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C L O S L E R
Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative
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Creative Arts in Medicine
Connecting with Patients
Passion in the Medical Profession
Lifelong Learning in Clinical Excellence
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June 25, 2018 | 2 min read

On The Professional Formation of Doctors

By Margaret Chisolm, MD, Johns Hopkins Medicine

By getting out of the business of knowledge and skills and returning to the work of professional formation, not only will medical schools and their patients win, but doctors—and the profession of medicine as a whole—will too.

The Osler Club of London's Osler Coat of Arms.

June 15, 2018 | 2 min read

Osleriana

By Margaret Chisolm, MD, Johns Hopkins Medicine

Enjoy our regular contributor Margaret Chisolm's fun exploration of all things Olser.

13 Norham Gardens, the Osler's home in Oxford from 1907 until their deaths.

June 6, 2018 | 1 min read

Open Arms: The Welcoming Spirit of the Osler Residence

By Margaret Chisolm, MD, Johns Hopkins Medicine

Although we might not all live in a “substantial Victorian house” like William Osler’s, we can all embrace the welcoming spirit of “The Open Arms,” and invite more of our learners into our homes for informal meetings, mentorship, and maybe even tea.

May 29, 2018 | 2 min read

Love At First Sight

By Margaret Chisolm, MD, Johns Hopkins Medicine

A clinically excellent physician always takes the time to ask his/her patient about the history of substance use in their parents and siblings, as well as aunts, uncles, grandparents, and cousins; and always asks about adoption.

October 26, 2021 | 3 min read

What is The Scope of a Clinician’s Work?

By Margaret Chisolm, MD, Johns Hopkins Medicine

We must help our patients achieve a state where body, mind, and spirit are working as a whole. We can help them do more than survive. Let’s help them thrive!

"Chrysantheme und Biene." Hokusai, K. (ca. 1832). Public domain, Wikimedia.

September 22, 2021 | 8 min read

The Role of Visual Thinking Strategies Coaching in Clinical Excellence

By Margaret Chisolm, MD, Johns Hopkins Medicine

Take an appreciative approach when giving feedback to learners. It will not only build clinical skills, but will also foster a healthy community of learning and practice.

May 24, 2018 | 2 min read

My Professional Totem

By Margaret Chisolm, MD, Johns Hopkins Medicine

A psychiatrist shares her story of how a painting by Raphael has reminded her of of why she wanted to become a doctor and what the profession of medicine is all about.

September 15, 2021 | 5 min read

Being Grateful for a Difficult Physician-Patient Experience

By Margaret Chisolm, MD, Johns Hopkins Medicine

A frustrating experience as a patient taught me how to be a better doctor. Lesson #1: Always take an interest in your patient as a person.

May 16, 2018 | 2 min read

The Stigma of Opioid Use Disorder

By Margaret Chisolm, MD, Johns Hopkins Medicine

Building a strong therapeutic alliance between patient and clinician—via open communication, mutual respect, and trust—is a lifeline for the individual patient with an Opioid Use Disorder.

April 6, 2018 | 1 min read

The Human Tragedy of the Opioid Crisis

By Margaret Chisolm, MD, Johns Hopkins Medicine

Addiction impacts more than just my patient, but their entire family. And our job as doctors is—in some way—to care for all of them, to bring them in close, and to try to relieve their suffering in some way.

June 15, 2020 | 1 min read

Getting CLOSLER: A Note to Our Readers

By Margaret Chisolm, MD, Johns Hopkins Medicine, Scott Wright, MD, Johns Hopkins Medicine

For two years, CLOSLER has been stimulating healthcare professionals and trainees to reflect on giving exceptional care to every patient.

Photograph by Dr. Margaret Chisolm.

January 30, 2020 | 6 min read

December Art Museum Challenge

By Flora Smyth Zahra, MA Clin Ed, DRestDent RCS, FHEA, Kings College London, Margaret Chisolm, MD, Johns Hopkins Medicine

The art museum is an emerging informal educational space for the health professions. Here, transformative learning theory provides educators with a model to understand how, through systematically challenging learners’ preconceived beliefs, assumptions, and values, students can grow in their developing professional role.

"An Infinity Room Installation," Yayoi Kusama. Wikivisually.com. Public Domain.

December 19, 2019 | 5 min read

November Art Museum Challenge

By Flora Smyth Zahra, MA Clin Ed, DRestDent RCS, FHEA, Kings College London, Margaret Chisolm, MD, Johns Hopkins Medicine

The reality of clinical practice can be complex and uncertain and these sessions away from the clinics in and around the art museum space allow students through haptic exploration to become more comfortable with ambiguity.

The courtyard within the Isabella Stewart Gardner Museum, Boston, Massachusetts. Photograph by Flora Smyth Zahra.

November 26, 2019 | 7 min read

October Art Museum Challenge

By Flora Smyth Zahra, MA Clin Ed, DRestDent RCS, FHEA, Kings College London, Margaret Chisolm, MD, Johns Hopkins Medicine

Students appreciate the opportunity to engage with one another in the sanctuary of an art museum; the setting itself fosters well-being.

A Reversed Retrogress: Scene 1 (The Purple Shall Govern) (2013), Mary Sibande. Courtesy of the artist and Somerset House London. Photograph by Flora Smyth Zahra.

October 28, 2019 | 5 min read

September Art Museum Challenge

By Flora Smyth Zahra, MA Clin Ed, DRestDent RCS, FHEA, Kings College London, Margaret Chisolm, MD, Johns Hopkins Medicine

By providing a creative space in which healthcare professionals can build skills integral to clinical practice, while also expressing their vulnerabilities and humanity, art museum-based education can humanize healthcare and provide an antidote to burnout.

Window at St. Leopold’s Church, depicting the seven corporal works of mercy. Photograph by Margaret S. Chisolm

September 18, 2019 | 7 min read

August Art Museum Challenge

By Flora Smyth Zahra, MA Clin Ed, DRestDent RCS, FHEA, Kings College London, Margaret Chisolm, MD, Johns Hopkins Medicine

Clinical learning and practice are not removed from cultural and political realities. As clinical educators, it is our responsibility to create both humanistic learning environments that inculcate respect for the ultimate purpose of healthcare: the well-working of the human being as a whole.

Édouard Manet: "A Bar at the Folies-Bergère," 1881-1882. This is a faithful photographic reproduction of a two-dimensional, public domain work of art. The work of art itself is in the public domain for the following reason: Public domain This work is in the public domain in its country of origin and other countries and areas where the copyright term is the author's life plus 100 years or less.

August 6, 2019 | 7 min read

July Art Museum Challenge

By Flora Smyth Zahra, MA Clin Ed, DRestDent RCS, FHEA, Kings College London, Margaret Chisolm, MD, Johns Hopkins Medicine

The skills required in the clinic are the same as those in the art gallery: to examine, investigate, embrace ambiguity, consider multiple interpretations, reflect, collaborate, and learn.

March 30, 2021 | 2 min read

Leveraging Your Professional Network For Your Growth

By Kevin Frick, PhD, Johns Hopkins Carey Business School

In your professional network, include those who challenge and question you. Peer feedback and coaching can help improve your care of patients.

September 1, 2021 | 2 min read

What’s The Problem?

By Ben Roberts, CRNP, AGACNP-BC, ACHPN, Johns Hopkins Medicine

Systematically formulating a clear statement of the patient’s problem can be incredibly helpful. This may improve your diagnostic reasoning and ability to formulate more effective therapeutic plans.

March 12, 2018 | 3 min read

13 Principles for Daily Living

By Rosalyn Stewart, MD, Johns Hopkins University School of Medicine

A primary care physician and clinician educator shares her core values for living a good life.

May 9, 2018 | 2 min read

Applying the Coaching Model to Medical Education

By Ryan Graddy, MD, AbsoluteCARE Medical Center, Atlanta, Georgia

Coaching—direct observation of learners with feedback geared toward skills development—is an important way to teach individualized medical education. Outstanding coaches across disciplines share characteristics that can be applied in clinical coaching encounters.

May 3, 2018 | 5 min read

Challenges, Choices, and Changes

By Catherine Parrish, MD, Johns Hopkins Community Physicians

CHALLENGE yourself to be a lifelong learner—make CHOICES in your career that make you HAPPY, and use the CHANGES in your personal life to inform and enrich your work.

October 22, 2019 | 2 min read

The Color of my Skin

By Kimberly Turner, MD, Johns Hopkins Community Physicians

With mentorship, advocacy, and open-mindedness by all, it is hoped that there will be greater diversity within the healthcare workforce.

The koru is a spiral shape based on the appearance of a new unfurling silver fern frond. It's an integral symbol in Māori art, carving and tattooing, where it symbolizes new life, growth, strength and peace. Photo by David Kopacz.

October 18, 2022 | 7 min read

A New Paradigm For Growth 

By David Kopacz, MD, University of Washington, Lucinda Houghton, PhD

As with other traumas, burnout, viewed as an opportunity for personal and professional development, offers a way to expand ourselves as wholehearted healers.

December 7, 2020 | 3 min read

Flipping the Switch

By Swathi Raman, MD, MPH, LifeBridge Health, Maryland

Shifting away from needing external validation can promote wellness. Self-reflection and awareness of our internal monologue may help with internal validation and improve feelings of self-worth.

"New Zealand Landscape," original artwork by the author, 2011.

July 18, 2019 | 4 min read

Circle Medicine: A Holistic Approach to Health for Clinicians and Patients

By David Kopacz, MD, University of Washington

It can be helpful to see the circle path of the hero's journey as the healer's journey, the path that we take through our lifelong medical education. For the true healer, this is not a journey we make just once, but periodically we embark on exploring new depths of the suffering of the world, reaching deep into ourselves to find new resources for healing to bring into our work and world.

May 10, 2022 | 2 min read

Supporting Underrepresented Trainees

By Vivian Altiery De Jesus, MD, MBE, Johns Hopkins Medicine

When witnessing racism, we must support those affected to foster an environment of safety and respect.

June 5, 2018 | 3 min read

5 Things Residency Taught Me About Parenting

By Laura Hanyok, MD, Johns Hopkins Medicine

A general internist reflects on insights gleaned from residency applied to parenting.

September 2, 2020 | 4 min read

A Call for Advocacy in Medicine

By Sara Wallam, Medical Student, Johns Hopkins Medicine

Systemic racism is prevalent throughout our society. To dismantle disparities in health outcomes for minority patients, clinicians must advocate for their patients at the local level and for communities on a regional and national scale.

August 25, 2021 | 2 min read

‘Stay calm and carry on’

By Nicole Cifra, MD, MPH, University of Rochester

Educating people about the value of vaccinations is our duty. If you encounter resistance or hostility, don’t take it personally, and reach out to colleagues for support.

January 9, 2020 | 3 min read

Top Tips to Support Yourself While Pregnant and Working in Healthcare

By Laura Hanyok, MD, Johns Hopkins Medicine

You yourself or clinician colleagues will undoubtedly take parental leave at some point. Clinically excellent clinicians and practices use this as an opportunity to enhance continuity and ensure high quality care.

February 13, 2023 | 3 min read

“Powershield”

By Drea Burbank, MD, Putumayo, Colombia

“Powershield:” a poem about power and responsibility. 

November 17, 2022 | 2 min read

Personalized Clinical Quality Improvement

By Jeffrey Krimmel-Morrison, MD, University of Washington

Use evidence-informed practices in your self-directed learning—build a case tracking system, work simulated cases, use quizzing, and seek new evidence efficiently. 

August 13, 2019 | 2 min read

How Does Bullying Relate to Clinical Excellence?

By Scott Wright, MD, Johns Hopkins Medicine

There is no place in medicine for bullying. It interferes with growth of individuals and collaborations among team members – both of these are critical for serving our patients.

August 27, 2019 | 3 min read

Letting the Laughter In

By Michelle Gyenes, MS, Columbia Mailman School of Public Health

Excellent clinicians know that laughter can be a powerful tool in enhancing communication and building trust, particularly when working with older patients.

August 22, 2019 | 3 min read

Leveraging Your Patient’s Strength

By Keri Bischoff, MA, WellBeing Coach partnering with Johns Hopkins, Rachel Salas, MD, Johns Hopkins Medicine

Excellent clinicians discover their patients talents to best deliver both recommendations and personalized care.

September 21, 2022 | 1 min read

Finding Passion, Purpose, and Meaning

By Carisa Parrish, PhD, Johns Hopkins Medicine

When experiencing burnout on the job, enjoying activities outside of work may lead to greater happiness and life satisfaction, until your passion for work returns. 

“We often jump to reassure, fix, and plan. If we can be still for a moment, we can remain present and let compassion guide our actions.”

December 8, 2020 | 3 min read

The Messy

By Cassie Ferguson, MD, Medical College of Wisconsin

Caring for children in the pediatric ED is both rewarding and exhausting. Cultivating compassion for patients and ourselves can help to sustain our practice and our well-being.

July 22, 2019 | 5 min read

5 Lessons From Visible Ink

By Anoushka Sinha, MD, Columbia University

It is humbling to remember we are merely characters in our patients' stories. We are neither the author nor the narrator, and certainly not the lead.

September 12, 2022 | 2 min read

The Medical Interview And All That Jazz 

By Jeffrey Millstein, MD, Penn Medicine

Like learning to play jazz, medical interviewing skills can grow and develop through close observation and imitation of mentors. 

June 22, 2018 | 2 min read

Ars Medica: The Art of Medicine

By Javier de la Maza, MD, Johns Hopkins University

Storytelling is a powerful tool that can be used to shape our reality and reconnect with our patients. Building meaningful relationships with our patients reminds us the importance of the human experience in providing clinically excellent care.

August 15, 2022 | 2 min read

Role Modeling Vulnerability

By Daniel Saddawi-Konefka, MD, MBA, Massachusetts General Hospital

When a patient dies, sharing your emotions with trainees normalizes this response and highlights our shared humanity.  

April 25, 2019 | 3 min read

Diagnostic Humility

By Nathan Douthit, MD, Brookwood Baptist Health, Birmingham, Alabama

Self-awareness is critical in making accurate diagnoses.

Public Domain, https://commons.wikimedia.org.

August 2, 2022 | 3 min read

Stranger Things in Healthcare

By Scott Wright, MD, Johns Hopkins Medicine

Working in healthcare can often feel like entering the “Upside Down.” The importance of teamwork, bravery, and embracing uncertainty are just a few of the valuable lessons from this terrific Netflix series.    

MERIT Health Leadership Academy students, Baltimore, Maryland, author's photo.

February 27, 2019 | 2 min read

The Need for Diversity

By Tyler Mains, MD, University of California, San Francisco

Our future healthcare workforce must be as diverse as the communities it serves.

June 7, 2022 | 2 min read

“What’s Your Name Again?”

By Simone Lescott, MD, Johns Hopkins Medicine

Those who are underrepresented in medicine experience increased discrimination. It’s important to speak up against micro and macro aggressions.   

November 5, 2018 | 2 min read

Providing Holistic Care

By Nancy Hutton, MD, Johns Hopkins University School of Medicine

Excellence in clinical care requires intellectual rigor, keen observation, empathic communication, an understanding of the context in which the patient lives, and consideration of the individual patient as the center of care. 

June 11, 2018 | 5 min read

Caring For The Patient

By Michael Carducci, MD, Johns Hopkins University School of Medicine

An oncologist shares his inspiring clinical mission and values statement on noticing beauty and knowing his patients.

May 5, 2022 | 1 min read

Lessons From Choosing a Specialty

By Howard Chang, Medical Student, Johns Hopkins Medicine

Deciding on an area of practice during medical school reminded me to ask for help when needed and to be comfortable with uncertainty. These skills will help me when I care for patients in the future.    

March 12, 2025 | 3 min read

5 tips to move forward after a challenging patient encounter 

After a challenging patient encounter, prioritize mindful breathing and reflective reframing. This may help you give your best care to the next patient. 

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