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Episode 2: The 2024 Updates to the AAMC Core Competencies
578 Plays11 months ago
In this episode, we welcome Tahnee C H Prokopow, MPH (University of Michigan-Dearborn) and Rebecca Fraser, PhD (AAMC) to discuss the work of the AAMC Premed Competencies Working Group. In particular, we will focus on the expansion of the competencies to reflect, "Cultural Awareness" and "Cultural Humility". Thank you for coming back and joining us on... The Lunch Hour.
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Transcript
00:00:01
Speaker
All right.
Introduction and Podcast Goals
00:00:02
Speaker
Hello, everybody, and welcome back. For this episode of the Lunch Hour podcast, we are welcoming members of the AAMC Pre-Med Competencies Working Group to talk about the updating of the AAMC core competencies.
00:00:17
Speaker
As pre-health advisors, you may have noticed that there have been some changes and there was a lot of intentionality behind those changes. So we're really excited to welcome some of our colleagues who have put in some really good work on some really important changes. So welcome back to another episode of The Lunch Hour.
00:00:57
Speaker
All right, hello and welcome back to The Lunch Hour, the official podcast of NAP, the National Association of Advisors for the Health Professions. This is specifically a production of the Committee for Diversity, Equity, and Inclusion. Each episode, we seek to educate, connect, and grow together as a community working to help prepare and support tomorrow's healthcare leaders.
Introducing the Guests
00:01:21
Speaker
My name is John Moses Bronson. I'm from Penn State in lovely,
00:01:27
Speaker
Happy Valley, Pennsylvania. I am joined by a wonderful group of colleagues. We're sort of clicking on a popcorn it for introductions because there's a number of us today. So I'm going to start by popcorning my good friend Misty.
00:01:42
Speaker
All right. Thanks, John. Hi, everyone. I'm Misty Wakuhala-Pointe. I'm the director for pre-professional advising at the University of Illinois Chicago, and it is, fingers crossed, a relatively nice day out today. I'm also currently the co-chair for the Committee on Diversity, Equity, and Inclusion, but I will be rolling off this summer, which don't tell anyone I'm kind of excited about.
00:02:07
Speaker
I know, I know. Y'all can't get rid of me yet. I'm going to stay on the committee and this podcast because I enjoy working with you guys and my colleague Zuri, who's going to introduce herself now.
00:02:18
Speaker
Hello, everyone in the whatever time zone you are in while we are listening to this. I'm Zoriel Bartle Bennett, and I am one of the co-chairs for NAPCDI along with Misty. I serve as an assistant director and pre-health advisor at Johns Hopkins University, working with the undergraduate population over there, because we do have post-bac, and that's a different unit.
00:02:45
Speaker
Um, we work together different unit. Um, so, uh, but very glad to be here hosting another podcast with, um, some guests who I guess now we can popcorn it so that they can introduce themselves. Um, go ahead, Tony. Hello everyone. And I hope it's a lovely day wherever you are, you are at.
00:03:10
Speaker
I serve as the Director of Health Professions Advising at the University of Michigan-Dearborn. I'm also a NAP CDI member and CDI co-chair elect. I'm also the CAP CDI chair as well. And I'm a popcornist to Dr. Rebecca Frazier.
00:03:32
Speaker
Thank you and thank you all for inviting me here today. I've already enjoyed the fun music at the beginning. Gets you in the mood to talk about competencies. I am actually a director on the admissions and selection research and development team at the Association of American Medical College. What our team does is explore the challenges and needs that are in the medical school admission space and the residency selection space.
00:04:00
Speaker
And then we do research for different purposes. It might be research to provide data and information to folks in those communities. It could be to create resources such as to support everyone is in the transition from in-person to virtual interviews, or it might be developing new or enhancing existing tools and assessments. But we are trying to do work that supports applicants, that supports advisors, medical schools, and residency programs.
00:04:30
Speaker
Fantastic.
Excitement Around Updated Competencies
00:04:31
Speaker
And not to put you on the spot, Tani, because we all know you and love you, but you forgot to mention your whole name. Sorry, Tani Propo.
00:04:41
Speaker
There you go, Toni Prokopo, the famous Toni Prokopo, one of my favorite people in the world who has been on this committee. So thank you all for joining us and for chatting about this. I know when we, when the announcement came out about the updated competencies and the fact that there were now more competencies, I think
00:05:01
Speaker
From our perspective, we were really excited to see that there had been new ones added, particularly those that we feel very strongly about, which is cultural competency and cultural humility. So when we were thinking about what topic should we do for a next episode, it didn't hurt that we already had our claws into Tani.
00:05:22
Speaker
But we're like, we should talk about this. This is really exciting. And we want to hear more about sort of the process that y'all went through and the things that you thought about with that. But before we jump into the actual work stuff, we'd love to learn a little bit more about you as individuals, as people. So can you tell us a little bit more about yourselves, both in a professional capacity, but also maybe what you like to do when you're off the clock, if you have any hobbies or interests, any of those sorts of things.
00:05:51
Speaker
Becky, why don't we start with you if you don't mind? Sure, sure. So I've been at the AEMC for almost seven years now. I'm coming up on my seven year anniversary. And prior to that, I worked in the federal government. So my background is actually in a field called industrial organizational psychology. And for those who are not as familiar with that field, what we do as IO psychologists is apply research that
00:06:19
Speaker
improves the well-being and the performance of people and the organizations that they're in. So this might involve anything from workforce planning to employee selection, leadership development, studying job attitudes or job motivation, working in teams, the whole nine yards.
00:06:40
Speaker
So it's a fun field. And so before the AAMC, I practiced IO psychology as a personnel research psychologist in the federal government. So there I did similar things to what I now do at the AAMC. I did job analyses. I developed competency models. I developed assessments to support training or selection or promotion in a whole variety of occupations across the federal government.
00:07:10
Speaker
Does that make it easier or harder to work with the AAMC having been? It was a fun transition. I had worked with truly a full range of occupations and I love variety in my work and I love
00:07:28
Speaker
I love challenging work and so it was exciting the opportunity to come over to AAMC and instead of working with federal agencies and different federal jobs, now working with medical schools and residency programs, I've enjoyed it. I thrive on variety and interesting, interesting work.
Backgrounds and Roles of Guests
00:07:56
Speaker
Tani, you want to tell us a little bit about any hobbies or things about your work that you want us to know? My name is Tani Prokopoe. That last name gets people all the time. And I would say I've had a couple of different careers. My most recent is Health Professions Advising. I've been doing it for about 13 years at a couple of different institutions. And then
00:08:27
Speaker
My advising philosophy approach is mission-based advising where I help students create a mission statement and use a mission map to help guide them. And I work with them across their years as a health professionals track student along their mission and help them create that mission statement and use their mission map, creating their clinical activities and their WC or competencies.
00:08:56
Speaker
and their academic work to really match two missions of medical schools or other health profession schools. When prior to health professions advising, I worked in medical education and diversity in higher education and worked at the University of Michigan Medical School as a senior diversity officer.
00:09:25
Speaker
And then prior to that, I worked in clinical research and engaging minority populations in clinical research. I have definitely enjoyed my very careers. And when I'm not trying to be a professional and run around trying to help people pronounce my last name, I run around as the monster in roller derby.
00:09:50
Speaker
So I remember the first time I heard that and I was like, I love it. And it makes so much sense. Yes. Everyone asked Connie to see pictures. Yes. I just suffered a concussion. So I have to say I am, I'm taking a little break right now. I recover. So it's a rough sport. Wow. That's intense. It's a rough sport. So
00:10:19
Speaker
So we are going to kick off the whole discussion around the work that was done around the competencies. And so I think, Tani, you kind of mentioned your role working alongside or liaisoning, I guess that's the fancy version of, say, working alongside of the AA&C on the committee.
Process of Updating Competencies
00:10:45
Speaker
It would be great to hear both you and Tonya and Rebecca, your perspective of being on the committee itself and being able to provide context to our listeners about what exactly was the process of the reiteration or the revamping of the competency and the major roles that each of you played.
00:11:14
Speaker
whichever way you want to ping pong that. Sure. If, Tanya, I don't mind kicking off, if that works, then I'll pop it over to you. So I think for, I think, Zuri, you mentioned something really important, which was that this is the second iteration of the competencies. The original competencies were developed about a decade ago.
00:11:39
Speaker
And similar to what we did a decade ago, we included a wide range of folks in the competency model to really make sure that we had a variety of perspectives contributing to the updates.
00:11:54
Speaker
So one core group that we had engaged throughout the work was the pre-med competency working group. And this working group was composed of about nine people that included medical school representatives across both MD granting and DO granting medical schools, folks that are in roles of admissions, student affairs, diversity affairs, and faculty, as well as pre-health advisors.
00:12:20
Speaker
And this group really worked really closely with us all along the way throughout the project. So they provided oversight and input into the work really as it unfolded. They served as our sounding board and we engaged in multiple conversations where we were trying to decide
00:12:42
Speaker
based on what we heard from our many, many focus groups, how are we gonna make updates to these competencies? How do we take the feedback that we were hearing from medical schools and students and advisors and make decisions on specific edits and work choice? So lots of laboring over those things. I think from my perspective,
00:13:08
Speaker
One, it was a great honor to be a member of this ninth number working group of the pre-med core competencies working group, and two,
00:13:17
Speaker
I knew that I was not only just speaking from my own perspective, but I was speaking from the advisor's perspective and also advocating for students because I knew that as an advisor, I was looking at this from a student perspective. The students may not immediately react, but over time they were going to be the ones implementing these.
00:13:41
Speaker
poor competencies. So as we were working on them I kept thinking how would a student react to this or how would a student think about doing this implementing this type of competency and how would I as an advisor think about how I would roll this out and think about how to advise a student to go about and implement this competency.
00:14:04
Speaker
So I kept thinking about that as we would get together and meet as a group and also as we were asked to give feedback each time there was an iteration that came out from reactions to the focus groups. I thought it was really important that the WAMC involved advisors from the beginning in the focus groups at the different levels of the groups and at the level of the working group.
00:14:36
Speaker
Definitely. So I guess I assumed, given that y'all are the AAMC, that obviously there would be MD schools involved, admission folks, AAMC folks in general. And I knew, obviously, that Tawny had been on there. But I have to admit, I was surprised to hear that y'all also included DO schools in the process. So if you maybe could talk a little bit, either one or both of you,
00:15:04
Speaker
why you felt like it was important to include pre-health advisors and and DO schools as well as sort of your own constituencies and if that if you felt like that made a difference in the outcome of of which competencies were selected.
Inclusion of Diverse Groups in Updates
00:15:21
Speaker
Sure, absolutely. You know we when we were getting ready to update the core competencies we have you know
00:15:31
Speaker
We have not only been talking with MD schools, but we've also in the work that we do at the AAMC and also on our research and development team in particular, also engage with DO schools. And we can see as we look at these competencies, the potential relevance and importance of these, not just to
00:15:52
Speaker
medical students who are applying for MD granting schools, but also for DO granting schools. And what an opportunity it would be to create a set of competencies that could apply to both, recognizing that there are applicants who are applying to both schools. And what a nice idea to have one common set of competencies for those applicants. And I imagine given the number of health professions you all are advising,
00:16:20
Speaker
one set of competencies for both of those to support y'all as well. So that was some of the impetus for the DO schools. And then in the work that I do and in a lot of the work that the AMC does around admissions, pre-health advisors are a critical part of that community. And I think Tani spoke really beautifully about the
00:16:46
Speaker
the incredible perspective that advisors can play in any of the work that we do, and especially with the competencies, advisors are not only, it's not only students, pre-health students that are working with these competencies, their advisors are working with them too, helping to
00:17:07
Speaker
kind of explain what these competencies are and why they're important, working with those students to think about how to find opportunities, different activities or experiences that might help them develop or how best to demonstrate these things on their application. And so making sure that we had, you know, not just the medical schools who are kind
00:17:28
Speaker
setting those expectations for students, but advisors who are some of the key folks communicating those expectations and working really closely with the students was important. They also have the benefit of working with such a wide variety of applicants. And so the more advisors that we can
00:17:48
Speaker
engage and who could be a part of the process, they can not only bring their perspective, but as Tani mentioned, they can think about how the different students that they're working with, how they'll react to the competency model, what may be clear, what may be confusing, how best we can kind of craft this to resonate with as many folks as we can.
00:18:18
Speaker
that makes me like really I mean as an advisor who I would say stretches across like you said multiple health professions but also tries to streamline advising in terms of efficiency and work and knowing that
00:18:40
Speaker
Behind the scenes, the work was being done collaboratively. So there is a unity in the messaging, regardless of what students are looking to do in terms of their choice in their health profession is something that's reassuring as an advisor.
00:18:57
Speaker
I think in terms of breaking down competencies to students, it can really be helpful for the listeners of this podcast, particularly thinking from an advisor perspective to understand the newer additions specifically to the competencies. We know that the cultural awareness and cultural humility was kind of parsed out from the cultural competency
00:19:26
Speaker
competency, competency, that's like duplicative, but you know. But why were these particular competencies really like differentiated or split apart? What was the big conversation behind that and how could advisors, you know, internalize what they hear today to help
00:19:50
Speaker
convey more clearly to their students as they guide them in the process about what that means and how that looks in your application. Sure.
Cultural Competency Breakdown
00:20:01
Speaker
I think one thing that you said, Zuri, I will reiterate, and that is that we parsed out different pieces that were already there in the competency model. We didn't add competencies.
00:20:14
Speaker
When we think about the number of competencies shifting from 15 to 17, we didn't add two brand new things to the competency model. What we did was take each of two competencies, cultural competence and service orientation, and split them into each, into two separate competencies. And the reason for that was
00:20:38
Speaker
In a number of our conversations in focus groups with medical schools and medical students and advisors, and then also in our working group, we realized just how many pieces there were to each of those competencies and how many important pieces there were to each of those competencies. And when we were
00:21:00
Speaker
creating the competency model, we weren't just trying to, or should I say we were not only trying to accurately communicate expectations for students as they entered medical school, we were also trying to do that in a way that was clear and concise and could really signal expectations, but also values that the medical schools have. And so as those two competencies became really big,
00:21:30
Speaker
really quickly. We thought it would be in everyone's best interest to split them out into two parts. That way, each part would be given the attention that it deserved and also would signal the importance of each of those parts. I think if I could add a perspective on cultural competency,
00:21:53
Speaker
that term has really gone out of vogue. If we look at one of the reasons why the competencies in general have been assessed, it's because times are changing.
00:22:08
Speaker
And, you know, the term cultural competency is not really used in diversity circles. And so using terms like humility and sensitivity are much more with the times and doesn't seem to give the illusion that I can check mark this off. A competency model really allows us to say these are things that we're always working on.
00:22:31
Speaker
and getting feedback on. And even when you go to medical school, you will still work on these areas. It means that these are areas that we want you to work on before you come, but you will continue to develop and improve and get feedback on and grow and learn. So I think, at least in the discussion of sensitivity and awareness,
00:22:55
Speaker
It wasn't a model of achievement. This is an area that we will continue to grow in. And the working group, at least in those two areas, had discussions about what that language looked like and sounded like in terms of how that would lend itself to not having a check mark, but lend itself to growth and maturity in that area.
00:23:24
Speaker
So I think that's at least, I don't know about the service, I don't remember the service orientation discussion. I just remember the cultural sensitivity and awareness discussion, but I feel like, you know, we were thinking about flexibility and dynamics. Is there like a snapping fingers, like, you know, like coaching? There we go. There it is, that works.
00:23:54
Speaker
What I think what's great is that the the cultural competency model we certainly found as we did the empathy mapping that we were moving away from that conversation towards cultural humility towards sort of a continual learning process versus a
00:24:12
Speaker
acquired knowledge and you're done process. So I think it's both interesting and maybe validating for all of us that we're all starting to move in that direction away from like this is just something that you know and you never have to think about it again to, nope, this is something that we all get to engage in for the rest of our lives if we want to continue doing this work.
00:24:38
Speaker
But to kind of circle back to the process, you guys were talking about separating out or looking at those two older competencies and separating them out. In this process, did you essentially go through and talk about every single one? Was there debate about removing competencies or replacing competencies? If you could give us maybe a peek behind the curtain a little bit for that process?
00:25:05
Speaker
That's a that's a great question, Misty. And absolutely, we can just pull that curtain right across wide open here. So we it had been, again, a decade since these competencies had been revisited, like truly revisited to think carefully about what
Relevance of Competencies for New Students
00:25:25
Speaker
the updates were. So we actually went, we started kind of
00:25:30
Speaker
We started out this process not with the actual competencies themselves, but we started by just talking with medical schools about what has changed in the last 10 years. What has changed in terms of their curricula and the medical school environment? What does medical school look like now?
00:25:49
Speaker
relative to what it looked like before. So we really wanted to understand how the curriculum environments and medical school training, how that's evolved over the last decade. And then given those changes, what are the qualities and characteristics of students who
00:26:08
Speaker
are better prepared for medical school and who more easily navigate or are more successful in those first couple of years of medical school. And that was the first step and that was the basis for the updates to the competencies. So once we understood kind of how things have changed and what's remained important, what's become more important, and how might some of these competencies be applied
00:26:37
Speaker
in different ways, then we could go through that list and say, okay, is everything moving forward? The answer to that is yes. Spoiler alert, everything moved forward. All of them are still relevant. All of them are still important. That broad range of competencies that was identified as core and critical 10 years ago is that still today.
00:27:02
Speaker
What we did find though, is that those professional competencies, they were highlighted consistently across all of the conversations that we had around how medical school has changed and what that means in terms of what students need today to be successful. And so those professional competencies were the focus of our edits and our updates. And so that leads me to that final step in the process, which was,
00:27:32
Speaker
taking what we learned as far as how medical school has changed and what those important qualities and characteristics are, and then looking at each of the competencies and the definitions, thinking about what we heard in those conversations as far as what pieces have become more important, what needs to be emphasized or elaborated upon, and then starting to draft those edits and then iterate those with many, many focus groups of
00:28:01
Speaker
medical school faculty and staff and medical students and advisors and then also iterate with our working group as well. There were many people that contributed. Did it feel like herding cats at times is what I want or maybe herding squirrels I think. No, we have I feel like we've perfected our perfected. I say that like I've achieved some
00:28:27
Speaker
level that's unattainable for focus groups, which is not true. But we facilitate a lot of focus groups. I think it was fun. There were groups that were more energetic, if you will, more passionate, where we did hear more variety and perspectives. And that made it a lot of fun. It made it fun. It also made it challenging. How do we
00:28:55
Speaker
How do we get to that end point that can serve all medical schools that resonates across the board? I actually have a sidebar question for Tani.
00:29:08
Speaker
I think it's always interesting. I know for me, I serve on another liaison role with the AAMC and you play this role of trying to foster the perspectives and the insights of the pre-health advising side in a beneficial way to the process as you serve on working groups or committees.
00:29:34
Speaker
For you, in terms of your own process of balancing, understanding and respecting the admissions process and what role the competencies might play, but also knowing that you want to be in a place of
00:29:48
Speaker
advocacy not only for your colleagues but also in a place for the students and those who represent the larger body. How was that for you being able to express your understandings while also being a representative for essentially the association as well as the students we serve?
Balancing Perspectives in Updates
00:30:10
Speaker
Very good question. There was one point where it was brought up
00:30:16
Speaker
about when we were actually going to rule out the competencies, at what point, and how early in the ballgame, if you will, was it going to be ruled out. And I don't remember who, but I think someone suggested very late in the process. And I carefully, which was very hard for me,
00:30:44
Speaker
was like, oh, no, no, no, no, we can't do that. And I had to be very careful and diplomatic, which is not my usual method. As you know, my MO is to be, you know,
00:30:58
Speaker
Very unfair. I love your honesty. Always. As you know, my usual MOS, I'm in your face and I'll tell you exactly how it is. And I'm a direct person and many people don't always like my style, but I always be honest with you. My friends love me for my honesty.
00:31:16
Speaker
They're like, the delivery may be a little rough, but she's always honest. I knew that the delivery could not be rough in this committee. After all, I was not a physician or a doctorate level person. I had to keep some decorum. But I pointed out why that the late delivery could be troublesome for advisors and students, and that really we needed to be thinking much earlier if we were going to go for the 2025 cycle.
00:31:45
Speaker
and that we couldn't wait late, the earlier the better for us. And once I clearly explained this, people understood. And people just weren't thinking about advisors and students at that point. And I think once people thought about that, people recognized. And then somebody else woke up and agreed with me.
00:32:04
Speaker
And, but it was for me personally a very tense moment because it wasn't so much that I wasn't right. I was just nervous about saying something for this group of people and saying it in a way that was both clear and reasonable without losing my temper.
00:32:25
Speaker
Which, as you know, is always hard for me. Because I know that I'm a very passionate person. Once I know that I'm right, sometimes my passion gets ahead of me. But I executed it well, and we rolled it out at a very good time. I haven't heard complaints about the lateness of the rule out. Let's put it that way. I haven't heard that at all. Yeah.
00:32:51
Speaker
there was a lot of eagerness to start working with the competencies, which, Tani, I think that really speaks to the work, the really great work that you and the working group did with us at the AAMC and with the rest of the community. Folks saw those competencies and said, oh my gosh, yes, this is what we want. We want to start using them. Can we start using them? And there was that, well, let's
00:33:17
Speaker
Let's stop for a second. Let's think about where we are in the admissions lifecycle. Let's talk about rolling them out, but not for immediate use. Let's roll them out so folks can get comfortable, wrap their heads around them, and then you can start using them. They'll go into effect for the following cycle. Everybody needs a minute.
00:33:39
Speaker
especially our applicants who are applying and will be evaluated using those competencies as a framework to adjust.
00:33:53
Speaker
That makes sense. Well, maybe you. I'm sorry, you're very right that being on a committee like that, which I'm sure you appreciate when you're the advisor and you're not the physician in the room and you're like, okay, I have to say it carefully, but yeah, convincingly.
00:34:14
Speaker
Yeah, for sure. It's a balance. Balance me. Well, Tani, that rolls right into my next question, which is, was there a challenge you faced that was unexpected in bringing change or bringing change to the working group? And how do you feel like that was addressed?
00:34:34
Speaker
For me, personally, there was, for me, and maybe Becky didn't know this or realize this, or there was some discussion about the cultural sensitivity and the cultural
00:34:49
Speaker
awareness about some specific language. And I really personally, I don't remember the exact language, I'd have to look at it. But there was some verbiage usage that I really wanted that I felt was very important.
00:35:07
Speaker
And I think the rest of the committee, to me, and this is just my perspective, they didn't seem that worried about it at first, but then once I brought it up, a couple people discussed it. The committee was not, it's not that they weren't a dispassionate committee. They didn't seem to, there wasn't about a big passion about every single word, every single thing. They were a very calm committee.
00:35:35
Speaker
But once we got on the cultural awareness and sensitivity, there was a little bit of discussion. But I was very particular about a certain word and language and what the implication of the phraseology was going to be. And what I didn't want the implication was that I didn't want it to sound like, again, once you did this, you were done. You didn't have to look back or think about continual growth and learning.
00:36:05
Speaker
And we did agree to change the language so it has that implication that you're doing continual growth and learning.
00:36:13
Speaker
And that, for me, again, it was a challenge of not letting my passion get ahead of what I was clearly thinking about. And that was disappointing for me. That was good. And I'm really glad I was able to calm and remain calm about that. At this stage of my career, it shouldn't be an issue. But again, I was one of the only people of color or a few people of color in the room.
Challenges in Reaching Consensus
00:36:39
Speaker
So that's important. And I thought that my voice was heard.
00:36:43
Speaker
So that was I felt an achievement. So that's a fantastic achievement to you in leading or organizing the committee, Becky, that Tawny, that you felt like your concerns were heard and that you were able to get those across. How about you? Do you feel like you had the same challenges or were there different challenges?
00:37:08
Speaker
I definitely think that there were challenges along the way. I mean, anytime you're trying to reach consensus among so many people, not just among the smaller group of folks that were on the working group, but just trying to synthesize everything that we heard and take the variety of perspectives that were out there on any given competency and get to a definition that would
00:37:38
Speaker
that would work for the different needs that were there. I think that was one of the bigger challenges. And kind of to Tani's point, that didn't happen on every competency, right? Some competencies were much easier to navigate and get to the end point than others. But I think working with folks to try and fine tune these competencies, be really clear
00:38:07
Speaker
but also concise in the definitions, that that's challenging. And, you know, wanting to do that because we know once these competencies are up there on the website, that anybody who's working with them, well, not everybody who works with those competencies will have been privy to all the many, many conversations that we had. So there was a lot of thought and challenge, I think, in
00:38:37
Speaker
in trying to pick the right words and being really precise in our language like Tani was speaking to with cultural awareness and cultural humility. I think the only other challenge that I would say is that I recall is as we were updating the definitions, you know, really needing to focus schools on entry, that entry point to medical school. So what students need in their first year when they come in and they're just getting started.
00:39:06
Speaker
What do they need then as that foundation to then further learn and develop in school versus what they might need later or what you might be teaching them? In focus groups and in the working group, I recall asking folks often to consider, is this additional detail that you want to add needed at entry?
00:39:28
Speaker
Or is that something that can be developed or will be developed in the curriculum? And then thinking about the common denominator and what is gonna work across all schools? What is that minimum level that is sufficient across all schools? Recognizing that some schools are gonna have higher expectations for some of these competencies based on their curriculum and the resources they have to support their students and their mission. How do we get to that common competency model that works?
00:39:57
Speaker
for all medical schools. That's super insightful. We're trying to figure out if we want to like backtrack or move forward because there's so little time and so many good questions. I'm like looking at the time and I'm like, oh. I actually will, I'm going to popcorn it to Misty, but I wanted to just acknowledge
00:40:24
Speaker
something that both Rebecca and Tani just said in terms of the efforts and the contributions of everyone on the I keep forgetting the word working group. There it is. And I think
00:40:42
Speaker
The purpose of this podcast obviously is to highlight how different organizations, groups within NAP are people we work with, organizations we work with, individuals who are making change within the DEIJ space. But one thing is that you've both highlighted is that it is not an easy task to not only gain empathy of the perspectives of others, but then utilize
00:41:11
Speaker
those perspectives as a way to implement change.
Importance of Thoughtful Listening
00:41:15
Speaker
And in full transparency, the NEB CEI has made a deliberate effort to provide opportunities for gaining perspective and utilizing
00:41:26
Speaker
the perspective of our membership as the vehicle for change or how we institute resources and things like that. And so, the efforts that you two directly did and those that you've worked with on the committee, I mean, essentially did just that. Quickly for Toni, being that you played a role in the empathy mapping process that we had with NAPCDI,
00:41:53
Speaker
and what you also were able to do on the working group. Is there a major commonality in the approach that you might highlight? I know this one was not on.
00:42:08
Speaker
the list of questions that we said we might ask you, but it kind of dawned on me, like, as you kind of talked about, just under, like, bringing understanding, being heard, and being able to see, like, your feelings, the thoughts, the things that you observe, the things that you feel also being brought into how change was being made actively. I think that the biggest commonality is
00:42:34
Speaker
to hear well and to listen well, which isn't always the same thing. I think I saw a quote recently, and I forgot who the quote is attributed to, which I'm terrible about that. But we often, oh, I think it's by Stephen Covey. We often listen to respond instead of listen to understand.
00:43:00
Speaker
And I think one of the things I learned from being in the working group was really listen to listen and to understand and also respond and act accordingly. And I really enjoyed the work.
00:43:19
Speaker
I really enjoyed that process. And like the empathy mapping, there's a lot of listening, a lot of reflection, a lot of thought process that went into it. And although it's not the same as empathy mapping, it's the same concept of the type of active listening and response and reflection that I was doing somewhat similarly. And I had to not
00:43:47
Speaker
act quickly. I had to think about my actions and reflection and what I wanted to say more carefully than I might typically do in a working group. So I felt that was very useful for me. And because I was being more deliberate in my thinking, because I was representing something larger than myself, I was being more careful. And as a result, I think more reflective. And that is definitely connected to the empathy
00:44:17
Speaker
So the two were connected for sure. For sure. Love it. Love to see it.
00:44:26
Speaker
And we like vehicles for change, whatever that looks like. Change is hard to manage, so getting into that. Knowing that we need to be mindful of time, since we are the Lunch Hour podcast and we do our best to keep these within that lunch hour, maybe we'll start to wrap up a little bit here.
00:44:50
Speaker
for both of y'all is there anything that we haven't asked about or When you got the thing the topics that we we thought we might chat about was there anything that you were like man I wish they had asked about this That you'd like to share with us now And this maybe is more like a hot potato rather than a popcorn
00:45:14
Speaker
Um, let me, I'm going to flip that question back to you, Misty and Suri. Oh man. One of the, well, one of the questions that you had asked was to kind of talk more about, um, cultural awareness and cultural humility. And so I wonder if you want us to dig into those a little more given that this is the CDI committees podcast. I'm happy to do happy to always, I mean, I think
00:45:43
Speaker
You know, one of the things that we, through the empathy mapping process and just as we all are learning and growing and hearing from other people is the, as Tani mentioned, like the way that language is important and words are important. And so yes, I mean, I think hearing more about
00:46:04
Speaker
like why those words or the way that you phrased them or like what you were trying to get at, that kind of process I think would be really interesting to hear about. Sure.
Ongoing Development in Cultural Competency
00:46:17
Speaker
So I think the changes that we made to these really stem back to what we were hearing from medical schools as far as what students are doing nowadays in medical school and how these competencies are important
00:46:33
Speaker
You know, we learned from medical schools that students and physicians are increasingly working with peers and colleagues in different disciplines and from different backgrounds. They're engaging with community members and patients from different backgrounds. And with this in mind,
00:46:56
Speaker
We hear from schools how they've included more content in their curriculum to help their students understand how to effectively serve their communities and serve patients, such as content towards understanding social determinants of health. And understanding the unique experiences of individuals, of cultures, of communities is important to effectively working with each individual patient
00:47:25
Speaker
And so students continued to need cultural competency, but specifically not that outdated language as Tani pointed out, they need cultural awareness and cultural humility. And so the cultural awareness was written to really focus more on the attitude and value that someone has towards different people and cultures and backgrounds. It involves recognizing that we're not all the same.
00:47:52
Speaker
that people are shaped by their different experiences and cultures and acknowledging that's important to interacting effectively with other people, whether it's patients or peers or anyone else. And then cultural humility was written really to focus on more of that perspective taking and openness to difference and self-reflection.
00:48:16
Speaker
It's how you think about and engage with other people, wanting to learn from others and inform your own thinking based on what they share about their experiences and their perspectives. And so it's that listening as well as being introspective. And these things are not totally distinct from one another. They kind of work together and they build off of one another kind of cyclically.
00:48:46
Speaker
Hey, I achieved that sound effect. I think the only thing I would add is that they're important as a pair because if you only did one,
00:49:01
Speaker
you're not going to do the other as well. So you need to do both and to really build your muscle, so to speak. And that's, I think what we're finding now is that we really want to do both well, to try to do both well and to be kind of one leads to the other. And so, and
00:49:22
Speaker
And so I'm really glad that that that preliminary work was done asking the community, if you will, what what is going on? So the schools were telling us what is going on, what students and med students and the population is experiencing. And I think students are experiencing. I am finding that the applicants are using the word social determinants of health without really understanding what that means. So I'm asking them.
00:49:52
Speaker
But still, the point is, is that they're really, they're starting to get what the concept of the reflection and the action. But I think that that's important that there is that combined through some repair rather than just a checkmark. I've done this, but there's that reflection and then the value. So.
00:50:20
Speaker
Yeah, that's super helpful. So I guess as we wrap up, it would be really great to know what is the hope for the future concerning the competency changes made by AAMC as it pertains to DIJ, that whole sphere?
Guiding Holistic Applicant Review
00:50:42
Speaker
Sure. And I'll speak to that question and also say that I think that what I'm about to say
00:50:47
Speaker
probably holds true for how the working group feels about this as well. We hope that these competencies can do a couple of things. One, we hope that they can help guide students as they develop and prepare for medical school. These competencies really serve as a starting point of a developmental roadmap for pre-med students. And students can seek out opportunities through a wide range of options.
00:51:14
Speaker
And the experiences and the activities and the courses that they choose to pursue don't have to be in medicine. They can pursue experiences that align with their interests and values and things that they're passionate about. And those are often a really great way to develop in these different competency areas. And as Tani mentioned,
00:51:37
Speaker
this is the start of their development of these competencies. These competencies are things that they're gonna continue to develop and learn about through their whole medical school training and their career. And then I think the other thing is that we hope the competencies really help facilitate equitable holistic review of applicants by medical school admissions committees. I've said before that these competencies offer a framework or a set of criteria to guide medical schools evaluation of applicants,
00:52:07
Speaker
Schools can review these competencies, identify what's important to assess in their applicant pools, given their curriculum, their mission and goals, and then consider the different ways that students
00:52:21
Speaker
might show their understanding or demonstrate these competencies. There's no one size fits all approach. And so we hope that medical schools can use these competencies and be flexible and acknowledge that there are many different ways that students can develop them. And that can help further holistic review and equitable review of applicants.
00:52:46
Speaker
That's the, what do you call it? The think Harry audacious goal. Anything that we can do to stop checkboxing and get anyone, our future physicians, our current physicians to like reflect and think.
00:53:07
Speaker
What a dream. Yeah, right. Yes. All better for future health professionals. Yeah, so I mean, I think it's our responsibility as advisors to be in a place of advocacy like Tani, you have done, but also be in a place where we are able to translate this information in our work every day. The systems that we build, the programs that we construct, the resources that we provide to our students so that they can
00:53:38
Speaker
better internalize what this looks like and then it creates diverse workforce and how it appears within their health professions careers and things like that. So we really appreciate you both for giving that perspective. Tani, did you have any sort of future goals for these competencies?
00:54:05
Speaker
Rebecca got to talk about that, but what do you see as next? Do you see you next? Well, what I would love as an immediate future goal is that not only MD and the old medical schools use them, but hopefully all of the health profession schools. And I know that
00:54:25
Speaker
health profession schools do have a sense of competencies that they use but I would like for once all of the health profession schools agree on something that we are not using different things.
Desire for Unified Competencies
00:54:40
Speaker
I know in the past sometimes dental schools agreed with the past double AMC core competencies like our dental schools in the state of Michigan agreed with the double AMC core competencies and I
00:54:54
Speaker
What I have done, and it's maybe been, was a bit lazy on my part, but I told my students with the past competencies that this is what you need to do no matter what your health professions tracks. These are the set of behaviors expected of you of all health profession schools. And later they would be like, well, actually they don't, but I'm like, actually they do.
00:55:20
Speaker
And, you know, I just kind of said that to all students, but it would be nice that there was a more formal mechanism for that process.
00:55:31
Speaker
So a future goal, a big hairy, you know, audacious goal would be for that. Put this on your agenda. Yes. And then, you know, I'm sure in another 10 years these goals will be up for review again. I think
00:55:54
Speaker
You know, as you look at the process, I think involving advisors, having DEI involved in that process was great. I think that's important. And we really appreciate being involved and having
00:56:13
Speaker
you know, someone who is any advisor who's thinking from both the advocacy as well as the diversity as well as the advisors and the students perspective is very important. So those are my comments. Thanks. Yeah. So to like kind of wrap up the episode and sort of get us out within that lunch hour, you know, I think a lot of folks in our field have been a little concerned, you know, post
00:56:39
Speaker
SCOTUS affirmative action decision, that conversations around diversity, equity, and inclusion would sort of fade into the wayside.
Conclusion and Importance of DEI
00:56:48
Speaker
So I think this was a really timely addition and sort of expansion of these expectations to say, while we might not be able to singularly use that data point in the selection process, these concepts and ideas
00:57:04
Speaker
and the importance of them have never been more important. And so we still expect you to have this exposure and awareness. So I really wanna, you know, on behalf of our membership, thank you for the work that you've done to really emphasize the importance and centrality of these concepts in the work that we do as advisors, but also the future work of healthcare providers. So yeah, thank you.
00:57:33
Speaker
Thank you both for being fantastic guests today. Of course, yes. And we want to thank everyone across the membership for tuning in to another episode of The Lunch Hour and keep striving for a more inclusive and just health professions community. Until next time.