Generational Differences in Medical Education

I read a phenomenal article on tips to educate “Generation Y”.  It brings up the issue: how does one learn?  What I like about the article is that it focuses not just on traditional learning, but also on approaches to professionalism, communication styles, and feedback methods.  What I also like is that it is non-judgmental, and does not make Generation Y out to be “bad” and earlier generations to be good. 

One focus of Generation Y which I have heard often is that they are “tech-savvy”; thus, educators should incorporate technology into their teaching repertoire.  Remember that this is not just traditional didactic teaching (the article mentions this), but also teaching at the bedside, teaching in small group sessions and other venues.  I have personally tried to do this myself, but have realized that sometimes the content of what needs to be taught/learned is overshadowed by the “cool tech toy”.  Take audience response systems (ARS), for example.  As more and more teachers are using them, the systems become second nature to learners; teachers should not use them just because it looks cool to flash a graph on a screen.  Use an ARS if it helps engage the learner, or reinforce concepts difficult to grasp.

Contrast that idea with this post on the “older generation” being tech-savvy and actually being more likely to integrate technology into their care of patients.   As another example, several medical schools have provided their students with iPads, and have made learning with the use of an iPad part of the curriculum.  The decision to make this leap forward to embrace technology in the educational realm likely came from an “older generation” physician. 

So how do you think medical educators can best help Generation Y learn?  What strategies can best optimize learning for the ultimate goal of improved patient care?  I am particularly interested in what Gen Y folks think.  One parting thought that the focus should be about the learner, and ultimately all about the patient!

Maintenance of Certification

Board certification as a marker of competence of the medical knowledge necessary in each medical field has been touted for a long time.  Residency programs stress the importance of passing “the boards”, and provide education to residents in the form of didactics that are commonly geared not only to clinical care, but also towards this examination and the skills needed to pass it.

What does it mean to be board certified?  The official term is “Diplomate of the American Board of ___” (depending on one’s specialty).  What it means is that the physician has completed training in her/his area of expertise, and has passed the initial certifying examination (or set of written and oral examinations, for some specialties).  Currently, this certification expires after a certain time period (ten years, for example).

In the past, physicians had to sit for and pass a “recertification” examination, although now the process has changed significantly.  Physicians are now required to demonstrate a valid license to practice medicine, complete an appropriate set of practice questions to demonstrate lifelong learning, pass another certifying examination, and also complete a performance or quality improvement project.  Together, these four parts are known as “Maintenance of Certification”.  An excellent explanation of this process, from the American Board of Pediatrics, is noted here.

There are some physicians who feel that this process to “recertify” is onerous, and not necessary.  There are others who feel it is absolutely essential to demonstrate a minimum standard within the specialty.  I personally fall into this second category.  There are a select few who “grandfathered” in, meaning that their original board certificate was lifelong, thus indicating that they were never required to recertify if they so choose.  This “grandfathering” process is not done anymore in any of the specialties, but there are obviously those who still hold such certificates.

An interesting point-counterpoint as to “should someone who is grandfathered go through maintenance of certification” has been noted.  Those in favor of pushing for everyone to recertify cite this article and others, which showed that those who maintained their certification provided improved processes of care for certain populations than those who did not maintain the certification. 

The American Board of Medical Specialties is soon making public the information around whether a diplomate is undergoing or has undergone maintenance of certification.   I applaud this reason, as I believe that patients deserve to know whether their physician has or has not met this “minimum standard”.  Others do not feel the same, citing multiple reasons why maintenance of certification is onerous, costly, and takes time away from direct patient care.

What do you think?  Should maintenance of certification be public information for all to see, or not?  Should we push physicians who have not maintained their certifications to do so, or to not be permitted to practice their craft?

Physicians, Academia and Social Media: Where’s the Beef?

I am relatively new to Social Media.  About 7 months ago, I began on Twitter.  In my work as a medical educator at an academic medical center, it has been a challenge to “disseminate” my interest in social media to my academic colleagues.  There are those who have been great supporters and mentors, such as Dr. Mike McKenna (AKA @IronSalsa, if you are on Twitter), who has given presentations at academic medical meetings, and also Grand Rounds, on Social Media in pediatrics.  On the other side of the coin, others have given me “the look”, as if to say “Why are you wasting your time with social media when there are other things to do?”

This is certainly a valid question, and one to consider if one isn’t yet a believer in the power of social media, or is at least questioning the impact of social media in medicine.  So, I thought that I would find some great posts which discuss this issue.  The question I will leave you with is this: how do those currently utilizing social media convert the academic naysayers?

Academic Social Media footprint 

Social Media and the Academic Ivory Tower

Twitter Tips for Academics 

Social Media Risk and Opportunity for Physicians

Medical Schools Embrace Social Media

Reasons Why Doctors should Embrace Social Media

Social Media for Residents and Medical Students

The Intersection of Social Media with Medical Students and Residents

The impact of social media on our current society is unmistakable.   This extends of course to the health care field as well, with a majority of adults seeking information about health care online and through social media venues.  Which brings me to how to consider trainees.  The overwhelming majority of medical students and residents are younger than their teachers, and are plugged in more than any previous generation.  They “live and breathe” in the world of social networking everyday.

Some medical educators have recommended for students to avoid involvement in social media.  “The risks are too great” is what is often said, citing examples of unprofessional behavior by trainees.  Certainly there are instances when students or residents acted in an unprofessional manner with their use of social media. 

But what about the positives?  What about opportunities to learn and have social media and medical education go hand in hand?  What about opportunities to help patients with the use of social media? 

Social media “policies” by academic medical centers or medical schools point out the “don’t do this, don’t do that”, but let’s also focus on what the trainees CAN do.  Let’s consider how we can IMPROVE our current health care system and ultimately the care of patients with innovative uses of social media and social networking, such as this amazing site from Webicina.

I really like this “policy” explanation by the Canadian Medical Association, which has a positive outlook on the use of social media for physicians. A wonderful article by a colleague of mine at the Indiana University School of Medicine, Dr. Gabe Bosslet, highlights both the positives and the potential negative ramifications from social media use by medical students (Dr. Bosslet also was instrumental in writing our medical school’s Social Media guidelines).

What’s your take?  Should we recommend trainees avoid the use of social media, fearing repercussions, or should we embrace these new technologies and try to work with (and learn from) trainees, in whom social networking is already playing a major role?

Twitter and Tweeting During Medical Conferences

I have recently read several different blogs or articles about using Twitter in medical conference meetings.  In fact, I recently returned from the AAMC meeting in Denver, in which apparently I tweeted more than anyone else from within the meeting (some people actually keep statistics on how many times a single person tweets during the time of a meeting; apparently this is relatively simple information to find).

Given lots of interest in this topic recently, I thought I would share what I have learned about this topic with others who may be considering whether to tweet during a conference.  Here are a few links on different aspects of the interplay between Twitter and Medical Conferences.  Most provide the potential positives that can come from Tweeting a meeting, but I have also included views on the other side of the fence that discuss pitfalls.

Tweeting PRIOR to Going to a Conference

This discusses finally meeting people you have been Tweeting with but have never met.

Tweeting Behind your Back

This blog discusses some of the negatives of providing a Twitter feed at a meeting, especially if a presenter isn’t quite prepared to give the presentation

Tweeting Content from the Meeting

This discusses issues related to embargoes within meetings.

Being knowledgeable about Twitter as the PRESENTER at a Meeting

This post describes how to optimize your presentation and presents tips and points to avoid as a presenter at a medical meeting.

How to use a hashtag to tweet at a medical meeting

This straightforward post explains how to tweet by using the hashtag.

How to use Twitter at medical conferences

This article from 2009 provides an excellent explanation of using Twitter at conferences, including before, during and after the conference.  The authors actually did a study as well, and provide some nice results.

The Importance of Twitter presence in conferences

This is an excellent set of suggestions for those who organize conferences, with ideas for how to set up Twitter to make the conference successful.

How to Use Twitter at a Medical Conference

This blog provides theories of how Twitter can be used at conferences, including “as a conversation starter”, “as an influence generator”, “as a goodwill creator”, and other suggestions.  A wonderful explanation of what these different categories can mean as well.

Reasons You Should NOT Use Twitter Feeds

http://ht.ly/1emUeJ

This blog provides some of the potential pitfalls to using Twitter Feeds at meetings.

Tweeting the Meeting

This blog explains general content on what it means to Tweet during a medical meeting.

I hope that these links are helpful to get a sense of what it means to use Twitter at medical meetings.  There are many other opinions written on this topic, and I am sure many more will be written.  Have you tweeted during a meeting, and if so, what have you learned from doing so?