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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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May 18, 2022 | 3 min read

A Matter of Interpretation

By Kathleen Page, MD, Johns Hopkins Medicine

Practice, preparation, and intentionality are essential to mastering medical skills, including how to communicate effectively with an interpreter. 

February 28, 2022 | 4 min read

To Our Interpreters: Gracias, Shukriyah, Todah, Danyavad, Merci, Danke

By Cecilia Murach, Medical Interpreter, Johns Hopkins Medicine, Kamna Balhara, MD, Johns Hopkins Medicine, Nathan Irvin, MD, Johns Hopkins Medicine

When working with an interpreter, remember that they’re a person, not a machine. Saying “thank you” makes them feel like a valued member of the healthcare team. 

September 4, 2018 | 1 min read

7 Tips for Working With an Interpreter

By Stephanie Nothelle, MD, Johns Hopkins University School of Medicine

Pause often, ask one question at a time, and avoid idioms when speaking through an interpreter.

September 23, 2021 | 2 min read

Best Practices for Cross-Cultural Communication

By Rebekah Fenton, MD, Northwestern University

When caring for patients with limited English proficiency, always use a licensed interpreter. Remember to direct your speech and body language to the patient. 

April 11, 2022 | 6 min read

Effective Partnering With Medical Interpreters

By Cecilia Murach, Medical Interpreter, Johns Hopkins Medicine

A medical interpreter can support successful communication between limited English proficiency patients and the other clinical team members. This collaboration helps build cross-cultural connections with patients and improve care. 

August 4, 2021 | 1 min read

Best Practices When Working With an Interpreter

When caring for a patient with limited English proficiency, understand that you’ll need to collaborate effectively with an interpreter. Speak naturally in the first person and maintain eye contact with your patient, not the interpreter.

October 1, 2019 | 4 min read

Developing a Complete Culture of Interpretation

By April Lugo, Program Coordinator, Johns Hopkins Medicine Office of Diversity and Inclusion

The clinically excellent clinician prioritizes training for themselves and their staff on the proper role of an interpreter. They work to empower interpreters to translate not only the patient's words, but also the patient's tone, cadence, and meaning.

August 12, 2021 | 1 min read

Beyond Language—Closing the Gaps 

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

Caring for a patient who didn’t speak English showed me that all patients can benefit from a compassionate facial expression, eye contact, and a soothing tone.

March 14, 2019 | 4 min read

How to Help Your Patient Understand Genetic Testing Results

By Leslie Ordal, MSc, CGC

To help your patient with their direct-to-consumer genetic testing results, use skills that apply for any sensitive clinical encounter: listen, acknowledge, and reassure of your presence in the process. Then connect your patient with a genetic counsellor for follow-up as needed.

September 19, 2022 | 1 min read

What I’ve Learned as an ESL Physician

By Ming-Hsien Wang, MD, Johns Hopkins Medicine

Growing up with non-English speaking parents, I know first-hand the challenges that these patients face. Being able to communicate is imperative for connecting and creating effective treatment plans. 

November 10, 2021 | 5 min read

Reading Between The Lines

We don’t always say what we’re thinking, particularly in difficult conversations. Sharing and exploring unspoken thoughts can lead to stronger connections with our patients and better care.

October 4, 2021 | 1 min read

Words Matter

By Leslie Miller, MD, Johns Hopkins Medicine

When serving as an advocate for a family member, I noted judgmental language in the EHR. This reminds me as a clinician to consider how patients (and their families) will feel when they read my notes.

January 21, 2021 | 1 min read

Lost in Translation

By Sonal Gandhi, MBBS, MD, Johns Hopkins Medicine

When you and your patient don’t speak the same language, clear communication is critical. When an interpreter is unavailable, reach out to staff and others for help.

October 11, 2022 | 6 min read

Learning About Your Patients And Their Communities

By Hailey Haffey, PhD, University of Utah

Receiving patient and community stories with thoughtful attention can help serve the aims of equity in healthcare. 

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.

Dr. Margaret Chisolm captures a photograph of the painting, "John, 1st Baron Byron," 2013, Kehinde Wiley (American, born in 1977), at the Museum of Fine Arts, Boston.

April 8, 2019 | 5 min read

On Looking: March Museum Visit

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

Visual Thinking Strategies and the Personal Response Tour are two examples of museum-based pedagogical practice that build critical thinking skills, foster empathy, and allow for reflective space away from the clinic.

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?

"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.

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.

March 8, 2022 | 3 min read

Tips For Assessing The Intensity of Pain

By Brian Lee, MD, PhD, Johns Hopkins Medicine, David Madder, DO, Johns Hopkins Medicine

When assessing pain, we often ask patients to assign it a number between 0 and 10. Asking about the effect of pain on behavior and functional status can often give us a more meaningful understanding. 

June 18, 2019 | 2 min read

Navigating the Uncertain: A Book Review of “The Laws of Medicine”

By Sam Kant, MD, Johns Hopkins University School of Medicine

Siddhartha Mukherjee, MD, provides a framework to reconcile the uncertainties we constantly experience in our practice of medicine in his book, "The Laws of Medicine."

December 20, 2018 | 9 min read

You’re not getting my f-ing box cutter: paradoxical ways kids ask for limits

By Hal Kronsberg, MD, Johns Hopkins University School of Medicine

The most important lesson I’ve learned as a child psychiatrist is how badly kids want limits when they’re struggling, even when they keep that wish to themselves. Kids are smart, and when we catch them breaking a rule, we need to be curious about why it happened.

May 19, 2021 | 3 min read

Clinical Training Translating to Clinical Excellence

By Jennifer Spicer, MD, MPH, Emory University

Bias awareness achieved in teaching/learning can transfer to the clinic. Thus learners can help clinicians become aware of bias toward patients.

Humility—a graceful bridge over the abyss of self-doubt.

April 7, 2021 | 3 min read

Humility

By Steve Bierman, MD, Del Mar, California

In medicine, all too often the optimal approach for diagnosis or therapy is not entirely clear. Acknowledging uncertainty with your patient is a sign of a humility that can strengthen the connection.

September 17, 2020 | 3 min read

5 Tips for Talking About Autopsy Results With Your Patient’s Family

By J. Stephen Nix, MD, Johns Hopkins Medicine

Managing loved ones’ expectations before the autopsy is critical. Ensuring there's ample time to privately review and explain the results can help bring meaning and closure to their loss.

August 23, 2018 | 4 min read

How To Incorporate Students Effectively Into Clinic

By Rachel Salas, MD, Johns Hopkins Medicine

Making the time and effort to integrate students into clinic cohesively can be associated with both improved clinical productivity and educational value.

October 1, 2020 | 3 min read

3 Tips to Improve Your Body Language

By Adam Koenig, Medical Student, University of Toledo

To build a strong patient-clinician relationship, position your body with an open posture and make good eye contact.

February 2, 2023 | 2 min read

We Just Disagree

By Eric Last, DO, Northwell Health, Wantagh, New York

When colleagues offer a conflicting opinion, remember to always put the patient first, check your facts, and be open to learning.  

September 10, 2020 | 2 min read

Collaborating With Physical Therapists

By John Corsino, PT, Cape Cod Hospital

Better collaboration between clinicians and PT colleagues can improve the health outcomes of our patients.

April 17, 2018 | 5 min read

Knowing Your Patient

By Khalil Ghanem, MD, PhD, Johns Hopkins University School of Medicine

Diagnostic excellence begins and ends with knowing your patient.

Boundary Waters Wilderness, Minnesota.

October 3, 2022 | 4 min read

Setting Boundaries in Medicine

By Laura Hanyok, MD, Johns Hopkins Medicine

Key to mitigating burnout is managing expectations of yourself and others, while still fulfilling our duties to patients. 

May 7, 2020 | 5 min read

Captivity and COVID-19

By Cesar Lopez, MD-PhD student, University of North Carolina at Chapel Hill, Zackary Berger, MD, PhD, Johns Hopkins Medicine

Severely ill incarcerated individuals will be hospitalized at disproportionately high rates during this pandemic. As always, healthcare professionals should treat them with dignity and respect. Better care of those who are imprisoned may help with our public health efforts and response.

September 27, 2022 | 2 min read

When?

By Shreya Srivastava, medical student, Albany Medical College

When my friend was struggling with her mother’s new diagnosis, she listened to the popular French song about cancer entitled, “Quand c’est?” It gave her a sense of support, empathy, and solidarity with others.

The Baltimore Museum of Art. Wikipedia.org. Photograph by Eli Pousson, 2018 March 25.

April 7, 2020 | 3 min read

The Personal Responses Tour in Medical Education

By Howard Chang, Medical Student, Johns Hopkins Medicine

Arts-based medical education improves fundamental clinical skills, including ambiguity tolerance, reflective ability, bias awareness, and empathy. It can also enhance the well-being of healthcare professionals.

September 21, 2022 | 1 min read

Helping Patients Navigate Risk in The New Normal

By David Hurwitz, MD, MBA, Johns Hopkins Medicine

Using empathic listening to give COVID-related advice will help your patients balance the risks of the pandemic with enjoying the activities in their lives that matter most. 

WWI Battle of Verdun Cemetery, Verdun, France.

March 23, 2020 | 4 min read

Finding the Right Words—Lessons From Nurse Mary Borden

By Iro Filippaki, PhD, Johns Hopkins University School of Medicine

WWI Nurse Mary Borden's autobiography provides inspiration to search for the right words to describe our experience, and perhaps, find solace as we face the challenges of medicine.

Encourage parents to support their teens in connecting with friends in physically-distanced ways.

March 3, 2020 | 3 min read

The Power of the “Ordinary”

By Gaye Cunnane, MD, PhD, Trinity College Dublin

Excellent clinicians recognize that sometimes the opportunity to make a difference in the lives of patients comes in the most unexpected moments.

Natya Dhrami Foundation for Performing Arts. Copyright with Eswar Avidi.

August 10, 2022 | 3 min read

Storytelling With Hands

By Shreya Srivastava, medical student, Albany Medical College

Exploring Non-Western art forms–like Indian classical dance–can diversify our understanding of the cultural and spiritual roles that body parts can play in healing.

July 11, 2022 | 5 min read

Navigating Power Relations in Healthcare

By Hailey Haffey, PhD, University of Utah

We must be aware of the power we have in relation to our patients. This imbalance must only be used in the service of care.   

December 16, 2019 | 4 min read

Top 10 Tips to be a Great Consultant

By Aline Charabaty, MD, Johns Hopkins Medicine

Read these 10 tips so that next time your pager goes off, you can be an outstanding consultant!

July 6, 2022 | 1 min read

Any Side Effects?

By Jeffrey Millstein, MD, Penn Medicine

Teaching my patients to ask questions helps address their worries about medications. 

November 27, 2019 | 3 min read

Clouds and Codes Aren’t Care

By Gisele Waters, PhD, Founder and President of Symbiotica Consulting

The promise of artificial intelligence is that it gives healthcare professionals the opportunity to improve the quality of care by allowing humans to focus on humans.

April 14, 2022 | 3 min read

Equity and Ethical Considerations With The Use of Psychedelics

By Ian Pocock, LICSW, Washington

Psychedelic medicines may help patients suffering with PTSD and treatment-resistant depression. As with many new therapies, ethical considerations and ensuring equal access for everyone are works in progress.

October 23, 2019 | 4 min read

A Tale of Two Stents

By Frank Cacace, MD, North Shore University Hospital

We are all vulnerable to cognitive biases. The clinically excellent clinician takes time to slow down and steps back when working toward the definitive diagnosis.

March 31, 2022 | 2 min read

A Lesson in Cultural Humility

By Mengyi "Zed" Zha, MD, Othello, Washington

Working at a community health clinic serving migrant workers from Mexico, I was confronted with a pervasive stereotype that the female patients were “dramatic.” I learned how important it was for patients’ concerns to be taken seriously.   

April 8, 2022 | 1 min read

“Better”

By Ben Roberts, NP, Johns Hopkins Medicine

Using precise language can help us partner with patients in hoping for the best, without causing confusion. 

August 6, 2019 | 2 min read

3 Lessons From Your Patient’s Impatience

By Iro Filippaki, PhD, Johns Hopkins University School of Medicine

The excellent clinician acknowledges their patient's impatience and frustration. In doing so, relationships with patients and clinical outcomes may be improved.

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.

"I tend to think I'm above average in singing, but my family isn’t shy in telling me that I’m unskilled and unaware."

February 9, 2022 | 2 min read

How to Improve Clinician-Patient Connections, Part 4

By Christine Ko, MD, Yale University

My “fast” thoughts about a patient may not truly represent their experience. “Slow” thinking may give a more accurate picture.  

Ruth and Carl J. Shapiro Gallery (Gallery 232), Museum of Fine Arts, Boston, featuring "Daughters of Edward Darley Boit," by John Singer Sargent (American, 1856–1925). Photograph by Flora Smyth Zahra.

June 6, 2019 | 7 min read

May 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 a space that has lessons to teach about clinical excellence, and fosters both the personal development and professional identity formation of clinicians.

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