Notes from BERST

Notes from BERST offers timely tools and tips for teaching and leading. If you'd like to learn more about anything you read here, please email BERST@baystatehealth.org.

How to Create Dynamic Virtual Sessions: It's Different, but Worth It

July 12, 2020

Back in March when everything we do went online, did you say, “Well, hopefully we’ll have next month’s meeting/educational session in person?” We hoped we could get back to our normal, dynamic team environment—doing the types of activities we believe can only be done in person.

Well, now it’s July, and it looks like we'll be getting together virtually for the foreseeable future.

Admitting and appreciating the advantages of virtual sessions

Many of us have seen more consistent attendance using virtual platforms because they remove the barriers of transportation and parking.

Perhaps we've noticed that participants are sharing more since there are more options to engage. Some team members who do not want to speak out may make great use of chat features.

Virtual platforms also reduce the additional planning and financing required for booking spaces and ordering food.

Those examples are only about staff—technology has also positively impacted some areas of patient care!

Learn from those who have been meeting and teaching online long before the pandemic.

There are great ideas already out there!

You can consult this list.for icebreakers and team-building exercises. It includes some ideas for leveraging the humor of the virtual environment by including a Bingo card that tracks common occurrences like pets or kids “bombing” the meeting. Some suggestions take advantage of the fact that we’re all at home by encouraging us to give each other home tours a la MTV Cribs, or do scavenger hunts for typical items found around the house.

This piece outlines several activities to engage learners like you would in the classroom by using different features of Zoom. It turns out that you can still put learners in groups, ask them to solve problems, call on them to share out, and ask them to do written reflections while teaching online—it just looks a bit different.

Preparing your online classroom and acquainting learners with the different ways they can engage may take a bit more time, but it’s worth it!

Teaching for Justice

June 15, 2020

We are teaching even when we think we are not teaching.

As educators, one aspect of our jobs is to be a role model for our learners. We are modeling more than our professions, more than our skills. We are modeling our mindsets, our perspectives, our values. Because of this, “it is not enough to not be racist.”

We must be anti-racist in our teaching by always taking a stance to oppose racism and systemic oppression. We must be conscious of modeling critical self-reflection and cultural humility — knowing when to take a step back and to share what we do not know. 

> Watch "Cultural Humility: People, Principles and Practices," a 30-minute documentary by San Francisco State professor Vivian Chávez that explains cultural humility and why we need it.

Know when to use our voices and when to listen to—and help amplify—voices of others.

Before we can ever hope to facilitate conversations on these topics with our learners and teams, we must seek to learn, listen, and look within. This is not easy work.

We need to face hard truths—for example, that we are susceptible to implicit bias and may be unconsciously acting on it. We need to not shy away from hard conversations. We can’t only be anti-racist in the classroom (or wherever we teach). We have to always be anti-racist. How you do anything is how you do everything. You are teaching even when you’re not teaching.

 > Take the Implicit Association Test to see if you have attitudes and beliefs you are not aware of.

The word "racism" can cause an immediate reaction rather than a response.

For many, it’s because the idea of racism suggests personal racism rather than participation in a system of racism.

However, not personally perpetuating racism through blatantly racist acts does not mean we do not participate in and benefit from—however passively—a system of racial oppression.

 > Read "A Gardener’s Tale" by Dr. Camara Phyllis Jones which unpacks this issue using her framework of 3 levels of racism: institutionalized, personally mediated, and internalized.

We need to recognize privileges some of us have simply by being born white.

Privilege is another fraught word. It often engenders thoughts like, “I’ve had it hard too,” or “Nobody’s life is perfect,” or “I’ve worked for everything I have.”

We might also be tempted to compare racial oppression to other forms of oppression, like class or gender. These are real areas of inequity, and intersectionality theory can support understanding how race, class, gender, and other individual characteristics interact. But retreating from the reality of "White Privilege" by equating it with other forms of privilege actually perpetuates it.

There are privileges some of us are afforded by virtue of simply being born white.

 > Consider 50 daily effects of white privilege by Dr. Peggy McIntosh—such as, "flesh" color bandages more or less match our skin, our accomplishments are not seen as a "credit to our race." 

Have compassion for yourself and others as you face implicit biases.

These knee jerk reactions around racism and privilege are normal—they just can’t be where our response to these concepts stops.

As you face your own implicit bias, have compassion for yourself. As you realize that you had never once thought of the life you enjoy as being a privilege, pause to acknowledge that part of why this system of oppression works so effectively is because it is hard to recognize without deliberate practice and attention.

Let’s also be compassionate with others as they begin to critically self-reflect on their biases. Just as with any other learning objective, we can hold ourselves and our learners to the highest standard, but we need to offer scaffolding to get there.

This is a process, and if you’re doing it right it doesn’t have an endpoint.

Resources

This comprehensive list of resources compiled by Sarah Sophie Flicker, Alyssa Klein in May 2020 is more than enough to get you started. It features best-selling books like Me and White Supremacy by Layla F. Saad, The New Jim Crow: Mass Incarceration in the Age of Colorblindness by Michelle Alexander, and Just Mercy by Bryan Stevenson as well as the landmark documentary 13th by Ava Duvernay and the pivotal podcast 1619.

Teaching For Justice LibGude: Articles on anti-racism for health professions education including Representations of Black, Indigenous, and other People of Color in curricular materials teacher preparedness tool kits, and more.

As always, BERST is here to help you adapt your teaching.

The Struggle

June 8, 2020

Dear BERST Members and Friends,

Like many of us, I've struggled with the news these past days/weeks.

I'm outraged, frustrated, sad, anxious, concerned, and hopeful.

If you are struggling, you are not alone.

I'm struggling too, and I'm trying to act:

• As a mother, I'm having conversations with my kids about racism and privilege.
• As a friend, I'm ensuring that I'm open to listen.
• As a leader, I am committed to ensuring our workplace is fiercely protective of what diversity does - how it makes us all better, how it makes all of our work better, and how it makes our hospital better.
• And as a learner, I am committed to continued growth.

Glennon Doyle wrote: "We are mugs filled to the brim, and we keep getting bumped. If we are filled with coffee, coffee will spill out. If we are filled with tea, tea will spill out. Getting bumped is inevitable. If we want to change what spills out of us, we have to work to change what's inside us."

We are all filled with biases, but through education, we can disrupt our biases and learn to behave with curiosity and humility.

My mug is currently carrying around anger, resentment, and sadness, but that's not what I want to spill out. I'd rather fill with gratitude, curiosity, fortitude to change, compassion, and patience... and then brace for the impact of getting bumped.

Use education to drive change.

With our expertise and connections across Baystate, we have the potential to lead the charge for using education to drive change.

This starts by looking inwards. Please continue to handle yourselves with compassion and curiosity so that you may continue to do that for our community as well. We are a thoughtful, supportive team.

We are ready to take on this challenge.

Thanks for all you do and for the many ways you inspire the best in me and our Baystate community every day.

Rebecca Blanchard
Director, BERST

P.S. Next week's BERST Note—Teaching for Justice

Your Story is Your Power

A Reflection (from the couch) on Crisis Leadership

May 13, 2020

I was watching Netflix the other day, halfway through my second bowl of popcorn, when I came across Michelle Obama’s documentary, Becoming.

In one scene, she’s sitting behind a table signing books for a long line of excited fans. While we watch her shake hands with each person, her voiceover says, “Don’t look past them. Don’t check your watch. Make eye contact,” she’s saying. “Make the connection with that person,” she’s saying. “Everyone has a story.”

Then Obama is at a high school, sitting in a circle of girls who’d each submitted essays for a chance to meet her. One of the teachers says to Obama: “The girls were just saying that they can’t figure out why they were chosen to be here.”

Michelle looks at the girls and asks, “Who thought that?” A young Hispanic (LatinX?) girl raises her hand, and Michelle prompts her to explain. The girl says, “I don’t know. I’m not valedictorian or in a bunch of clubs or anything. I come to school, do what I have to do, then I go to work.”

Michelle asks her, “Why do you work?” She answers, “Because my dad is sick and my mom is taking care of my younger brother and sister and so I work to help them out, so that he doesn’t have to worry about it as much.”

“Right there,” Michelle Obama says. “That’s why you were chosen.” And she looks at the girl and says, “Your story is important. Your story is your power.”

I sat up on the couch, M&Ms and soda cans tumbling to the floor. Your story is your power.

Sharing Our Unique Stories Gives Us Authenticity

There are a lot of great lessons in leadership being shared right now. How to lead through a crisis; how to lead your team virtually; how to build resilience. They’re all important. But the passion behind these—the thing that makes them YOU, is the way that they fit into your story.

Each of us has come to this crisis—and will come through this crisis—in a unique way. As leaders (and teachers) our story of this time includes the stories of those we lead and teach. To hear those stories—in order for those to come through loud and clear, so that they empower you to lead clearly, openly, and successfully—we must be the kind of leaders that listen.

The compendia of resources—including this virtual library from the AAMC broken down into three areas: Managing Self, Leading Others, Leading Your Organization —share critical insights for leadership. But our stories—our own unique combinations of creativity, frustration, mishap, emotion, judgment, transparency, honesty, and gratitude—are just as critical for making them work.

So, dig into these leadership resources and think about how your story powers you right now.

Then eat some M&Ms (you deserve it).

Why You Shouldn’t Put Off Your Writing

April 24, 2020

The COVID-19 pandemic has forced us all to strip down to what’s most important—for ourselves and our communities.

For our health professions education community, you might be surprised that this includes writing.

Academic writing is arguably more important than ever.

Consider the commentary in NEJM by Baystate's Dr. Andy Artenstein that is bringing national attention to the extraordinary efforts needed to secure crucial personal protection equipment.

And, that medical journals are fast-tracking COVID-related papers so that emerging information can be quickly shared amongst our global healthcare community.

Healthcare education is a critical part of the pandemic response.

Our work is so important and sharing it through scholarly writing makes a difference—for your colleagues across the country, for your students’ preparation, and for your future patients who will benefit from all that we learned and shared during this time.

Kevin Eva, editor of Medical Education, even wrote a commentary on the value of health professions education scholarship during these Strange Days—for the sheer importance of our field. His journal is also quickly sharing information by publishing accepted articles on educational innovation within days of submission.

Let's all agree to take one tiny step forward this week.

Here’s what we can do.

Read this blog post on Writing While Distracted.

Or, read this Med Ed Twitter Chat with lots of good ideas for writing during these crazy times—including lowering your expectations for yourself, using writing prompts, or paying attention to calls for papers.

Why is writing important?

It keeps us connected as a community. It’s what makes great ideas spread.

Writing is how we bring the resources of ideas and energy to those who so desperately need them.

April 10, 2020

How-To Set up Your Online Discussions for Success

Loss of the dynamic classroom environment can be a big issue for educators transitioning to online learning.

Discussion forums are a key component of online teaching—they help your learners reflect, teach each other, and demonstrate their learning to you.

But, how can I have a facilitated discussion? How can learners pair-share or learn from one another in small groups?

Consider a few practices as you switch to this platform.

Let learners weigh in.

Start with a discussion forum that allows learners to state their expectations. More often than not, learners themselves will establish the norms you want for discussion forums.

Be clear about what you expect.

Consider what you need to determine effective participation. Do all learners need to start a thread? How many responses are required?

Determine your role.

Are you going to respond to every post or only jump in to stir more discussion? You can even ask learners what they want your role to be.

Be mindful of group size.

Do you have a big class? It’s not a bad idea to create more than one forum to make groups smaller, allowing learners to have more space to share their ideas.

Discovering ways to make discussion forums most effective is worth the time.

March 30, 2020

COVID-19 is Changing How We Teach—But Not How We Learn

Learning only happens through reflection.

So, while your learners are engaged with virtual resources, consider how you can also encourage them to reflect.

Reflection can happen in group discussion or individually, and online classrooms offer a variety of ways to capture it.

For example, you can list resources then ask learners to participate in a virtual discussion on a specific topic.

If you’d rather receive reflections individually—but without clogging your inbox—consider creating an assignment submission portal where students can submit a longer written reflection with you as their only audience. (See our Remote Teaching Resources for examples of online classrooms.)

Make sure students are in the right headspace to learn.

Feel like you need to check in with learners a little more personally?

Consider sharing this Deliberate Self-reflection Quick Guide to support a deeper look at how this situation is affecting them. It’s a great resource at any time, but feels particularly useful now.

Creating an online classroom or connecting with learners in another way?

Share your reflective process with them from time to time. A little can go a long way.

Clinical Education—Without the Clinic

March 24, 2020

When COVID-19 was officially recognized as a pandemic, it became clear that learning experiences in the clinical setting for our health professions learners would be put on pause.

A dean at our affiliated medical school encouraged us to think of “educational opportunities that are more appropriate for the circumstances.”

Our learners are digital natives and we immigrants get to follow their lead.

We can learn how virtual education methods can provide clinical education—without the clinic.

Programs like Case X and i-Human are pricing their products with heavy discounts or free as a result of our current situation. There are also online simulation cases for nursing students and for emergency medicine that are getting heavy traffic.

Of course, Free Open-Access Medical Education (FOAM) is not new, particularly since emergency medicine educators have led the way by sharing via social media (#FOAMed on Twitter).

Twitter is full of clinical education discourse and always a way to keep up—if you can keep up.

And don’t think our journals are dinosaurs just yet.

Many are keeping up with the pace of information by publishing articles quickly online (like JAMANetwork and NEJM).

And some of them offer blogs that are helpful too, like AM Rounds from Academic Medicine or the Nurse.com blog.

These are all valuable for encouraging different learning objectives, but for them to be educational?

That still requires you.

The volume of resources continues to grow—consider a thoughtful, deliberate release of educational materials. And consider asking your learners who are interested in a career in health professions education to collaborate on ideas.

Any off-road adventure is hard, but it creates paths that never existed before.

And we're here to help, too.

BERST has put together a catalog of resources for remote teaching, including online classrooms, presentation software, and useful tips.