Academic productivity and personal well-being during COVID-19
Welcome to raise the line, academic productivity and personal wellbeing during COVID-19. We're delighted that you could join us this morning in terms of agenda for this webinar.
Um We'll start with welcome. Um and introductions.
Uh We'll talk a little bit about what it means to raise the line. Um And of course, our focus will be on academia and balancing uh balancing wellness during this time, our intention is that this is a community sharing uh and storytelling more than a presentation.
Um So we invite you to participate uh to that end a couple guidelines for uh housekeeping. Uh Please, you should all be muted but please keep your mic muted.
If you're unmutated, uh We would love to see you. Please share um share your faces.
Uh uh Jack Kaufman is going from the Asmus team is going to help moderate. So if there's something you want to share or you have a question, please post it.
Um And again, uh for community, please let us know who you are when you post something and where you're from. So today's presenters uh are Amine Azam uh Sean Tackett and uh and as I said, moderated by our colleague, Jack Hoffman.
I let, I mean, and uh Sean introduced themselves as we get to them and we will start with, uh with, with Sean Tackett, who I am giving control to.
Ok, thanks. Um Yup.
And just to introduce myself. Um So for first anybody who was here last week, thanks for coming back.
Um But I'm a general internist at Hawkins also uh I a research director and help out with osmosis in other ways. Um And I am in Lutherville, Maryland, which is about 10 miles north of Baltimore at home.
And I guess just to give you the lay of the land, given that this is a, a bit about work-life balance. I'm spending all my time in this room right here.
Uh So my wife normally works there next to me and my seven year old first grader typically works there and our, with three year old, we try to keep outside in a safe place where you can't break things.
Um And uh and right now the door is locked, so they're downstairs and then they, so they will not come in here and cause uh havoc.
Um You know, so the title of this webinar, uh you know, raising the line. So what does raz a line mean?
Uh Some of you may have seen the music video or other osmosis content that, that describes it, but it's just in case you haven't, you know, um as part of the public health intervention to try to decrease the incidence of COVID-19 cases.
Um A lot of people talk about flattening the curve and you know, that's where the social distancing or physical distancing tends to fit in and in the sense that we just want fewer people to get COVID-19.
But there's another aspect here because flattening the curve is to keep it under the line. Um and that line represents he the healthcare system capacity to care for patients who develop illness from COVID-19, particularly those who have severe illness and you know, in intensive care units, uh U unit support ventilators, that sort of thing.
And it's so really both need to be done, right? You need to flatten the curve and raise a line um in order to, to make sure that all the patients who need care receive it.
And so, you know, uh up on the top here are different ways to sort of raise a line. And so, you know, if you're, if you're a provider and you're sick, stay home, um you know, you can raise a line by educating like or upskilling existing providers to provide specialized care for uh this required for COVID-19 uh patients.
Um you know, staying away from the hospital if you can. So telemedicine, uh almost all outpatient providers these days are strictly doing telemedicine.
Um Yeah, avoiding spread. Um So now there's public health interventions for this but also with within the hospital.
Um you know, people have talked a lot about PPE and how necessary that is to prevent providers from getting sick, um prevent providers from uh getting other providers sick as well as spreading it through the hospital setting.
So, um so that's, that's what we have a raise a line. So raising the, the the increasing healthcare system capacity.
So then, you know, the the next step is, well, how can we, and I'm assuming most people who are joining are probably part of academia, um how can we raise the line?
And so, you know, actually, as I was thinking about this there, we can do it in all three ways of that align with the, the traditional tripartite mission.
So which is, you know, and the uh so in academia, especially academic medi medicine, we talk about patient care, uh research or discovery and an education as being the three parts of the tri partite mission.
So in patient care, obviously, you know, we get into the, the, the clinical setting and take care of these patients, um research and discovery.
There's a ton of research going on right now, especially related to COVID-19. Uh And then education is probably what most people who are joining us are interested in.
What we're trying to do right now is uh is, you know, help people become more informed. What about COVID-19?
And we've actually seen this kind of uh in each of the three domains. So inpatient care, uh you know, there's been talk of providers uh going from different areas.
Uh So I think I was telling me yesterday that uh providers from UCSF flew into New York City to help care for patients there.
Uh given that they, you know, they, they didn't feel like they didn't or they didn't have enough providers to, to do so.
Um research and discovery mentioned that, I mean, there's been numerous stories about sort of unprecedented collaboration and track and vaccine discovery and advancing the basic science and, and uh clinical trials in education.
Um you know, uh I, I've noticed on a numerous serves as, as well as professional organizations just curating information, putting it out there.
There's really no shortage of education um that, that's being produced and shared. Um And, and so, II think that's, that's been great to see.
And, you know, one thing we should think about is how we can sustain that beyond the crisis. So now, you know, transitioning to the role of, of balance and, and the role of self care in the crisis cause, you know, raising the line, right?
We, we need to support, we all need to sort of support uh health healthcare system capacity in our own way, you know, uh but we also need to support those who are supporting healthcare system capacity.
Um And so I think it's, it's worth mentioning, a lot of us are struggling these days with just trying to find uh a new normal.
Um And it's, it's important to acknowledge that even before this people are struggling with work life balance. And so, um, you know, there was more work at work, more work at home and it's, it was always difficult to tell how to prioritize and how to, you know, prevent work from creeping into the evenings and into weekends, uh, e especially in academic medicine when you throw on, um, the crisis itself, um, as well as uncertainty around the duration and everything else that has come with the crisis.
Um, you've thrown in, it's actually more difficult for people to, to destress. Um, so lots of the outlets people we used to go to like, you know, going to group settings or just traveling anywhere.
Um, and, and seeing people in person who have social occasions which are, are rejuvenating, uh are, are not there anymore.
Um And then for a lot of people, there's actually more work happening and there's much more work at home, especially for those who have, uh, childcare thrown on top of this.
Like I, I'm, I'm one of those people and, and you know, so it becomes even harder to prioritize and to feel like you're making good decisions and moving forward.
So first, you know, this is a, this is a, a data free area. We, there's a lot of anecdotes, there's a lot of assumptions.
Um uh I think I'm gonna present the only data that I I'm aware of which we collected earlier this week at, at a medical school.
Um So this is also a, a demonstration of how a Emia can support um raising a line through, through research. Um But when we ask medical students sort of their concerns.
Um Right now, uh as they're sitting at home, they, they were extremely concerned about health of family and loved ones not knowing when this will end.
Um and act actually less concerned about themselves. So their own health uh generally, again, far less concerned and, and not as concerned about their own academic or professional future.
So, um medical students and again, many, many of us are medical educators. Uh They're actually more focused on sort of societal needs and altruistic needs um less on like sort of self-preservation or self-interest needs.
And then we also asked them, you know, since you've had to change your whole lifestyle, how have you changed it? Um And we asked about these specific behaviors.
Um So, you know, the red bar is they doing less, um green is doing more and this gray one is no change. This is organized as sort of, the most change was spending time outdoors and the least change was in meditation or other mindfulness practices.
So, I think you can see, you know, some, some of there, there are some patterns where people are doing more, like connecting with family.
People are doing more, I guess watching TV. Yeah, it's true.
It's true. My house too, I think, um, people are doing more sleeping.
Uh, people actually appear to be doing less uh studying even though classes were, were continuing. Not sure, you know, not sure exactly why I think the other thing that stood out to me when I looked at these data was that for almost every one of these activities, um There were, there were large proportions that were green and large proportions that were red.
And so the way I II interpret that is that each individual is dealing with this in their own way, right? So some people are doing more exercise, getting outside more, some people are just doing less.
Um Some people find that they have more, more errands to do. Some people have less and, and so on and, and so, you know, it's very hard to, to assume that any, any one person is doing the sa things the same way cause we're all adapting differently to based on our, our own needs and context.
Um And then just one more final thought before I tr I transition over to, I mean, is that while we have spent a lot of time thinking about how not to get sick and how not to get burned out.
Ho how to prevent just again, feeling bad and stressed in general. The uh there are opportunities here to strive and, and to make progress.
And so I throw up this, this slide, the Japanese word you could guide life reason. Um but it, it still is the purpose uh finding purpose.
And I do think there are plenty of opportunities for us to continue to strive for joy, for purpose, for finding meaning throughout all of this.
Um And to sort of, and to take advantage and learn and, and um you know, whenever we learn to bring it with us beyond this crisis.
Um and uh and so just be mindful of that. And a as you know, as we're all going through this and also as we're, you know, going through the rest of the session today.
So now I will pass it to Amin who will talk about uh Wellness. Great.
Thanks Shawn. Uh My name is Amin Azam.
I'm on faculty at three San Francisco Bay Area Health Science Universities and just like Shawn, I'm working from home here.
Uh Just a little tour. Um This is a little space that we're trying to sort of make more professional.
Um So this weekend, we'll finish painting it because my wife and I both uh do uh clinical care and we rotate and alternate who gets this, what we call a conference room up here away from our kids.
Uh, you know, it's sort of a partially finished attic space that, um, we can close the door off and then like Shawn, um, you know, try to work as professionally as possible from home.
Um, I am a group psychiatrist by training, um, and I currently run psychotherapy groups for patients living with chronic medical conditions.
So anybody with active symptoms and no cure. And in my clinical work, uh one of the big advantages of that patient population in group therapy is that individuals even as early as the very first group when they join the group, um they suddenly realize they're not alone, even though everyone else in the group has different medical conditions, maybe different symptoms.
They're all struggling to make it work in this terribly broken healthcare system that we have. Um if we can even call it a system in some ways.
And so uh that guy on the right there is like suddenly realizing, wow, I'm not alone. It's ok.
I'm gonna be able to make it a little bit better and str struggling to cope because of that. And at the bottom there um with the animation, it would have, you just would watch those people socially distance.
Uh The key uh element of group therapy is that even now as I do the groups from my home here and I zoom a video chat with all the patients in my groups, we're still not alone even as we social distance.
And I think that's part of what we're trying to a message to you all today and having this opportunity to raise the line at osmosis.
And through osmosis, we put together a on several videos which we can link out in the chat later. But they're all free for free on the youtube osmosis channel.
And they are uh my thoughts as a psychiatrist, group therapist about how we manage the mental health of our learners. And so uh the bottom are just my own notes to myself.
And in the same kind of transparency way that uh Sean has done, I wanted to just share my thoughts what's allowed with you about them.
So this first uh video was about managing the mental health of our students during this COVID-19 uh pandemic. And there's three points I wanna make.
The first one is being explicit with our learners that acknowledging uh acknowledge with them explicitly that providing healthcare can be stressful work.
None of us are immune to the pressures uh of the external uh virus and the uh changes in the more home at home and more home at work stuff that uh Shawn referred to.
So let's just own it if we own it and stop pretending that we're superhuman. We will role model for our students that sharing feelings is a part of being good high quality health care providers.
Second, one is we should be checking in with our students uh as much as we can, we wouldn't care. Uh We don't, we know we c you care for your students.
Um But they may not hear that caring as much as specifically since we're not physically with them as much. And so increased attention to their emotional wellbeing is similar to focusing on the organ systems of a patient's chief concern.
Next slide, third uh point, let's highlight the available resources for our students. Uh uh You know, the most of your universities will have some kind of a student health services, uh some kind of wellbeing office perhaps and links to uh all of those resources, all of those resources will also have links to external sources.
So for example, at UCSF, we now have a, a page at our uh website uh departmental website that links that to supporting your mental health during Coronavirus.
So I've been sending that link to my students. They may not know about it, but let's make sure they're aware of it.
Um The fourth point there, let's remind our students that uh seeking help is a healthy sign of healthy health professionals.
So let's destigmatize mental illness, especially in the context of the radically increased stress load that everybody's experiencing in a global pandemic.
Next slide, there's a separate video that we produced on mental health for educators. So now how do you take care of yourselves uh during this global pandemic.
And the first topic here I wanna highlight is engaging in self care. Um When you used to travel on planes and the airline uh would drop the, they would remind you if the masks fell down and you were traveling with someone who needed help.
Please put your own mask on first before assisting others. And that is so fundamentally true for all of us as health educators uh and clinicians, you have to make sure you take care of yourselves.
This is a not a sprint, it's a marathon as is globally true. So you've gotta make sure to take care of yourself as well.
Um Our CEO shiv uh from osmosis has said he needs to take mental health time too. He goes for hikes when uh socially distanced appropriate and he is role modeling for the rest of the company that he needs.
All of us need to take care of ourselves. Topic number two and support your team and community of peers.
That is really fundamentally what we're doing with hosting this webinar is being part of your team and your community to let you know that you're not alone at your local institution.
You now have this network of people that are uh uh all trying to make it work as well from home. Um And in your local context.
So there are list serves and um and we also have an osmosis list serve if you'd like to join it, just uh you'll see at the end, Catherine's uh email address, I moderate Listserve.
We'll welcome you to our community. We'll all continue to build our network.
Next slide. OK?
The third one is just to remind you all to look for signs of burnout and seek help yourselves. Uh Remember seeking help is a sign of strength, not weakness.
Um Look for your local resources, just look them up if nothing else. If, if anybody is still feeling like shy about it, do it for your colleagues.
So that way you can say by the way, uh not for me, I have a friend who might be interested in learning about these wellness resources.
And then lastly, let's remember to look for signs of burnout in your own care. Uh You all know your body as well.
In my case, it's lower back pain. So I'll just stretch right now cause that helps me um to make sure that that stress in my lower back is a little better.
Next slide. OK.
There's a third video that our partner at osmosis Gil hasn't finished producing yet, but it's around mental wellbeing during social distancing.
I think in this video, I have four points to make. The first one is to acknowledge we're social creatures because by definition, we're mammals and mammals like to touch and feel and be with each other, that's say in contrast to reptiles.
So let's not. And we're not mammals, we are mammals that's natural.
At the same time, we're humans. So we're intelligent.
So we can do mammalian socializing with intelligence. So I've been hanging out with my family members on Zoom and we've been pouring glasses of wine together and sipping wine together or we've been playing video games or cards together or all those things that humans connect with, but we're doing it at a social distance.
So you can maximize collaboration while minimizing physical contact. All of those things listed in the slide are things that we have done in workplaces to maximize collaboration.
Not one of them, not one involves being together in the same space. So there are absolutely a myriad of ways we can continue to collaborate.
And in fact, even more now collaborating effectively at a distance just like we're doing now next slide. OK.
Be attuned to your personal physical manifestations of stress. I already told you about this.
And uh and lastly, let's express love and caring through words, not touch. I mean, I when I first put this together, it was still early in the coronavirus pandemic impact here in the United States.
And so it was at a time when the vice president had flown to Washington State and there was a like a fist bump in the air between him and the governor of Washington State and that way, all sorts of news.
Oh my God. That was so crazy.
Why would they do such a crazy thing? And now that seems like a distant memory and uh while, while many of us are masking as we go out in public, so remember you can still express love and you can still communicate through those masks.
Uh And it, it, talking about your feelings makes them realer. It doesn't make them um bigger or worse.
It actually makes it better. Next slide.
All right. So we thought we wanted this to be a, a storytelling opportunity for everyone.
And so uh Shawn and Catherine and I are each gonna tell you one COVID story related to our own personal lives um in role modeling for you the opportunity for then all of us to hear from you and to continue to build this community during the webinar.
So, uh in my personal life in our family, we have created physical spaces exclusively for work and not work. So you've already seen it.
This is our office, this is our clinical space or conference room. As we joke, my wife and I joke about like who can reserve the conference room and keeping it clean when you leave it.
So she does childhood obesity work. And so she's got little plastic bottles of food.
And sometimes I come up to this conference table and she's got the food splayed all over the table and I have to go down and say June, like we're both working from the conference room.
You've got to keep it clean. I've got to keep it clean.
So um so that's what we're doing up here. Uh Next slide or image on the slide.
So uh so this is me working from upstairs, away from my family. There's a nice little picture of my wife and two kids.
Um And the inverse is also true. So there needs to be spaces for explicit network in our family.
Next slide that is our meal times. So we are off screens and we have nothing but food and the family around us and music, we love music.
So we listen to music with all our meals. So we've made an explicit choice in our family for that life.
Work balance or work, work imbalance as Seann has alluded to again, uh to just have some sacred space away from work. Next slide turns out osmosis feels the same way.
So here's a nice image of osmosis for uh for our students, let's say who are living in studio apartments uh where we wanna remind them that's your workspace in the corner, your desk with your computer or laptop.
And that other part of your physical space is your living space. So try as much as possible to create those as as much as possible, firm boundaries.
So you can have that life work balance even while we uh shelter in place. I think it's next slide time for me to turn it over.
OK. So here's some questions we're gonna ponder and then we're gonna open it up for your stories in a moment.
I'm gonna pass the microphone back to Catherine who will sort of shepherd and dialogue. Jack is gonna monitor the chats for us on the chat and webinar and these are just some suggested questions like any good educators, we want to follow the lead of our students.
And so you may have other directions you wanna take the conversation. But our hope our goal during this webinar is that we really are building community and hearing from you all about how and what you're doing to uh maintain your academic productivity and also to uh uh maintain your wellbeing during the COVID-19 pandemic Catherine.
I passed the ball back to you. Thank you.
All right, I'm having some technical difficulties. Um So Jack is going to be in charge of promoting people.
Um So I think the first person I am going to call on if he's here as kindly volunteered to share a story is uh Doctor Mark Slifko from uh Idaho.
So I am a, a full disclosure, the data that Sean showed you earlier is actually from our medical studentss and I am the course director for the respiratory course.
So that was just great, great timing on this, the course we were about a week into the course and then immediately following that first weekend, we went to an online course, we went to remote, remote learning.
So I had to make the adjustment in the course. First adjustment of course was to take care of the academic side of it because there was a midterm the next week and then the final.
So what I did was I, and it, this was a, this was a, a very challenging situation because we didn't want to open up all our questions to our students.
But we wound up doing that in that the midterm and the final, we had made open book and we, I doubled the number of questions and there was a big honesty factor with this.
And I was told by numerous students that they took this incredibly seriously. And so the, I guess the responsibility of learning on your own by your own and not quote unquote cheating, that really was uh it was extraordinary the way the students actually um um came to that challenge.
So I um so that was the first adjustment academically. And then we also had and the way I communicated with the students.
And I really like um what was said earlier about we're not alone even when we socially distance. And also you can still express love.
I have a very deep relationship with many of my students and just a relationship with as many as I can. And so what I refused to do was to give out any course updates through email.
I went into my amateur uh video producing skills. So I would produce videos with updates on the course and actually videos of myself around the, around the house.
Uh with my, my cats, I kept my wife and my daughter out of it and getting my daughter out of her bedroom. Anyway, is quite difficult.
She is a teenager. So that's the way she's expressed that.
So anyway, I've, I've gone around my house, I have a lot of house projects, building a patio and all these other fun things.
So I'm showing the students that as I walk around my house and then sharing my, my pets and just my life usually with a hat on and just being very, very informal.
And I've also reached out to them to make videos. Uh If they respond to me, I want them to send me videos and II have received 20 to 30 videos from the students in their own lives in their apartments, walking their dogs or what have you.
But uh the, the response to this has been extraordinary, the students ii actually feel more connected to the students because just through these video chats and then emails as well and the phone calls, the phone calls never end also.
So anyway, so academically and then personally, I've, I've adjusted to this. But again, the the data continues to come in and we're looking at this data, we've captured all this and it seems to be a very, have a very positive effect.
And also I would add that we preach their, their self directed learning, we preach that so much even through the ad through the admissions process.
And I would, I would add that most of the students have really have really come, come to bat with that. So it's been, again, it's just been an extraordinary experience.
Thank you for getting video dressed for us today. I was kind of hoping to see you in your casual hat and thank you for sharing.
Um Would anyone else like sure, I see some things happening in um uh in the chat. I um Alice Hutter, could I call on you to, to talk about Zoom for your students?
Hello, everybody. Um I'm loving zoom.
Uh I've been meeting with my students. I teach mainly 1st and 2nd year medical students at le com and um our second years are gearing up for boards and when this first happened and we went to remote learning, gotta say our second years are pretty happy not to have to come to class anymore because this is what they dream about it just being able to study for boards on their own.
Um But they're getting a little frustrated, they're feeling isolated. Some of them are just anxious and meeting with them, one on one or in small groups on Zoom, brings us all together, brings us closer.
And um you know, you gotta remember, these are young people who are afraid that you may. It's a tough time for everybody and they're so grateful when we reach out to them and have that face time, face to face time.
And our first year students really had more trouble adjusting to working from home, getting all remotely delivered content.
Um They felt like there was lack of structure. So we had to remind them that they have to apply the structure, they have to keep to the schedule.
Um And they're, they're doing ok, everybody's doing the best they can, but I don't know what we would do without this current technology.
Um It's been such a blessing in this tough time. Um And then just to comment on what I'm doing personally in my life, uh I, I've had a tough time working from home at first because I really like to separate compartmentalized work and home.
I don't like to have a lot of overlap and bringing my work into my home. Um I'm set up in what's normally my music room where I'm studying music and learning to play an instrument and among other other things.
Um And having this become my workspace over crowded with papers and books and files and, and things II felt like I was giving up something of my personal life which was hard on me.
But uh I made the adjustment and now try to integrate it. So I have my saxophone next to me at all times and between meetings, I can pick it up and play a couple of scales and then put it down and, um I feel very inspired and I'm working on writing songs, which I've never done before and just published my first youtube video.
So it can be a productive time because after being on the screen all day for 1012, 14 hours a day, the last thing I wanna do is watch TV, Alice, you gotta put the link in to your youtube video in the pass it.
Well, it, it's not a cheerful tune. It's a song about dementia from the patient's side and how music helps them connect.
Well, as long as you caring for an older patient and uh or caring, supporting my mother, caring for someone who has dementia.
I am in favor of hearing the song, send it along. All right, I will so long.
Um Excellent. Um And uh so I really appreciate you sharing.
Um Matthew uh Sakamoto. Would you uh thank you for agreeing to share.
Would you like to go next? Sure thing can hear me.
Yes. Hey, so I I'm actually really excited to be kind of joining up on math AO uh internal medicine trained.
I'm a clinical informatics fellow at the UCSF and I was actually one of the question writers with sh like back in 2015 as an M four.
It's kind of a little like circle back, see like what it's become uh frankly, quite amazing. So if there's anybody that was there in the early days, good to see you guys again.
Uh, so stuff from my end, I guess, on the academic side, but, um, this isn't something that I can kind of take credit for one of our hospitalists.
Um, it's put together the program, but I'll be one of their first virtual attendance is, you know, we, with the whole social distancing and everything we wanted to be able to keep um our, you know, med students and uh wanted to have them be able to experience um the COVID learning, but without being exposing them to um possible risk of infection.
So there's actually an entire virtual curriculum where an M three is going to follow along um with the patient in parallel, they'll kind of call in and listen to the intern present the patient.
Um and kind of do all like the E HR data gathering and then in the afternoons, uh like three or four me students will kind of present back to me as a virtual attending.
We'll also have either an M four or early um R one R two internal medicine resident help kind of facilitate some of the learning.
So we're basically a parallel wards team that actually never sees the patient um themselves um but like try to get some of that learning um kind of along the way.
So it's sort of a compromise while we, you know, are in lockdown mode and we're hoping to open up, you know, reopen the hospital in, luckily in San Francisco, um, we've not borne the brunt of a lot of things that are happening on the east coast.
Um, but, you know, from now through July, um, the hospitals are on lockdown except for, you know, the most essential personnel.
So we've tried to keep with our residents and our, uh, trainees out but trying to find ways to keep their learning going.
So that's the uh the pilot, we're sticking it off next week. So, um we'll see how that goes, but really excited to kind of try these new ways of learning Sean.
Why don't you go ahead and describe that while we're, while other people are bravely deciding whether they wish to share or not.
Just because I think this is an uh what uh Matt has just shared is a good example of incredibly creative thinking about students in clerkship education.
Go ahead Shawn. Yeah.
And also, I mean, again, we, I think uh we, it's great to have everybody else sharing and so please keep doing it. Uh If we don't call on you, um It's not because we didn't read what you put in the chat.
I think we're just seeking explicit permission to put you on the spot and, and say something. Uh So uh so pay attention to the chat because we, we do want uh everybody's voice to be heard especially if you, if you have something that um you, you wanna share and you want everybody else to know about.
Um But yeah, just to tie into what Matt said that at Hopkins, there's a similar pilot that's happening where uh you know, uh both in the ICU and medicine wards where students are at home.
But they're rounding pre rounding on their patients by phone. Um rounding with the team via Zoom.
Uh you know, they're writing notes and Epic because they have Home Epic access in the E Mr. Um you know, they, they've all done their sub.
So they're actually putting in orders which can be co signed. So they, they're doing like almost everything that you could do without actually sort of being present.
Um So that, that also in a pilot stage and then, you know, the first formal elective is happening now and something else that we're kind of actively trying to research.
Um And II, I'm aware of one other one that's again pretty much the same but just different technology based on the context which was a case Western.
Uh So there's a double AMC webinar that covered this. And so they also described it, Sean and I have been joking about how we were with different ways to make sure that you all don't see us as the ex content experts because you're all the content experts in your local context.
Um Larry uh her to be has encouraged us to use the raise your hand feature in uh in Zoom as a way for us to know who is willing to volunteer to share a story.
So full credit to Larry for that. I don't know why we didn't think of that team, but uh we're all better when we learn from each other.
So we'll use that mechanism as another way to sort of call on people. I will um tell you uh anecdotally.
Um I remember one of my first lectures as a sort of young faculty member to first year med students with an audience of 100 and 50 or so.
And I wanted them to talk and uh and so I just waited them out in front of the lecture hall. I was like, does anybody have any questions?
And we sat and there was all that awkward silence and um and I said to them at one point, look, you know, shrinks are really good at waiting out the awkward silence.
Uh And eventually one of the 150 broke the silence and asked a question. So we really do wanna hear from you all.
Not from us. It's easy to put it in chat.
It's even braver if you're willing to sort of share your own voice. So please, please, please, let's hear from you all so we can all learn and grow together.
Uh I'd like to invite Martha Vena Bossert to share. I actually just have a question.
Um I know that in Massachusetts they, uh, the governor passed the opportunity to, um, graduate their students early and, um, I know in the RN world they're like, encouraging them to take nursing jobs without even having, um, uh, without sitting for the, uh, national Boards.
And I just have, um, I don't know, some concerns and I was just wondering if the group felt that way too or, um, and maybe this is, it isn't the right forum, but I was just wondering if some of that is going on and in your professional domains and what people's thoughts are on that.
Um I'll share first um and then invite Catherine Shawn Jack. Anyone that wants to share, feel free to put it in the chat or respond to Martha's question.
Uh uh I know that at UCSF, we've made a decision with our medical students to not graduate early. Um I'll know at Samuel Merit University.
Uh with our nursing students, we have made a decision to allow more simulated clinical learning to count for what would used to be clinical or clerkship type uh clinical experiences as a way to create capacity for our imminently graduating nursing students to be able to graduate on time, not early, but at least on time.
So those are the two examples I'm aware of in which there's some thoughts about um sort of graduating early um or modifying the timeline in graduation.
I do know there are medical students in in the New York metro area that have been allowed to graduate early. So that's a different example and different local context.
Yeah. I'm wondering if it's geographically or of geo geographical concerns and considerations here in Maine, we have, um, senior students who we've done.
Fortunately, they've already had at least 50% of their training in an actual clinical situation. So, or more than that actually.
But, um, so the last six weeks have been virtual sts and things like that and um conversations and discussion boards and case studies.
But um I just was a little concerned, I know that those are higher uh hit areas that are probably considering that. So I just wondered, um or hoping it's not gonna be a trend, I guess.
Yeah. Yeah, I think, well, and there, there's in medicine, there's guidance from the different regulatory authorities.
So basically, um the medical school of creditors are saying that that if there's active community COVID spread, they still strongly encourage students to stay out of the clinical environment.
Um And however, you know, students can volunteer to help out um provided that, you know, they're not coerced into it. There isn't like some strong incentive for them to do it.
Um And that other conditions are met like they have health insurance and other other things. I think the, you know, one of the, it's, it's a lot of the regulatory hurdles um as well as like, you know, um loan the rules around med student loans and so on that, that make, uh, graduation from med school especially difficult because if they graduate from med school early, where do they go?
Um, can they start residency early? That's really hard to do.
Um, give me a BMS have also kind of indicated though they're flexible with things but not, you know, but there's so, there's just so many complexities for, with, with that transition that, um, it, it's not, yeah, it's, it's definitely not being encouraged.
Um It's being permitted to some degree maybe in, in certain spots. Well, I would imagine that this would bring its own, speaking of health and wellbeing and concern, I would, I would imagine graduating early would bring its own um incredible level of stress and um add a different dimension to that, I think perhaps, yeah, you know, the, the, the thing about the med students and so, you know, there's not a lot of data out there but the data that exists suggests that med students wanna get in there and, and help out and be part of the solution.
Yeah, nursing students too. There's like, let, let us go.
Can we graduate early? We really wanna get there and help.
Yes. But.
Well. Right.
Yeah, they may not, they probably just won't be ready to practice at their level of license or if they're not um licensed actually, uh if they haven't sat down and taken a board and passed an exam Yeah.
And again, just, it's a medicine, I think at this stage, uh we are, we're in April, most of them would be graduating in May.
So they've, they've already matched to their residence programs. So in, in medicine, they're all, they're all pretty well qualified to move on.
They're just kind of binding their time. Again, the vast majority of them were just bing their time until they get their graduation.
So that, that competence part wouldn't be as big of an issue. Um But yeah, but still it's still an issue, you know, cause they would still need to be supervised and other providers who could supervise them whenever you know, there's still lots of clinical needs, the providers need to meet those first.
Yeah, so it's a very complex issue and, and like I said, II think it is, it makes the most sense to handle it locally. Oh, thank you for entertaining the question.
Thank you so much, Martha. Uh Up next we have uh Peter Dan uh Peter.
The floor is yours. I uh until recently was the Associate dean for academic affairs at the New York Institute of Technology College of Osteopathic Medicine.
I stepped away from that and I do part time consulting for academics now for that institution. Um But when I moved to a different role, II began doing most of my work with my colleagues uh by remote communication.
We did a lot of zooming and I've, I've learned a bit. So I just had a few observations I wanted to make to, to reinforce some of the things you have made in this uh conference.
Um One II realized and I'm sure those of you with the psychiatry background can appreciate this. There, there are introverts and extroverts in our population.
And I've discovered much to my surprise that I'm, I'm, I'm actually an introvert all, all these years. I've been teaching, I've been standing in front of crowds and dealing with lots of people.
I'm an emergency physician by training II deal with a lot of people, uh different people and, and I've always found satisfaction with that, but I've found uh this uh what we're calling social distancing is, is not particularly hard for me.
II II actually, um ha have discovered that I've adapted to this very comfortably. Uh It doesn't create the kind of anxiety it does to other people.
For example, my wife was an extrovert. Uh She needs to be around people all the time and it's, it's been, it's been more difficult for her particularly uh since she's an extrovert that wants to go for walks and avoid crowds.
So she's an extrovert that has turned into an agoraphobe, which is a really difficult conflict to deal with. But um so I mentioned that simply because there are some people I, I'm sure who are much more comfortable with these dynamics than, than others.
And uh I have to remind myself that it's not as easy for, for some people as it is for me to, to say, yeah, I spend my whole day talking to people on my computer, um, for other people, it's, it's draining to have to do that and very unfulfilling.
So I, so I have to keep that in mind. Uh, a, another point is I suspect a number of people who are not, uh, as uh familiar with the distance with the remote communication as I've become over the past several months um are still feeling some awkwardness with the, with the uh what's considered the artificiality of this kind of meeting this kind of interaction.
Um It reminds me, I'm old enough to remember the time before we had answering machines and some of you may remember as well.
But when they first came out, people were very uncomfortable, they'd call and they'd get a voice saying hello, I'm not here, just, just say whatever you wanna say and I'll get back to you and there'd be a pause and there's, there'd be come there, there'd be comments like uh hello.
Um This is your father Clyde calling. Uh I mean, it was just awkward because they, they don't feel, they just feel weird talking to somebody who's not really there.
So I've seen the same type of reaction with people who are trying to get used to being a video uh uh communicator. Um It's just weird to be seeing 7, 10 people on a screen and to recognize that they can see you as well.
And um so somebody called her friend of hers called her and said, oh, you can do this here. Click here, click here, download this, do this and when it's time to start, just click this button and you'll be with us.
So she did and there were all these pictures of people and she sat and listened to the conversation for a few minutes. And then her friend called her on her cell phone and said, Jane, you do realize we can see you sitting in your red robe with a towel wrapped around your head and she said, no, I didn't know you could see me.
So that, that took a, you know, there, there are those instances I think it just takes some time for people to uh to get used to that.
And speaking of the video, this has been the last point I'll make um I still run into people who are, who, who prefer to remain off video.
They, they don't, they don't want to be live. Maybe they didn't want to sit in the red bathroom with their hair and the towel.
Um But II try to convince people that it's part of the community, the, the sense of community involves being able to see each other.
And even though it's awkward, I encourage them to put out the effort to join in a picture is OK. Uh But uh especially when I'm dealing with students, students will come online with it for a group meeting for, for a class, for example, and somebody will be just have a picture, still picture up and somebody will say, hey, we can't see you say, oh, I'm eating breakfast.
I just don't want you to have to watch me eating. Um Well, several of my colleagues have said, hey, when you came to class before, when we were all meeting in the same room, you didn't bring your breakfast.
So have that done before we meet this time, we all need to be looking at each other so that we're, we're much more comfortable communicating.
Uh But, but you sort of have to train some people I think to, to realize the importance of all of those visual stimuli hearing as well as watching facial expressions.
So just a few comments on this, uh the changes this remote communication has forced us to adjust to Leslie Jones. Um Leslie, you should now be able to share.
I am at Howard University in Washington DC. Uh We're not quite where New York is, but we are an anticipating um a surge and running our hospital to accept um to double its bed capacity right now.
So that's where we are. Um I chair our ophthalmology department.
It's a small department and we generally have one medical student at a time rotating for a month period. Um We have nine residents in total three per year and generally at grand rounds, we'll have that group plus um AFA few faculty members like three or four.
And what we have seen now in this post COVID world in Zoom technology is a doubling in our participation at grand rounds.
We've opened up to alumni who've got on and they've shared their experiences um in their work environments with uh the pandemic.
But also it has really en uh enriched our discussions about um the cases presented by our residents. Um We generally have one faculty deep and in each specialty, but with our alumni, uh we'll have three cornea specialists or three glaucoma specialists discussing a topic and it's, it's really been great.
Um And I would just add that as far as the nonwork discussions, we have opened up a whatsapp chat now and people have shared uh what's going on in their personal lives and what they're doing.
And some of the personal time they take when they work in their home environments. Terrific.
Thank you. That's a great story.
And I'm sure your students have really benefited from the extra expertise and uh from the trenches, right? Uh uh uh clinical ophthalmology experience.
Yeah, they really have. And in addition to the one rotate rotator the entire ophthalmology interest group now joins us for grand round.
So II really hope that they have seen a benefit to that level of participation. Thank you.
Thank you for sharing. Oh, I guess I'm next.
So I guess I'll share my story. Uh So uh similar to what, what Amine said, um I really do try very hard.
I'm home with uh I'm home with two teenagers and a geriatric pug. Um And I find that trying to manage work, like all of us, I think, managing work and, um, and excelling in anything, whether it's parenting or, or my work care osmosis.
It's important to make space in my day for self care. Um, you know, as I mean, said, putting my own oxygen mask on first, let's maybe, um, if I take a break to work out in the middle of the day or to take a walk with the dog, I come back and I'm much more engaged in the, uh, in the work that I, that I want to be doing in the afternoon and I can be my better self and, um, you know, happily, uh, I have a lot of support, uh, to be able to do that.
Um, on a, on a side note, I found a needle point that I started 25 years ago as I was cleaning the house over the weekend.
So I'm looking at it now. Um, I'll, I'll, uh, one day I'll have a meeting where I'm not typing and I can, I can needlepoint during my call.
So we'll see how that goes. I don't know, figure it out.
So I had to think about it in terms of like the timeline and, and, uh, so, uh, December 31st for you guys, uh, recollection that's whenever wh O was first informed about some abnormal pneumonia and Wuhan and what I was doing was learning about tiktok for the first time on, on New Year's Eve at a party at our house.
Um And then January people were mentioning it and I didn't really care that much because there was a Ottawa conference which is a big assessment, medical education conference in, in Kuala Lumpur.
And so like within the, the week before that, I was four of the people I was supposed to be presenting with at, at 11 session and all four of them backed out.
So I ended up standing in front of a mic with four people who had recorded their video and being like the lone like MC for the session which was awkward.
Um And then II got home on March 6th and I just tried not to pay attention to the news because it just didn't matter. I just wanted to make it home and as soon as I got home, it was just COVID nonstop.
And within that week was the week that, you know, everybody started making these drastic changes. Um And for me, March 16th, whenever the Governor of Maryland announced that the gyms had to close.
I was like, oh, no, this is for real. Um Cause I for, I mean, II go, I go to the gym like probably four or five days a week and II need it just to be stress.
So knowing that that was not gonna happen for me, it was like, II got a deal. Um And then, uh and then another milestone as part of this whole process was March 26th is my son's seven year old birthday and we, we did it by Zoom.
And it was very sad because we had planned uh like for months in Ava for a couple of months in advance to do an outdoor Pokemon party.
It's the only time I've done it. Um But also glad I had the experience and then again, last Saturday of my clinical schedule was finalized and I think psychologically having a certain certainty around the schedule um that I could count on for the next couple of months was, was just huge and has made, made me feel much better.
Um So anyway, so those were like the big milestones for me and I'm sorry if I'm, I'm going beyond time. Uh And So I think the tips that have come out from, from our experience as we continue to transition has been, you know, we're trying to approximate our usual life.
So keeping a daily routine for ourselves and for our kids, they wake up at 7 a.m. every day, uh and we wake up with them and then we reserve Saturday and Sunday to be truly weekends and not try to like mix weekend and work like constantly.
Um You know, I've lowered my own expectations for myself in terms of my productivity, but also kind of engaged and leaned in with COVID-19 stuff to try to um you know, learn and you've seen a little bit of the research and, and we're doing this webinar now and try to do more of that type of thing.
Um Actually making sure I get extra sleep and practicing extra self care. Uh cause I, I've, I noticed, you know, sleep gives you emotional reserve, the rem po component in particular.
And then I think the other thing that's come out of this for me is um that uh you know, we are extremely lucky to have jobs and to like the biggest problem I have right now is, you know, my kids shouting or making a mess in the kitchen.
Um But you know, we, we, we have no problem putting food on the table. Um We're not being furloughed, like even people at Hopkins are being furloughed.
Um You know, there's, we, we have certainty in that domain. Um And, and so again, ii feel extra grateful that, you know, we are in this position.
So you extra um obligated to try to help out. So those are my, those are my reflections.
Thank you. All right.
Well, so that brings us to the end. Um Next week, we hope that you'll join us for a totally different topic.
We'll be talking about curricular integration of um of uh online learning resources. Thank you all.
Stay well until next time. Hi, everyone be.
Well, for more info, visit our medical educator page at osmosis.org/educators.
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