About this project
The problem we solve: Medical educators are challenged today as never before to help trainees develop into humanistic clinicians. Advances in science & technology have illuminated the molecular & genetic underpinnings of many disease processes, but have not led to a concomitant understanding of other aspects of illness. Changes in healthcare delivery models are transforming both inpatient & outpatient clinical practice, leading to shorter hospital stays & greater emphasis on ambulatory care, which frequently is fragmented. The electronic health record - a repository of information - creates additional barriers between doctor & patient. Although the patient is at the center of every encounter, the complexity of medical practice today often leaves patients feeling that their doctors don't know them as individuals & learners absorb these undesirable practice behaviors. Studies have demonstrated that these learners tend to experience a reduction in empathy towards patients as their clinical training progresses.
About our solution: One didactic approach which has been demonstrated to be effective in helping medical learners retain empathy & deepen understanding of the human condition is reflective practice. While writing is the most frequently used method to promote introspection & deeper consolidation of new ideas in learners, there is robust evidence that other art forms - storytelling, dance, theater, music, literature, & visual arts - can also help deepen reflection & understanding of the human aspect of medical practice. The overall goal of BEAM is to create an arts-based humanities curriculum to be used by clinical teachers to deepen learners' understanding & shine a light on what it means - for patients & clinicians - to be human, live well, experience loss, encounter disease, & engage in a therapeutic relationship. BEAM is a smartphone application to deliver brief, focused, crowd-sourced, arts-based humanistic clinical teaching in either hospital or ambulatory care settings. Progress to date: We have identified the problem,conducted general/targeted needs assessments, articulated goals/objectives, & developed educational strategies. We are currently developing content for modules, as well as implementation & evaluation strategies. Content for each module will include an arts-based visual & written prompt & brief, focused discussion questions designed to spark reflection on the meaning of a particular patient's condition. For example, if a patient is experiencing vision loss, one may enter "vision loss" into the app to access a module featuring the prompt of images of Monet's water lily paintings & written content focusing on impact of his vision loss on the quality of his paintings & his psyche, along with questions for discussion such as "What impact is vision loss having on our patient today? How is this affecting his livelihood &/or view of himself?" Once the app is developed, it will be beta-tested by members of the Hopkins Miller-Coulson Academy of Clinical Excellence.
About Our Team
Dr. Margaret Chisolm, MD Psychiatry , Practicing Physician Location: Maryland Medical school: Johns Hopkins University Bio: Dr. Chisolm is Vice Chair for Education in her department. She is co-author of a textbook on psychiatric evaluation & has written more than 70 scientific and clinical articles about substance use (& other psychiatric disorders), humanistic practice, & medical education. Dr. Chisolm is a member of the Miller-Coulson Academy of Clinical Excellence, an Arnold P. Gold Foundation Humanism Scholar & the recipient of the 2014 Johns Hopkins University Alumni Association Excellence in Teaching Award.
Hospital Affiliation: Johns Hopkins Bayview Medical Center Title: Associate Professor of Psychiatry & Behavioral Sciences Twitter:@whole_patients LinkedIn:https://www.linkedin.com/in/margaret-chisolm-9b6b427
About Team Members
Associate Professor of Psychiatry & Behavioral Sciences, MD Biography: Dr. Lehmann is Psychiatry Clerkship Director at Johns Hopkins. She has received multiple awards for excellence in medical education from the American Psychiatric Association, the American Association for Geriatric Psychiatry, & Hopkins. She serves on the Council of the Association of Directors of Medical Student Education in Psychiatry & is a member of the Miller-Coulson Academy of Clinical Excellence. Her scholarship has been both in medical student education & in geriatric psychiatry. Vinay Parekh
Instructor of Psychiatry & Behavioral Sciences, MD Biography: Dr. Parekh is Director of Adult Emergency Psychiatric Treatment Services & Co-Medical Director of the Broadway Center for Addiction. He is co-creator of the ‘mADAP’ free mobile application that seeks to educate patients, families, & the general public on adolescent depression using a combination of videos & text. He is also co-creator of the askhopkinspsychiatry.org website, which provides brief video responses to questions submitted by the public via an anonymous online education portal. Twitter:@vparekh1
BEAM has the potential to impact clinical teaching of humanistic practice in a way that will ultimately improve patient health. We will demonstrate success in the following 3 ways: 1) Engagement of teachers & learners. We will quantify the frequency & other use characteristics (e.g., clinical setting, initiating team member, patient engagement, illness type, anticipated & actual duration); 2) We will compare learner empathy & personal growth before & after exposure, as well as between exposed & control groups, via Jefferson Empathy and Personal Growth Scale ratings; 3) We will compare humanistic practice behaviors, in same way as #2, via medical Humanism & Professionalism Attributes Scale ratings by peer team members & Professional Practice Scale ratings by patients.
How We Help Education
Time for clinical teaching in hospital & ambulatory care settings is shrinking rapidly, due to competing demands associated with changes in healthcare delivery &the electronic health record. With less time for clinical teaching, learners are more often exposed to education focused on the molecular & genetic underpinnings of disease rather than on other aspects of illness, including the meaning of the illness to an individual patient. This narrow focus can undermine the doctor/patient relationship.We believe that the arts help us focus on meaning & that focusing on meaning helps patients feel understood. The overall goal of BEAM is to create an arts-based humanities curriculum to be used by any clinical teacher anywhere to enhance their teaching of humanistic practice. Bringing arts-based curricular resources to the bedside in a modular, brief, focused, & patient-centered way will revolutionize the clinical teaching of humanistic practice, an essential domain of medical education.
How We Help Physicians
Physician educators are in need of resources to help them teach humanistic medical practice. And it is by teaching that we are able to learn. BEAM will not only support clinical teaching, but also learning of the entire healthcare team. In addition to engaging clinical teachers in the use of BEAM's existing content, the application will encourage teachers to upload their own arts-based content - images, music, poems - thus engaging with a global community of medical educators. This crowd-sourced content will then be available to and rated by clinicians, learners, and even patients around the world.
Mission: BEAM is a physician-led innovation that we believe will engage clinical teachers & learners, improve empathy & personal growth of learners, & promote the humanistic practice of medicine. Use of funds: The estimated cost of our project is $25,000 for technical support/online tool (website & smartphone application) development, token compensation for educational intervention trial, proprietary rating scales to evaluate outcomes, biostatistical support services, & research administrative support services. Intellectual Property Status: As an employee of Johns Hopkins University, the University owns all rights, title and interest in and to Intellectual Property developed as a result of support either directly from or channeled through the University. FDA Status: Not applicable Personal Message: Medical educators are challenged today as never before to help learners develop into humanistic physicians. Patients feel that their doctors don't know them as individuals & learners lose empathy through their medical training. Learner-centered educational strategies are likely to fall flat unless they enter practice environments that reflect what students are learning. We need to bring humanistic clinical teaching to the dehumanizing environment of the hospital & clinic. BEAM will do just that.