July is a time for transitions. Students are transitioning to clinical training in clerkships and into autonomous practice in internship. Graduating residents and fellows are transitioning into independent practice as attending physicians. For those in the autumn of their careers, there are perhaps transitions to non-clinical roles, or better yet, retirement.

Several theories of transition have been described in the literature. Atherley et al. described three conceptual perspectives to illustrate a learner’s transitions through the medical education continuum. These are: educational, social, and developmental. Unsurprisingly, each of these conceptual perspectives has associated with it feelings of struggle, difficulty, anxiety, and stress. These tensions can arise when there is no shared mental model of expected performance between trainees, supervising faculty, and governing bodies.

When we think of influence, we tend to think about how we can affect someone’s character, development or behavior. Yet, we underestimate how we influence others indirectly or without knowing it. As leaders or educators in health professions education, how do we employ influence we have positively in trainee/educator relationships?

Why do you teach? When are your most enjoyable moments as a medical educator?

The final stretch of the medical academic year often involves faculty performance evaluations and student remediations. Most faculty performance reviews tend to be positive and arguably future-focused with collaborative goal-setting processes. However, what happens if a faculty member receives a poor outcome?

‘Lately, I have been feeling inadequate – both as a clinician and as a teacher… I think I need to give one up for my own sanity…’ Does this sound familiar? It can feel as though there is so much opportunity to teach, yet not enough time to do so as we take care of our patients.

How do we do this? One solution is to recalibrate “performance reviews” as future-focused, collaborative, goal-setting conversations—those that will motivate individuals (humans) to envision a future beyond traditional outcomes measures—to wonder and dream. Modernizing the performance review “system” is an important step for taking our organizations to a new level from the ground up.   This may mean elevating and redefining metrics for performance, beyond strictly business or work-related units of measure like RVU calculations or faculty work load.

What could this look like? Scholars are increasingly examining the psychological needs of workers including, autonomy, competence, and relatedness, among others, and during a pandemic, these needs were heightened, yet often blurry. So now, more than ever before, we have an opportunity to pay attention to the messages we send, or don’t send, in our performance conversations.

Asking better questions during our reviews is an investment that helps people feel and be seen. Bringing better questions to performance conversations is also “power agnostic”—anyone can enrich performance outcomes through questions and conversations that matter. 

Connecting as humans, not machines or cogs, we can interrupt our everyday biases, and pursue clarity and focus around additional needs, roles, and dialogues--such as mentor, advisor, sponsor, or coach--which only expands the possibilities of promising results.

In the shift to the Learning Paradigm and a flipped classroom approach, learners acquire prerequisite knowledge before attending an in-class session with peers while faculty assume a guide/facilitator role. This facilitator role requires tools for educators to skillfully foster effective verbal and nonverbal communication with learners. Topperzer et al. (2021) indicate that thoughtful questions (tip 10) can be posed to stimulate thinking, guide discussion, and encourage bidirectional communication and engagement with learners. The authors outline question categories (specific, clarifying, open, probing, and confrontational) with examples that facilitators can use to promote learner reflection.

Dr. Lara Varpio challenged educators and thought leaders in health professions education (HPE) to rethink the impossible during her Generalists in Medical Education plenary talk entitled “When the Earth Moved Under Our Feet.” In reflecting on changes in health professions education during the COVID-19 pandemic, Dr. Varpio suggested that there were “earthquakes” in our thinking—seismic events that shook the very foundations of our core as educators and thought leaders. She helped the audience reflect on changes to our normal every day practices that we once knew to be true. Speaking of change…

As health professionals seek to prepare a diverse workforce, it is essential that unnecessary barriers to learning be removed. By incorporating Universal Design for Learning (UDL) principles during the curriculum development process, we can provide flexibility and allow learners to customize their learning experiences to meet their individual needs. In his article Twelve tips for Designing an Inclusive Curriculum in Medical Education Using Universal Design for Learning (UDL) Principles, 

Two decades ago, medical errors were brought into the spotlight with the Institute of Medicine’s report To Err is Human. This report highlighted the alarming rate of medical errors and can be credited to the numerous efforts undertaken to improve the safety of health care delivery. After a medical error occurs, patients expect disclosure of the event. What exactly does the process of disclosure entail? Galagher provides a simple assessment of disclosure that includes three elements:

How many times have you heard the following: “You should write that up!”? While mentioned by colleagues and mentors with positive intent, suggestions such as these are usually mentioned after implementation of an educational initiative. Educators who take the time to develop novel or unique experiences for trainees or colleagues would be wise to consider how it could be shared with others as scholarship during the development stage, before it is implemented. 

During his plenary at the June 2021 IAMSE annual conference entitled “Top Ten Ways an ID [Instructional Designer] can help you Define the New Normal,” Dr. Atsusi Hirumi reminded us that learner motivation is as important as ability (i.e., skills and knowledge) and opportunity in determining performance.

As many of us are preparing to return to work, it is important to consider what that return looks like and how we will approach our work differently post pandemic. A recent article in the Harvard Business Publishing Education section prompts higher education institutions to consider a four-step framework for implementing best practices resulting from the COVID era.

Not all who wander are lost…but many of us are. How often have you wandered through a day unaware of your own physical and emotional presence as you walk from one patient to the next? Take it a step further – how often have you cared for “another (insert common diagnosis) patient” with a checklist of management protocols? How often have you felt on the verge of burnout?

Have you ever asked yourself what you would attempt to do if you knew you could not fail? Failure is scary. It is typically not celebrated or advertised. However, in this #MedEdPearls, we look at ways to acknowledge and embrace our vulnerabilities and find the childlike wonder that comes from failure and leads to innovation. If we are not attempting great things, amazing things stop happening. By embracing failure, amazing things become possible. 

Take one minute to think about the first time you realized you mattered as an educator. What happened? How did you feel?

Whether it was an action from organizational leadership taken in your favor, an encouraging word spoken over you by a student, or an object that represented deep meaning to efforts, you experienced the power of mattering: you felt valued and knew you added value.

One year ago, I contributed a MedEdPearl titled "Mastering Adaptive Teaching in the Midst of COVID-19" that offered strategies for maintaining teacher, social and cognitive presence during our rapid transition to remote online learning. And now, I consider our needs as educators as we prepare for the possible transition back to the classroom this fall. Unlike last year, though, this possibility is conflated by more issues than merely the learning environment. As I write this blog, I reflect on a recent opinion article titled "America Isn't Ready for the Coming Wave of Grief." In addition to the direct human cost and long-haul effects of the pandemic, delayed mourning, physical isolation, economic burden, and exaggerated inequalities have compounded the toll on our collective mental health. So once again, I find myself asking how we as medical and health professions educators can prepare, stay resilient and step courageously into this unfamiliar territory?  

Although many of us will reflect on the COVID-19 pandemic as disruptive to our way of life, COVID-19 has radically transformed the process of medical education and has served as a catalyst for incorporation of new technologies, remote learning platforms, and novel methods of instruction. These changes have placed faculty development at the forefront of the medical education response to COVID-19. Faculty developers provided continual and responsible support during this “emergency online education pivot” as institutions minimized the catastrophic spread of disease and by changing the traditional medical education approach. Faculty developers, as experts in online learning pedagogy, educational technology tools, and online student services, designed, produced, and delivered training quickly and effectively to meet the immediate needs of faculty and to save institutions.

Health Professions Education thought leaders consider reflective practice to be an essential characteristic for professional competence. However, the start of spring semester does not usually elicit reflection about “How am I going to teach next fall?” However, these are unique times and instead of a normal evolution of our curricula, teaching, and assessment strategies, we may find ourselves returning to old strategies or perhaps on new trajectories. Chances are Fall of 2021 will not look like Fall of 2020 or 2019. What are good questions to ask as you reflect on fall of 2020 and begin to plan for fall of 2021? That question was posed to the team of faculty developers from the MedEdPearls team who developed the following list of ideas for health professions educators to consider.

How are you teaching? The question, and aptly titled teaching initiative, posed by The Michael V. Drake Institute of Teaching and Learning asks us to reflect on what discoveries about remote learning have surfaced and consider artifacts to curate and share with colleagues. What instructional strategies worked? What do you need to be successful in the virtual environment? Furthermore, what are the ways in which we are staying connected with peers and student learners? Quickly establishing communities of practice during the COVID-19 Pandemic is important. This #MedEdPearls highlights a teaching initiative leveraging an iterative rapid prototyping strategy for professional development.

This #MedEdPearls highlights the importance of and need to understand the Professional Identify Formation (PIF) of physicians considered to be under-represented in medicine (URM) as supported by in the article Whispers and Shadows: A critical review of the professional identity literature with respect to minority physicians by Tasha Wyatt and colleagues. Dr. Wyatt first presented on this topic at the 2019 Generalists in Medical Education conference via an Ignite session which exposed the gap in the current PIF literature and the need to illuminate race and ethnicity as it relates to PIF.