Dr. Lesley Gotlib Conn

As a medical anthropologist working at one of Canada’s busiest hospitals, Dr. Lesley Gotlib Conn examines important aspects of health care delivery like communication and care transitions, and uses theories and methods from her anthropological training to improve care experiences and outcomes for patients, families, and health-care providers. She also examines the experiences and perceptions of trainees.

“We recently published the results of a study examining North American surgical residents’ attitudes toward the educational value of caring for injured older adults,” says Dr. Gotlib Conn, an associate scientist in the Tory Trauma Research Program at Sunnybrook Research Institute and Associate Director of SHARE. “A major finding of the research was that trainees reported less interest in learning about geriatric trauma care as they progressed through their training. This has important implications for the future of surgical training and care, since surgeons will be increasingly needed to treat the growing population of injured older adults.”

Dr. Gotlib Conn first became interested in education research while working on her PhD which explored the social construction of gender and sexuality in a psychiatric teaching clinic. Her research explored, in part, how learners and trainees in the clinic were socialized to think about gender and sexuality in medical ways. “The study of doctors’ and health professionals’ socialization has a long history in anthropology and sociology and that is what drew me into the field of education research,” says Dr. Gotlib Conn.

Now in her tenth year as a scientist at Sunnybrook, Dr. Gotlib Conn is proud to be advancing education research with SHARE. “At Sunnybrook we are fortunate to have a diverse and highly collaborative group of education researchers who are focused on understanding and improving learning, teaching and clinical training across many health professions. Every year I am more and more impressed by the caliber of the education research that is proposed to our grant competition and presented during rounds and at our annual symposium.” 

Dr. Giovanna Sirianni

As a family physician with a focused practice in palliative care, empathy is a core competency for Dr. Giovanna Sirianni.

Among her many education research interests, she is particularly focused on developing communication skills and the provision of compassionate care, which is in part why she co-created the About Empathy podcast, a healthCARE podcast that focuses on patient, caregiver and health-care provider stories.

“Podcast guests discuss their personal stories, while myself and my co-hosts reflect on those stories to help enable and support empathic interactions in the health-care community,” says Dr. Sirianni. “Our team has undertaken a qualitative exploration of the podcast’s role in education from the perspective of medical students, residents and faculty members.”

The podcast’s role in medical education is just one of many projects Dr. Sirianni is working on at any given time. “Whenever I’m developing a new curricular intervention, assessment method or project, I try to approach each initiative through a scholarly lens to help question, evaluate and eventually disseminate,” says Dr. Sirianni, who is also an Assistant Professor and Enhanced Skills Residency Program Director in the Department of Family and Community Medicine in the Temerty Faculty of Medicine at the University of Toronto.

Her passion for education research is inspired by many of the physicians, teachers and scientists she’s had the opportunity to work with throughout her career. “They modeled the importance of asking provocative questions about our approach to medical education and not accepting the status quo,” says Dr. Sirianni. “They also helped demystify the world of academia and made it accessible for me to feel like I had a place in education research too.”

Dr. Sirianni says that spirit is supported at Sunnybrook, in particular through Sunnybrook’s Education Advisory Council, via their yearly grant program that funds education research projects. “This is a tangible and practical way that we recognize and move forward the work of educators, scholars and researchers.”

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The field placement is an important component of all health-care degree programs. It is the key context in which theory and classroom teaching can be observed, applied and integrated through practice and the process of skill development. In Social Work, the Council on Social Work Education refers to field placements as the “signature pedagogy” of the profession, underscoring the preeminence of this component of the degree.

The issue of how to generate sufficient numbers of student placements in agencies has long been a concern for both universities and the field alike. On the one hand, there has been increasing pressure on the practice community to supervise more students as degree programs have increased their admission quota. On the other hand, hospital settings in particular have experienced well-documented challenges that have negatively impacted their abilities to offer field placements, especially due to high volumes, acuity and complexity of caseloads, as well as restructuring of hospitals and the loss of clinical positions.

Within this context, the social work service at Sunnybrook has developed an innovative and unique approach to ensuring that each of our staff is fulfilling their education mandate in working in a teaching centre. We have developed and implemented a Social Work Student Education Standard (SSES), adopted in May 2010. This is one standard within the profession’s “Standards of Practice” document, which sets out the minimum standards of professional practice, expectations, and accountability for all social workers at Sunnybrook in regard to student education. The aim is to ensure consistency and equity across all areas of practice, and in so doing, to ensure participation in teaching activities, specifically in the area of offering student placements.

In essence, the SSES clarifies the nature and components of social work field education at Sunnybrook and sets forth the indicators and activities for social workers, in line with the University of Toronto Teaching Centre Guidelines. It has been affirmed that such expectations for education should be made explicit in job descriptions and in the process of new staff hiring, as well as incorporated into performance appraisals of existing staff members. Clearly, a key indicator in the SSES is the one that states: “All staff are expected to offer an MSW practicum a minimum of once every 2 years if it is undertaken in a rotational model, or once every 3 years if it is a full placement”.

This standard is really a formalizing of the activities one expects from a staff member who chooses to work at a tertiary care centre such as Sunnybrook, where our mandate includes being a teaching hospital and a centre of excellence in student education. The assumption is that if you choose to work here, you commit to educating students, and to doing so continuously. However, we recognize that such a standard does not speak to the issue of the quality of the education program, nor the subjective approach undertaken by the staff members in carrying out these activities. Indeed, you simply cannot ‘standardize’ a passion for teaching!

Since implementing the standard in 2010, social work staff participation in education activities at Sunnybrook, including offering student placements, has increased. We are currently in the process of evaluating the impact of this standard through a research grant from the Bertha Rosenstadt Trust Fund at the University of Toronto, to be completed in 2014. We believe the SSES is the first of its kind in Canada, and that it will have further positive impacts in its potential for replication across other health care disciplines.

If you’d like more information about the SSES, or would like a copy, please email illana.perlman(at)sunnybrook.ca.

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Want to hear which first-year medical student has a set of pipes that could rival any contestant on the X Factor? And, how about the second-year student who’s been balancing the classroom with the concert stage?

EarthTones organizers 2011 Now’s your chance. EarthTones, an annual benefit concert organized by the medical students at the University of Toronto, showcases the talents of students and faculty in a variety of musical styles – classical, pop, comedic and more.

This year, the proceeds from the concert will go to three organizations that work to better the lives of children both in Canada and abroad: Canadian Feed the Children, CWEF – Tanzania, and Helping Hands International.

When: Saturday December 1st, 2012. Doors open at 6:30 pm. Concert begins at 7 pm. The concert should end by around 9:30 pm.

Location: Convocation Hall, University of Toronto, 31 King’s College Circle, Toronto, Ontario, M5G 3G4

Cost: $25 General Admission, $15 with valid student ID. Tickets can be purchased in advance online at http://earthtones2012.eventbrite.ca. Tickets will also be available at the door.

For more info, please visit: http://uoftearthtones.com.

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As millions embrace the release of The Hunger Games on the big screen, health professional students all across the GTA are gearing up for a battle of their own – entering into the job market.

In preparation for our final test of aptitude and intellect, students spend upwards of six-to-eight years training in demanding post-secondary and clinical institutions.

We write, we present, and we collaborate until we’re sure that we cannot possibly do it again.

And then we do.

This same process is then repeated in the hospital setting where we must prove to our peers and superiors that we are capable and competent. Not a small task when we are also trying to convince ourselves.

During our training, we all develop unique strengths and clinical skills. As the end nears, however, we also begin to realize the incredible number of other students just like us – each with their own set of skills. It is after this realization (and as graduation looms), that conversations about extra learning or networking opportunities become more guarded, and job search strategies become strictly confidential.

At a time of economic uncertainty and instability in healthcare funding, health professional students feel especially vulnerable. As an article in the Globe and Mail last week highlighted, “competition for jobs when the unemployment rate is high has given employers the luxury of being more selective in new hiring’s.” Just reading those words has the ability to increase student anxiety.

Despite this, I myself will enter the job search arena next week. I am keeping my fingers crossed that when I am selected, it is for a job opportunity and not for The Hunger Games. Although at this moment they both seem to be a fight for survival. I know the competition is tough, but I am confident I will be successful in my hunt. My only concern is how hungry I will get before I succeed.

Looking back on my training, I am thankful for my many mentors and teachers both at Sunnybrook and the University of Toronto. They have provided me with the tools I need to begin my career as a Social Worker, and are cheering me on as I take this next step. They have also reminded me that, “we are all learners”, and that although my formal instruction is ending, I have a lifetime of learning ahead of me.

Stacey Creak

Social Work Intern

Sunnybrook Odette Cancer Centre

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If you have found your way to this blog, you are probably already aware of the renewed commitment to education that is underway at Sunnybrook.

As an academic health sciences centre, Sunnybrook has a mandate that goes beyond providing the highest standard of clinical care to our patients. We are committed to creating, translating, and integrating new knowledge into patient care, education, and research. We take seriously the idea that everyone is a teacher and everyone is a learner. In fact, it is likely that it was this active learning environment that drew you to Sunnybrook in the first place.

However, in the midst of all of our activities related to patient care, the business of health care, research, and teaching, it is easy to overlook the idea that that practice of education itself is a focus for research and innovation. Part of our renewed mandate as an academic health sciences centre includes a sharper focus on development, implementation, and dissemination of best practices in clinical education.

There are many excellent and innovative education activities going on at Sunnybrook. Some of these have emerged out of necessity, some reflect the natural talents and instincts of our staff and physicians, and some are the result of focused and deliberate scholarly activity. It is important that we profile these activities, not only within Sunnybrook, but in the larger community. Equally important is the need to explore in a systematic way, how and under what circumstances these approaches are effective.

In our day-to-day work, each of us encounters multiple opportunities to be both a teacher and a learner – working with a student, assisting a new staff member to “learn the ropes”, encountering a job situation that is unfamiliar or unique. As committed lifelong learners, we typically approach these situations using our individual tried-and-true approaches. However these situations can also present opportunities to push ourselves to try something a little different.

Perhaps you’ve noticed patterns in the way different patients respond when you explain routines and procedures. You may have found that you and your colleagues have different ideas about the best way to introduce a new procedure, teach new staff, or master a technical task.

Pay attention to your reflections and hunches. Share them with your colleagues. These are the seeds of education scholarship.

Imagine the possibilities…

Marg Blastorah, RN, PhD

Director, Nursing Knowledge, Research and Innovation

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The Ontario Ministry of Health developed the Just Clean Your Hands (JCYH) program for Ontario healthcare facilities that defines when you should clean your hands. They narrowed it down to the most critical 4 moments of hand hygiene to prevent transmission. If you are about to enter a moment of hand hygiene, stop and clean your hands!

Know and Perform the 4 Moments of Hand Hygiene:

1. Before contact with a patient /patient environment

2. Before conducting a clean procedure (even if gloves will be worn)

3. After potential exposure to bodily fluids (even if gloves were worn)

4. After contact with the patient /patient environment

Figure 1. Just Clean Your Hands – 4 Moments of Hand Hygiene

When on the Unit, Take Note and Locate Alcohol-based Hand Rub Stations.

Having Alcohol-based Hand Rub readily available is just as important as remembering and performing the 4 Moments for Hand Hygiene. Alcohol-based Hand Rub is the preferred method for Hand Hygiene over traditional soap and water at point-of-care.

The next time you’re on a Unit, take a look around and see if you can spot where all the alcohol-based hand rub bottles are located. If there isn’t one near the entrance or at the bedside speak up and bring it to the attention of a staff member or the manager.

Public Health Ontario has loads of great resources available online just visit: http://www.oahpp.ca/services/jcyh/index.html and click the links for your needs.

We Want Your Input!

Healthcare provider compliance with hand hygiene has traditionally been challenging because of the changing environment and conditions in which healthcare providers work.

Within healthcare provider groups, the physician group has made great strides, but there is room for more improvement, especially among residents and fellows.

If YOU have an idea on how to raise awareness for Hand Hygiene in your area WE want to hear about it! We want to make it safer for patients one hand at a time.

Contact Ben de Mendonca in the Quality and Patient Safety Department by e-mail at ben.demendonca@sunnybrook.ca if you have specific ideas or want to learn more.

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