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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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April 15, 2019 | 1 min read

7 Things I’ve Learned About Mentoring in 51 Years

By David Levine, MD, MPH, Johns Hopkins University School of Medicine

Helping others to achieve their full potential is the most incredible, wonderful, and exhilarating role one can undertake.

June 14, 2018 | 1 min read

AI and the Art of Medicine

By Souvik Chatterjee, MD, Johns Hopkins Medicine

Exploring the new challenge of combining the art of healing with the new science of machine learning.

February 5, 2024 | 1 min read

When patients emphatically question the diagnosis

By Will Frye, PhD, Johns Hopkins All Childrens, St. Petersburg, Florida

Sometimes patients and families struggle when processing a new diagnosis. Embracing open communication, education, and collaboration may transform disagreements into understanding. 

November 23, 2021 | 3 min read

Preventive Care And COVID

By Aline Charabaty, MD, Johns Hopkins Medicine

As a gastroenterologist, I’ve been encouraging people to continue with colon cancer screening through the pandemic. A delay may have serious health consequences.

November 4, 2025 | 2 min read

The way we live 

Lifestyle medicine involves co-creating plans with patients for diet, physical activity, sleep, stress, and social connection. This can have an impact on both prevention and treatment of disease.

December 2, 2019 | 2 min read

Improving Communication Between Inpatient Teams and PCPs

By Stephen Berry, MD, Johns Hopkins Medicine

While it's not always easy, hospital-based providers need to find a way to connect with the healthcare professionals who will continue their patient's care.

December 1, 2022 | 1 min read

World Cup Fever

By Scott Wright, MD, Johns Hopkins Medicine

As you watch lots of “The Beautiful Game” this month, there are lessons for healthcare professionals. All members of our teams are important and diversity drives success.  

February 25, 2021 | 2 min read

How You Can Help With Intimate Partner Violence

By Lisa Geller, MPH, Educational Fund to Stop Gun Violence

Intimate partner violence (IPV) is a public health crisis and most deadly when a gun is involved. Clinicians should screen patients for IPV, ask about firearm possession, and refer those at risk of IPV to appropriate services.

August 26, 2024 | 1 min read

The medical Tower of Babel  

Immigrant patients often face challenges when accessing healthcare because of language and cultural barriers. Certified medical interpreters can help reduce the likelihood of inequities in care. 

May 2, 2022 | 3 min read

The Alarming Rise in Pediatric Suicide

By Elizabeth Reynolds, PhD, Johns Hopkins Medicine

Rates of childhood suicide have been rising steadily and this is now the second leading cause of death for youth. It's critical to screen children for suicidal thoughts and behaviors.   

June 28, 2019 | 1 min read

How to Improve Outpatient Handoffs

Consider performing outpatient handoffs and preparing patients when you will be away. This will make your time away easier for your covering colleagues and for your patients.

June 2, 2020 | 3 min read

“Flattening the Curve”

By Madeline Rodriguez, MD, Johns Hopkins University School of Medicine

The pandemic is breaking down the traditional hierarchy of medical education. Opportunities are emerging for faculty to learn even more from residents.

August 1, 2023 | 2 min read

Psychological First Aid

By Albert Wu, MD, MPH, Johns Hopkins Medicine, Matt Norvell, DMin, Johns Hopkins Medicine

Healthcare professionals experience traumatic events that may exceed their ability to cope. Timely emotional support can help maintain their well-being. 

"When the hospital is suspiciously quick to sweep everything about the error and suicide under the rug, Noah turns for guidance to the journal of his late father, a respected surgeon."

January 31, 2024 | 1 min read

Book review of “The committee will kill you now” 

By Joan Naidorf, DO

This novel reminded me that even in a complex healthcare system, individual clinicians can make a substantial contribution to the ethical treatment of their patients.  

November 22, 2021 | 4 min read

Noticing What We’ve Seen Without Seeing

By Ekene Ojukwu, MD, Johns Hopkins Medicine

Carefully observing our patients can lead to clinically relevant insights. Sometimes what seems inconsequential at first glance may be surprisingly significant.

October 28, 2025 | 2 min read

Far from routine  

What feels run of the mill to clinicians can be life-changing for patients. A focused moment of empathic presence may alter the course of their life. 

This is from "The Spirit Catches You and You Fall Down," written by Anne Fadiman. The art copyright is believed to belong to the publisher, Farrar, Straus and Giroux, or the artist. Public domain from wikipedia.org.

November 20, 2019 | 2 min read

“The Spirit Catches You and You Fall Down”

By Laura Pugh, Medical Student, Johns Hopkins Medicine

The gap between cultural systems can be wide. Openness, curiosity, and humility will improve cross-cultural care.

Aiden Crowley said that “a hug can be medicine” and that simple “presence and accompaniment” provides more for the patient and family than we might think.

November 23, 2022 | 1 min read

Using CLOSLER For Grand Rounds

By Richard Schaefer, MD, MPH, Johns Hopkins Medicine

CLOSLER has a wealth of material that can be leveraged to enhance teaching in a variety of settings, including lectures, bedside, and small group discussions. 

August 21, 2024 | 2 min read

Confessions of a non-flosser 

By Kyra Reu, medical student, University of Pennsylvania

When I told my dentist I didn’t floss regularly, it reminded me of a patient who shared she was not taking her medication as directed. Careful questioning of how the patient is actually taking their medication should be done before modifying the treatment. 

April 26, 2022 | 1 min read

The Power of Beliefs

By Stephanie Trudeau, PhD, The Thrive Center For Human Development

Explore your patient’s beliefs that invite healing, as well as those that are causing them to suffer. By understanding this, you can guide them to do more of the former and less of the latter. 

November 29, 2018 | 2 min read

Management Reasoning: Diagnostic Reasoning’s Underappreciated Sibling

By David Cook, MD, MHPE

Management reasoning is primarily a task of shared decision-making and monitoring, and is inherently more complex than diagnostic reasoning. A better understanding of management reasoning will offer insights into the causes and avoidance of medical error, clinical practice quality improvement, and training and assessment of health professionals.

Kau Sai Chau Public Golf Club, Hong Kong.

July 21, 2020 | 1 min read

Medicine is Like Golf

By Barry Bryant, MD, Johns Hopkins Medicine

In both medicine and golf, it's helpful to accept that much is beyond our control. Trusting our ability —grounded in thousands of hours of focused practice—may allow us to have the confidence that our best efforts will usually translate into favorable results.

Role playing "Dungeons and Dragons."

July 31, 2023 | 3 min read

Dungeons and Dragons and Medicine

By Lillian Houston, MD, Southern Illinois University

D&D teaches us that the team is our most important asset. Interdisciplinary and diverse teams that communicate openly are most successful. 

July 6, 2021 | 2 min read

CARE: Connect, Assess, Respond, Evaluate

By Cheryl Barnes-Neff, PhD, MDiv, RN, President, Laurel Oak Group, Online Education & Training

To understand and better care for your patients, be curious about their life stories. Reflect on what you hear and consider the extent to which you are truly connecting.

April 1, 2019 | 3 min read

Practicing Medicine and Having a Ball

By Wilma Ferthler, MD, Rural Country Doctor, Northeast Kingdom, Vermont

Hope our 2019 April Fool's piece makes you chuckle!

June 27, 2022 | 3 min read

Caring for people and their gender stories

By Hailey Haffey, PhD, University of Utah

To care for people is to care for the stories that shape them. Clinicians can enhance patients’ confidence in the healthcare system by skillfully engaging with their stories of gender and sexual orientation.

January 23, 2024 | 1 min read

Book review of “The algorithm will see you now”

By Joan Naidorf, DO

In this medical thriller set in the not-too-distant future, diagnosis and treatment are performed entirely by AI. The novel serves as a reminder that AI must be used thoughtfully and responsibly.  

November 16, 2021 | 1 min read

Collaborating With Patients For Optimal Care

By Leslie Miller, MD, Johns Hopkins Medicine

For patients to participate in their treatment planning, clinicians must first share knowledge and insights. From this foundation, shared decision-making may be possible.

October 22, 2025 | 3 min read

Coordination with compassion 

To build an exceptional care team: foster psychological safety, model humility, and solicit input from every person. Daily rituals of respect can sustain excellent patient care. 

November 19, 2019 | 2 min read

Aging isn’t a dirty word

To many, "aging" and "old" are considered dirty words. Clinicians should fight ageism.

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. 

December 17, 2020 | 4 min read

Racial Discrimination And Larger Bodies

By Kristal Brown, PhD, MSPH, Johns Hopkins Medicine

We must be aware of our own biases and prejudices in order to give excellent care to every patient.

August 7, 2024 | 2 min read

Wait! Is that a zebra?

Common things are common, but occasionally unusual conditions are seen. To improve diagnostic accuracy, clinicians should consider alternative explanations and challenge their own assumptions.

April 14, 2022 | 3 min read

Afraid to Tell The Truth

By Kirsten Elin Smith, PhD, National Institute on Drug Abuse

When I shared with my clinician that I had previously been a heroin user, she made me feel ashamed. This taught me the importance of listening to patients with nonjudgmental curiosity. 

November 12, 2018 | 3 min read

Insights From “A Whole New Mind”

Daniel Pink's "A Whole New Mind" highlights the importance of cultivating empathy, humor, and the ability to create meaning.

July 24, 2023 | 2 min read

Prince of Yonkers

By Carey Roesler, PA-C, Johns Hopkins Medicine

When my car broke down, a mechanic went above and beyond to make sure I made it to my aunt’s funeral. This reminded me of how lucky I am to be able to help my patients through challenging times. 

July 7, 2021 | 1 min read

Lessons Learned During my Palliative Care Rotation

By Rayah Sawaya, MD, American University of Beirut

In the wake of disaster, I witnessed the value of palliative care firsthand. This service prioritizes patient comfort and end-of-life preferences.

March 13, 2019 | <1 min read

Dr. Elliot Fishman, A CLOSLER Look

By Gretchen Miller, Managing Editor

Artificial intelligence (AI) will drastically alter all of medicine, with the potential to enhance patient care through improved diagnoses.

June 23, 2022 | 2 min read

Reflections at The End of a Busy Clinical Year

By Madeline Rodriguez, MD, Johns Hopkins University School of Medicine

Outstanding clinicians are humble, curious, and nonjudgmental. 

January 17, 2024 | 1 min read

“I’m not comfortable”

By Jeffrey Millstein, MD, Penn Medicine

Patients sometimes ask for interventions that conflict with clinical best practice. The most effective responses are ones that focus on patients’ needs and level of understanding rather than on the clinician’s discomfort with their requests. 

November 4, 2021 | 3 min read

Dissection And Reintegration

By Aidan Crowley, Medical Student, University of Pennsylvania

We sometimes “cut” patients apart to assist in the diagnostic process. We must remember to put them back together; we’re charged with caring for their minds and spirits in addition to their bodies.

October 21, 2025 | 2 min read

Stroke, breath, care

Swimming taught me the importance of rhythm and breath. During difficult conversations with patients and families, I make room for quiet pauses to give them time to process.

November 12, 2019 | 2 min read

The Early Bird Special

By Rebecca Hamburger, Medical Student, Central Michgan University College of Medicine

Timing is everything. Doing our best to optimize access to healthcare is a first step to serving our patients.

December 16, 2020 | 2 min read

The Danger of Stereotyping Specialties

By Sarah Temkin, MD, Greater Baltimore Medical Center

Clinicians must critically evaluate the stereotypes that they assign to one another. A diversity of training and backgrounds is beneficial to patient care.

April 14, 2022 | 4 min read

Talking About Climate Change With Patients

By Dean Chien, CLOSLER team, Baltimore, Maryland

Climate change affects the health of everyone. When talking with patients about climate change, meet them where they are and listen nonjudgmentally. 

The Bluebird Cafe, Nashville, Tennessee. Copyright by the author.

May 11, 2020 | 3 min read

Redefining Rounds—Will The Circle be Unbroken?

By Chase Webber, DO, Vanderbilt University Medical Center

A patient care team performs best when all voices harmonize and creative approaches are applauded.

July 10, 2018 | <1 min read

Better Dementia Care Through Music

By Michele Bellantoni, MD, Johns Hopkins University School of Medicine

Having your older patients listen to music can be an effective way to reduce dementia-related behavioral disturbances.

June 22, 2021 | 1 min read

How You Can Take Action Beyond Pride Month

By Nat Mulkey (they/them), Medical Student, Boston University Medicine

To improve the health and well-being of LGBTQI+ patients, we must commit to being lifelong learners and teachers in this continually evolving space.

March 28, 2019 | 6 min read

Integrating Psychology and Primary Care

By Benjamin Bensadon, PhD, University of Florida College of Medicine

Person-centeredness holds great potential to maximize healing in the way Osler envisioned more than a century ago. But to translate this concept clinically, psychology and medicine must come closer together. The closer we can come together, the closer we can come to Osler.  

June 22, 2022 | 1 min read

Explaining The Risks of Vaping

Prioritize discussions about the long-term consequences of smoking. Be aware that just because someone has quit doesn’t mean that they won’t relapse.

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