Presenter: Megan Brown, Ph.D. Senior Research Associate in Medical Education Newcastle University

[The following blog was generated by Susan Ely and Doug McKell]

Navigating the Hidden Curriculum in Health Professions Education

The Learning Objectives for the fifth Spring 2024 IAMSE Webinar on Teaching and Learning in Medical and Health Professions Education includes the following: First, understand the hidden curriculum in health professions education, including its impact on students’ learning experiences and clinical practice. Second, identify the effect of the hidden curriculum in clinical medicine, highlighting the mismatch between expectations and job requirements. Third, recognize the complexity of the hidden curriculum, the potential adverse effects, and the need to create a safe space for students to voice their concerns. Fourth, identify opportunities for the hidden curriculum to enhance the student educational experience and promote inclusivity.

Dr. Brown began by expanding upon the four objectives of her presentation. 1. Understanding what the hidden curriculum is and is not. 2. Recognizing the hidden curriculum in daily educational practice. 3. Identifying strategies for the hidden curriculum to enhance the impact of teaching. 4. Reviewing resources and helpful hints for working with the hidden curriculum in different health profession environments. Dr. Brown explained that she began her career as a physician and now identifies as someone with a medical background who’s left clinical practice to teach and research in health professions education. Dr. Brown described the impact of the hidden curriculum during her training and when she qualified to practice as a physician. As a disabled person working in clinical practice, she related that she wasn’t prepared for how the hidden curriculum in healthcare impacted communication with and about her and other people like her. This motivated her to obtain a Ph.D. in medical education and to leave clinical practice.

Dr. Brown discussed her research on the hidden curriculum and its relationship to identity development and professionalism. She pointed out a gap between the theoretical knowledge of the hidden curriculum, which is increasingly well-developed in the literature, and a deficit in practice. For example, how does one translate an understanding of the hidden curriculum into practice? How can the hidden curriculum be navigated to support students and learners in ways that challenge some potentially negative impacts? To answer these questions, Dr. Brown focused on understanding educational objectives and the curriculum as a roadmap for education. She invoked a comprehensive plan that outlines the intended aims, objectives, contents, and experiences that form an educational program. It encompasses all methods of learning, teaching feedback, and supervision. Health professions education covers required content and professional identity with greater detail to develop a learner’s knowledge, skills, attitudes, and expertise.

Dr. Brown described how a broader perspective highlights other layers of education beyond this explicit outline. The formal curriculum comprises the tangible, the measurable, the overt components of an educational system and acts as the skeleton on which the body of the learning experience is built. In addition to the formal curriculum, there is an informal curriculum, which tends to occur in workplaces or clinical settings. Dr. Brown stressed that there are differences between the informal and hidden curricula, with the informal curriculum being opportunistic, idiosyncratic, and unplanned. Dr. Brown pointed out that the informal curriculum acts similarly to the formal curriculum by emphasizing what teachers think students should know. She then referred to Hafferty’s (1998) definition of the hidden curriculum as “The unwritten rules, values, and patterns of behavior that students learn and are expected to conform to whilst learning.” It is the unintended, unofficial learning that students absorb through education. She pointed out that the hidden curriculum involves tacit messaging about what is and isn’t important. These messages can influence students both positively and negatively.

Dr. Brown continued to emphasize that educators’ current understanding of the hidden curriculum in the health professions involves appreciating that what is implicitly taught in the hidden curriculum is just as impactful as what is explicitly taught in the formal curriculum. It shapes knowledge and professional identity by reinforcing social norms, values, behaviors, and ethical perspectives. She referred to a scoping review of the hidden curriculum by Sarikhani et al. (2020), which identified four main categories: 1. structural factors, 2. educational factors, 3. cultural factors, and 4. social factors. The structural factors include the organizational frameworks and roles within educational institutions that subtly dictate the expected behaviors and priorities of medical students and educators and educational practices. The educational factors include the way we teach. The cultural factors refer to prevailing attitudes, values, and norms in educational settings that informally influence learners’ perceptions and identities. Social factors influence the dynamics of interpersonal relationships and role models’ choices. Dr. Brown noted that this is an example where the impact of identity and social factors is linked to interpersonal relationships. She also referred to the influence of role models, which significantly affect students’ learning and professional conduct in the healthcare environment.

Dr. Brown then asked that the hidden curriculum be considered in four ways: 1. What happens in corridor conversations (what is said and not said)? 2. How do organizations behave when confronted with controversy? 3. What types of direct and indirect stereotyping exist? 4. What is being accessed as valuable faculty and student performance? She stated that the hidden curriculum must be navigated in a very intentional manner. She gave examples of the design of anatomy labs that reinforce learning silos, the lack of age, sex, and racial diversity represented in printed material, and the gender and body type bias in clinical training for physical examinations. Dr. Brown stressed that this lack of diversity sends strong messages within medicine and healthcare, thus perpetuating this under-representation. In her experience, the hidden curriculum can perpetuate traditional hierarchies and intimidate students from questioning authority or contributing valuable input. Eventually, this can lead to burnout and stress, especially when the hidden curriculum emphasizes overwork and the expectation of constant availability. Furthermore, there can often be unintended bias and discrimination. The hidden curriculum reinforces resistance to change, can discourage innovation, and can promote adherence to outdated practices if not identified and addressed.

Dr. Brown also pointed out some positive aspects of the hidden curriculum. For example, positive role modeling and informal mentorship play a big part in making the experiences of the hidden curriculum constructive. It can instill empathy and sell compassion to students, which is crucial for patient-centered care. She then highlighted four ways to identify the hidden curriculum. These are to observe, reflect, seek, and review. She indicated that it is imperative to carefully observe signs that represent the hidden curriculum. Dr. Brown strongly suggested we should become very aware of the language used, recognize nonverbal cues, and identify the reward or discourage behavior in the work environment. Do these observations align with or contradict the formally taught curriculum? This line of questioning can reveal much about the implicit values being communicated. She challenged educators to critically reflect on what’s being conveyed as necessary by the formal curriculum and examine their priorities in their teaching and student interactions. Similarly, she stressed carefully evaluating discrepancies between what’s being said and what’s being done. Finally, Dr. Brown encouraged the promotion of an open dialogue through anonymous feedback mechanisms, reflective assignments, focus groups, or other formats that can be included in teaching. The last step, the review of the hidden curriculum, is completing a formal critical look at institutional policies and procedures. She encouraged introspection about the language used with students and the procedures students are asked to perform. What messages do these send? Does the institution have policies that inadvertently place certain student groups at a disadvantage? Dr. Brown suggested that awareness and understanding of those elements can aid in identifying areas that will help align those hidden and implicit messages with the institution’s educational goals.

Dr. Brown asked the audience to reflect on their engagement with the hidden curriculum. How do the actions of educators influence learners? Are educators demonstrating the conduct that they articulate How are any discrepancies revealed by these reflections addressed? Lastly, Dr. Brown asked the audience to consider what lessons students might be learning from their faculty’s positive and negative conduct. Once these reflections have been considered, educators can consider the root causes of what has been discovered and seek to address or change those lessons. In summarizing, Dr. Brown listed four actions to address the challenge of the hidden curriculum. These were to integrate reflective practice, support critical consciousness development, support inclusivity, and foster a culture of feedback because, as she pointed out in her final slide, … “What is taught is not learned, and what is learned is not
taught…sometimes [the Hidden Curriculum] is hiding in plain sight.”

References:
Dewey, J. (1938). Experience and Education. New York, NY: Macmillan.
Hafferty, F. W., & Franks, R. (1994). The Hidden Curriculum, Ethics Teaching, And The Structure Of
Medical Education. Academic Medicine, 69(11), 861-871.
Hafferty, F. W. (1998). Beyond curriculum reform: Confronting medicine’s hidden curriculum. Academic
Medicine, 73,403–407.
Jackson, P. (1974). Life in Classrooms. New York, NY: Holt, Rinehart & Winston.
Landreman, L.M., Rasmussen, C.J., King, P.M. and Jiang, C.X., 2007. A phenomenological study of the
development of university educators’ critical consciousness. Journal of College Student Development,
48(3), pp.275-296.
Lempp, H., & Seale, C. (2004). The hidden curriculum in undergraduate medical education: A qualitative
study of medical students’ perceptions of teaching. BMJ, 329, 770–773.
Martin J., R. (1994). What should we do with a hidden curriculum when we find one? In: Martin J., R.
Ed. Changing the Educational Landscape: Philosophy, Women, and Curriculum. New York, NY: Routledge Sarikhani, Y., Shojaei, P., Rafiee, M. et al. Analyzing the interaction of main components of the hidden
curriculum in medical education using interpretive structural modeling method. BMC Med Educ 20, 176
(2020). https://doi.org/10.1186/s12909-020-02094-5
Wear, D., & Skillicorn, J. (2009). Hidden in Plain Sight: The Formal, Informal and Hidden Curricula of a
Psychiatry Clerkship. Academic Medicine, 84(4), 451-458.

Presenter: Yoi Tibbetts, Ph.D. Research Director at Motivate Lab and Assistant Professor of Education at the University of Virginia
Zach Himmelberger, Ph.D. Lead Data Science Manager at Motivate Lab
Kenn Barron, Ph.D. Fellow at Motivate Lab and Professor of Psychology and Director of the Motivation Research Institute at James Madison University

[The following blog was generated by Susan Ely and Doug McKell]

Student Motivation and Well-Being in Medical School and the Resilient Mindsets in Medicine Initiative

The Learning Objectives for the fourth Spring 2024 IAMSE Webinar series on Teaching and Learning in Medical and Health Professions Education includes the following: First, identify and understand the challenges to medical student well-being, focusing on burnout. Second, describe a possible solution using the Mindset GPS concept and review the data supporting this approach. Third, review ways to implement a solution, specifically the Resilient Mindsets in Medicine Initiative.

Dr. Barron began the webinar by asking the attendees to respond to two questions about working with medical students. First, attendees were asked about their experience in increasing students’ motivation and, second, what conceptual model or framework they used. After completing the polling, he reviewed the webinar’s three objectives again, listing how he and his colleagues would frame their presentations. Dr. Himmelberger began by describing comprehensive AACOM survey data on medical student well being. Next, Dr. Tibbetts described a motivation framework called Mindset GPS. Finally, Dr. Barron concluded by reviewing the Resilient Mindsets in Medicine Initiative program.

Dr. Himmelberger began by describing the burnout crisis that is a significant driver of poor mental health among healthcare professionals. He acknowledged that the COVID pandemic increased burnout, with an estimated 40% of healthcare professionals affected in 2021. The problem predates COVID, however, and physician burnout hasn’t dropped post-pandemic. He indicated that COVID might have worsened professional burnout but that it isn’t a problem caused by COVID. It is, instead, a persistent and multifaceted system problem seen for many years; it is both a societal and an ethical problem. Dr. Himmelberger continued to stress that solutions must be multifaceted. Because the root cause of this problem is at the system level, solutions need to address how we train physicians and support them in the workforce. This problem starts very early. Physicians who enter the workforce are already experiencing burnout. Residents and medical students face high burnout as well. In particular, medical students are facing higher rates of emotional exhaustion, an aspect of burnout where one feels both physically and emotionally drained, often as a result of consistent stress over a long period. Because medical school creates consistent stress over a long period, the result is documented poor mental health in medical students with very high rates of depression.

Dr. Himmelberger continued by presenting data collected through a partnership with the American Association of Colleges of Osteopathic Medicine (AACOM) that surveyed all matriculating and graduating osteopathic medical students in the United States during the 2022-23 academic year. The survey included 75.5% (N = 7407) of all matriculating students and 50.1% (N = 3996) of all graduating students. It revealed that burnout was significantly associated with moderate-to-severe psychological symptoms. It also demonstrated that students who failed COMLEX Level 1 or COMLEX Level 2 on their first attempt had significantly higher burnout scores than students who passed either exam on their first attempt. They also more often failed to match into desired residency positions.

In conclusion, Dr. Himmelberger stated that medical students face significant burnout, which seems to worsen throughout medical school. These findings are consistent with those of allopathic medical students and students in other healthcare professions. Burnout is associated with poor mental health, worse performance on board exams, and a lower likelihood of getting a top residency match.

Dr. Tibbetts began his presentation by describing learning mindsets, which are students’ beliefs about themselves and the learning environment. His research at Motivate Lab has focused on three characteristics that create the acronym GPS; much like a cellphone GPS, this helps users locate and map where they want to go. The G stands for Growth Mindset, the theory that intelligence can be developed through hard work, practical strategies, and help from others as needed. According to this theory, mistakes are not an indictment of one’s intelligence. The Growth Mindset promotes room for growth and improvement. It emphasizes that students can learn from their mistakes if they work hard and implement effective strategies. The P in Mindset GPS stands for Purpose and Relevance, reinforcing the belief that one’s schoolwork is valuable because it is connected to a larger purpose and is relevant to one’s life. The S stands for Sense of Belonging, the belief that one is connected to and respected by peers, cared for by teachers and mentors, and fits with the culture. The Motivate Lab research focuses on these three specific mindsets or motivational constructs. It is based on compelling evidence from decades of research demonstrating that learning mindsets are meaningful concepts related to academic success and students’ well-being.

Dr. Tibbetts then shifted his presentation to four reasons to support learning mindsets. They are Meaningful and related to academic success and students’ well-being. They are Measurable – they can be accessed and tracked. They are Malleable – they can be altered through targeted activities and changes in the educational context, and they are More Effective – meaning that learning mindset interventions can be powerful and improve outcomes for students from traditionally marginalized groups (e.g., Black, Latine, Indigenous, and 1st generation college attendees). How is this measured? The first way to measure learning mindsets is to attempt to understand what’s happening in the student’s head. To what extent do they endorse a growth mindset? Are they perceiving purpose or relevance? Do they feel a sense of belonging? The second is to assess the “psychological air” around them, i.e., does the classroom context support a growth mindset purpose and a sense of belonging? Is it evident that the instructors believe in a growth mindset and that mistakes are viewed as an opportunity for growth? Is the purpose and relevance of the curriculum apparent?

Based on the AACOM survey data, about 30% of entering osteopathic medical students are already reporting moderate to severe psychological symptoms that are associated with psychiatric disorders. When they graduate, over half of these medical students report moderate to severe psychological symptoms related to psychiatric disorders. This underscores the belief that the psychological air within the medical school context doesn’t seem to be very adaptive, particularly when we’re looking at the psychological symptoms related to psychiatric disorders. Dr. Tibbetts concluded his portion of the webinar by emphasizing that faculty whose teaching and assignments employed GPS strategies had students’ feelings of burnout decrease by as much as 30-40%, with a concomitant reduction in maladaptive psychological symptoms.

Dr. Barron concluded the session by repeating the evidence that these measures of GPS are even more effective for students from historically marginalized backgrounds. He stressed that the stronger the perceptions of purpose and relevance that can be created for students, the more purpose and relevance they perceive within their studies, and the more psychological symptoms diminish. He described implementing the Resilient Mindsets in Medicine program to address what faculty and administration identified as the most significant medical school stressors, i.e., exams for courses during the first semester and the first licensing exam (COMLEX Level 1 or Step 1). Given this information, Dr. Barron’s team created a program explicitly designed to build better student learning connections to master the material for early exams and pass the first licensing exam. The faculty training program for this initiative is divided into two parts, the most significant being online training modules. The first part of the course introduces the learning mindset GPS and how to adopt it in instructional strategies and messaging, emphasizing knowledge and skill. They are currently piloting a program to help faculty implement these ideas.

Dr Barron then described the four specific activities in the faculty course. The first is to develop a transparent preparation guide to share with students to provide information about assignments and exams. The second activity is course communication, i.e., announcements regarding exams and communications with struggling students. He noted the importance of using encouraging language to give students hope that they can succeed. The third activity is the creation of an “exam wrapper“ for use both before and after exams. This involves conceptually wrapping the exam between how the student prepared for it and then, after the exam, helping them reflect on what worked and what didn’t. The fourth task is a connections activity that helps students answer the following questions: What am I learning in any given course? How is that connected to other classes? How is what I am learning linked to prepare me for board exams? Dr. Barron’s research group created these four strategies for their faculty training course to address low medical student motivation, improve mental well-being, and reduce stress.

Dr. Barron concluded the webinar by saying that faculty should consider adopting an active learning strategy that promotes a G or P or an S or use any other pedagogy already supporting GPS. He ended by listing several active learning resources, including a curated list by D. Kevin Yee of 289 Active Learning Techniques; www.usf.edu/atle/documents/handout-interactive-techniques.pdf. He also recommended James Lang’s book, Teaching Small (2016, Jossey-Bass), as an excellent example of making incremental changes in teaching approaches to produce significant results in student learning.

References

1. Sexton JB, Adair KC, Proulx J, et al. Emotional Exhaustion Among US Health Care Workers
   Before and During the COVID-19 Pandemic, 2019-2021. JAMA Netw Open.
   2022;5(9):e2232748. doi:10.1001/jamanetworkopen.2022.32748
2. Agerbo, E., Gunnell, D., Bonde, J. P., Mortensen, P. B., & Nordentoft, M. (2007). Suicide
   and occupation: the impact of socio-economic, demographic and psychiatric differences.
   Psychological medicine, 37(8), 1131–1140. https://doi.org/10.1017/S0033291707000487
3. Shanafelt, Tait D. MD; Balch, Charles M. MD†‡; Bechamps, Gerald MD†§; Russell, Tom MD†; Dyrbye, Lotte MD; Satele, Daniel BA; Collicott, Paul MD†; Novotny, Paul J. MS;
   Sloan, Jeff PhD*; Freischlag, Julie MD†‡. Burnout and Medical Errors Among American
   Surgeons. Annals of Surgery 251(6):p 995-1000, June 2010. | DOI:
   10.1097/SLA.0b013e3181bfdab3
4. Fares, J., Al Tabosh, H., Saadeddin, Z., El Mouhayyar, C., & Aridi, H. (2016). Stress, Burnout
   and Coping Strategies in Preclinical Medical Students. North American journal of medical
   sciences, 8(2), 75–81.
   https://doi.org/10.4103/1947-2714.177299
5. Fitzpatrick, O., Biesma, R., Conroy, R. M., & McGarvey, A. (2019). Prevalence and
   relationship between burnout and depression in our future doctors: a cross-sectional study
   in a cohort of preclinical and clinical medical students in Ireland. BMJ open, 9(4), e023297.
   https://doi.org/10.1136/bmjopen-2018-023297
6. Rotenstein LS, Ramos MA, Torre M, et al. Prevalence of Depression, Depressive Symptoms,
   and Suicidal Ideation Among Medical Students: A Systematic Review and Meta-Analysis.
   JAMA. 2016;316(21):2214–2236. doi:10.1001/jama.2016.17324

Presenter: Shannon Jimenez, DO, MPE, FACOFP Dean, Arkansas College of Osteopathic Medicine
&
Kara Sawarynski, PhD. Sarah Lerchenfeldt, PharmD, Tracey A.H. Taylor, PhD, and Stefanie Attardi, PhD. Department of Foundational Medical Studies William Beaumont School of Medicine Oakland University

[The following blog was generated by Susan Ely and Doug McKell]

Communication Differences among Generations

The Learning Objectives for the second Spring 2024 IAMSE Webinar series on Teaching and Learning in Medical and Health Professions Education includes the following: First, discern the generational differences and how they affect communication. Second, recognize the history and sociology behind differences among generations. Third, remember the dominant communication preferences of each generational group. Fourth, develop strategies to design and deliver health professions education to meet the needs of Gen Z learners.

Dr. Jimenez began her presentation by outlining the primary communication preferences of each of the five identified generation age groups, specifically Traditional, those born before 1945, Baby Boomers born 1945-1965, Generation X (Xers, or Gen X) born 1965 -1980,  Generation Y (Gen Y or Millennials) born 1980 – 1996, and Generation Z born 1996 – 2012. She focused on the critical points of difference and emphasized the communication choices of each group.

Dr. Jimenez described the traits of the Traditional Generation in the following ways. They are known as “The Silent Generation” for being more formal, stoic, risk-averse, and for prioritizing duty. They let their actions speak louder than words and expect others to understand their behavior. For this reason, they make decisions based on what worked in the past, focusing on values,  respect, stability, order, and practicality. When speaking to the Traditional Generation, use formal communication, i.e., letters or emails. They can be counted on to respond and will be direct, polite, and respectful, using thank-you notes and personal expressions to convey their feelings and interests.

Dr. Jimenez emphasized that Baby Boomers respect authority but only sometimes trust it. Many are very accepting of diversity, and they tend to be optimistic. They also tend to be more politically liberal, conflict-avoidant, and relationship-oriented.  Baby Boomers value directness, respect, and optimism.  Boomers value hard work and innovation, prioritizing relationships and questioning the status quo. When speaking to Boomers, be diplomatic and avoid confrontation, as confrontation can be interpreted as disrespect. Speak to their sense of righteousness and their contributions to the greater good.

The critical issue for Gen X is that they grew up in a period of financial insecurity, with both parents working and limited wage mobility, leading them to question authority and walk away from the workaholic lifestyle of the previous generation. According to Dr. Jimenez, they value a balance between work and life. They tend to be fiercely independent, entrepreneurial, pragmatic, and creative. They value actions more than words, although slightly less so than the baby boomers, and they value accomplishments more than money. When communicating with Gen X, realize that their words can sound harsh. They are less formal and more to the point. They prefer in-person communication or a phone call. They need to be reminded to give and take feedback and use empathy.

Because of the significant digital communication experience Millennials have grown up with, they tend to have a slightly shorter attention span. They are very used to things being clear and well-categorized, and they much prefer it that way. Millennials tend to expect a rapid return of information. For example, Millennials will send a presentation for review to educators via email, and they expect at least an acknowledgment of the receipt. They prefer digital communication rather than phone calls. Millennials also tend to be less formal in communication and seek connectivity with coworkers and bosses outside of work. By and large, they are confident and optimistic idealists for whom words mean more than actions. They are good at teamwork but have correspondingly high expectations from authority figures. Overall, they have a shorter attention span and place exceptional value on achieving a work-life balance.

The Generation Z (Gen Z) cohort values hard work, initiative, and contributions to the greater good. Dr. Jimenez pointed out that Gen Z members are known as technological idealists and social justice warriors. They value meaning and are motivated to contribute positively to the next generation; they are the most racially and ethnically diverse generation in history. They embrace diversity and expect their leaders and institutions to do the same. They perceive that the world is smaller because of technology, and they use technology for communication more than any other generation. A key trait for Gen Z individuals is that while they are Digital Natives, their trust must be earned. As social justice warriors, they want to be part of the greater good and, when doing so, value effectiveness over convenience. Dr. Jimenez noted that Gen Z members prefer face-to-face communication, expect digital communication from school/teachers, and require frequent feedback or check-ins to see how they are doing.

Exploring Best Practices in Health Profession Education for Gen Z Students

Dr. Sawarynski began her presentation by reminding everyone that generation classifications are broad categories that are not scientifically defined. They can lead to stereotyping and oversimplification, and discussions too often focus on differences instead of similarities. Despite these cautions, she and her colleagues strongly believe that reflecting on the experiences and perspectives our students bring to their education can help us understand how our student populations have changed over time and improve the medical education environment for everyone. Data from the AAMC matriculating student questionnaire from 2016 to 2023 indicate that age group cohort breakdowns haven’t changed over time. The average age of the entering medical student is still 23 years old. Although their average age hasn’t changed, the generation that they belong to has dramatically changed. Most current first-year student classes belong to the Gen Z generation.

Dr. Sawarynski continued by pointing out that based on several national data sets, Gen Z students have had a drastically different set of social experiences than many previous generations. For example, there has been a steep decline in the percentage of students obtaining their driver’s license by the time they’re in 12th grade, and in alcohol use, part-time work, having sex, dating, and a whole range of social experiences. Because significant technological shifts drive many generational cut-off points at the beginning of new generations, monumental advances in communication patterns have affected how we meet, connect, and communicate. Today’s online connections for Gen Z students differ significantly from previous generations. Dr. Sawarynski emphasized that Gen Z individuals are comfortable reaching out and communicating with friends, peers, and people they may only know through online connections, including affinity groups.  This interaction with all kinds of social media groups can be drastically different from the communication experiences the medical school faculty had at the same age. In addition, Internet technology allows constant communication with peers throughout the day. The result is that students can participate in parallel dialogues even while in the classroom. The result is that those present need to think about what is happening in person versus what is potentially happening simultaneously via electronic communication.

Dr. Lerchenfeldt began by highlighting a concerning trend in mental health among young people. She presented national data reporting that the prevalence of critical-level depression among teens and young adults has more than doubled from 2011 to 2021. In only 16 years, the rate of clinical depression has doubled in US teens and young adults. By 2021, nearly 30% of teen girls and 12% of teen boys were reported to suffer from clinical-level depression. She focused on Generation Z, individuals born from the late 1990s to the early 2000s times, who are particularly facing serious mental illness, especially the oldest members of Gen Z, those aged 18 to 25. They exhibit a strikingly high prevalence of mental health illness at 11.4%, about twice as high as the general population.  A 2018 meta-analysis published in 2018 synthesized data from 69 studies with over 45,000 medical students. It reported the global prevalence of anxiety in students was 33%, three times higher than in the general population. Some of the factors contributing to this high percentage included the intense academic workload, sleep deprivation, financial burdens, and exposure to patient deaths. The same study reported medical student depression at 30%  and burnout at 37%.

Dr. Lerchenfeldt continued by discussing communicating with Gen Z students who value equality, social justice, and transparency. As a result, they want fairness and inclusivity from their education, and they have a greater awareness of mental health. That might mean expanded mental health services, on-demand counseling, and curriculum integration, including wellness and self-care literacy.  She reminded everyone that Gen Z individuals value autonomy and want to be involved in decision-making with clear communication and personalized collaboration.  Gen Z students prefer a flexible, self-paced environment that integrates technology and offers opportunities for collaboration. She asked, “How can we address this as educators?” She discussed using backward design to focus on desired learning outcomes before choosing our instructional method. She also invoked the need for transparency and explanation of selected instructional strategies and learning goals so students can better understand and engage with the educational material. This brings up a couple of additional questions. What does engagement in the hybrid or asynchronous learning environment look like? Does it involve flexibility and modification of course materials? Does it include in-person and online interactions like discussions and digital forums? In an asynchronous environment, does it allow students to use content they believe is essential to understand these preferences? Students expect a robust support system and medical education. Educators should consider more highly developed digital literacy for their Gen Z communication preferences, engaging them with higher-quality visual and interactive content.

Dr. Lerchenfeldt continued the webinar by reminding us that the end goal is to develop health professionals who can be successful in intergenerational clinics. Educators could think about building useful toolbox-type things within the curriculum, being very intentional about when, why, and how to be transparent about in-person events. Feedback on skills should be offered, keeping in mind what is relevant to the practice of future physicians. For example, can we deliberately and transparently incorporate these ideas and practices into our curriculum in new places not previously considered? Integration of role models for interpersonal and team skills across generations also needs consideration.

All three speakers emphasized the need for educators to support students’ mental health given the following realities:

Many students will spend more time with educators than any other university employee.

Mental health issues may appear on the surface as professionalism issues (e.g., missed deadlines, absenteeism, lack of care with instructions)

While faculty members must work within their qualifications and roles, all educators canseek to understand signs of distress in students, be aware of campus mental health resources and keep their materials readily available (e.g., brochures, QR codes), refer students to the appropriate personnel (e.g., counseling center, dean of students) be aware of campus emergency contacts and reporting procedures, and model self-care, as applicable.

The webinar concluded with two final thoughts from the speakers. First, continue to seek and embrace change. Consider whether or not educators are adapting at the same rate as the available technology our students already use. Explore opportunities to empower students to teach faculty members. Ask students for their perspective on how new tools, ideas,  resources, etc., meet their needs. The speakers encouraged involving student representatives, soliciting their concerns and ideas as an acknowledgment of the vast differences between their experiences and ours. Second, work to be transparent whenever possible. Sound pedagogical reasons for doing things a certain way may be present, but students may have different understandings. Being transparent can go a long way to help bridge those gaps.

Presenter: Carrie Tibbles, M.D., Director of Graduate Medical Education, Designated Institutional Officer Beth Israel Deaconess Medical Center Boston, MA

[The following blog was generated by Susan Ely and Doug McKell]

Teaching Professionalism: Strategies for the Frontline

The Learning Objectives for the second Spring 2024 IAMSE Webinar series on Teaching and
Learning in Medical and Health Professions Education include the following: First, define
professionalism and the process of integrating professional values. Second, review real-time
strategies to address episodes of unprofessional behavior. Third, identify struggling learners
and strategies for remediation and intervention. Fourth, develop a systematic approach to
interventions for learners with academic difficulties and professional or behavioral issues.

Dr. Tibbles began her presentation by focusing on improving learning environments and
hospitals to train the next generation of doctors. She highlighted trends in the last decade that
have impacted clinical learning environments by transmitting professional values to the next
generation, especially those relevant to medical students and residents’ professional identity
formation. She reviewed some good and not-so-good behaviors that could be impacted during
a medical student’s preclinical years to foster more positive attitudes. Dr. Tibbles posed the
following questions as central to understanding professional identity and professional
development, specifically asking attendees to ask themselves and their colleagues: How am I
instilling curiosity? How am I instilling a love of learning? How am I instilling reliability and excitement for this field early on, and how am I helping medical students take those values into
the clinical learning space? Dr. Tibbles contends that how we think about professionalism in the
clinical space needs to be revised. Instead, she suggests a focus on professional values
integration, not simply managing someone’s behavior but helping them tie their behaviors to
the values that will support them throughout their career.

Dr. Tibbles presented information about her group’s work at Beth Israel Deaconess Medical
Center and with other researchers in professional identity formation. She began by providing
two definitions: First, medical professionalism signifies a set of values, behaviors, and
relationships that underpin the public’s trust in doctors. Second, professionalism in medicine
requires the physician to serve the interests of the patient (and community) above his or
her self–interest. Dr. Tibbles pointed out that some enduring characteristics of professionalism,
such as reliability, commitment to lifelong learning, curiosity, altruism, humility, cultural
humility, competence, and compassionate communication skills, are at the core of
professionalism and professional identity. Simultaneously, however, medical education is
evolving and interfacing with emerging tools such as AI. These developments will introduce a
new set of questions on professionalism and what it means to take good care of patients as the
tools, technology, and environment change.

Dr. Tibbles continued her presentation by discussing the concept of wellness in medicine. She
believes that we need to improve the ability of faculty to help students find meaning, purpose,
and joy in their work while incorporating self-care and balance in their lives. The goal is to help
students flourish so they are physically, emotionally, psychologically, and intellectually
prepared to care for others. She stated that this needs to begin early in medical school because
wellness interventions in residency are too late and too little to truly affect the needed
behavior changes. In her view, this is because we aren’t doing enough to truly understand what
makes people well in the workplace and what makes people well in medicine, so it is an area
that we all should be focusing on earlier in a physician’s career path.

Dr. Tibbles shifted her focus to strengthening professionalism and professional identity
formation during the transition from undergraduate to graduate medical education. For faculty
supervising medical students or residents, the question of paramount importance is how
learners view themselves. Are medical students focused on getting good grades, or are they
now concentrating on learning to be the best possible patient caregiver? l Once this transition
occurs, they will be less anxious and more ready to thrive in practice. This transition pertains to
the classroom, where physician skills, attitudes, competencies, and disciplines are discussed.
She further points out that a vital aspect of this transition is discovering that some students are
uncomfortable in the clinical space, especially when they don’t know something. Similarly,
students struggle with the discomfort of training. Unfortunately, some students and residents
confuse some of this discomfort with mistreatment. This is not to say that there isn’t
mistreatment, which certainly warrants attention. Sometimes, however, students need more
time to prepare for the discomfort of clinical training and the unpredictability of providing
direct patient care.

Dr. Tibbles shifted her focus to how the process of caring for patients can put an added burden
on professionalism and professional identity formation. When medical students enter the
clinical environment, they want to behave ethically toward their patients and may feel that the
environment does not support that desire. For example, in a dermatology clinic, a patient needs
an expensive medication, but the provider may not be able to get the patient the medicine they
need. Another example is an environment with healthcare disparities, where different patients
appear to receive different care. These situations are challenging to navigate, especially when
the required actions differ from their personal values. Students experience moral distress when
they feel powerless to change those circumstances. There may also be a culture of silence
around this problem. That leads to moral injury when students ask, “Can I even do this job
anymore?” Dr. Tibbles pointed out that what we want to achieve through our training programs
in medical school and residency are physicians who have enduring values and resilience to
sustain ethical integrity in response to morally complex or distressing situations. She
recommended increasing opportunities for discussion with students about these professional
challenges and how medical systems and structures can be adjusted to make a difference. She
listed five conditions for effectively confronting these problems: authentic role experiences,
longitudinal relationships, intact teams, interdepartmental learning, and safe spaces for
intentional reflection.

Dr. Tibbles described the expectations of professional training by pointing out that we don’t
need perfection – we need reliability, authenticity, honesty, and respectful behavior. The most
challenging problem is dealing with a student who needs better self-awareness, is not sensitive
to others, requires more insight into their behavior, and is resistant to feedback. Suppose pre-
clinical faculty have a student who’s struggling with feedback. In that case, it is essential to
work on it immediately because it later becomes extremely difficult to address it in the fast
pace of residency. She asked us to think about our department’s professionalism challenges.
First, if you are witnessing unprofessional behavior, how long will it be before it’s detected?
Immediately, relatively soon, it takes a while, or never. Ask yourself if unprofessional behavior
slips under the radar in your department because everybody knows each other. Then, ask
yourself the second question: If there is unprofessional behavior in your department, how long
will it take before it’s effectively addressed? Immediately, relatively soon, it takes a while, or
never. The answers to these questions may well expose a gap between how effective our
processes and procedures are in dealing with a trainee or student with issues. Are we getting to
things early? Are we good at early intervention? Or does a pattern develop before something
happens? Or, in some ways, do we let some things go, assuming they’ll get taken care of down
the road?

Dr. Tibbles concluded her presentation by emphasizing the role of faculty as expert teachers,
mentors, coaches, and interprofessional learning examples for students. She recommended
using the R2C2 Facilitated Feedback Model as an excellent tool for faculty to adopt, specifically
the 4 phases of faculty-student relationships: Phase 1: Rapport and Relationship Building,
Phase 2: Exploring Reactions to Feedback – “What do you think?”, Phase 3: Exploring Feedback
Content – “Do they get it?”, and Phase 4: Coaching for Change. This effort is to help medical
students, and residents integrate assisting patients while training for an essential job where patients will rely on them daily. These approaches target the process of increasing professional
responsibility while acquiring the professional identity of our calling and recognizing why our
job is so meaningful.

References:
Rosenbaum, L. (2024). Being Well while Doing Well – Distinguishing Necessary from
Unnecessary Discomfort in Training. N Engl J Med 2024; 390:568-572
DOI: 10.1056/NEJMms2308228
https://www.nejm.org/doi/full/10.1056/NEJMms2308228
Mak-van der Vossen M, van Mook W, van der Burgt S, Kors J, Ket JCF, Croiset G, Kusurkar R.
Descriptors for unprofessional behaviours of medical students: a systematic review and
categorisation. BMC Med Educ. 2017 Sep 15;17(1):164. doi: 10.1186/s12909-017-0997-x. PMID:
28915870; PMCID: PMC5603020.
https://pubmed.ncbi.nlm.nih.gov/28915870/

Presenter: Mark C. Henderson, MD, MACP, Associate Dean of Admissions, University of California Davis School of Medicine

[The following blog was generated by Susan Ely and Doug McKell]

Creating a Diverse Class of Learners via Socially Accountable Admissions

The Learning Objectives for this first Spring 2024 IAMSE Webinar series on Teaching and Learning in Medical and Health Professions Education include the following: First, evaluate the paradigm of social accountability in medical education, including the relationship of representation of increased diversity of health professionals to health equity of underrepresented, underserved, and marginalized patient communities. Second, examine trends in the composition of the US physician workforce, including the percentage of physicians from underrepresented groups compared to their percentage of the population and the changes over time. Third, discuss the UC Davis holistic admissions process, which has increased the diversity of their medical student population despite the 1977 passing of California Prop 209 banning affirmative action.

Dr. Mark Henderson discussed the underrepresentation of marginalized groups in medical schools and the inequities in medical education, emphasizing the need to address these inequities. He stressed the importance of implementing holistic admissions strategies to increase diversity, including long-term changes in the admissions process, cultural support, and peer mentorship. He spoke about the UC Davis School of Medicine and its process over the last 15 years to admit increasingly diverse medical school students. Dr. Henderson began by discussing the paradigm of social accountability as it applies to medical education, specifically medical school admissions, focusing on the current medical student application process that results in the excess or deficit selection of students from some groups compared to their proportional representation in the general population. This negatively affects health equity access and increases health disparities among several underrepresented patient populations. He presented a conceptual model demonstrating why proportional health professional representation and diversity are essential to health equity since individuals and practitioners from disadvantaged groups are more likely to have cultural and language concordance with their patients. This leads to better communication, better trust amongst marginalized communities, and greater health advocacy for such communities, with more health practitioners working in the communities where they are needed.

Dr. Henderson presented data showing that in the United States, the racial/ethnic background, educational advantages, and family income proportions of the demographic composition of physicians who practice in the United States don’t match the United States population as a whole, except for the white population. For example, for the Latino population, which is now almost 20% of the United States, only about 7% of physicians are Hispanic or Latino. There is a similar disparity with the African American population, although it’s not quite as severe, where 6% of physicians are black compared to 13% of the US population. Finally, there is an overrepresentation of Asian subpopulations, where almost 22% of practicing physicians are from Asian subgroups, while Asian Americans comprise only 6% of the US population. Dr. Henderson pointed out that while the US population became much more diverse, with the number of individuals from underrepresented groups living in the US almost doubling from 66 million to over 105 million, and the number of medical schools grew by over 50% between 1997 and 2017, our future physicians do not reflect the US population. Based on the family income of students in medical school today, your chances of being admitted to medical school based on your family’s income are directly proportional to your family income. This means a lower- income student is less than half as likely to be admitted to medical school as a higher-income student.

Dr. Henderson then paraphrased Dr. Martin Luther King’s statement that as capitalism has grown, there are specific segments of the population that have been left out and, in a sense, have exploited impoverished black and white individuals and communities of color. His point was that the inequities he presented dealing with the lack of a representative physician workforce and diversity in the workforce overall were present before last year’s Supreme Court decision that banned affirmative action in the United States. He stated that based on affirmative action bands in California as well as seven other states after those bands were put in place, the racial and ethnic representation in medical schools got much worse. He expects the same thing will occur across the United States unless there’s attention focused on this issue.

Dr. Henderson then described how to make the necessary changes to create a more diverse and representative medical student population. The most crucial step is to have a sense of urgency. The UC Davis School of Medicine was directly affected by the state-wide affirmative action ban enacted in 1997. In 2005, they began a series of process changes, and the enrollment of underrepresented groups has tripled over about 15 years. Many structural elements are present, as alluded to earlier, e.g., privilege, class, and racism. These elements tend to preserve the status quo. Inertia is another factor, as is the fear of lawsuits, even before the recent SCOTUS decision. What is most important is an institution’s mission. Dr. Henderson stated that it is essential to ask your medical school the following question: What medical education goals is the institution trying to accomplish? He argued that the mission of medical education is to train physicians to meet the health needs of society. Fundamentally, it is a social mission. The first step at UC Davis School of Medicine was to adopt a mission focused on meeting society’s needs: socially accountable admissions. This meant that the mission of the UC Davis School of Medicine was to matriculate future physicians who will address California’s diverse health workforce needs.

The UC Davis School of Medicine admissions office shifted its operation to include input from a diverse group of faculty, students, trainees, and patients. They use multiple mini- interviews blinded to several biasing elements that favor the admission of individuals from privileged backgrounds or those who have had more excellent educational opportunities. Using a holistic review is an important paradigm involving choosing students who fit within a school’s mission. It’s about more than just their grades or test scores, which don’t tend to correlate necessarily to the mission. Dr. Henderson emphasized the importance of previous healthcare experiences, whether personal experiences or work experiences within the healthcare system. 45% percent of UC Davis School of Medicine students are the first in their families to graduate from college, which results from applying more inclusive selection criteria to create a more comprehensive economic representation of enrolled students. Finally, Dr. Henderson explained that UC Davis School of Medicine has developed several partnerships with local high schools, local community colleges, and other medical schools that share a similar mission.

Another critical way the UC Davis School of Medicine has approached its mission is to develop inclusive programs focused on community health needs. The Community Health Scholars program comprises almost a third of enrolled students. Most of these students are first-generation-to-attend-college individuals from low-income backgrounds and are often from underrepresented groups. Admissions criteria for these programs prioritize individuals from these communities. The first one, established in 2007, is called Rural PRIME. It is meant to address the maldistribution of physicians in California. Another program, TEACH-MS, focuses on the underserved urban population. The Central Valley REACH program is concentrated in the Central Valley, the agricultural hub of California. The Accelerated Competency-based Education Primary Care program is a 3-year MD degree pathway for Primary Care physicians and is the beneficiary of several external funding sources. Lastly, a program focused on California Native American/American Indian communities was established in 2022.

Dr. Henderson then described the long-term outcome of the residency program match for UC Davis School of Medicine students. Based on data from 147 students over the last ten years, about 80% come from groups underrepresented in medicine. Most students are matched into specialties of need in California, with 43% going into traditional primary care. If ob-gyn, pediatrics, emergency medicine, and internal medicine are included, about 75% of the students would go into some form of primary care.

Dr. Henderson stressed that this level of success requires looking at your applicant pool differently. UC Davis School of Medicine developed a tool called the data scale, which is a metric derived from each student’s application. It incorporates several socio-economic variables to form a score from zero to 99. A high score on this scale means the student has experienced significant socio-economic distress. A low score would mean they’ve experienced very little hardship. The variables include income, parental education, working during college, or growing up in an underserved area. Because traditional measures of excellence or merit tend to be confounded by educational opportunity, we use this scale to provide context to those other measures. Because it’s a number, it tends to nudge our committee members to be more holistic and dive deeper into every applicant’s application. Dr. Henderson indicated that he believes this correlates to resilience or grit and the ability to overcome obstacles, i.e., essential qualities in future physicians.

Dr. Henderson focused on three programs that help ensure medical student success. The first program is their Community Health Scholar program called ACE PC, which admits eight students a year, all of whom have primary care experience before medical school admission, either as an emergency medical technician, a medical assistant, an ancillary health provider, or someone who worked in a healthcare center. 85% of these students are first-generation college graduates. They are admitted to medical school with lower grades and lower MCAT scores, but they finish in three years instead of four, and almost 90% of them match into a primary care residency. They get a full tuition scholarship because accumulated medical school debt discourages many students from pursuing primary care.

The second program is a community college-to-medical school Pathway Program. It turns out that about half of the Latino family residents came through the community college system, and a third of the black family residents went to community college. This is a significant pathway for underrepresented students. The problem is that many community college students don’t finish, or they don’t transfer, or it takes them quite a bit of time to transfer. About 2.5% transfer within two years of community college, and only a quarter within four years. This program aims to build bridges between community colleges and the UC Davis undergraduate campus. Once the students are at the undergraduate campus, they provide additional health professions career advice and help them address gaps in their educational preparation.

The last program is a partnership with Oregon Health Sciences for a tribal health medical school pathway program called Wy’est. This residential post-baccalaureate program accepts Native American students who have applied to medical school but have been unsuccessful. They spend ten months in Portland. If they meet the requirements of the post-baccalaureate program over this period and the Wy’est program requirements, they receive conditional acceptance into UC Davis School of Medicine, Oregon Health Sciences University School of Medicine, or the Washington State School of Medicine. This program has been quite successful over the last eight years. The students from this track enter the Tribal Health Community Health scholar program when accepted at UC Davis School of Medicine.

Dr. Henderson concluded his presentation by repeating his main point that the mission of medical education is to train physicians to meet society’s health needs. He reported that supporting students with additional academic advising resources and financial aid has additional costs. At the same time, he was optimistic that other advances in medical education, such as AI, may make the holistic admission process more equitable despite concerns about fairness and potential misuse.

Presenter: Thirusha Naidu, PhD, Clinical Psychologist, Associate Professor Department Behavioral
Health, School of Nursing and Public Health, University of Kwazulu-Natal, South Africa

[The following notes were generated by Michele Haight]

Refracting Lenses Seeing Women of Color in Global Health

This presentation includes my reflection on the entire “One World, One Health: Tackling the Global
Health Crisis” IAMSE webinar series. It also includes artwork created by Faith Ringold and other artists,
whose work depicts the content of the presentation and provides a visual representation of ideas.

My historical identity in South Africa is connected to my ancestors who were slaves/indentured servants
from India, forced to leave their home due to the ongoing extraction of goods and resources from the
Asian continent by the British colonizers. I grew up in South Africa during apartheid and attended
segregated schools. I have been a recipient of the global health experience, and I position my research
through the lens of a recipient rather than a provider. All these aspects of my identity inform my
positionality and have influenced the way I think about and conduct my research.

The following are my reflections on the prior webinars presented during this series.

Baenziger: Global Health Electives: Impact, Challenges and Best Practices This perspective speaks from
the Global North (GN) to the Global South (GS), intervening, talking, and acting toward the GS. It is
critical to understand how GS researchers experience this. The flow of global health training is not
bidirectional in an equitable way. Most GN trainees go to the GS for training, not vice versa. Training and
intervention occur in the GN. Knowledge flow goes from the GN to the GS, whereas extraction goes from
the GS to the GN. Work needs to be done to level extraction and exchange, learning and ideas. Critical
questions: Are we teaching white saviorism or respecting local knowledge and agency? What is the
global health archetype student we are creating?

Richardson: Impact of Climate Change on Global Health. Climate change is not experienced equally.
Africa and African women disproportionately experience the negative effects of climate change.
Because African women are tied to the land, climate change impacts their lives more severely. These
impacts include agricultural production, food nutrition, food security, and health impact on water,
energy, disaster migration and conflict. Climate change must address the needs of women in the poorest
parts of the world in order to be relevant. People in political and economic power are making decisions
as to how climate change needs to be addressed and dealt with. Critical question: Whose perspective
and interests are we focusing on in climate change conversations?

Rashid: Global Approaches to Medical Education: Who Wins? This presentation deals with accreditation
and how the WFME sets global standards for medical/health professions education. Clinical standards
are set by Euro-North American methods, and do not really reflect the context of the training in other
countries. The WFME is skewed towards Western interests, perspectives, and ideas of how people
should be trained. The WFME system promotes the credibility of Western ideas and content while
keeping silent about, even ignoring the fact that there are other methods of teaching health professions
education in the world. Methods for teaching health professionals are relevant to the context in which they are taught. However, the educational methods of the GS are not given credibility because the
powers lie with the GN.

There has been a feminization of the health professions in the GN but not in the GS where fewer health
officials are women. Women get a worse deal in health systems because these systems are structured
according to a male dominated health system. We need more women in the health professions to
provide experience and perspective to properly address the needs of women. We need to develop plans
to train more women. Critical questions: Are we teaching a masculine curriculum that epitomizes male
thinking? Who is determining the basic criteria for standards and what ways of thinking do they base
their determinants on?

Cianciolo, De Jong, & Ramani: Culture and Practices for Global Inclusion in Health Professions Education
(HPE) Publishing: What Can Work? The leaky pipeline in medical education (Kusurkar, 2022), shows how
knowledge production in publishing occurs in medical education where low- and middle-income
countries (LMIC) are not part of the knowledge conversation. This creates a lack of diversity among
reviewers who do not see what is important for researchers in these countries. The knowledge system is
designed to rely on methods that are structured by Western epistemology. Editorial boards lack diversity
as well and further marginalize differing perspectives and epistemologies. There needs to be deepened
partnerships between the GN and GS, widened access to publications, and diverse types of papers that
are published. Critical questions: In medical education publishing, whose voices are we hearing most?
Who is controlling access to knowledge production?

GS authors identified three different categories of difficulty in getting their papers published: practical,
academic, and transformational.

Modern medicine is an artifact of colonialism because the science it underpins emerged from Western
knowledge structures that are based on a history of colonialism. The colonial roots of medicine include
colonization, colonialism, and coloniality. Coloniality has outlived colonialism and is preserved in our
books and our criteria for academic performance.

Quijano (2000) has proposed a colonial matrix of power that consists of a triad of colonialism, racism,
and patriarchy. He stated that this matrix permeated the colonial world and has cascaded down into the
modern world; it continues to dominate our knowledge and subjectivity.

Maldonado-Torres (2007) noted that coloniality is not over, it is all over, everywhere; it is ubiquitous.

In Zero Point Hubris, Castro-Gomez, (2021) points out that our behaviors and decisions continue to be
influenced by coloniality through our internalized colonizer. The information problem in global health is
that we are all victims of this mindset.

If we focus on women of color in the world who experience the most difficulties and challenges, we will
get it right for everyone else. By attending to women of color we can enhance global health and health
for all.

Medical education presents ever-changing opportunities and challenges for learning communities and institutions. In the past five years alone, learners and educators have confronted a global pandemic that temporarily ended in-class content delivery, the advent of Pass/Fail score reporting on USMLE Step 1/COMLEX Level 1with dramatic effects on residency placement for both US and foreign medical graduates, and the expanding use of Artificial Intelligence in clinical practice and medical education. The Spring 2024 IAMSE Webinar Series will address strategies to expand and enhance a dynamic culture of teaching and learning for our educators and learners. This five-part series will begin with a consideration of how best to serve an increasingly diverse group of learners and promote the expansion of diversity at all levels. The webinar series will explore the importance of maintaining and enhancing a culture of professionalism, then generational differences within learning communities will be addressed, reflecting the three or more generations represented by learners and faculty at most medical schools. Another session will examine approaches to promoting wellness and mitigating burnout among all learning community members in the context of educating future clinicians on the importance of work-life balance. The series will conclude with a consideration of the “hidden curriculum”, perceived by many learners as a parallel curriculum. The goal of the series is to encourage and enable participants to embrace change and foster innovative approaches to teaching and learning as we conclude the initial quartile of the twenty-first century.

Empowering Minds: Fostering a Dynamic Culture of
Teaching and Learning

Join us for each one-hour session beginning Thursday, March 7 at 12 PM EST. Sessions in the Spring 2024 series include:

• March 7, 12 PM EST – Creating A Diverse Class of Learners presented by Mark Henderson
• March 14, 12 PM EDT – Moving beyond Professionalism to Professional Values Integration in Medical Education
  presented by Carrie Tibbles
  Please note that Daylight Savings begins in the United States on March 10. Please be sure to check the presentation times with your local time zone.
• March 21, 12 PM EDT – Exploring Best Practices in Health Professions Education for Gen Z Students presented by Shannon Jiminez, Sarah Lerchenfeldt, and Kara Sawarynski
• March 28, 12 PM EDT – Student Motivation and Well-Being in Medical School and the Resilient Mindsets in Medicine Initiative presented by Kenn Barron, Zachary Himmelberger, and Yoi Tibbetts
• April 4, 12 PM EDT – Navigating the Hidden Curriculum in Health Professions Education presented by Megan Brown

As always, IAMSE Student Members can register for the series for FREE! Email support@iamse.org for more details.