​PHRONESIS PROJECT

Course Goal: 

The Phronesis Project focuses on professional identity formation, organized around the conceptual framework of wisdom. Our educational goal is to foster our capacity for wisdom development, setting the stage for wisdom development throughout our careers.

 

Optional, but recommended textbooks:

Plews-Ogan M, Owens JE, and May N. Choosing Wisdom:  Strategies and Inspiration for Growing through Life-Changing Difficulties.  Templeton Press. Templeton Press, 2012.

 

Schwartz B, Sharpe K. Practical Wisdom: The Right Way to Do the Right Thing. New York: Riverhead Books, 2010.

 

Longitudinal Patients

The Phronesis Project is designed so that all of your learning takes place within the context of patient care. In September, you will be assigned an adult patient from one of four clinical sites, corresponding to your CPD group:  Family Medicine Primary Care Clinic (PCC); University Medical Associates (UMA); the Infectious Disease/HIV Clinic; or University Physicians—Charlottesville (UPC). Typically, your patient will be medically complex, affording you the opportunity to see the health care system from multiple angles and to learn many facets of patient care. You will participate in your patient’s care throughout your four years of medical school with increasing responsibilities as you develop your skills.

 

Patient Contact Log

We ask that you complete a patient contact log, recording all of your contacts (by phone, in person, email) with your patient.  We will ask to review these logs during your individual meetings with Natalie May (fall) and your CPD Mentor (spring), and you will turn them in at the end of each academic year.  A copy of the log is in your Phronesis handbook, Google docs, and our website.

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Document:  Phronesis Patient Guidelines

 

Phronesis Workshops

We will hold eight workshops throughout the year outside of CPD, opportunities for us to delve deeply into topics that we believe will help you grow in your role as a wise physician. We will notify you of specific workshop dates as soon as possible. We also do our best to provide opportunities for you to meet your fellow Phronesians from the classes of 2018, 2019 and 2020.  They are anxious to meet you and share their Phronesis and medical school experiences with you. They are also an excellent resource when you have questions, and they are happy to help.

 

Clinical Professional Development (CPD)
You will meet with your Phronesis mentors in groups of 6 for the weekly CPD sessions. As Phronesis students, at the start of each CPD session, we will devote 10-15 minutes to one or more of the following:  (1) reflective practice/mindfulness and (2) Phronesis patient-related activities. Phronesis Student Directed Learning (SDL) topics in the CPD sessions will be topics of your choosing, but we do require that they have a general focus on (1) the physician’s role in society to foster the greater good; (2) the bigger picture; or (3) mindful and reflective practices.  In past years, these presentations have covered a fascinating range of topics:  health disparities in the diagnosis and treatment of heart disease screening; the neuroscience of happiness; therapy dogs; climate action in medical education; the health benefits of vegetarianism and veganism; the role of the physician in the Holocaust; the impact of poverty on health outcomes; and physician work-life balance.  There is a list of previous topics available here, and students’ Powerpoint presentations available on our website.  

 

Social Issues in Medicine (SIM) Requirement

Phronesis students are not required to participate in community setting placements or the SIM service project. You will learn about the role of community programs through your advocacy work with your patients and their families as well as a service project at your clinic sites (more on this at orientation). However, you are required to attend SIM classroom activities (content sessions and panel presentations) and submit the SIM reflective writing assignments that have been modified for Phronesians. Two primary goals of the SIM course are to provide 1st year medical students with an introduction to the social issues in medicine and the societal context in which medicine is practiced, and to encourage students to develop an ethic of service.  

 

Portfolios and Individual Meetings

All of your Phronesis materials throughout the four years will be kept as a portfolio. Natalie May will store your portfolios in her office, although you are encouraged to keep your own electronic and/or hard copy. The portfolio includes everything – patient logs, narrative interviews, behavior change table, SIM essays, and even emails related to your Phronesis experience. If you have a great day with a patient, shoot your mentor or Natalie an email or even a text. We hope you will consider your portfolio a creative repository of your work and documentation of your growth as a young physician.  The portfolio also helps us keep track of your progress working with your patient.

 

Each year, you will be asked to write a reflection highlighting your Phronesis experience, with a focus on wisdom.  We also ask every student to complete an annual online evaluation.  We take student feedback very seriously and anticipate that the Phronesis Project will continue to evolve and grow, with your help.

 

Each student will have a one-on-one meeting with Natalie May in October/November to review your progress and identify any needs you may have in terms of Phronesis work, your patient, etc. You will receive a Sign-up Genius email from Natalie to schedule these meetings. All students will also have individual meetings with Dr. Plews-Ogan, Dr. Kon, or your CPD mentor in the spring.

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August 8 2017  -- Phronesis Project Orientation:  Why Wisdom in Medicine?

Peggy Plews-Ogan, MD & Rachel Kon, MD

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Tuesday, August 8

2:40 – 4:00 pm

The Learning Studio

 

Learning Objectives:

• Be able to discuss the key elements of wisdom.

• Apply the three elements of wisdom to the characteristics of doctoring.

• Identify and reflect on formative experiences on their journey to becoming a doctor.

 

Readings – Required:

All PDFs are available in the lists below.

 

Plews-Ogan M, Owens JE, and May N. Choosing Wisdom:  Strategies and Inspiration for Growing through Life-Changing Difficulties.  Templeton Press. Templeton Press, 2012. Introduction & Chapter 1: Defining Wisdom, pp. 3-25.  (PDF)  Read here.

 

Kaldjian L. Teaching practical wisdom in medicine through clinical judgment, goals of care, and ethical reasoning. J Med Ethics. 2010;36(9):558-62.  Read here.
 

Kumagai AK. From competencies to human interests: ways of knowing and understanding in medical education. 2014;89(7):978-83.  Read here.

 

Reading – Optional:

Kinghorn WA.  Medical education as moral formation:  an Aristotelian account of medical professionalism. Perspect Biol Med. 2010;53(1):87-105.  Read here.

 

Plews-Ogan M, May NB, Owens J, Ardelt M, Shapiro J, Bell S. Wisdom in medicine: What helps physicians after a medical error?  2016;Acad Med; 91:233-41.  Read here.

 

Portfolio Assignment (Please email completed reflective writing to Natalie May (nlb7r@virginia.edu or nbmay@verizon.net)

• Reflective writing: What does a wise doctor look like?

 

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September 2017 – Tell Me a Story: Using Story to Care for Your Patient

Phronesis faculty

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Tuesday, Sept 12
1:00 – 3:00 pm

Learning Studio

 

Learning Objectives:

• Compare and contrast narrative history and the traditional medical history, considering how these differences might affect patient care.

• Describe the relationship between telling stories, eliciting stories, and wise doctoring.

• Conduct a narrative interview with a patient.

 

Readings:

 

Plews-Ogan M, May N, Becker D.  Tell me a story:  teaching residents to find and share their patients’ stories. Med Encounter. Accepted for publication.  Access PDF article manuscript here.

 

Optional:

Plews-Ogan M, Owens JE, and May N. Choosing Wisdom:  Strategies and Inspiration for Growing through Life-Changing Difficulties.  Templeton Press. Templeton Press, 2012. Chapter 7:  New Narrative, pp. 97-113.  Access PDF chapter here.

 

Patient activities:

• Get patient assignment

• Familiarize yourself with the patient guidelines, especially the confidentiality expectations

• Contact PCP to introduce yourself (and program if PCP not your Phronesis mentor)

• Tour your clinic site on scheduled dates & times

• Schedule patient home visit to conduct narrative interview

• EPIC training and review patient history in EPIC

 

Portfolio Assignments:

• Conduct narrative interview and write arrative interview summary (Instructions here.)

• Begin keeping patient log (Available here.)

 

Reflective & Appreciative Practices:  TBA

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October 2016 – Mindfulness & Medicine Workshop

Susanna Williams

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Learning Objectives:

• Be able to practice STOP and body scan techniques.

• Develop reflective practice, metacognition, and self- awareness using mindfulness techniques.

• Describe applications of mindfulness in medical practice.

 

Date & time TBA

Location TBA

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Readings:

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Epstein R. Mindful practice. JAMA. 1999;282:833-9.

 

Krasner MS, Epstein et al. Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians. JAMA 2009;302:1284-93.

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Portfolio Assignment:

• Complete narrative interviews

 

Individual meetings with Natalie May (through November).  You will receive an email from Sign Up Genius to schedule your meeting time.

 

Reflective & Appreciative Practices:  Same as workshop learning objectives.

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November 2017 – Patient Advocacy

Mo Nadkarni & Carolyn Engelhard

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Date & time TBA

Location TBA

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Learning Objectives:

• Discuss social determinants of health and the physician’s role in influencing those determinants.

• List social benefits programs in Charlottesville area.

• Elicit and identify patient strengths.

• Identify community strengths and resources that will have a positive impact on patient outcomes.

 

Video -- Required:

http://www.ted.com/talks/rishi_manchanda_what_makes_us_get_sick_look_upstream