March 19, 2018 — In order to create future generations of physicians who practice empathy, professionalism and a commitment to safety and continual improvement, change must begin at the academic health center in which students receive their education.
To commemorate 2018’s Medical Education Week, the UF College of Medicine hosted four speakers who discussed their visions for creating a culture of excellence in the next generation of practitioners.
The week began March 12 with a talk from Wiley “Chip” Souba, M.D., former professor of surgery at the UF College of Medicine and emeritus dean at the Dartmouth Geisel School of Medicine. His seminar, “Flipping the Professionalism Paradigm,” discussed the behaviors and attitudes necessary to create a culture of professionalism in a health care setting. He said becoming a professional is more than adhering to a set of rules and policies — it’s achieved by altering one’s mental state.
“Professional leaders are challenged by problems requiring solutions that are outside the currently available expertise, things that entail a revision of our engrained beliefs and values,” he said. “The foundation of being a professional is grounded in awareness, integrity, authenticity and commitment. Caring supersedes curing.”
Fred Southwick, M.D., a professor in the UF College of Medicine department of medicine, hosted a talk for students and faculty March 13 titled “Health Care Systems and Quality Care: Promoting Asynchronous Learning Using Electronic Platforms.” He emphasized the importance of keeping safety and quality top of mind when educating future health care providers and noted five steps necessary to teach systems improvements, including the need to compensate for human error and to practice effective interdisciplinary teamwork.
“The heart of medical school, in addition to research and clinical care, is our education,” said Southwick, who said he first became interested in quality and safety education in health care after witnessing the inefficiencies in the care his wife received as she faced a life-threatening illness.
On Wednesday, Grant Harrell, M.D. ’10, director of the UF Mobile Outreach Clinic and a professor in the department of community health and family medicine, gave students and faculty an overview of the evolution of service learning at UF, both at the Equal Access Clinic Network and the Mobile Outreach Clinic. He also stressed the importance of teaching students about social determinants of health — factors like access to transportation, housing, education and employment status that affect a patient’s health outcome.
“Poverty, childhood trauma, crime and birth rates are all intimately related and all correlate with future risk of chronic disease,” he said. “Students should learn that social determinants of health are every bit as important as traditional medical issues and should be part of the assessment plan process.”
The seminar series ended Thursday with a talk from Gurpreet Dhaliwal, M.D., a professor of medicine at the University of California San Francisco School of Medicine and director of the internal medicine clerkship program at the San Francisco Veterans Affairs Medical Center. His talk, titled “Clinical Reasoning: Good to Great,” offered four methods to improve one’s clinical reasoning skills. Dhaliwal cited research that found that within five years of completing medical training, physicians report they experience less challenges and feel more comfortable in their practice. The research also identified this time as the point when a physician’s rate of performance improvement begins to slow.
“Just because you do something for a long time doesn’t make you great at it,” he said. “Ask yourself, ‘What needs improvement?’ We need to strive for expertise.”
Dhaliwal offered methods like progressive problem solving, in which one reformulates problems to make them more nuanced and challenging; feedback on patient outcomes or following up on your patients over time to ensure accuracy of your diagnoses and recommendations; reading case studies; and deliberately practicing skill sets that need improvement. According to Dhaliwal, the process of learning is an ongoing endeavor that should continue long after one’s formal medical training is complete.