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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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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.  

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. 

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.

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.

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. 

"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.

April 23, 2025 | 3 min read

Teamwork Rx

Medical team huddles are a powerful practice to foster unity. This routine promotes teamwork, collaboration, and respect. 

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. 

"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.

"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.  

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.

December 15, 2025 | 2 min read

Pause, pattern, plan 

Turn gut feelings into patient-centered next steps. Instincts may guide you, but confirm each step with the patient’s goals, evidence, and team input. 

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. 

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.

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.

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 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. 

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.

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 8, 2025 | 3 min read

“Can you help me die?” 

By Carolyn Rennels, MD, University of San Francisco

When a patient asks about medical assistance in dying, prioritize deep listening and exploration of fears and hopes over immediate procedural responses. This can help reassure them that you’ll accompany them to the end. 

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.

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. 

"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.

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.  

September 19, 2019 | 2 min read

The Importance of Partnering With Patients

By Michael Crocetti, MD, MPH, Johns Hopkins Community Physicians

What patients and families need is a clinician advocate who is available to listen, translate complex medical language, and support both the physical and mental health of the patient.

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.

December 4, 2025 | 3 min read

Winter humbles the leaves 

Balance diagnostic exhilaration with goals-of-care conversations centered on the values of the patient and family. 

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. 

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.

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.

"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.

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.

Newly Renamed Black Lives Matter Plaza NW, Washington, D.C., June 2020.

June 30, 2020 | 1 min read

Learning to be Antiracist

By Ashlyn McRae, Medical Student, Johns Hopkins Medicine

We must acknowledge the ways in which we have been, and are racist. This will allow us to provide the most equitable care to all of 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.

If a patient doesn’t appear to understand what you’re saying despite repeated efforts, ask how they learn best. Perhaps draw a diagram and/or use an analogy.

March 20, 2025 | 3 min read

Falling up 

By Emily Ma, medical student, Johns Hopkins Medicine

The transition from pediatric to adult care poses significant challenges for patients with disabilities. Healthcare professionals can help by seeking to improve access and continuity of care. 

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. 

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. 

"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.

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. 

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.

December 1, 2025 | 2 min read

“My Own Private Idaho”

Ask patients how they want their housing documented, and use patient‑preferred, nonstigmatizing language. Some patients may prefer, “lives in a tent, self-identifies as housed."

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.

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.

December 27, 2018 | 2 min read

“Charm City” Movie Review

The upcoming film "Charm City" emphasizes that the struggles of each patient who comes to clinic extend far beyond a medical diagnosis. We must be conscious of our patients' many challenges and mindful to address them. Making time to ask about your patient's day-to-day concerns, worries, and fears about their homes, neighborhoods, and communities can help you to get a fuller perspective of their medical and social determinants of health. This will allow you to reach relevant goals of care together.

July 18, 2023 | 1 min read

Can a chatbot be a clinician’s friend?

By Adam Poliak, PhD, Bryn Mawr College, Eric Leas, PhD, Mark Dredze, PhD, Johns Hopkins University

ChatGPT can draft seemingly empathic answers to patient questions on medical portals. This may help clinicians respond more efficiently to their patients’ concerns. 

Mahabharata. Published by Geeta Press in Gorakhpur. Public domain, Library of Congress.

July 13, 2020 | 2 min read

Eklavya and the Power of Online Learning

By Mrinali Shetty, MD, University of Chicago, Yuvraj Chowdhury, MD, SUNY Downstate Medical Center

During the pandemic, there has been an increase in educational offerings that can enhance our clinical skills. This expansion of virtual learning opportunities, (like open-access Zoom lectures and grand rounds, and #MedTwitter #tweetorials on countless topics), can be a boon for all.

"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.

March 10, 2025 | 2 min read

The B12 fix

By Selvi Rajagopal, MD, MPH, Johns Hopkins Medicine

Clinicians should remember to watch for fatigue in patients shifting to plant-based diets; a B12 test can reveal a significant, reversible cause of feeling poorly. 

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.

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.

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