April 2024: Postdoc Fellow Perspective
Zinia Mohanta & Shilpa Gopinath

Postdoctoral Fellows are Often Considered the Backbone of Research

Postdoctoral fellowship is an important phase of a researcher's life as it is the first steppingstone of an early stage of an independent research career. We play a pivotal role in advancing academic institutions, infusing fresh perspectives, advanced basic and applied research, and offering unique expertise. As many aspire to be future academicians, postdocs contribute significantly to the intellectual vibrancy of their host institutions with great enthusiasm.

Postdoctoral fellows bridge gaps between disciplines. Our diverse academic backgrounds foster interdisciplinary collaborations, allowing convergence of ideas to address complex challenges. Postdoctoral fellows serve as mentors and educators, being the frontline of interaction with the next generation of scholars. we have close interactions with graduate and undergraduate students. This mentorship is invaluable, shaping the trajectory of emerging scholars and ensuring a continuum of excellence within the educational ecosystem.

The JHU Teaching Academy (Teaching Academy, JHU) provides various teaching opportunities to postdoctoral fellows. However, time constraints can make participation difficult.

In recent years, we have seen a great shift in the educational environment which is promoting more postdoctoral fellows as educators recognizing our contribution towards educational excellence of the institution. This progressive step also facilitates quality future educators and fuels the career of one of the pillars of the institution in education and research.

March 2024: Student Perspective
Mattea Miller & Matthew Guo

Reflections on Advocacy as Medical Student Senate Student Body Presidents

As Student Body Presidents of the Medical Student Senate (MSS), we sit on many curricular committees within the School of Medicine and are members of the IEE Board of Directors. We primarily serve to represent the collective student voice. In this role we are often bridging students’ opinion, administrations goals, and the reality of what can be changed. Navigating these sometimes-conflicting threads can be difficult, but we have learned much from our advocacy efforts and have been honored to partner with faculty and administration to improve the student experience.

As 4^th year medical students and Student Body Presidents for MSS, these are our reflections from our time serving on the Senate.

• Change is slow, sometimes painfully slow, and that’s okay.
  • When we first started on MSS we often found ourselves frustrated with the pace of change in curricular policy. We had ideas, support from the student body, and wanted immediate gratification from our work and that of the Senate. However, the longer we have spent in the advocacy space, the more we have come to realize the importance of evaluating changes from multiple angles and perspectives. Often this reveals hidden pitfalls that we can take time and address, thus making a more responsible change to the curriculum.
• Nothing is black and white in advocacy.
  • There are often unintended consequences of curricular changes. In our tenure on the Senate, we advocated strongly for clerkship grading to be pass fail for a multitude of reasons such as the learning environment, self-directed learning, and student wellness. We are grateful for the partnership from faculty leaders in this discussion and the collective decision to extend the pass-fail period for a three-year cycle. While we still feel strongly about our efforts, we wish we had thought more closely about the unintended consequences, such as the increased pressure placed on board exams and research output for already time-poor medical students as these pressures can have strong negative impacts on students’ lives.
• Effective advocacy hinges on bridging opinions and having buy in from all stakeholders.
  • Working in silos is detrimental to advocacy work. While we represent the student voice at all meetings we attend, all of our advocacy efforts would have come to a standstill if we hadn’t taken time to understand the perspectives of all stakeholders. When this perspective has been the most vital is in situations when there have been strong opinions. Though difficult, we have made the most progress when we value the opinions most opposite to our own.

Part of what makes a Hopkins medical student so special is our fire to advocate for change, our drive to build something better. We are only two voices, but it has been the highest privilege to listen and to represent the diverse sea of hundreds of voices that constitute the Hopkins medical student body. We have learned that to advocate, we must listen, we must be patient, we must anticipate, and we must widen our perspectives. We are humbled and thankful to have had the opportunity to grow with our peers, advocate for their needs, and partner in change.

February 2024: Tina Kumra

How do you find the time to teach in a busy community clinical setting?

More of our care of patients, and our teaching, has moved to community settings which are often unpredictable learning environments.  While many of us derive immeasurable reward and joy from teaching, we must also be honest about the time and effort needed to achieve excellent clinical education. Here are three tips on how to navigate teaching in our fast-paced, volume-based medical practices:

• -Don’t try to do too much.  Often busy clinicians get bogged down with trying to teach all of the knowledge they have on a patient rather than picking one or two main teaching points appropriate for student level.  When I started teaching in my practice, I found myself utterly drained at the end of the day because I was doing too much of the talking.  If we allow the learner to uncover where they are in their knowledge base and fill in one or two knowledge gaps, it’s more effective for them and much more manageable for us.
• Rely on your team members to also teach students, they have a lot to offer.  Interprofessional education has rightfully become an important part of medical education.  Whether it’s a nurse, a medical assistant, or a social worker, each of these roles in the office has incredible interactions with the patient and there is much to learn from our teammates.  I often stand in awe of my own medical assistant’s knowledge and memory of each of the families we care for, including things that families sometimes hesitate to share with me directly.  That type of intimate knowledge makes us better together as a care team.  When I ask a student to go in the exam room with her to see how she gives a shot to a four-year-old, I not only want the student to see how the shot is given but all the things surrounding the rapport and relationship in the room during that dynamic. 
•  Embrace the priority you place on caring for patients, as that in itself is the most important lesson we can teach our learners.  If they see you pull away from other responsibilities in order to take care of an urgent result or phone call from a patient, they will understand the value that you place in patient care and that critical role modeling will impact their future care of patients.

January 2024: Rachel Levine

Why We Should All Care About the Well-being of Faculty Educators and What We Can Do About It

 The link between physician burnout and patient care outcomes is the primary driver of efforts to foster faculty well-being by addressing individual and system level factors. Similarly, the well-being of faculty educators is critical for maintaining a supportive, safe, and inclusive learning environment for our students and trainees. The American Medical Association in its 2022 ebook, Educator Well-being in Academic Medicine (https://livejohnshopkins.sharepoint.com/:b:/s/ECMC/EeWdNs77op9GkSwSzL7VRFQB4wQ2sCMAkXQfFmkuNPhDJw?e=leIiMH) describes the features of well-being specific to faculty whose primary effort is education and offers systems-based recommendations to ensure that as faculty educators we can thrive and in turn so will our learners and ultimately our patients.

 We are fortunate to work in an environment with many supports for educators. The IEE, the Office of Faculty Development, The Johns Hopkins Faculty Development programs and the Masters of Education in the Health Professions (MEHP) provide opportunities for faculty to develop expertise and be in community with other educators to share ideas, scholarship, and be recognized. And yet, the current climate in academic medicine places increasing pressures on faculty with fewer rewards for those who wish to focus their efforts on medical education.

 Here are a few steps we can take to support our faculty who teach and mentor learners, design, implement and evaluate curricula, conduct educational scholarship and lead our educational programs: 1) continue supporting academic promotion of educators based activities done in the domains of education, and at Hopkins using recommendations of the Educator Competencies and Metrics Committee; 2) revise compensation models to recognize and reward the work of educators; 3) ensure that educators are included in decision-making around major SOM priorities and initiatives; and 4) measure educator well-being and satisfaction.

December 2023: Pamela Lipsett

Entrustable Professional Activities: A Primer 

Our systems for assessing performance and providing feedback to learners is changing with a greater emphasis on providing real-time assessments of directly observed behaviors to learners. These direct observations are intended to provide formative feedback to the learner. Over time, variation in patient presentation, disease and complexity, these assessments should form a portfolio that demonstrates evidence of learner progress, possibly the rate of progress, and area in which the learner may need additional development. For these assessments to be helpful to the learner and easy for the supervisor to complete, they must share a mental model about what constitutes a good and effective performance and what components are needed for the trainee to practice independently.

 In Graduate Medical Education (GME) the ACGME (Accreditation Council for Graduate Medical Education) has utilized both “Competencies” and “Milestones” to help describe the abilities of our resident and fellow trainees over time to independent practice. For some, these terms are rather obtuse and not easily applied to every day observations and assessments in the workplace.  More recently, Entrustable Professional Activities (EPA’s) have been operationalized as part of assessments in both GME and soon in Undergraduate Medical Education. EPA’s are units of work that a learner performs that can be directly observed. This is in contrast to competencies which are broad domains of ability such as medical knowledge, and milestones, which describe the progress of a learner across a domain from novice to expert. EPA’s are believed to be more applicable to day to day interactions as a supervisor inherently makes a decision with an individual learner how much (or how little) they will need to supervise and/or provide autonomy to an individual learner.

November 2023: Douglas Robinson

We are educators and mentors for our trainees across many domains - in the classroom, lab, and life. We are gifted with a rich community of highly inspired and inspiring trainees. We must constantly value this privilege we have with our trainees.

Here are some thoughts:

• Our trainees bring heart-warming motivation, spirit, and intellect.
• We must challenge our students and trainees while giving them space to think independently and to pursue their vision. Of course, their vision needs to be aligned with their mentors, but mentors need to be flexible and allow for growth. Often, trainees push their mentors to expand their own thinking.
• In the research domain, the goals must always be to truth-seek. Research cannot be structured “to show” anything; there cannot be “preferred answers”. Research teams should not “care what the answer is”, but they should be super-motivated to “figure out what the answer is.” This should be the lab mantra!
• It is important to remember that trainees come from all over the world. They can be far away from their support network. Lab environments often fill this gap and should be ready and willing to support their members when needed.
• Because we sit in an inspiring community, we leverage this community to provide supportive, enriching experiences for those who might not otherwise have such opportunities. We built the Johns Hopkins Initiative for Careers in Science and Medicine (CSM) to provide research experience with academic fortification, complete with wholistic, longitudinal mentorship, for scholars from socioeconomically under-resourced backgrounds. In addition to making impact on our scholars, our graduate and postdoctoral trainees get to feel the impact of mentoring a young person, helping them to grow, achieve, and succeed. This is highly rewarding for all trainees.

You may find additional resources through the Institute of Excellence in Education website and by participating in IEE’s Foundations of Teaching and Learning course or the Summer Teaching camp.

October 2023: Jessica Bienstock

What’s are some of the most important things you can do to enhance your learner’s experience early on in their time on your service?

• One of the easiest things to do is to learn their name! If you’re like me and are juggling many different ideas and tasks simultaneously, once you know your learner’s name, writing their name down somewhere that allows you to quickly reference it even if you forget it initially.
• When your learner first joins you in clinic or in the OR, introduce them to the other members of your team (you already know their name so this is easy). This allows the learner to benefit from your “standing” within the team and more quickly be seen as part of the team.
• Ask the learner about their goals for the day, the week, or even the whole rotation. This can help you be aware of learner self-identified areas for growth upon that you can use to provide them educational resources and feedback.
• With the learner’s goals in mind, identify for your learner how they can help facilitate the work of the team.
• Remember to send them home. Learners are hesitant to leave before the entire team leaves even if there is nothing specific for them to do or learn.

Okay, now that you know how to start, you can build upon this foundation through accessing some of the IEE resources including the Foundations of Teaching and Learning course or the Summer teaching camp.

And (because this IS Johns Hopkins after all) remember that Sir William Osler said “I desire no other epitaph than the statement that I taught medical students in the wards, as I regard this as by far the most useful and important work I have been called upon to do.”