Opening Remarks: Charles Friedman, PhD, Department of Learning Health Sciences (DLHS) Chair
This issue of "The Loop" features two recent and important events in which our department has played a central role. First is the annual Health Professions Education Day. I'm proud that DLHS is one of the lead co-sponsors of this event. HPE Day brings together educators from across the professions on campus, and additionally from  other campuses in the region, in recognition of the fact that preparing the next generation of health professionals must be an exercise in team science. Later in this issue, we describe a recent workshop sponsored by the Gordon and Betty Moore Foundation and organized by DLHS. The workshop brought together 35 leading scholars from across the nation to explore how Learning Health System concepts and methods could be applied to the quest for more timely and accurate medical diagnoses.
The issue concludes with features on two of our many superb DLHS people. Ed Lockett works long, hard, and well to keep the many programs of the Clinical Simulation Center running as demand for simulation programs continues to grow. And Martha (Marti) Funnell has retired to emerita status on our faculty. Marti has become legendary for her work in diabetes education and patient empowerment. While we will miss Marti's contributions in a full-time capacity, we are delighted that she will remain an active member of the faculty.
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DLHS Professional Development Programs - Apply Now
Our Patient Safety & Quality Leadership (PASQUAL) Scholars Program is seeking Michigan Medicine faculty and staff who have a passion to become leaders in quality and patient safety. Learn from experts in quality control and patient safety while also executing a hands-on project. 2018-19 cohort meets on Thursdays from October 18, 2018 to May 23, 2019. Apply by June 1, 2018 for priority consideration.
The Medical Education Scholars Program (MESP), a 10-month leadership program beginning in September, is accepting applications for the 2018-2019 Cohort from among the U-M Medical School faculty. Scholars attend a weekly half-day seminar, build peer relationships and also develop an Individual Project. Apply by the first week of May.
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Making connections and sharing work, Health Professions Education Day 2018 brings the U-M health science schools, and other learning institutions, under one roof.
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HPE Day 2018 Bringing Health Sciences Together
On April 3rd the university’s wide-ranging interprofessional scholarship was on display at the Michigan League as the academic community from across U-M’s health science schools assembled for the annual U-M Health Professions Education Day (HPE Day).
The event featured keynote speaker, Molly Cooke, MD, MACP, a Professor of Medicine at the University of California, San Francisco, and a global leader in the field of medical education. Delivering the inaugural James O. Woolliscroft lecture, How much difference can one teacher make? Dr. Cooke saluted the former medical school dean’s body of work – including an impressive number of peer-reviewed publications spanning diagnostic reasoning, clinical decision-making and educational assessment – while also sharing the impact of significant teachers throughout her own career.
Among the HPE Day attendees was Carol R. Bradford, MD, MS, Executive Vice Dean for Academic Affairs, Medical School who introduced the Woolliscroft lecture. Dr. Woolliscroft, a member of DLHS joint faculty has been an enthusiastic HPE Day supporter and was on hand to receive the honor.
Now in its fourth year, HPE Day has become an important destination for scholars from U-M’s three campuses while also welcoming participants from Saginaw Valley State University and Macomb Community College. Dr. Elizabeth Kuzma is a returning scholar to HPE Day. The Clinical Assistant Professor in the U-M School of Nursing, who displayed her pilot project on improving LGBTQ access to quality care, appreciates the reach of the event. “It’s a great time to be able to connect with other disciplines, to see what other schools are doing and learn from one another.”
Nearly a third of this year's 227 participants were students, adding to the HPE Day energy. Undergraduate Nicholas Zoppi brought his comparison piece on diversity-related field trips for dental students during orientation, while medical student Keerthi Gondy’s work evaluated the effectiveness of a new Culinary Medicine Elective for 4th year medical students. The event even drew an entire class from the School of Social Work to peruse the nine categories of posters including research areas such as: “Interprofessional Education Experiences,” “Autonomy, Entrustment, Feedback,” and “Patient-Centered Care.”
The Michigan Center for Interprofessional Education, the Center for Research on Learning and Teaching and the Office of Academic Innovation collaborated to sponsor the event along with the Division of Professional Education in the Department of Learning Health Sciences. Caren Stalburg, MD, MA, Division Chief for Professional Education, is a founding HPE Day Co-Chair and serves as emcee for the proceedings. “HPE Day has become a centerpiece for our health sciences education community here at the University of Michigan,” says Stalburg. “It is so exciting to see the progress we all are making in Interprofessional Education and Collaborative Care as well as the continued connections being built across schools and campuses.”
Save the date for April 2nd to join us for #UMHPEDay 2019! Till then, visit the HPE Day 2018 Photo Gallery or watch the video of the keynote.
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Collaborating on Improving Diagnosis
On March 27th and 28th the Department of Learning Health Sciences (DLHS) hosted “Toward a Learning Ecosystem for Diagnostic Excellence,” a workshop sponsored by the Gordon and Betty Moore Foundation to explore how Learning Health Systems (LHS) concepts and methods could be applied to the pressing problem of improving diagnosis in health care.
Patient care improvement is a central tenet of the foundation’s mission. With the goal of reducing diagnostic error being a particular area of focus, the Moore Foundation reached out to DLHS in 2017. A DLHS team, led by department chair Charles Friedman, PhD, identified the need to bring three communities together: researchers and leaders advocating for methods that reduce harm from diagnostic error; Artificial Intelligence (AI) and Machine Learning researchers who have developed models related to diagnosis; and those interested in developing Learning Health Systems.
Kate Satterfield, a Graduate Student Research Assistant working with DLHS, interviewed 32 leaders from the three communities and also conducted a literature review, both of which resulted in a White Paper that provided the foundation for the March gathering. For two days, 35 experts from these three communities came together to serve on exploratory panels, identify obstacles in select use cases, and determine the potential of Learning Health Systems as means to widely improve diagnosis with two goals guiding their work:
- To establish the key LHS concept of learning cycles (Data to Knowledge begets Knowledge to Performance which then becomes Performance to Data), examine how learning cycles can be implemented in relation to diagnostic excellence, and explore the benefits of cross-community collaboration.
- To further develop the idea that an ecosystem inspired by LHS principles (example: continuous learning) can help achieve a more cohesive approach to diagnostic excellence; establish the concept of LHS infrastructure; identify and highlight potential shared infrastructural resources.
A panel discussion set the stage each day. The first panel examined how the learning cycle can be applied to a goal of achieving diagnostic excellence. It was chaired by Hardeep Singh, MD, MPH who serves as the Director of Houston DISCovery (Diagnosis Improvement Safety Center) and Chief of the Health Policy, Quality & Informatics Program in the Center for Innovations in Quality, Effectiveness and Safety at the Michael E. DeBakey VA Medical Center. Dr. Singh was joined by Suchi Saria MsC, PhD, who directs the Machine Learning and Healthcare Lab at Johns Hopkins University, and Professor Brendan Delaney, Chair in Medical Informatics and Decision Making at Imperial College, London.
The panel on the second day turned toward specific policies, processes, and technologies that are necessary to support these learning cycles. Julia Adler-Milstein, Associate Professor & Director of the Center for Clinical Informatics and Improvement Research at UC San Francisco, chaired this panel. She was joined by Paul Epner, MBA, Med, Chief Executive Officer of the Society to Improve Diagnosis in Medicine (SIDM), Allen Flynn, PharmD from the DLHS, and Gari Clifford, DPhil from the Department of Biomedical Informatics at Emory University School of Medicine and the Department of Biomedical Engineering at Georgia Tech.
In order to examine diagnosis obstacles from the LHS perspective, four diverse medical problems were selected ahead of the meeting to serve as use cases; sepsis, stroke, lung cancer, and melanoma. Working in small groups over both days, participants designed a prototypical learning cycle for each use case, and were then tasked with determining the infrastructure components for an LHS ecosystem that would facilitate diagnostic excellence in each case.
The outcome of the workshop was encouraging. "It is always an adventure when you bring together three groups, each focused on its own set of approaches to address a common goal,” reflected Dr. Friedman. “I believe this meeting succeeded in creating a shared vision of how the three communities can join forces to improve medical diagnosis, potentially achieving what none of the communities could do by themselves."
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OUR PEOPLE, THEIR PURSUITS
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DLHS Profile: Edward Lockett III, Multi-Faceted
 You might say Ed Lockett’s responsibilities as a Simulation Technician require him to be a bit of a renaissance man. The Clinical Simulation Center (CSC) where he employs his various skills is a hub of training activity for Michigan Medicine faculty, students and staff. On a typical CSC workday he might be manning the control room, writing a new training scenario, repairing a hi-fidelity manikin, creating a realistic “wound” for an emergency room training or even occasionally acting the part of an upset hospital patient.
Lockett, a Metro Detroit area native, came to the CSC by way of the U.S. Navy. A stand-out football player in high school Lockett opted for a naval career after graduation, intrigued by a recruiter’s description of health care training opportunities. His seven years as a Hospital Corpsman (HM), a role similar to EMT, took him to Okinawa, Japan and then the Navy Medical Center San Diego. “I loved it,” says Lockett of his time in the Navy. “I made a lot of good life connections.” But when it came time to settle down, he and his wife Leslie decided to move back to Michigan to be close to family.
A fixture at the CSC since 2014, Lockett’s greatest enjoyment comes from teaching. About 10 times a year he works with Deborah Yake, RN conducting American Heart Association Advanced Cardiac Life Support (ACLS) classes for doctors, nurses and other health care professionals. Recently, Lockett and all the CSC team have been getting their steps in, running between CSC Towsley and the newly opened second location, CSC Med Sci II. He’s excited about the opportunity the new center’s more realistic, more immersive, environment provides – noting the design, “conforms to the best practices from the simulation literature.”
There aren’t many off hours for Lockett. He’s taking courses at Eastern Michigan University to earn a nursing degree and eventually hopes to become a Physician’s Assistant. There might be the occasional chance to squeeze in a game of pool or a night at the bowling alley but with a three-year old son and a new baby boy, playtime is the main focus of the Lockett family’s leisure time.
Edward Lockett III is a Simulation Technician in the Clinical Simulation Center.
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DLHS Profile: Martha Funnell, MS, RN, CDE, FAAN, Becomes Emeritus Faculty on January 3, 2018
 In the global diabetes education community Martha M. Funnell, MS, RN, CDE, FAAN, is a giant. A champion for patient empowerment, she is also responsible for improving raising the level of diabetes education and care through her involvement in developing evidence-based diabetes education standards and care.
After completing graduate school, she taught in the U-M School of Nursing and began her career in diabetes in the early 1980s in the U-M Diabetes Research and Training Center where she held a variety of positions. She began her work with the African American and other underserved communities in diabetes management education starting in 1990s. When working in both clinical settings and the community, Funnell observed that the daily burden of living with diabetes is often not fully appreciated. “I wanted to make a difference for people who struggle, as well as their families and communities” reflects Funnell.
She and others here have pioneered research efforts for the past 20 years to bring diabetes management education closer to African American communities in Southeast Michigan by offering effective programs in partnership with local churches. The author of the first article on patient empowerment in diabetes management, Funnell has been on the forefront of destigmatizing diabetes and helping patients become more informed participants in their own disease management.
In 2006 she moved to her current academic home, the Department of Learning Health Sciences. She has had the honor of having leadership roles in both national and international diabetes organizations and has been invited to present our research and experiences in more than 30 countries. She became the first nurse (i.e. non-physician) chair of the National Diabetes Education Program from 2009 to 2011. Associate Professor of Learning Health Sciences, Gretchen Piatt, PhD, who used Funnell’s work to inform her own dissertation, praises her breadth of knowledge. “In the 15 plus years I’ve worked in diabetes, I have not encountered anyone who knows more about the disease and its implications than Marti Funnell.”
With plenty of opportunities for international travel already under her belt, in her emerita role Funnell plans to stay local with the occasional jaunt to see her son and daughter-in-law in San Francisco. She’ll remain active by continuing her Praise 2 diabetes education work in churches while making sure to finally carve out some well-deserved leisure time enjoying a good read on her back deck.
Martha M. Funnell, MS, RN, CDE, FAAN is Research Scientist Emeritus of Learning Health Sciences.
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Save These Dates!
July 10 and 11, 2018: MCBK Meeting
Mobilizing Computable Biomedical Knowledge (MCBK) Meeting in Bethesda, Maryland. Attendees are those interested in building a community to accelerate the application of biomedical knowledge into practice by representing knowledge in computable forms so it can be better curated, managed, and disseminated. Posters are being accepted now through June 15, 2018 – 5:00 PM.
July 31, 2018: CSC Research Grant Proposals Due
The Michigan Medicine Clinical Simulation Center (CSC) Research Committee is accepting proposal submissions for research projects that apply best practices in simulation-based education for UME, GME and other health professions. A maximum of $15,000/project will be available from the Department of Learning Health Sciences to support up to three projects with priority given to projects that evaluate impact on patient outcomes. July 31, 2018 is the deadline for submissions with an August 17, 2018 announcement of funded proposals. Funding start date is September 3, 2018. Submit electronic proposals to Dr. Deborah Rooney at dmrooney@med.umich.edu and copy administrative assistant, Dierdre Jeske at dierdre@med.umich.edu by the deadline. For more information go to the CSC Research Funding Opportunities webpage.
October 4, 2018: Hiss Memorial Lecture Debuts
Don’t miss David G. Marrero, PhD the inaugural lecturer for The Roland G. “Red” Hiss, MD, Lectureship in Medical Education. The annual lectureship was recently established to honor the passion Dr. Hiss (1932 - 2016) had for medical education. Hiss was a professor of internal medicine, professor and chair of medical education (now the Department of Learning Health Sciences) and director of extramural education in the University of Michigan Medical School. The Hiss Memorial Lectureship encourages the exchange of innovations in medical education by providing funding for a leader in the field to visit and lecture while also facilitating interactions with Michigan Medicine faculty, including Medical Education Scholars Program (MESP) faculty, to share ideas and expertise with a national expert, and each other. Dr. Marrero is the Director of the UA Center for Border Health, University of Arizona Health Sciences, Professor of Public Health and Medicine, University of Arizona Health Sciences. Register today.
November 9, 2018: ELSI-LHS Returns
The 3rd Annual Symposium on the Ethical Legal and Social Implications of Learning Health Systems (ELSI-LHS) will address “The Learning Health System in Practice.” The daylong event held in Palmer Commons will focus on use cases and lessons learned from emerging learning health systems and learning health system technologies locally, in the state of Michigan, and across the US to address chronic diseases such as cancer. Special emphasis will be placed on themes and issues arising in previous symposia such as trust, systems ethics, equity. In Spring look for registration info and the call for posters at elsilhs.org or on the DLHS Service and Outreach webpage.
Noteworthy...
 Kudos to HILS PhD candidate Rama Mwenesi. He was recently named a 2017 Top Five Black Alumni under 10 by the Alumni Association. The Five Under Ten Young Alumni Recognition Award is bestowed annually to five recent U-M graduates for their professional achievements and/or contributions to the community-at-large. In order to be recognized for the “Five Under Ten” award, an alumnus must have received an undergraduate degree from the University of Michigan within the last ten years.
Did You Know?
The DLHS Strategic Plan was completed December 2017 and is now online.
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