Scholarship in health professions education is often based on paradigms and methodologies unfamiliar to clinician educators. This risks a ‘disconnect’ – where educators may be looking for randomized controlled trials, and scholars are providing theoretical frameworks and thematic analysis!

In this episode Lara Varpio and Subha Ramani discuss their scholarly work in health professions education and how they have made that work rigorous and useful to practitioners, while also educating their readers and challenging some positivist norms.

Lara Varpio is Professor, Center for Health Professions Education & Department of Medicine and Associate Director of Research, Center for Health Professions Education at the Uniformed Services University of the Health Sciences in Maryland. Subha Ramani is Associate Professor of Medicine, Harvard Medical School, and an internal medicine physician at the Brigham and Women’s Hospital in Boston. She is senior faculty with the Harvard Macy Institute.

We had an interesting discussion on the cultural contexts in which this scholarship is placed and look forward to more ‘bidirectional’ influence of non-Western perspectives on knowledge and ‘ways of knowing.’ Subha and Lara provided excellent advice to those early in their scholarship journey – being clear on goals, engaging in scholarship for the right reasons and the importance of collaboration. Many thanks to them for their time and expertise!

While the evolving pandemic provides unique learning opportunities, it also poses numerous educational barriers. How learning is prioritized at individual institutions will vary greatly depending on the local needs of patients, providers, hospital systems, and the community. Effort explicitly devoted to learning may be proportionately reduced during a crisis, yet, even in severely affected areas, learners maintain important roles in the workplace. For example, an emergency medicine resident must triage patients with respiratory syndromes, a nephrology fellow will help initiate dialysis for a critically ill patient, and a medical student may assist an overstretched infectious disease consult team.

Even in this time of crisis, we remain obligated to teach learners and to provide strategies to help them learn. However, considering the stress the COVID-19 pandemic imposes on all stakeholders, we cannot assume that usual methods of teaching will be effective without some adjustments. Cognitive load theory (CLT), developed by John Sweller, provides an educational framework based on cognitive psychology that can inform workplace teaching and learning during the pandemic.

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, 

Health professions educators must remain attuned to the ways in which healthcare is delivered if we want to produce graduates who are ‘work ready.’ This is an enormous challenge when healthcare technology and systems evolve at a rapid rate. 

So, what is on the horizon of health delivery? What changes in practice can we anticipate? What will be the impact of technology? Changing workforce roles? changing consumer expectations? And how will COVID-19 continue to influence care delivery?

In this episode of the Harvard Macy Institute podcast, we spoke with Ann Somers Hogg about the top trends to watch in healthcare delivery. Ann-Somers is a senior research fellow at the Christensen Institute where she focuses on business model innovation and disruption in healthcare, including how we can transform a sick care system to one that values and incentivizes total health. Prior to joining the Institute, Ann Somers spent eight years at Atrium Health.

We talked about technology, personalised medicine, ‘health coaches,’ mental health apps, companies that are ’healthcare aggregators,’ telehealth trends and exemplars such as the Health Design lab at Jefferson Health. We conjectured about what this all means for health professions education and look forward to more of these conversations.

At programs who use noon conference or morning report model, trainees are expected to attend the teaching sessions unless there is a patient emergency. However, it is difficult to ignore pleas for pain medications or a diet order for patients who had a procedure cancelled and who have been fasting since midnight the night before. These are not ‘emergencies’ but I think most of us would struggle with the idea of leaving anyone in pain for an hour. When I have previously worked in hospitals with this model, I have rarely attended a lecture which did not necessitate me leaving early, arriving late or answering a call during the session.