Valerie Chen’s essay dealt with her first day on the palliative care rotation at a local hospice facility. Courtesy MSU College of Human Medicine
Editor’s note: Word of Annie Yang’s death was received after this story published in the Grand Rapids Business Journal. Our condolences go to the Yang family. A GoFundMe page has been set up here.
Michigan State University’s College of Human Medicine recently launched a new contest.
The Shared Discovery Curriculum student essay contest began during the 2018-19 school year.
The contest gave students who are in their first or second year of medical school the opportunity to participate in writing an 800-1,000-word essay explaining how the connections between their clinic and classroom experiences have impacted their growth as medical students and sense of self as a physician-in-training, according to the College of Human Medicine.
The winners of the contest were Valerie Chen and Annie Yang. Chen, a Williams MCE (Middle Clinical Experience) student in Grand Rapids was awarded first prize and Yang, an ECE (Early Clinical Experience) Addams student in East Lansing, was named the second-prize winner.
Brian Mavis, Ph.D., faculty member of the MSU College of Human Medicine, said the essay contest was a fun idea because, at the time of the contest, most students were already writing essays for scholarship applications and other things.
“We thought if they are already writing essays about what they are doing and what they are thinking, let’s see if we can add another dimension to that or help them think about ways to write their essays by doing this competition,” he said.
The essay contest originated from the school’s Shared Discovery Curriculum, which Mavis said is a curriculum that was first implemented in 2016 for first- and second-year students. The entire curriculum is not expected to be completed until fall 2020, however.
SDC allows students to integrate the “necessary basic and disease sciences along with clinical experience throughout all four years of the educational program.” This process eliminates the "2+2" model, in which students learn the basics and disease science in the first two years and the last two years are dedicated to clinical experiences, according to the university.
“This is a complete revision of the medical school experience for students from the time they enter and through all four years,” Mavis said. “Instead of classes, which a lot of traditional medical schools have like physiology, microbiology and anatomy, we have an integrated curriculum. So, it is not taught in courses as it has been traditionally, or the other common model is organ systems. So (students) learn about the cardiovascular system or learn about the pulmonary system. Instead, our curriculum is organized around what we call chief complaints or concerns. What those are, are reasons why a person would seek health care or enter the health care system. There are 93 chief complaints and concerns and those are things like chest pains, headaches, joint pains or blood pressure. Instead of teaching about science from a (certain) point of view and having classes in those areas, the (school) weeks are organized as experiences and all of the experiences tie into whatever the chief complaint or concern is for the week.”
With the curriculum being implemented, first- and second-year students participated in the contest. The essays were rated by four individuals who were university Learning Society Chiefs.
Chen, who was in her second year of medical school, wrote her essay about her first-day experience of a two-week palliative care rotation at a hospice care facility, where she was assigned to a patient. During her assessment of the patient, she rested her stethoscope on her patient’s chest and lungs. Chen realized her heart was beating “incredibly fast,” which could be “tachycardia, irregular heartbeats, a systolic murmur on the apex mitral regurgitation,” according to Chen. She heard the patient taking “distant breath sounds” when she listened to her lungs.
“I realized how the many hours spent learning disease mechanisms in small groups and practicing physical examinations in simulation provided value to the rotation, especially at such an early stage in my training,” Chen stated in her essay. “However, it’s not just the learning, studying and practicing that have been valuable. It’s how I was learning the concepts, skills and knowledge that has been most meaningful to me.
“For example, the hospice patient’s heart failure brings me back to week 10 of my first year as an ECE student, where we discussed blood pressure concerns as part of the chief complaint topic in our weekly scholar groups. I’ve drawn a flow diagram of causes to hypertension and explained how changes in cardiac output lead to heart failure in front of my classmates. Instead of passively listening in a traditional lecture setting, I’m actively engaging with my peers and faculty fellow in this intimate, more informal discussion environment. Here, I am more open to sharing my knowledge and asking questions without the intimidation of talking in front of a large group. I also gain a lot while problem-solving with peers as they share their own questions and thought processes with me.”
Yang, who was a first-year medical student, wrote about her initial fear of how she would treat patients as she studied more about basic and social sciences. She feared she would be “led to reduce a patient to a collection of illnesses.”
“During our first week as medical students, Dean (Norman) Beauchamp reminded us that patients won't care about how much you know until they know about how much you care,” she stated in her essay. “The significance of this aphorism was not fully impressed upon me until Clinical Simulation Lab began, and I emerged from a trial by fire: the first round of recorded patient interviews. I distinctly remember my heart sinking while watching my own video during Post Clinic Group — watching my inept attempts to address the simulated patient's emotions. When the patient expressed fears about missing work, I briefly touched upon his concerns and then launched into questions about his illness. I had treated him like nothing more than a constellation of symptoms.”
Yang stated in her essay that because there were repeated simulated patients encounter in the Shared Discovery Curriculum, her fears diminished as she was able to improve her social interactions with patients, like a patient she cared for during her early clinical experience at the MSU Family Health Center.
“(The essay contest) gave us a chance to validate our sense of what we thought what the curriculum was accomplishing by getting their firsthand account of something that had happened to (the students).”