Eva’s Excerpt January 2020

On January 20th, we recognize Martin Luther King Jr. Day. Although advocacy for the creation of Martin Luther King Day began shortly after his assassination in 1968, it was not until 1983 when Ronald Reagan signed it into law as an official holiday. Moreover, it was not until 2000 when all 50 states recognized it as a legal holiday. I bring this up because important change is often slow- especially at the beginning.

We can see this here at the School of Medicine and in St Louis. That is certainly not for a lack of trying or for a lack of significant success. Under Dean Ross’ and Dean Stevenson’s leadership, we have made marked strides in the diversity of our student body. Since 2010, the number of students who self-identify as under-represented in medicine (URiM) has almost doubled with nearly 20% of the current first and second year students self-identifying as URiM. In recent years, new programs were developed to enhance URiM resident, fellow and faculty recruitment and retention. OUTMed has seen massive support and growth with a new mentoring program and enhanced engagement in student recruitment. The appointment of our first Associate Vice Chancellor for Diversity, Equity and Inclusion, Dr. Sherree Wilson, resulted in the creation of enhanced educational programming on diversity and equity and has created new conversations on campus. We are proud residents of the St. Louis community. Over the years, we have invested in urban renovation, biotechnology incubators, and community partnerships to improve the health of all St. Louisans. All of these things have made an important impact.

Yet there is much to do. The population of healthcare professionals and scientists is nowhere near representative of the population we serve. Like other schools, we have identified structural racism in standardized tests as a major challenge to equity in grading and therefore opportunity. We are confronting unconscious and conscious biases in our systems and ourselves. We face massive economic, social, health and healthcare disparities in the St Louis region. These and others are daunting problems without easy solutions. Problems that are born from centuries of racism and inequity.
But, I believe we are near a tipping point- that place where complex change begins to occur more rapidly, snowballing into a new future, no longer of incremental change, but change of a more sudden and sweeping nature. That change stands on the foundation of years of painstaking work that is done before it. Why do I say this? This year, we have seen increased applications from students underrepresented in medicine. Our Dean has made a substantive financial commitment to scholarships, both need-based and merit, an issue, which frequently hampers both applications to medical school and effective recruitment of students from disadvantaged backgrounds. Dr. Wilson and her team are engaging in a number of new initiatives that will increase and sustain our student, staff and faculty diversity while enhancing the cultural climate on our campus. In this issue of the newsletter, we highlight two senior leader recruitments who add important diversity to the leadership of our school. Chancellor Martin has announced critical new initiatives to transition us from Washington University in St Louis to Washington University for St Louis.

In July, the School of Medicine will launch a new curriculum for medical students. In addition to expanding on the work already done in the existing curriculum to train students in health disparities and social medicine, we are expanding our partnerships with community organizations. Dr. Ross was recently named the Principal Officer for Community Partnerships and Dr. Laurie Punch is spearheading our efforts to collaborate with both healthcare and non-healthcare organizations for this curriculum. The Gephardt Institute on the Danforth campus has expanded its reach and increased its programming and support for community engagement. Siteman, the ICTS and our clinical partners are also expanding their engagement in and with our community and doubling down on their investments to reduce health and healthcare disparities. We are perhaps more aligned and engaged with community partners than we have ever been.

So, in this month of remembrance of the great Dr. Martin Luther King, I am truly hopeful. Hopeful that we are reaching a tipping point here in St Louis. Hopeful that we will see a more rapid transition toward equity than we have yet seen. Hopeful that together, we will see the place of Dr. King’s dream speech. Yet, it is clear that we cannot rest and there is much, much to be done. For as Dr. King so eloquently stated:

“We are not satisfied and we will not be satisfied until justice rolls down like waters and righteousness like a mighty stream.”

I wish you resilience and hope in the important work that is to come.

St. Louis Integrated Health Network-led Enhanced CenteringPregnancy Collaborative Receives First Place

FOR IMMEDIATE RELEASE

Contact: Kelly McKay-Gist
St. Louis Integrated Health Network
Phone: 314-657-1506
Email: kmckay@stlouisihn.org

St. Louis Integrated Health Network-led Enhanced CenteringPregnancy Collaborative Receives First Place in Council on Patient Safety in Women’s Health Care National Improvement Challenge on Reduction of Peripartum Racial and Ethnic Disparities

The Council on Patient Safety in Women’s Health Care has awarded the Enhanced CenteringPregnancy Collaborative first place in their 2019 National Improvement Challenge. The Council on Patient Safety in Women’s Health Care represents over twenty health care and patient advocacy organizations united to provide safe health care for every woman. The 2019 National Improvement Challenge required entrants to show successful implementation of one of the Council’s patient safety bundles in combination with a patient safety framework designed to increase equitable pregnancy outcomes.

“We are grateful for the support of the Council on Patient Safety in Women’s Health Care,” said Kelly McKay-Gist, Program Coordinator at the St. Louis Integrated Health Network for the Enhanced CenteringPregnancy Collaborative. “Eliminating racial and ethnic disparities and accelerating racial equity is our core mission and we are thrilled to be able to improve health outcomes and change care delivery.”

The Enhanced CenteringPregnancy Collaborative seeks to: 1) Reduce patients inequitable adverse pregnancy outcomes and buffer against trauma and stress. 2) Provide intensive trainings for health care teams to support patients who are experiencing trauma, depression and psychosocial stress as result of racism, and 3) Increase shared accountability to promote direct practice changes while catalyzing system level changes to ensure community members and health care teams are working together to eliminate racial disparities through development of innovative solutions, policies and new approaches to care delivery. The effort brings together a trans-disciplinary collaborative representing key St. Louis health care institutions, community collaborators and community-based organizations. The entire effort is planned and executed in partnership with community collaborators, who bring the voice of women seeking and accessing care throughout the area.

“This necessary work centers the women and babies shouldering the greatest burden of health disparities in our region –Black moms and babies,” said Dr. Melissa Tepe, Vice President and Chief Medical Officer at Affinia Healthcare and Chair, Enhanced CenteringPregnancy Collaborative. “It is powerful because the work is led by the community, implemented by a collaborative, region-wide, diverse health care team, and increases the vitality of moms and babies in our communities.”

Outcomes from the Collaborative’s innovative pilot group prenatal care model indicate a promising trend in lower rates of preterm birth, lower rates of depression and higher birth weights.

Partners and group prenatal care sites include:

  • Community Collaborators: Jessica Belton, Joie Cruesoe, Jenelle Norman, Teneisha Parks, Cheron Phillips and Richelle Smith
  • Affinia Healthcare
  • BJC Healthcare Barnes-Jewish Hospital
  • CareSTL Health
  • Family Care Health Centers
  • Flourish STL
  • Good Shephard Children and Family Services
  • Jamaa Birth Village
  • Mercy Hospital -St. Louis
  • Saint Louis Integrated Health Network
  • Saint Louis University School of Medicine
  • SSM Health St. Mary’s Hospital
  • Washington University in St. Louis School of Medicine

Other award-winning programs the Council selected for the 2019 National Improvement Challenge: Rutgers-Robert Wood Johnson Medical School (2nd place), University of Maryland-St. Joseph Medical School (3rd place), and Penn Medicine-Hospital of the University of Pennsylvania (4th place).

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The Council on Patient Safety in Women’s Health Care seeks to continually improve patient safety in women’s health care through multidisciplinary collaboration that drives culture change. The National Improvement Challenge, offered annually, seeks to improve women’s health care through the development of patient safety and quality improvement projects and to foster a culture of collaboration, teamwork, patient safety, and communication between clinicians and patients while concurrently increasing widespread implementation of the safety tools and resources put forth by the Council on Patient Safety in Women’s Health Care.

The St. Louis Integrated Health Network, through collaboration and partnership, strives for quality, accessible, and affordable healthcare services for all residents of Metropolitan St. Louis, with an emphasis on the medically underserved. IHN members include five community health center organizations totaling 18 sites, two medical schools, two public health departments, and three major hospital systems coordinating care. If you would like more information about this topic, please call Kelly McKay-Gist at (314-657-1506) or email kmckay@stlouisihn.org.

Eva’s Excerpt November 2019

“Success is not final, failure is not fatal: it is the courage to continue that counts.” Winston Churchill

In medicine and health professions training, we spend a lot of time and effort seeking perfection, or at least near perfection—high test scores, excellent grades, the “right” research project, the most impressive record of service, the best residency, the most competitive fellowship, all culminating in a successful career. We (appropriately) anguish over medical errors, even though we know that we are humans and, therefore, we are imperfect. None of this is bad or wrong. And yet, it can get in the way when we are trying to make change or innovate.

Recently, I was talking to a colleague about complex or ultra-large-scale systems. These systems are composed of many components which interact with each other and whose behavior is intrinsically difficult to model or predict due to the dependencies, competitions, relationships, or other types of interactions between their parts or between the system and its environment. Because of these complexities, failure or error is the norm, rather than the exception, and changes in one area cause unpredictable consequences in another area. So, it is extremely unlikely that all components of such systems are functioning perfectly at any one time.

Healthcare is a complex system and so is medical education. We certainly see in both of these areas that it basically never occurs that all elements of these systems are functioning perfectly at one time. In fact, one might even consider the job of any educational or healthcare administrator to be “chief problem solving officer”. I bring this up in my excerpt this month because many of us are currently working on large-scale change initiatives through curriculum renewal, residency program restructuring or changes, hospital restructuring/moves, and clinic operational changes. It’s a lot and we are all striving for it to go perfectly. This can sometimes stall us from making a decision or moving forward, “We just need more information or more detail.” Or, when the inevitable failure or error occurs, we beat ourselves up or point fingers.

I find this a fascinating contradiction to how we think about research. A recent conversation with Dean Perlmutter led me to this video interview of Bob Lefkowitz, Nobel Laureate, who speaks about the importance of failure to achieve innovation and find truth. In fact, there are pages and pages of quotes about the importance of failure in science as a critical step to learning and ultimately success.

So, I want to ask all of us to be okay with something less than perfection out of the gate as we move forward with these immense changes in medical education, our hospital, and system. We should all be prepared to fail in some ways. We should also challenge ourselves to learn from these failures, constantly growing, changing and improving along the way. Because, after all, Malcom Forbes said, “Failure is success, if we learn from it,” and isn’t this what we actually want to role model for our students, residents, and colleagues? Can we make a pact to be okay with some failures in the face of the unknown? Can we similarly commit to learn and strive to continually improve? And, maybe most importantly, can we promise to support and help each other through it? This is my commitment to our students, residents, and faculty: I can’t promise what I/we do will be perfect, but I promise to learn from it and keep striving to get it right.

Keystone: The New Teaching and Learning Platform for the Gateway Curriculum

The Gateway Curriculum requires a digital teaching and learning platform designed for Competency-Based Medical Education (CMBE). CBME is built on a foundation of formative and summative assessments of learning, with transparent use of aggregated assessment data to make progression and competency attainment decisions for all students. The Elentra Teaching and Learning Platform began at Queen’s University School of Medicine in Ontario, Canada in 2008. An early consortium of medical school partners designed Elentra to meet a shared goal of delivering a seamless, integrated CBME experience for students and faculty.

ETIU’s Carolyn Dufault and Emily Thompson discuss plans for the new Keystone platform

In the spring of 2019, Washington University School of Medicine (WUSM) signed on to become Elentra’s 19th consortium member. At the time of its rollout in July 2020, Elentra will be called Keystone here at WUSM, to align with the Gateway Curriculum theme and as a reminder of the centrality of this new digital platform to the successful delivery of the MD curriculum.

Keystone was carefully reviewed and selected as our new teaching and learning platform by the Educational Technology and Innovation Unit (ETIU) in close collaboration with education leaders in the Office of Education, key stakeholders within Washington University Information Technology, and after local demonstrations for students and faculty here at WUSM in January 2018.

During the selection process, we considered the possibility of continuing to use our current learning management systems, Canvas and OASIS. It was determined that continued use of these two platforms, which are not integrated with each other, and which are missing key assessment functions, was not a feasible approach for a new CBME curriculum. Canvas—the university’s campus-wide LMS—is an excellent course management system, however it lacks the ability to aggregate, visualize, and report on learning artifacts (including content and assessments) at the program level. For CBME to work, we need a program-level tool, and that’s what we will have in Keystone.

In the coming months leading up to the July 2020 launch of the new curriculum, ETIU will work closely with the curriculum design teams and other key stakeholders to develop Keystone into a fully functioning integrated teaching and learning platform. For more information or a demonstration of the Keystone platform, contact ETIU at omseedtech@wustl.edu.

Eva’s Excerpt October 2019

September was a month of celebration of the outstanding teaching that is the legacy of this institution, as well as the new opportunities in education going forward. On September 24th, we celebrated the graduation of our first class of 14 Teaching Scholars. This program, led by Steve Taff, PhD, OTR/L, FNAP, FAOTA trains an interprofessional group of faculty on best practices in education, curriculum design and program evaluation. The scholars complete a project that is aligned with their interests and roles in education. The graduation ceremony was followed by a wonderful keynote address by our visiting professor, Abbas Hyderi, MD, MPH, who spoke to us about the importance of gratitude and lifelong learning in education. His speech kicked off the induction ceremony for the new Academy of Educators, led by Dr. Mary Klingensmith. The Academy welcomed 42 members, who were recognized for their achievements in education but also for their ongoing commitment to supporting the educational mission through teaching, advocacy, mentorship and faculty development. The Academy will also launch the Foundations in Teaching Skills Program, which begins this month.

As we enter into fall, we have much to be thankful for. We are part of a community of truly outstanding and generous teachers, mentors, and role models. We have the privilege of teaching and interacting with some of the best medical students, residents and fellows in the country. Each day, we have the ability to learn and grow in our work.

Later this month, we will have the opportunity to recognize some of our outstanding student teachers at the Distinguished Service Teaching Awards on October 24 in EPNEC. These awards recognize outstanding teachers, course directors and departmental student education. See here for current and past awardees.

Progress towards the implementation of the Gateway Curriculum continues to be an exciting time for us all. I am forever thankful for all of the hard work everyone is putting forth in designing Phase 1. We are nearing the completion of this stage and there will soon be chances to apply for new positions for Phase 1. We will also begin opening opportunities to participate in curriculum design for Phase 2, and develop innovative selective and advanced clinical content for Phase 3 The opportunities abound for further engagement in our new curriculum.

For more information about the new curriculum, don’t forget that the Gateway Curriculum website is continuously updated and provides an opportunity to leave questions and concerns. In addition, I am happy to speak with departments interested in learning more about the specifics of the Gateway Curriculum. Please don’t hesitate to reach out to any of us on the Office of Education Team for more information. I leave you with this quote, which springs from the lessons taught by Dr. Hyderi in his keynote:

“Gratitude makes sense of our past, brings peace for today, and creates a vision for tomorrow.”
–Melody Beattie

Save the Date: Upcoming Diversity, Equity and Inclusion Presentations

The Office of Diversity Equity and Inclusion is hosting two upcoming Fall events:

  • Flatlining:  Race, Work and Health Care in the New Economy with Dr. Adia Harvey Wingfield will be held Wednesday, October 23, 2019 from 12-1 pm or 5-6 pm. Event is open to all. Click here for more information.
  • The 2019 Academic Medicine Career Development Regional Conference November 2, 2019 at Washington University School of Medicine in St. Louis. The conference is a program of Building the Next Generation of Academic Physicians (BNGAP). Event is tailored to 3rd year students but open to all students, residents, fellows and PhD students.  Click here for more information.

Women Leading in Medicine & Science Symposium: Forging Ahead

Please join us for the inaugural WUSM symposium aimed at the professional development of women in academic medicine to provide strategies for career advancement, opportunities for networking and interdepartmental community building. The symposium will be held on Tuesday, November 19, 2019. Please see flyer for more information and to rsvp.

White Coat Ceremony

The entering class of 2019 received their white coats from School of Medicine faculty and took the class oath in the presence of family and friends at Washington University School of Medicine’s annual White Coat Ceremony on Friday, August 16, 2019. Watch the livestream video, read the class oath and view photos from the event here.

Capstone Course Director Position Announcement

Hello everyone. I am writing to let you know that Dr. Gina LaRossa (Assistant Professor of Medicine, Division of Hospitalist Medicine, Department of Medicine) has decided to step down as director of the 4th-year Capstone Course. We are enormously grateful for the considerable work Gina has put into the course and for seeing it through the process of becoming core curriculum.  Gina approached the course with care, integrity, and accountability. Her contributions have been substantive and we will miss her input. Thank you Gina.

Consequently, we are in need of leadership for this important curricular element. Given the direction of both the current Capstone Course and the new Gateway Curriculum, it seems appropriate to modify the course leadership to reflect this. To that end, we are seeking four faculty members, one each from Internal Medicine, Pediatrics, Surgery, and Obstetrics & Gynecology to collaboratively direct this multidisciplinary course.  Each co-director will receive 0.10 FTE support for their efforts. The 4-week Capstone Course is currently administered twice a year, February/March and March/April and is required for all graduating students. This course or a direct outgrowth of it will persist with the roll out of the Gateway Curriculum. Click here for a detailed job description.

Interested parties should submit a letter of interest and CV to the Office of Education’s Project Manager, Kelly Noll no later than Friday, September 13, 2019. If you have any questions do not hesitate to ask.

Office of Education Instructional Design Studio

Construction is nearly complete on the Washington University School of Medicine Instructional Design Studio, located on the lower level of Becker Library. The seven-hundred square foot space includes a sound-proof video-recording studio which supports filming using lightboard and greenscreen technologies. It also houses a recording booth for supported or independent screencast recording, along with a conference area where faculty can collaborate with our new Videographer, Matt Rice, and other education specialists to design video-based education resources.


The studio and its technologies are available to faculty teaching in all School of Medicine programs. With the Gateway Curriculum redesign in full swing a number of MD programs have used the studio and its resources to produce educational video content. Examples include Dr. Tim Yau, who recorded a series of screencast recordings on clinical exam skills for the Practice of Medicine I course. The studio was also used to produce a Campus Safety orientation video for the upcoming Plunge—the MD Program’s first-year orientation. In addition to videos produced in the new studio, educational videos are currently in production all over campus, including a new orientation for the Standardized Patient Center.

For more information about using the Instructional Design Studio, the production of educational videos, or a tour of these resources please contact OMSEedtech@wustl.edu with your request.