@umassmed The University of Massachusetts Medical School Magazine
Success UMASS MEDICAL SCHOOL INVESTS IN THE FUTURE OF THE CITY OF WORCESTER
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Okwara appointed to UMass Board
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New hope for Tay-Sachs disease
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Pathways of Promise update
2019
Partners in
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The University of Massachusetts Medical School is the commonwealth’s first and only public academic health sciences center, home to three graduate schools. Our mission is to advance the health and well-being of the people of the commonwealth and the world through pioneering education, research and health care delivery with our clinical partner, UMass Memorial Health Care.
2019
@umassmed contents
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FEATURES
Avina Joshi awarded Fulbright-Fogarty Global Health Student Fellowship
COVER STORY: Partners in success 8
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UMass Medical School receives national recognition for immersive opioid-safe prescribing curriculum
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214 degrees awarded at 46th Commencement
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School of Medicine grad Noreen C. Okwara appointed to UMass Board of Trustees
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Second annual RNA Therapeutics conference moves from mechanism to therapy 5 ON THE COVER:
New hope for Tay-Sachs disease
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Bringing life to online teaching
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Profile: Mary Ellen Lane
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Profile: Lisa Colombo
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Pathways of Promise campaign update
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Last Word
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(From left), Josephine Essuman; Serkan Sayin; Johanna vanderSpek, PhD; Amir Mitchell, PhD; Wesley Kinyanjui; Brittany Rosener; and Hailey Doyle stand in front of Worcester Technical High School after Dr. vanderSpek’s biotechnology class enjoyed a visit from UMass Medical School researcher Dr. Mitchell and graduate students Sayin and Rosener.
news notes A GLIMPSE OF WHAT’S GOING ON @ UMASSMED
Avina Joshi awarded Fulbright-Fogarty Global Health Student Fellowship Medical student will address prevention and treatment of preeclampsia in Ghana
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chool of Medicine student Avina Joshi is one of 20 recipients nationwide of a Fulbright-Fogarty Award in Public Health. She will conduct her public health-focused research, which combines her interests in global health and obstetrics & gynecology, in Ghana, studying knowledge and attitudes related to preeclampsia. Joshi, a member of the School of Medicine’s Global Health Pathway, completed her second-year population health clerkship in refugee health and is a member of the Global Surgery Student Alliance. “The FulbrightFogarty lines up so well with what I want to do in the future and is a great opportunity to meet people also interested in careers in global health,” she said.
The U.S. Agency for International Development reports that
Fulbright-Fogarty awards are offered through a partnership between the Fulbright Program and the Fogarty International Center of the U.S. National Institutes of Health. They were established to promote the expansion of research in public health and clinical research in resource-limited settings. Preeclampsia is a serious complication of pregnancy that can result in maternal death, premature births and newborn deaths. The U.S. Agency for International Development reports that preeclampsia is the leading cause of maternal deaths in some regions of Ghana. These deaths are preventable, yet essential medicines and tools to treat the disorder are often unavailable. “Less prenatal care means it is harder for women to 2 | 2019
OFFICE OF COMMUNICATIONS
preeclampsia is the leading cause of maternal deaths in some regions of Ghana.
know if they are at risk for or have preeclampsia—for example, not recognizing the warning sign of headache,” said Joshi. “The treatment is 48 hours of intravenous magnesium sulfate, but in places like Ghana with limited resources, it is hard to treat someone for that long with that drug.” Joshi will survey Ghanaian health care providers and women about their knowledge of and attitudes toward preeclampsia. “The goal is to create an educational campaign based on what we find about misconceptions or misinformation,” she said.
news notes
“WHEN YOU ARE ABLE TO TALK TO THE PATIENTS, IT MAKES IT VERY AUTHENTIC AND VERY REAL.” –JILL TERRIEN
OFFICE OF COMMUNICATIONS
UMass Medical School receives national recognition for immersive opioid-safe prescribing curriculum
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t the height of the opioid crisis, UMass Medical School took a leadership role in Massachusetts, becoming the first to approve curriculum to ensure that all graduates of the School of Medicine and the Graduate School of Nursing were prepared to recognize and treat opioid-use disorder. Last year, UMMS was selected as one of four recipients of the Association of American Medical Colleges Curricular Innovation Award for its Opioid Safe-prescribing Training Immersion (OSTI) program. “One of the gaps that we identified in the curriculum was providing our students with exposure to patients who are suffering with opioid misuse,” said Melissa Fischer, MD, MEd, professor of medicine, associate dean for undergraduate education, curriculum innovation and the interpersonal Center for Experiential Learning and Simulation. “While we worked with faculty from across multiple disciplines to create our cases, we also asked for patient input.”
actors specially trained to portray a diverse array of patients. Five simulations represent the range of pain management needs health care providers typically will encounter in their day-to-day clinical practice. Following the simulations, students meet with patients and families in recovery to hear their stories, ask questions and reflect on what they’ve learned. “When you are able to talk to the patients, it makes it very authentic and very real,” Dr. Terrien said. In the AAMC award announcement, the organization said the UMMS program “stood out as a stellar example of how AAMC member institutions are working to advance the education of students, residents and practicing physicians about opioids, substance use disorder and pain management.” UMMS was asked to present information about the program and lead related workshops at an AAMC national workshop with health care leaders in Washington, D.C., in May.
AAMC said the UMMS program stood out as a stellar example of how member institutions are working to advance education... about opioids, substance use disorder and pain management. Dr. Fischer and Jill Terrien, PhD, ANP-BC, associate professor and director of nurse practitioner programs in the GSN, along with their colleagues, were instrumental in creating the OSTI. As part of the required training, the program features a series of simulated clinical encounters with standardized patients, who are
@ UMASSMED MAGAZINE | 3
news notes 214 degrees awarded at 46th Commencement
On a beautiful, sunny Sunday in June, UMass Medical School held its 46th Commencement, at which it awarded 214 degrees, including an honorary degree to Association of American Medical Colleges President Darrell G. Kirch, who delivered the keynote address. Dr. Kirch, center, is pictured with Terence R. Flotte, MD, the Celia and Isaac Haidak Professor in Medical Education, executive deputy chancellor,
provost and dean of the School of Medicine (left) and UMass Medical School Chancellor Michael F. Collins. Susan Coghlin Mailman, owner of Worcester’s Coghlin Electrical Contractors, Inc., and Richard P. Kennedy, president of The Angel Fund for ALS Research, who is, himself, living with amyotrophic lateral sclerosis, also received honorary degrees.
In addition to the three honorary degrees, Chancellor Collins presided over the presentation of 118 Doctor of Medicine degrees; three Master of Science in clinical investigation degrees; 40 Doctor of Philosophy degrees in the biomedical sciences; eight MD/PhD degrees; and, in nursing, one post-master’s certificate, three PhD degrees and 30 Doctor of Nursing Practice degrees. Pictured here is Molly Jurewicz (center) of the Graduate School of Biomedical Sciences, as she is hooded by (left) Brian Lewis, PhD, associate professor of molecular, cell & cancer biology, and her mentor, Lawrence Stern, PhD, professor of pathology.
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news notes
SOM grad Noreen C. Okwara appointed to UMass Board of Trustees serve with distinction.” Okwara is an internal medicine resident at Brigham and Women’s Hospital in Boston. A native of Kenya, Okwara was inspired to pursue a career in medicine as a result of the tragic death of her brother, who died at age 9 from lack of access to medical care after a car accident. The UMass Board of Trustees comprises 19 voting members, including two full-time students, the Massachusetts Secretary of Education and 16 appointed members, five of whom are UMass alumni representing each of the UMass campuses.
JOSEPHINE PETTIGREW, OFFICE OF THE GOVERNOR
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oreen “Chioma” Okwara, MD, a 2017 graduate of the School of Medicine, was appointed to the University of Massachusetts Board of Trustees. The recipient of the Charles D. Baker II Scholarship while a student at UMass Boston and UMass Medical School, Dr. Okwara was sworn in by Massachusetts Gov. Charlie Baker. “Dr. Okwara is a hardworking and dedicated individual who will bring experience and passion to the University of Massachusetts,” said Gov. Baker. “I am proud to appoint her to the Board of Trustees and am confident that she will
Massachusetts Gov. Charlie Baker swears in Noreen C. Okwara as her parents look on.
Second annual RNA Therapeutics conference moves from mechanism to therapy
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Medicine and distinguished professor of RNA therapeutics, who, with Andrew Fire, discovered RNA interference in 1998. The RNA Therapeutics Institute was founded in 2009 and became an academic department in 2016, chaired by Phillip D. Zamore, PhD, Howard Hughes Medical Institute Investigator, the Gretchen Stone Cook Chair of Biomedical Sciences and chair and professor of RNA therapeutics. Dr. Zamore is a leader in the field of RNA biology. The RTI is dedicated to developing novel therapies for which RNA is the therapeutic target or treatment. RTI faculty members are recognized as scientific trailblazers, and include a Gairdner Prize recipient, the 2018 RNA Society early and mid-career award recipients, and three Howard Hughes Medical Institute Investigators. Among the topics explored at the conference were emerging applications for the use of the geneediting tool CRISPR; and the clinical pathways toward therapeutics for cardiovascular disease, cancer and neurological disease.
FAITH NINIVAGGI
early 400 of the world’s top minds in the field of RNA biology convened in the Albert Sherman Center in June for the second annual conference and symposium, “RNA Therapeutics: From Mechanism to Therapy.” This year’s keynote speakers were Danesh Moazed, PhD, of Harvard Medical School, and Dinah Sah, PhD, of Voyager Therapeutics. “We are thrilled to host such a prestigious group of scientists, academics and industry leaders at the RNA Therapeutics symposium,” said co-organizer Angela MessmerBlust, PhD, senior scientific advisor and assistant professor of RNA therapeutics at UMass Medical School. “It is really wonderful to see so many people in the field as enthusiastic as we are for the progress toward RNA therapeutics.” UMass Medical School is home to the most distinguished researchers in RNA biology, including Nobel Laureate Craig Mello, PhD, Howard Hughes Medical Institute Investigator, the Blais University Chair in Molecular
@ UMASSMED MAGAZINE | 5
PROFILE
Mary Ellen Lane Dean of the Graduate School of Biomedical Sciences
“It’s well known now that our faculty are among the most impactful, productive and innovative scientists in the world. It’s less well known that GSBS students often play significant roles in driving the research, and that our faculty are excellent mentors and educators.” Mary Ellen Lane
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ome people arrive at their dream career by happenstance, while others embark on a thoughtful process built on years of intentional decisions. The road to the Graduate School of Biomedical Sciences for its new dean Mary Ellen Lane, PhD, followed the latter course. Dr. Lane’s pursuit of a career in academic leadership was gradual, but purposeful and deliberate. Her professional objective has been clear: to facilitate student and faculty success in their educational goals. Lane, who was appointed dean in April of 2018, believes the role of educators is to commit to lifelong learning and knowledge creation, to inspire learners through example, and to foster mastery. An educational leader should support students and faculty in the pursuit of excellence, she said. Throughout her education—as an undergraduate at Colgate University in Hamilton, New York; a doctoral student at Columbia University in New York City; and her early career as a basic science researcher— Lane maintained a strong interest in helping develop programs to support faculty in their academic work and lead graduate students toward their own careers in science. While an assistant professor of biochemistry and cell biology at Rice University in Houston, Lane researched the control of cell proliferation and organ size in zebrafish embryonic development. Her work was supported by grants from the National Institutes of Health and the National Science Foundation. In addition to training and mentoring doctoral students and undergraduates in her lab, Lane advised undergraduates,
and participated in service in the areas of curriculum, assessment and residential life. She strove for innovation in her classroom teaching in order to create learning experiences that aligned with the scientific inquiry process. After recognizing the need to adjust teaching methods so that they translated to enduring learning and greater understanding of science, she developed a problem-based undergraduate course in developmental biology that emphasized the experimental foundations of contemporary biological research. In 2009, Lane made the difficult decision to close her lab and concentrate fully on advancing biomedical science education. She accepted a position as assistant dean for admissions at MD Anderson Cancer Center University of Texas Graduate School of Biomedical Sciences in Houston. “During my career as an assistant professor and PI, I noticed that I was drawing most of my energy from interacting with students. I enjoyed mentoring my grad students and developing my teaching skills to promote critical thinking, analytical skills and argumentation,” she said. “Surprisingly, I also enjoyed those aspects of institutional service that exposed me to enterprise-level thinking and challenged me to consider how individual faculty members and departments can support the overall mission of the university. So when I hit an unexpected roadblock in my research career that would require me to disengage from meaningful educational and service activities, I made a career change that would allow me to align my time and effort more closely
PROFILE
with my personal values.” In 2011, Lane joined UMMS as assistant dean for GSBS curriculum and academic affairs. In 2013, she was appointed associate professor in the Department of Neurobiology, and her role in the GSBS was elevated to associate dean. In 2018, she was selected to succeed retiring GSBS Dean Anthony Carruthers, PhD, who held the position for 15 years. While assistant dean, Lane created the Office of Academic Affairs within the GSBS; led a team of faculty in remodeling the first-year student experience in the Basic Biomedical Sciences program and in implementing the new curriculum; created and convened the Academic Advancement Committee; and implemented structural improvements to the Pathways to Graduate Study program. As dean, Lane is charged with developing and implementing a strategic vision for the GSBS. In addition to a focus on all aspects of educational programming, a personal goal is to better inform the greater academic and professional scientific community of the
progress being made in the labs by faculty and students. She has worked to increase faculty visibility at national conferences, build partnerships with other academic institutions as well as industry, and continue to advance the skills of students to keep them competitive after graduate school. She is also working to make it easier for GSBS students and faculty to apply for training funds and to create more incentives for doing so. She also wants to better inform the scientific community outside of UMMS about the role graduate students play in the medical school’s success. She hears from alumni working as postdocs in academia and industry about how far ahead UMMS is in terms of student support and professional development. “It’s well known now that our faculty are among the most impactful, productive and innovative scientists in the world. It’s less well known that GSBS students often play significant roles in driving the research, and that our faculty are excellent mentors and educators,” she said.
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COVER STORY
Partners in
Success UMASS MEDICAL SCHOOL INVESTS IN THE FUTURE OF THE CITY OF WORCESTER
n a late spring morning in the biotech lab at Worcester Technical High School, a spirited class discussion focuses on the remarkable places the students have been and on the places they are going. Marleen Nunez, 17, spent her senior year of high school studying gene therapy in the lab of one of the world’s leading scientists in the field, Guangping Gao, PhD, the Penelope Booth Rockwell Professor in Biomedical Research and professor of microbiology & physiological systems at UMass Medical School in Worcester, where she earned a citation for research on a potential 8 | 2019
therapy for treatment-resistant high cholesterol. “Dr. Gao’s lab made a huge difference for me,” said Nunez, who is now a freshman at UMass Amherst studying molecular biology and biochemistry. “At school, they teach you an overall, broad idea of many parts of science. In Dr. Gao’s lab, it is more intense and focused. Being so young and presenting to people who are older than me provided me with more confidence. Knowing that I can do that at this age, I can just imagine what I can do when I’m 20. I think I’m a step ahead.”
COVER STORY
Worcester Technical High School graduates Michelle Haigbea (left) and Marleen Nunez say their internships at UMass Medical School helped prepare them for careers in science.
Michelle Haigbea, also 17, investigated new treatments for parasitic ringworm disease in the lab of Raffi Aroian, PhD, professor of molecular medicine at the medical school. The research holds deep meaning for her, as her Ghanaian parents came to America when they were 17 and still have close family in Africa, where the rate of parasitic infection is high. The disease, which affects 2 billion people worldwide in tropical and subtropical climates, stunts physical growth and brain development. “I feel very blessed to have been able to work in Dr. Aroian’s lab because our work is potentially
“By identifying where
the needs of the city of Worcester overlap with the expertise and resources of UMass Medical School, we have been able to effectively serve our community and achieve our common mission of public service.” Chancellor Michael F. Collins
saving lives,” said Haigbea, who also participated in the High School Health Careers Program at the medical school, an initiative focused on preparing underrepresented students for biomedical research, biotech and health care careers. She is now a freshman at Holy Cross. “The average high school student is not given the chance to help another country. It’s a great opportunity for me and for them, as well.” Johanna vanderSpek, PhD, the biotech department chair at Worcester Tech, ticks off the names of students and graduates going great places this year, and a roster of scientists at continues on page 10 @ UMASSMED MAGAZINE | 9
OFFICE OF COMMUNICATIONS
COVER STORY
Robert Layne, assistant dean of outreach programs at UMass Medical School, is pictured with a recent High School Health Careers class. He says he is the “proudest papa” when students graduate from his programs and go on to excel in their studies. UMass Medical School who helped them on their way, including William Theurkauf, PhD, professor of molecular medicine; Marian Walhout, PhD, the Maroun Semaan Chair in Biomedical Research and professor of molecular medicine; Christelle Anaclet, PhD, associate professor of neurobiology; and Michael Czech, PhD, the Isadore and Fannie Foxman Professor of Medical Research and professor of molecular medicine. Worcester Tech instructor Andrea Pereira, PhD, names three graduates thriving in college who interned with UMass Medical School’s Nobel Laureate Craig Mello: Tauny Tambolleo at Worcester Polytechnic Institute; Jai Chavis at Brown University; and Isaac Quiles at Columbia University in New York. “UMass Medical School has helped our program the most,” said Dr. vanderSpek, describing the impact of the relationships between scientists and students, along with an $875,000 donation from the medical school that equipped her classrooms with state-of-the-art lab equipment. “Working in a real lab helps our students experience the working environment and they 10 | 2019
realize they can do it. They’ve worked hard for it and they fit in. We get glowing recommendations when they’re done.” From Worcester Tech to City Hall, the fruits of a 45-year partnership between UMass Medical School and the city of Worcester are evident. The medical school’s Office of Outreach Programs provides city students with an array of mentoring, job shadowing, internship, summer employment, laboratory research and after-school science programs. Charitable contributions from medical school employees and students are giving families access to laundry facilities in five city schools and a food pantry at North High School. Inside City Hall, the medical school provides funding to support the public health commissioner, who holds a faculty position at the medical school. The spirit of commitment extends across the community, as staff and students volunteer at dozens of organizations, from free medical clinics to refugee centers. “Our partnership with the city of Worcester is important because the schools can’t do this alone,” said Robert Layne, MEd,
the chief representative, liaison and connection to the Worcester school community in his role as assistant dean for outreach programs at the medical school. Layne is dedicated to motivating and preparing students from educationally and/or economically disadvantaged backgrounds and ethnic groups underrepresented in STEM professions for careers in the health sciences. “There are so many students falling through the cracks because the support mechanisms aren’t there for one reason or another. Together, we can make a difference.” “By identifying where the needs of the city of Worcester overlap with the expertise and resources of UMass Medical School, we have been able to effectively serve our community and achieve our common mission of public service,” said Chancellor Michael F. Collins. “What began as a single program focused on the North Quadrant in the Worcester Public Schools has grown dramatically, because we keep finding new ways in which to engage with students and assist them at many different phases of their educational careers.
COVER STORY
We couldn’t be prouder that this year, we again graduated a North High alum from our School of Medicine. By growing our engagement with the city, we are able to help students have success in the early years of their education, so they will be prepared for college and beyond. We want great Worcester students to populate our school because we know when they do, they have a desire to stay in the community and practice in the community.” The story of the medical school’s partnership with the city of Worcester begins with its people. Of the 6,000 people employed by UMass Medical School, 5,000 work in Worcester; 1,200 live in the city. Those employees, as well as students, are generating more than $1 billion in economic activity, according to the UMass Donahue Institute. “UMass Medical School is truly one of the cornerstones of Worcester’s economy,” said Mayor Joseph M. Petty. “The staff and students at the medical school are our homeowners and concert-goers and restaurant patrons. Just as the doctors, researchers and students at UMass are trailblazers to the next economy, they are active participants in our city’s resurgence. More than that, the doctors and staff are out in the community, working at free clinics, advising us on policy and working to make our city healthier.” “We are incredibly fortunate to have a world-class research institution like UMass Medical School located within our city,” said City Manager Edward M. Augustus Jr. “Consistently ranked as one of the leading medical schools in the nation, UMass attracts some of the brightest medical minds to Worcester and our entire city benefits from this high level of intellectual capital.” That intellectual capital is an important and sustaining draw to new businesses and employers in the biotech field, both tiny startups and more established companies. When the owner of a research park
“We are incredibly fortunate to have a world-class research institution like UMass Medical School located within our city,” City Manager Edward M. Augustus Jr. adjacent to the medical school’s campus put the park up for sale in 2012 to focus on its properties in the Boston area, the medical school saw the opportunity and bought what is now called UMass Medicine Science Park in 2013. At the time of the purchase, vacancies were rising and the buildings were dated. The medical school, along with new and existing business tenants, invested nearly $5 million in upgrades and improvements. The Science Park is now 100 percent leased to a mix of startups and established biomedical companies, such as Fresenius Medical Care and Mustang Bio. In part because of the success of the Park, UMass Medical School paid more than $1 million in real estate taxes to the city in 2018, part of nearly $4 million in payments and fees for services to Worcester. Like his counterparts at Worcester Tech, Amir Mitchell, PhD, assistant
professor of molecular medicine in the Program in Systems Biology at UMass Medical School, is passionate about turning the next generation on to science. With the assistance of two graduate students in his lab, Serkan Sayin and Brittany Rosener, Dr. Mitchell collaborated with the Weizmann Institute of Science in Israel to develop a unique outreach program that allows high school students at Worcester Tech, and around the world, to remotely operate a robotic arm in the Mitchell lab to create antibiotic-resistant bacteria, or “superbugs.” “As a kid in high school, I wasn’t inspired by science,” said Mitchell. “I think it’s because, from the outside, people often don’t realize how exciting biology can be. Hopefully, we are opening a window to students that will allow them to realize science isn’t just mixing a few continues on page 12
With funding from the North Quadrant Support Services program and the Remillard Family Community Services Fund, UMass Medical School is addressing root causes of chronic absenteeism among school children in Worcester by building and stocking a food pantry at North High School, installing laundry rooms in four city schools and distributing hundreds of backpacks filled with school supplies. TOP: Chancellor Michael F. Collins and Kola Akindele, assistant vice chancellor for city and community relations, announce the launch of the initiative in 2017. BOTTOM: Lisa Dyer, principal at North High in 2017, Worcester City Manager Edward M. Augustus Jr., Chancellor Collins and Worcester School Superintendent Maureen Binienda, tour the food pantry. OFFICE OF COMMUNICATIONS
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COVER STORY
UMass Medical School scientist Amir Mitchell, PhD, (fourth from left), visits the biotech classroom at Worcester Technical High School with PhD students Serkan Sayin (third from left), and Brittany Rosener (fifth from right). Johanna vanderSpek, PhD, biotech chair at Worcester Tech, (fourth from right), says Dr. Mitchell and colleagues at UMMS are providing valuable insight into science careers for her students. things in a tube. The science of the 21st century is technology driven— it’s robotics, it’s sequencing, it’s collaboration and open science.” Mitchell’s lab works with more than 100 high school students a year in Worcester, Brockton, San Francisco and Israel. Students collaborate to evolve dozens of bacterial strains on various concentrations of antibiotics over several weeks. Worcester Tech student Wesley Kinyanjui said it was his first foray into conducting experiments in which there were no predetermined results. He aspires to a career in biomedical engineering, “developing medicines to help people,” he said. “I think Dr. Mitchell’s program was a good experience because it got teenagers understanding what really goes on in a lab,” said Kinyanjui, who is in the biotechnology program. Classmate Josephine Essuman said the experiment was an interesting example of science, because “you really have to think; you have to look at the data, think about what happened and then choose your next move.” The senior said she has wanted to be a doctor for as long as she can remember, inspired by the patient visits on which she 12 | 2019
accompanied her grandmother, a midwife. “I have always wanted to care for people as a doctor, but now I’m discovering that research—finding the reason why something happened—is also compelling,” she said. Dr. Theurkauf helped establish the Worcester Tech internship program. “The internships are as important to the grad students at the medical school as they are to the high school students,” said Theurkauf. “The interns get first-hand experience in professional labs. Perhaps more importantly, interactions with the students and postdocs here can really expand horizons. The high school students see people not much older than they are pursuing PhDs and realize that they could do this. I’ve had interns come to the lab planning careers as research assistants who are now in college and planning on graduate or medical school.” “For our students, postdocs and faculty, it’s a great opportunity to mentor bright, enthusiastic students, many of whom have had to overcome obstacles our students never considered. It’s always educational, and often inspiring.”
The longest-running partnership between the medical school and the city was founded more than 20 years ago, when the Worcester Pipeline Collaborative K–12 outreach initiative was launched to encourage underrepresented and disadvantaged students from the North Quadrant to pursue careers in biomedical research, biotech and the health care professions. Today, more than 6,500 Worcester Public School students participate in numerous programs. Structured activities include mentoring, job-shadowing, tutoring, clinical observation, research internships, after-school science programs, visiting scientist programs, a speaker’s bureau and family engagement. The Summer Enrichment Program for college students, the High School Health Careers Program and the pipeline are the largest initiatives in the Office of Outreach Programs. “Through these activities, students learn to set high expectations for themselves, as they participate in rigorous K–12 mathematics and science lessons and develop language skills required to enter competitive collegiate programs,” Layne said. “Students also become academically prepared to pursue biomedical research, biotechnology and health careers in Massachusetts.” Many students who have participated in these programs over the years now work at UMass Medical School or at clinical partner UMass Memorial Health Care, or have gone on to careers in medicine, nursing or biomedical science. Kingsley Essien, PhD, and Marian Younge, MD, both participated in outreach programs at the medical school, including the High School Health Careers program, and went on to graduate from the medical school last spring. Dr. Essien earned his PhD from the Graduate School of Biomedical Sciences and is now working as a postdoc in the Department of Dermatology at the medical school. Essien’s siblings followed in his footsteps: his sisters,
COVER STORY
Marian Younge, MD, (left) and Kingsley Essien, PhD, (right) credit UMass Medical School’s outreach programs in Worcester for helping propel their health and science careers.
Clara and Gloria, and brother, Charles, took part in the medical school’s outreach and mentoring programs. They all went on to earn college degrees, according to Layne. Dr. Younge entered the Worcester schools at age 10 when her family came to Worcester from Ghana. Now a resident at Contra Costa Regional Medical Center in Martinez, Calif., the North High School graduate credits her involvement in the Worcester Pipeline for influencing her decision to pursue a career in medicine. “As the oldest child and first person in my family to travel this path, I appreciated all the help I got from this program,” said Younge. “I had thought about a career in health care, but it wasn’t until I was exposed to clinicians through the pipeline that I was given a level of relatability that made it seem more tangible and real. It made a huge difference for me.” The North Quadrant Support Services program was launched in 2017 to address some of the socioeconomic barriers to academic success. With the support of a grant from the medical school’s Remillard Community Service Fund and nearly $100,000 in donations from school employees and students, the North Quadrant Support Services program built and stocked a food pantry at North High School; installed washers and dryers in schools where students lacked access; and provided more than 1,000 backpacks filled with school supplies to elementary school children. The program has also funded 60 classroom initiatives over
“It wasn’t until I was exposed to clinicians through the pipeline that I was given a level of relatability that made it seem more tangible and real. It made a huge difference for me.” Marian Younge
two years, fulfilling teachers’ wishes for a wide variety of assistance, such as a new drama club for North High School this fall and new sensory materials and furniture for special needs students in one preschool teacher’s classroom at Belmont Street Community School. In addition to supporting the North Quadrant Support Services, staff and students at the medical school give more than $100,000 a year in donations to support other nonprofit institutions in Worcester through a workplace campaign. They also volunteer their time at dozens of city organizations, such as the Dress for Success program that provides business attire for women heading into the workforce and the Worcester Free Clinic Coalition that cares for those who cannot get medical care elsewhere. Some of the largest city programs were started by students, such as the Worcester Refugee Assistance Project (WRAP), which was
co-founded by Graduate School of Nursing alum Meredith Walsh, MS, MPH, RN, to assist local refugees from Burma achieve sustainable self-reliance through mentoring, advocacy and providing material support as needed. Jessica Long, MD, SOM ’17, who credited the Health Sciences Preparatory Program for showing her the path to medical school, co-founded the Young Men of Today: Medical Professionals of Tomorrow program, in which young men of color in Worcester are supported in their pursuit to gain access to the field of medicine. Another initiative run by medical students at Worcester East Middle School is targeted toward young women interested in the health field. For Layne and his colleagues in the Office of Outreach Programs, to witness medical school students and graduates mentoring young charges in the city is to feel their efforts have come full circle. “I am the proudest papa when I run into our former students and they say ‘hello,’ and I see they have succeeded,” said Layne, who has been in his role for 24 years. “UMass Medical School has grown in a number of significant ways since its founding,” said Chancellor Collins. “Importantly, the growth of our commitment to our community has kept pace. We are deeply involved in the educational and economic life of the city in many ways, which is as it should be: we are embedded in the success of the city.” By Lisa Larson @ UMASSMED MAGAZINE | 13
for Tay-Sachs disease
Miguel Sena-Esteves, PhD, and Heather Gray-Edwards, PhD, DVM
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FEATURE STORY
he death sentence of Tay-Sachs disease is being challenged by a new gene therapy formulated at UMass Medical School. Tay-Sachs, a fatal genetic neurological disorder that destroys nerve cells in the brain and spinal cord, affects about 1 in 300,000 Heather GrayEdwards, PhD, DVM, spends a moment with Madelyn and Mollie Ronaldson at the 2018 National Tay-Sachs & Allied Diseases Association conference. Both girls have juvenile Sandhoff, a lysosomal storage disease similar to Tay-Sachs.
infants in the United States.
SOULUMINATION
Working under an “expanded access” protocol approved by the U.S. Food and Drug Administration, a research team at UMMS has administered the new gene therapy to two children with Tay-Sachs—the first was treated in the fall of 2018 and the second in the summer of 2019. Both children have tolerated the gene therapy well and are being followed by a clinical research team from the medical school. “We all realize there is still a long way to go, but taking this new therapy to patients is an important step forward,” said Miguel Sena-Esteves, PhD, associate professor of neurology, member of the Horae Gene Therapy Center, and the principal investigator of the Tay-Sachs gene therapy program at UMMS. The new gene therapy is the result of more than a decade of collaborative research by the Sena-Esteves lab and a team at Auburn University led by Douglas Martin, PhD, professor of anatomy, physiology and pharmacology at Auburn’s College of Veterinary Medicine. It’s been an intense effort of scientific discovery and molecular engineering, with instances of rapid progress tempered by disappointing setbacks. Most importantly, Dr. Sena-Esteves said, it is a story of perseverance, both among the research teams and members of the Tay-Sachs community who saw the potential of the gene therapy and funded the research at critical junctures. In 2018, their research approach moved into further clinical development when Axovant Gene Therapies, a Swiss-based company with U. S. operations, licensed the discoveries. “We have been waiting for this moment for a long time,” said Rick Karl, president of the Cure Tay-Sachs Foundation, which has been
“We all realize there is still a long way to go, but taking this new therapy to patients is an important step forward.” Miguel Sena-Esteves a financial supporter of the research. “The science and technology have finally caught up with what we have known for years about the genetics of the disease. The work Miguel and his colleagues are doing is the most promising treatment we have seen so far.” Tay-Sachs is a cruel and insidious disease. Children with the disease appear healthy at birth, but the destruction of their neurons has already begun. Symptoms develop around 6 months of age, first apparent when children start missing developmental milestones. Muscle function and cognitive abilities decline. By age 3, most are unable to move continues on page 16
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NEW HOPE FOR TAY-SACHS DISEASE
Alisha Gruntman, DVM, PhD, assistant professor of pediatrics, with Dean Terence R. Flotte in their gene therapy lab. Dr. Gruntman’s work on optimizing delivery methods for gene therapy vectors for different diseases shows the rapid progress and maturation of the field of therapeutic gene replacement.
or breathe on their own. Few reach their fifth birthday. The disease is caused by an error in the gene that carries instructions for an enzyme called Hexosaminidase A (HexA). The enzyme helps neurons clear out cellular waste products. Without that enzyme, waste products accumulate in the cells, eventually killing neurons in the central nervous system. The new therapy delivers a working copy of the HexA gene directly into the brain and spinal cord. That new gene is taken up by neurons and directs production of the HexA enzyme, which is then released and spreads throughout the central nervous system for use by other cells. In animal studies, the new gene did its job well, and the enzyme it produced functioned properly, helping neurons clear out the waste products. While the therapeutic impact for the two children who have been treated is being studied, Axovant expects to launch a multipatient Phase I/II clinical trial of the TaySachs gene therapy in 2019. Axovant also licensed a gene therapy for a similar disease, GM1 gangliosidosis, developed by the UMMS and Auburn teams, and is now funding a Phase I/II clinical trial 16 | 2019
“The work done by this collaborative team, to develop a first-ever gene therapy for Tay-Sachs, shows what translational research is all about.” Terence R. Flotte
being conducted at the National Institutes of Health. Until now, there has been no treatment, other than supportive care, for those with these genetic disorders. Now, there is hope that change is on the horizon. “The work done by this collaborative team, to develop a firstever gene therapy for Tay-Sachs, shows what translational research is all about,” said Terence R. Flotte, MD, the Celia and Isaac Haidak Professor of Medical Education, executive deputy chancellor, provost and dean of the School of Medicine at UMass Medical School, who is the clinical investigator for the Tay-Sachs expanded use trial. “It is scientists and physicians working together to address medical conditions that can be truly tragic for patients and families.” The gene therapy approach that is making this possible is based on the technology of viral vectors— engineering a harmless and naturally
occurring virus called an adenoassociated virus (AAV) to deliver a therapeutic gene. AAV infects many different tissues and organs, but does not cause disease. Like all viruses, AAV has an outer shell that encloses its genes. On the surface of the shell are elements that help guide the virus to a target cell. When the virus gets into a cell, the shell opens and releases its genes, which in turn use the host cell’s machinery to make more copies of the virus. “Viruses have evolved over millions of years to do one thing—deliver genetic material to a cell so they can replicate,” Sena-Esteves said. “We use what evolution has given us as a starting point, then engineer the delivery mechanisms and the genetic payload.”
FEATURE STORY
How it works To understand how a viral vector works, think of shopping online and getting a package delivered to your home. In that process, you select a specific product, which is then packaged in a standard size cardboard box. An address label is affixed to the box and the package is sent for delivery. The delivery truck hits the road carrying many boxes that all look very much the same. The only difference for your order is the information on the address label that tells the driver where to leave the box. When delivery is completed, you bring the box inside, open it and use whatever you bought. In this analogy, the box is the AAV’s outer shell. The address label contains surface elements on the virus shell that guide the AAV to enter certain cells. The product inside the cardboard box is a good copy of the gene required to make the enzyme missing in Tay-Sachs patients, and no virus genes are carried along.
Populations at risk Tay-Sachs was first described in the 19th century among the children of
Erin Horn, foreground, a veterinary student from the Cummings School of Veterinary Medicine doing an internship at UMMS, identifies microscopic inflammation markers in brain scans of mice with a disease similar to Tay-Sachs, along with Miguel Sena-Esteves; postdoctoral associate Rita Batista, PhD; and Heather Gray-Edwards. Eastern European Jews—specifically, Ashkenazi Jews—who remain the population at greatest risk. According to the National Human Genome Research Institute of the NIH, approximately 1 in 27 adult Ashkenazi Jews are carriers of the disease. In general, people have two copies of every gene—one each inherited from their mother and father.
A person with one copy of the TaySachs gene, and a healthy copy, will be a carrier but will not develop the disease. Tay-Sachs arises when both parents are carriers and both pass on the faulty gene to their children. In the 1970s, a blood test was developed to identify the Tay-Sachs gene. For generations, the test has continues on page 18
E
C
B
D F
How it works
A
HexA gene synthesized in lab
D
Vector enters neurons and other cells
B
Gene packaged in virus shell (viral vector)
E
Gene released and makes HexA enzyme
C
Many copies of the vector containing the synthesized gene injected in the brain and spinal cord
F
HexA enzyme secreted to help other cells
ILLUSTRATION: REGINALD SWINNEY
A
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NEW HOPE FOR TAY-SACHS DISEASE
A
D
been recommended for Jewish couples prior to starting a family. “The Jewish community has done a terrific job of, essentially, screening this disease out,” Karl said. “There are very few new Jewish cases of Tay-Sachs today. The big problem is that a misperception persists, even still among many physicians, that Tay-Sachs is only a Jewish disease. It is not.” Karl doesn’t approach this issue casually. His daughter Krystie Anna died of Tay-Sachs in 2015. Neither Karl, nor his husband, Bruce, nor the egg-donor for the surrogate pregnancy is Jewish. Yet they were carriers. “We were not tested, because we didn’t realize we were at risk,” Karl said. Current research shows that people of Cajun, French-Canadian and Irish descent are also at higher risk for Tay-Sachs, with approximately 1 in 50 adults carrying the gene. The incidence of disease is also now rising in Brazil, Argentina and in some Middle Eastern countries as awareness and diagnosis of the disease improves. Overall, 1 in 250 people in the general global population carry the Tay-Sachs gene. There are approximately 30 new cases in the United States each year, and an estimated 400 to 700 cases world-wide. “Whenever I get the chance to speak with groups of young people, I urge them to get tested,” Karl said. “It’s a simple blood test. It costs about $100. And it can prevent this disease.” 18 | 2019
B
E
C
F
Cat and mouse Tay-Sachs is one of 40 similar rare genetic disorders called lysosomal storage diseases. There are minor biologic differences in each, but all have a similar profile: a missing enzyme disables a nerve cell’s ability to remove or recycle waste products. The result is a loss of motor and neurological function. The collaboration between Sena-Esteves and Martin arose serendipitously at a gene therapy scientific meeting in 2006. At that time, Sena-Esteves was working on the lysosomal storage disease GM1 gangliosidosis. He was presenting a poster on his lab’s recent discovery of an effective method to deliver a lysosomal enzyme throughout the brain in mice. Before the meeting began, SenaEsteves was reading through the program and noticed a researcher from Auburn University was presenting a poster about his work on GM1 in cats, in which a naturally occurring form of the disease was discovered in the late 1970s. When the poster session began, the two GM1 posters were placed opposite each other and the authors struck up a conversation. “It was just by chance that we were at that meeting together, but it was obvious right away that we could work together,” Sena-Esteves said. The Sena-Esteves lab worked on engineering the viral vectors to enhance delivery and therapeutic
Magnetic resonance images of the brains of Tay-Sachs disease sheep show differences between normal sheep (A and D), untreated sheep (B and E) and sheep treated with a low dose of gene therapy (C and F). Significant improvements in the presence of disease in Jacob sheep, which have a gene mutation that causes Tay-Sachs disease, was an important precursor to human trials.
impact; the Martin lab would then test those vectors in the cat model and analyze the results. That information would help SenaEsteves with further development of the vectors. “We work mostly independently, but it has been a great collaboration. We bring different strengths to the project and we respect each other’s opinions,” Sena-Esteves said. It was through this collaboration that Sena-Esteves and Martin expanded the scope of their research to include Tay-Sachs, after a meeting with Sophia Pesotchinsky, who emigrated to the United States in 1976 with her husband, Leon, and infant daughter, Vera. Pesotchinsky is a chemical engineer by training and became a successful serial entrepreneur, building several medical device companies. Her husband, who passed away in 2018, was a professor of mathematics at the University of California. When Vera was diagnosed with a late-onset form of Tay-Sachs in 2000, her mother threw herself into the cause. “I quit my company. I needed to have time to learn about the disease,” she said. “This was the pre-Google era, so I spent a lot of time in the library and started to make phone calls. By 2007, I pretty much knew everybody who was working in the field.” Pesotchinsky learned about Sena-Esteves and his GM1 gene
FEATURE STORY
therapy work from Martin—and promptly reached out. After an initial phone call, she flew to Massachusetts to meet with him and to urge him to include Tay-Sachs in his work. She also asked Sena-Esteves, Martin and another researcher who ran a lab at Boston College to unify their efforts on Tay-Sachs. “I am an engineer, so my inclination is always to look for efficiencies when trying to solve problems,” Pesotchinsky said. “I knew that we couldn’t have three people working independently—there wouldn’t be enough money to go around. We had to get them together.” The result was the formation of the Tay-Sachs Gene Therapy Consortium, with Sena-Esteves and Martin as founding members. The consortium has played an important role in coordinating the field and raising money to support research. Pesotchinsky remains on the consortium’s board and is also a leader in the National Tay-Sachs & Allied Diseases Association, which funds research to find a cure for Tay-Sachs, Sandhoff, Canavan, GM1 and related diseases. “I do this, because I don’t have any choice,” she said. “My daughter is losing the ability to walk and to talk. Her quality of life is going down with every neuron lost. We are in competition with time, so I have to keep fighting.”
Jacob sheep As the gene therapy research continued in animal models of the disease, a naturally occurring form of Tay-Sachs was discovered in Texas, in a herd of an ancient breed of sheep called Jacob sheep. That created an opportunity to test the emerging therapy in a larger animal, with a brain closer in size and complexity to humans. Heather Gray-Edwards, PhD, DVM, now an assistant professor of radiology at UMass Medical School, was working as a postdoctoral fellow in the Martin lab at Auburn when the Jacob sheep model was discovered. The team quickly moved to test their
Rita Batista, PhD, with Toloo Taghian, PhD a postdoctoral fellow in the laboratory of Heather Gray-Edwards
Ryan Senecal, a research technician in the Esteves lab, foreground, with Miguel Sena-Esteves
To date, three children have been treated with the new gene therapies: two children with Tay-Sachs treated by the team at UMass Medical School, and one child with GM1-gangliosidosis, treated at the NIH in May of 2019. latest AAV vectors and gene therapy in the sheep, with Dr. Gray-Edwards taking the lead on administration of the therapy and the analysis of the results. A breeding flock of Jacob sheep was established at Auburn. Sheep that were born with the Tay-Sachs equivalent were studied and some were treated with the new therapy. “Every single animal we treated had some improvement,” Gray-Edwards said. “Even at low doses, we saw therapeutic effects, which is quite amazing.” The treated sheep were able to walk better and lived nearly twice as long the untreated sheep. Beyond the efficacy of the gene therapy, the sheep studies also helped refine the treatment plan proposed for the human trials. Gray-Edwards found that delivering the gene therapy only to the sheep brain was not sufficient, because the therapeutic enzyme did not spread throughout the entire
spinal cord, as it had done in the cat and mouse models. “Based on the sheep studies, we added the spinal cord delivery to the expanded access trial. All of the kids who may be treated in the future will get that as well to overcome the limitation,” Gray-Edwards said. Meanwhile, the research team continues to explore the science and refine the technology, working on a second-generation Tay-Sachs gene therapy and collaborating with others in the Horae Gene Therapy Center to extend the AAV platform to treat other neurological diseases. Through it all, the children with Tay-Sachs are never far from mind. “We have been working on this for a long time. I think about all the children who have died since we began. And I hold on to hope for the children who are living with TaySachs today, that we may be able to help them in the coming years,” Sena-Esteves said. By Michael Cohen @ UMASSMED MAGAZINE | 19
PROFILE
Lisa Colombo Executive Vice Chancellor of Commonwealth Medicine
“Wherever I go, I encounter Commonwealth Medicine staff who are engaging every day with people who depend on us for services...they handle it with such grace and compassion...It inspires me to make sure I perform my role with that same commitment.” Lisa Colombo
W
20 | 2019
hen Lisa Colombo, DNP, MHA, RN, joined Commonwealth Medicine last fall as executive vice chancellor, she knew there would be a lot to learn. She was delighted to discover that there was also a lot to like. Colombo, who holds degrees in nursing from the MGH Institute of Health Professions and Worcester State University and in health administration from Clark University, came to Commonwealth Medicine from her role as senior vice president and chief nursing officer at UMass Memorial Medical Center. For the past decade, she also has held a faculty appointment at the rank of assistant professor in the Graduate School of Nursing. What she’s found at Commonwealth Medicine are “talented, experienced people with a real passion for the mission of helping those helped by public programs,” she said. “This attitude creates tremendous energy in the organization that is really nice to be around.” Colombo’s experience in health services delivery at a number of academic medical centers, including Beth Israel Deaconess Medical Center, Lahey Health, and two years as president and CEO of UMass Memorial-Clinton Hospital, required many of the same skills she is depending on to lead Commonwealth Medicine. “What sometimes seems the most relevant experience for me, interestingly, was when I was president at Clinton Hospital. When you move from being the operational person to being the CEO, you have to have a different perspective. You have a team that is focusing on the operations, so you have to help set the vision and the strategy and find ways to support
the values that are unquestionably such a big part of Commonwealth Medicine, which has a strong culture of respect and accountability. So for me, this is a chance to take what I’ve learned in number of different roles and apply them in a different way.” Commonwealth Medicine’s business reach is broad: about two-thirds of its work is within Massachusetts—much of it in concert with state agencies, especially MassHealth— but the other third of the work that Commonwealth Medicine performs is in 27 states. While growth is always on the agenda, it is not the first priority. “It’s becoming clear that we need to balance the business we do a bit more: working for out-of-state clients and agencies helps us diversify our portfolio, but our first commitment will always be to our partnership with the commonwealth,” she said. This is one of the reasons that Commonwealth Medicine has embarked on a reorganization and a strategic planning process, the latter in concert with the medical school’s own ambitious 2025 strategic plan, which will be announced in the fall of 2019. The reorganization of Commonwealth Medicine aligns programs into four broad areas. Clinical delivery solutions includes some of the most broadly known programs, such as New England Newborn Screening, Disability Evaluation Services, Health and Criminal Justice, Community Case Management and the Office of Clinical Affairs for MassHealth. Health care finance solutions works with public payers and includes programs such as Medicare eligibility enhancement, state and federal claiming, and third-party liability programs
PROFILE
that make sure that MassHealth dollars are spent on the right beneficiaries and the right services. The third, public and private health solutions, captures Commonwealth Medicine’s renowned expertise in health policy research and development and health law and economics. The fourth, business transformation solutions, enhances project support both internally and for Commonwealth Medicine clients. Colombo said the changes are important, in part, because Massachusetts and MassHealth continue to lead the way in health policy and in measuring and managing the quality of service delivery. Medicaid Accountable Care Organizations— the entities that pay providers for the health outcomes of the patients they care for—are a key focus of MassHealth, and Commonwealth
Medicine shares that focus, working on policy issues such as payment model design and with MassHealth on seemingly intractable problems such as the opioid crisis. “This is an important example of how our expertise helps inform policy,” said Colombo. After a year in the role, Colombo can’t help but note how she continues to be “moved and awed” by the impact and the broad reach that Commonwealth Medicine has. “Wherever I go, I encounter Commonwealth Medicine staff who are engaging every day with people who depend on us for services, sometimes people in distress or great difficulty, and they handle it with such grace and compassion, in large part because of the pride they take in handling these important roles. It inspires me to make sure I perform my role with that same commitment.”
Lisa Colombo (third from left) meets with members of the Disability Evaluation Services leadership team, including, from left, Medical Director Peter Lindblad, MD; Senior Director Frank Joyce; and Clinical Director Jody Simpson.
@ UMASSMED MAGAZINE | 21
BRINGING LIFE TO ONLINE TEACHING
Bringing
to online
The Graduate School of Nursing is embracing innovation in online education to meet the learning needs of postgraduate nurse practitioners n today’s health care environment, advanced practice nurses are increasingly relied upon to provide comprehensive, high quality health care. As a result, nurse practitioners who need new skills to meet expanding patient needs are searching for online courses and degree programs to fit their busy schedules. In particular, nurses are scrambling to add behavioral health to their skills portfolios, in the face of a shortage of mental health care providers. A new postgraduate certificate program for psychiatric nurse practitioners at the Graduate School of Nursing is being taught almost entirely online, aiming to fill the gap with a convenient option for busy adult learners. “A lot of our discussion is about what they do in their clinical setting, bringing it to life online,” said Mechelle Plasse, PhD, assistant professor of nursing, who developed and teaches the pilot program. “Having postgraduate certificate programs online caters to the needs and experiences of working clinicians.” continues on page 24
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FEATURE STORY
teaching
Online teaching doesn’t cast doubt on classroom teaching effectiveness, it just approaches it in a different way, ... I focus on a metacognitive strategy to help students think about how they think. Mechelle Plasse
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BRINGING LIFE TO ONLINE TEACHING
When Dr. Plasse was asked to teach mental health from a computer screen instead of a classroom, she thought it couldn’t be done. Now, she says, “Not only can it be done, it can be better in some ways.” Online education has come a long way since its inception decades ago. Plasse and fellow GSN faculty say it is particularly suited for the learning needs of advanced practice nurses. Online courses employ innovative multimedia and interactive components along with traditional lectures and readings. Digestible “chunks” of text, enhanced visuals and participatory elements like discussion threads offer students a variety of instructional methods to accommodate different learning styles. They also allow flexibility and convenience for working professionals wanting to gain new skills and advance their careers. Plasse, who is a psychiatric nurse practitioner, and GSN instructional technologist/designer Ricardo Poza, MEd, designed the program using best practices for online teaching and learning. The program is designed for nurse practitioners who want to add mental health treatment to a current practice, or to switch their focus entirely to mental health. Soft skills like communication, reflection and self-awareness, essential to providing effective mental health care, are addressed. “Online teaching doesn’t cast doubt on classroom teaching effectiveness, it just approaches it in a different way,” said Plasse. “I focus on a metacognitive strategy to help students think about how they think.” Metacognitive strategies are techniques increasingly used in online education that help people become more successful learners by looking inward to examine how they learn and to judge which methods are effective. For example, in one assignment, Plasse asks students to reflect on a clinical experience involving substance use disorder, put their thoughts in writing and present to another student, who then offers 24 | 2019
Beyond watching a recorded lecture or reading a chapter, these tools allow us to integrate video, graphics, slides and audio with built-in questions for assessments that students can navigate at their own pace. Ricardo Poza
feedback. “Working online gives the student more time to reflect and respond than in a classroom,” said Plasse. “If I’ve asked a probing question, you have fewer distractions when you’re comfortable at home. “Woven throughout is the notion of self-awareness and reflection, so everything I’m having a student do is about having them reflect upon what they thought they knew before, how they performed with what they thought they knew, what they learned so far and has that changed their thinking? There’s an ongoing theme of developing soft skills, including reflection, metacognition and self-awareness, built into every assignment.” Jessica Ventura, DNP, enrolled in the psychiatric nurse practitioner program to obtain the skills and knowledge necessary to integrate mental health care into her full-time practice as a pain management specialist. “There’s no question that chronic pain affects mental health. But no matter what specialty you’re in, mental health issues will come up with many patients for whom you are caring,” Dr. Ventura said. “Having the flexibility to get online when we have time at the end of the day or on the weekends is really helpful to a working person. This program made the most sense in terms of reputation and quality as well as being able to study online.” Ventura is satisfied that while she participates remotely, online platforms provide multiple ways to
interact with Plasse and fellow students—via email on Blackboard, text messages and discussion threads. “The online technique of threaded discussions creates interactive classes,” said Plasse. “You have to be thoughtful about how you do that to keep individuals’ comments from all being the same. For example, asking personal questions where everyone’s answer is going to be different.” She posts images of artwork as prompts for online discussion, asking students to discuss the emotions the images evoke, then talks about that in the context of what they are learning about relationship building. In another pilot for online course delivery, the GSN is offering a hybrid postgraduate program taught in class and online for the adult gerontology acute care nurse practitioner certification. Taught by Dawn Carpenter, DNP, the program enables nurse practitioners to participate remotely in classroom courses being taken by GSN students in other academic programs. “Online postgraduate students can participate synchronously via Zoom, or participate asynchronously by watching class recordings, and doing work on their own,” said Dr. Carpenter, assistant professor of nursing. “Asynchronous class members have the same curriculum, due dates and exams; they’re just doing it on their own time.” Conversely, the traditional students also have a hybrid learning experience in which some work is
FEATURE STORY
Having Ricardo Poza, MEd, a dedicated instructional technologist/designer, on staff has been key to incorporating online modalities into classes. Here, Poza meets with Mechelle Plasse, PhD, who developed and teaches the psychiatric nurse practioner pilot program.
completed online. For example, since class members have different levels of experience in nursing, some already know how to interpret blood gases and electrocardiograms while others don’t. Carpenter posts modules with the foundational information online for review and use on students’ own time as needed for their individual learning needs. “I have the students do reading and write questions with answers and rationales to practice certification exam questions before class, then we share all on Google Documents so I can give them feedback on each question,” Carpenter said. Students then download the material to use to study for their exam as well as their certification. “Classroom learning and online resources are symbiotic. Using both makes learning richer because we’re taking advantage of multiple modes of teaching.” Longtime nurse Catherine Curtis, MSN, RN, is the first graduate of the hybrid adult gerontology acute care nurse practitioner postgraduate certificate program. After researching options, she determined that the Graduate School of Nursing offered the only practical way for her to gain the additional knowledge required for her full-time position as an advanced practice nurse hospitalist in an emergency department.
“After speaking with Dawn, I knew this program would fit my life,” said Curtis. “She made it so easy to communicate and realizes that life happens for adult learners already working in full-time jobs.” Having a dedicated instructional technologist/designer on staff has proven key to incorporating online modalities into classes. Poza employs software, online platforms and learning management systems including Zoom, Blackboard, Kaltura, Adobe Spark and Articulate to create online modules. “Built-in multimedia capabilities enable us to enliven visual and written course material for a richer online learning experience,” he said. “Beyond watching a recorded lecture or reading a chapter, these tools allow us to integrate video, graphics, slides and audio with built-in questions for assessments that students can navigate at their own pace.” In one example, while the postgraduate psychiatric nurse practitioner curriculum does require students to come to campus several times to participate in simulations with patient actors, Poza is currently working with Plasse to make simulations more accessible to offsite students. They will be able to use video platform Kaltura to set up a scripted role play at home with a
friend or family member and record the interaction for review when posted into the Blackboard learning management system. Graduate School of Nursing Dean Joan Vitello, PhD, who earned her doctorate through a hybrid classroom/online program, is enthusiastic that the school is offering online options to enable nurse practitioners, many of whom work full-time, to enhance their skills, enhance their career options, and help meet the shortage of health care providers with doctoral training. “We are always striving for innovative ways to provide educational programs,” said Dr. Vitello. “Embracing online teaching and learning allows us to offer a myriad of learning opportunities to current and future students. We’re very proud of our ability to provide creative ways of sharing knowledge and helping our learners.” Faculty are continuing to explore the potential of online teaching techniques, and the Graduate School of Nursing has more online offerings in the works. “Having successes with new techniques fuels our passion to improve online teaching,” Plasse said. By Sandra Gray
@ UMASSMED MAGAZINE | 25
N E W D I S C O V E R I E S . N E W M E T H O D S . N E W P A T H W AY S .
THE CAMPAIGN FOR UMASS MEDICAL SCHOOL
Promises kept U Mass Medical School has successfully completed its ambitious Pathways of Promise fundraising campaign, surpassing the $250 million goal ahead of schedule. “We embarked on a campaign with the bold aspiration of driving advances with the power to transform the course of human disease and guiding promising students to become world-class medical practitioners, researchers and educators,” said UMass Medical School Chancellor Michael F. Collins. “We discovered a world hungry for our style of creative, rigorous medical science, education and collaboration. The belief and generosity of our community, friends and supporters will strengthen our institution today and for years to come.” Over the course of the campaign, 101 new endowed funds totaling $40 million were created and the institution received the largest single gift from a graduate in its history, as well as the largest gift from a parent. With commitments totaling $4.7 million, the campaign has also helped support financial aid for deserving candidates, as well as curricular and technological
26 | 2019
enhancements that ensure students have access to a cutting-edge academic experience. Through Pathways of Promise, UMass Medical School strengthened ties to the community—both locally and internationally. Close to home, the campaign helped support engagement initiatives, scholarships and programs that create opportunities for residents of Worcester and Massachusetts. Internationally, UMMS researchers are working with communities around the globe to reduce health disparities, strengthen health care infrastructure and education, and develop responses to disease outbreaks and epidemics. Generous donors also made it possible for the institution to continue to invest in attracting and retaining the best and brightest researchers, practitioners and educators. Resources from Pathways of Promise helped create 19 new endowed chairs and five term chairs. Donors supported initiatives that help transform biomedical breakthroughs into lifesaving therapeutics, some of which are now in clinical trials. The establishment of the Li Weibo Institute for Rare Diseases Research was made possible by a $10 million gift, and the launch
Among the initiatives made possible through the Pathways of Promise campaign was the establishment of the Duchenne Program at UMass Medical School. With major support from Charley’s Fund, the program offers an integrative approach to treating young patients with Duchenne muscular dystrophy. Pictured here is Brenda Wong, MD, director of the Duchenne Program, with Tracy Seckler, co-founder with her husband Benjamin of Charley’s Fund, and Charley Seckler, for whom the fund is named.
of a clinical and research program on Duchenne muscular dystrophy resulted from $6 million in financing from a coalition of donors and funders. Recent philanthropy has also played a significant role in advancing scientific discoveries into first-in-human clinical trials, among them a clinical trial for ALS and one for Tay-Sachs disease. “The Pathways of Promise campaign has been
an overwhelming success,” said Vice Chancellor for Advancement John R. Hayes Jr. “The generosity of our alumni, parents, friends, corporations and foundations has been unprecedented and will forever impact, in so many positive ways, the world-class medical research and education taking place at UMass Medical School. Thank you to everyone who supported this vitally important initiative.”
CAMPAIGN HIGHLIGHTS
101 new endowed funds totaling $40.9 million
Largest ever gift from a parent
$300K
$2M
Largest ever gift from an alum
101
For rare diseases research
From the Remillard Family Foundation to support community projects
$4.7M
Student financial aid and scholarships
$3M
$7.5M
From Paul G. Allen Family Foundation to support Ebola outreach
$10M
19/5
19 new endowed chairs and five term chairs
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lastword FAITH NINIVAGGI
M
atch Day, the third Friday in March, is the annual, nationwide pairing of graduating medical students with postgraduate residency
training programs—and one of the most important moments in the life of a physician. Our medical students spend hours comparing programs, visiting academic medical centers around the country and consulting with trusted mentors to find a program that feels right and fits with their aspirations: the perfect match. By any measure, our School of Medicine students do exceptionally well in matching to training programs that are challenging, rigorous and committed to the values we teach. In the 2019 match, our graduates choose— and were chosen by—programs at UMass Memorial, Mass General, Stanford, the Mayo Clinic, Johns Hopkins, Duke, Yale and Brown, among others. True to our founding mission, more than half of our graduates stay in Massachusetts, and more than half choose to train in primary care residencies. Following the extremely competitive match process, the sense of euphoria and accomplishment (and relief!) felt on Match Day make it a truly special moment for all of us who are privileged to teach, mentor and learn with these students. Our students’ undeniable success should not tempt us
Michael F. Collins, MD, Chancellor and Senior Vice President for the Health Sciences
to believe that the resident matching process is working perfectly and as intended. As I, joined by my senior colleagues in the administration of the medical school, described earlier this year in a commentary in the journal Academic Medicine, all is not well with the match. The problems are vivid and alarming: students report being asked about birth control, religion and why they are pursuing residency training when they are married
Common sense reforms will help to protect the careers of these students who have worked so hard to prepare themselves for America’s best postgraduate programs.
with a partner who can support them. In explicit violation of match policy, students are asked how they plan to rank specific programs, posing an ethical dilemma. In
enforcement of the National Residency Matching Program
responding to someone in a position of power, does the
rules restricting questions about how students rank their
candidate speak truthfully and potentially harm their
choices; a prohibition on post-interview communication
chances of matching at the program if it is not their
between students and programs; the elimination of
number one choice? Or do they skirt the truth to protect
second-look days, which are financially burdensome
their future training options?
and pose unfair advantage; and an anonymous system
Clearly, such interview questions are inappropriate, yet students encounter them each year. Common sense reforms will help to protect the careers of these students
to report violations of NRMP policies to an objective ombudsman to help students navigate violations. These sensible reforms are about supporting an
who have worked so hard to prepare themselves for
environment in which future doctors are treated
America’s best postgraduate programs.
professionally from day one. That’s a ‘match game’
What should change? We call for stronger 28 | 2019
all can support.
@umassmed @umassmed is the magazine of University of Massachusetts Medical School, one of five campuses of the UMass system. The magazine is distributed periodically to members, benefactors and friends of the UMMS community. It is published by the Office of Communications. Readers are invited to comment on the contents of the magazine, via email to ummscommunications@umassmed.edu; please include “@umassmed magazine� in the subject line. Chancellor and Senior Vice President for the Health Sciences: Michael F. Collins, MD Executive Deputy Chancellor and Provost, Dean of the School of Medicine: Terence R. Flotte, MD Vice Chancellor for Communications: Jennifer Berryman Editor: Mark L. Shelton Managing Editor: Ellie Castano Writers: Megan Bard, Ellie Castano, Michael Cohen, Jim Fessenden, Sandra Gray, Lisa Larson, Mark Shelton, Sarah Willey Design: Casey Design + Visual Communication Photography: Robert Carlin Photography (except where noted)
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UMass Medical School launches Season 2 of podcast UMass Medical School is highlighting the always interesting and often amazing stories behind the people and pioneering work that takes place here every day with the launch of Season 2 of the Voices of UMassMed podcast. The series seeks to provide rich conversations
with members of the UMMS community so that listeners have the opportunity to learn about who they are and how they contribute to science, medicine, education and public service. Upcoming topics include advances in gene therapy for rare diseases, a pipeline
program in primary care and the Anatomical Gift Program, an invaluable part of medical education and research. A new podcast is released about every two weeks. You can listen to all episodes at www.umassmed.edu/news/ voices and also through iTunes and SoundCloud.
SEASON
Readers, because our mailing lists are supplied by several departments, some of you may receive more than one copy of this magazine. Thank you for passing extras along to others who are interested in UMass Medical School.
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