Subscribe
Share
Share
Embed
In this episode of “Lab Medicine Rounds,” Justin Kreuter, M.D., and Kamran Mirza, M.D., Ph.D., Associate Professor of Pathology, Medical Education, and Applied Health Sciences and Vice Chair of Education in the Department of Pathology and Laboratory Medicine for Loyola University Chicago Stritch School of Medicine, discuss the importance of interprofessional education within patient care, for medical professionals and students, and advocacy.
A Mayo Clinic podcast for laboratory professionals, physicians, and students, hosted by Justin Kreuter, M.D., assistant professor of laboratory medicine and pathology at Mayo Clinic, featuring educational topics and insightful takeaways to apply in your practice.
(upbeat music)
- This is Lab Medicine Rounds,
a curated podcast for physicians,
laboratory professionals and students.
I'm your host, Justin Kreuter,
the bow tie bandit of blood.
A transfusion medicine
pathologists at Mayo Clinic.
Today, we're rounding
with Dr. Kamran Mirza,
associate professor of
pathology, medical education
and applied sciences and
vice chair of education
for the department of pathology
and laboratory medicine
at Loyola University Chicago
Stritch School of Medicine.
And we're really excited to
have him on the podcast today
to talk about interprofessional education.
So thank you for joining
us today, Dr. Mirza.
- Thank you so much for having me.
- I think that there's
many different ideas
that come to mind when people talk about
interprofessional education.
And I know that some of us
that are really in the literature on this,
this has really been a challenge.
And so I'm curious maybe to start us off
from your perspective,
why is interprofessional education
an important topic for us
clinicians, lab medicine
colleagues, the students as well?
- Sure, absolutely.
I think my own introduction
to interprofessional education
was when I as a pathologist
started working on developing
a master's degree in
medical laboratory science
and in our day-to-day
practice as you know,
we work with medical laboratory
scientists all the time
and I value what they do,
but it wasn't until I started
creating educational programs
that actually dealt with
what they were doing
on a day to day basis,
that I really started
understanding the value
of what they represent.
And if I think about
the future of medicine,
even actually the present
times in medicine,
I find that no one can
really practice in a silo.
There are gray zones
around all of us, right?
Whether we be physicians,
whether laboratory
professionals, et cetera.
And I think from my own experience,
the value of interprofessional education
perhaps can be discussed in
three different settings.
One would be patient care,
which is obviously first and foremost.
And I would say that
for good patient care,
we need to be able to really understand
what the roles of the
different professionals
within medicine, right?
Or within healthcare are achieving.
So I think that, if we think about it
from a patient centered lens,
we'll realize that understanding
the value or the education
or collaborative education
with our colleagues around us
is probably better for healthcare overall.
The other is for education itself.
I think that, our residents
in pathology, for example,
or my graduate students in
medical laboratory science
or my medical students,
they will perhaps understand their job,
the knowledge that they need to know
and the functioning of diagnostics better
when they are involved
in interprofessional sorts of activities,
whether they be simulation-based
or just didactic.
And finally, I think that
it's really great for advocacy.
I think that it's very important
to have people on your side
who understand what you do.
And if all of our healthcare workers
are trained in interprofessional education
in a way that they understand
what their counterpart is doing,
I think that's really great for advocacy
on like a broader level,
federal level, right?
Where everyone can support
the other profession
within healthcare, within
the discipline of medicine.
I think that, it's basically a win-win
as far as I'm concerned.
- Yeah, thanks for kind
of breaking us off in this
and highlighting,
I think we're all agreeing about
we can't practice in a silo.
It really is.
And that's one of the
things I love about medicine
is that we're in a team sport environment.
I think about, sometimes there's
some very transparent
areas where I think about
interprofessional practice,
you kind of started us off,
when we have interdisciplinary
rounds that may occur.
- [Kamran] Right.
- And also, there's also challenges
that come with that, right?
You highlighted different professions,
we have different roles.
And so there's also just a
different schedule all together.
- Right.
- What do you think are a
few of those key lessons
that you've learned about,
how to really do this
interprofessional education?
- I think that what I've
learned, I guess in a nutshell,
is that you need a champion for it.
It needs to be pushed
from the highest levels
of administration, in order
for it to be valued, I think.
That's one lesson.
The other lesson that I've learned is that
there are more opportunities
for it that exists
than we typically think about,
I think if this takes a little bit of
out of the box thinking.
If we look at basically
the structure around us,
as you know right now in the throws of
God knows which number,
increase the numbers of cases
we're getting with COVID-19,
we know that the lab staff is strapped.
Like we know we have openings everywhere.
It's really a difficult situation.
So in this particular situation,
carrying the banner of
interprofessional education
and having activities
may not be the appropriate time for it.
But I think that, if planned correctly
there overlaps, and I
love how you discussed it
as an integrated, like lab rounds, right?
Like where people have pharmacists
and they have nurse
practitioners and they have,
many different disciplines
or professions within healthcare coming in
to round on patients directly.
Why can't we do that when
it comes to pathology
and lab medicine, and perhaps
it will look different, right?
The way we see patients looks different.
We don't see them in-person,
at least most of us, right?
Unless you're doing blood bank or cyto,
we see them at the microscope,
or we see them as a fluid.
And I think that
surrounding that structure
there are mechanisms in
which I think we can do
an interprofessional type
of a teaching activity.
In my experience, it's
been mostly didactic
or simulation-based.
And so I am dealing with a lot of trainees
in my roles in education.
And so the work is easier
to put together, right?
Because it's already,
like it's basically putting it
into their didactic schedule.
I think it also becomes very unique
when you're familiar
with the different people
who are champions in
interprofessional education,
and you can pick and choose kind of,
I can pick a resident,
a pathology resident,
let's say I have a star
who knows medical about
science really well,
and he or she could go and teach
in the medical laboratory science program.
Similarly, one of our program managers
in the medical laboratory science program
could be a great asset in
some of the laboratories
we do for medical students.
And so of course it will
take a little bit of planning
because there are challenges with time.
But I think that a lot
of opportunities exist
if we put the lens of
interprofessional education on
when we're looking at
curricular development.
- I really liked the idea
you're kind of expanding to,
there's more opportunities out there.
And I think you're saying that,
we all come across key
people that seem like
they're very open and sharing,
what is it that they do in their practice?
How do you think we make
it a meaningful experience
for the students, right?
Because just having a
simulation and having people
co-localized for a period of time,
how does that made a significant event?
- I totally agree.
I think that there needs to be
a certain amount of intentionality
towards this, right?
To be successful,
like any other kind of
educational activity,
there needs to be a goal in mind, right?
We need to have goals and objectives.
We need to have the right audience.
We need to have the right speaker.
We need to know,
that the speaker is going to cover
what we would like them to cover
and then we need feedback.
We need evaluation and
feedback of the session.
I think that by and large,
when we think about laboratory
medicine as pathologists,
I think we will do a good
job as to understanding
what types of things our trainees need.
But perhaps there are
things outside our realm
that we haven't thought about, right?
And I think that the
setting also really matters.
I think that we're very fortunate
here at Loyola University,
the health sciences campus,
that we have a couple of
different schools, right?
You mentioned, we have a buckets
of school of health
sciences and public health.
We have a medical school,
we have a nursing school,
we have an institute for bioethics.
And I think that there are opportunities
that organically arise
because of the fact that
you have numerous people
doing similar, but different things.
And then there are opportunities
that you need to create.
And I think that the ones
that you're trying to need to create
need to be created very intentionally
so that you kind of are doing
a service to the students
and not wasting their time.
And I think that it has to
be an iterative process.
It has to be a process
that's guided by feedback
so that you can do it
better in the future.
But I think that, all in all,
I would say that there isn't any type of
interprofessional activity
that I would deem useless,
to start off with.
I would definitely say
that there's use utility
in kind of putting something together.
However, I do agree that
there could be some activities
that perhaps aren't as useful as others.
And I think that maximizing
on those which are useful
or engaging to the students is best
because I think that for the longevity,
you do need students to keep promoting
and showing interest in it,
otherwise interest will just fizzle out.
- It kind of brings up
that idea of feedback
and, it makes my heart go pitter-patter
when you say the idea of
being iterative, right?
And really there's something special
about just getting started.
With the feedback, a lot of times,
and I've been guilty of this asking
did you like this, the
simulation or something?
And I think as we're learning,
or at least I'm learning,
that's a very low level
of feedback that may not,
really probably should
not be as informative
to what do I do?
How do I iterate this?
And so I'm kind of curious,
what sort of approach
do you take to feedback
to get that feedback
that's really going to
help you meaningfully
iterate in a positive way?
- That's a great question.
I think that the generic question
of whether you like something or not,
that's actually not a bad question, right?
To start off with, I
think that if for example,
even in that simplistic question,
the answer is no, we didn't like it.
Well then, we definitely need
to decide to be more granular
with why they didn't like it.
But I do think that that isn't necessarily
an unhelpful question.
That said, though, I do agree that,
I think that part of the
feedback should be developed
or the questionnaire for the
evaluation should be developed
as you're creating the structure
for the session, I would say.
And then that way it's
easier to be more granular
about specific aspects of it,
especially the aspects that
you are a little hesitant
or not so sure about putting together.
And then after that,
naturally making it easy for
them to answer, like at scale,
kind of easy, like shorter numbers,
like not too long.
You can leave certain things open-ended
so that they can put their thoughts there,
but otherwise having
quantifiable objective data
is probably important.
One thing that has helped me a lot,
I think is just, in-person feedback,
from a group of individuals
who've participated
in the course or the
sessions, for example.
And I think that there's a lot of value
in this sitting together
and asking them before
they come to the session.
And we do this for medical school.
We do this for graduate school.
We do it in our house
staff meetings as well,
this idea that call it the feedback
that you have as a group, right?
And anonymously put it
together on a piece of paper,
and then we can go over it, right?
What worked? What didn't work?
What you would improve and why, right?
And what I realized is that over time
students as they change years,
they will come up with similar examples
or similar questions that we've
thought about in the past,
implemented them and they haven't worked.
And so we can tell them
that, oh, we tried this two years ago
and it didn't work for
this, whatever reason.
And then sometimes it's amazing
students have a brilliant
way of viewing things.
And sometimes these
fantastic ideas come about
which you haven't even considered before.
So I think that in general,
it does take a lot of love and effort
to putting it together.
But over time it can
become a great product.
- I'm gonna enter the
confessional with you
for a second Dr. Mirza, I would say,
I am better about things
that are happening quickly.
For example, in transfusion medicine here,
I get new anesthesia
trainees every two weeks.
And so there's some
things that are happening
very frequently and I'm really quite good
at being iterative and making changes.
Some of the other things that we do,
like when I teach the medical students,
when it comes like once a year,
if I can confess to you that
I'm not necessarily the
best at those less frequent
yet very critical things.
I'd like to be better.
Do you have any kind of
advice for maybe people,
if there's other people like me out there
that have difficulty,
some of the less frequent things
yet still important things,
how can we still keep
forward movement on those.
- Since we're at a confessional,
I'll confess to you as well.
There are times when that one
yearly lecture that I gave,
as soon as I'm finishing it.
And based on the questions
that are asked live,
I think, oh, wow I should
probably change these slides,
or change this thing on the side.
And then the whole year goes
by and I haven't done it.
So that's a problem I
think that as educators,
we need to continue to see
beyond our doors, right?
There are some natural
tendencies for us not to do that
until we're forced to.
That said, though, I will
tell you, Dr. Kreuter
there is someone in that course
who is keeping an eye on that evaluation.
So what you're talking
about is self improvement,
and that's a very lofty, elevated goal,
which I applaud you for.
But I can assure you that
if there was something,
administrative or an issue
in the lecture that you gave,
you would be told by some other authority
that you need to make some changes.
So I think there are two
levels of feedback or change
that we need to consider.
One is, are you effective, right?
And that is happening because
if you're not effective
in any LCME or any kind
of accredited program,
there is a mechanism in
place to let you know
as a teacher that you're
not being effective.
What you're talking about is
elevating the game, right?
And elevating the game is something
that naturally is a beautiful thing
that we need to keep aspiring towards.
And that's more of a stuff driven thing.
I think that, as long
as we can keep a balance
of trying to elevate for
things that are less frequent,
I think you're okay. Basically.
- I appreciate your framework
and also swaging some of my guilt there.
Now I imagine that some of our listeners
may very well know you from social media
and your social media expertise.
I'm always curious about these junctions
that we have in our practices.
And I'm curious about,
do you have any broad thoughts
about how social media
may or may not have a role in this
interprofessional education?
- Okay, let me roll up my sleeves.
Yeah. So absolutely.
I remember I talked about,
a few minutes ago I
talked about the setting
is important, right?
And I think that,
and the reason why I
think I value the setting
is because we recently developed
a school of health
sciences and public health.
And we didn't have that
in a couple of years ago
when I started here at Loyola.
And I think that what I
realized by its presence is that
it's really great to have
things happen on campus,
but what COVID-19 has taught us,
if there is a silver
lining to that gray cloud,
it is that you don't necessarily
need everything to happen
in one campus for it to be successful.
And social media is that
missing piece really
where you and I both know,
I'm going to speak like
a social media nut,
I'm sure people will be laughing about it
'cause they know how nuts I can be,
but it's all backed up
by successes, right?
The fact that, what if you
don't have a pharmacy program
where you're teaching, right?
And you would like a pharmacist's input.
Or what if you don't
have a nursing program
at the same place or a
medical worker science program
or a pathology training program,
or what if you're AP only.
You can put that energy
towards social media
and find the missing piece,
the missing element that
you need for that IPE,
for that interprofessional
education through social media.
Many of the talks, let's say I've given
in the last couple of years
have been supplemented
by people that I found
on social media, who are experts
in the things that I
don't know anything about.
And we have been able to
speak at national gathering,
international kind of conferences,
and we've invited them
over locally into our own
residency program.
And now with Zoom, look at
our conversation, right?
I'm not even sitting
with you in your office,
I'm like hundreds of miles away.
And I think that what we've
realized is that the future
of education really is
hybrid in that sense, right?
iConference is a hybrid,
iDidactics is a hybrid.
And so I think that if you think about
interprofessional education, I
think the rules are the same.
You can really go and find
whatever you're looking for
and you are not restricted anymore by
the kind of boundaries
of your own institution.
And I think that that's very important
for interprofessional education
when it comes to trying to find people
who are like-minded champions,
who will put together something good.
If you don't have one on campus.
I think that it's a win-win.
So that's another check.
Social media has a lot of issues.
I'm not saying that it's all perfect,
but I think that when
it comes to education,
specifically interprofessional education,
I think it's a win-win.
- That's wonderful.
I love the idea of this combination of
the rules are the same,
but you're in this new environment, right?
That's something that I think as humans
that's sort of something
new but in a new context,
it's so exciting and
interesting to dive into.
I hope that some of our listeners
start thinking along those lines.
I'm curious though,
we've kind of dabbled
in a couple of things
and talked about a lot of great topics
that hopefully some
people are thinking about,
identifying champions,
thinking about opportunities,
looking at the setting and
being very deliberate at that,
thinking about how are we really
gonna capture that feedback
if we just take it to maybe
that practical kind of
what would be a good call
to action next first step
for our listeners that maybe,
aren't as developed yet in this area,
but are stimulated by this conversation.
What do you think would be a
good step one or two for them
to look at the next couple of weeks?
- Sure, absolutely.
All right.
I think that everybody has to
figure out where they're at,
what types of training programs
that they are dealing with
and then start there.
So I'll speak as a pathologist
naturally with a residency
training program here.
I think that if I didn't have
a medical laboratory
science program, which I do,
if I didn't have one, I would say that,
perhaps that you need to find synergies.
I think you need to find synergies where,
and I'm going to keep
giving you an example
of a pathology training program.
I think that there are synergies in,
let's say where a history
technology program
talks to bachelor students in histotech
about how historic technology happens
and what histotech's role is.
When are PGY one residents come in
and they kind of start learning
the art of frozen sections
and doing that histotech part, right?
Find synergy there, do a session where
you can have both types of
students trainees in one room.
Similarly for clinical pathology,
I think that the field is wide open,
where you can have your graduate students
in medical laboratory science or,
and I've talked sometimes
over Zoom to institutions
that aren't Loyola at
all, like they're far away
and I've given sessions on
flow cytometry for example.
These are equally relevant to floor techs,
to medical laboratory scientists
as they are to our medical students
and also of pathology residents.
I think that if you break up
what your trainees need to learn,
and you put them in the context of
how they will implement that in real life,
who are the individuals
or the types of groups
or professions that are
going to be touching
our trainees lives in their
professional careers, right?
And I think that getting
those individuals together
early on, it doesn't have
to be every single session
is interprofessional, right?
It can just be like,
let's say one session a
year or two sessions a year,
depending on where you are.
But I would say that as call to action,
try and recognize what types
of interprofessional activities
would be beneficial for your students,
what they are currently doing.
And maybe develop a plan
to create one more session,
let's say in calendar year 2022, right?
One more session and build towards that.
And if you need any assistance
in championing this,
you can find me on social
media and I'm happy to assist.
- Brilliant.
I love these next steps
of looking for synergies
and then reflecting on
what's gonna be that meaningful activity.
I think that's something that
all of our listeners out there
can be thinking about clinicians,
laboratory professionals.
And students this is something
that you can put attack in
and think about as well for,
as you're looking at your education,
because sometimes I think that
interprofessional activities
can be occurring that we're
not really even quite aware of
or deliberate about.
And I think that for student listeners,
that's something maybe
that they can take forward
is to when they are exposed
to an interprofessional activity,
to be thoughtful and reflect on that.
- Absolutely.
- We've been rounding with Dr. Mirza
on interprofessional education.
Thank you so much again for being here.
- It was my pleasure. Thank you.
- To our listeners, thank
you for joining us today.
We invite you to share your thoughts
and suggestions via email.
Please direct any suggestions
to mcleducation@mayo.edu.
If you've enjoyed Lab
Medicine Rounds podcasts,
please follow or subscribe
until our next rounds together.
We encourage you to continue
to connect lab medicine
and the clinical practice
through insightful conversations.
(upbeat music)