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Spotlight Meeting Learners Where They Are; Giving Them What They Need – An Interview With Dr. Julianna Jung, MD, MEd
SPOTLIGHT
An Interview With Julianna Jung, MD, MEd
Julianna Jung, MD, MEd is the director of innovation in medical education and an associate professor of emergency medicine at the Johns Hopkins University School of Medicine. She served as director of medical student education in the department of emergency medicine for 16 years before being promoted to her current institutional position in 2021. She has also served as the associate director of the Johns Hopkins Medicine Simulation Center since 2011. She oversees the implementation of innovative educational methods across the Johns Hopkins curriculum and directs major educational initiatives for medical students including the Transition to the Wards course and the Comprehensive Clinical Skills Assessment Program. Dr. Jung has won numerous teaching awards, including the Johns Hopkins Alumni Association Award for Excellence in Teaching, the George Stuart Award for outstanding contributions to clinical education (three times), and the Professors’ Teaching Award. She is also a national leader in education, serving as the immediate past president of SAEM’s Clerkship Directors in Emergency Medicine (CDEM) academy, current member-at-large for the SAEM Board of Directors, and chairing several national task forces on education and assessment topics. Dr. Jung received her MD from the Johns Hopkins University School of Medicine, where she also completed an emergency medicine residency. She received her master’s degree in education from the Johns Hopkins University School of Medicine and has been a full-time Johns Hopkins faculty member since 2002.
What led you to choose emergency medicine as your specialty and, specifically, why academics?
More than anything, I was drawn to emergency medicine by the fact that we are on the front lines of medicine, providing care to all patients regardless of their resources or insurance status. We provide the only federally guaranteed entitlement to health care for Americans and being part of that was important to me. I also love the breadth of the field, the acuity, and the ability to work in a team environment with residents, nurses, technicians, and others. I knew I wanted to stay in academics because I love teaching and learning, and the challenge of staying current with residents keeps me sharp! At first, I wanted to do health services research, but the vagaries of my career pulled me into medical education, and I really found my true passion there.
What is it about working with students that you most enjoy?
Oh my heavens — I love EVERYTHING about working with students! It’s such a joy to see their excitement when complex topics click into place for them, or when they experience the sense of confidence that comes from mastering a new skill. And for students, especially early on, everything is an epiphany! It’s amazing to get to share their wonder in knowledge and skills that are entirely new and fresh for them, even if we as longtime practitioners have long since taken them for granted.
What is your teaching philosophy?
More than anything, I try to begin every teaching interaction with a stance of positive regard for the learner. Everyone comes to medical school with different experiences, unique aptitudes, and their own individual learning needs. People learn at different speeds and in different ways, and it’s our job to support them in their educational journey. Some students just intuitively grasp things, and others must really work at it. It’s important to honor the fact that they are ALL capable, intelligent, motivated people who are doing their best. When I approach learners with that fundamental assumption, I become more able to cast aside judgment, and to meet the learner where they are, giving them what they need to grow and flourish. It makes me a more effective educator, and a happier human!
What inspired your interest and involvement in simulation education?
I have tremendous sympathy for students who have trouble translating concepts from the classroom to clinical practice. I was a very strong preclinical student in med school because
I’m great at learning things and taking tests. When I started on the wards, I realized that I had absolutely no aptitude for applying all that book knowledge to patient care, and I felt constantly clueless. As I resident, I know that I harmed a few patients because of my difficulty in making connections between knowledge and practice. So when I started teaching students, I knew that I wanted to give them a way to practice applying their knowledge to real clinical problems. I started off doing this in problem-based learning sessions and various practicums, but when my school built a simulation center, I knew I’d found my true calling! Simulation is amazing because it forces learners to translate knowledge into action, and it allows them to experience the consequences of their decisions in a very palpable way — all without endangering patients. It lets them enter practice with a wealth of “experience” to draw upon, and ultimately makes them much more confident and competent doctors.
What do you think are some other urgent issues facing academic emergency medicine in the U.S. today? What issues do you feel are most germane to current and future emergency medicine trainees?
This is probably where I’m supposed to talk about workforce issues or something, but honestly, I worry more about the moral injury inflicted upon emergency medicine doctors by our incredibly broken health care system. Most physicians choose careers in EM for noble reasons — we want to serve people in need and provide comfort for patients in their darkest hours. But over and over again, factors beyond our control conspire to thwart our best efforts. We can’t provide the quality of care we want because our departments are too crowded. We can’t link patients with the care they need because our health system is too convoluted, and it prioritizes insurance company profits over the health of patients. We can’t give patients and families the time they deserve because we are pulled away by ever-increasing administrative burdens. EDs are really tough places to work, mentally and physically, and it can be hard for EM physicians to stay connected to the joy of medicine. I’m so grateful for the times when I can really help someone — those experiences give me strength to weather the difficult times.
How has SAEM supported you throughout the phases of your career?
I joined CDEM back when it was founded — it was SAEM’s very first academy. Before then, I really had no idea that there were people all over the country doing the same work as me, taking it seriously, trying to learn how to do it better. Being able to connect with fellow EM educators at the national level taught me SO much! I learned from amazing mentors, collaborated with incredibly talented colleagues, and found inspiration in a wealth of creative ideas for making EM education better. SAEM provided venues where we could communicate and share our work, and the annual meeting became a highlight of the year for me. I’ve been fortunate enough to develop not only professional connections, but also real and lasting friendships through SAEM, and I can’t imagine my career without it! Now that I’m a member of the SAEM Board of Directors, I’m really excited about engaging and contributing to the organization in a new way.
Do you have any pearls to share with those who are just beginning their journey in academic emergency medicine?
This may be an unpopular opinion, but my best advice is to say YES! There is so much power in saying yes. Conventional wisdom is that we should establish rigid career goals, set five- and 10-year plans, and avoid doing anything that distracts us from our mission. That may be a great approach for some people, but many of us don’t actually know what we want to be when we grow up, and doggedly pursuing goals can prevent us from exploring new areas that bring us joy. Many of the most fulfilling parts of my own career have grown out of seizing unexpected opportunities and trying new things. I’ve had the privilege of teaching learners all over the world, building simulation capacity in developing nations, and collaborating with entrepreneurs to bring my teaching to new audiences — just by virtue of being willing to take up a new challenge; just because I said YES.
If you weren’t doing what you do, what would you be doing instead?
I’d have my own fashion line! Sewing is one of my main hobbies, and I make almost all my own clothing. I love the
way that sewing marries technical skills with creativity — you have to really know what you’re doing to create a garment that fits and works the way it’s supposed to, but then you can use fabric and stylistic touches to evoke the right feeling and make it unique. Wearing great clothing also elevates the wearer’s confidence and mood. It’s a gift I’d love to be able to share with other women.
Looking back, what advice would you give to your younger self, just starting out in this specialty?
Ha! Young me probably wouldn’t listen to old me anyway, but I think I’d tell myself to be open-minded, and don’t be afraid to try new things.
Stigma is a leading barrier to mental health care for emergency residents and trainees. Many fear that treatment for mental illness could jeopardize their careers or their licenses to practice.
• What would you say are the key challenges to addressing this stigma?
I think that the most important thing we can do is to be more open about our own mental health struggles. Trainees only see the public-facing versions of us — polished, professional, and invulnerable. It can lead to the misconception that they’re
alone in their feelings of depression or anxiety or self-doubt and that everyone else has it all figured out. We need to make it okay to not be okay, and that requires us to be honest about ourselves. I try to share my own stories as appropriate so that my students and residents know that it’s normal, and it’s safe to talk about. • What advice would you give trainees who are struggling but too afraid to seek help?
It’s heartbreaking just to think about this. We’ve created a toxic culture in medicine that values “strength,” and it’s taught us to suppress anything that might be construed as
“weakness.” All I can say about this is that TRUE strength comes from self-knowledge and self-love, and that means taking care of every part of yourself —mind, body, and spirit.
Addressing your mental health needs will make you a stronger person and a better, more compassionate doctor. • What can be done to create a sense of safety for EM residents and medical trainees that would encourage them to ask for help or self-report when they’re struggling?
Again, we need to lead by example. We need to normalize mental health care and share our own vulnerabilities. We also need to make ourselves safe people for trainees to confide in, and approach the trainees who do trust us with their mental health concerns with unwavering support and respect.
Up Close and Personal
1. Complete the following sentences:
• In high school I was voted most likely to star in the school play. • A song you’ll find me singing in the shower is “Love Cats” by The Cure • One quote I live by is “Whatever you can do or dream you can, begin it. Boldness has genius, power, and magic in it.” — Goethe
2. Who would play you in the movie of your life and what would that movie be called?
If I’m lucky, they’ll get Gillian Anderson to play me, or maybe Tilda Swinton. I’m not sure what the movie would be called, but I definitely want to have magic powers in it, and a killer wardrobe!
3. Name three people, living or deceased, whom you invite to your dream dinner party.
Ugh, I think they actually made me answer this question on a college essay, and I still don’t know!
Maybe Jorge Borges, since he’s an amazing writer and super weird. I’ll also include Dolly Parton, since she’s the mother of all strong women and takes zero crap from anyone. And how about The
Rock? He can show us all some workout moves, and he seems really personable.
4. What is your guiltiest pleasure (book, movie, music, show, food, etc.)?
PBJ with barbeque chips— like ON the sandwich! I fancy myself a bit of a gourmand, but this is absolutely the greatest food, and I will fight anyone who says otherwise.
5. You have a full day off… what do you spend it doing?
Long morning hike in nature with the dog, afternoon sewing and listening to podcasts, evening dinner with family and friends — ideally somewhere outdoors with great beer. I would love to watch a movie or do some reading afterwards, but I probably can’t stay awake.
6. Name one thing on your bucket list.
Visiting the Galapagos Islands — and I’m going there in September to celebrate my 25th wedding anniversary!
