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The Faculty Chronicles (TFC) podcast, sponsored by the Touro Center for Excellence in Teaching and Learning (CETL), is about building community, connection, and conversation. It will bring to life the stories behind the great works of Touro faculty, across disciplines in all our schools, focusing on classroom innovation in teaching and learning, science, business, medicine, education, wellness and more.
00:00:01:05 - 00:00:37:17
Gena
Hello and welcome to the Faculty Chronicles TFC, a podcast sponsored by the Touro Center on Excellence in Teaching and Learning and the Office of the Provost. Your TFC podcast hosts AMI, Professor Gina Bardwell and Dr. Elizabeth Ni Across academic disciplines, tural faculty are producing great work and the faculty Chronicle's wants you to hear all about it. TFC Podcasts will highlight faculty chatting about their favorite project in research, teaching, learning, science, medicine, technology and so much more.
00:00:38:01 - 00:01:14:15
Gena
So let's get busy building community connection and continuous conversation to a wide. Our next Faculty Chronicle guest is on deck waiting to chat Welcome, Mary. We're so happy to have you with us on the Faculty Chronicles. I'm Gina Bardwell, and our guests is Dr. Mary Flanagan Kongo. Mary Flanagan. Kendall is the co-chair of the physician assistant PR programs at the School of Health Sciences of Pearl University.
00:01:15:05 - 00:02:05:14
Gena
She chairs assessment and remediation. Dr. Flanagan Kendall received her Master of Science Degree in Physician Assistant Studies and then advanced certificate in health care management from Stony Brook University. Most recently, she attained her doctorate, a physician assistant from Touro University worldwide as a practicing for over 40 years. Dr. Flanagan Kondo works in family practice medicine and is experienced in cardiothoracic surgery, emergency medicine, pediatrics, family practice and spinal scoliosis surgery Dr. Flanagan, candle's favorite moments have been her one on one remediation sessions, helping students achieve their dream of becoming a P.A..
00:02:05:23 - 00:02:41:15
Gena
She's a site visitor for our accreditors the arc people since 2016 and she spearheads accreditation for continuing and newly developing PA programs. There are currently five plus programs established at TURAL University When she's not working, she spends as much time as she can with her four precious grandsons, ages two to six. And let me say with full disclosure, I have seen photos of those beautiful children and I can see why she would want to spend time.
00:02:42:03 - 00:02:51:08
Gena
They are fantastic. So hello, Mary, and I am so glad you could join us today and speak about physician assistance education.
00:02:52:00 - 00:02:54:18
Sara
Thank you for having me, Gina. I'm delighted to be here.
00:02:55:10 - 00:03:05:13
Gena
You have a terrific story about how you found your career path as a physician assistant. Will you share a brief synopsis of your journey with us?
00:03:06:21 - 00:03:37:04
Sara
I would love to. So it's kind of an interesting story. I was a sophomore at Saint John's University, and I was in the pre-med track because I scored well in math and science. But I really didn't want to be a physician. I wanted to be have a family and be at home with my children. I was taking an Italian course, and there was a pre-med student senior ready to graduate who was struggling So I ended up tutoring him through the course.
00:03:37:04 - 00:04:00:00
Sara
He was successful. He ended up graduating and going off to med school. And when I entered my junior year, I received a letter from him. He was thanking me. And he also told me that he found the perfect profession for me. It's the physician assistant program, and it was right there at Saint John's University. And I think the rest of my story is history.
00:04:00:04 - 00:04:03:22
Sara
And I am forever grateful for that individual for writing that letter.
00:04:04:06 - 00:04:14:15
Gena
Oh, I know you are. So you tutored him in Italian, and then he calls and says, I've got the perfect job for you. That's that's really great. That's what you call karma. Good karma.
00:04:15:08 - 00:04:20:08
Sara
Yeah, it was it was wonderful. I don't believe I would be here today if it wasn't for that letter.
00:04:20:24 - 00:04:29:24
Gena
You know, I've also heard you say that student folks need to know what they don't know. Now, I'd like to hear more about that. Could you explain?
00:04:30:18 - 00:05:00:04
Sara
Yeah, sure. The curriculum begins with foundational knowledge in the biomedical sciences, and then we gradually build on that knowledge through the clinical medicine courses we teach them to gather information, take a history, perform a physical order, diagnostic test, develop a differential, and then come to that final diagnosis. They have to become critical thinkers, but finding a final diagnosis is not always easy.
00:05:00:07 - 00:05:25:22
Sara
So what I tell my students, and I really believe this firmly and have experienced it through my many years in clinical medicine. Illnesses do not read the books. They don't always present in that classic form. And they have to realize that medicine isn't easy. They definitely need to know what they don't know. They are part of a team or health care team.
00:05:25:22 - 00:05:51:21
Sara
And together, using multiple resources and subspecialties, we're able to treat our patients effectively. And I think it's important for them to reach out and consult. And I also tell them that as a clinician for over 40 years, there's not a day that goes by in clinical medicine that I don't have to look something up or refer one or two of my patients that day to a specialist.
00:05:52:07 - 00:06:00:11
Sara
If I've learned nothing, I have learned that the more you know, you recognize that there is a world of information out there that you don't know.
00:06:01:14 - 00:06:22:00
Gena
That's excellent advice. Excellent advice, Mary. So my next question here is algorithms or health care analytics are an important part of patient care. We know that. And additionally, in your classes, how do you teach a student to treat the whole patient to be an intuitive patient care provider?
00:06:23:06 - 00:06:49:23
Sara
That's a great question because it's really critical to effective and optimal care. We start right in the first semester. There are two courses. One is physical diagnosis, lab and lecture, as well as psychosocial and the role of the physician assistant. And we really teach them the importance of the patient encounter, developing an autonomous and trusting relationship with their patients.
00:06:50:12 - 00:07:25:23
Sara
And that course builds in semester two and three with physical diagnosis two and correlate of medicine where they can fine tune those skills. And all through the clinical medicine courses. We reinforce the need for them to treat their patients understanding cultural, economic, educational barriers, those social determinants of health. If you don't look upstream, if you don't know what your patients do for a living where they attend school or what their educational level is, you really won't know how to treat them effectively.
00:07:26:09 - 00:07:49:13
Sara
So I think those are really critical. The other thing is I always tell them, Look at your patient. And if they look healthy, they probably are. But if they don't, you really need to dig deep and try to figure out what's going on. Not to mention, you don't want to miss that subtle body language that may suggests some fear, anxiety, depression.
00:07:50:03 - 00:08:09:09
Sara
All of these things will affect how you treat your patients. And I also tell them my last lecture in my infectious disease course is be good listeners. Have empathy and to be kind and compassionate. And together, those tools will help them to provide the most effective care.
00:08:10:23 - 00:08:34:22
Gena
And as simple as you've stated that sometimes those are the hardest things to do just to be present. But that's, again, excellent advice. So Dr., since COVID, what has changed in the way patient care is discussed or taught in a physician assistance course? Let's look at how you teach infectious diseases since COVID 2019.
00:08:36:14 - 00:09:02:24
Sara
As we know, COVID changed how we delivered a curriculum from pretty much overnight. You know we went from in-person because we are in basically an in-person program to synchronous zoom and I just have to give a shout out again to our senior leadership who called for that trial run for us before the shutdown because I felt like we were a step ahead when it happened.
00:09:03:11 - 00:09:24:09
Sara
So I just have to say thank you to them. Once again, keeping the students engaged in the classroom is challenging And on Zoom, it's even more challenging because I think we all know that students have or we all have I'm going to say 15 to 20 minutes of attention span Max. I think there are studies that say that's more like eight to ten.
00:09:25:01 - 00:09:52:08
Sara
You have to kind of switch it up all the time. So in the synchronous zoom we teach infectious diseases in a case based format. I have the students read the cases. There are a lot of questions throughout the cases, so I'm having them interact I actually will call on students to read because if I don't do that, I feel like the same four or five students of the cases, and I want to try to get everybody engaged I also used to break out rooms, which they liked.
00:09:52:20 - 00:10:11:12
Sara
Sometimes I would give a lecture or even narrate a lecture, and then we would come together and I would put them in breakout rooms and they would each have an activity to do. And then we would come back together and each group would speak to those questions and review the material with one another. So I tried to keep them all engaged.
00:10:11:18 - 00:10:29:14
Sara
The other thing I love is Jeopardy! I even put the music to my slides, so I love to do Little Jeopardy! Reviews, and sometimes I actually use a Jeopardy game as a form of assessment, which is fun for them because all they ever get is written exams. So it's nice once in a while to do it a little bit differently.
00:10:30:05 - 00:10:52:09
Sara
And I think the other thing that I always try to do, both in the classroom and in Zoom, is to make them laugh a little bit because I know that that just settles their nerves a little bit, re engages them and then they're able to listen. Most of our lectures are 2 hours long so you have to use a lot of different pedagogy and techniques to keep them interested.
00:10:53:13 - 00:11:17:00
Gena
Well, that's fascinating. And I do ditto that trial run that senior management put in place when we went from the classroom on to video conferencing, zoom synchronous classes and Jeopardy! And the case based studies that you use in class. And the breakout rooms are very useful. Students do love the breakout rooms. That's true.
00:11:17:13 - 00:11:40:19
Sara
Yeah. And I will say those cases, many of them are my cases or cases from Dr. Roy. She's our medical director, Dr. John Ackroyd. And we co teach infectious diseases together. So it's all interesting. It's all real. And it also shows them how different people with the same illness can present in a number of different ways. So it helps to keep them engaged.
00:11:41:01 - 00:11:56:07
Gena
Absolutely. So at what point during the program to students learn about the general relationship, let's say, between the doctor and the P.A. and what are some classroom activities or training that takes place Okay.
00:11:56:09 - 00:12:32:10
Sara
So this begins early on, right? In the first semester, we have a course called Psychosocial and the role of the P.A. In this course, the students will learn not only about the relationship between the physician and the P.A., but also their professional role, as is in clinical practice. There's a focus on cultural competency, cultural diversity, inclusivity, different personality types, how to conduct an adequate and appropriate interview, looking at the psychosocial issues that patients may have.
00:12:32:21 - 00:13:00:23
Sara
And of course, integrating that diversity and inclusion for Patient-Centered Care. And our profession was modeled in physician partnership with the first program coming out of Duke University. That was the model. And that's what I preach to. I have a great autonomous relationship with the physicians that I work with. I asked them questions. They asked me questions. And the students need to know that we're a team and we work together.
00:13:01:17 - 00:13:15:04
Sara
And the way we deliver some of that curricula and they use some different techniques in this course in particular, where they'll do group activities, role playing along with the more standardized written quizzes and exams as well as discussion boards.
00:13:15:23 - 00:13:31:08
Gena
But what are some of the challenges students face as they study and trying to become CPAs? What are the trends you're seeing in terms of student challenges, and are there some strategies you use in your classes to help them reach some successful outcomes?
00:13:32:04 - 00:13:58:04
Sara
In my opinion, there is just no other program like a school. I mean, they are getting 123 credits sort of crammed into those brains in 28 to 32 months, depending on the program. It's really the first two years of medical school and the analogy that we've often heard used is that it's kind of like sipping water from an open fire hydrant.
00:13:59:00 - 00:14:23:24
Sara
You know, they have long, hard days, they have constant studying, they have tons of exams. In fact, we just had the patch ceremony at the end of the didactic year for our Long Island cohort, and they count it out and let us know that they have over 170 exams the first year. So they do keep track. So what do we do What do we do to help them?
00:14:24:01 - 00:14:43:15
Sara
Well, first and foremost, we let them know we all have an open door policy. We are there for them whenever they need us. We do have a nice I'm going to say a robust remediation process where we have early identification in the first six weeks. Students meet with their advisers early on and we work with them and we encourage them and we support them.
00:14:44:22 - 00:15:09:23
Sara
More recently, we're trying to remove redundancy from the curriculum. It used to be in the past, Oh, teach it over and over again if it's important. Well, when you're trying to do a 123 credits in, in the, in two years and the majority of it in one year, you have to remove redundancy. So we're trying to streamline the curriculum a little bit just so they're not sitting and listening so much.
00:15:10:11 - 00:15:38:03
Sara
As I said, always try to get them to laugh a little bit during lecture to have them relax. I love teaching with cases. I am not a memorize or I was back in the days, but no longer I need to be able to understand. I need to be able to think through processes so that if I have a case or a patient or I'm taking an exam and I see a question able to actually think about the knowledge that I have and try to figure it out.
00:15:38:03 - 00:15:58:09
Sara
That's critical thinking. That's Problem-Solving. So that's what we want them to do. And I think the case based teaching helps them a lot. And the other thing we also try to do for them, since they have so many exams, is we do try to spread them out as best we can. Unfortunately, sometimes they have multiple exams in one week, but we try not to do them back to back.
00:15:58:14 - 00:16:08:14
Sara
We certainly try never to have two exams in one day, and we do our best to make it a doable process because it's rigorous. So I give them a lot of credit.
00:16:09:11 - 00:16:26:16
Gena
You know, I would love to be in one of your classes and they just they just fascinating. They sound rigorous, they sound active, and that you change a lot. And I and I love case based learning and case based studies and case based teaching. So if.
00:16:26:20 - 00:16:27:03
Sara
You.
00:16:27:03 - 00:16:36:03
Gena
Had one piece of advice to give students training to become a physician assistant, what would it be?
00:16:37:03 - 00:17:07:19
Sara
No matter how much they prepared, they have to prepare to study longer and harder than they ever had before. But they also need to get straight A's, right? This is not about being the smartest. They need to have heart perseverance. They need to be dedicated and they need to work together and they also need to remember that they need to reach out for us if they need anything that they should adapt and overcome.
00:17:08:07 - 00:17:16:06
Sara
And I have created a hashtag for our students, and it is hashtag Toro P. S for students strong.
00:17:16:22 - 00:17:44:11
Gena
Oh, that terrific. Oh, Mary, thank you so much for spending some time with us today. And this concludes our session. And I certainly enjoyed listening and learning and having you as our guest on The Faculty Chronicles. A huge thanks to our listeners for joining Dr. Mary Flanagan Candle as she shared her ideas and expertize on education. Thank you so much.
00:17:44:22 - 00:17:47:21
Sara
Oh, and thank you so much for having me. It was a joy to be here.
00:17:50:08 - 00:18:22:00
Gena
Thank you for tuning in to the Faculty Chronicles TFC Tours Podcast, featuring the projects and work of faculty throughout the Tural College and University System. TFC is sponsored by the Office of the Provost and Kettl, the Center for Excellence in Teaching and Learning. We hope you like what you heard and we'll keep listening. So join us next time on the Faculty Chronicles as we highlight and share faculty achievements that build community connection and continuous conversation.