Transformational Ideas Initiative (TI2)
The annual initiative funds projects proposed by MCW faculty, staff, students, residents and fellows that focus on innovating medical education aligned with one or more of the Triple Aims of Medical Education: Character, Competence and Caring.
In these projects, collaboration and partnerships within MCW and with other institutions, community members and organizations are encouraged. Accepted ideas get refined through a human-centered design process led by experienced facilitators who help teams scope and finalize their project implementation plans for success.
2021-22 Transformational Ideas Initiative Projects
Most medical students come from households with stable food, housing and security whereas a significant number of our patients do not. Currently, for our students at MCW, there is opportunity to expand formal teaching on social determinants of health (SDH), provide a safe space to practice crucial SDH assessments, and increase exposure to vulnerable patient populations and community resources in the preclinical years. Recently, virtual platforms have become widespread, enhancing opportunities to engage with vulnerable populations and community-based resources.
We propose a five-session curriculum for pre-clinical students to provide tools to effectively and holistically care for vulnerable patients using simulation, narrative and visualization complemented with a one-session training on providing effective feedback for residents and attending physicians. We will provide a safe space for students to practice and receive feedback on interview skills, engage with persons who have undergone housing, food or security crises, and “see” places in the community where these needs are addressed.
Key steps will be to 1) partner with key educational stakeholders at MCW and leaders with shared goals; 2) administer a needs assessment of students including baseline knowledge of SDH, personal familiarity with vulnerable groups, and familiarity with hospital and community-based resources; 3) finalize cases to practice SDH assessment; 4) finalize community partners, such as advocates and persons who have the life experience of housing, food or safety insecurity; 5) develop a high yield training session on providing effective feedback on SDH assessment skills; and 6) recruit faculty and resident advocates to assess SDH simulation as well as student’s final project in small groups.
Our goal is to help students ACCESS better care by enhancing Awareness of the importance of SDH to biologic health outcomes; Competence and Comfort interviewing patients on SDH, Empathy for vulnerable patient groups experiencing housing, food, or security crises through personal encounters; and Social Services awareness and referrals.
While the impact of racism and bias in medical education at MCW is beginning to be acknowledged, novel strategies are needed to ensure that confronting racism in medicine in the new curricular design process is prioritized.
To address the paucity of lessons about racial and health equity (including social determinants of health, health disparities and historical policies) in the medical school preclinical curriculum, our ultimate goal is to develop a list of actionable recommendations that we will propose to leadership making curricular re-design decisions. The current plan is a three-step process. First, we will build a diverse team comprised of faculty, students, and staff at MCW who will review published literature for successful implementation of an antiracist medical school curriculum. The second step is the creation and distribution of a survey based upon the aforementioned literature search in order to collect current student input on the future antiracist curriculum. Step three involves analysis and synthesis of the survey data to develop a list of actionable steps the team will present to leadership and those making decisions in curriculum redesign at MCW. The timing of this project aligns beautifully with curriculum redesign to be implemented in Fall 2022. As such, MCW has a unique opportunity to intentionally and thoughtfully design an antiracist medical school curriculum that emphasizes mattering and character. Our research team will focus on cultivating a culture of teamwork, kindness, and gratitude for one another and for student input. A key element of our proposal is to identify topics informed by current students that need to be more explicitly taught and learned early in the careers of student physicians. To do so will employ curiosity, love of learning, and humility. We are very excited to improve health equity and inform the future medical school curriculum at MCW!
By Leilani Hernandez, M3; Pinky Jha, MD; Brian Gooley, MD; Brady McIntosh, MD; and Sanjay Bhandari, MD
Emergency physicians and hospitalists have a shared responsibility in caring for the sickest patients while utilizing expensive hospital resources. However, there are few opportunities for collaboration. Our goal is to improve collaboration between providers in the ED and hospital floor using a novel approach. We will provide EM residents with follow-up information on patients they met after being worked up on the hospital floor. To decrease the burden on the hospital side, we will utilize medical students to summarize this information.
First, we plan to collaborate with medicine clerkship directors to ensure that student outcomes align with the clerkship. Medical students will write a succinct summary and review it with an attending/senior resident before sharing with EM resident.
We hope that medical students will benefit because this will create more opportunities to demonstrate clerkship learning objectives such as gathering the appropriate amount of information, interpreting basic diagnostic tests, generating a prioritized differential diagnosis, and describing diagnostic and therapeutic plans. We hope that EM residents will benefit from learning more about patients’ course of illness, and it may help them realize certain biases in clinical decision-making, to act more cautiously in a similar scenario, as well as fostering a “no blame” culture for learning from patient errors.
By Melinda Pierdomenico, DO; Sarah Larsen, MD, MPH; Jessica Smoko, MS3; and Kevin Robertson, MD
On average, medical schools nationwide provide an average of two hours of pre-clinical lectures dedicated to LGBTQIA individuals, while these sexual and gender minorities (SGM) experience increased levels of alcohol and substance use disorder, homelessness, mental illness, HIV, certain cancers, and hate crimes compared to their cis, heterosexual counterparts. This project will focus on incorporating interactive, facilitated, case-based learning into pre-clinical curriculum to increase the awareness of unique disparities that SGM experience, as well as addressing the implicit bias that many have towards LGBTQIA individuals.
We plan to use an Implicit Bias test through Harvard of both the sexuality IAT as well as the transgender IAT for all students participating in case-based learning. Multiple cases will be generated centered around SGM as it pertains to well exams, cancer screenings, sexual history, hormone replacement therapy, and acute concerns. These cases will be based off of real-life scenarios that those who are LGBTQIA have experienced. Studies have shown that when facilitated, case-based learning is taught by someone who identifies as that patient population (in this instance, LGBTQIA) that students have greater empathy moving forward when working with those populations, so it will be imperative to recruit medical professionals to facilitate these cases who identify as LGBTQIA.
The primary outcome will be increasing the general awareness of pre-clinical students of the unique disparities that SGM face on a daily basis, especially in a doctor’s office which will hopefully lead to greater empathy and compassion towards this population.
By Harini Shah, M1; Kathlyn Fletcher, MD; Jessica Miller, M1; Tracy Bui, M1; Elizabeth Dominguez, M1; Aliyah Keval, M1; and Marisa Tobes, M1
Studies show that minority medical students experience racism that continues through residency, physician-hood, and leadership. Despite advancements in gender equity at the medical school level, progress is marginal or nonexistent for black, indigenous, and physician trainees of color. The AAMC has suggested that “non-inclusive learning environments…have profound implications for the well-being and academic success of students” and are implicated in higher attrition rates among minority physicians.
We propose the creation of an annual anti-racism pledge around the time of M1 orientation, modified to each incoming class’ specific goals, to serve as an intentional reminder to foster an inclusive environment for minority peers. We hope that this anti-racism pledge will instill a sense of personal diligence in creating a welcoming environment for everyone, especially for our minority colleagues and patients. In doing so, we aim to increase the sense of inclusivity felt by minority students, which will have profound implications for both academic success and career longevity.
By Chase LaRue, MEd, M2; Erica Chou, MD; Kerrie Quirk, MEd; Max Hershey, M1; Enrique Avila, M1
COVID-19 disrupted traditional methods of education delivery and pivoted teaching to virtual platforms. Teachers now need to address additional considerations in their teaching sessions, such as managing and utilizing technology, which takes practice, trial and error to learn what works. Medical education has been moving away from traditional lectures and is beginning to embrace a more student-centered pedagogy. In designing new educational sessions focused on active learning, teachers must consider how students will engage in these activities, but they don’t have the opportunity to seek feedback from students prior to implementing their sessions.
Currently, students provide feedback on courses and teaching sessions through end of course evaluations, which are not timely and doesn’t allow for changes to be implemented until the following year. This makes the educational quality improvement process slow and less effective.
Our idea is to develop a Teaching Test Kitchen which provides a forum for teachers to test teaching sessions with volunteer testers. The teachers can practice or perform a “dry run” of their sessions and receive real-time, low-stakes, constructive feedback on any or all aspects of the session, including content, instructions, timing, technology, logistics, etc. This process will allow teachers to improve and adjust their sessions as necessary and feel more confident when delivering their sessions to a real audience. This also allows students to contribute at their level of expertise and collaborate in co-designing curriculum, which provides both teachers and students with different perspectives.
We would like to have the Teaching Test Kitchen be an easily accessible resource that is available to all students, residents, fellows, faculty and staff who will be conducting teaching sessions.
Medical student dissatisfaction with their surgical clerkships, including the third year 8-week Surgery and the 2-week Gynecology rotations, is a long-standing problem for medical schools across the nation. Surgical rotations are unique in that students balance time between wards, clinics, and operating rooms. The exposure to high stress environment in the operating room, and the varying clinical environments, negatively impacts the students’ perception of mattering on the team. The concept of mattering, in which another person’s behaviors, actions, or words make you feel useful and valued, is important for medical students’ satisfaction in a learning environment.
Our project will expand on work from the KINETIC3 program where we explored mattering among Surgery Clerkship Students. This project extension will incorporate Gynecology, from the student perspective, as well as the entire interdisciplinary care team. We hope this project will motivate members of the interdisciplinary care team to recognize strengths in themselves and how to best connect with students, recognizing their value in the care team.
By Nathan Rosenberg, BSN, RN, CCTN; Andrew Cochran, PT, DPT; and Kurt Hammitt, MSN, RN
Medical students, residents, and nurses are required to practice and collaborate in the clinical environment. However, in the educational environment they are educated in isolated curriculums. We propose to integrate medical students and residents into the nurse residency program to enhance communication, role definition, and teamwork development through the chain of command and care needs.
We plan to develop a simulation curriculum for blended nurse residency and medical provider simulation scenarios with hands-on simulation for residents, nurses and medical students. We hope this project will increase self-reporting of feeling valued and respected by team members, increase understanding and use of team debriefing in the clinical environment and lead to improved patient outcomes.
By Emelyn Zaworski, M1; Sofie Kjellesvig, M1; Eric Weaver, M1; Eric Lee, M1; Meghan Peterson, M1; and Jesslyn Hendrickson, M1
First year didactic courses do not expose medical students to the realities of medicine. Unless students have had prior work experiences with healthcare delivery, they often have little knowledge regarding crucial components of their future practice. In order to provide more competent, patient-centered care, students need earlier exposure to topics such as interprofessional teamwork, care coordination, and healthcare financing early in their academic careers. This project aims to develop learning applications in Health Systems Science starting at the beginning of medical school.
Our team will create a series of exercises to better prepare first year medical students for residency and beyond. Instructional content will be developed collaboratively with current residents and social workers to ensure material is relevant and presented effectively. Exercises will include interprofessional education sessions with social workers and social work students. Students will also be provided a reference sheet for local resources (free clinics, transportation, diet programs, childcare, etc). For healthcare financing education, we will partner with the Benjamin Rush Institute.
By integrating Health Systems Science modules into the curriculum, we hope to:
- Increase interprofessional collaboration to foster systemic change
- Enable students to provide more compassionate care
- Improve student competence and comfort
- Improve quality of patient care
By Allison Carlisle, MPH, MS1 and Emma Lankey, RDN, MS1
Due to the COVID-19 pandemic, mental health has been tested in an unprecedented way. As first-year medical students, we have been unable to connect with our peers and faculty in a normative format and working to find our sense of mattering within this new community we’ve joined has proven difficult. Outside of the setting of a global pandemic, we saw a need for a community gathering space where people can come together to discuss health topics to supplement our formal medical training (personal wellness, nutrition, community, belonging, sustainability, social determinants of health) and establish a gathering place just to unwind with friends.
The MCW-Green Bay campus garden program aims to build community and provide an outdoor gathering space. In addition to garden maintenance, each gardening session will begin with conversation starter for participants to discuss topics related to personal and community wellness. “Wellness Minute” conversation starters may include gratitude, mindful movement, nourishing/fueling the body with garden products, mindfulness meditation, access to produce, and sustainability/environmental wellness. The social media arm aims to expand on the “Wellness Minute” topics and highlight the importance of the work with the broader community.
In addition to gardening, we hope to create a place of gathering for our peers. We intend to host events, barbecues, cooking classes, and other social activities in this community space. We also intend to expand our “space” into the greater De Pere/Green Bay area by taking group outing to the farmer’s market and other local outdoor events.
Overall, we hope the garden program builds a sense of community, improves student mental health/wellness, fosters a sense of belonging, and increases awareness of the impact that nutrition and social determinants of health have on overall wellness.
2020-21 Transformational Ideas Initiative Projects
2019-20 Transformational Ideas Initiative Projects
By Pinky Jha, MD; Sanjay Bhandari, MD; Brian Hillgeman, MD; Patrick Foy, MD; Hari Paudel, MD; Mario Scarpinato; Kevin Schlidt
We propose developing a longitudinal curriculum to help M3 and M4 develop empathy skills during their M3 inpatient clerkship and M4 ambulatory medicine rotation, respectively. We will use multiple modalities of teaching including real time patient feedback, short app-based secure tweets, and group-based didactics, all aimed on addressing barriers. Students will be asked to tweet short narratives via a secure app to reflect upon their patient interactions, and we will survey students with regards to the efficacy of direct patient feedback, workshop and narrative tweets, and their overall perceptions of empathy.
By Michael Nordness, Med Student; Nathan Fleming, MD, MPH; Audrey Burghardt, MSCP, CSW; PI: Theresa Maatman, MD, FACP; Joanne Bernstein, MD; Bob Waite
We propose the development of an app-based SDOH education tool that instructs learners on how to screen for and address health-related social needs to address this SDOH knowledge gap. Using the proposed app before seeing each patient, students would enter each patients zip code, which would generate a list of SDOH indicators for the patients community. Students would additionally be able to click on the individual SDOH indicators for a brief educational summary of each indicators influence on health outcomes. They would also have access to both SDOH-based interview questions and the contact information for 2-1-1, a nationwide non-profit that connects people with community resources, to help address each patients SDOH needs.
By James McCarthy, MD; Kelsey Porada, MA
We propose developing a mobile app to assess the impact of mobile learning on students in the third year pediatric clerkship. For over a year we have been producing a podcast, titled Peds Soup, that focuses on evidence-based review of core topics in pediatrics. In this project, we plan to develop a mobile app as a supplement to the podcast. The app would include pre- and post-test questions for students to track their knowledge gain after listening to podcast episodes, links to relevant articles for further reading, and a progress report where learners can compare their scores against the overall average and identify their own strengths and weaknesses.
By John Hayes, DO; Jessica Hayes, MS4; Shena Johnson, PsyD
We propose the creation of difficult conversations OSCEs to be used as a formative tool, facilitating debriefing that will coach students on handling these challenging scenarios. We will use simulated patient conversations, teaching students how to master these encounters before they must do it in real life. Students will leave these sessions better able to identify pitfalls in patient communication before they effect patient care.
By Amy Prunuske, PhD; Jacob Prunuske, MD, MSPH; Carolyn Nash, MD; Eric Giordano, PhD; and Haley Pysick, Med Student
We propose the development of a tool to assess the competency of students with respect to community engagement. We will work with community partners to identify student-level competencies for effective community partnerships, with an emphasis on the character aspects of trust and teamwork, and nurturing caring relationships. Once those competencies are identified, we will refine with students, faculty, and community partners to optimize language, relevance, and consistency of conceptual understanding. We will then seek to develop an app that will allow real-time feedback from community members regarding student progression and attainment of competencies in community engagement.
By John Astle, MD, PhD; Paul Guillod, MD (Massachusetts General Hospital); Alexandra Harrington, MD; Maria Hintzke, MD; Steven Kroft, MD; Vasiliki Levantaki, MD; and Molly Young
We propose developing an interactive informational resource that will help rotating pathology residents access hematopathology information in a way that follows the diagnostic thought process. This project aims to provide a proof of concept for a resource that will ultimately be useful for learning and reviewing nearly any area of diagnostic medicine. While initially useful primarily to physicians-in-training who are learning the diagnostic thought process, this resource has the potential to provide practical learning and review for even the most seasoned physicians, particularly by reminding them of rare diseases to consider, notifying them of novel laboratory tests that have become available, and aiding in interpretation of atypical findings.
By Michael Nagy, PharmD; Kajua Lor, PharmD; Meaghan Hayes, MEd; Kenneth Lee, MD; Sean Blaeser, Pharm Student; Megan Grochowski, Pharm Student; Isabelle Sviatloslavsky, Pharm Student; Taylor Williams, Med Student
We propose to develop and implement an interprofessional elective course between the medical and pharmacy schools that trains and evaluates students on providing competent care for veteran and military members. The main focus is on the culture and communication surrounding this unique population.
By Valerie Carlberg, MD; Stephen Humphrey, MD; Alexandria Bear, MD
We propose to develop a collaborative curriculum titled "The Art of Observation" between the Medical College of Wisconsin and the Milwaukee Art Museum to improve visual literacy, diagnostic accuracy, communication, self-reflection, tolerance for ambiguity, and build empathy. By sharing observations aloud, students will build confidence and communication skills, as well as improved observation skills leading to increased competence in diagnostic reasoning. Through listening and paraphrasing others observations, students will develop an appreciation for diverse perspectives and increased tolerance for situations without a clear answer.
By Sonali Srivastava, Med Student; Srisha Kotlo, Med Student; Alonzo Walker, MD; Kurt Pfeifer, MD; PI: Malika Siker, MD
We propose to address the challenge many URM medical students face in finding mentors from diverse backgrounds and specialties to obtain invaluable career advice and encouragement as they begin to define their medical interests. This program will facilitate mentorship relationships between first/second year medical students and clinical faculty through regular, casual lunches over diverse cuisines. This program will pair mentors with students to provide career guidance, serve as role models, and help provide implicit knowledge of how to navigate the medical profession, as well as imparting emotional support and encouragement.
By Courtney Barry, PsyD, MS; Rachel Piszczor, PsyD; Constance Gundacker, MD, MPH; Jonathan Perle, PhD, ABPP; Carly Wallace, MA; Jineane Shibuya; Mai'ana Feuerborn; Michelle Leininger
This project, which is a collaboration between the Medical College of Wisconsin and Midwestern University-Downers Grove, aims to improve trauma-informed care knowledge and skills. This unique partnership, between MD and DO programs, will foster interdisciplinary collaboration between physicians, psychologists, medical and psychology students. The training will address topics on ACEs and trauma, the physiologic response of trauma, the presentation of trauma in a medical patient, and finally, tools that providers can utilize during an encounter. The goal is to develop competent and caring future healthcare providers, who understand the impact of trauma on health outcomes.
2018-19 Innovation Celebration
Thank you to everyone who joined us in celebrating the completion of the 2018-19 Innovative Ideas Initiative on Monday, April 29 at the Medical College of Wisconsin. We are extremely proud of our 2018-19 teams and all that they accomplished this year.
2018-19 Innovation Celebration
In early 2018, the Kern Institute at the Medical College of Wisconsin (MCW) asked faculty, students and staff for ideas on how to innovate medical education through character, competence, and caring. An overwhelming response of ideas resulted in the funding of ten innovation projects poised to expand the learning opportunities of MCW medical students. Each of the project teams utilized human-centered design thinking and the entrepreneurial mindset to shape and frame their projects for success. To celebrate their innovation journey and launch their projects, an Innovation Celebration was held at MCW on September 5, 2018.
Douglas E. Melton, PhD, began the program with a presentation titled "Want Better Medicine? Become Infected with the Entrepreneurial Mindset," followed by presentations from all ten Innovation Teams.
2018-19 Ideas Initiative Poster Presentations
Faculty Resilience, Grit, and Character Strengths: Requisite Elements of Success (PDF)
by Robert Treat, PhD; Kristina Kaljo, PhD; Jennifer Apps, PhD; Bipin Thapa, MD; Kerrie Quirk, MS
The Quality Rounds Initiative Parent Coaching Program (PDF)
by Heather Toth, MD; Kelsey Porada; Kelly Lynch; Mike Weisgerber, MD, MS; Sarah Vepraskas, MD; Erica Chou, MD; Amanda Rogers, MD; Sarah Lauck, MD
Student Leadership Development Initiative: Building Confidence and Leadership Skills in Medical Education (PDF)
by Allison Linehan; Alex Chartier; Michael Sobin; William Hueston, MD; John Meurer, MD, MBA
Teaching Cultural Humility Through Education, Service and Leadership Experiences (PDF)
by Wasif Osmani; Alex Schurman; Joanna Obaoye; Megan Cory; Linda Meurer, MD, MPH
Fostering Cultural Humility in Medical Education Through Service Learning (PDF)
by Nicole Runkle; Mahir Mameledzija, MBA; David Nelson, PhD, MS
Increasing Refugee and Trainee Comfort in Cross-Cultural Medical Interactions (PDF)
by Caitlin Kaeppler, MD; Kelsey Porada, MA; Carmen Cobb, MD
Mental Health from Orientation through Commencement (PDF)
by Sarah VanderZanden, DVM and Jennifer Haluzak, MEd
Virtual Clinic Videos: Using Design Thinking to Improve Medical Education (PDF)
by Austin Dopp; Nathan Klesmith; Scott Self; Ryan Spellecy, PhD
Point of Care Cartooning (PDF)
by Theresa Maatman, MD; Katinka Hooyer, PhD, MS; Rushi Patel; Branden Vugrnick; Sara Graciano
Empathy: Can It Really Be Taught? (PDF)
by Katarina Stark; Alexandria Bear, MD; Aamer Ahmed, MBA
Transformational Ideas Initiative Advisory Committee
Member, Human-Centered Design Lab, Kern Institute
Director, Human-Centered Design Lab, Kern Institute
Member, Human-Centered Design Lab, Kern Institute
Member, Human-Centered Design Lab, Kern Institute
Medical College of Wisconsin
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