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  • AMSA National Leaders Publish Survey in BMC Education

    Advocacy is increasingly being recognized as a core element of medical professionalism and efforts are underway to incorporate advocacy training into graduate and undergraduate medical school curricula. While limited data exist to quantify physician attitudes toward advocacy, even less has been done to assess the knowledge, skills and attitudes of future physicians

    Congratulations to AMSA national leaders - Kristin Huntoon, Colin McCluney, Dr. Elizabeth Wiley (AMSA National President), Christopher Scannell, Richard Bruno and Dr. Matthew Stull (Graduate Trustee) - who recently published, "Self-reported evaluation of competencies and attitudes by physicians-in-training before and after a single day legislative advocacy experience," in BMC Education. Here is the link: http://www.biomedcentral.com/1472-6920/12/47/abstract. The purpose of this study was to assess students' experiences and attitudes toward legislative advocacy using a convenience sample of premedical and medical students attending a National Advocacy Day in Washington, D.C. in March 2011.

    Data from 108 pre-advocacy and 50 post-advocacy surveys were analyzed yielding a response rate of 46.3%. Following a single advocacy experience, subjects felt they were more likely to contact their legislators about healthcare issues (p=0.03), to meet in person with their legislators (p<0.01), and to advocate for populations' health needs (p=0.04). Participants endorsed an increased perception of the role of a physician advocate extending beyond individual patients (p= 0.03). Participants disagreed with the statement that their formal curricula adequately covered legislative healthcare advocacy. Additionally, respondents indicated that they plan to engage in legislative advocacy activities in the future (p<0.01).

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  • New @ 2011 AMSA National Convention: Thought Leaders Series

    Katherine Ellington
    Vice President-Elect, Program Development
    National Chair,Wellness & Student Life Committee
    St. George's University School of Medicine

    A few months ago, I had a conversation with Dr. Matthew Stull, AMSA National Education & Research Fellow about new programming during convention. He discussed the vision for a new “New Thought Leaders” series of talks to provide more opportunity to hear from a broader range of leading voices within the profession of medicine.

    The new “Thought Leaders” series included 3 sessions held on Friday morning. The first featured Dr. James Prescott, chief academic officer at the Association of American Medical Colleges (AAMC), which carries a mission to serve and lead the academic medical to improve health care for all. Dr. Prescott is enabling the AAMC dialogue to help the profession of medicine rethink approaches to the medical education continuum. He acknowledges a new era of transformation in medical education as well as the complexity of our changing health system, which also affords new opportunities (e.g. new medical schools). The commitment to embrace quality and excellence stands unchanged, consider the core competencies for every physician:

    Patient care that is compassionate, appropriate,and effective
    Medical knowledge
    Practice-based learning and improvement
    Interpersonal and communication skills
    Professionalism
    Systems-based practice

    Dr. David Nash, the new Founding Dean of the Jefferson School of Population Health, Thomas Jefferson University provided a conversation from his decades of experience in quality-of-care improvement and outcomes management. He also discussed his new book, Demand Better: Fix Our Broken Healthcare System (2011). Dr. Nash’s blog offers rich discussion on health policy. 


    Gloria A. Wilder, M.D., M.P.H. Inductee, Gold Humanism In Medicine Honor Society & Founder, Core Health LLC practices“street doc” medicine and mobile patient care. She offered discussion on five components driving health:

    1- Access to quality healthcare

    2- Access to quality education

    3- Fair economic opportunity

    4- Environmental justice

    5- Access to an unbiased legal system

    Dr. Wilder is well-known for her real talk, pushing us to think about the interplay between our environment and health. For example, a situation where a child continues to return to the doctor with episodes respiratory distress needs more care than a new prescription for albuterol, it's time for a home visit, if the child lives in poor housing conditions (e.g. mold, poor ventilation) changes need to be addressed before any medicine can be effective.

    special thanks for notes on Dr. Wilder’s talk from Kimberly Fe'Lix Kimes,
    University of North Carolina at Charlotte
    Premedical Regional Director- Region V
    Premedical Trustee-Elect

    The Thought Leaders series was sponsored in part by The New England Journal of Medicine

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  • A Practice of Compassion: part 2

    Aliye Runyan
    Incoming AMSA Medical Education Action Committee Chair
    University of Miami-Miller School of Medicine

    The theme of compassion was elaborated on by two other presenters during AMSA's Annual Convention & Exposition – Jack Coulehan’s session “The Patient is Why I’m Here: Humility and Professionalism in Medical Training” and Allan Peterkin’s “Creative Writing for Teaching and Evaluating Professionalism”.

    Coulehan, professor emeritus and senior fellow of the Center for Medical Humanities at Stonybrook University in New York, spoke to a definition of professionalism, which indeed includes compassion. He quoted John Gregory, eighteenth-century Scottish physician and writer: “The chief quality [in practice of medicine] is humanity, the sensibility of heart that makes us feel for the distress of our fellow creatures, and which, in consequence incites us…to relieve them.”

    “Humility is the most absent of virtues in medicine”, Coulehan observed. He went on to discuss humility as self awareness, unpretentious openness, and gratitude for the privilege of caring for others. Techniques for conveying such attributes in medical education were discussed – such as Balint groups and interprofessional leadership training among the various health care professions.

    Allan Peterkin, author of “Staying Human During Residency Training”, and associate professor of psychiatry and family medicine at the University of Toronto, helped to wrap up the convention weekend with his Sunday morning storytelling session. Peterkin led students through the CanMEDS prompts for teaching professionalism in Canadian medical schools, and created a 20 minute quiet space in which attendees could write to each prompt. Students were then able to share their stories, and to give and receive feedback on each’s strengths, edits, and possibilities. This model and others like it provide an outlet for the daily frustrations and joys encountered in the medical practice, and serve to develop a physician or physician in training’s self awareness as well as their perspectives on patient care, the medical system, and their role within it.

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  • Communication and Collaborative Technologies

    Scott Hagan
    Vanderbilt School of Medicine, Class of 2013

    Dr. Danny Sands, President of the Society for Participatory Medicine and Director of Medical Informatics at Cisco Internet Business Solutions, gave a great presentation (slideshow available here) on the use of emerging technologies to improve patient-physician communication in healthcare on Saturday, March 12th at the AMSA Annual Convention & Exposition. Some particular points that I found intriguing:

    • Pagers are quickly becoming irrelevant in medicine, as physicians are moving toward smartphones and cell phones to receive messages. This is a welcome change, as beepers are an inefficient way of communicating.
    • In general, inefficient communication in the hospital accounts for a massive amount of wasted time. For example, 65% of nurses spend than 20-60min/shift just trying to reach staff, and over 66% use more than one channel of communication to do so.
    • According to the Joint Commission, communications failures are considered to be the greatest contributor to sentinel events in hospitals. Thus it is a moral imperative for the future clinician workforce to improve the processes of communication in healthcare if we are to do right by our patients.
    • New forms of e-Communication, whether it be improved patient access to their health information (like Beth Israel’s http://www.patientsite.org) or advanced telemedicine that allows clinicians to interview and even to record signs of patients remotely, are revolutionizing the patient experience, and we should welcome new technologies that empower patients and increase the efficiency and ease of communication.
    • Both provider and patient use of social media has exploded in the past 5 years, whether it be Twitter (check out Sands’ recommendation of 140 Health Care Uses for Twitter), Facebook, I Move You, or the myriad blogs and websites on health care.

    To read more about Dr. Sands, follow him on Twitter. Also check out the blog of his most famous patient, e-Patient Dave, who blogs about patient empowerment.

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  • A Practice of Compassion

    Aliye Runyan
    Incoming AMSA Medical Education Action Committee Chair
    University of Miami-Miller School of Medicine
    Keynote speakers Dr. Patch Adams and Susan Parenti, from the Gesundheit Institute (www.patchadams.org), provided a meaningful and compelling welcome to AMSA’s 2011 Annual Convention & Exposition. 



    Parenti (pictured) emphasized the importance of “nesting” – nurturing that which is vulnerable- in this case, the process of healing and care of patients – in a nurturing community. This is the background for Adams’ brainchild – the design and now, building of a completely not-for-profit health care organization that is a project in holistic medical care – based in West Virginia. The project is a response to what Parenti and Adams call a “cry for compassion” from patients. The pair stress that burnout among physicians can be attributed not to too much time spent seeing patients, but too little time per patient, leaving both provider and patient unfulfilled. They emphasized the importance of the “bidirectionality” of the physician-patient relationship over time, and that the health of the staff in medicine is just as important as health of patients.

    Adams stated that medicine is “a practice of compassion” and “no medical school in the world teaches compassion”. He proposed a “study of compassion”, in which a cell of four students collect information about observations on the giving and receiving of compassion for a two year period – the first six months being a time for the breakdown of preconceived judgments. Learn to be comfortable with the language of compassion, Adams implored. Notice how you and those around you give and receive love. Learn the types of people you tend to avoid and befriend such a person.

    In response to a question about the use of self-reflection as a tool for teaching compassion and self-care in medicine, Parenti responded that we should reflect, but to go a step beyond and ask “what is my vision to make a situation better or different?”

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