Medical Educator Minute – Educators as leaders

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Collaboration is at the heart of what we do at MedStar Health, especially within the GME community. All of our residents, fellows, and faculty bring diverse perspectives and experiences to the table, and creating an environment where everyone feels valued and heard is essential to our collective success.

The Josiah Macy Jr. Foundation defines the learning environment as “…the social interactions, organizational culture and structures, and physical and virtual spaces that surround and shape the learners’ experiences, perceptions and learning.” Many theories and frameworks have tried to encompass the complexity of the learning environment and emphasize challenges in workplace learning. Gruppen, et. al outlines a framework that focuses on the multidimensional aspects of our learning environment as follows1:

 

The authors conclude that the learning environment is comprised of not only complex social interactions but also involves the surrounding support and environment and encompasses not only learners but the patients, teachers, and leaders within an organization.

1.Gruppen, Larry D. PhD; Irby, David M. MDiv, PhD; Durning, Steven J. MD, PhD; Maggio, Lauren A. MS(LIS), PhD. Conceptualizing Learning Environments in the Health Professions. Academic Medicine 94(7):p 969-974, July 2019. | DOI: 10.1097/ACM.0000000000002702

To foster constructive and respectful conversations, begin by building trust.

Take the time to understand where your colleagues come from and what they aim to achieve. Actively listen – without planning your next response while they’re speaking and offer positive reinforcement that encourages additive dialogue. Simple tools like saying, “That’s a great point. Let’s discuss it further one-on-one,” or “What if we explored this idea together?” can enhance collaboration and show that every voice matters.

Motivating one another to teach and learn is also crucial.

By creating a safe space for exploration and experimentation, we can challenge assumptions, offer valuable insights, and uncover innovative solutions. Use open-ended questions to clarify ideas and delve deeper into issues: “Can you elaborate on that?” or “Help me understand your perspective.”

Inclusion is key.

By ensuring all voices are heard, we harness the power of diverse ideas and backgrounds. Encourage participation with phrases like, “What do others here think?” or “Thank you for sharing your perspective—it’s helpful to hear different views.”

Together, we are stronger. Let’s continue to learn from each other, embrace our collective strengths, and grow as a community dedicated to advancing healthcare excellence

To learn more, check out: journals.lww.com

People Profile – Dr. Brandon Albert

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Brandon Albert, MD, (PGY4 Chief Pediatric Resident at MedStar Georgetown University Hospital)

Brandon Albert, MD, (PGY4 Chief Pediatric Resident at MedStar Georgetown University Hospital) was inspired to go into the field of medicine because of the opportunity to influence others through what he calls the gift of service. The concept of service is a consistent thread throughout his time at MedStar Health.

“MedStar’s inspiring community – environmental services, nursing, respiratory therapy, pharmacy, attendings, co-residents, and others have all helped me succeed,” he says. “I have been fortunate enough to make several friends in the hallways on my commute to the floor and those brief interactions consistently uplift me.”

Originally from Springfield, Virginia, Dr. Albert finds deep fulfillment in collaborating with families to achieve shared health goals, appreciating the unique opportunity to work with all members of a family toward common objectives. He envisions a future where medicine in the United States is easily accessible and equitably integrated across all demographics.

Like other specialties, pediatrics is a field that requires clinicians to take care of themselves before they can care for others. To prioritize their wellbeing, Dr. Albert reminds his colleagues and himself of the remarkable impact they have on patients and encourages them to allow themselves grace in all aspects of their job.

He also encourages residents and fellows to maintain their individuality. “Never lose yourself in this process,” he says. “You are what got you here, and your patients benefit greatly from interacting with your true, authentic self.”

Spending time with friends and family is one way Dr. Albert pays attention to his personal wellbeing. He and his wife, Lauren, enjoy cheering on the Ohio State Buckeyes and the Los Angeles Lakers. His hobbies also include attending concerts, playing basketball, and photography.

Nearly halfway through his final year of residency, Dr. Albert says it has been a privilege to work alongside his colleagues at MedStar.  “Thank you, everyone, for playing such a huge role in this pivotal part of my life.”

People Profile – Dr. Stephen Kane

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Stephen Kane, MD, PGY 4; Family Medicine/Preventive Medicine)

Stephen Kane, MD, (PGY 4; Family Medicine/Preventive Medicine) is encouraged by the fact that our healthcare system in the United States is beginning to look more at the social drivers of health—the factors encountered outside of clinical care that make up 80 percent of a patient’s health.

Dr. Kane says that his combined specialty of family medicine and preventive medicine has allowed him to help with this shift and to focus on making programmatic and policy changes for underserved populations.

“With advanced primary care models focused on funds for quality of care and social drivers, we are set to create a system that works for patients—and not in spite of their social conditions,” he says.

Dr. Kane pursued medicine to support and guide people at some of the most vulnerable moments of life, and his specialty has allowed him to enjoy an incredible continuity of care with his patients and walk with them through life’s medical and social challenges.

As a fourth-year resident at Medstar Franklin Square and a student at Johns Hopkins University Bloomberg School of Public Health, Dr. Kane encourages other residents not to go it alone and to ask for help when needed. “Residency is a marathon, not a sprint. Sometimes you’ll excel, and sometimes you’ll fail. That’s normal—you are in a training program. If you are underwater, you’re not alone and the program likely has the resources to help you. Make sure to ask,” he says.

In addition, Dr. Kane suggests leaning on others in your program. He says his own program and co-residents have been a source of support through the long hours and difficult cases and have connected him with fantastic mentors that exemplify the type of physician he hopes to become.

He also suggests finding restorative activities to enjoy outside of work. Running with his pup, hanging out with his nieces, finding live music, or sharing hikes, food, or quality time with his co-residents are a few of his favorites.

People Profile – Liz Joseph

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Liz Joseph, Senior Director, HR Lead

Most residents and fellows know Liz (Senior Director, HR Lead) as the primary contact for HR, benefits, and payroll questions, as well as for the GME Parental, Caregiver, and Medical Leave program. She is often recognized for sending timely reminder emails about important deadlines.

Liz has lived in Alexandria, Virginia for more than 20 years, up the east coast from Miami where she spent most of her early years.

Her path into healthcare began unexpectedly after meeting someone from MGUH at a wedding. With a background in advertising, the world of GME was new to her, but she embraced it, starting as a GME Coordinator at MGUH and working her way up to Senior Director. Liz is passionate about supporting residents and fellows at this exciting stage of their careers.

“I love working with residents and fellows,” she says. “It is such an exciting time in their career. I hope that the GME leadership team helps them feel comfortable and at ease as they embark on their career journey.

One of the most rewarding aspects of her work is onboarding interns. While it’s a busy time of year, it’s also one of the most exciting. Meeting the interns in person at orientation, after months of preparation, and seeing their enthusiasm as they begin their training is what makes the effort truly worthwhile.

Liz knows HR plays an important role in a thriving GME program. Her team oversees the entire employment lifecycle for residents and fellows, from hiring to graduation. They begin the onboarding process several months before the start date, ensuring smooth transitions into training programs without delay. This includes conducting background checks, drug screenings, visa processing, and handling payroll, benefits, and wellness support.

Her success at MedStar Health is largely attributed to the collaborative and experienced GME team, many of whom have been with the department for more than 15 years. This collective expertise and teamwork ensure that goals are met, and the department functions smoothly.

Her perseverance is evident outside of work, too. Liz has completed three marathons: Marine Corps, Chicago, and the Nashville Rock and Roll Marathon.

 

Medical Educator Minute – Best practices for simulation in medical education

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Medical education has learned from other professions that have established uses of simulation in training, such as aviation and the military. With limitations on duty hours potentially restricting patient encounters, and a growing emphasis on patient safety, simulation increased steadily across healthcare education. Simulation is traditionally used for learning or practicing low-frequency, high-stakes patient encounters or for procedural skills. However, more recently, simulation is being used in health profession education to practice complex communication scenarios (e.g., delivering bad news) or situations that may be emotionally charged and require an environment of psychological safety to practice (e.g., responding to microaggressions). Beyond traditional simulation, new and innovative ways of using simulation are emerging in medical education, including rapid cycle deliberate practice, ‘just in time’ simulation, and group simulation (stay tuned for future MEMs to learn more about these!).

Features of high-fidelity simulation that lead to effective learning:

Curriculum Integration

The simulation experience must be planned, scheduled, implemented, and evaluated in the context of a broader medical curriculum.

Feedback

A critical component of learning, use the three Ps for simulation: Plan, Pre-brief/Prepare, and Provide feedback/debrief

Deliberate Practice

Involves repetitive performance of cognitive or psychomotor skills with specific and rigorous skills assessment; must have multiple SIM experiences that are not exactly the same

Mastery Learning

The goal of mastery learning is to ensure that all learners achieve the objective level of mastery performance, a higher level than competence alone – some learners may require more time/practice than others

Range of Difficulty

Learning is most effective when trainees begin at an appropriate level for them, demonstrate performance mastery at that level, then advance through increasing levels of difficulty

Capturing Clinical Variation

Simulations that encompass a variety of patient presentations are far more effective for learning than those having a single case, presentation, or scenario

Individualized Learning

It’s not only about learning at one’s own level, but also about the learner being an active participant, continuously shaping and adapting the learning experience to meet their specific needs

To learn more, check out AMEE Guide #82 – Best Practices for Simulation in Healthcare Education

People Profile – Dr. Kathy Stolarz

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Kathy Stolarz, DO, FAAFP, (Family Medicine)

Kathy Stolarz, DO, FAAFP, (Family Medicine) dreams of a healthcare system where each and every patient has access to excellent care without regard to socioeconomic factors or type of health insurance.

“As the daughter of an immigrant and the granddaughter of Holocaust survivors, I am passionate about creating an inclusive healthcare system that addresses the needs of populations that experience adversity,” she explains.

This passion—and an interest in developing tangible skills to address healthcare disparities in her own backyard and across the globe—initially led Dr. Stolarz to become a Family Physician. Now, as the Associate Director of Global Health, MedStar Academic Affairs, she underscores how the recent pandemic made clear the importance of global health. “We cannot provide healthcare in a silo. The future of healthcare IS global health,” she says.

According to Dr. Stolarz, the opportunities at MedStar Health for global health engagement have allowed her to grow an international network of bidirectional partnerships, work with residents and faculty from all specialties across Medstar Health, and advocate to Senators and Congressmen on important healthcare issues.

And, through the MedStar-Georgetown Global Health Equity Track, Dr. Stolarz says MedStar Health is training the next generation of physicians to meet global health needs. She encourages interested MedStar Health GME learners to contact her and get involved. She also encourages GME learners to travel and experience another healthcare system outside of the United States, if possible, and explains, “Your eyes will be opened to the possibilities and opportunities that exist for change.”

In addition to her role in global health, Dr. Stolarz is also the Associate Program Director for the Department of Family Medicine at MedStar Franklin Square Medical Center and an Assistant Professor in the Department of Family Medicine at Georgetown University. Dr. Stolarz calls family medicine physicians the “Swiss Army Knives of healthcare” on account of their unique skillset and ability to care for patients of any age in a multitude of settings.

When she’s not caring for patients or training family medicine residents in the inpatient, outpatient, and labor and delivery settings, you can find Dr. Stolarz on hiking trails around Baltimore with her son, daughter, and husband or on the soccer field where she plays each week (and says she is actively recruiting other physicians to join her!).

People Profile – Dr. Jeffrey Breton

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Jeffrey Breton, MD, (PGY 4; Neurological Surgery)

Jeffrey Breton, MD, (PGY 4; Neurological Surgery) was recently elected as one of the newest members to MedStar Health’s Graduate Medical Education Committee (GMEC), the team of residents and administrators that oversees the system’s many residency and fellowship programs.

Dr. Breton hopes to use his GMEC role to help fellow residents maximize valuable education time while respecting their needs as humans and providing an equitable and fulfilling workplace.

“There are many competing pressures on residents to be productive clinically and academically, with the expectation of somehow simultaneously mastering a specialty, possibly securing a fellowship, and trying to live your life outside of the hospital,” Dr. Breton explains.

He says his co-residents—whom he describes as “a source of knowledge, support, occasional commiseration, and friendship”—have been an immense help in managing these pressures. He also credits the neurosurgery faculty with taking a keen interest in their learners’ education and well-being and helping them succeed.

To incoming residents, Dr. Breton suggests a practical solution for juggling competing priorities: “Organization is paramount. With inspiration from one of the senior residents, I developed a color-coded organizational system to make sure I knew which consults I needed to call, drains I needed to pull, orders I needed to place, and consults to see and staff.” With a system like this in place, he says he’s been able focus more of his energy on learning medicine and taking care of patients.

Outside of the hospital, Dr. Breton tries to set boundaries and make space for the activities he enjoys most, like reading; hiking; following his favorite baseball teams, the Boston Red Sox and San Francisco Giants; honing his musical talents on the guitar, piano, and ukulele; and spending time with his co-residents, friends, and fiancée.

A fellow at the Center for Medicare and Medicaid Innovation (CMMI), a part of the Centers for Medicare and Medicaid Services (CMS), Dr. Breton often thinks about how healthcare might change in the future. CMMI develops and implements models for new and innovative forms of healthcare delivery. “These alternative payment models revise the incentive structure with the goal of improving quality or decreasing cost while keeping an eye towards addressing health inequities,” he explains. “In the future, I expect that there will be a larger role for quality and outcome-based metrics for public and private payers than there is today.”

People Profile – Liza Shaban

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Liza Shaban, MD, (PGY 2; Internal Medicine)

Liza Shaban, MD, (PGY 2; Internal Medicine) is a dedicated physician who calls both Jordan and Washington, D.C. home. She draws inspiration from her upbringing, where she was encouraged to look for ways to make a difference in the world. This sense of service led her to a career in medicine, with a focus on internal medicine. Dr. Shaban is passionate about providing equitable healthcare and has developed a strong interest in working with diverse populations through her clinical training and research.

“My inspiration to pursue medicine came from a combination of personal experiences and a desire to serve others,” she says. “Growing up in an empowering home and school environment, I was encouraged to overcome societal limits and give back to my community. Volunteering ignited my passion for equitable healthcare. My clinical training and research further solidified my interest in internal medicine and affirmed my commitment to serving diverse populations.”

As one of the newest members of the System GMEC (Graduate Medical Education Committee), Dr. Shaban is committed to improving medical education and residency training. She advocates for resident well-being and inclusivity, aiming to shape policies that create a supportive learning environment. Her success at MedStar Health has been driven by the collaborative culture and leadership within the organization, along with her proactive approach to learning and skill development.

In her personal life, Dr. Shaban maintains a balance through activities like pickleball, cooking, and spending time with friends. She encourages her colleagues to prioritize their well-being and build strong support networks during the demanding training years. Looking ahead, Dr. Shaban envisions a future in U.S. medicine that prioritizes preventive care, improves care coordination, and addresses healthcare disparities to ensure equitable access for all.

People Profile – Dr. Katherine Lewis

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Katherine Lewis, DO, (PGY 2; Family Medicine)

Katherine Lewis, DO, (PGY 2; Family Medicine) is a dedicated Family Medicine physician at MedStar Franklin Square in Baltimore, MD. Originally from Columbia in Howard County, Maryland, Dr. Lewis is excited to be practicing medicine in her home state. Her passion for medicine began early on, driven by a desire to interact with people daily and serve her community.

“Medicine was the only career I ever considered because I had always wanted a job where I could interact with people daily and serve my community,” she says. “I love that everyone is their own puzzle with a thousand different solutions, and it’s our job to find the best solutions to the puzzle that fits the patient’s goals.”

Dr. Lewis was drawn to family medicine because of the continuity of care it offers and the opportunity to help patients navigate the complexities of the healthcare system. She values being a central point of support for her patients and providing holistic, patient-centered care.

At MedStar Health, Dr. Lewis credits her success to the support of her colleagues, including her fellow residents and attending physicians, who provide mentorship and encouragement. Outside of work, she prioritizes her well-being by staying active with the Canton Run Club, kayaking, and spending time with her family, friends, and pets, Riggins and Rory.

As a prospective member of the System GMEC (Graduate Medical Education Committee), Katherine strives to make a difference. She is an advocate for positive change that enhances the resident experience at MedStar. She is approachable, open to feedback, and committed to being a team player. Her focus includes improving resident safety, wellness, and creative supportive spaces, ensuring that residents can thrive both personally and professionally.

Dr. Lewis envisions a future healthcare system that is more accessible and supportive for all patients, without the barriers that currently limit access to necessary care and treatments. When she’s not focused on medicine, she enjoys exercising, cooking, and planning her upcoming wedding.

Medical Educator Minute – “Coaching” in medical education

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What is “coaching” in medical education, and how is it different from traditional teaching and feedback?

Coaching helps learners recognize their growth potential and fosters responsibility in finding their own path to improvement. Unlike traditional teaching, which focuses on telling, coaching emphasizes asking, enabling learners to develop lifelong adaptive skills (Hammound et al., 2022). While formal coaching programs exist, “impromptu coaching” is gaining attention for its ability to support trainee growth through brief, focused interactions based on a specific area, skill, or patient encounter that has been directly observed by the coach.

Five factors for effective impromptu coaching:

  1. Identify coachable moments – this can be any observed moment of patient care
  2. Create a supportive setting – ensure appropriate time and space for conversation
  3. Use time wisely – focus on a specific skill or area
  4. Ask questions – the hallmark of coaching – to help the learner uncover their own mental processes, strengths, and gaps
  5. Build a trusting relationship – coaching is grounded in growth mindset, ensure the learner feels capable of improvement

So, what does this look like in practice?

You’ve just finished rounds with your learner. During the last patient encounter, the patient’s family member became upset when discussing the plan of care. The learner seemed uncomfortable and ended the encounter quickly, seemingly dismissing their concerns.

  1. “Before we move on for the day, do you have a minute? I’d like to debrief that last encounter.”
  2. “I felt it got a little tense at the end, what was your experience?”
  3. “What part made you uncomfortable?”
  4. “Why do you think the family member responded that way? How might you have approached the conversation differently?”
  5. “Conflict can be very uncomfortable. What do you think you can do to make the conversation more comfortable?”
  6. “How can I help you work on these skills?”

To learn more: