(NYTimes, published November 15, 2020)
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(Straits Times, published December 4, 2020)
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Yerkes, R.M. and Dodson, J.D. (1908), The relation of strength of stimulus to rapidity of habit‐formation. J. Comp. Neurol. Psychol., 18: 459-482. https://doi.org/10.1002/cne.920180503
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" ... cannot pour from an empty cup. Self-care is important so that ... can give the best of themselves, not the remnants of what is left after fatigue." - Anthea Ong, The Straits Times, on 25 December 2020
Technology connecting our Hearts, Minds and Hands - Globally
A reflection on 2020, and COVID-19
Poh-Sun Goh, 19 December 2020 @ 0748am, Saturday, Singapore time
"Technology connects us, allows us to share stories, raise awareness, work together, assist and help one another, individually and collectively, bringing out the best in all of us, on a global basis. COVID-19 has brought the world together, our hearts, minds and hands, in a milestone transformative moment in human history. To share information, work together, support and help one another."
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above posted on session blog for APMEC 2021
at
Opening Comments for Panel Discussion
APMEC 2021
Theme: Continuing Medical Education - Building Resilience in Challenging Times
Poh-Sun Goh, 20 December 2020 @ 2.41am
"Internal and external factors apply (to building resilience in challenging times, including during this COVID-19 global pandemic). These can be considered at an individual, group, national, and global level. Situational awareness and individual knowledge, skills and crucially attitudes-feelings-emotional stability (which requires both individual perception and assessment, information, innate behavioural characteristics and abilities, training and coaching), and building up physical, mental and emotional fitness and reserves (physical, cognitive and emotional reserves - through adequate sleep, rest, "time off", nutrition, exercise, relaxation and unstructured time), combined with support mechanisms, external support (heart, mind and hands - family, friends, peer-work colleagues, well planned and aware HR practices and organised, supportive work and home environments, including providing manpower, resources, training and up to date, accurate, trusted information, and access to these). Technology provides tools, and platforms to assist, support, skill up, access information, global best practices, training, support reflection, assist (through Apps for example) sleep, relaxation practices, resources, networks to build resilience, and support practice; and to deploy this at scale both locally and globally."
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Training in Digital Literacy and a Technology Orientation To Future Proof Adaptable, Resilient Healthcare Practitioners to Deliver Holistic Care
Poh-Sun Goh, Yanika Kowitlawakul, and John Wong Chee Meng
APMEC 2021 Virtual Conference Panel Discussion
Abstract
The COVID-19 pandemic has accelerated the integration of digitalisation and technology in healthcare practice, and throughout the continuum of education and training, from undergraduate, through postgraduate to continuing education and professional development. Training in digital literacy and a technology orientation is one key element to enable a future proof, healthcare practitioner. The aim of this panel discussion will be to explore how we can plan a curriculum to do this, and what experiences and competencies we can focus on to produce an adaptable, resilient healthcare practitioner, capable of delivering holistic care. A review of current and near future technology and pedagogy will be made, as well as a critical examination of challenges and pitfalls when using and relying on technology.
"online has been a lifeline ..." Sundar Pichai, Google and Alphabet CEO speaking at Singapore Fintech Festival 2020 and https://www.businesstimes.com.sg/atom/225779
Sandars, J., Correia, R., Dankbaar, M., de Jong, P., Goh, P.S., Hege, I., Masters, K., Oh, S.Y., Patel, R., Premkumar, K., Webb, A., Pusic, M. (2020). 'Twelve tips for rapidly migrating to online learning during the COVID-19 pandemic'. MedEdPublish, 9, [1], 82, https://doi.org/10.15694/mep.2020.000082.1
Goh P.S, Sandars J. (2020) 'A vision of the use of technology in medical education after the COVID-19 pandemic', MedEdPublish, 9, [1], 49, https://doi.org/10.15694/mep.2020.000049.1
"There is nothing good or bad, but thinking makes it so."
William Shakespeare, Hamlet, Act II, sc. 2
"Life and death are one thread, the same line viewed from different sides." Lao Tzu
"Do the difficult things while they are easy and do the great things while they are small. A journey of a thousand miles must begin with a single step." Lao Tzu
"Life is a series of natural and spontaneous changes. Don't resist them - that only creates sorrow. Let reality be reality. Let things flow naturally forward in whatever way they like." Lao Tzu
"An ant on the move does more than a dozing ox." Lao Tzu
"Great acts are made up of small deeds." Lao Tzu
"One who is too insistent on his own views, finds few to agree with him." Lao Tzu
"In dwelling, live close to the ground. In thinking, keep to the simple. In conflict, be fair and generous. In governing, don't try to control. In work, do what you enjoy. In family life, be completely present." Lao Tzu
I have just three things to teach: simplicity, patience, compassion. These three are your greatest treasures. Lao Tzu
Resilience of primary healthcare professionals working in challenging environments: a focus group study
Catriona Matheson, Helen D Robertson, Alison M Elliott, Lisa Iversen, Peter Murchie
British Journal of General Practice 2016; 66 (648): e507-e515. DOI: 10.3399/bjgp16X685285
Balme Eleanor, Gerada Clare, Page Lisa. Doctors need to be supported, not trained in resilience BMJ 2015; 351 :h4709 https://www.bmj.com/content/351/bmj.h4709
Five concept definitions
Digital literacy
https://blogs.bmj.com/bmj/2019/08/08/zack-hassan-digital-literacy-a-blind-spot-in-medical-education/
Goh P.S, Sandars J. (2020) 'A vision of the use of technology in medical education after the COVID-19 pandemic', MedEdPublish, 9, [1], 49, https://doi.org/10.15694/mep.2020.000049.1
A look at digital literacy in health and social care
Susan Kennedy and Jo Yaldren
British Journal of Cardiac Nursing 2017 12:9, 428-432
Kuek, A., & Hakkennes, S. (2020). Healthcare staff digital literacy levels and their attitudes towards information systems. Health Informatics Journal, 26(1), 592–612. https://doi.org/10.1177/1460458219839613
Bhatt, I, de Roock, R & Adams, J. (2015). Diving deep into digital literacy: emerging methods
for research, Language and Education, doi: http://dx.doi.org/10.1080/09500782.2015.1041972
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Kumar R. (2015). The leadership crisis of medical profession in India: ongoing impact on the health system. Journal of family medicine and primary care, 4(2), 159–161. https://doi.org/10.4103/2249-4863.154621 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4408692/
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Future-proof
Greenhalgh T. (2014). Future-proofing relationship-based care: a priority for general practice. The British journal of general practice : the journal of the Royal College of General Practitioners, 64(628), 580. https://doi.org/10.3399/bjgp14X682357
Adaptable (and Agile)
Pype, P., Mertens, F., Helewaut, F. et al. Healthcare teams as complex adaptive systems: understanding team behaviour through team members’ perception of interpersonal interaction. BMC Health Serv Res 18, 570 (2018). https://doi.org/10.1186/s12913-018-3392-3
Richard, L., Torres, S., Tremblay, M. et al. An analysis of the adaptability of a professional development program in public health: results from the ALPS Study. BMC Health Serv Res 15, 233 (2015). https://doi.org/10.1186/s12913-015-0903-3
Resilience
Wright, Barry & Mynett, Joseph. (2019). Training medical students to manage difficult circumstances- a curriculum for resilience and resourcefulness?. BMC Medical Education. 19. 10.1186/s12909-019-1712-x. https://www.researchgate.net/publication/334691575_Training_medical_students_to_manage_difficult_circumstances-_a_curriculum_for_resilience_and_resourcefulness
Resilience of primary healthcare professionals working in challenging environments: a focus group study. Catriona Matheson, Helen D Robertson, Alison M Elliott, Lisa Iversen, Peter Murchie
British Journal of General Practice 2016; 66 (648): e507-e515. DOI: 10.3399/bjgp16X685285
Lopez V, Yobas P, Chow YL, Shorey S. Does building resilience in undergraduate nursing students happen through clinical placements? A qualitative study. Nurse Educ Today. 2018;67:1-5. doi:10.1016/j.nedt.2018.04.020
Emel Bahadır Yılmaz, Resilience as a strategy for struggling against challenges related to the nursing profession, Chinese Nursing Research, Volume 4, Issue 1, 2017, Pages 9-13, ISSN 2095-7718,
https://doi.org/10.1016/j.cnre.2017.03.004. https://www.sciencedirect.com/science/article/pii/S2095771817300075
Nemeth C, Wears R, Woods D, et al. Minding the Gaps: Creating Resilience in Health Care. In: Henriksen K, Battles JB, Keyes MA, et al., editors. Advances in Patient Safety: New Directions and Alternative Approaches (Vol. 3: Performance and Tools). Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Aug. Available from: https://www.ncbi.nlm.nih.gov/books/NBK43670/
Holistic care
Goh, P.S., Sandars, J. (2019). Using Technology to Nurture Core Human Values in Healthcare. MededPublish, 8, [3], 74, https://doi.org/10.15694/mep.2019.000223.1
Jasemi, M., Valizadeh, L., Zamanzadeh, V., & Keogh, B. (2017). A Concept Analysis of Holistic Care by Hybrid Model. Indian journal of palliative care, 23(1), 71–80. https://doi.org/10.4103/0973-1075.197960
Three takeaways, and Three sustaining innovation tips
Several key competencies and strategies
Awareness, Information, Training (for individual practitioners, teams and institutions) - up to date, current, accurate information and data; including skills to access and assess information. Building individual, team and institutional skills in adaptability, resilience and future-thinking (including in innovation, design thinking, systems thinking and action research). Faculty development and training for teachers. Role of reflection, self-awareness, situational awareness, insight, feedback, support (peer, team, social).
https://www.oecd-ilibrary.org/education/preparing-teachers-and-developing-school-leaders-for-the-21st-century/preparing-teachers-to-deliver-21st-century-skills_9789264174559-4-en
CROSSING THE GLOBAL QUALITY CHASM
Improving Health Care Worldwide
A Consensus Study Report of The National Academies of Sciences, Engineering, and Medicine
2018
https://www.nap.edu/read/25152/chapter/5
Lifelong learning for practitioner, teams and institutions - regular systematic efforts to keep up to date, access information, create and share information, data and best practices
Technology enabled, facilitated and augmented
Training to develop a holistic, adaptable, resilient healthcare practitioner from Poh-Sun Goh
Nemeth C, Wears R, Woods D, et al. Minding the Gaps: Creating Resilience in Health Care. In: Henriksen K, Battles JB, Keyes MA, et al., editors. Advances in Patient Safety: New Directions and Alternative Approaches (Vol. 3: Performance and Tools). Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Aug. Available from: https://www.ncbi.nlm.nih.gov/books/NBK43670/
Fairbanks, Rollin & Wears, Robert & Woods, David & Hollnagel, Erik & Plsek, Paul & Cook, Richard. (2014). Resilience and Resilience Engineering in Health Care. Joint Commission Journal on Quality and Patient Safety. 40. 10.1016/S1553-7250(14)40049-7.
https://www.researchgate.net/publication/264089773_Resilience_and_Resilience_Engineering_in_Health_Care
Anderson, J. E., Ross, A. J., Back, J., Duncan, M., Snell, P., Walsh, K., & Jaye, P. (2016). Implementing resilience engineering for healthcare quality improvement using the CARE model: a feasibility study protocol. Pilot and feasibility studies, 2, 61. https://doi.org/10.1186/s40814-016-0103-x
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5154109/
Neufeld A, Malin G, 2020, 'Twelve tips to combat ill-being during the COVID-19 pandemic: A guide for health professionals & educators', MedEdPublish, 9, [1], 70, https://doi.org/10.15694/mep.2020.000070.1
https://www.mededpublish.org/manuscripts/2986
Nemeth C, Wears R, Woods D, et al. Minding the Gaps: Creating Resilience in Health Care. In: Henriksen K, Battles JB, Keyes MA, et al., editors. Advances in Patient Safety: New Directions and Alternative Approaches (Vol. 3: Performance and Tools). Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Aug. Available from: https://www.ncbi.nlm.nih.gov/books/NBK43670/
Fairbanks, Rollin & Wears, Robert & Woods, David & Hollnagel, Erik & Plsek, Paul & Cook, Richard. (2014). Resilience and Resilience Engineering in Health Care. Joint Commission Journal on Quality and Patient Safety. 40. 10.1016/S1553-7250(14)40049-7.
https://www.researchgate.net/publication/264089773_Resilience_and_Resilience_Engineering_in_Health_Care
Anderson, J. E., Ross, A. J., Back, J., Duncan, M., Snell, P., Walsh, K., & Jaye, P. (2016). Implementing resilience engineering for healthcare quality improvement using the CARE model: a feasibility study protocol. Pilot and feasibility studies, 2, 61. https://doi.org/10.1186/s40814-016-0103-x
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5154109/
Neufeld A, Malin G, 2020, 'Twelve tips to combat ill-being during the COVID-19 pandemic: A guide for health professionals & educators', MedEdPublish, 9, [1], 70, https://doi.org/10.15694/mep.2020.000070.1
https://www.mededpublish.org/manuscripts/2986
Gonzalo JD, Haidet P, Papp KK, et al. Educating for the 21st-Century Health Care System: An Interdependent Framework of Basic, Clinical, and Systems Sciences. Academic Medicine : Journal of the Association of American Medical Colleges. 2017 Jan;92(1):35-39. DOI: 10.1097/acm.0000000000000951.
https://europepmc.org/article/med/26488568
Gonzalo JD, Caverzagie KJ, Hawkins RE, et al. Concerns and Responses for Integrating Health Systems Science Into Medical Education. Academic Medicine : Journal of the Association of American Medical Colleges. 2018 Jun;93(6):843-849. DOI: 10.1097/acm.0000000000001960.
https://europepmc.org/article/med/29068816
Gonzalo JD, Chang A, Wolpaw DR. New Educator Roles for Health Systems Science:
Implications of New Physician Competencies for U.S. Medical School Faculty. Acad
Med. 2019 Apr;94(4):501-506. doi: 10.1097/ACM.0000000000002552. PubMed PMID:
30520810.
https://www.ncbi.nlm.nih.gov/pubmed/30520810
https://www.insidehighered.com/digital-learning/article/2020/03/18/most-teaching-going-remote-will-help-or-hurt-online-learning
Frenk, Julio, Lincoln Chen, Zulfiqar A. Bhutta, Jordan Cohen, Nigel Crisp, Timothy Evans, Harvey Fineberg, et al. 2010. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. The Lancet, 376(9756): 1923-1958.
http://nrs.harvard.edu/urn-3:HUL.InstRepos:4626403
Global Forum on Innovation in Health Professional Education; Board on Global Health; Institute of Medicine; National Academies of Sciences, Engineering, and Medicine. Envisioning the Future of Health Professional Education: Workshop Summary. Washington (DC): National Academies Press (US); 2016 Apr 18. Introduction. Available from: https://www.ncbi.nlm.nih.gov/books/NBK362412/
Linda Darling-Hammond, Lisa Flook, Channa Cook-Harvey, Brigid Barron & David Osher (2020) Implications for educational practice of the science of learning and development, Applied Developmental Science, 24:2, 97-140, DOI: 10.1080/10888691.2018.1537791
https://www.tandfonline.com/doi/10.1080/10888691.2018.1537791
https://europepmc.org/article/med/26488568
Gonzalo JD, Caverzagie KJ, Hawkins RE, et al. Concerns and Responses for Integrating Health Systems Science Into Medical Education. Academic Medicine : Journal of the Association of American Medical Colleges. 2018 Jun;93(6):843-849. DOI: 10.1097/acm.0000000000001960.
https://europepmc.org/article/med/29068816
Gonzalo JD, Chang A, Wolpaw DR. New Educator Roles for Health Systems Science:
Implications of New Physician Competencies for U.S. Medical School Faculty. Acad
Med. 2019 Apr;94(4):501-506. doi: 10.1097/ACM.0000000000002552. PubMed PMID:
30520810.
https://www.ncbi.nlm.nih.gov/pubmed/30520810
https://www.insidehighered.com/digital-learning/article/2020/03/18/most-teaching-going-remote-will-help-or-hurt-online-learning
Frenk, Julio, Lincoln Chen, Zulfiqar A. Bhutta, Jordan Cohen, Nigel Crisp, Timothy Evans, Harvey Fineberg, et al. 2010. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. The Lancet, 376(9756): 1923-1958.
http://nrs.harvard.edu/urn-3:HUL.InstRepos:4626403
Global Forum on Innovation in Health Professional Education; Board on Global Health; Institute of Medicine; National Academies of Sciences, Engineering, and Medicine. Envisioning the Future of Health Professional Education: Workshop Summary. Washington (DC): National Academies Press (US); 2016 Apr 18. Introduction. Available from: https://www.ncbi.nlm.nih.gov/books/NBK362412/
Linda Darling-Hammond, Lisa Flook, Channa Cook-Harvey, Brigid Barron & David Osher (2020) Implications for educational practice of the science of learning and development, Applied Developmental Science, 24:2, 97-140, DOI: 10.1080/10888691.2018.1537791
https://www.tandfonline.com/doi/10.1080/10888691.2018.1537791
Training to future proof healthcare professionals from Poh-Sun Goh
Google search for "training to future proof healthcare professionals"
https://ec.europa.eu/digital-single-market/en/news/training-future-proof-doctors-digital-society-how-smart-health-changing-profession-our-doctors
https://www.futurelearn.com/courses/health-workforce
http://www.smj.org.sg/article/future-medical-education
https://www.straitstimes.com/opinion/training-doctors-for-a-post-pandemic-world
Google search for "training to future proof healthcare professionals"
https://ec.europa.eu/digital-single-market/en/news/training-future-proof-doctors-digital-society-how-smart-health-changing-profession-our-doctors
https://www.futurelearn.com/courses/health-workforce
http://www.smj.org.sg/article/future-medical-education
https://www.straitstimes.com/opinion/training-doctors-for-a-post-pandemic-world
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