EPISODE 446

Getting a New Medical School Ready for Take-Off - Dr. Stephen Halm, Dean of Des Moines University College of Osteopathic Medicine

01-18-2024

February marks a major transition for Dr. Steven Halm as he moves on from leading one of the nation’s oldest schools of osteopathic medicine, at Des Moines University, to launching of one of its newest, at Xavier University, which is set to welcome its first class in 2027. Launch is actually a fitting word to use due to his background in aviation as a licensed pilot and former Senior Aviation Medical Examiner for the FAA. In fact, Halm believes medicine has a lot to learn from commercial aviation in the use of simulation to achieve the highest standards of safety. “One of my goals for the first week of the new medical school at Xavier is to have students in a simulation lab, working with task trainers and interacting with standardized patients in real scenarios of taking care of patients.” Other plans include an emphasis on newer teaching approaches such as small group and active learning paired with what he considers to be the fundamentals. “Student success depends on a combination of great faculty and great resources.” Join host Hillary Acer for a birds-eye view of osteopathic medical education and stay tuned to learn about Halm’s leadership education program for medical students and residents.

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Transcript

Hillary Acer: Hi, I'm Hillary Acer, welcoming you to Raise the Line with Osmosis from Elsevier, an ongoing exploration about how to improve health education and healthcare.

 

Today, I have the pleasure of speaking with Dr. Steven Halm, who has the distinction of leading the launch of one of the nation's newest schools of osteopathic medicine, while also having been the leader of one of its oldest. 

 

Xavier University recently announced the selection of Dr. Halm as the founding dean of its proposed College of Osteopathic Medicine, which would be the nation's first Jesuit school of its type. Until he assumes that role in February, he will remain the dean of the Des Moines University College of Osteopathic Medicine, widely considered to be one of the strongest programs in the US. In fact, DMU's class of 2024 achieved the highest pass rate among all osteopathic medical schools nationwide on level one of the COMLEX national board exams.

 

Dr. Halm joined DMU in 2019 after a thirty-year career in clinical practice, medical education, and academic leadership. He’s also the founder of a leadership education program for medical student and residents, and has served on numerous national committees supporting student medical education and research. 

 

Thanks so much for being with us today.

 

Dr. Steven Halm: Hillary, it's a pleasure, and I'm very grateful to have a chance to talk with you. 

 

Hillary: Likewise, Dr. Halm. So I'd like to start with learning a little bit more about what got you first interested in medicine, and then in your case, internal medicine and pediatrics. 

 

Dr. Halm: Well, it really started in pediatrics for me. I was about fourteen years old, and I was on a mission trip in Haiti, and I have since been back to the Dominican Republic a couple of times in that area, serving on mission trips. But I was exposed at that time to a number of pediatric patients and it just kind of - I realized very, very quickly that that's the profession I wanted to pursue. 

 

During those years, I was a member of an explorer's post, which is a forum of co-educational exploring of careers for young men and young women. And our hospital sponsored the explorer's post, it was a medical explorer's post, so I had a great opportunity to spend some time in emergency rooms and in surgical suites. We were hypnotized by a psychiatrist and also exposed to pediatrics and that kind of just reinforced with me, my interest in going into pediatrics. That continued through medical school till my third year in medical school, when I really enjoyed my adult cardiology and pulmonary medicine rotations. So I kind of opened up a Pandora's box of wanting to go into both specialties. So it was an evolution over time, but it really has been a great adventure for me. 

 

Hillary: Definitely sounds like you've had a pretty impactful career. I'm curious, Dr. Halm, why did you choose osteopathic medicine? 

 

Dr. Halm: Hillary, I'd say that it, it chose me as much as I chose it. I was treated by an osteopathic physician when I was in college, and he sat down and talked with me and really got my interest peaked. At the small liberal arts college that I went to in Pennsylvania for undergraduate work there was a pretty solid pathway to osteopathic medical school in Philadelphia, Philadelphia College of Osteopathic Medicine. 

 

So, that's kind of, I spent all my education years, including my residency in Pennsylvania. So in Western PA for four years, Philadelphia for four years. And then, I enjoyed the smell of chocolate every morning living in Hershey, Pennsylvania, where I did my residency at Penn State University. 

 

Hillary: We have quite a few fans of the park there in Hershey. So I'm sure many of our team members would be happy to revisit that, alma mater with you and some of those old memories, if you ever take a walk down memory lane, but, now you're based obviously in Iowa and you've come a long way from that residency and your medical education. Was being a leader always on your radar, or was that more of an unexpected path?

 

Dr. Halm: Interestingly, I really think it's always been some pretty significant part of me. I mean, I think as a physician we all learn to lead our patients. We lead healthcare teams in everything that we do, but my study of leadership theory and application started as a boy scout. Leadership roles and scouting really opened up my interest. I had gained some confidence through the scouting program and then right through medical school, college medical school and as a Chief of Staff at a hospital system, I started leading medical education [for] the last ten years, and it's just been a kind of a natural progression for me. 

 

Hillary: Yeah, it sounds like it. And after serving in a couple of leadership roles I know that there are multiple sides of being a leader, it can be wonderfully fulfilling, but it can also be quite challenging. So can you talk a little bit about the challenges and opportunities you face, especially as you go from leading one of the oldest and largest schools of osteopathic medicine to a brand new program? 

 

Dr. Halm: Well, I think it's exciting to be able to become a founding dean in a new program I get to create, essentially, from a blank canvas and I get to create based on my experiences in both healthcare and medical education, what I think and the way I think, is the best way to learn. So I've taught at four different medical schools and, I think I look back and I see great things at each of those schools and I see some challenging areas as well. So my goal going forward is to kind of take a little bit of each of those four medical schools and make a medical school that is even better, that is even more outstanding and innovative. 

 

Hillary: I'm sure you'll bring all of those learnings to create something amazing, and I'm not sure if you can share, but can you preview any of the innovations you and the Xavier University are hoping to bring to the new program?

 

Dr. Halm: Well, with my simulation background, I'm a big believer in small group learning, active learning, simulation medicine, kind of experiencing, experiential learning. So, that is very different than the traditional lecture and lab for two years and then clinical rotations for two years that I did when I was in medical school.

 

One of my goals is the first week of the new medical school at Xavier, my goal is to have students in a simulation lab, working with task trainers to learn and start to be introduced to learning procedures, and interacting with standardized patients or actor patients, as we call them in real scenarios of taking care of patients. So it's very exciting. 

 

Hillary: That sounds incredibly exciting, and you mentioned, you know, our founder and CEO, Shiv Gaglani, who is now back in medical school, but, you know, very, innovative, and more visionary on how medical education could be changed and how we can integrate more of these evidence-based learning science techniques into the education. So I am excited to hear how all of that goes and Osmosis will definitely be rooting for you and supporting you along the way.

 

I noted the excellent results DMU students achieved on the COMLEX exams, and I'm curious to what you attribute that.

 

Dr. Halm: I have to brag about my faculty. I think my job is not to deliver the curriculum, the faculty delivers and is responsible for the curriculum, I empower my faculty. So, I kind of work with them to nurture them to make sure that they're well prepared and that they're confident. So the great thing is that I am responsible for the outcomes. So if the board scores were the lowest in the nation, that's on me. But fortunately, DMU has always been near the top, and this last year, we're number one in the nation for COMLEX level one and for the average numeric score for COMLEX level two. So we've essentially hit a home run. And I think I attribute much of the success of the students to that faculty, core faculty, that teach them.

 

We also offer students great resources and like Osmosis. We have offered it to our second-year class in their preparation for their first board evaluation, and it really is something the students enjoy. We've actually encouraged and have had our other programs, our P.A. program in particular, also use it and incorporate the materials into their coursework. So it's a combination of great faculty and great resources. 

 

Hillary: Well, congratulations to you and the team. I'm sure you've played a big role in that as well, and you should be very proud as the leader of that program to see such amazing results. I mentioned that actually, I'm sorry, Michael, we'll cut this part out, I skipped my questions here going back a bit. 

 

Prior to coming to DMU, you were the Chair of Simulation Medicine at Campbell University's School of Osteopathic Medicine. I'd love to get your perspective on the role simulation medicine plays in medical education today and in particular how it's changed over your career.

 

Dr. Halm: I love that question, Hillary, because simulation medicine changed my life about ten years ago and it's kind of launched a revolution in healthcare going way back. The similarities to commercial aviation and healthcare have always been there and in the seventies, 1970s, commercial aviation went through some big changes utilizing simulation techniques and debriefing, teamwork, communications, improving things so that today commercial aviation is it's much safer to fly in an airplane than it is to go to a hospital.

 

So we have to take some of those tricks and tips and system improvements that you see in commercial aviation and bring them over to healthcare. And that's really the last probably twenty years what you've started to see in medical education. It is just getting bigger and bigger, more and more emphasis on experiential learning. Learning use of task trainers, mannequin based simulation and standardized patients. So I think it's a great opportunity to push healthcare safety forward.

 

Hillary: I hadn't actually drawn the connection between aviation and medical education, but that makes a lot of sense and hopefully we'll continue to draw from other industries and other fields and kind of cross pollinate those best practices and ideas within creating high performing teams, creating cultures where people can speak up if there are mistakes made. And of course, for our students, make sure that they get plenty of repetitions and time to practice before they actually see their real patients. So, we're excited to continue partnering, especially across Elsevier with other tools and expanding our resources around simulations and that kind of education.

 

Dr. Halm: Hillary, there is a great book that compares the successes in commercial aviation to the potential successes in hospitals and healthcare. It's called Why Hospitals Should Fly. And the idea is that hospitals need to have that level of safety that commercial aviation has established. Tthe author is John Nance and John is a national leader in improving healthcare outcomes and healthcare quality. So, I'd recommend that as an easy read, and I think listeners will be able to apply what I'm saying in recognizing how important this is. 

 

Hillary: Thanks for sharing that and we'll definitely include that in the show notes. One side note. So Shiv actually, our CEO, was a pilot or is a pilot and early on in Osmosis, he actually had created a website, Osmosis Aviation. I'm not sure if it's still around. But I think his hope was to teach people how to learn medicine and how to learn aviation at the same time. So I'm curious. I'll have to go back and ask him if he knows about this book or if he's ever heard of it, because maybe that's where osmosis was inspired from. Who knows? 

 

Dr. Halm: That's a great story. I'm actually a private pilot as well. I was instrument rated and I haven't flown in a long time. But right before I left practice, I spent about ten years doing FAA medical examinations on pilots. So they had to be cleared by me as a senior aviation medical examiner on a regular basis in order to be safe in the air. So that was a fun and enjoyable part of my career.

 

Hillary: Wow. I didn't realize that. That's really neat, and you and Shiv will definitely have to connect on that soon. Switching gears just a little bit. I want to talk about the medical leadership education program that you've started. Can you tell us a little bit more about that? What is the program? What is your goal? And how is it performing today? 

 

Dr. Halm: I started that program actually eleven years ago when I started in medical education and left my private practice. It's called Professionalism and Leadership in the Medical Setting, or PALMS, P-A-L-M-S. And it's a formal program curriculum. There's an online portion of it.

We do eight hours live with small groups, with students and the whole idea is I was able to apply leadership principles by a national leadership coach and author. His name is Jim Anderson. Jim and I worked together with a couple of students to create this curriculum. And what I brought to his principles of leadership are all of the healthcare experiences I've had in dealing with patients, dealing with other physicians, medical staff, professionals, hospital administrators, and medical education leaders. So it's really a great program and I've done it every year I've been in the last eleven years, probably over 1,500 students that have completed the program. And I have a new group starting in January here at DMU that will do it again.

 

Hillary: That's great. And is this program something that is open to all students or DMU students in particular?

 

Dr. Halm: I've only been able to do it with my DMU students. I've gone back to previous medical schools and given some legacy programs. But currently, I hope to grow it and do some national presentations. 

 

Hillary: Yeah, I'm sure many students would be very excited to get involved in a program like that. We at Osmosis actually have been running for about five years now a professional development program called the Osmosis Medical Education Fellowship. Now we're actually changing it to the Osmosis Health Leadership Initiative to expand across other health professions as well. So not just medical doctors, but now we're serving nurses and PAs and dentists. And it's been one of the most fulfilling parts of my time at Osmosis is actually seeing our students learn and grow and develop these skills and go out into their schools or into their clinical settings and take what they've learned from these programs. So I would love to stay in touch with you about that in case there's any learnings we can share. 

 

Dr. Halm: That's super. You know, today, healthcare is so interdisciplinary and interprofessional. I've done the program with podiatry students, with PA students, physical therapy students, as well as MD and DO students. I've done it with residents as well after they're done in medical school. So it's exciting to share some thoughts and perspective that I have at this point in my career with young students and young doctors.

 

Hillary: Yeah, I'm sure, and on this topic of leadership skill development, there's so much to get through in a medical education, three or four years of school plus residencies or fellowships. They're really strapped for time. But one of the things that we love about Osmosis is that we have short videos that we can share with students. We can work with faculty or deans or programs like yours and really try to supplement the learning so that maybe what would normally take an hour to educate somebody will a short seven-minute video or something like that. But I'd love to know also, are there topics that you think Osmosis should make videos on or courses about, or maybe gaps in our knowledge that you're particularly passionate about?

 

Dr. Halm: I love, and I just learned from what you just said about the leadership opportunity and course. I think that's tremendous. I think systems-based practice improvement, quality improvement, I think another piece is financial security for young students and young physicians, areas that are sometimes overlooked by medical schools. And so I brought my leadership program to three different medical schools, and it's in the curriculum for two of those three. So absolutely love the thought collaborating in some way to just grow this process. 

 

Hillary: Likewise. We'll definitely be in touch about that. And I guess on our last question here, I'd love to know if you have any general advice to our healthcare students about meeting the challenges of this moment or the challenges that we foresee in healthcare around the corner.

 

Dr. Halm: Yeah, I think it's important, whatever level, to get into medical school. If you are trying to get the best residency, trying to get the best job after becoming an attending physician, it's really important that you stand out in some positive way. Make yourself special with some kind of skill or talent or expertise, and always be kind and compassionate. Do not ever underestimate the role that compassion has in your life. 

 

Hillary: What a beautiful way to close up our conversation, Dr. Halm. It is very aligned with the Osmosis value of start with the heart and something that we try to teach our learners as they go through our programs and also something that we make sure our team embodies. Is there anything else you'd like to cover today with our audience?

 

Dr. Halm: I think you've asked some great questions, and I just appreciate your time and your audience's time. So thank you. 

 

Hillary: Well, thank you so much for being with us today, Dr. Halm. It was a pleasure learning about your journey and we're very excited to see how Xavier University opens with your leadership and would love to stay in touch. With that, I'm Hillary Acer. Thanks for checking out today's show. Remember to do your part to raise the line and strengthen the healthcare system. We're all in this together.