Presentation for UBC Medicine/Dentistry Orientation tomorrow.

1. We will be using the audience response systme (clickers ) during this Session

2. The Self You Bring Into Medical/Dental School Andrew Clarke, MD DOHS Executive Director, Physician Health Program John Palmer, DDS, MC, RCC Director, Dental Professionals Advisory Program This work is licensed under the Creative Commons Attribution-Noncommercial-Share Alike 2.5 Canada License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/2.5/ca/

4. become aware of how our strengths can beassociated with vulnerabilities

5. begin to recognize some of the implications that our particular strengths and vulnerabilities have for us as (future) practitioners

6. individually

7. in relationships with others (pairs and small groups)

9. Turn on your clickers now! Ready, set…

10. Practice Question (wait for instructions) Which Faculty are you affiliated with? Dentistry Medicine

11. How well would you say that you know yourself? Extremely well Quite well Not sure Not very well Hardly at all

12. How have you learned about yourself in the past? Most of my learning about myself so far has come from: Introspection (thinking by myselfabout my experiences) Reflective dialogue with another about our experiences Hearing others’ opinions of me Hearing an important story or fable and thinking about how it might apply to me Answering survey questions, and seeing how my responses compare to others’

13. Learning about ourselves is difficult Becoming aware of our assumptions is a puzzling and contradictory task. Very few of us can get very far doing this on our own. No matter how much we may think we have an accurate sense of ourselves, we are stymied by the fact that we are using our own interpretive filters to become aware of our own interpretive filters. - Brookfield S. Critically reflective practice. J. Contin. Educ. Health Prof. 1998;18(4):197-205.

14. Your Current Theory of Intelligence Indicate your degree of agreement with the following statement:You can learn new things, but you can’t really change your basic intelligence. Note – only four choices here. No "can't decide" option Agree strongly Agree somewhat Disagree somewhat Disagree strongly

15. Your aspirations as a learner When studying for an examination, I usually aim to get 100% Agree strongly Agree Uncertain / no opinion Disagree Disagree strongly

16. Abundance of success, or lack of failure? You've been successful students. You may not yet be skilled at learning from failure. Whether you are or not, is well correlated to the question we asked earlier about your theory of intelligence. If you believe intelligence is fixed, you’re at higher risk for having a maladaptive response to failure.

17. “To each one of you the practice of medicine will be very much as you make it – to one a worry, a care, a perpetual annoyance; to another, a daily joy and a life of as much happiness and usefulness as can well fall to the lot of man” - Sir William Osler The risks and benefits for you…

18. The kind of subjects you’ve been drawn toward I’m drawn toward subjects where the right answer is always clear: where there’s less room for teacher bias to affect my evaluation. Agree strongly Agree Uncertain / no opinion Disagree Disagree strongly

19. Shift in decision context from "pure" to "applied" There will cease to be “right” answers (more complexity, even chaos) You won’t be able to please everyone at the same time. Harder work, less appreciation. http://xkcd.com/435/ Snowden, D. J., & Boone, M. E. (2007). A leader's framework for decision making. Harvard Business Review, 85 (11), 68-76.

20. My (future) professional identity I think that the profession I’ve chosen represents a higher calling than other professions. Agree strongly Agree Uncertain / no opinion Disagree Disagree strongly

21. The culture you’re about to be immersed in Haidet, P., & Stein, H. F. (2006). The role of the student-teacher relationship in the formation of physicians. the hidden curriculum as process. Journal of General Internal Medicine : Official Journal of the Society for Research and Education in Primary Care Internal Medicine, 21 (1 Suppl), S16-20. doi:10.1111/j.1525-1497.2006.00304.x

22. Patients’ lives? It is as important to ask patients about what is happening in their lives as it is to ask about their physical complaints. Agree strongly Agree Uncertain / no opinion Disagree Disagree strongly

23. Think like patients? Physicians and dentists should try to think like their patients in order to render better care. Agree strongly Agree Uncertain / no opinion Disagree Disagree strongly

24. Affectional ties Physicians’ and Dentists’ affectional ties with their patients cannot have a significant place in professional practice. Agree strongly Agree Uncertain / no opinion Disagree Disagree strongly

25. Patients’ personal experiences Physicians and dentists must be attentive to their patients’ personal experiences. Agree strongly Agree Uncertain / no opinion Disagree Disagree strongly

26. Empathy Declines

27. Plan for this session We will conduct a brief survey of your beliefs using the iClickers. The results will be presented immediately so that you can see how your personal beliefs fit into the context of your peer group. There are no “right” answers to these questions. No personally identifying information will be collected. We will present some of the results from Monday's small groups We will hear some observations about the connection between strengths and vulnerabilities. We will hear a personal story of strength and vulnerability

28. We asked you about your personal strengths What is one strength you value in yourself that has helped you get here?

29. Here's what you said about your personal strengths

30. We asked about what you value in colleagues What strength would you value most in a professional colleague?

31. Here's what you value in each other

32. We asked what you think patients value What strength would patients value most in a treating physician or dentist?

33. Here's what patients would value in you…

34. Why is any of this important? The context for your learning will change radically in the next four years – the "right answer" may not be clear. For some of you, your lack of experience with failure (i.e. success) may become a vulnerability. The professional culture may take your strengths, and expose them as vulnerabilities. This may lead to cynicism and a decline in your ability to empathize with colleagues, patients and yourself.

35. Plan for this session We will conduct a brief survey of your beliefs using the clickers. The results will be presented immediately so that you can see how your personal beliefs fit into the context of your peer group. There are no “right” answers to these questions. No personally identifying information will be collected. We will present some of the results from Monday's small groups We will hear some observations about the connection between strengths and vulnerabilities. We will hear a personal story of strength and vulnerability.

36. An Anecdotal Perspective:Dental Profession Advisory Program Dr John Palmer, DDS, MC,RCC Director, Dental Profession Advisory Programme August 27th 2009

37. Freud’s observation: The two chief tasks in life are: To love To work Succeed at both and you will have a successful and satisfying life. 33

38. IQ v. EQ : That is the question: Emotional Intelligence (1995) Daniel Goleman EQ predicts life success more accurately than IQ. EQ is not simply innate, it can be developed.

43. Strengths that can tumble into liabilities: Independence (grandiosity) – a need to be in control (actively, by aggressive control and competitiveness, or passively, by opting out). Perfectionism – a driven need to be perfect in every way – technically productive but personally and interpersonally destructive. Tendency to “hyper-focus” (obsess) and lose the bigger picture.

45. Tension between professional practice and life process issues.. Professional practice– involves the scientific method, clustering around concrete, discrete, predictable outcomes. Life process -involves ambivalence around complex issues (in relation to self and others), experimentation, and the incorporation of feedback.

46. “I certainly have been thrust into unknown territory. I am used to being in total control of my life. All of a sudden,I have no control over what is going on.”

47. “It has been the scariest, most difficult time of my life and, without professional support (and family support), I literally may not have made it through this alive.”

48. So what relevance does this have for me as a medical/dental student? 1. During your training you will face significant stressors. 2. The coping choices you make will tend to match your temperament and become a fixed pattern over time. 3. The self-awareness you develop, practice, and manage will be a “make or break” factor in your life trajectory.

49. Establish or reinforce a durable platform to build on……….. Self-monitoring and management. Peer and/or community support Development of spirituality Make use of services available

52. Plan for this session We will conduct a brief survey of your beliefs using the clickers. The results will be presented immediately so that you can see how your personal beliefs fit into the context of your peer group. There are no “right” answers to these questions. No personally identifying information will be collected. We will present some of the results from Monday's small groups We will hear some observations about the connection between strengths and vulnerabilities. We will hear a personal story of strength and vulnerability

53. Thanks!Questions and Comments?