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The first global wave of reform in modern medical education occurred early in the 20th century, following the Flexner report. The second wave came in the latter half of that same century, led by innovations in problem-based learning and community orientation. Recently, the Lancet Commission called for a third wave of reform to create transformative system-based medical education that is socially accountable. This may be a fine aspiration, but is it possible? How can we translate new understandings from neuroscience, sociology, and the sciences of learning to meet this aspiration? In doing so, may we also transform research on medical education from eminence-based to evidence-based medical education? How accountable are we prepared to be for the results of our efforts? And to whom?
In his Brodie Medical Education Award Lecture, Dr. Paul Worley draws on evidence from medical schools around the world to explore these critical questions and consider the challenge that social accountability brings to academic medicine's combined research, education, and service mission.
The Brodie Medical Education Award Lecture
Co-presented with the Department of Medicine and the Brodie Medical Education Award Committee, in association with the School of Medicine’s Medical Education Week, 29 February-4 March 2016.
The opioid epidemic is currently exacting a terrible toll on the health, lives, safety, and livelihood of persons and communities across Virginia, the Appalachian region, and, indeed, much of North America. What is being done to address this crisis at the levels of policy and practice in the Commonwealth of Virginia and in Charlottesville-Albemarle and environs? In this Medical Center Hour, the Honorable William A. Hazel Jr MD, Secretary of Health and Human Resources for the Commonwealth, discusses Virginia’s five-pronged approach to the epidemic and the impact of that approach to date. He is joined in this conversation by a primary care physician and community mental health professionals.
The Jessie Stewart Richardson Memorial Lecture of the School of Medicine
Co-presented with the Office of Quality and Performance Improvement, UVA Health System
The 1918 influenza pandemic was a global calamity that brought death on an unprecedented scale and intensified the devastating impact of World War I even as the armistice was signed in November 1918. Statistics tell the tale of this flu in one way, science tells it in another, but this Medical Center Hour—the third in a mini-series marking the pandemic's centenary—lets poetry speak to the human toll exacted by the 1918 H1N1 virus. In 1995, Virginia native and distinguished poet Ellen Bryant Voigt published Kyrie, a book-length sequence of poems in which small town speakers live through the harrowing epidemic and remember, defy, and mourn. Kyrie's fierce, moving poetry brings the global calamity home. In this Medical Center Hour, Voigt (on video) reads selections from Kyrie and discusses with poet Marianne Boruch the making and meaning of this American masterpiece.
Co-presented with the Bjoring Center for Nursing Historical Inquiry, Historical Collections in the Claude Moore Health Sciences Library, and Influenza! 1918-2018
Some physicians are born to write, while others have writing thrust upon them. As one of the latter, 2013 Moore Lecturer Margaret Mohrmann discusses what she has learned from writing about doctoring. The act of articulating her experiences as a pediatrician and teacher has shown her, over time, much more about her encounters with patients, and about herself, than she could see at the time those events occurred - or even at the time she wrote about them. Rereading one's own stories and having others read (and co-construct) them can expose the "ghost" in the story - "the story's silent twin," as British novelist Jeanette Winterson puts it. What couldn't be said, or wasn't noticed, or was forgotten often gets written in anyway, quietly, between the lines and within word choices and narrative structures. The process of discovering what went unseen before cultivates in both writer and reader the practice of paying close, compassionate attention to what's happening now, an essential ingredient of good doctoring.
The Moore Lecture
Whether we are students, educators, or clinicians (learners all!), our stated assumptions and principles are sometimes at odds with our actual practices. In this Brodie Medical Education Award Lecture, learners of all stripes will practice foundational skills such as cultivating beginner’s eyes and more accurate data collection in order to uncover and examine habits and thought patterns that may no longer serve us. Understanding our own assumptions and the values they reflect will allow us to be more intentional in designing educational programs and clinical learning/practice environments that are principle-driven and meet the needs of patients, learners, and caregivers.
The Brodie Medical Education Award Lecture/Medicine Grand Rounds
Since passage of the Patient Protection and Affordable Care Act (ACA) in 2010, this particular road to health care reform in the U.S. has been riddled with political potholes and subject to slowdowns as a result of legislative and judicial challenges. But with the Supreme Court's landmark stamp of constitutional approval this past June and with President Obama's reelection on 6 November, it is now clear that some form of "Obamacare" is here to stay, at least for four more years. Indeed, repeal of the ACA may no longer be a top Republican priority, as House Speaker John Boehner noted on 8 November: "The election changes that-Obamacare is the law of the land." So what's ahead as we implement the ACA? In this Medical Center Hour, Washington and Lee law professor and ACA expert Timothy Jost and University of Virginia health policy analyst Carolyn Engelhard outline what must be accomplished in order to realize this ambitious overhaul of our health care system. And what will be the responsibilities of and implications for academic health centers like UVA as the ACA takes effect?
Co-presented with the Sadie Lewis Webb Program in Law and Health, the Institute for Practical Ethics and Public Life, the Department of Public Health Sciences, and the Bioethics and Health Policy Medical Student Interest Group
A John F. Anderson Memorial Lecture
Amid the current opioid epidemic in the U.S., discourse around addicts and addiction can be overwhelmingly negative, pessimistic, and hopeless, reinforcing negative stereotypes. Even in health care, negativity about addiction prevails, making it more challenging for clinicians and organizations to respond with appropriate care, services, and resources. The toll of addiction is staggering. But while statistical and fiscal analyses of the national epidemic can also overwhelm and add to the negativity, might we gain a different view of addiction by accessing the particular experience of it, as it affects individuals and also their families? To know better what is at stake and how to foster recovery, this Medical Center Hour turns to poets Kate Daniels and Owen Lewis for their response to addiction when it strikes close to heart and home. How can writing serve to access the lived experience of addiction—in this case, addiction inside the family circle—and how might writing aid in recovery, for everyone involved?
Questions about transplant candidate suitability and priority made headlines earlier this year, when 10-year-old Sarah Murnaghan's parents went to court (and to the media) to request that their daughter, dying of cystic fibrosis, be placed on the eligibility list for a lung transplant. The court's decision, UNOS's followup (Sarah got a new, fictitious birthdate to qualify to receive adult lungs), and Sarah's two double-lung procedures galvanized the transplant community, bioethicists, policymakers, and the public alike.
Even as efforts continue to increase the organ supply, what should we do about our allocation systems? In this Medical Center Hour, three experts engage the medical, legal, and ethical questions raised by the Sarah Murnaghan case.
Co-presented with the Institute for Practical Ethics and Public Life
A John F. Anderson Memorial Lecture
Many doctors have also been celebrated writers, from Anton Chekhov, Arthur Conan Doyle, and William Carlos Williams to Perri Klass, Atul Gawande, and Maxim Osipov. The reading public (including other doctors) eagerly devours what doctors write, not least in hopes of glimpsing what makes physicians tick, as persons, as healers. But why do doctors write? In this Medical Center Hour, three of UVA's own accomplished physician writers respond, in their own inimitable words.
An Ellis C. Moore Memorial Lecture
Theresa Brown became a nurse-who-writes quite accidentally: she had a bad experience at work, wrote it down, and sent what she'd written to the New York Times. To her surprise, the newspaper published it, to great acclaim. From that column came the contract for Ms. Brown's first book, Critical Care, and she also began writing regularly for the Times, proud to have this chance to give voice to the often under-recognized nursing profession.
Only lately, though, while writing her second book, The Shift, did Ms. Brown realize not just how much her nursing gives shape to her writing, but also how her writing influences her nursing. There's much to mull over in health care and usually not much time to do that. Writing forces Ms. Brown to reflect. She learns both positives and negatives about her nursing work in the process of putting that work into words. In this Medical Center Hour, Ms. Brown talks about how writing, which she loves, makes her a better nurse.
The Catherine Strader McGehee Memorial Lecture of the School of Nursing
Co-presented with the School of Nursing, the Virginia Festival of the Book, and Hospital Drive
