On June 30, the Center for Bioethics welcomed members of the 2014 Summer Bioethics Fellowship. The fellowship, now in its fifth year, is a five-week immersion experience exposing students to many ethical, social and cultural issues associated with modern health care. This year’s fellowship of six is the Center’s largest to date.They are Joseph Maxwell, Anya Kremer and Anna Grace Stout from the University of Mississippi, Merrilee Bufkin and Charles Stevens from Millsaps, and Amir Khadivi from the University of Chicago.
During this fellowship experience the students will attend sessions conducted by 44 discussants and docents, visit various clinics and attend Weekly Fetal Conference. In addition, they are assigned selected readings from biomedical literature and view films that serve as the basis for weekly discussions.
To date, the students have toured the Animal Lab Facilities as well as the Simulation Center, have seen the Dialysis Unit at the Jackson Medical Mall, attended Mortality/Morbidity Conference and met with the Director of the Institutional Review Board. Additional experiences included a visit to the Tissue Bank, and accompanying rounds in the Pediatric Palliative Care unit at Batson. A trip to the MS State Hospital at Whitfield was the highlight of their second week of the fellowship.
Sessions during the fellowship cover a broad spectrum of topics for the students: religion and spirituality, literature and medicine, allocation of scarce medical resources, organ transplantation, confidentiality, dual loyalty in both military and correctional medicine, public health policy, genetics, medical anthropology and cosmetic procedures, to name a few.
Many other exciting events are scheduled before the fellowship concludes Aug. 1. The students will meet with Dr. Gloria Perry, Chief Medical Officer, MS Department of Corrections, participate in the UMMC Poverty Simulation, visit the UMMC Center for Telehealth and view several films of Dr. James Hardy’s surgeries performed at UMMC.
It is the ultimate goal of this fellowship to produce a population of humanities scholars versed in the human aspects of medical care and bioscience research. Our hope is that these scholars can bring the skills of their respective disciplines to a better understanding of how people experience health, injury and illness.
Selection of the prize winners was done by four reviewers, each with experience in health care education, a love of literature, and a current or former engagement with literary scholarship, poetics, essays, and/or reviews. Two further readers from the Center for Bioethics and Medical Humanities served as “tie breakers” – or tried to! First place was awarded to Will Berlin for Before, a poem that moves its reader through the strengths and fragilities encountered in initial clinical experiences and “the fierce magic it takes to live.” The unbreakable tie for second place went to Leslie Davis for her reflective poem Where You Are and to Andrea McLaughlin for her good-humored, light verse rendition of This Chaos they Call, “Nursing School. Third place went to Allison Pace for her reflective essay, A Year of Firsts.
The book prize, a copy of William Carlos Williams’ The Doctor Stories, was selected for its literary quality and eye witness documentation of the health care assumptions, practices, and relationships prevailing over the course of Williams’ lifetime (1883-1963). His Paterson, New Jersey medical practice is portrayed in these studies and poems through clinics, hospitals and house calls, but most importantly through vignettes – not always flattering and some outright objectionable – of William’s interactions with those who sought care. All local, some would arrive through world wars, the Great Migration, revolutions; all 20th century, many would be affected by the Great Depression, or benefit by the advent of discoveries that would lead to astonishing changes in our approach to illness, health and health care, changes that continue to unfold. Robert Coles (b 1929), who introduces this volume and the Williams who observed to a medical student “There’s nothing like a difficult patient to show us ourselves,” finds in Williams professional renderings the following caution:
Coles goes on to state that, "Presumptuousness and self-importance are the wounds this life imposes upon those privy to the wounds of others. The busy capable doctor, well aware of all the burdens he must carry, and not in the least inclined to shirk his duties, may stumble badly in those small moral moments that constantly press upon him or her – the nature of a hello or good-bye, the tone of voice as a question is asked or answered, the private thoughts one has, and the effect they have on our face, our hands as they do their work, our posture, our gait. (xiii)"
These words apply to health care providers in every discipline, and the submissions to Writes … of spring showed that our students try diligently to heed them.
Finally, the awards were made only a few hours after word of the passing of Maya Angelou (1928-2014). In honor of her contributions within American letters and art, and in recognition of her immense influence on literary forms by which to examine the histories we live, the Book Awards began with a reading of the first stanzas of Maya Angelou’s Still I Rise, followed by an excerpt from Theories of Time and Space by Mississippi and U.S. poet laureate Natasha Tretheway.
The Center for Bioethics and Medical Humanities would again like to congratulate each student who participated in the 2014 launch of Writes … of spring for picking up the mandate of Williams, Coles, Angelou, Tretheway, and uncountable others to intervene on behalf of healing through the reflective exercise of their profession. We look forward to reading more work by all of these students – and you?!
The Center for Bioethics and Medical Humanities is pleased to introduce Dr. Caroline Compretta, our Quality Enhancement Plan (QEP) Post-doctoral Fellow. A graduate of Millsaps College, Dr. Compretta received her master’s and doctoral degrees in Cultural Anthropology at the University of Kentucky, Lexington, where she investigated the complex and contested relationships between service providers and recipients in faith-based social service programming.
Her doctoral research examined the contradictions and commonalities in providers’ conceptualizations and implementations of services and the lived realities of participating children and families. In view of agency struggles to meet the needs of children and families, her research showed that giving voice to service populations, especially children who are rarely considered in the creation and provision of services, helped to identify areas for service development and collaboration. Her work advocates listening to clients’ voices so service professionals can construct more responsive programs given their knowledge about the everyday issues clients face. In addition to her research interests, Dr. Compretta brings to CBMH an expertise in qualitative methodologies. As an anthropologist, she conducts structured analyses using techniques such as interviewing, focus groups, surveys, and “participant observation,” a method that allows a researcher to immerse herself in the participant community to gain first-hand knowledge about research issues. The analyzed data generated from these and other qualitative methods helps to create a holistic understanding of social dynamics in order to affect social change. Dr. Compretta’s work at CBMH will focus on issues of engagement as a means to work toward the improvement of patient outcomes. She plans to investigate engagement as it relates to the communicative dynamics within interdisciplinary healthcare teams, between patients/families and practitioners, in patients’ cultural and spiritual practices that affect health, and between practitioners and the wider community. Dr. Compretta will apply her knowledge and skills to examine how people within healthcare communities can create more effective responses to patients’ medical and sociocultural needs through communication and understanding. In so doing, her work will help to improve the quality of care at UMMC.
Topics important to national health care education and policy discussions on both physician retention and the declining interest in rural and primary care practices provided the focus for original investigations by Therese L. Sison (M3) and Khang Dang (M2), respectively, of the UMMC School of Medicine. The students, who have worked with the Center for Bioethics and Medical Humanities since their M1 year, continue to evaluate and interpret data on physician management of professional grief (Sison) and on election to practice in Mississippi (Dang).
Coping patterns for professional encounters with grief comprise an important skill set for physicians and other clinical caregivers. To examine these patterns among resident UMMC physicians, Sison modified a survey instrument jointly designed by Kenneth J. Doka, professor of gerontology at the College of New Rochelle (NY), as well as a senior consultant to the Hospice Foundation of America, and Terry L. Martin, associate professor of Psychology and Thanatology at Hood College (MD). Their metric delineates grief patterns into "instrumental'" (modulation through problem solving), "intuitive" (modulation through demonstration), and "blended" approaches.
Sison piloted her modified metric in a survey of 281 residents from a range of UMMC specialties to identify the patterns most frequently used to manage professional grief. A blended grief pattern was seen for most of the residents surveyed. However, statistically significant differences were observed in a number of areas. Among the most interesting for further investigation, one comparison showed that respondents in primary care specialties had significantly higher instrumental scores (p ≤ 0.001) than their colleagues in non-primary care specialties. Policy discussions about the election to practice in a Mississippi practice after completing UMMC medical training helped prompt Dang's interest in medical graduate specialty selection and practice locale. This pilot retrospective study was conducted as the initial segment of an effort to develop useful models for predicting both election to practice in the state and specialty selection among graduating UMMC School of Medicine Students. For this work, Dang examined demographic data for 1,056 students and for 1,599 residents at UMMC to identify patterns and policies that positively correlated with the election to practice in Mississippi between 2002 and 2012. Dang's study results showed that the election to practice in Mississippi was positively correlated with primary care residencies (more female than male physicians), a Mississippi origin and/or family in Mississippi, a dedication to primary care medicine, and a Mississippi undergraduate education. Sison and Dang hope that their work will contribute to policy and education efforts that will ultimately help improve physician satisfaction and retention, and thereby improve standard of care for patients throughout Mississippi.
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