Educational Portfolio James N. Lau MD MHPE
I have always and always will express myself through teaching and learning. My thirst for learning fuels my penchant for teaching. This was my entryway into first surgery, then education, and thereby an academic surgical practice. My philosophy of education begins with empathy/learner centeredness, goes through modeling, and ends with mentorship. Simply put, a teacher should: 1) remember who it is they are teaching and how it was to be them at that stage, 2) model the behavior that one is espousing, and 3) have mentors and mentor other to create a network and environment of collaboration and inspiration.
My path to becoming a surgeon was defined by those of which I have dedicated to teaching in my formal academic roles. I became the surgery core clerkship director 8 years ago and my empathy for the plight of the medical student has enabled me to champion several causes for them. These include, but are not limited to: enhancing the support of the struggling student, initiatives to introduce medical students to specialties throughout their pre-clerkship and clerkship curricula, procedural skills training, teaching advocacy in the clerkship educational environment, adapting the clerkship structure to asynchronous learning styles, and attempting to curb the marginalization of the medical student in the modern care of the patient. This has led to my more formal integration into the school of medicine leadership structure and this has broadened the breadth of the population in which I serve. Residents require a champion, especially, in this overly complex educational and clinical service environment. Since I think of myself as a resident, I have created and continue to create educational programs and curricula that speak to what they need to become surgeons and physicians. At two institutions, I have turned this empathy into creating skills curricula within simulation centers that speak to the technical, decision making, and leadership needs of residents. This had led me to the role of associate program director at these same institutions whereby I could evolve these curricula into a goal of providing residents with all the support and tools to help them acquire the knowledge skills and attitudes necessary to be the best surgeon possible. Even as I formally do not administer the residency program, I continue to mentor the resident that I have recruited and create programs mostly in non-technical skills to grow their faculties as leaders and more mindful patient care advocates. As a clinical fellow, I understood that teaching in the operating room required patience and an ability to verbally coach to technical and clinical decision making skills. Leadership in my specialty societies in medical student, residency, and fellowship education allows me a conduit to mold the spectrum of education in the paradigm mastery versus that of mere competency. Thinking that medical education in surgery requires more in depth training, much as our clinical specialties do, I have realized my vision of creating an educational fellowship for surgery residents. This fellowship gives surgical residents; a way to learn the language of medical education, a venue to enhance their teaching skills and style, populations of learners to use research to answer important educational questions, and become a part of international networks of educators in medicine and surgery. This model of fellowship has spread to other academic surgery department and those fellows now collaborate in inter institutional works of curricular innovation and the scholarship of sharing.
Teamwork has become ubiquitous in the care of the modern patient and especially in surgery. The teams in which we work are ever shifting yet increasingly more important in gathering the data, formulating plans for diagnosis, and in dispensing both medical and surgical care. Communication is a skill that can be learned and honed, and interprofessional teamwork and communication requires training and working together to a common goal. Medicine gives us that common goal of caring for patients. Behavior in the clinical environment is how we interact with patients, colleagues, team members, other providers, and our families. Learning and teaching interprofessional teamwork and communication requires one to live and model this since the behavior is the teaching lesson. An annual interprofessional crisis simulation program with anesthesia and surgery residents, with operating room nurses and scrub technicians has sparked my passion and formal advocacy in this area. As medical director of Program Transform for Stanford Hospital I learned many lessons in embedding an interdisciplinary simulation teaching program within every inpatient unit at Stanford Hospital. These experiences have lead me to partnerships with the hospital and operating room leadership, simulation leaders, and educators within the disciplines in the operating room in order to formulate, secure funding for, initiating, maintaining, and then evaluating a three year research project utilizing in-situ simulation to enhance interprofessional communication and therefore improve patient safety and operating room efficiency outcomes. This is an attempt to change the behavior of those ubiquitous, ever-changing, team members to be mindful of everyone and value all input for the safe efficient care of surgical patients in the operating room. We are now transitioning this grant funded project into a integrated program within the interventional platform at Stanford Healthcare.
Mentorship comes with mindfulness and the caring for others in a comprehensive way. Formal professional mentorship encompasses this caring but places the focus on career, specialty, and academic areas. I have few clinical mentors but many educational mentors. The sharing of this these special relationships has been a wonderful living theme throughout my career progression and development. I serve formally as a mentor in my roles as surgery core clerkship director, associate program director of the general surgery residency, and director for the surgical education fellowship. However, it is my informal roles as coach, confidant, facilitator, and advisor that I feel I have made the most impact no matter the level of trainee or type of adversity that is encountered. In my many academic roles, both nationally in society committees and locally at Stanford, exposing and mixing colleagues of different disciplines has been my way of creating new networks and seeding new mentorship relationships. All of my educational curricular and research projects involve people of different academic levels and disciplines. It has been a joy to break down silos and watch talented people grow and accomplish wonderful things.
The educational environment matters in teaching and learning. Educators that can be learner centric, walk what they teach, and support, while being supported by, others are the most effective in creating thoughtful, wickedly effective, and comprehensive care providers. My educational philosophy is to be one of those educators. I have and will spend my life in pursuit of this.