May 28, 2012

Reflective Practice Notes: #FSLT12 #MOOC

My first massive open online course (mooc) has started.  The 2012 First Steps into Learning and Teaching in Higher Education (#FSLT12) is a diverse group of medical educators engaged in a collaborative environment. My experience as a learner in medical education awakens my pursuit for a career in academic medical education.  My strength as innovator shapes my motivation for this platform as a beginning. The profession of medical education has formidable and complex challenges to address in healthcare, this holds around the wold.  I see my futurist position in Geoffry Moore’s Crossing the Chasm based on diffusion of innovations theory from Everett Rogers.
My academic progress has come with a considerable investment in independent self-directed learning. I have experience in the development of peer-to-peer learning modules in medical education through webinar experiences for physicians-in-training.  In these brief online settings, interactive involvement supports a short-lecture format with a move from discussion to dialogue to enhance learning and experiential connectedness. For example, a “Learning Well Webinar” planned for premedical and preclinical medical students about the strategies for learning the basic science curriculum was developed in collaboration with medical students, premedical students and a faculty member based on innovative approaches.  My efforts began with online book discussion webinars for physicians' storytelling.
Professional Standards Framework
In considering the framework of professional values this models is based on respect of peer learning adding a diverse learning community to medical education. Open registration and enrollment aims at equal opportunity for learners. The aims and objectives of the “Learning Well Webinar” offer an innovative approach to higher education learning.  The model was limited in “evidence-informed approaches and the outcomes from research, scholarship and continuing professional development” because it was new, but does fully recognise the implications for future professional practice.
I blog and write for reflective practice in medicine and life. A reflective practice on teaching and learning will be a new endeavor that’s staring in the very early stages of my professional development.  Using Brookfield’s lens of autobiography, I see my unique experience in developing peer-to-peer webinar modules as valuable, where credibility has been maintained with the support of faculty and the power of space beyond institutional walls enabling authentic encounters for learning. In Educating Physicians—A Call for Reform of Medical School and Residency Cooke, Irby and O’Brien describe four goals for medical education: standardization and individualization; integration; habits of inquiry and improvement as well as formation of professional identity.  Reflective practice provides support for evidence of personalized competency throughout the unique trajectory of training and career advancement.  

N.B. I'm also reading about mooc skepticism as Joshua Kim shares his "7 Concerns"at Inside Higher Ed.
  • Cooke M, Irby DM, O’Brien BC. Educating Physicians—A Call for Reform of Medical School and Residency. San Francisco, CA: Jossey-Bass; 2010.
  • Kies S, Martinsek, A. Improving first-year medical student performance with individualized learning strategies. Journal of International Medical Science Educators 2010 March; 20(1). 
  • Moore GA. Crossing the Chasm: Marketing and Selling High-Tech Products to Mainstream Customers. rev ed. New York: Harperbusiness; 1999.

May 14, 2012

An Open Mind On Obesity

Twitter poetics by Elizabeth Alexander

My tweet in response to reading a New York Times opinion by Alice Randall

At a time when 2 out 3 Americans are overweight, a story about black women and fat has gone viral. Perceptions about what women see in the mirror, feel about their bodies  and others tell them about beauty is not sufficient for health. The opinion that "many black women are fat because we want to be" may nurture bias that can hinder health care for those who are overweight or facing obesity. Just like cancers and cardiovascular disease there are striking disparities in health for minorities especially vulnerable are black women. Growing diversity in America creates an opportunity for research as well as dialogue to help us understand differences with sensitivity. The U.S. Department of Health & Human Services has identified focus areas revealing significant disparities in health access and outcomes among racial and ethnic minorities that need be addressed with interventions found within health systems beyond, but not excluding the patient-doctor relationship.

I grew up among five generations of black women who worked hard and laughed often to live long lives.  My great-grandmother was a midwife in South Carolina. Many of the  black women in my life have battled and overcome all sorts of illness including obesity.  Black women and men often face health challenges with diagnoses occurring at later more serious stages of disease leading to more preventable deaths than expected. This is true over life course and is the hallmark of health disparities. For example, among black women health doesn’t follow wealth as it should, education and socio-economic achievement does not improve our odds against infant mortality, the causes are considered unnatural.
I invite the author of the story who is a novelist along with others to consider a more imaginative context shaping unhealthy environments making healthier eating and physical activity a dilemma instead of a matter of habit. The rich storytelling in Toni Cade Bambara’s The Salt Eaters where the cost of healing is considered with this question:  "Are you sure, sweetheart, that you want to be well?… Just so's you're sure, sweetheart, and ready to be healed, cause wholeness is no trifling matter. A lot of weight when you're well." This question invites an individual response in the context of a community where healing (beyond cure) is matter of transformative relationships, support and structures for health and well-being.  

If you want to go quickly, go alone. If you want to go far, go together.  — African Proverb

Those who strive to lose weight with a combination of healthier eating and more physical activity may find challenges where the physical environment is out of shape for health. For example, there's a connection between obesity and food deserts, it's a complex disease of ill nutrition as well as poverty for some. This is an indication that obesity requires us to move beyond stigmas, dispel myths and open our minds to consider matters of research, policy and practice in health care and beyond along with individual lifestyle choices. The Institute of Medicine (IOM) has just released “Accelerating Obesity Prevention” a consensus report with actionable items, calling on all heath providers to consider:
“Adopting standards of practice (evidence-based or consensus guidelines) for prevention, screening, diagnosis, and treatment of overweight and obesity to help children, adolescents, and adults achieve and maintain a healthy weight, avoid obesity-related complications, and reduce the psychosocial consequences of obesity. Health care providers also should advocate, on behalf of their patients, for improved physical activity and diet opportunities in their patients’ communities.”
IOM report staff study directory Dr. Lynn Parker says “we and our committee members also are concerned about the lack of curriculum in medical schools on nutrition and physical activity for patients and the community.” 
The Institute of Medicine Infographic "Obesity: Complex But Conquerable"
The upcoming four-part documentary "The Weight of the Nation" offers a view of obesity as a complex, out of control, unaddressed rampant epidemic across America.  This is a conversation worth having whether or not you are a patient or health professional, overweight or not,  we should all weigh-in and be moved to take on the problem as a nation with dignity and respect.

May 10, 2012

In conversation about global sustainable development and health

I'm taking on a series of meetings and discussions on global sustainable development and health. Please leave your comments.