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April 2014 Newsletter

 
In this edition:

Ken Roberts on WSU medical school feasibility

Medical students hear pitch for rural practice
Using Native stories as a teaching tool
Working together to revise medical teaching
Finding new tools to teach medical students
Awards, presentations, publications, patents and jobs
Upcoming events
Final notes


From Medical Sciences director Ken Roberts

Word is spreading about Washington State University’s interest in creating an independent, fully-accredited medical school on the WSU Spokane campus.

President Elson Floyd and WSU Spokane Chancellor Lisa Brown made the formal announcement during a meeting of Spokane business and medical leaders in early April.

For several reasons, Dr. Floyd, Dr. Brown and I believe Washington needs to train more medical students as part of a strategy to increase the state’s physician workforce, especially in rural and underserved urban areas.
  • The need for doctors is growing in Washington as the Affordable Care Act drives more people to buy health insurance. The state’s Health Benefit Exchange reports nearly a million Washington residents have been used its website to buy insurance.
  • Our population, especially in rural areas, is aging and as people age they generally need more care.
  • Our physician workforce is aging too, with doctors leaving the profession at a faster rate than we are replacing them.
  • Washington isn’t training enough doctors. It only offers 120 medical school seats for its citizens in its publicly-funded medical school each year. Last year another 220 Washingtonians who weren’t accepted in-state had to leave the state to start their medical education.
How we're proceeding

WSU has hired the consulting firm MGT of America to research the cost and process involved in creating a new medical school.

MGT has impressive credentials. What caught our eye was the firm’s work in helping Florida State University build a new medical school about 10 years ago.

MGT staff members have already visited Spokane and our campus to conduct a round of interviews and collect information that my staff and I have been compiling. We expect to receive some preliminary findings in May and a final written report by mid-summer.

Once we have that information, WSU can make the determination about whether to move forward and create a medical school. As we wait, we’re engaging in important conversations with people at many levels: elected leaders in federal, state and local offices; business and health care leaders, including local physicians, and medical students.

Media around the region – and beyond – have reported on the university’s plans and editorial boards have begun issuing their opinions.

It’s the right time for this

Our medical school explorations come during an exciting time for our program.
  • The Medical Sciences program, which includes medical education, and the College of Pharmacy are now operating in their new shared building on campus. Both programs are busy adding faculty and expanding their research programs. All of the lab space in the building has already been assigned.
  • WSU Spokane is moving forward with plans to build an on-campus medical clinic that will serve the community and give health sciences students from several programs a place to develop their skills. It is scheduled to open in 2016.
  • The clinic will be home to 18 new medical residents, thanks to a recent federal grant. The city’s Family Medicine and Internal Medicine residency programs, now at Sacred Heart, plan to relocate to the new clinic.
  • The WSU Board of Regents will vote in early May whether to create the College of Medical Sciences, consolidating medical research and education with our new partner, the WSU Department of Speech and Hearing Sciences.

The infrastructure is in place if WSU and the state decide to move ahead with a second publicly-funded, fully-accredited medical school. Many states with similar populations allocate far more training slots for doctors. It’s time for Washington to catch up with the rest of the country.

Read more about WSU's decision to explore a new medical school at medicine.wsu.edu.

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Words of wisdom from Colville


Medical residents Matt Kaiser, Mo Campbell and Paul Gloe tell WWAMI medical students about working in Colville.

Every year Dr. John McCarthy takes a group of WWAMI (Washington Wyoming Alaska Montana Idaho) medical students on a road trip. McCarthy is one of two University of Washington School of Medicine assistant regional deans based at WSU Spokane and an energetic promoter of rural medicine.

One April morning his chartered bus pulled up next to the Pharmaceutical and Biomedical Sciences Building and took on students ready for the 70-mile trip north to Colville. The excursion was funded by the group Friends of WWAMI Spokane.

This year, though, the entourage was larger than usual. For the first time, about 20 WWAMI students from Moscow and Pullman were making the trip; they joined a dozen or so from Spokane. And instead of McCarthy leading the commentary on the ride out of town, Pullman internist Dr. Stephanie Fosback, a Colville native, was in front, presenting a Powerpoint presentation about the need for more rural doctors.

“I wanted to work in an underserved area and also have the chance to teach,” Fosback said. “And now I do some outpatient work, I do some work in the ICU (intensive care unit) and I do lots of operations. I love the variety.”

Fosback’s teaching duties include participating in a clerkship for third-year medical students. This spring, she and her colleagues are hosting an internal medicine resident for a month. In 2015, she says they will host a third-year medical student for four months as part of the WRITE (WWAMI Rural Integrated Training Experience) program.

Fosback says she wanted to practice in Colville after her residency, but her husband – also a Colville native -- found an engineering job in Pullman and they like the town’s school system for their children. For those reasons, she says Whitman County is a better fit for them right now.

The pros and cons of working in a small town

When the bus reached Colville, the first stop was not at Providence Mount Carmel Hospital, as in past years, but at Hearth and Home, a company that makes fireplaces and other heating devices.

“I want them to see the types of industry that drive small-town economies like Colville’s,” McCarthy said.

After a short visit there it was off to the hospital for a brief tour and then lunch at the Garden Homes Clinic, where the students ate with two local doctors and the three family medicine residents associated with Colville’s Rural Training Track medical residency, the oldest such program in the nation.

The students heard from third-year resident Dr. Matt Kaiser and second-year resident Dr. Paul Gloe, who are doing their training in Colville, and first-year resident Dr. Mo Campbell, who is based in Spokane this year, but who will move north to the Stevens County town in September.

Campbell, a native of Ely, a small town in northern Minnesota, said she has long known that she wanted to work in a small town and was recruited to apply for the Colville residency.  

“I came here because primary care is really valued in the Northwest,” she said. “This residency is known for the range of opportunities available to new doctors.”

Also at the table were Dr. Katrina Gardner, a North Dakota native who recently finished her Colville residency and has stayed in the area to practice, and Dr. Kal Kelley, a Montana native and former Colville resident who started his medical career in eastern Oregon.

The five doctors shared stories about the challenges and joys of small-town medicine. They also talked about their roles as visible people in a small town, about trying to maintain some sense of private life and about the professional and personal isolation they sometimes feel.

After lunch, while the students lingered outside before boarding their bus for the ride back to Spokane, first-year student Cyrus Haselman said he was impressed enough by the Colville residency that he might look into it when it’s time for him to consider that.

If he does, he may find the Colville residency is unusually competitive as far as rural training track programs go. Campbell says the RTT received 100 applications for the newest resident, an Arizona native with a background in international medicine who will start the first year of his residency in Spokane in the fall.


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Native stories’ project provides learning, cultural awareness


Speech and Hearing Sciences students Viktoriya Barabin, Suzanne Matson and Sandra Larios were among those presenting Native stories at a ceremony attended by a representative from the state school superintendent's office.

Story and photos by Judith Van Dongen

From the legend of the skunk and how it got its stripes to the tale of the brave, little crab that survived the storm—in a classroom reconfigured to form a traditional talking circle, 34 students took turns presenting a Native American story before passing a smooth, round stone to the next presenter. The presentations concluded a service-learning project that will help ensure that Washington state public and tribal schools will have continued access to the Northwest Native American Reading Curriculum, a culturally responsive learning resource for grades K through two.  

The project was organized by associate professor of speech and hearing sciences Ella Inglebret as part of her undergraduate course on language and literacy.

The idea first came to Inglebret when she heard from superintendents and principals throughout the state that they would not recommend use of materials that were not aligned with the Common Core State Standards, the new national K-12 learning standards that were recently adopted by the state.

“It made me think of the Northwest Native American Reading Curriculum, a 12-year old resource that hadn’t yet been aligned with the Common Core for English Language Arts and Literacy,” said Inglebret. “The more I thought about it, the more it seemed like this would provide the perfect service-learning project for my students. As speech-language pathologists, we have a strong foundation in language, and our professional association has been advocating for us to take a leadership role in implementing the Common Core State Standards across K through 12.”

Inglebret partnered with the Office of Native Education within the Washington state Office of the Superintendent of Public Instruction (OSPI) to plan and implement the project. She divided her class into teams of three students each, with each student taking on a story related to one of three themes: the drum, the canoe, and hunting and gathering.

Students were asked to analyze text complexity for each story, looking at meaning, structure, and knowledge demands and calculating readability scores to arrive at an assigned reading grade level.  

They then aligned the curriculum’s learning activities and expected outcomes with the Common Core State Standards and came up with differentiated instructional strategies that could be used to facilitate language learning for students with disabilities or English language learners.

For the final presentation of their work, which was attended by OSPI Native Education Program Supervisor Robin Butterfield, the student teams created posters to summarize their work. The students also presented key findings on their stories and reflected on what they had learned from the process.

“I really enjoyed learning about how Native Americans teach morals and values to children through these stories that really engage them,” said one student.
 

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Working together to change the way teaching happens
By Dr. Alisa Hideg
 
WWAMI Spokane medical students are accustomed by now to being the first at many things. This is especially true for the second-year medical students of 2013-14.
 
Spokane is the pilot site for a two-year University of Washington School of Medicine experiment examining whether the second-year curriculum can be adapted for non-Seattle sites in the WWAMI region (Washington Wyoming Alaska Montana Idaho).
 
During this academic year each of the second year courses has been taught in a small group setting of anywhere from two to 19 students with an emphasis on using “flipped classroom” techniques and small-group dynamics with peer teaching.
 
Preparation for each day’s topic in the “flipped classroom” format is done prior to that day of class. In all of the Spokane courses there are cases used to help students learn to think creatively and more intuitively with the facts they are actively digesting. Many of the courses here also have daily quizzes on each day’s topic to help reinforce the material and encourage students to come prepared.
 
Courses taught in Spokane have required significant adaptation by the four faculty “guides” to make the material work in this new setting. Students watch prerecorded lectures from Seattle; some are shorter and done just for the flipped classroom format and others are longer – often recorded during the regular lectures at UW. Students read and prepare for the class with numerous resources, some assigned and others they have chosen with their future medical licensing exams in mind. 
 
One course, “Mind, Brain & Behavior,” took an even greater leap. A Seattle colleague – Dr. Marcella Pascualy, psychiatrist and UW faculty – and I completely redeveloped the course for both Seattle and Spokane.  Neurology faculty in Seattle and pharmacology faculty in Spokane worked with us to prepare the materials for this course. First we chose neurology and psychiatry topics based on requirements for board exams and preparation for students’ upcoming psychiatry and neurology rotations in the third year.
 
We distilled the essentials of each topic and the applicable pharmacology into handouts and tables that were supplemented with assigned readings from online neurology and psychiatry texts and the “First-Aid” book for psychiatry boards. A few lectures were prerecorded for the Spokane students. Reading and reviewing assignments prior to class was the expectation for both Seattle and Spokane students.
 
Seattle is working towards a small group format like Spokane’s, but they still had lectures this year due to the student-to-faculty ratio there. However, the lectures were more interactive than the traditional format used in the past. Both Seattle and Spokane students had daily quizzes and there was not a final for “Mind, Brain and Behavior.”  
 
We are already making plans to further revise the “Mind, Brain and Behavior” course. Dr. Mara Rendi, pathology faculty at UW, may incorporate applicable pathology material into the course for next year. Quiz questions and cases will be revised and handouts with other assignments improved. Students in Spokane and Seattle have already been making their suggestions.
 
As we move forward into the future of medical education, there will be a lot of “firsts”.  WWAMI Spokane is helping to lead the way as we work together with our UW colleagues moving our courses into active learning, small groups and new challenges.
 
We work in a world of constant change -- part of both the joy and stress of academics. Yet this school year will always be remembered as a year of firsts in Spokane: first group of second-year WWAMI Spokane medical students, first course to be completely revised in preparation for 2015, first time “Mind, Brain  and Behavior” was graded entirely by quizzes, and the first course to be redeveloped across multiple departments and multiple locations (Spokane WWAMI site and UW) in a cooperative and creative way.
 
Dr. Alisa Hideg is a family practice physician and one of four “guide” faculty for the second-year medical education program on the WSU Spokane campus.


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Teaching physician-teachers new tricks


Brian Stamm (left, with beard), Bob Maurer (blue shirt) and Chris Behne were among the doctors learning new ways to engage with medical students.

What is the best way to teach medical students and/or resident doctors about, say, psoriatic arthritis or new federal cholesterol guidelines?
 
If you like traditional methods, you might write an outline, create a few Powerpoint slides and give a lecture. But lectures aren’t always effective ways to impart information, says Lynne Robins from the University of Washington School of Medicine.  

Robins and her colleague Chris Surawicz recently led a group of 90 doctors in a workshop aimed at giving physician-teachers new tools to engage their students.
The event was held in the auditorium of WSU Spokane’s new Pharmaceutical and Biomedical Sciences Building.

“We can’t just mind meld students with what we want them to know,” Robins said. We have to help them develop their own ideas and thinking skills, she said.

To “stretch your imaginations and show you new teaching methods”, as she put it, Robins split the participants into groups of six-to-eight and gave each set of doctors a deck of cards, which offered different options for engaging students.

In one group, Dr. Matt Hollon dealt the cards to six colleagues. They thumbed through them and discussed the relative merits of the teaching strategies. One physician was interested in how she could tell students about new federal cholesterol guidelines. Another wondered about how he could explain the nuances of psoriatic arthritis.

They discussed a variety of presentation methods, from roleplaying to “expert” interviews. The physicians pondered social media uses, scavenger hunts, and even an old technique used by pioneering broadcast journalist Edward R. Murrow that he entitled “This I Believe,” in which a person writes and reads a short essay based on a closely-held personal belief. “This I Believe” has been revived and used in recent years on National Public Radio programs.

Some of the new teaching methods are already in use in Spokane doctors’ offices and medical school classrooms.

One doctor in Hollon’s group said he used roleplaying to teach his residents about hospital billing techniques. It’s effective and fun, he said; the students really got into it.

Another physician opined that roleplaying could be useful in teaching about arthritis by using different scenarios to expose students to patient points of view and treatment options.

A neonatologist said when a nurse calls him at home with a question about a baby, he asks to have the phone placed near the baby so he can listen to them. So the doctor decided to use that as a teaching tool. He plays the sounds of babies recorded over the phone for students and residents to help them discern healthy babies from sick ones.

Othello physician Randy Bunch said his strategy for teaching first-year medical students who come for month-long summer visits is to get them involved in research projects that might have some application at his practice.

After the workshop, some attendees said it was a useful exercise.

“The discussion with others with different backgrounds gave rise to great ideas,” wrote one physician on a follow-up evaluation form.

“I cannot be an effective educator without interactive learning,” wrote another.

When asked what they would likely do differently in their practice as a result of what they had learned that evening, one wrote, “Try to teach the students the way they like to learn instead of the way I like to teach, or at least compromise.”

Another wrote: “Engage students more emotionally and create learning experiences rather than ‘teaching’.”

Another promised to “put more mental energy into prep time with students.”

Workshop organizers say they were surprised and pleased by the strong physician turnout. They hope to hold other events later on.

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Awards, presentations, publications, patents and jobs

Awards:
  • WWAMI assistant regional dean John McCarthy received the Spokane County Medical Society’s “Physician/Citizen of the Year” award at the society’s annual dinner. The society honored McCarthy's contributions to the medical profession and community. In addition to his work as WWAMI clinical coordinator, McCarthy works as a resident faculty member for Family Medicine Spokane, teaches first-year medical students on the WSU Spokane campus and serves as Okanogan County’s public health officer.
  • Medical Sciences director Ken Roberts will receive the WSU’s President’s Award for Leadership during a ceremony April 24 in Pullman.
  • Samantha Riedy (postbaccalaureate research assistant) and Brieann Satterfield  (graduate student) from the Sleep and Performance Research Center will receive a Sleep Research Society Abstract Merit-Based Award at the SLEEP 2014 national conference in Minneapolis, May 31-June 4.
  • Research professor Hans Van Dongen has been elected to a three-year term on the board of directors of the Sleep Research Society.
     
Presentations:
  • May 11-15: Medical students Erik Larson and Halloran Peterson will present research posters at the International Leksell Gamma Knife Society meeting in New York.
  • May 16-21: Medical student Danny Olson will present an abstract of his research at the American Urological Association annual meeting in Orlando, FL. 
Publications:
  • Assistant professor Weihang Chai was a co-author of “Rare Missense Variants in POT1 Predispose to Familial Cutaneous Malignant Melanoma,” published online March 30 in the journal “Nature Genetics.”
  • Assistant professor Bin Shan was one of the authors of “Prevention of CpG-induced Pregnancy Disruption by Adoptive Transfer of In Vitro-induced Regulatory T Cells,” published online April 8 by “Public Library of Science.”
  • Associate professor Kenn Daratha was one of the authors of “Rapid Response Team Implementation and In-Hospital Mortality,” published online April 16 by the journal “Critical Care Medicine.”
Patents: Jobs:
WSU Medical Sciences/WWAMI Spokane has posted this open position:
  • Clinical Assistant Professor
Please check the WSU jobs page for more information.

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Upcoming events

May 9: ASWSU Spokane commencement breakfast, 9 am, Phase 1 Classroom Building, second floor studio (open to each graduating student and up to four of their guests). Contact the WSU Spokane student affairs office.

May 9: WSU Spokane commencement ceremony, 2 pm, Spokane Convention Center
Exhibit Hall C

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Final notes

Dr. Paula Silha takes advantage of a 'teachable moment' with first-year medical student Emily Bulley and third-year medical student Heidi Shovell during an examination at the House of Charity's Saturday morning clinic. Medical students organize and staff the clinic under the supervision of local physicians.


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WSU Medical Sciences combines a thriving medical education program with our partner, the University of Washington School of Medicine's WWAMI (Washington Wyoming Alaska Montana Idaho) program, a growing medical research portfolio and WSU Speech and Hearing Sciences. Read more about us at medicalsciences.wsu.edu.
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