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Finding teachers outside of the classroom

Self-directed learning isn’t just for small group lessons. It’s a story of improvisational comedy, innovative podcasts, and bite-sized videos.

Finding teachers outside of the classroom

Carolyn Chan (left); Ian Drummond (center); Ryan Augustin (right)

Learn about two CWRU students and one University Hospitals resident who have built initiatives that benefit not only their own learning, but are supporting the education and careers of their colleagues and friends.

Part 1: Funny Bones: Using Improvisational Comedy to Improve Communication Skills

Carolyn Chan has made it her mission to share some of her wisdom with CWRU Medical School students. “I’ve already gone through what these students are about to get into,” she says. “I’ve had a lot of time to reflect on how improvisational comedy skills translate to what I went through at that time in my life. I’m hoping what I learned will be helpful to them as well.”

Carolyn teaches workshops on improv, geared specifically to the challenges facing CWRU medical students. “It’s really scary as a beginning med student to stand in front of an attending and a whole medical team and have to present a patient,” she recalls. “After learning improv skills, I found myself feeling more comfortable in uncomfortable situations, just because I had experience answering questions on the fly. I was less anxious standing up in front of people and giving my thoughts.”

Growing up in Ypsilanti, Michigan, Carolyn didn’t have any background in theatre or comedy.  But as a student at Wayne State University School of Medicine, she was looking for a distraction outside of medicine and some stress relief. She stumbled onto an improv comedy class and discovered she loved the creative outlet.  At about the same time, she was starting her clinical years in med school – and saw some very practical applications.

In July 2015 Carolyn began her residency in Internal Medicine at University Hospitals and began meeting CWRU students. It’s also when lessons learned in improv took on a lot more value, as she faced new responsibilities to meet with patients, run family meetings and deal with the unexpected.  “In medicine, communication is crucial. You form so many first impressions and you want to start off on the best foot with a patient so you can work together to provide the best care possible.”

Wanting to share the practical applications of improv, Carolyn began teaching a workshop to help CWRU medical students improve communication and reduce stress.  “I start every class off by saying you don’t have to be funny to do improv,” she explains. “Improv is about having honest reactions.  Comedy flows out of that. The funny in our everyday life is how we relate to each other.  Medicine tends to be a very serious field but it’s okay to step back, be light-hearted and laugh at yourself.”

Carolyn’s top three lessons for applying improv to medicine:

  1. First rule of improv is “Yes, and…” meaning you start from a point of agreement and build a conversation -- very helpful with difficult patients or differing agendas.
  2. Body language is crucial in nonverbal communication, so Carolyn teaches a game called “Gibberish” where students must speak in nonsense words and communicate entirely through body language.
  3. Don’t take status too personally in the medical hierarchy where high social status people tend to dominate. Improv exercises teach students to treat all with respect.  

Carolyn will pursue a career in Internal Medicine as a generalist, and plans to continue teaching workshops to CWRU students and doing improv as a hobby and stress reliever.  Catch her performances around Cleveland with a group of women called “Asking for a Friend.” Find info and schedules on their FaceBook page.

Part 2: Big Decisions: Using Podcast Interviews to Help Medical Students Choose a Specialty & Build a Career

Ian Drummond is helping his fellow CWRU medical students tackle what he calls “the third-year fallacy” -- the idea that exploring medical specialties during the clinical year of med school leads to a clear decision on what specialty to pursue. 

That’s why Ian created a podcast series called The Undifferentiated Medical Student (TUMS) to share his audio interviews with physicians from each of the 120+ specialties listed on the AAMC’s Careers in Medicine website. He’s already recorded 52 episodes, uploaded 42 of them on iTunes and had more than 105,000 downloads.

Growing up in San Diego, Ian was attracted to the science of medicine and the idea of helping people and building relationships. But as a student at CWRU, he started to see the daunting challenge of choosing from a list of subspecialties that’s exploded since World War II – and decided to do something to address this conundrum facing today’s medical student.

“It’s not completely altruistic. I’m solving my own problem,” he laughs. “But it’s also very motivating to hear people say ‘Ian, your podcast is amazing, it’s helping me through the process and leading me to take action.”

A devoted fan of podcasts, Ian has developed a remarkable ability to connect with the physicians he interviews, many of them 20 to 30 years his senior.  He begins the conversation with a set list of questions: 1) what are the nuts and bolts of your specialty, 2) how did you determine this was the right specialty for you, and 3) what advice can you give on long-term career planning? But from there, he happily explores tangents, gathering unexpected insights and delving into personal stories of life choices and the often-messy business of building a medical career.

With the portability and emotional power of audio, Ian’s podcasts tackle another problem: the lack of mentorship.  “These relationships are difficult to form,” explains Ian, “so I wanted to champion medical students to start thinking about career-planning on their own, with guidance from interviews with 128 physicians.”

Ian’s interviews are usually between 1.5 to 2 hours long, seeking to provide more than “trite, cliché, bromide version advice” like “you have to be flexible” – the kind of tidbit a medical student might pick up in 5 minutes snatched with an attending physician.  Ian wants to provide deeper insights that medical students can’t learn in school, including “the wonderful details.”

Ian is also fascinated by the business side of medicine. After his third year at CWRU, he took a year off to work with a medical device start-up.  This fall, he’ll be an MBA student at the CWRU Weatherhead School of Management, and the following year will overlap his fourth year of medical school in a dual-degree program.

And after all those interviews, has Ian determined his own medical specialty? “I dread that question!” he says with a smile. “I don’t have a great summary document, synthesizing all that physicians have told me, but I have narrowed it down, I believe, to a combined anesthesiology and pediatrics or anesthesiology and internal medicine residency.” Along with his business degree, Ian hopes this path will help him see how all the pieces fit together in our medical system – and find a way to make it better.

Part 3: Students Take the Lead in Making On-Demand, Bite-Sized Medical Videos

Being a medical student is hard enough. But Ryan Augustin took on extra duties two years ago with an idea for a project to help guide his fellow learners through the intricacies of pre-clinical biomedical education.

Augustin, from St. Paul, Minnesota, founded CaseMed Minute, a student/faculty alliance that creates short videos on fundamental physiological concepts, helping medical students learn more, dig deeper, and clear up confusion during the intensive experience of the first two years of medical school. To date, the team-up has resulted in the creation and online posting of over 100 short videos featuring CWRU faculty experts tailored to the SOM curriculum.

Video topics are suggested by the students themselves. Each class has CaseMed Minute representatives who speak with students (and use Facebook) to identify concepts for which students would like more information. Team CaseMed Minute then identifies CWRU faculty members who supply the answers, taking the form of several-minute long videos that are primarily pictorial in nature. In less than two years, the videos have amassed over 85,000 views and more than 700 subscribers. In addition to Case Western Reserve students, medically curious individuals from around the world have watched the productions.

Augustin and fellow third-year SOM student Divya Seth developed the first list of over 50 videos two years ago. Today, production and oversight are carried out by a new generation of first- and second-year students.

“We view these videos as a medium and route for learning,” said Augustin, who continues to participate in the process. “They directly meet the needs of SOM students, who raise the topics on which they would like to see videos made. The videos are short, which increases the efficiency of learning. And by encouraging students to ask questions and work with faculty members to address the questions, the process strengthens communication and builds relationships between both groups.”

CaseMed Minute student-participants use Explain Everything, an iPad-based presentation application, to make the videos. As part of the process, faculty participants verbally explain a concept while drawing freehand diagrams or annotating preexisting images.

“This project has been a wonderful experience for the faculty, both in terms of teaching and learning,” said Mimi Lam, MD, a nephrologist and associate professor of medicine. “It has been a lot of fun to work with the students to create our own clear, concise videos. They are like little works of art that encapsulate those ‘teaching moments’ that we’ve shared with individual students many times in our teaching careers; and now they are preserved for the use of future generations of students.”

The videos, which are grouped into over 20 playlists ranging from acid-base disorders to visual field defects, appear under CaseMed Minute Facebook posts to students’ newsfeeds and are subsequently stored on the project’s YouTube channel. They include a six-video series on sepsis, five-video compendiums on pneumonia and antibiotics, a triptych on diabetes, and targeted presentations on such key topics as reading chest x-rays  and differentiating between Hodgkin’s and Non-Hodgkin’s lymphoma. YouTube analytics show that the videos are especially popular during exam periods.

“We are always working to improve,” said Augustin. “We will be soon be sending formal surveys to students and faculty members and convening focus groups to find which formats people like best.” Also on tap are plans to develop best practices for faculty collaborators, with an aim of consistently high video quality.

Augustin is now in phase two of CaseMed Minute: developing clinically-oriented pediatric videos for upper-level students and residents. Production is underway and he plans to have the first set of videos completed and posted this summer. Meanwhile, a new generation of tech-savvy first- and second-year SOM students is preparing to add to the growing vault of CaseMed Minute learning videos by identifying new topics for inclusion.

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