Commentary by Katherine D. Ellington, Class of 2011, St. George’s University School of Medicine; Creator, Producer and Host, AMSA National Book Discussion Webinars
Over the last year, I've had the opportunity to create, develop and implement the American Medical Student Association (AMSA) National Book Discussion Webinars. A diverse group of physicians have discussed their books, writing pursuits, work experiences, and lives. The AMSA National Book Discussion Webinars offer a unique online experience between physician-authors and medical students to encourage reading beyond the medical school curriculum, both for professional development and for personal enrichment. The group of physician-authors selected represent a cross-section of backgrounds and their books were chosen based on relevant themes to engage the AMSA community.
New technology: What is a webinar?
Webinar technology is a new tool emerging in the world of medicine and elsewhere, making it possible to connect people beyond conference calls and e-mails. During webinar sessions online participants have the opportunity to watch, listen, use text chat, ask questions and have a discussion with the presenter and host. There's also a presentation area for slides and document sharing. Desktop sharing and audience polling are also possible. The real-time session includes time for questions or discussions either via chat or live by phone or VoIP (voice over Internet Protocol) for a complete online experience.
While some physicians presenters were concerned about being able to use the technology, doing a trial-run before the session made it possible to setup and then present during the actual webinar with ease. Physician comments indicate overwhelmingly positive experiences with the webinar technology.
Exploring texts beyond the medical school curriculum
The inaugural session was held in February 2009 with well-known psychiatrist-author Samuel Shem, M.D.(pen-name of Steve Bergman, M.D., Ph.D.) discussing his new book, The Spirit of the Place, along with his Annals of Internal Medicine article, "Fiction as Resistance." In contrast, the following month a young cardiologist and physician-writer Sandeep Jahaur talked about his book, Intern, and New England Journal of Medicine essay "The Demise of the Physical Exam." The webinar sessions have allowed for conversations beyond the books and articles selected; for example Dr. Katrina Firlik's discussion about women in medicine offered themes beyond her memoir Another Day in the Frontal Lobe. Neurosurgeon Nozipo Maraire participated in this session as a special guest to provide her insights on family life and medicine. Dr. Maraire's work of fiction Zenzele: A Letter to My Daughter, was written during the long nights of her residency training at Yale.
AMSA National Book Discussion Webinars have also touched on dilemmas within health care. Dr. Audrey Young's discussion of her latest book, The House of Hope and Fear: Life Inside in a Big City Hospital, helped us think about how the commitment of public hospitals to indigent communities is complicated by the need to control health care costs, and how the complexity of "cost-shifting" becomes the physician's burden and affects everyone. This conversation continued on through the summer to the fall when Dr. Young joined in a dialogue with pediatrician and health policy expert Dr. Fitzhugh Mullan. In this webinar on Narrative Matters, Dr. Mullan described health policy writing as political narrative that falls between editorial and short story memoir.
"I was telling stories that were pertinent to people's concerns about health care and that were, to some degree, a goad to those in charge. My writing was an invitation to change things."
Fitzhugh Mullan, M.D.
Like Samuel Shem, Dr. Mullan and Dr. Young talked about their writing as a tool for advocacy and activism in medicine, a long-held AMSA theme.
Bringing physician's stories closer to students
Book titles have been selected in some cases many months in advance, yet the webinar announcements and schedule give participants at least a few weeks to read the book and articles before registering and joining a webinar session. The selected articles provide a glimpse of the physician's writing in a different context. The hour-long program format also allows for a "reader's response" when participants can take a few minutes to comment about their perspectives on a book and/or article, further enriching the dialogue. These webinars close the distances that separate dispersed but enthusiastic students who read and wish to share in a group experience.
To date, the AMSA National Book Discussion Webinars has had more than 500 participants and 18 physician-writer presenters. Webinars are scheduled to accommodate physician and physician-in-training schedules in order to encourage participation of a national audience. Each webinar session is limited to 25 participant connections; preference is given to AMSA members and chapters viewing as groups. Feedback and audience survey results indicate positive experiences among participants. The power of physicians' storytelling resonates through these webinars that connect storytellers and medical and premedical students, interns and residents, physicians, health professionals, and those in the medical humanities field. The live webinar is authentic and allows for an informal, shared experience and unique learning opportunity.
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Firlik, Katrina. Another Day in the Frontal Lobe: A Brain Surgeon Exposes Life on the Inside. New York: Random House;2007
Jauhar, Sandeep. Intern: A Doctor's Initiation. New York: Farrar Strauss Giroux;2009.
Jauhar S. The demise of the physical exam. N Engl J Med. 2006;354(6):548-51.
Maraire, Nozipo, Zenzele: A Letter to My Daughter. New York: Delta;1997
Mullan, Fitzhugh and Ficklen E. ed. Narrative Matters: The Power of the Personal Essay in Health Policy. Baltimore: Johns Hopkins Press;2006.
Shem S. The Spirit of the Place. Kent: Kent State University Press;2008.
Shem S. Fiction as resistance. Ann Intern Med. 2002;137:934-7.
Young, Audrey. The House of Hope and Fear: Life in a Big City Hospital. Seattle: Sasquatch Books;2009.