Department of Medical Education 2019–2020 Year in Review
The past academic year was one of rapid change — some planned and much unexpected. Our medical education curriculum was already primed for renewal when COVID-19 arrived and ushered in a new plan. I am proud of our Department of Medical Education for their quick work adapting to a new environment and for their wisdom and discernment in acknowledging early on that the virus wasn't a temporary nuisance but a once-in-ageneration chance to look at what we do with fresh eyes. In the following pages, Dr. Bill Jeffries, vice dean for medical education and vice president for academic affairs, will walk us through this evolution under four themes: faculty creativity, clinical skills, telemedicine and the virtual classroom. Our journey is not complete, but we have advanced farther in the few months of COVID-19 than I would have believed possible, thanks to the talent and tenacity of our educators and staff. — Steven J. Scheinman, MD President and Dean of Geisinger Commonwealth School of Medicine Geisinger Executive Vice President and Chief Academic Officer
Department of Medical Education 2019-2020 Year in Review Faculty creativity....................................................................2 Clinical skills...........................................................................6 Telemedicine.........................................................................10 The virtual classroom.......................................................... 12 Curriculum.............................................................................. 14 Match results......................................................................... 16 Student news......................................................................... 18 Faculty news......................................................................... 22 An interview with the dean............................................... 28
On the cover: Geisinger Commonwealth School of Medicine student Wojciech Losos confers with faculty member Dr. Margrit Shoemaker in Geisinger’s e-ICU.
Medical education is evolving
Even before the COVID-19 pandemic, medical education was evolving. Educators knew the problems of modern healthcare demanded clinicians prepared to navigate a system vastly more complex than any within which they had learned. The pandemic, however, served as a clarifying agent. The abrupt loss of clinical learning venues forced a reckoning with the capabilities of technology and how, in some ways, faculty and student experiences are enhanced — rather than diminished — by the virtual world. Although we are far from knowing exactly what the post-COVID world will look like, much less the extent of change it will bring to medical education, we have identified some general themes. I suspect these themes will guide our evolution going forward and that some COVID-inspired curricular adjustments are here to stay. — William B. Jeffries, PhD Vice Dean for Medical Education and Vice President for Academic Affairs
A student-side view of the e-ICU examination: Visible on Wojciech Losos's screen are Dr. Lippold and patient Kenneth L. Schreffler Jr.
Medical education's future:
Faculty creativity: An unexpected treasure
COVID-19 had one salutary effect on education. It unleashed faculty creativity by instantly removing barriers — some we didn’t even know we had. Pre-pandemic, we had a model that had a lot of strictures around it. When faced with crisis, they just fell way. All that was left was our pact with students and with the public to produce the best doctors possible. Faculty rose to the challenge and deftly put together an emergency curriculum that met all learning objectives. Along the way, we developed new means to work together and many novel innovations based on a new understanding of technology. Although creativity is not necessarily an educational theme, we hope to find ways to keep the freedom and energy our faculty experienced during the crisis alive as we plan for the future. — William Jeffries, PhD
2
Faculty creativity
Triano
Welsh
A second-year confidence builder Gaining confidence in the clinical space takes time. Asking the sensitive questions required in a good history and laying hands on a person you’ve just met aren’t tasks to be undertaken without adequate preparation. For medical students, this means early, high-quality clinical exposure that takes place well before the third year.
“I had a checklist from my Art and Practice of Medicine (APM) class,” she said. “I worked with a PA, Patty Snyder, and she was great. I took histories and conducted physical exams on real patients. And they were also great — so willing to help and so patient with me. I learned things that are difficult to convey in a lecture, like how to talk to people about their conditions, how to take a social history and talk to people about their beliefs. It could be awkward at first, like when a person might admit to drug use, but it’s a kind of communication that’s hard to practice on a standardized patient.”
“We know that educationally, our students do much better with earlier experiences,” said Mary Lawhon Triano, MSN, CRNP-C, medical director of Geisinger Commonwealth’s Clinical Skills and Simulation Center, director of Clinical Skills and assistant professor of clinical sciences. “The clinic is an intimate space. Communicating professionally with and physically touching patients doesn’t happen without practice.” She said that The clinic is an intimate space. Communicating faculty who teach the school’s Physician professionally with and physically touching and Patient-Centered Care curriculum created the LCE, or longitudinal clinical patients doesn’t happen without practice. experience, in the second year to make students comfortable and confident in their skills well before they begin thirdyear rotations. “The idea is to send students in pairs into clinics to learn from physician assistants, certified registered nurse practitioners and family and internal medicine physicians for one-half day, 10 times per year. The LCE allows students to advocate for their own education, gain positive clinical experiences and get comfortable with real patient interactions,” she said. Geisinger Commonwealth’s second-year students have responded enthusiastically to the LCE. For example, Rebecca Welsh, a member of the MD Class of 2022, said her LCE at a Geisinger primary care clinic in Tunkhannock was exceptional.
Rebecca said she is glad to have the experience of going into a patient room for the first time before beginning her third year. “Knocking on that door for the first time — you are really nervous,” she said. “When I would go back to check in with Patty, I’d discover that I forgot something, but Patty was very patient. By the end of my LCE, I felt so confident. I know now that I won’t forget those vital pieces. I’ll have a leg up when rounding in my third year.”
D e p a r t m e n t o f M e d i c a l E d u c a t i o n 2 0 1 9 - 2 0 2 0 Ye a r i n R e v i e w
3
Faculty creativity
Gabi Waite, Professor of the Year Gabi Waite, PhD, professor of physiology and immunology, was chosen as professor of the year by second-year medical students. “It’s such an honor when the students choose you. It means a lot because they are my stakeholders,” she said. Dr. Waite received the recognition because of her leadership in rapidly transitioning the yearlong Systems 2 course from the classroom to the virtual world. Dr. Waite credits her co-course directors, John Szarek, BPharm, PhD, CHSE, professor of pharmacology and director of clinical pharmacology, and Youngjin Cho, PhD, assistant professor of immunology, in working with her to deliver a clear and consistent message to the students about how the course would be completed. “The systems course has multiple teachers and I think we were all as nervous as the students, but we offered a lot of communication and, I think, leadership. We were confident and strong — determined not to change things every 5 minutes. And I think we were reassuring. We let the students know that we believed everything was going to be all right. We had the whole course online in just a few days. It was really a team effort. We all worked together, and the students were fantastic, so enthusiastic. We did it — it wasn’t easy, and we did not get everything right, but we all felt good about it,” she said. Dr. Waite said every faculty member teaching the systems course is responsible for its success, in particular the core faculty: Carmine Cerra, MD, pathology; Dr. Szarek and Youssef Soliman, MD, PhD, pharmacology; Dr. Cho, immunology; Kimberly Miller, PharmD, and Christian Carbe, PhD, microbiology. Brian Wilcox, MD, PhD, was the physician whose reproduction block was first up after COVID-19 shut down the school’s Medical Sciences Building. He was followed by Leighton Huey, MD, and Brian Piper, PhD, who taught the mind block immediately afterward.
We had the whole course online in just a few days — it wasn’t easy, and we did not get everything right, but we all felt good about it.
4
Faculty creativity
Faculty present ‘The Geisinger Story’ on professionalism to APHC Several faculty members from Geisinger Commonwealth School of Medicine presented a webinar entitled “Integrating Professional Formation into Your Curriculum – The Geisinger Story” for the Academy for Professionalism in Health Care on June 4. The faculty members are Tanja Adonizio, MD, associate dean for student affairs and an assistant professor of medicine; Carly Ellman, MSW, LCSW, assistant professor of medicine; Michelle Schmude, EdD, MBA, associate dean for admissions, enrollment management & financial aid and an associate professor; and John Szarek, BPharm, PhD, CHSE, professor of pharmacology and director of clinical pharmacology.
Adonizio
Professionalism is a key competency identified by the Accreditation Council for Graduate Medical Education for medical students to demonstrate in order to be successful in their residencies. During the webinar, the presenters focused on the strategy Geisinger Commonwealth has used to integrate core components of the Professional Formation modules into the school’s curriculum by educating and tracking progress in: • Professional growth and formation • Bioethics and foundations of professionalism • Hidden curriculum and professional formation • Healthcare professional’s role in regulating peers and the profession
Schmude
• Interprofessional teamwork in healthcare • Compassion and resilience • Confidentiality The Academy for Professionalism in Health Care, headquartered in La Crosse, Wisc., is dedicated to optimizing patient care through professionalism education, scholarship, policy and practice in all health-related fields.
Szarek
Ellman
D e p a r t m e n t o f M e d i c a l E d u c a t i o n 2 0 1 9 - 2 0 2 0 Ye a r i n R e v i e w
5
Medical education's future
Clinical skills:
Virtual space creates more time to develop critical thinking skills One big COVID-inspired revelation was our understanding of just how rich virtual learning experiences can be, even on the clinical side. It began as an exploration of the repurposing of education technology that was already being used to remotely care for ICU patients. The e-ICU program (full story on page 7) for our fourth-year learners was like an Apollo 13 moment, when we realized we could leverage existing technologies for educational purposes. For example, one problem we had with the clinical learning environment was the sheer number of learners. In the past we just accepted the traffic and the burden it placed on patients, doctors and staff. The e-ICU experience taught us that the virtual setting actually increased the face-to-face, one-on-one time students had with preceptors and residents. So, even as we regretted the disruption, we happily found that students enjoyed a very rich experience, one that will have a deep, long-lasting impact on their approach to patient care. Virtual third-year clerkships, established within one week of the loss of in-person clinical experiences, revealed a level of direct supervision by physician faculty that simply would not have been possible in a normal setting. Now, as we look ahead to our Class of 2022 entering their third year, we’ve learned a valuable lesson. When the Class of 2021 was taken out of the clinical space, each The renewal has many exciting features, but none student already had more important than connecting our curriculum to the hands-on experience technology, tools and point of view of Geisinger. in all of the core disciplines thanks to our — William Jeffries, PhD Longitudinal Integrated Clerkship (LIC). This is not the case with the Class of 2023, who entered as novices. With the clarity gained from the emergency virtual curriculum, however, we now know that certain clinical skills can be learned virtually. Our third-year curriculum will now focus on honing critical thinking and reasoning, note writing and presentation skills in the virtual setting before a student steps into a hands-on scenario. In the preCOVID world, we let students acquire these skills “on the job.” Our COVID clarity demonstrates that we can teach these virtually so that a student’s in-clinic time can be devoted almost exclusively to patient care.
6
Clinical skills
e-ICU: Saving fourth-year students’ required ICU rotations Ashlyn Reiser, MD ’20, was eager for Match Day and ready to close out her required rotations with four weeks in an intensive care unit (ICU) when COVID-19 struck. “My ICU rotation was my last requirement,” she said. “I was very worried. I matched into ophthalmology, but I still need to do a transitional year and it will require time in the ICU. I was afraid my medical education would be incomplete.” Dr. Reiser and her classmates who still required ICU rotations didn’t have long to fret. Margrit Shoemaker, MD, assistant chair of internal medicine and assistant professor of medicine, along with Cassiopia (Cass) Lippold, MD, a critical care fellow at Geisinger, devised a solution in less than a week. Together, they created a rotation in the e-ICU, giving fourth-year students a virtual experience that included direct patient interaction. “I can’t say enough about how impressed I was that Dr. Shoemaker came up with a solution so quickly,” Dr. Reiser said. “But I admit, I was a little skeptical about how they were going to pull it off.” In the end, Dr. Reiser said her four weeks in the e-ICU rivaled — and in some ways, exceeded — physically being in the ICU. The cardiac ICU in Danville is equipped with a camera and screen typically used by hospital staff for clinical care purposes. This technology was repurposed to allow students to “enter” the patient room remotely, interact with the patient to conduct a history, and then direct a bedside fellow or resident to obtain a physical exam under the students’ direction.
Dr. Lippold said she and her other colleagues gently prompted students if they missed a step by asking questions like, “Are you sure there isn’t anything else you’d like me to do?” Students were granted permission to access “their” patients’ electronic health records in a special platform that allows student practice of note and order entry, as well as following the patient’s entire hospital course. Students and residents found that most patients were eager to help with the lessons. “Dr. Shoemaker was right there with us the whole time,” Dr. Reiser said. “She would send us our schedules for the week. Then we could access Epic to prepare to follow patients, present patients and do handoffs, just as I will in residency. In some ways, I think I learned more than I would have if I had done a normal ICU rotation. We had protected time with the residents. During that time, they weren’t pulled in a dozen other directions. They spent so much time on differing topics, like COVID-19 and mechanical ventilation. I feel well prepared for my residency.” Although participating in the e-ICU placed extra demand on residents’ and fellows’ time, in addition to Dr. Lippold, six other house staff taught medical students rotating in the e-ICU: • Alejandra Garcia-Fernandez, MD, critical care fellow • Alexis MacDonald, MD, critical care fellow • Dan Leopone, MD, critical care fellow • Brandon Nuckles, MD, general surgery resident • John Samies, DO, internal medicine resident • Gregory Stoner, DO, emergency medicine resident
Cass Lippold, MD, critical care fellow, performs a physical exam on Geisinger e-ICU patient as directed by Geisinger Commonwealth School of Medicine student Wojciech Losos (visible on screen).
D e p a r t m e n t o f M e d i c a l E d u c a t i o n 2 0 1 9 - 2 0 2 0 Ye a r i n R e v i e w
7
Clinical skills
Abigail Geisinger Scholars From birth to death: Building connections for future primary care providers Kim Kovalick, DO, loves her work as a family medicine practitioner — especially the way she gets to practice it in a Geisinger clinic. Geisinger’s focus on team-based primary care gives her more time with patients, building the longlasting and trusting relationships that make her calling a joy. Now, as assistant dean of primary care and assistant professor of family medicine in Geisinger Commonwealth School of Medicine’s Department of Medical Education, Dr. Kovalick can share that passion as she shapes future primary care physicians. She is leading the effort to create a network of mentors for Geisinger Commonwealth students in the school’s growing Abigail Geisinger Scholars Program. In addition to herself, she now has mentors to pair one-on-one with incoming scholars. The mentors will form a close bond with their students and act as advisors as the students progress in their education. “The mentor role is a guidance role,” Dr. Kovalick said. “The mentor will be there to talk to students about their aspirations and to guide them on their journey to becoming a primary care physician.” In addition to acting as a mentor, Dr. Kovalick is also a preceptor, teaching third-year students in her clinic in Kingston. As a teacher, she hopes her students will appreciate the breadth of care a primary care physician provides. “We see everyone, from birth to elderly,” she said. “No other specialty is like that. Primary care physicians really earn the trust of their patients. They come to us about everything — even when they get advice from another provider, they want to talk to us about it.” Helping her students to begin to build that trust is one of the things Dr. Kovalick enjoys most as a teacher. “I try to teach students to talk to the patient the way they would want a doctor to talk to their family member: with kindness and respect. It helps that our patients have been very positive about helping students to learn. It’s a joy to see them begin to build that confidence to have the more difficult conversations.” These intimate human connections make Dr. Kovalick’s role as both doctor and teacher deeply satisfying. When the newest Abigail Geisinger Scholars begin their studies this fall, Dr. Kovalick hopes all mentors convey that message. “Primary care is about caring for the whole person,” she said. “You need to understand everything about a patient — medical, social, family life. It really is the most challenging specialty, but it is also the most rewarding.”
Geisinger wants its smart, hardworking medical students to be free to practice medicine the way every future doctor imagines it — through meaningful, long-term relationships with people who become more like family. And we all want our family members to stay healthy and strong so they can live their best lives, unburdened by disease. That’s why we created the Abigail Geisinger Scholars Program. Here’s how it works: • Selected students graduate without tuition debt and receive a $2,000 per month stipend. • Upon completion of residency training, program participants become Geisinger-employed physicians. Specialties include family medicine, internal medicine, medicine-pediatrics and psychiatry. • 1 year of service equals 1 year of support, with a 2-year minimum. geisinger.edu/AbigailScholars
8
Scholar spotlight Focusing on what’s important: Sophia Costan hopes to work with underserved communities Two encounters with medicine inspired Sophia Costan to become a doctor herself. When she was 13, she was troubled by a barrage of mysterious symptoms — severe anxiety, weight loss, palpitations. A calm and reassuring family doctor solved the problem, discovering that Sophia has Grave’s disease. “She was so great,” Sophia said. “She took a scary situation and turned it into a learning opportunity.” Sophia was eager to emulate her doctor’s knowledge and kindness, so she pursued dual degrees in cell & molecular biology and psychology at Chatham University in Pittsburgh. There, she also pursued another of her passions: serving the community. It was while volunteering as a front desk clerk at Catholic Charities Health Care Center that she found her next source of
inspiration. “I loved working at the center and found that you can have a huge impact just by being kind,” she said. “However, I was lucky to have the chance to shadow a doctor at the center. He was retired and was working full time at the clinic for free. In his retirement, he could have been doing anything and he chose this. That really made an impression on me.” As Sophia was researching medical schools, Geisinger’s focus on community captured her attention. “I was looking for schools with a community emphasis and was thrilled as I explored programs like the Fresh Food Farmacy. I had already applied to Geisinger Commonwealth when I learned about the Abigail Geisinger Scholars Program and I was just floored. I want to focus on internal medicine, so it’s incredible that on Day 1 I will be immersed in primary care opportunities. I can also focus on what’s important to me — making medicine accessible to everyone. I am so excited. I’ve been dreaming of this since I was a teenager.”
‘Geisinger wants to do right by its community. I want to be a part of that.’ Growing up in Cameroon, Frank Monney learned to connect doctors and hospitals with death and trauma. “I had several close relatives die for lack of access to care at the most basic level,” he said, noting his early negative impressions had persuaded him to avoid medicine as a career. Instead, Frank’s love of science led him to study biological sciences with a concentration in STEM education at the University of Maryland Baltimore County, where — fortunately — positive research experiences changed his mind. “I conducted research with a shadowing component at the University of Connecticut,” he said. “I learned that medicine doesn’t always have all the answers, but doctors and scientists never stop looking for them. It was a big turning point for me.” To prepare for medical school, Frank chose first to get a master’s degree in biomedical sciences (MBS) from Geisinger Commonwealth. That’s when he fell in love with Geisinger and its approach to medicine. “While I
was a graduate student, I got involved in a lot of community service. As a Black man in medicine, I realized that, although the area is not very diverse, Geisinger is encouraging diversity in all aspects. It’s not just lip service; it shows through every activity. The school celebrates, encourages and understands the value of diversity in healthcare. I felt it from the first day of my master’s program — that Geisinger wants to do right by its community and its people — and I continue to feel it today as a first-year medical student.” Citing programs like the school’s annual cultural bazaar and the 25,000 meals project, Frank said there was only one place he wanted to go for medical school. “I like to be involved in my own community. I like being a mentor and role model for youth in the area. I want to stay here at Geisinger Commonwealth and do more,” he said. That’s also why Frank applied for the Abigail Geisinger Scholars Program and is looking forward to his future as a physician in Geisinger’s region. “The School of Medicine is young, but just look at the strides it’s made already. There is complete cohesion between the stated mission and the developed programs. Geisinger Commonwealth truly is concerned with the health of its population, and I want to be a part of that.”
D e p a r t m e n t o f M e d i c a l E d u c a t i o n 2 0 1 9 - 2 0 2 0 Ye a r i n R e v i e w
9
Medical education's future
Telemedicine:
It’s here to stay and students can play a meaningful role Pre-COVID, telemedicine was a minor component of patient care, mostly applied to solve problems related to physician shortage. At the start of the pandemic, when the use of telemedicine exploded, students and physicians learned that patient satisfaction — and their own — increased. Patients enjoyed not having to travel while physicians found themselves more efficient, and neither found the ability to communicate impaired. With this in mind, Geisinger Commonwealth is building a curriculum that will provide students a meaningful role in patient care via telemedicine. Our Health Resources and Services Administration (HRSA) grant (see page 11) will look at using telemedicine to increase access for minority and disadvantaged patients. We know from numerous surveys that patients like student involvement in their care. Students have more time to talk, to listen and to take a deeper dive into issues. One way to make the student’s role meaningful is for them to participate in telehealth sessions from the patient side, for example writing a history and recording any questions a patient has and maybe even directing the patient to resources that Geisinger has. There are exciting opportunities we want to exploit to benefit both student and patient. — William Jeffries, PhD
10
Telemedicine
COVID CARES funds The U.S. Department of Health and Human Services (HHS) notified Geisinger Commonwealth that it will receive $150,000 in new federal funds as part of the Coronavirus Aid, Relief and Economic Security (CARES) Act’s Centers of Excellence COVID-19 program. These awards come from funding authorized by the Coronavirus Preparedness and Response Supplemental Appropriations Act, which U.S. Rep. Matt Cartwright helped enact as a member of the House Appropriations Committee. Health centers funded by HHS may use the awards to help communities across the country detect the coronavirus; prevent, diagnose, and treat COVID-19; and maintain or increase health capacity and staffing levels to address this public health emergency.
said Cartwright. “I applaud Geisinger Commonwealth School of Medicine for continuing to play a critical role in charting our path to recovery in northeastern Pennsylvania.” “Center of Excellence COVID-19 funds will help us understand the impact on medically underserved communities and how to best serve them,” said Ida Castro, JD, vice president for community engagement and chief diversity officer at the School of Medicine. “Training our students and clinical staff to educate and advocate for these communities is crucial to the overall well-being of our region. This grant will allow us to pilot important new initiatives, including telemedicine, in this area.”
“This new funding is an important part of keeping our health centers equipped as they continue their quest to identify and care for those with the coronavirus,”
D e p a r t m e n t o f M e d i c a l E d u c a t i o n 2 0 1 9 - 2 0 2 0 Ye a r i n R e v i e w
11
Medical education's future
The virtual classroom: On pre-clinical side, virtual learning accommodates all learning styles
Geisinger Commonwealth faculty, who rose so ably to the occasion on the clinical side, also produced a virtual curriculum in very short order for first- and second-year students. Both students and faculty were surprised by the unexpected benefits of online learning. Faculty were able to interact with students quite directly. There were no anonymous questions, but instead a specific student asking a specific question to whom faculty could give a pointed answer that adds meaning to encounters. Being able to see faces individually added nuance lost in large lecture halls. Online learning is also efficient, with the instructor able to access more resources than is possible in a lecture hall. Students enjoy the multiple ways one can ask questions and interact virtually. Students who need a more distractionfree environment like the fact that the ordinary din of a classroom is removed. More introverted students don’t need to be the center of attention every time they have a question, while more extroverted students can continue to be as outgoing as they wish to be. Additionally, in terms of scheduling and physical space, freed from the restrictions of a building, we can have an unlimited number of small groups. We all talk about “post-COVID” as if there will soon be a COVID-free world. That’s not realistic. We believe the new personal space rules will persist and that some social mores around physical interaction will change forever. That may seem disheartening, but it shouldn’t be. Change is inevitable and change was coming. The pandemic gave us the push that was necessary. — William Jeffries, PhD 12
Leadership structure enhanced by appointment of institute chairs Steven J. Scheinman, MD, Geisinger Commonwealth president and dean, announced a major addition to the leadership structure of the medical school. Since the transformation of The Commonwealth Medical College into Geisinger Commonwealth School of Medicine, it has been leadership’s goal to integrate the school fully into Geisinger. To advance this integration, Geisinger Commonwealth will recognize the eight clinical institutes of Geisinger as integral institutes of the School of Medicine, with a status similar to the academic departments found in most medical schools. Effective September 21, each institute lead now holds a dual appointment as chair of a school institute, reporting to the dean for academic matters. These new school institutes will be the operational home for Geisinger physicians who have faculty appointments, reporting to their respective institute chairs. These institutes will be responsible for the clinical elements of the curriculum. They will continue to collaborate with faculty at our non-Geisinger campuses to assure the provision of excellent instruction and student advising. The school’s Department of Medical Education will continue its mission of instruction in the basic sciences, formal clinical skills instruction and assessment, medical education and scientific research, curriculum development and pedagogical expertise. This structure will engage the institute chairs more fully in design and delivery of curriculum and foster integration
Casale
of the clinical faculty within the medical school. It will enhance involvement of Geisinger physicians in clinical teaching, student advising, curriculum development, faculty development and advancement, and participation in undergraduate medical education administration. Together with the recent restructuring of the faculty appointment and promotion process, this should streamline and promote consistency of clinical faculty appointments. The Department of Medical Education will be busy over the next several months orienting institute staff and faculty on their new roles and realigning our governance model to ensure success of this new structure. New institute chairs are: Medicine: Kenric Allen Maynor, MD Surgery: Mohsen Mohammad Shabahang, MD, PhD Women’s and Children’s Medicine: Sandra Culbertson, MD Neuroscience: Neil Holland, MD (Interim Chair) Musculoskeletal Medicine and Surgery: Michael Suk, MD, JD Diagnostic Medicine: Myra Wilkerson, MD Cardiovascular Medicine: Alfred Casale, MD Cancer Medicine: Rajiv Panikkar, MD
Wilkerson
Maynor
Suk
Holland
Panikkar
Culbertson
13
Shabahang
D e p a r t m e n t o f M e d i c a l E d u c a t i o n 2 0 1 9 - 2 0 2 0 Ye a r i n R e v i e w
13
Year 2
Year 1
The curriculum at a glance
14
Course
Topic
Case-Based Learning 1 (CBL1)
CBL1 prepares students for clinical practice by linking classroom-based knowledge to clinical practice through the discussion of clinical case studies.
Community Health Improvement and Promotion (CHIP)
The goal of CHIP is to give students the opportunity to learn about the principles, methods and complexities involved in community health/public health interventions through active participation in group projects.
Foundation of Systems (FoS)
FoS covers biochemistry, cell and molecular biology, medical genetics, physiology, clinical anatomy and radiology, histology, immunology, microbiology, pathology, embryology and pharmacology.
Physician and Patient-Centered Care (PPCC1)
PPCC1 is a year-long course that assists students and one another to connect to humanity and humanism — our own as well as that of our peers and those who will benefit from our professional skills, knowledge and presence.
Physician and Society (PAS)
The goal in PAS is to illustrate the need for and the benefits from collaborative approaches and efforts for advancements in health, health policies and clinical practices among the fields of clinical medicine, research epidemiology, biostatistics and public health.
Neuroscience
The instructional material is presented in a multidisciplinary format to foster the integration of the basic disciplines of neuroanatomy, biochemisty, histology, immunology, microbiology, pathology, pharmacology and physiology.
Course
Topic
Case-Based Learning 2 (CBL2)
The purpose of CBL2 is the development of clinical reasoning skills, which is the central most important skill for a physician.
Physician and Patient-Centered Care 2 (PPCC2)
PPCC2, a year-long course, is a broad vision course that addresses physicians’ unique relationship to individual patients as well as clinical skills development, professionalism, cultural awareness, legal and moral values, and quality improvement.
Systems I
The purpose of Systems I is to acquire the knowledge of the skin, muscles, bones, gastrointestinal system, blood and kidneys needed to describe the major related diseases.
Systems II
The purpose of Systems II is to acquire the knowledge of the cardiovascular, respiratory, endocrinological and reproductive systems, as well as behavioral health, needed to describe the major related diseases.
Curriculum at a glance
Rotations
2
Pediatrics
2
Psychiatry / Neurology
2
Surgery
2
Family Medicine (2 days per week, 9 weeks)
9
Internal Medicine (1 day per week, 9 weeks)
9
Pediatrics (1 day per week, 9 weeks)
9
Independent Student Learning (1 day per week, 9 weeks)
9
Internal Medicine
4
Neurology
3
OB-GYN
4
Pediatrics
3
Psychiatry
3
Surgery / Anesthesia
6
Elective
2
NBME Prep ACLS Professional Identity Formation
2
March
April
May
Graduation
November - February
Break
Oct.
Subinternship: Medicine
Sept.
Critical Care Medicine
August
Subinternship: Student Choice
Electives: Student Choice
Year 4
July
OB-GYN
Senior Seminar
Capstone (2 weeks)
2
Interprofessional Selective
Inpatient Clinical Rotations (25 weeks)
Internal Medicine / Family Medicine
Electives: Student Choice
Year 3
Ambulatory Medicine (9 weeks)
Weeks
Match / Core Week
Clinical Fundamentals (10 weeks)
Electives: Student Choice
Component
D e p a r t m e n t o f M e d i c a l E d u c a t i o n 2 0 1 9 - 2 0 2 0 Ye a r i n R e v i e w
15
Match results Anesthesiology • • • • • • •
Cedars-Sinai Medical Center, CA Geisinger, PA Icahn School of Medicine at Mount Sinai, NY Icahn School of Medicine St Luke’s-Roosevelt, NY The George Washington University, Washington, DC University of Chicago Medical Center, IL University of Louisville School of Medicine, KY • University of Maryland Medical Center, MD • University of Southern California, CA • Westchester Medical Center, NY
Child neurology • UPMC Medical Education, PA
Dermatology • Broward Health Medical Center, FL • Geisinger, PA • Loyola University Medical Center, IL
Emergency medicine • • • • • • • • • • • • • • • •
Baystate Medical Center, MA Christiana Care, DE (2) Crozer-Chester Medical Center, PA Geisinger, PA Guthrie/Robert Packer Hospital, PA Harbor-UCLA Medical Center, CA Kern Medical Center, CA Medical College of Georgia-Augusta University, GA Medical University of South Carolina, SC St. John’s Riverside Hospital, NY Thomas Jefferson University, PA University of Rochester/Strong Memorial, NY University of Virginia, VA UPMC Medical Education, PA West Virginia University School of Medicine, WV Wright-Patterson Air Force Base; Wright State University, OH • Zucker School of Medicine-Northwell NS/LIJ, NY
Family medicine • • • • • •
Guthrie/Robert Packer Hospital, PA Kaiser Permanente-Napa/Solano, CA Maine-Dartmouth Family Medicine, ME UPMC Altoona Hospital, PA UPMC Medical Education-Susquehanna, PA Ventura County Medical Center, CA
General surgery • • • •
16
Bassett Medical Center, NY Christiana Care, DE Geisinger, Wilkes-Barre, PA Louisiana State University School of Medicine-New Orleans, LA
• Spartanburg Regional Healthcare, SC • University of Rochester/Strong Memorial, NY • University of Tennessee Health Science Center–Memphis, TN • Virginia Commonwealth University Health System, VA
Internal medicine • Christiana Care, DE • Family Health Centers at NYU Langone, NY • HCA Healthcare/University of South Florida Morsani Graduate Medical Education-Trinity, FL • Kaiser Permanente–San Francisco, CA • Loyola University Medical Center, IL • Massachusetts General Hospital, MA • MedStar Georgetown University Hospital, Washington, DC • Montefiore Medical Center/Einstein, NY • Orlando Health, FL • Penn State Hershey Medical Center, PA • Rhode Island Hospital/Brown University, RI • The George Washington University, Washington, DC • University of Miami/Jackson Health System, FL • UPMC Medical Education, PA • Westchester Medical Center, NY
Medicine-pediatrics • Case Western/MetroHealth Medical Center, OH • Maine Medical Center, ME
Medicine-preliminary • Olive View-UCLA Medical Center, CA • Pennsylvania Hospital, PA
Medicine-primary • Virginia Mason Medical Center, WA
Neurodevelopmental disabilities • Baylor College of Medicine–Houston, TX
Neurology • • • •
Maine Medical Center, ME Mayo Clinic School of Graduate Medical Education, FL Temple University Hospital, PA Virginia Commonwealth University Health System, VA
Obstetrics-gynecology • Cooper Medical School of Rowan University/Cooper University Hospital, NJ • Geisinger, PA • Lankenau Medical Center, PA • Penn State Hershey Medical Center, PA • Walter Reed National Military Medical Center, MD
Match results
Ophthalmology
Preliminary
• Larkin Community Hospital, FL • UT–Southwestern, TX • West Virginia University Eye Institute, WV
• University of Chicago Medicine–NorthShore University Health System, IL
Orthopaedic surgery
• Lehigh Valley Hospital, PA
• Hospital of the University of Pennsylvania, PA • SUNY Upstate Medical University, NY • University of Tennessee Health Science Center–Memphis, TN
Otolaryngology • Thomas Jefferson University, PA
Pathology/combined-anatomic & clinical • Yale-New Haven Hospital, CT
Pediatrics • • • • • • •
Geisinger, PA (3) Icahn School of Medicine at Mount Sinai, NY Jefferson Medical College/duPont Children’s, PA Medical University of South Carolina, SC UCLA Medical Center, CA UPMC Medical Education, PA Zucker School of Medicine–Northwell Cohen Children’s, NY
Pediatrics/psychology/child psychology • Indiana University School of Medicine, IN
Psychiatry Radiology-diagnostic • Boston University Medical Center, MA • Geisinger, PA • Hospital of the University of Pennsylvania, PA • West Virginia University School of Medicine, WV
Surgery preliminary • Medical University of South Carolina, SC • MedStar Georgetown University Hospital, DC • Temple University Hospital, PA
Transitional • • • • •
Geisinger, PA (3) John Peter Smith Hospital, TX Lehigh Valley Hospital, PA Nassau University Medical Center, NY University of Miami Miller School of Medicine/Holy Cross, FL • West Virginia University School of Medicine, WV (2)
Urology • Penn State Hershey Medical Center, PA • Westchester Medical Center, NY
Two Geisinger Commonwealth alumni match into fellowships at Geisinger Two Geisinger Commonwealth School of Medicine alumni have returned to Geisinger to pursue sports medicine fellowships. The fellows matched through the Medical Specialties Matching Program (MSMP). Shrut Patel, MD, Geisinger Commonwealth School of Medicine Class of 2016 and Jessica Williams, MD, Geisinger Commonwealth School of Medicine Class of 2017 will begin their fellowships this summer. Patel
“I could not be prouder to see our alumni returning to seek more training from Geisinger,” said Steven J. Scheinman, MD, Geisinger Commonwealth School of Medicine president and dean and executive vice president, Geisinger. “We warmly welcome both Dr. Williams and Dr. Patel back. I should also note that, as a Lackawanna County native, Dr. Patel is also a local alumnus returning home to practice medicine. I am pleased to see the continued fulfillment of our school’s founding mission.” MSMP is conducted by the National Resident Matching Program (NRMP), which also conducts the main residency match, whose “Match Day” is held annually in March.
Williams
D e p a r t m e n t o f M e d i c a l E d u c a t i o n 2 0 1 9 - 2 0 2 0 Ye a r i n R e v i e w
17
Transforming the future:
Student news Guthrie Campus students participate in Stanley Conklin Research Day In April, Geisinger Commonwealth School of Medicine students at the Guthrie Campus participated in the second Stanley Conklin Research Day, an event which will be held annually. The purpose of the event is to showcase resident and student research and quality improvement projects conducted in the Guthrie system. Oral and poster presentations were judged by a panel of physicians and awards were announced at the end of the event.
and Shital Patel, who presented their research, “Use of Cumulated Ambulation Score to Assess Mobility in Hip Fracture Patients.” Faculty member R. Shri Jai Kirshan, MD, contributed.
Two Geisinger Commonwealth students who worked with general surgery residents and faculty on two research projects tied for first place in the student research poster category:
Shane Zeshonski, Yasmeen Daraz, Scott Schoenborn and Meghan Sutryk, who presented their research, “Implementation of Frailty Screening Tool for Hip Fracture.” Faculty member Darshan Lal, MD, contributed.
Mathews
Management of Small Bowel Obstruction: A Clinical and Financial Perspective Authors: Trey Mathews with Brandon Bullock, Amber Hussain, DO, and Robert Behm, MD
Matthew Weirich, Katsiaryna Malykhina, Catherine Faulkner, Jonathan Jackson and Carol Tang, who presented their research, “Assessment of Delirium/ Dementia in Hip Fracture Patients – Placement on Treatment.” Faculty member Radhika Bompalli, MD, contributed.
Using Glasgow Coma Scale to Predict Outcomes After Traumatic Brain Injury Authors: Daniel Scheese with Ashley Wojciechowski, Cara Hannigan, MD, and Robert Behm, MD
Geisinger Commonwealth students participating by presenting quality improvement posters included:
Geisinger Commonwealth students participating by presenting research posters included: Scheese
18
Gabrielle Prezkop, John Baranoski, Cynthia Ciccotelli and Tim Corcoran, who presented their research, “Addressing the Code Status at Robert Packer Hospital.” Faculty members Ravi Kumar, MD, and Donielle Park, RN, contributed.
John Curtis, Elizabeth Eich, Maddison Kane
Jee S. Moon, who presented his research, “QI: Does Guthrie ‘C.diff’erences in Treatment of Clostridioides difficile?”
Warren Acker, Gina Baiamonte, Laura Grezzo and Daniel Scheese, who presented “Identifying and Increasing Palliative Care Consults in the Medical ICU.” Faculty member Sukriti Kamboj, MD, contributed. Lindsay Falgoust, Evan Frigoletto, Trey Mathews and Zachary Sporn, who presented “Improving Transitional Care Management in the CHF Patient Population to Decrease Readmission Rates.” Faculty member John Pamula, MD, contributed. Katsiaryna Malykhina and Shane Zeshonski, who presented “Prevalence of Incidental Findings on PreProcedural Multidetector Computed Tomography Angiography in Transcatheter Aortic Valve Replacement Patients in a Rural Setting.” Faculty members Guy Rogers Jr., PA-C, and Edo Kaluski, MD, contributed.
Student news
Through Geisinger Commonwealth partnership with TJU, 4 students receive MPH degrees In June, four Geisinger Commonwealth School of Medicine students presented their master of public health (MPH) capstone projects at Thomas Jefferson University. These students took a gap year between their third and fourth years to pursue their MPH, an opportunity provided to them thanks to Geisinger Commonwealth’s partnership with Jefferson. A fifth School of Medicine student presented his capstone project in March. All are members of the MD Class of 2021.
Cynthia Ciccotelli’s presentation, The REACH Study: Measuring Usability and Outcomes of the Merckengage Internet Diabetes Education Tool, explored the utility of an internet-based Type 2 diabetes education tool. She worked with Jefferson faculty on the project.
“My capstone project revolved around foster care. I worked with a Philadelphia foster care agency to analyze the feedback and needs of foster parents, in order to ultimately develop a standardized foster parent training curriculum,” said participant Vanessa Thiel. “Through this project and through my participation in the program, I’ve learned so much. Not only have I learned about different public health issues, but I’ve gained the tools to help assess and tackle the issues, from a more in-depth look at biostatistics to learning about health literacy to learning how to develop effective policy. I’ve learned how to be a more effective patient advocate and I’ve learned how to look at issues from a different lens.”
Vanessa Thiel completed her capstone, Fostering Feedback: Using Focus Groups to Develop a Standardized Foster Parent Training Curriculum, working with Rosemary (Rosie) Frasso, PhD, CPH, associate professor and Public Health Program director, and Steve DiDonato, PhD, a faculty member in the Department of Counseling and Behavioral Health. The project focused on improving the care for foster children.
The dual-degree students were engaged in a number of research and practice endeavors related to their capstone projects:
“We love having these students in our program and look forward to future collaborations,” Dr. Frasso said. “We believe their public health training will be an asset to them and others as they return to Geisinger Commonwealth and move into residency.”
Sahil Pandya presented his project, Caring for Older Adults During COVID: A Rapid Review. He worked with a team from TJU’s Sidney Kimmel Medical College on a project exploring telemedicine.
Thiel
Pandya
Ciccotelli
Nathan Hoff presented Sleep Deprivation as a Treatment for Depression: Comparison of Mood Ratings and Improving Prediction of Treatment Response. He worked with Jefferson colleagues at Penn on a project looking at sleep deprivation as treatment of depression.
Sean Farrell’s project, completed in partnership with a Jefferson medical student and mentors from the Hepatitis B Foundation, explored the needs of patients with hepatitis B and hepatitis D. He delivered it in March.
“The past year at Thomas Jefferson University was truly amazing, and I’m so excited to begin my pediatric career with this additional education,” Vanessa said.
Hoff
Farrell
D e p a r t m e n t o f M e d i c a l E d u c a t i o n 2 0 1 9 - 2 0 2 0 Ye a r i n R e v i e w
19
Student news
Students develop app to get kids moving Three Geisinger Commonwealth School of Medicine students joined a Geisinger Health Foundation team working to address the problem of childhood obesity. Michael Ryan, DO, and Alison Woody lead the Foundation team, which is now in the running for a national prize of $150,000. Max Cornell, Class of 2021, Jino Park, Class of 2022 and Mark Mandel, Class of 2022, helped create an app, including shooting and editing video, that the Foundation has put to use to get kids moving. The app brings to life the Foundation concept “Pediatricians Prescribing Play” by providing a tool families can use to encourage their child’s physical activity and track the child’s progress. The videos, created by Max, Jino and Mark and starring numerous Geisinger Commonwealth classmates, teach children everything from yoga poses to how to do jumping jacks. There’s even a high-energy exercise sequence filmed to the infectious global hit “Baby Shark,” recorded by Geisinger Commonwealth student Kenneth Lam (Class of 2021) and starring Terrence Habiyaremye (Class of 2022). Max and Mark traveled with the Foundation team to Rockville, Md., the week of Sept. 16 to compete in the U.S. Health Resources and Services Administration’s (HRSA) “Grand Challenges Demo Days.” Health Resources and Services Administration (HRSA) Challenges are prize competitions seeking innovative technology solutions to critical maternal and child health issues. The Geisinger team’s app was entered and was a winner in HRSA’s Maternal and Child Health Bureau’s “grand challenge” to prevent childhood obesity. This challenge supports innovative technology-based solutions to empower low-income families to achieve and 20
sustain healthy eating practices and healthy lifestyles. After a successful presentation, the Geisinger team won the right to move on to phase 3, an achievement that came with a check of $25,000 and the chance to compete for $150,000. Before reaching the “Demo Days” round of the competition, the Geisinger team’s proposal won HRSA seed funding to build out and test their ideas, with the help of experts who served as mentors to the teams. HRSA selected “Physicians Prescribing Play” as one of 10 winning ideas from a field of more than 70 nationwide applicants. During the September Demo Days, teams competed for a share of a $125,000 prize and an opportunity to move to the third and final phase of the competitions by demonstrating their innovations to a panel of judges in a format much like the reality show “Shark Tank,” where contestants have just a few minutes to make a winning pitch. Judges were all federal employees and experts in the field. Demo Days also included two panel discussions with leaders in the fields of health technology innovation and commercialization, as well as two showcase sessions for teams to network with the panelists, judges, HRSA staff and each other. Over the past 8 months, a comprehensive internal team at Geisinger worked to build a prototype app that uses elements of game-playing and exercise videos to get low-income kids moving. The Geisinger Commonwealth students worked in pediatric clinics in the Scranton area to enroll and educate Medicaid-eligible children and their families on how to use the app, as well as created and filmed all the videos.
Student news
Geisinger team wins first-place award for ‘Enhancing Medical School Curriculum on Care for Individuals with Intellectual and Developmental Disabilities’ A team that leads National Curriculum Initiative in Developmental Medicine grant activities at Geisinger Commonwealth School of Medicine presented curriculum enhancement projects at the school and their impact at the 18th Annual American Academy of Developmental Medicine and Dentistry (AADMD) virtual conference in June. AADMD is a membership organization of interdisciplinary health professionals, including primary physicians, medical specialists, dentists, optometrists, nurses and other clinicians, committed to improving the quality of healthcare for people with an intellectual and developmental disability (IDD). The grant team includes Drs. Douglas Wells and Avisha Shah, both members of the Geisinger Commonwealth MD Class of 2020; Emily Herman, a member of the MD Class of 2021; Tonoya Sengupta, an alumnus of the MBS program and a research assistant; Michelle Cornacchia, MD, co-principal investigator and a physician at Geisinger Comprehensive Care Clinic; and Youngjin Cho, PhD, co-principal investigator and a medical educator at Geisinger Commonwealth. Because the conference occurred virtually, almost all curriculum and research findings were presented
as poster presentations. The Geisinger team won the first-place award in the best poster presentation category. The winning poster was titled “Enhancing Medical School Curriculum on Care for Individuals with Intellectual and Developmental Disabilities.” It examined five curricular enhancements incorporated at Geisinger Commonwealth: • Patient presentations by people living with IDD to better understand the impact of the disease on quality of life. • Standardized patient experience to practice obtaining history and physical exam skills with patients with IDD. • Family-centered experience, in which students meet with volunteer members of the community with IDD outside of a medical setting to help them better understand the socioeconomic aspects of their condition. • Quality improvement projects, or community projects involving individuals with IDD to understand barriers to care. • Interprofessional elective course, in which fourthyear students conduct a 2-week rotation at Geisinger Medical Center’s Comprehensive Care Clinic to practice providing healthcare for children and adults with IDD. Dr. Cho acknowledged that the team’s work was only possible with support and participation from all students and faculty at Geisinger, as well as community organizations.
D e p a r t m e n t o f M e d i c a l E d u c a t i o n 2 0 1 9 - 2 0 2 0 Ye a r i n R e v i e w
21
Honing the craft:
Faculty news Dr. Janet Townsend named senior associate dean Steven J. Scheinman, MD, Geisinger Commonwealth School of Medicine’s president and dean, announced that Janet Townsend, MD, has been appointed senior associate dean for Faculty Affairs. She assumed the role on March 23. Dr. Townsend has served the School of Medicine since its inception. She was the founding chair of the Department of Family, Community and Rural Health from 2008 through 2015. In this capacity she recruited the founding faculty and established our program of community-based education and research. Most recently she served as regional associate dean for the Central Campus. Dr. Townsend was recruited to Geisinger Commonwealth in 2008 after 25 years of medical education leadership at Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, N.Y. As senior associate dean for Faculty Affairs, Dr. Townsend will oversee the process for appointment, promotion and tracking of faculty members at the School of Medicine. Dr. Townsend’s strong relations with clinical leadership will be invaluable as the School of Medicine works to integrate the hundreds of preceptors across the Geisinger system fully into the faculty.
Dr. Mark Olaf named regional associate dean Mark Olaf, DO, FACEP, has been named regional associate dean of Geisinger Commonwealth School of Medicine’s Central Campus in Danville, where he will also serve as campus chief academic officer. Dr. Olaf is a Geisinger emergency medicine physician certified by the American Board of Emergency Medicine. Prior to his appointment as regional associate dean, he served as both assistant regional dean and emergency medicine medical student clerkship director for Geisinger Commonwealth. In addition, he serves as core faculty and journal club director for the school’s Emergency Medicine Residency Program. As regional associate dean, Dr. Olaf will provide leadership and oversight of all activities on the Central Campus. He oversees delivery of all clinical education activities, including faculty training, monitoring the quality of the overall student learning experience and ensuring students have the appropriate learning experiences to achieve their educational objectives for all clerkships and required and elective rotations.
22
Faculty appointed APHC Education Committee co-chairs Tanja Adonizio, MD, and Michelle Schmude, EdD, MBA have been appointed co-chairs of the Education Committee for the Academy for Professionalism in Health Care (APHC). Dr. Adonizio is associate dean for student affairs and assistant professor of medicine at Geisinger Commonwealth School of Medicine. Dr. Schmude is Geisinger Commonwealth’s associate dean for admissions, enrollment management & financial aid and an associate professor. APHC, headquartered in La Crosse, Wisc., is dedicated to optimizing patient care through professionalism education, scholarship, policy and practice in all health-related fields. As Education Committee co-chairs, Drs. Adonizio and Schmude will help APHC members achieve their goals of promoting collaborative, multidisciplinary dialogue and research among professionalism educators, as well as help members develop syllabi, evaluation and assessment tools, methods and strategies. Additionally, they will engage accreditation bodies to develop the best educational assessment methods and instruments. Drs. Adonizio and Schmude were appointed based upon their extensive work in professionalism at Geisinger Commonwealth. The two were responsible for developing the school’s e-Portfolio, an electronic means of tracking students’ progress in terms of professionalism. They have also lectured and presented on professionalism and e-Portfolio at several national conferences, including at the prestigious Harvard Macy Institute.
Faculty news
Dr. John Arnott named chair John Arnott, PhD, has been named chair of the Department of Medical Education. The Department of Medical Education is responsible for curriculum and student assessment for undergraduate medical education at the school, including clinical and classroom learning. “Dr. Arnott has extensive experience with medical education at Geisinger Commonwealth School of Medicine, having been a faculty member since the school’s founding,” said William Jeffries, PhD, vice dean for Medical Education and vice president for Academic Affairs. “His leadership has helped us to build a robust collaboration with clinical faculty to deliver outstanding learning experiences for our students and has been instrumental in leading the ongoing enhancements to our medical school curriculum. I am pleased he will lead the department during this time of profound change to the ways we deliver education.”
As department chair, Dr. Arnott will play a major role in Geisinger Commonwealth’s comprehensive curriculum renewal for its MD program, and he is responsible for developing a culture of scholarship within the department in order to disseminate the unique aspects of the School of Medicine’s research, curriculum and mission. He will also ensure that the department’s educational initiatives support student research programs and graduate medical education. Finally, he’ll continue to develop and implement the department structure, mission and goals and oversee operations of the Education Office, the Gross Anatomy Laboratory and the Clinical Skills and Simulation Center. Dr. Arnott is an associate professor of cell biology who joined the Geisinger Commonwealth faculty in 2008 at the school’s founding. He helped lead the school’s integration with Geisinger, implementing the merger of all academic departments and the Curriculum Department into a single Department of Medical Education. Dr. Arnott played a key role in leading the design of the department’s leadership structure and committees.
Resilience subject of faculty research Personal resilience has emerged as a quality believed by researchers to sustain people exposed to adverse conditions and protect them from long-term health consequences ranging from cardiovascular disease to depression. Scientists know what resilience is, but not why some people have it while others do not. Gabi Waite, PhD, and David Averill, PhD, both professors of physiology, dream of finding a biomarker for resilience, a finding that could increase our understanding of resilience and help to build it in people at risk. The researchers have devised a study to seek the biomarker. It will use heart rate variability to search for clues. Dr. Waite explained that heart rate is controlled by the autonomic (involuntary) nervous system, which a person can’t consciously control but which reacts to stress by producing measurable changes in heart rate. The study will evaluate the feasibility of having subjects wear a small device that continuously records their electrocardiogram, or ECG (the electrical signature of the heart’s electrical activity). The time between each heartbeat is then extracted and its fluctuation over minutes, hours, and even days is measured as heart rate variability. Subjects will also self-report their levels of stress throughout the study period. “We know any stress — emotional, physical — affects the autonomic nervous system. We believe that people
Waite
Averill
Adonizio
whose patterns of autonomic nervous system activity are relatively constant may be under stress continuously. So, yes, this may define the current state of a person. The question is, how does this relate to resilience? That is not so clear,” she said. Dr. Waite said that before COVID-19 hit, the research team (composed of Drs. Averill and Tanja Adonizio, MD, associate dean for student affairs, and herself) was ready to go with wearables and logbooks for a starting sample of about 50 people. The pandemic forced a rethinking of the logbook. At present, the team is working with people who help develop an app that would allow subjects to record their stress and submit their data virtually. “Our dream is to give to every student enrolled at Geisinger, every staff member, every faculty member at school a wearable and ask them to self-monitor and selfcollect. But first, we’ll beta-test the app and roll it out with about 50 people — most likely students,” she said.
D e p a r t m e n t o f M e d i c a l E d u c a t i o n 2 0 1 9 - 2 0 2 0 Ye a r i n R e v i e w
23
Faculty news
Geisinger Commonwealth School of Medicine granted continuing full accreditation from LCME, MSCHE Geisinger Commonwealth School of Medicine has received notification from the Liaison Committee on Medical Education (LCME) that it has been granted continuing full accreditation for 8 years, which is the maximum cycle possible. LCME is the U.S. Department of Education-recognized accrediting body for programs leading to the MD degree in the United States.
The school’s next MSCHE accreditation visit will occur in the 2026–27 academic year. The MSCHE site team attached six commendations to its affirmation, recognizing the School of Medicine’s excellence pertaining to community engagement and cultural competence and diversity, in addition to various programs that support student success.
The Middle States Commission on Higher Education (MSCHE) also reaffirmed Geisinger Commonwealth’s accreditation for the maximum possible cycle of 8 years. MSCHE is recognized by the U.S. Secretary of Education to conduct accreditation and pre-accreditation activities for institutions of higher education in Delaware, the District of Columbia, Maryland, New Jersey, New York, Pennsylvania, Puerto Rico and the U.S. Virgin Islands. A medical school cannot receive LCME accreditation without first being accredited by MSCHE.
Steven J. Scheinman, MD, Geisinger Commonwealth School of Medicine president and dean and executive vice president of Geisinger, said he was proud of the school and its staff and faculty for the achievement. “Together these renewed accreditations represent a significant milestone in the history of our school and provide meaningful validation of the quality of our educational programs,” he said.
Professor emeritus honored at symposium In November, Geisinger Commonwealth School of Medicine held a fall symposium sponsored by the Academy of Clinical Educators. The event featured as its guest lecturer prominent scientist Alan Flake, MD, FACS, FAAP, director of Children’s Hospital of Pennsylvania Center for Fetal Research. Dr. Flake’s presentation was titled “Extending Gestation: Towards physiologic support of the extreme premature infant.” The lecture introduced a new technology Dr. Flake led the development of, called EXTEND (EXTrauterine Environment for Neonatal Development). The EXTEND system aims to mimic as closely as possible the intrauterine environment and to maintain normal growth and development outside of the womb.
The Academy of Clinical Educators (ACE) at Geisinger Commonwealth School of Medicine honored Thomas Martin, MD, (right) at its fall symposium. Dr. Martin was recognized for his appointment as emeritus professor at Geisinger Commonwealth. The event featured as its guest lecturer prominent scientist Alan Flake, MD, FACS, FAAP, (left) director of Children’s Hospital of Pennsylvania Center for Fetal Research.
24
The symposium also provided an opportunity for friends and colleagues to honor Thomas Martin, MD, on the occasion of his appointment as emeritus professor at Geisinger Commonwealth. Dr. Martin was recognized for his distinguished career which, in addition to serving as longtime assistant chair for pediatric education, includes his integral role in the development and founding of the Geisinger Janet Weis Children’s Hospital. He was also previously named professor emeritus in the Department of Orthopedics and Rehabilitation at Hershey Medical Center. He practiced pediatrics and served as associate medical director of the Family Practice Residency at Williamsport Hospital. Dr. Martin is board certified both in pediatrics and in the subspecialty of sports medicine. In addition to numerous clinical and academic appointments in pediatrics, Dr. Martin served as team physician for the Penn State University football and wrestling teams from 1997 to 2004. He is a graduate of Franklin and Marshall College and the University of Pittsburgh School of Medicine.
Faculty news
Castro received Latino Legacy and Leadership award Ida Castro, JD, vice president for Community Engagement and chief diversity officer at Geisinger Commonwealth School of Medicine, received the first-ever Lillian Escobar-Haskins Latino Legacy and Leadership Award. This prestigious honor was awarded to her at the Pennsylvania Latino Convention, where she served as keynote speaker. Dr. Castro’s address at the conference focused on Latinos’ present and future contributions to Pennsylvania. She was introduced by Wilton Curiel, a Dominican-born Geisinger physician assistant, who also works with Geisinger Commonwealth’s outof-school enrichment program, Regional Education Academy for Careers in Health – Higher Education Initiative (REACH-HEI). Mr. Curiel shared his personal journey as a Latino in the United States and why he became a physician assistant. In presenting the award, Serena Escobar-Haskins, the daughter of Lillian Escobar-Haskins, said of Dr. Castro, “Your remarkable body of work and commitment to social justice is a legacy. Our Latino communities have been served brilliantly by you. You have advocated for our interests at all levels from local to national. It is an honor well deserved.” Geisinger served as a platinum sponsor of the Pennsylvania Latino Convention, which was held in Bethlehem. The surrounding area of Bethlehem — including Easton, Allentown, Lancaster, Lebanon, York, Harrisburg and Gettysburg — boasts more than 50 percent of Pennsylvania’s total Latino population. In addition to being home to almost 1 million Latinos, Pennsylvania welcomed the second-largest migration of Puerto Ricans after Hurricane Maria hit the island in 2017. The convention was dedicated to discussing challenges and opportunities for these new Pennsylvanians by providing a platform for data, research and policy agendas.
D e p a r t m e n t o f M e d i c a l E d u c a t i o n 2 0 1 9 - 2 0 2 0 Ye a r i n R e v i e w
25
Faculty news
Dr. Maloney assumes role as associate dean of clinical affairs Steven J. Scheinman, MD, president and dean of Geisinger Commonwealth School of Medicine and executive vice president of Geisinger, announced the appointment of Gerald Maloney, DO, chief medical officer for Geisinger hospitals, as associate dean of Clinical Affairs for Geisinger Commonwealth. Dr. Maloney will retain his chief medical officer (CMO) role. The associate dean designation, however, recognizes Dr. Maloney’s central role as liaison between the educational function and the clinical system, and fits naturally with his CMO responsibilities, according to Dr. Scheinman. “Since the inception of the integration of the medical school with Geisinger more than three years ago, Dr. Maloney has been an invaluable partner in linking education with the clinical system. He has played a pivotal role integrating Geisinger physician faculty,” Dr. Scheinman said. “This appointment acknowledges these critical functions and enhances Dr. Maloney’s authority within the teaching mission. He is an effective and respected leader who is absolutely committed to the educational mission.”
As associate dean for clinical affairs, Dr. Maloney is responsible for advising the dean and senior leadership regarding the integration of education functions with the clinical enterprise. Such education functions include both undergraduate and graduate medical education programs, as well as nursing and programs in other areas of the health profession. The associate dean assists the dean and vice dean in recruiting faculty to assume both teaching roles and advising roles for the medical school and also participates in faculty development activities. Helping to design, lead and implement innovative educational programs for all learners at Geisinger is another role responsibility. “I am honored to accept the role as associate dean for Clinical Affairs and look forward to continuing to help align medical education at Geisinger Commonwealth with Geisinger’s unique vision of making healthcare easier for everyone,” Dr. Maloney said. “We are already training some of the best doctors in the nation and I’m confident that, in the future, our program will be the gold standard for 21st-century medicine.”
Dr. Gatson appointed assistant dean for equity and inclusion Na Tosha N. Gatson, MD, PhD has been appointed assistant dean for equity and inclusion at Geisinger Commonwealth School of Medicine. Dr. Gatson will retain her roles as director of the NeuroOncology Division at the Geisinger Health Neuroscience and Cancer Institutes; associate neuro-oncologist; associate professor of research and medicine at the School of Medicine, as well chair of the school’s Health Equity Group. Dr. Gatson’s work as assistant dean for equity and inclusion will take place within the parameters of Geisinger Commonwealth’s Center of Excellence for Diversity and Inclusion. She has been an integral part of COE’s Health Equity Group (HEG) since 2017. In her new role, Dr. Gatson is responsible for developing, planning and delivering GCSOM’s undergraduate medical curriculum health equity thread. This curricular thread focuses on both clinical and didactic content, including development of clinical experiences, skills and inclusive campus environments. The curriculum Dr. Gatson develops will address the health-related impact of social determinants of health, race, ethnicity, culture, sexual
26
orientation, gender, geodemographics, age, religion, socio-economic status and health throughout the four years of the MD curriculum. In addition, she will promote research related to health equity and/or in other areas relevant to interests within the medically underserved community and oversee the diversity activities of the director of student engagement, diversity and inclusion. Dr. Gatson completed a two-year neuro-oncology fellowship at the University of Texas MD Anderson Cancer Center (MDACC) in Houston, Texas. Prior to fellowship, she spent 14 years training at The Ohio State University in Columbus, where she earned an MD/PhD as part of the Medical Scientist Training Program with a graduate research focus in neuroimmunology. She completed a neurology residency with an enfolded one-year NIH (National Institutes of Health)/NINDS (National Institute of Neurological Disorders and Stroke) R25 Post-Doctoral Research Fellowship in neurosurgery focused on viral-oncolytic targeting of glioblastoma. Her current clinical and research interests include brain tumor imaging, cancer neuroimmunology and defining sex/ gender-based disparities in the field of neuro-oncology.
Faculty news
Dr. McBride named regional assistant dean for student affairs Darrell McBride II, DO, has been appointed to the position of Geisinger Commonwealth School of Medicine’s regional assistant dean for student affairs at the Central Campus. Dr. McBride will also retain his role as attending physician in Geisinger’s Division of Infectious Disease. William B. Jeffries, PhD, Geisinger Commonwealth’s vice dean for medical education, vice president for academic affairs made the announcement Sept. 9. “Dr. McBride has a keen interest and great depth of experience in medical education, having served as clerkship director for Geisinger’s Division of Infectious Disease and as a member of the school’s internal medicine core faculty since 2018. He is regularly recognized by learners as a skillful teacher and cares deeply for our students and their welfare,” Dr. Jeffries said. “I am confident that his leadership and guidance will enhance and elevate the learning environment at the Central Campus.”
In his new role, Dr. McBride will provide support for medical student professional identity formation and resources for Geisinger Commonwealth students during the clinical education curriculum years. He will be responsible for direct third- and fourth-year student advising in regard to academics, future residencies and career choice. Dr. McBride will work in collaboration with Dr. Mark Olaf, regional associate dean, as well as regional clerkship directors, the regional education specialist and the student affairs team. He received his medical degree from Lake Erie College of Osteopathic Medicine and completed his residency in Internal Medicine at Case Western University School of Medicine. He completed a fellowship in Infectious Diseases at Barnes-Jewish Hospital in St. Louis. Dr. McBride serves on the HIV Medicine Association’s Ending HIV as an Epidemic working group and is board certified in internal medicine by the American Board of Internal Medicine (ABIM) and in infectious disease by the American Board of Infectious Disease (ABID).
Faculty member’s curricula now part of AAMC diversity and inclusion ‘toolkit’ Vicki T. Sapp, PhD, director for student engagement, diversity and inclusion and an assistant professor in Geisinger Commonwealth School of Medicine’s Department of Medical Education was notified by the American Association of Medical Colleges (AAMC) that three training modules she developed for a cultural humility curricula were peer reviewed, accepted and published on the AAMC website as part of the organization’s Diversity and Inclusion Toolkit Resources for all U.S. medical schools. The three modules are: •
Examining Concepts of Privilege appears in the “Power and Privilege” section of the AAMC toolkit.
•
Understanding and Interrupting Microaggressions appears in the “Microaggressions, Identity, and Cross-Cultural Communication” section of the AAMC toolkit.
•
Cross-Cultural Communications appears in the “Microaggressions, Identity, and Cross-Cultural Communication” section of the AAMC toolkit.
“I am honored that the AAMC selected my work for inclusion in its Diversity and Inclusion Toolkit,” Dr. Sapp said. “At Geisinger Commonwealth we work hard to build a welcoming and equitable environment. Being able to share our training strategies with the wider educational community is very gratifying.” To access the resources, visit the AAMC website: aamc.org/professional-development/affinity-groups/cfas/ diversity-inclusion-toolkit/resources
D e p a r t m e n t o f M e d i c a l E d u c a t i o n 2 0 1 9 - 2 0 2 0 Ye a r i n R e v i e w
27
Patient Safety Movement Foundation launches a new safety curriculum World Patient Safety Day was Sept. 17. To celebrate, we look back a year ago to the Patient Safety Movement Foundation (PSMF) and its new curriculum on patient safety. Inside Medical Liability magazine interviewed Geisinger Commonwealth dean, Steven Scheinman, MD, one of the co-chairs of the head of the curriculum project, to learn about the incentive behind this new venture, and glean some details about how it was accomplished. Here’s what he shared: Q: How did you achieve the goal of making the curriculum appropriate for any learner? Dr. Scheinman: Our task force developed a general structure of eight domains, such as error science, technology and communication. Within each domain, there are subdomains of knowledge. For each subdomain, we have defined learning objectives of knowledge. Those objectives are different for a novice than they are for an advanced beginner or for an expert practitioner. For each of the learning objectives, we define five developmental levels. And for each of those, there are links to resource materials: videos of patient stories, examples of that kind of error occurring, standard textual materials. The instructor can then choose the level of learning objective for the level of learner that they are working with, and can choose the resource material that they think will most effectively illustrate what they need to teach to that level of learner. So the instructor becomes an active participant in choosing the material. What the curriculum provides is a framework and links to material for every competency and every domain. Q: Are there tests or certification exams, something like that, after the students have heard all of this?
28
Dr. Scheinman: We intend to work with licensing agencies and certifying boards in a range of professions to have material on patient safety incorporated into those board exams and those licensing exams. The students will know that they need to master this material in order to do well on their licensing exams. Our group has not developed examination materials. Q: I note that one of the foundational domains is error science. How detailed is the curriculum in advising on how to minimize this sort of error? Dr. Scheinman: Let’s open up the chapter on error science and see what it says. “This domain addresses the spectrum of error introducing concepts of human factors, human and technology interface, and error-prone complex systems. Content to improve patient safety through understanding and management of clinical risk, utilization of effective error reporting systems, root cause analysis performance and application of continuous quality improvement is highlighted.” The first subdomain focuses on “Spectrum of error and understanding and managing clinical risk.”
Dr. Scheinman: Each of the domains touches on how the competencies needed relates to The Joint Commission’s National Patient Safety Goals and National Quality Forum Safe Practices. Specifically, a goal of The Joint Commission’s National Patient Safety Goal is to reduce errors associated with anticoagulant therapy. The National Quality Forum Safe Practices stipulate that disclosures should be timely, transparent and clear. Q: Do you have all of the medical specialties represented? Dr. Scheinman: Ours is a broad curriculum. We don’t, for instance, address issues of safety in regard to cardiac catheterization. Instead, we focus on the larger issues like patient handoffs. Q: Has the curriculum been tested in any sort of way — by a double-blind sort of test, for instance? It would be difficult to design this sort of study, right? Dr. Scheinman: It would be very difficult to design such a study, but as the curriculum is adopted, there will be enhancements.
For this, the curriculum includes a list of ways that competency can be demonstrated for each level of professional. For example, the novice learner, after the discussion of an inpatient case, would need to identify the human factors involved, elements of the human and tech interface, and complex systems that impact clinical risk.
I think it would be very good to assess what works and what doesn’t. There is a broad opportunity for scholarship around educational efficacy that would focus on doing that.
And then, in contrast, the competent professional would need to state how to utilize an emergency department setting to model application of clinical risk assessment.
Dr. Scheinman: Yes, the Foundation is working on checklists for various circumstances. This was announced at their recent meeting, for example, for patient handoffs.
The second subdomain is “Error reporting systems; root cause analysis; quality improvement (QI).” For the novice, after a didactic session, could show competency by, for example, discussing the rationale for error reporting and investigation. The competent professional could demonstrate competency by demonstrating the reporting of “near miss” insulin dosing error.
Q: What was your biggest challenge in working on the curriculum?
There are diverse resources for this domain, including a video and text on a patient who survived an error (Alicia Cole), a text on a patient who suffered a preventable death, provider stories and case studies. Q: Is there any contradiction in the sources you use, or are they all in synch? Dr. Scheinman: I think that overall they have been very complementary to each other.
Q: Is the Foundation also working on other safety tools, like checklists?
Dr. Scheinman: I would say it was this: At the beginning, arriving at the framework. We had some very wideranging discussions at the beginning. They were so broad that it was not clear how we would provide shape to these very exciting discussions. Then we came upon the idea of establishing domains and then subdomains, and that framework made everything else possible. Q: Do you have a plan for how often the curriculum will be updated? Dr. Scheinman: Our group meets monthly, and we plan to update it at least every 6 months. But we will also be collecting data in real time as people start using the curriculum.
Q: Does what you’re doing relate in any way to standards of care?
D e p a r t m e n t o f M e d i c a l E d u c a t i o n 2 0 1 9 - 2 0 2 0 Ye a r i n R e v i e w
29
Scranton, PA 19 525 Pine St., Scranton, PA 18509 geisinger.edu/gcsom
Geisinger Commonwealth School of Medicine is committed to non-discrimination in all employment and educational opportunities. 2015-8494-12/20-EZYG/SL