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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 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 12, 2024 | 2 min read

DIY drugs: a risky prescription 

Healthcare professionals need to know about the growing trend of do-it-yourself (DIY) medicine. By asking open-ended questions about medication sources, clinicians can prevent adverse health outcomes. 

August 4, 2020 | 2 min read

3 Tips for Talking With Patients About Advance Directives

By Ambereen Mehta, MD, Johns Hopkins Medicine

ALL clinicians can and should encourage patients to document their wishes regarding medical decisions in case they’re unable to make these decisions for themselves.

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.

July 18, 2018 | 2 min read

The Bell Curve

By Lee Akst, MD, Johns Hopkins University School of Medicine

The difference between a 99.5% and 99.95% success rate isn't necessarily in knowledge or training, but in physician attitudes towards adapting and changing to evolving information.

June 10, 2019 | 4 min read

Lessons learned from my journey through depression

By Shannon Scott-Vernaglia, MD, Mass General

Being a patient has taught me patience, with myself, with those I care about, and with those I care for as physician. 

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.  

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 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.

July 30, 2018 | 1 min read

What’s a book club doing at a medical conference?

By Scott Wright, MD, Johns Hopkins Medicine

Join a book club or start a book club - in either your professional or personal context. You'll be glad you did!

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.

April 10, 2023 | 1 min read

Sips And Gulps

By Judy Ashley, patient

Patients may need a clinician’s help with things that seem easy or obvious, like how to swallow pills.

January 10, 2019 | 3 min read

How to Improve Your Physical Diagnostic Skills With a Digital Database

By Samuel Durso, MD, Johns Hopkins Medicine

To sharpen diagnostic skill, take a minute to cross check the physical exam against images and lab results in the electronic record - if not congruent, then why?

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 7, 2024 | 2 min read

Following my own rules  

By Julie Caffrey, DO, MS, Johns Hopkins Medicine

Having my own set of guidelines has helped me to continuously improve. One of my favorites is consciously learning something new every day.

August 12, 2020 | 2 min read

Chief Complaint: Racism

By Syeachia Dennis, MD, University of Oklahoma

Patients are increasingly recognizing the impact of racism on their health. We should be prepared to help patients confront this and consider this core to our work to systemically address this public health crisis.

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.

September 20, 2023 | 2 min read

Sharing Our Stories

By Hailey Haffey, PhD, University of Utah

Stories we’ve internalized about healing may direct our approach to patient care. Find the one that resonates most with you.

"The Starry Night," Vincent Van Gogh, 1889, Museum of Modern Art.

May 16, 2019 | 5 min read

Starry, Starry Night

By Juliette Perzhinsky, MD, MSc, Central Michigan University

There are times that as clinicians we become patients ourselves, needing compassionate care for injuries entirely unrelated to our chief complaint.

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 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.

April 11, 2024 | 1 min read

Takeaways from Adam Grant’s “Think Again” 

By Gretchen Miller, Managing Editor

Healthcare professionals can benefit from adopting a growth mindset that emphasizes rethinking existing beliefs and approaches. A key strategy is questioning assumptions and biases, which can lead to better decision-making. 

January 28, 2020 | 3 min read

Racism From Patients—an Ethical Dilemma

By Sonal Gandhi, MBBS, MD, Johns Hopkins Medicine

A cornerstone of clinical excellence is treating all patients with respect and dignity. This is true even when treating those patients who are not respectful to you.

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.

March 30, 2023 | 2 min read

Cultivating a Beginner’s Mind

By Clara Watkins, student, Emory University School of Nursing, Colleen Christmas, MD, Johns Hopkins Medicine

Remember when you were a new learner? Approach situations with that open, creative, and nonjudgmental mind that you may have had when you started training. 

January 7, 2019 | 2 min read

Helping Your Patient Get Better Sleep During Hospital Stays

Sleep is important during hospitalization, and we need to maximize quality and quantity the best we can for our patients. Asking about your patient’s sleep and identifying ways to improve it when possible is one way to start.

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. 

"Imperial Purple," by Spencer Finch. Photo copyright with the authors.

July 20, 2020 | 6 min read

Art and Connection During COVID-19

By Kamna Balhara, MD, Johns Hopkins Medicine, Sarah Clever, MD, Johns Hopkins Medicine

In a time of physical distancing, stepping out of our comfort zone to find creative and unconventional ways to connect with patients and colleagues can bring us together.

June 16, 2021 | 1 min read

Why we Must Talk About E-cigarettes with Teen Patients

By Mike Fingerhood, MD, Johns Hopkins Medicine

Proactively counseling adolescents about the risks of e-cigarette use is essential. The message should acknowledge both the health implications and the pressures that they may feel from their peers.

September 18, 2023 | 3 min read

Do you “need” to say it that way? 

By Gina Piscitello, MD, MS, University of Pittsburgh Medical Center

Using the word “need” to describe a treatment option may mislead patients and loved ones into believing it should be pursued. Prioritizing patient values and preferences may help reduce this risk.  

"L'Atelier au mimosa," Pierre Bonnard.

May 13, 2019 | 7 min read

April Art Museum Challenge

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

Slow looking can enable clinicians to see more deeply, think more critically, and engage more meaningfully in patient care. Time spent in a museum supports clinician wellness and nurtures student professional identity formation.

August 8, 2022 | 1 min read

988

By Patrick Hemming, MD, Duke University

When we identify patients who are experiencing mental illness, we need to let them know about this new resource in the U.S.

October 16, 2025 | 4 min read

Prescribing humility 

Standard of care is provisional—reassess therapies as evidence evolves. Be open to changing your thinking and practice as new data emerge. 

November 8, 2021 | 1 min read

Lessons Learned From 30 Years of Night Shifts

By Kimberly Turner, MD, Johns Hopkins Community Physicians

Patience, stamina, and fortitude are important traits to cultivate in medicine at any and all times.

April 3, 2024 | 2 min read

Military kids serve too 

By Richard Schaefer, MD, MPH, Johns Hopkins Medicine

April is the Month of the Military Child. Clinicians caring for military family members should understand their history and stressors specific to the armed service to give the best possible care.    

March 21, 2018 | 2 min read

İnsan Olmak—Being Human

By Ezgi Ozalp Akın, MD, Ankara University

Developmental pediatrician Ezgi Ozalp Akın, MD, shares insights gleaned from "İnsan Olmak" on being human.

"Spending time outdoors helps me cope with the stress and sadness of the job." -Dr. Jared Rubenstein

December 10, 2020 | 3 min read

Coping With Patients’ Heartbreak

By Jared Rubenstein, MD, Baylor College of Medicine

When supporting patients and their loved ones during times of great sadness and loss, cultivating a daily habit of self-care may protect against burnout.

June 26, 2018 | 1 min read

Harnessing Digital Technology for Clinical Excellence

By Margaret Chisolm, MD, Johns Hopkins Medicine

Digital technology can be leveraged for the greater good of clinically excellent patient care. Social media tools like Twitter enable you to connect with healthcare stakeholders from around the world.

April 14, 2022 | 2 min read

“Explainaholics”

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

Sometimes patients and caregivers feel overwhelmed when clinicians provide too much information. When you sense this to be the case, offering clear recommendations can be helpful.

October 28, 2024 | 2 min read

Spark the change

By Sadiqua Sadaf, MBBS, Deccan College of Medical Sciences, Hyderabad, India

To motivate patients toward change, healthcare professionals can focus on building trust and setting achievable goals.

Juneteenth Flag

July 2, 2020 | 4 min read

3 Tips for Dismantling Anti-Black Racism in Academic Medicine

By LaShyra Nolen, Medical Student, Harvard University

White educators and learners must commit to doing the work and educating themselves on how to be antiracist. Black colleagues should not be responsible for educating those around them.

September 13, 2023 | 1 min read

Firearm Suicides on The Rise

By Katherine Hoops, MD, Johns Hopkins Medicine, Paul Nestadt, MD, Johns Hopkins Medicine

To stem the increase in self-inflicted gun deaths, we must work toward early and accurate diagnosis of mental illness, as well as advocate for better firearm laws.

"Blue Rider," Franz Marc, 1911.

May 14, 2019 | 4 min read

Review of “Critical Crash”

By Andre Lijoi, MD, York, Pennsylvania

We all have our woundedness, and our own story is important in the context of caring for our patients. These stories and wounds operate in the background of our consciousness and we must recognize and manage them.

August 1, 2022 | 1 min read

Keeping Children Safe

By Katherine Hoops, MD, Johns Hopkins Medicine, Monique Burke, MD, President, MD Chapter of the AAP

The new Safer Communities Act helps clinicians connect patients to mental healthcare. Hopefully, this will reduce youth gun violence, including suicide. 

October 13, 2025 | 2 min read

The word “want” may leave patients wanting 

When prior notes document that a patient doesn’t “want” a specific intervention, elicit the patient’s desired outcome and acceptable trade-offs. Then determine whether “I don’t want X” is absolute or conditional and align the care plan accordingly. 

November 9, 2021 | 3 min read

Giving Exceptional Care Without Exception

A one-liner works in comedy but leads to biases in medicine. Listening, getting to know, and learning from each patient will allow you to serve them best.

April 2, 2024 | 3 min read

A dose of reality (TV)  

By Maria Fazal, MD, Baltimore, Maryland

A patient who had severe anxiety and depression told me that watching “The Great British Bake Off” was a helpful relaxation technique. She taught me that shows like this may provide a therapeutic escape.  

February 12, 2020 | 1 min read

Agents of Change—Learning From Gen Z Healthcare Students

By Kevin Pan, Medical Student, Ohio University School of Medicine

Excellent clinicians are committed to reducing health inequity.

March 6, 2023 | 1 min read

Supporting Menopausal Patients

By Talia Sobel, MD, Mayo Clinic

Women often receive misinformation about menopause and even experience medical gaslighting from healthcare professionals. Clinicians should validate patients’ symptoms, and work with them to improve quality of life. 

"Nighthawks," Edward Hopper, 1942.

January 2, 2019 | 3 min read

The Human Experience of Illness

By Tina Zhang, MD, Johns Hopkins Medicine

Paintings, photographs, and poems can foster dialogue about the human experience of illness and allow learners to approach challenging topics in a more comfortable way.

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