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The 21st Century Medical School and the “Flipped” Classroom

Sep 30, 2014, 9:30 AM, Posted by Susan Dentzer

Flip the classroom video still

Pity the poor medical student...or at least many students now slogging away in medical schools across the nation.  

Most spend the first two years of medical school cramming their heads with facts about the functions of cells, organ systems, and other aspects of the human body. Having contact with real patients—the reason most students went to medical school in the first place—is quite limited until the third year, when clinical clerkships begin.

Meanwhile, medical knowledge is exploding, doubling every five years, and taxing the human brain’s capacity for processing and recall. Today’s medical students know that one day, they’ll be most likely to practice medicine with the aid of “cognitive computing” systems like IBM’s Watson, which has already “learned” as much as a second-year med student, and is helping clinicians at the Mayo Clinic, Memorial Sloan-Kettering Cancer Center, and other institutions process reams of medical information to make clinical decisions. 

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Bringing in Diverse Perspectives to Build a Culture of Health

Sep 24, 2014, 9:00 AM, Posted by Lori Melichar

Susannah Fox Susannah Fox, RWJF Entrepreneur in Residence

Entrepreneurs start from a place of passion, then work tirelessly to make others see their vision. I'm excited to announce that Susannah Fox will be pushing all of us at the Foundation to behave more like entrepreneurs.

This month, Fox began a new role as the Foundation's next entrepreneur in residence. She was previously an associate director at the Pew Research Center’s Internet & American Life Project, where she combined traditional survey research with field work in online patient communities. She excels at using data and storytelling to compel policymakers, consumers, and entrepreneurs to understand and discuss key health care issues.

To build a Culture of Health in the United States, we have to consider new approaches and ways of thinking. We need the creativity, imagination, and efforts of people from a range of backgrounds and industries to develop innovative solutions to our most pressing health and health care challenges. A health and technology researcher and trend spotter, Fox will be a valuable asset to these efforts.

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I’m RWJF’s Newest Entrepreneur in Residence

Sep 23, 2014, 1:54 PM, Posted by Susannah Fox

Susannah Fox offers office hours at RWJF. Susannah Fox offers office hours at RWJF.

I am thrilled to begin my job as the entrepreneur in residence (EIR) at the Robert Wood Johnson Foundation.

You might think that the EIR role is traditionally associated with venture capital firms, not foundations. But scratch the surface and you’ll find commonalities between the two industries. Both VCs and philanthropists have daring ambitions, place lots of bets, and hope for a big pay-off every once in a while. The difference is that a philanthropy like the Robert Wood Johnson Foundation places a priority on societal dividends, such as greater access to health care or a reduction in childhood obesity.

I also like this definition of entrepreneurship: “The pursuit of opportunity without regard to resources currently controlled.” That fits the Foundation to a T as we pursue the audacious goal of building a Culture of Health in the United States.

But how will we measure success? How will we know if our bets ever pay off, especially when we are talking about culture change? I have a story to tell that I think illustrates how a small grant can make a big difference in the world.

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Coming to the Rescue of Young Men of Color

Feb 27, 2014, 4:30 PM, Posted by Maisha Simmons

The Alameda County Public Health Department's EMS Corps program is supported by the Robert Wood Johnson Foundation.

When he was 17, Dexter Harris was good at two things: football and hustling. Although he went to school, he spent most of his time trying to earn money. He wasn’t thinking about his future. He was thinking about surviving the here and now.

Instead of finishing his senior year, Dexter found himself in a California juvenile facility. There, he met a mentor named Mike who told Dexter about a new program, EMS Corps, that offered far more than emergency medical training (EMT) classes. EMS Corps also provided tutoring, mentoring and leadership classes, and was looking for people from the community who were willing and ready to serve in the emergency services field.

After hearing about EMS Corps, something changed for Dexter. He weighed his options and saw that with EMS Corps he could actually have the chance for a different life. Dexter threw himself into studying, and eventually graduated first in his EMS Corps class. As a certified EMT, Dexter now has a career with Paramedics Plus and returns to the juvenile facility to teach other young people about being a First Responder.

Dexter Harris Dexter Harris

In every community there are young men like Dexter who have the potential to succeed.  But like most young people, they need help and support to bring out their best.

Today, I was honored to be present at the White House as President Obama helped to add more momentum to a growing movement to expand opportunity for young men of color. I was joined by leaders from both the public and private sector committing their intellect, creativity, passion and resources to continue to identify solutions for men and boys of color.

I was inspired by the continuing and new energy to ensure that every young man has the opportunity make healthy choices and has the tools to live a healthy life. That includes skills to succeed in school and work. EMS Corps is just one bright light among the many innovative and inspiring approaches that the Robert Wood Johnson Foundation has been proud to support as part of its effort to create a culture of health and opportunity for all young people.  This new national initiative announced at the White House brings a new chance to build upon this exciting and important work.

It’s not just EMS Corps. Look at our Forward Promise partners to see the richness of programs already lifting up young men. It’s not just the White House and our Foundation colleagues in this movement either. There are thousands of teachers, police chiefs, state and local legislators, judges, church leaders, and community based organizations from across the country that are taking steps to ensure that all young people in America, including our young men of color, have the opportunity to succeed. If our job is to build a culture of health for all young men, then those collective efforts are its vital building blocks.

As I arrived at the White House this afternoon, I couldn’t help but think of Dexter. And of all of the “Dexters” who will benefit from this unprecedented moment of commitment to hope, change, and opportunity for our sons, brothers, students and neighbors. I’m proud to be a part of the Robert Wood Johnson Foundation and of this larger movement. Together we can bring out the best in our young men. And they—in achieving their promise—can bring out the best in all of us.

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What Would Melanie Do?

Jun 25, 2013, 11:20 AM, Posted by Beth Toner

 A critical response medical team walking in a hospital corridor.

The Robert Wood Johnson Foundation has long been committed to the improvement of nursing education—and to supporting academic progression in nursing. While nursing shortages may wax and wane, it’s clear that the baby boomers will need high-quality nursing care as they move into later life. Meanwhile, nursing schools turn away more than 75,000 qualified applicants each year.

In short, really good nurse educators have never been more necessary, yet they are increasingly in short supply. Last week, we lost one of the best I’ve ever known.

I heard about Melanie’s death, sadly, the way we sometimes do when we’ve lost touch with people—via a community college classmate on social media. Melanie had learned she had pancreatic cancer in January—and given a grim prognosis; in the end, she lived less than five months after diagnosis, dying far too young—at the age of 58. In the first awful moment, I felt a crush of regret that I’d learned of her death this way. And then I found myself smiling, thinking of when I’d first met Melanie on a warm August night in 2008—squeezed into a stuffy and cramped classroom with 31 other people in a room better suited for 15.

We were, all of us, first-year nursing students on our very first day of nursing school. We were, in many respects, a motley crew—ranging in age from our early 20s to our early 60s (I was somewhere in the middle). Stay-at-home moms rejoining the paid workforce, retired Army medics, and second-career students (like me) all shared one emotion that evening: fear. How would we manage full-time day jobs and evening/weekend classes and clinicals? From studying material that was completely foreign to me—with what felt (at the time) like a worthless master’s degree in journalism—to learning tasks that seemed incredibly complicated (how could I stick a needle in another human being?), I didn’t feel up to the task ahead. What the heck had I been thinking? Me? A nurse?

Melanie gave us an overview of the semester ahead. She calmly answered each agonized question we asked her. As she wrapped up her remarks, she smiled at her nervous charges and said, “I know you feel overwhelmed right now, and you feel like there’s so much to do. I’ll just remind you that you can do this the same way you’d eat an elephant: one piece at a time.”

It was exactly the right thing to say at exactly the right time. Melanie would repeat those words to me—often just saying “one piece at a time”—when she saw me in the hallway, agonizing over a clinical skill I hadn’t mastered or a lab value I couldn’t remember, more times than I can remember. I would often come to class exhausted and near tears from a grim day in corporate America, but Melanie would, with her real-life stories of patients to illustrate that night’s lecture, remind me why I had decided to become a nurse in the first place. We knew her for her pithy summary of the most obvious fact (“smoking is baaaaaaaaaaaaad!” she would say in a near-hiss), but also for her fierce love of, and advocacy for, each and every patient.

I made it through nursing school, passed the NCLEX, and thought of Melanie as I worked weekends in long-term care. If my patient had been Melanie’s mom, what would she have wanted me to do for her? When I felt as if I couldn’t make it through my first night shift alone, I remembered Melanie’s words of advice on that first day.

I thought of her again last week, and realized what a loss the world of nursing education suffered with her passing. It’s not only important to support our nurse educators—and to encourage others to join their ranks—but to thank them for sharing their love of nursing and their patients with us. I never got to say a proper “thanks” to Melanie. But you can bet that I’ll remind each nursing student I see that she (or he) can get there, one piece at a time.