(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.
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We encourage you to continue to connect lab medicine
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