In medicine and science, we are trained to recognize patterns. Whether it’s interpreting an EKG or identifying patterns in massive datasets, pattern recognition is critical to being an outstanding physician or scientist. But we also have to be able to appreciate the anomaly… when something just doesn’t make sense.
On September 26, 1983 – during one of the most tense periods of the Cold War – 44-year-old Stanislav Petrov was monitoring the early-warning satellite system for the Soviet Air Defense Forces. Suddenly, the alarms went off, and Petrov observed what appeared to be several approaching U.S. nuclear-armed intercontinental ballistic missiles. He had been trained to recognize this pattern and to act immediately to alert his superiors to launch a counterattack.
But something just didn’t make sense.
And Petrov did something that could have cost him his job…or worse. He concluded it was a false alarm.
Petrov later explained, “I had a funny feeling in my gut...” and he was right: the satellite system misinterpreted the reflection of sun off clouds for missiles. Although Petrov is largely unknown, it is thought that his recognition that something just didn’t make sense avoided a large-scale nuclear war and that he “saved the world.”
So how do students, residents, clinical fellows, and postdoctoral research fellows learn to recognize patterns? By spending time in the lab, in the clinics, in the operating rooms, on the wards. And how do they learn to recognize when something just doesn’t make sense? The same way. There’s no other way to do it.
At Johns Hopkins, people work hard to make the world a better place… and when people are not kind, the work is that much harder.
I thought about this when I watched the February 3rd episode of Saturday Night Live. The host that night was Ayo Edebiri – a terrific young actress on The Bear, one of my favorite TV shows – and the musical guest was Jennifer Lopez. Of course, the two shared the stage, not unusual for the host and musical guest.
However, in this case it was… shall we say… interesting.
You see, in a podcast back in 2020, Ayo Edebiri said that J Lo was scamming the public into thinking she’s a good singer, “even though…she’s not singing for most of these songs.”
https://www.tmz.com/2024/02/02/the-bear-ayo-edebiri-trashed-jennifer-lopez-2020-podcast-snl-host/
And now four years later, here they were on SNL… sharing the same stage.
In the SNL episode, Ayo Edebiri played a contestant on a game show called “Why’d You Say It?” In the sketch, the host (played by Kenan Thompson) reads something posted on social media by each contestant and asks, “Why’d you say it?” When it’s Ayo Edebiri’s turn, she answers:
“OK, OK! We get it. It’s wrong to leave mean comments or post comments just for clout — or run your mouth on a podcast and you don’t consider the impact because you’re 24 and stupid… But I think I speak for everyone when I say, from now on, we’re going to be a lot more thoughtful about what we post online.”
The lesson?
Be kind. It helps people know their work is appreciated… and it makes it seem just a little less hard… and it will save you a lot of problems down the road.
There’s a lot of buzz out there about the importance of “soft skills” in STEM careers.
What are soft skills? The term refers to communication, teamwork, creativity, leadership, resilience, critical thinking, professionalism, emotional intelligence, and integrity.
Of note, experts say that soft skills have actually become more important in STEM careers with the advent of AI. In the Top 5 Education Trends in 2023, Forbes noted that soft skills, “are human skills that are unlikely to be replicated by machines anytime soon.” So what about the recent study that found that ChatGPT demonstrated more empathy than physicians (Ayers, et al. JAMA Intern Med 2023; 183:589-596)?
Here’s what I think. Machines may do well head-to-head against doctors because many doctors lack the so-called soft skills.
Let’s consider another recent study (Pollak, et al. JAMA Intern Med 2023; 183:544-553) that randomized cardiologists to either receive a coaching intervention on communication or not. Forget about the main results of the trial for a minute. Here’s the real takeaway: the control group of physicians expressed empathy in only 1 in 4 patient encounters!
I agree that it is unlikely that human skills will be replicated by machines anytime soon; the real question is whether they will be demonstrated by humans!
The bottom line is that the public feels that soft skills are really important in STEM careers. I think we all need to ask ourselves whether we are doing enough to teach and model them for the physicians and scientists we're training today.
You’ll remember that early in the pandemic, people applauded and banged pots and pans for health professionals who were hailed as heroes… deservedly so in my view. It was obvious to all that people who care for patients save lives.
While the connection between education and saving lives may not be as obvious, I want to call your attention to a brief document published recently by the AAMC (https://www.aamc.org/media/33211/download) that shows that what each of us does as an educator does, in fact, save lives.
The document notes that patients do better when cared for at teaching hospitals like ours. While this may be due in part to the greater expertise, highly specialized services, and more advanced technology available at teaching hospitals, the AAMC also notes that, “Teaching hospitals are also the only places where patient care, medical education, and research converge. The intersection of these missions creates an environment that not only advances health care broadly but, as the studies suggest, also benefits individual patients.
So the next time you hear someone talking about the importance of clinical care and biomedical research to our mission, tell them you agree… and then tell them how education contributes. Tell them that the AAMC document notes that as a cardiologist, I have to treat many patients with blood pressure medications and blood thinners to save a single life. However, through your contribution to patient care as medical and biomedical educators, you pack an even greater punch. That’s right… education saves lives.
Happy New Year… hero!
I’m sure most of us find ourselves reflecting daily on the events of our troubled world, our polarized country, and the challenges we face closer to home. It is difficult times like these that may make people retreat into their own world rather than reaching out to others they work and study with.
That got me thinking of a statement we are asked to respond to on many employee surveys:
“I have a best friend at work.”
Gallup notes that people who strongly agree with this statement are 7 times more engaged than others. They note that, “having a best friend at work has become more important since the start of the pandemic, even considering the dramatic increase in remote and hybrid work.” (Patel and Plowman, “The Increasing Importance of a Best Friend at Work” https://www.gallup.com/workplace/397058/increasing-importance-best-friend-work.aspx).
The concept of a “best friend” seems odd to me and makes me think of elementary school, and so I usually skip this question. However, I do have many close relationships with people who are part of a community of educators. We are brought together because we care about the same thing: the education and experience of students, residents, clinical fellows and postdoctoral research fellows who will improve human health, biomedical science, and the state of the world. I hope you feel that sense of community as well, and join me in feeling that the IEE Educators’ Corner is our community gathering place… a place for best friends… whatever that means.
Many know the children’s story about Elmer, the elephant who stood out from the drab gray herd because he was a patchwork of many bright colors. Elmer wasn’t happy being different and so he covered himself with elephant-colored berry juice. When he rejoined the herd, he blended in with all the other elephants, and no one was happy… not Elmer or the other elephants in the herd. After the rain washed the berry juice off, Elmer was again a patchwork of colors, and everyone was happy again. I always enjoyed reading this story to my kids when they were young because it helped illustrate the importance of diversity and the value of celebrating uniqueness.
I talk about Brené Brown’s work on the distinction between fitting in and belonging when I remind learners that they were recruited here because of their uniqueness and when I remind educators that our environment must allow learners to be the best version of themselves.
A few weeks ago, I read something that made this all come alive. On July 31, 2023, a giraffe named Kipekee (“unique” in Swahili) was born in a Tennessee zoo and is believed to be one of a kind… it has no spots and instead is a uniform brown color (https://www.theguardian.com/world/2023/aug/21/spotless-giraffe-tennessee-zoo?CMP=oth_b-aplnews_d-1).
So what do Elmer and Kipekee teach us? Diversity is critical both to the group and to personal well-being. As educators, it is our obligation to work every day to create an environment in which learners feel safe and comfortable demonstrating their unique characteristics.
In 2018, the IEE’s inspirational director, Joe Cofrancesco (and several other authors you know well) published a peer-reviewed paper on the IEE (Teach Learn Med 2018; 30:103-111). Consider that for a moment… a work of educational scholarship about an institute dedicated to educational scholarship. That’s not just talking the talk; it’s walking the walk. Since then, the IEE has developed and implemented additional programs and events, and obtained additional resources to support medical and biomedical educators. I want to express my appreciation for the IEE and my admiration for all the amazing people who have walked the walk by contributing to all that the IEE offers.
Joe and his co-authors noted something important in that 2018 paper. Providing resources to support educators costs money. As they wrote, “It was clear from the beginning that additional, noninstitutional funding would be needed to support educational research and develop successful programming.” The importance of philanthropy to support education is part of our institutional DNA. A letter written by Johns Hopkins University President Daniel Coit Gilman in 1889 highlighted, “an opportunity to establish in Baltimore a school of medicine such as the world does not now possess; but it will take a considerable sum of money…” So even if there is not a Mary Elizabeth Garrett reading this today, I want to express the hope that you support the IEE in whatever way you can… creating educational resources, leading seminars and new programs, or providing funding to support those who do. Walk the walk.
Expertise: Cardiology, Cardiovascular Disease, Cardiovascular Medicine, Coronary Care Unit, Depression in Heart Disease
Primary Location: Johns Hopkins Bayview Medical Center, Baltimore, MD
