those can be expressed, whether explicitly or implicitly.

222 "Rebecca L Campos MD" (3376588800)
00:30:02.789 --> 00:30:08.549
Uh, regarding the teachings, so, here, we'll see patterns of teaching behavior that can be, um.

223 "Rebecca L Campos MD" (3376588800)
00:30:08.549 --> 00:30:14.639
Limited or encouraged by the physical and the social environment. So overall, that modality of teaching.

224 "Rebecca L Campos MD" (3376588800)
00:30:14.639 --> 00:30:24.659
Next slide when we look at the hidden curriculum, there's a lot that faculty needs to be aware of, not just the environment by which they're delivering it but also.

225 "Rebecca L Campos MD" (3376588800)
00:30:24.659 --> 00:30:38.369
Um, the learner, so you have to be aware of the development stage of our learners, which is really important because aside from having to factor in being a role model, how to demonstrate the proper way of dealing with the stress there.

226 "Rebecca L Campos MD" (3376588800)
00:30:38.394 --> 00:30:51.984
Or how the student observes the caution that a faculty or detailed oriented nature that they used to approach a patient or a situation, the social environment, the collaborating versus the venting environment and then more unspoken,

227 "Rebecca L Campos MD" (3376588800)
00:30:51.984 --> 00:30:54.864
which very most often is very positive. But.

228 "Rebecca L Campos MD" (3376588800)
00:30:55.199 --> 00:31:06.774
Um, when overlooked can lead to a negative impact and so being very aware and cognitive of making the effort to be more encouraging the patients, the compassion and demonstrating of advocacy,

229 "Rebecca L Campos MD" (3376588800)
00:31:07.374 --> 00:31:15.054
because some concerns are that things can lead to the other perspective where there is the scene of the lack of apathy when we see burn out or.

230 "Rebecca L Campos MD" (3376588800)
00:31:15.199 --> 00:31:16.079
Um.

231 "Rebecca L Campos MD" (3376588800)
00:31:16.079 --> 00:31:29.639
Demonstrating genuine accountability to patients how legal phobias affect how physicians practice in many cases. And then the 1 area that was mentioned in a different article was shaming to motivate the learning. So, instead of, um.

232 "Rebecca L Campos MD" (3376588800)
00:31:29.639 --> 00:31:39.479
Where we see the resident or the learner student that can be more independent and, and caring for a patient see that as, and then encouraging of that.

233 "Rebecca L Campos MD" (3376588800)
00:31:39.479 --> 00:31:51.564
Others might see well, I guess the less I have to interact with less questions I have, I've seen a stronger and take the negative inferred approach, which was not the intention. And so it's really important when you look at the learners role.

234 "Rebecca L Campos MD" (3376588800)
00:31:51.864 --> 00:31:59.364
Um, as we end with that for the slide, because there are some new recognition of the extended adolescence where there's an article, and then.

235 "Rebecca L Campos MD" (3376588800)
00:31:59.479 --> 00:32:01.079
Scientific that came out.

236 "Rebecca L Campos MD" (3376588800)
00:32:01.079 --> 00:32:13.649
Notably before Kobe in 2017 called extended adolescence, when 25 is the new 18, and I think it's important to note that before Kobe, which might only be aggravated with Kobe because.

237 "Rebecca L Campos MD" (3376588800)
00:32:13.649 --> 00:32:18.299
In that, um, article, which was a journal article, not necessarily a medical article.

238 "Rebecca L Campos MD" (3376588800)
00:32:18.299 --> 00:32:25.289
There were the notice slowing of routine, adulthood, related tasks and responsibilities and some examples were, um.

239 "Rebecca L Campos MD" (3376588800)
00:32:25.289 --> 00:32:31.409
Adolescence learning how to drive later late, not necessarily having after school jobs like, before.

240 "Rebecca L Campos MD" (3376588800)
00:32:31.409 --> 00:32:37.709
Um, dating later as well, and so there was more time spent with homework or extra curricular activities.

241 "Rebecca L Campos MD" (3376588800)
00:32:37.709 --> 00:32:41.849
And most notably as we would all agree more digital activity.

242 "Rebecca L Campos MD" (3376588800)
00:32:41.849 --> 00:32:55.679
Next slide so we want to be aware of the impact on faculty so, where our role is to decrease the distance between the basic science and the clinical medicine, and to blur the traditional distinctions between what is characterized as the art.

243 "Rebecca L Campos MD" (3376588800)
00:32:55.679 --> 00:32:59.519
And the science of medicine, and so it requires a lot of planning.

244 "Rebecca L Campos MD" (3376588800)
00:32:59.519 --> 00:33:03.359
In preparation, and ultimately a lot of awareness of the faculty.

245 "Rebecca L Campos MD" (3376588800)
00:33:03.359 --> 00:33:12.059
So, what we want to make sure that we are aware of is also the influence that that has on faculty.

246 "Rebecca L Campos MD" (3376588800)
00:33:12.059 --> 00:33:20.759
Because that downstream effects the learner and, um, so these are somewhere I had to make some changes because this new article was, uh, just.

247 "Rebecca L Campos MD" (3376588800)
00:33:20.904 --> 00:33:35.784
Highlighted the negative aspect, but I don't think that's always the case. You can also have valuing, not just undervaluing of the importance of the teaching expertise of your teachers and the experience and confidence that they have in certain areas of teaching instead of just undermined teaching goals.

248 "Rebecca L Campos MD" (3376588800)
00:33:35.934 --> 00:33:40.734
But also supporting those teaching goals and providing the support that they need to be able to complete that.

249 "Rebecca L Campos MD" (3376588800)
00:33:40.759 --> 00:33:41.429
Right.

250 "Rebecca L Campos MD" (3376588800)
00:33:41.429 --> 00:33:49.439
Um, and instead of isolation, more collaboration between others, and we do a good job of that when we have integrated sessions in our curriculum.

251 "Rebecca L Campos MD" (3376588800)
00:33:49.439 --> 00:33:56.609
Next license so here, what we would make sure is that we were cautiously looking.

252 "Rebecca L Campos MD" (3376588800)
00:33:56.609 --> 00:34:00.989
Um, and being focused on teaching the art of medicine and the care of people.

253 "Rebecca L Campos MD" (3376588800)
00:34:00.989 --> 00:34:04.679
Being aware that there are, um, unintended.

254 "Rebecca L Campos MD" (3376588800)
00:34:04.679 --> 00:34:09.419
Or unconscious teaching that can be overlooked, but it can also be.

255 "Rebecca L Campos MD" (3376588800)
00:34:09.419 --> 00:34:15.779
Positive, um, unfortunately, the awareness doesn't need to be there so that way it's not opening doors to negative.

256 "Rebecca L Campos MD" (3376588800)
00:34:15.779 --> 00:34:28.379
Environments and so that just takes that extra effort of promoting reflection being the highlight of what I would emphasize from this, um, from this slide here. And 1 example would be as well, as far as the, um.

257 "Rebecca L Campos MD" (3376588800)
00:34:28.379 --> 00:34:32.129
Avoiding shaming as a motivator for learning.

258 "Rebecca L Campos MD" (3376588800)
00:34:32.129 --> 00:34:46.499
Is when your student or your resident says? I don't know, I'd rather have that then make it till you make it approach, but I'd rather then come back within an effort to answer that then just leave it as, I don't know, and not have that have that. So.

259 "Rebecca L Campos MD" (3376588800)
00:34:46.499 --> 00:34:51.629
Drive to future learn and that's part of that cognitive apprenticeship that we need to.

260 "Rebecca L Campos MD" (3376588800)
00:34:51.629 --> 00:34:54.779
Uh, guide them through and then next.

261 "Rebecca L Campos MD" (3376588800)
00:34:56.219 --> 00:35:05.429
So, all of that is, uh, the key component for me here is a psychological safety, and that would be defined as that ability and comfort to express their individuality.

262 "Rebecca L Campos MD" (3376588800)
00:35:05.429 --> 00:35:11.219
Where students can share their concerns, or just their uncertainty about some of the material that they may have.

263 "Rebecca L Campos MD" (3376588800)
00:35:11.219 --> 00:35:21.719
But more importantly, so that they don't have that fear of the negative repercussions, or feeling that they're just not preparing enough because those are really important for them to be able to articulate.

264 "Rebecca L Campos MD" (3376588800)
00:35:21.719 --> 00:35:28.349
And perhaps it may just be more of learning how to articulate those concerns that we can guide them through.

265 "Rebecca L Campos MD" (3376588800)
00:35:28.349 --> 00:35:33.209
As a key factor in establishing a good and successful learning environment.

266 "Rebecca L Campos MD" (3376588800)
00:35:33.209 --> 00:35:38.159
You that's it for me, I will hand it over to Dr.

267 "Pfarr, Curt" (3946910720)
00:35:41.279 --> 00:35:50.339
Thank you Dr. campus and thank you. Dr brower. You did a very nice job of introducing the challenges and some of the framework.

268 "Pfarr, Curt" (3946910720)
00:35:50.339 --> 00:36:04.469
Um, to kind of move forward and address these what I'll do, and just to pair of slides here is sort of touch on the intersection in a sense between professional identity formation and the learning environment.

269 "Pfarr, Curt" (3946910720)
00:36:04.469 --> 00:36:08.009
And I'll preface this by just suggesting.

270 "Pfarr, Curt" (3946910720)
00:36:08.009 --> 00:36:13.709
You know, whenever I've heard the word hidden environment, this is a term that's been bounced around over the years.

271 "Pfarr, Curt" (3946910720)
00:36:13.709 --> 00:36:17.999
It always struck me as having, sort of a negative connotation sort of a.

272 "Pfarr, Curt" (3946910720)
00:36:17.999 --> 00:36:24.179
Implying a subterfuge or something behind the curtains kind of aspect to it.

273 "Pfarr, Curt" (3946910720)
00:36:24.179 --> 00:36:28.859
And I think it might a more useful term might be the informal.

274 "Pfarr, Curt" (3946910720)
00:36:28.859 --> 00:36:33.359
Curriculum right. Instead of hitting curriculum, the idea of being that.

275 "Pfarr, Curt" (3946910720)
00:36:33.359 --> 00:36:43.319
There's a lot going on that's not formally part of the competency building knowledge based and professional development. That sort of thing.

276 "Pfarr, Curt" (3946910720)
00:36:43.319 --> 00:36:47.759
So, that's just a commentary and what I'd like to point out is.

277 "Pfarr, Curt" (3946910720)
00:36:47.759 --> 00:36:51.989
Um, that the recognizes.

278 "Pfarr, Curt" (3946910720)
00:36:51.989 --> 00:37:03.024
The impact of the whole learning environment, including the formal and informal pieces on what they term, what is generally termed is professional identity formation, which is a pretty broad,

279 "Pfarr, Curt" (3946910720)
00:37:03.054 --> 00:37:11.814
been relating to behaviors and attitude that are relevant or developing competencies, that map clearly to the 6.

280 "Pfarr, Curt" (3946910720)
00:37:11.989 --> 00:37:13.349
You.

281 "Pfarr, Curt" (3946910720)
00:37:13.349 --> 00:37:25.529
Competencies 1 of which is professionalism itself and the other most importantly is communication, interpersonal and professional communication.

282 "Pfarr, Curt" (3946910720)
00:37:25.529 --> 00:37:30.359
And what I'll point out is, I'll skip to the 3rd bullet point here, is that.

283 "Pfarr, Curt" (3946910720)
00:37:30.359 --> 00:37:38.249
In our school, we have what are called colleges more generally termed learning communities and this is a collection of.

284 "Pfarr, Curt" (3946910720)
00:37:38.249 --> 00:37:48.449
About half the medical schools, Catholic schools in the country have these some similar structure here. We have actual home room, like architectural.

285 "Pfarr, Curt" (3946910720)
00:37:48.449 --> 00:38:02.399
Um, locations where students are each cohort of students who split into 5 colleges and have lockers, and a luncheon area, kitchenette, um, a lounge area, and so on. And this provides.

286 "Pfarr, Curt" (3946910720)
00:38:02.399 --> 00:38:13.410
Um, an informal place for, for communications sharing, reflections, um, talking to faculty, talking between students studying and so on.

287 "Pfarr, Curt" (3946910720)
00:38:13.915 --> 00:38:28.525
And then we have a formal piece to this part of the formal curriculum, which is a colloquium, a 2 hour discussion based course that meets each week that hits on a range of topics around ethics, humanities, controversial kind of.

288 "Pfarr, Curt" (3946910720)
00:38:28.830 --> 00:38:43.380
Uh, cutting edge topics, and both these venues, the, the formal and informal piece here, allow the students to connect with each other and with faculty, their college mentors and other faculty that.

289 "Pfarr, Curt" (3946910720)
00:38:43.380 --> 00:38:52.590
That all around, and kind of mix in rub elbows with the students and going back to the slides you showed Dr at the beginning.

290 "Pfarr, Curt" (3946910720)
00:38:52.590 --> 00:38:59.010
Seems to be the pretty profound challenge, because I would suggest that a lot of those.

291 "Pfarr, Curt" (3946910720)
00:38:59.010 --> 00:39:02.940
In those different questions, right? There's a consistency there.

292 "Pfarr, Curt" (3946910720)
00:39:02.940 --> 00:39:10.680
That might have some aspect of a contagion. You almost get the feeling that once they started answering negatively, they kind of follow through.

293 "Pfarr, Curt" (3946910720)
00:39:10.680 --> 00:39:17.910
Right. So you can't really know how that impacts it, but by and large, a lot of it, I would suggest.

294 "Pfarr, Curt" (3946910720)
00:39:17.910 --> 00:39:32.310
Relates to how the, the students are connecting and and trusting the faculty that we have their best interests at heart. And I think the, the college, the learning community vibe is useful for addressing that.

295 "Pfarr, Curt" (3946910720)
00:39:32.310 --> 00:39:45.300
Right and embracing its its ability to sort of connect with the students and encourage them and support them as they grapple with all the grind of medical school next slide. Please.

296 "Pfarr, Curt" (3946910720)
00:39:47.490 --> 00:39:54.870
And I just want to point out, I think a pretty interesting framing by Wall. Sorry it should be walled.

297 "Pfarr, Curt" (3946910720)
00:39:55.375 --> 00:40:00.025
Proposes that reflection, the ability of students to actually sit back,

298 "Pfarr, Curt" (3946910720)
00:40:00.025 --> 00:40:14.755
take a deep breath and we encourage them we'd have writing reflections built into the colloquium course that he refers to this as the roots of a tree that are fertilized by mentor feedback and exposure to the humanities, and in the.

299 "Pfarr, Curt" (3946910720)
00:40:14.870 --> 00:40:19.260
Colloquium context we provide explicit feedback. We have them.

300 "Pfarr, Curt" (3946910720)
00:40:19.260 --> 00:40:24.360
Write a series longitudinally of reflective exercises.

301 "Pfarr, Curt" (3946910720)
00:40:24.360 --> 00:40:39.090
Um, and provide feedback on those, and we also expose them to poetry, um, different readings. For example, this year, we're having them read in class. When breath becomes there by Paul. This is the most popular book.

302 "Pfarr, Curt" (3946910720)
00:40:39.090 --> 00:40:45.390
Read by medical students, it's a big hit. It's it's a really well written book about.

303 "Pfarr, Curt" (3946910720)
00:40:45.390 --> 00:40:51.810
Death and the challenges disease, um, and it resonates with the students, it really connects.

304 "Pfarr, Curt" (3946910720)
00:40:51.810 --> 00:41:00.870
With the faculty and their peers, when we, when we talk about this, um, and he goes on to say these promote the development of the trees crown.

305 "Pfarr, Curt" (3946910720)
00:41:00.870 --> 00:41:10.050
Which are habits of heart mind and practice and enhance well being and these are all pretty high flooding, positive traits that we would expect.

306 "Pfarr, Curt" (3946910720)
00:41:10.050 --> 00:41:16.620
Of our students when we graduate them trend towards compassionate, confident physicians.

307 "Pfarr, Curt" (3946910720)
00:41:16.620 --> 00:41:27.270
And then manifested externally in these map more explicitly to the competencies, which we expect them to be developing as.

308 "Pfarr, Curt" (3946910720)
00:41:27.270 --> 00:41:37.320
Residents communication skills, humanism, emotional intelligence, moral behaviors right? Pretty ambitious set of goals. So I'll stop there.

309 "Pfarr, Curt" (3946910720)
00:41:37.320 --> 00:41:42.570
Um, I want to leave time for discussion, I think certainly all the way back to those.

310 "Pfarr, Curt" (3946910720)
00:41:42.570 --> 00:41:47.430
Um, graduation questionnaire, results that you presented Dr.

311 "Pfarr, Curt" (3946910720)
00:41:47.430 --> 00:41:53.610
And see, if the audience can kind of pull these threads together into some interesting.

312 "Pfarr, Curt" (3946910720)
00:41:53.610 --> 00:42:03.930
Ideas, thank you. Thanks to all of our speakers. So.

313 "Mulla, Zuber" (1314477312)
00:42:03.930 --> 00:42:08.640
We do have plenty of time for questions feel free to unmute yourself or.

314 "Parsa, Michael D" (1978368512)
00:42:08.640 --> 00:42:13.680
Type something in the chat. Um, hi, this is Mike. Personally, can you guys hear me.

315 "Parsa, Michael D" (1978368512)
00:42:13.680 --> 00:42:26.970
Yes, sir. Yes. Yeah. Well, thank you guys all of you for that presentation and I just, um, you know, 1 of the things that comes to mind is, like, Dr far was saying.

316 "Parsa, Michael D" (1978368512)
00:42:27.235 --> 00:42:38.095
How these things feed on themselves to contagion this sort of thing and so now we've actually painted ourselves into a difficult corner with these negative feedback.

317 "Parsa, Michael D" (1978368512)
00:42:38.095 --> 00:42:46.885
So, what happens is now the new students are going to start this summer and they're going to say to the new 2nd years. Hey, how do I succeed in this?

318 "Parsa, Michael D" (1978368512)
00:42:46.970 --> 00:42:54.540
Cool. Or they're going to ask questions and then, um, you know, what they may get is well.

319 "Parsa, Michael D" (1978368512)
00:42:54.540 --> 00:42:58.560
All of these activities are, um.

320 "Parsa, Michael D" (1978368512)
00:42:58.560 --> 00:43:11.100
You know, you just have to go through the motions and you're going to have to succeed to do things on your own. Don't go anything that's not required. And so I think this is the sort of a mentality that a lot of the students have.

321 "Parsa, Michael D" (1978368512)
00:43:11.100 --> 00:43:25.915
And then they and then they pass that on to others and they go in with an expectation. Like, well, this is actually the required things I do. I'm just going to have to, but I don't really have any great expectations for them. So, the whole other way for this to happen is.

322 "Parsa, Michael D" (1978368512)
00:43:26.220 --> 00:43:36.810
So, you know, I think this is how I, when you see a patient in the hospital, or in the clinic, or something, your patients like the very, very beginning of my encounter with them.

323 "Parsa, Michael D" (1978368512)
00:43:36.810 --> 00:43:42.810
Sets a tone and they're going to decide right away whether.

324 "Parsa, Michael D" (1978368512)
00:43:42.810 --> 00:43:57.505
You know, they can trust me or whether, you know, I'm a caring person and if I give them some vibe that I'd like to have disinterested or something, they'll, they'll catch that. And then that will set the tone for the rest of my relationship with them.

325 "Parsa, Michael D" (1978368512)
00:43:57.985 --> 00:44:01.285
So, I think we have to really set a tone early.

326 "Parsa, Michael D" (1978368512)
00:44:01.620 --> 00:44:12.150
To help them to see so when they go to class, they go, hey, I'm actually getting something really valuable from this. This is actually really good and especially because now they may be coming in with a mindset.

327 "Parsa, Michael D" (1978368512)
00:44:12.150 --> 00:44:23.965
Of this isn't going to be such a great I just have to do the required things to go through the motions, but I'm really going to get all my learning done with sketchy or whatever outside resources.

328 "Parsa, Michael D" (1978368512)
00:44:24.145 --> 00:44:27.565
So I think we've really got to set the tone early.

329 "Parsa, Michael D" (1978368512)
00:44:27.870 --> 00:44:37.680
That people the students say, hey, this is a value to me. I really want to, um, I'm really looking forward to class. I'm not gonna just go to the bare minimum because it's really high value.

330 "Parsa, Michael D" (1978368512)
00:44:37.680 --> 00:44:50.670
For me thanks. Dr. um, I'll just jump in and.

331 "Brower, Richard" (3902980608)
00:44:50.670 --> 00:45:01.980
I think what you said about contagion is, uh, we've definitely experienced that. We've, uh, uh, understood that from some conversations with various student groups. Uh.

332 "Brower, Richard" (3902980608)
00:45:01.980 --> 00:45:05.910
We also know that, uh, um, the past.

333 "Brower, Richard" (3902980608)
00:45:05.910 --> 00:45:12.840
Couple of years have been, uh, uh, negatively affected by a few, uh.

334 "Brower, Richard" (3902980608)
00:45:12.840 --> 00:45:20.700
Disgruntled students that were unsuccessful and it caused a lot of trouble and and this not only resonates, uh, once they.

335 "Brower, Richard" (3902980608)
00:45:20.965 --> 00:45:35.605
Once students get here and begin kind of learning from, uh, the other students around them about what may have been perceived negatively, but it even starts before they arrive through these, uh, uh, applicant, uh, chat groups.

336 "Brower, Richard" (3902980608)
00:45:39.810 --> 00:45:54.415
Other questions or comments feel free to

337 "Mulla, Zuber" (1314477312)
00:45:54.415 --> 00:45:55.615
unmute and, um.

338 "Cheryl Samaniego" (48720640)
00:45:57.990 --> 00:46:05.550
Sometimes my microphone works, and sometimes it does it on this computer. Can you guys hear me?

339 "Cheryl Samaniego" (48720640)
00:46:06.570 --> 00:46:15.030
Yes, okay. I was just curious. Are you guys considering the possibility of returning to in person bosses?

340 "Cheryl Samaniego" (48720640)
00:46:15.030 --> 00:46:25.860
Your Pre clinical Dr accomplished you want to take that.

341 "Rebecca L Campos MD" (3376588800)
00:46:26.910 --> 00:46:33.240
We have essentially, right? I want to make sure I understand the question as far as, like the, uh.

342 "Rebecca L Campos MD" (3376588800)
00:46:33.240 --> 00:46:36.660
Pre, clinical course courses and learning.

343 "Rebecca L Campos MD" (3376588800)
00:46:36.660 --> 00:46:41.760
Yes, um, so for medical skill, that's 11 of the courses.

344 "Rebecca L Campos MD" (3376588800)
00:46:41.760 --> 00:46:45.540
We quickly did return to being a in person.

345 "Rebecca L Campos MD" (3376588800)
00:46:45.540 --> 00:46:49.260
And right now we are 100% in person for those activities.

346 "Rebecca L Campos MD" (3376588800)
00:46:49.260 --> 00:46:54.900
And for the rest of the course, I think Dr farm might be more involved with the.

347 "Rebecca L Campos MD" (3376588800)
00:46:54.900 --> 00:46:59.250
Organ system based courses that as our integrated curriculum.

348 "Cheryl Samaniego" (48720640)
00:46:59.250 --> 00:47:03.300
And those 2 are in person. Okay.

349 "Cheryl Samaniego" (48720640)
00:47:03.300 --> 00:47:09.600
Great I, I'm at dental school, so I'm not aware. I just know that when I came, um.

350 "Cheryl Samaniego" (48720640)
00:47:09.600 --> 00:47:19.950
Our students were our 1st year students were saying, hey, the, the medical schools not required to go to their classes. Like, nobody goes in their classrooms and things like that.

351 "Cheryl Samaniego" (48720640)
00:47:19.950 --> 00:47:34.440
And I just think that starting off on that foot of, like, there's no required classes, there's no human interaction in an age where the students are connected by these electronics, but not in person and having that personal connection.

352 "Cheryl Samaniego" (48720640)
00:47:34.440 --> 00:47:37.920
Bad to hear that they're returning back so that's awesome.

353 "Cheryl Samaniego" (48720640)
00:47:37.920 --> 00:47:45.960
Good I just thought maybe that's a big part of these last 2 years dips just that aspect of at least having.

354 "Pfarr, Curt" (3946910720)
00:47:47.490 --> 00:47:53.940
Those major changes. Yeah, thank you. Cheryl. That's an important point, I think is.

355 "Pfarr, Curt" (3946910720)
00:47:53.940 --> 00:48:06.150
I think there there is a correlation between attendance to non required classes in the main scientific principles of medicine. Course, for example, and this down trend.

356 "Pfarr, Curt" (3946910720)
00:48:06.150 --> 00:48:14.820
In the graduation questionnaire results globally, suggesting that there's a loss of connectedness.

357 "Pfarr, Curt" (3946910720)
00:48:14.820 --> 00:48:22.530
Between the faculty and push forward as part of the formal curriculum that connectedness. Um.

358 "Pfarr, Curt" (3946910720)
00:48:22.530 --> 00:48:27.750
What those actual dynamics are understanding them that's always.

359 "Pfarr, Curt" (3946910720)
00:48:27.750 --> 00:48:36.840
You know, dynamically discussed and argued about in faculty meetings. It's hard to put your finger on. Exactly.

360 "Pfarr, Curt" (3946910720)
00:48:36.840 --> 00:48:41.700
What motivates students to go to class or not a 10 class part part of it is the.

361 "Pfarr, Curt" (3946910720)
00:48:41.700 --> 00:48:56.010
The quality and the accessibility of 3rd party resources, like D*** boss and boards and beyond and so on. Sure. Um, and part of it is social media and as Dr Brower alluded to and others, the idea that.

362 "Pfarr, Curt" (3946910720)
00:48:56.010 --> 00:49:04.045
That students are already coming in with a set of expectations and some knowledge, fragmented knowledge about the curriculum.

363 "Pfarr, Curt" (3946910720)
00:49:04.045 --> 00:49:11.125
They're, they're entering, um, being told, you don't have to go to class, except for required activities.

364 "Pfarr, Curt" (3946910720)
00:49:11.850 --> 00:49:18.090
Of, which, for example, just as a quick sidebar so there are required activities, medical skills.

365 "Pfarr, Curt" (3946910720)
00:49:18.090 --> 00:49:26.455
Um, the college colloquium I spoke about earlier and any, um, dissection laboratory activities that required team.

366 "Pfarr, Curt" (3946910720)
00:49:27.295 --> 00:49:37.915
Um, so those are monitored and required, but we're still challenged with building a social network of expectations. So, students rely on each.

367 "Pfarr, Curt" (3946910720)
00:49:38.090 --> 00:49:44.010
For for group activities and more tbl and active learning environments, we're still.

368 "Pfarr, Curt" (3946910720)
00:49:44.010 --> 00:49:47.760
Working on developing better and more dynamic.

369 "Pfarr, Curt" (3946910720)
00:49:47.760 --> 00:49:51.270
You know, sessions that will attract students.

370 "Pfarr, Curt" (3946910720)
00:49:51.270 --> 00:49:56.850
So that's been, I think it's to our credit that we've never mandated.

371 "Pfarr, Curt" (3946910720)
00:49:56.850 --> 00:50:01.200
Attendance for all the course work because then we couldn't really.

372 "Pfarr, Curt" (3946910720)
00:50:01.200 --> 00:50:09.720
Measure accurately how the students find it. I think by voting with their feet, we're in a position to be able to improve.

373 "Pfarr, Curt" (3946910720)
00:50:09.720 --> 00:50:13.380
Non required sessions and hope to attract.

374 "Pfarr, Curt" (3946910720)
00:50:13.380 --> 00:50:26.610
Better attendance, so but thanks, Cheryl, I think that's an important connection between, you know, how we deliver the formal curriculum, and this sense of connectedness and how the students feel supported.

375 "Brower, Richard" (3902980608)
00:50:27.925 --> 00:50:38.995
And I would just add that really the policies of the medical school relating to attendants haven't fundamentally changed certainly instruction methods, pivoted during the, uh, pandemic.

376 "Brower, Richard" (3902980608)
00:50:39.265 --> 00:50:46.285
Uh, but even in those founding years, with very high, even relative to national benchmarks, uh.

377 "Brower, Richard" (3902980608)
00:50:46.610 --> 00:50:59.940
Things across, you know, overall satisfaction with the curriculum in the program, um, for the large lecture type sessions. Um.

378 "Brower, Richard" (3902980608)
00:50:59.940 --> 00:51:11.700
Attendance has always been expected, but not required. Um, the required attendance has always been for small group activities, team activities. Um, and, uh.

379 "Brower, Richard" (3902980608)
00:51:11.700 --> 00:51:15.480
Uh, and the, the sorts of things that, uh, Kurt outlined.

380 "Parsa, Michael D" (1978368512)
00:51:17.820 --> 00:51:23.010
You know, I think at the beginning of the year, most of the students are going to come.

381 "Parsa, Michael D" (1978368512)
00:51:23.010 --> 00:51:28.290
To the non required sessions and then that's your time to really.

382 "Parsa, Michael D" (1978368512)
00:51:28.290 --> 00:51:32.460
Prove to them that this is a high yield and high value.

383 "Parsa, Michael D" (1978368512)
00:51:32.460 --> 00:51:46.470
Um, use of time, and if they they go to a few of those, and they feel like, you know, my time could have been better spent also they're not gonna keep coming back. So we really have to catch them early with these, um, high value sessions.

384 "Mulla, Zuber" (1314477312)
00:51:49.500 --> 00:51:55.800
Thank you and we do have a comment in the chat from Dr. Dr.

385 "Mulla, Zuber" (1314477312)
00:51:55.800 --> 00:52:03.000
Uh, she says office of medical education and I think family medicine faculty are collaborating on a research project.

386 "Mulla, Zuber" (1314477312)
00:52:03.000 --> 00:52:08.340
That would explore the reasons for the decline and teaching effectiveness.

387 "Mulla, Zuber" (1314477312)
00:52:08.340 --> 00:52:19.230
Quality of educational experiences declined interest to practice family medicine as evident from the, the graduation graduate questionnaire trends and also to understand.

388 "Mulla, Zuber" (1314477312)
00:52:19.230 --> 00:52:22.620
What these domains may actually mean to the students.

389 "Mulla, Zuber" (1314477312)
00:52:22.620 --> 00:52:28.500
And she goes on to right we would be happy to collaborate with departments faculty who may want to look into something similar. So.

390 "Mulla, Zuber" (1314477312)
00:52:28.500 --> 00:52:34.140
Thanks for allowing me to jump in and it I don't know if we have a question maybe from Dr.

391 "Irene Sarosiek" (3644051200)
00:52:36.210 --> 00:52:50.460
No okay. Oh, no, I got it. Okay. Great. Okay. Sorry I tried. Hi, I have to start with thinking all of you for even having guts to talk about the problems. I appreciate very, very, very much.

392 "Irene Sarosiek" (3644051200)
00:52:50.460 --> 00:52:53.610
What you just told us today, because it comes from your heart.

393 "Irene Sarosiek" (3644051200)
00:52:53.610 --> 00:53:03.600
Obviously something, but we all would like to see better outcomes in the future and showing the past and getting somewhere right now is very important for everybody.

394 "Irene Sarosiek" (3644051200)
00:53:03.600 --> 00:53:17.010
But I have a question related to the fact that a constellation only on the teachers who are available as a mentor, the score. That's 1 issue. But what do we do.

395 "Irene Sarosiek" (3644051200)
00:53:17.010 --> 00:53:20.940
When we try to educate the educators.

396 "Irene Sarosiek" (3644051200)
00:53:20.940 --> 00:53:24.180
Who are on the clinical side of the stories.

397 "Irene Sarosiek" (3644051200)
00:53:24.180 --> 00:53:38.095
This is very important time. When students go to the please, go to the hospital. Do you have any kind of requirements though? Now what does the actors are doing when they are with their patients, how they behave do they know about those hidden problems.

398 "Irene Sarosiek" (3644051200)
00:53:38.095 --> 00:53:43.825
They that things, which are there was a telomeres. I wrote this down somewhere there.

399 "Irene Sarosiek" (3644051200)
00:53:44.205 --> 00:53:53.955
Legal saga and whatever comes with this and how we behave in the front of the patient. This is the ethics. This is the teaching.

400 "Irene Sarosiek" (3644051200)
00:53:53.955 --> 00:54:03.345
This is everything that comes in a very heavy kind of package, but my standards and I think maybe we should focus and do some kind of.

401 "Irene Sarosiek" (3644051200)
00:54:04.180 --> 00:54:05.010
Thank you.

402 "Irene Sarosiek" (3644051200)
00:54:05.010 --> 00:54:10.920
Sub classes and courses for people to, to give this kind of, and.

403 "Irene Sarosiek" (3644051200)
00:54:10.920 --> 00:54:19.380
Mostly an unconscious conscious behavior of us in a clinical hospital, because students they see everything.

404 "Irene Sarosiek" (3644051200)
00:54:19.380 --> 00:54:30.540
And they take your Mimi, can they take your gesture and they take your comments very seriously and if that's an before they learn from the darker Square, not on a top of the best.

405 "Irene Sarosiek" (3644051200)
00:54:30.540 --> 00:54:38.850
Kind of attitudes our approach towards the staff or or other doctors. Our impatience that's most important.

406 "Irene Sarosiek" (3644051200)
00:54:38.850 --> 00:54:49.770
That's very, very crucial point. And I don't know. Do we do anything about this? Do they now? Um, not many of them are able to attend programs next 2 days.

407 "Irene Sarosiek" (3644051200)
00:54:49.770 --> 00:54:52.860
They are in a clinic are in a hospital they are busy.

408 "Irene Sarosiek" (3644051200)
00:54:52.860 --> 00:54:56.790
What do we do to help them out to understand.

409 "Irene Sarosiek" (3644051200)
00:54:56.790 --> 00:55:03.510
That may be something should be changed. This is our goal for this call. Not for 1 person only.

410 "Brower, Richard" (3902980608)
00:55:04.860 --> 00:55:18.205
Please help me, so I would just comment that there's layers to that, and it's a constant battle that requires constant reinforcement, but basically, uh, the clerkship directors, as with, for that matter,

411 "Brower, Richard" (3902980608)
00:55:18.205 --> 00:55:24.805
the residency program directors are responsible for, um, briefing. Well, they have to present a plan.

412 "Brower, Richard" (3902980608)
00:55:24.860 --> 00:55:38.805
And for how they prepare their faculty, uh, introduce them to the, uh, requirements of the program and, and expectations for assessment and the, like, there's also elements related to teaching clinical teaching in the faculty development course,

413 "Brower, Richard" (3902980608)
00:55:38.805 --> 00:55:44.565
which is essentially an expectation for all junior faculty to go through before they go up for.

414 "Brower, Richard" (3902980608)
00:55:44.860 --> 00:55:55.440
Um, and and so I would say that there is a, some accreditation based and institutionally based expectations. Um, now we can't.

415 "Brower, Richard" (3902980608)
00:55:55.440 --> 00:55:59.280
It's not always the case that we can.

416 "Brower, Richard" (3902980608)
00:55:59.515 --> 00:56:11.635
I'm convinced everybody to actively participate in those or to even, uh, you know, engage, uh, with the principles that are taught. Um, but it's a, it's a constant battle.

417 "Brower, Richard" (3902980608)
00:56:12.055 --> 00:56:19.195
And, uh, I think there probably are things that we need to do to strengthen that program. But, but we do have a layer to.

418 "Irene Sarosiek" (3644051200)
00:56:19.280 --> 00:56:20.160
French.

419 "Irene Sarosiek" (3644051200)
00:56:21.720 --> 00:56:34.620
And the end of this would be just the accountability of Sunday for them to even have idea what is expected. And maybe maybe we all are fantastic. I don't know, but just hearing the.

420 "Irene Sarosiek" (3644051200)
00:56:34.620 --> 00:56:49.590
Uh, you know, stories, uh, probably will have to put more attention on those teachers who are in a clinic as scenario, and they, they can help out with, uh, with the outcomes then. Goodness. Which comes many smart people are teaching. Obviously I know.

421 "Irene Sarosiek" (3644051200)
00:56:49.590 --> 00:57:00.750
But I would like to see how this can be put in a broader spectrum, some kind of outcomes with the accountability of people who are doing that.

422 "Irene Sarosiek" (3644051200)
00:57:00.750 --> 00:57:04.410
Thank you thank you for your program. I really enjoyed it.

423 "Irene Sarosiek" (3644051200)
00:57:04.410 --> 00:57:08.880
You send it from you I get my very old people, so.

424 "Irene Sarosiek" (3644051200)
00:57:08.880 --> 00:57:20.670
We didn't have any kind of a programs classes, which you are not obligated to attend. We all had to do it. There was no mercy. We didn't have any media. So now.

425 "Irene Sarosiek" (3644051200)
00:57:20.670 --> 00:57:34.230
Probably our new generation, and every young during the country now, having all those access to dictionaries and helping their pockets on their phones on their computers is just something what may be.

426 "Irene Sarosiek" (3644051200)
00:57:34.230 --> 00:57:38.520
Just make the splash on the teaching, which is done.

427 "Brower, Richard" (3902980608)
00:57:39.775 --> 00:57:45.655
To another person, and just being keeping those pieces together. And I think that's a very important point.

428 "Brower, Richard" (3902980608)
00:57:45.655 --> 00:57:58.195
Because, for example, uh, you go back a couple generations and attending the lectures are attending the sessions was the key way of understanding what was expected and what the content was. And the students have multiple.

429 "Brower, Richard" (3902980608)
00:57:58.520 --> 00:57:59.910
And now.

430 "Brower, Richard" (3902980608)
00:57:59.910 --> 00:58:08.605
Uh, the other thing that I would just, you know, point out from a student's, uh, kind of educational systems perspective, um,

431 "Brower, Richard" (3902980608)
00:58:08.635 --> 00:58:19.885
these students are highly selected by the time they get in the medical school and when they come into systems and programs, that don't have a certain degree of clarity and consistency to them.

432 "Brower, Richard" (3902980608)
00:58:19.910 --> 00:58:31.230
And aren't focused on the outcomes that the student is looking for, which is basically the clinical contextualization of everything for a medical student. Um, and then.

433 "Brower, Richard" (3902980608)
00:58:31.230 --> 00:58:40.170
You know, the other aspect of this is is projecting a sense that the school is caring for them and caring for their mission. Um.

434 "Brower, Richard" (3902980608)
00:58:40.170 --> 00:58:50.070
These things I think are, are the systematic issues that have to be addressed. Certainly we all need to be trained and how to teach and how to contribute to this.

435 "Brower, Richard" (3902980608)
00:58:50.070 --> 00:58:53.580
But when I reflect on the numbers.

436 "Brower, Richard" (3902980608)
00:58:53.580 --> 00:59:04.260
And think about the general approach to, to promoting professional identity formation, among our medical students, I can see how we select these thoroughbreds.

437 "Brower, Richard" (3902980608)
00:59:04.260 --> 00:59:07.920
And if we, we aren't projecting.

438 "Brower, Richard" (3902980608)
00:59:07.920 --> 00:59:17.250
Again, clarity, consistency, constant focused on the clinical contextualization of how they're going to use the knowledge and we don't project.

439 "Brower, Richard" (3902980608)
00:59:17.250 --> 00:59:23.190
Caring both about them and about our health care mission. Um, then.

440 "Brower, Richard" (3902980608)
00:59:23.190 --> 00:59:28.020
We can get into big problems, which is.

441 "Brower, Richard" (3902980608)
00:59:28.020 --> 00:59:31.050
I think, uh, something that we're seeing right now.

442 "Irene Sarosiek" (3644051200)
00:59:31.050 --> 00:59:41.880
That's my editorial statement at the end is wonderful. I'm sorry I'm sorry. Solution a solution a advice or something question.

443 "Irene Sarosiek" (3644051200)
00:59:41.880 --> 00:59:52.170
We have many great teachers on campus. We don't have to go outside the campus to, to have nice people teaching here. Can we put them all on the panel?

444 "Irene Sarosiek" (3644051200)
00:59:52.170 --> 01:00:06.840
And they can tell us why they achieved a awards from the students residents for their what do they do? What they think they deserve to be recognized by the students? Maybe we all can learn because if they're good within.

445 "Irene Sarosiek" (3644051200)
01:00:06.840 --> 01:00:11.460
Does something created something very nice on our site and we can be there too?

446 "Irene Sarosiek" (3644051200)
01:00:11.460 --> 01:00:18.780
The centers who don't know who gets those awards by each department, but maybe we can brag about them those good 1.

447 "Irene Sarosiek" (3644051200)
01:00:18.780 --> 01:00:21.960
And give us an example for us to learn from them.

448 "Irene Sarosiek" (3644051200)
01:00:24.420 --> 01:00:27.690
That's something, thank you.

449 "Mulla, Zuber" (1314477312)
01:00:29.730 --> 01:00:33.390
Thank you. So I'm a sincere Thank you to all of our speakers.

450 "Mulla, Zuber" (1314477312)
01:00:33.390 --> 01:00:37.650
To our audience, thank you for attending today's session. Please complete the survey.

451 "Mulla, Zuber" (1314477312)
01:00:37.650 --> 01:00:44.970
And please join us next Wednesday for our next, need to know series that will be in nursing education next Wednesday.

452 "Mulla, Zuber" (1314477312)
01:00:44.970 --> 01:00:48.300
At noon thanks 1 and all have a good afternoon.

453 "Mulla, Zuber" (1314477312)
01:00:51.180 --> 01:00:51.900
Bye.