We Need to Talk: Advancing Open Inquiry.

ABSTRACT: In this article, the authors explore the current state of divisiveness in U.S. society and its impact on medical schools. Higher education institutions are increasingly faced with challenges in supporting freedom of speech while respecting marginalized groups who may feel attacked by certain kinds of speech. "Cancel culture" has resulted in misunderstandings, job loss, and a growing fear of expressing ideas that may offend someone. These dynamics are particularly relevant in medicine, where issues of racial justice, reproductive health, gender identity, and end-of-life care, occurring in the context of personal and religious differences, affect patient care.Despite these challenges, there must be ways to talk and listen respectfully to each other and bridge sociopolitical divides. Open inquiry and discussion are essential to medical education and patient care. There needs to be a common language and a setting where open engagement is encouraged and supported. This requires expertise and practice. The authors describe several models that offer constructive approaches toward this goal. Organizations including Braver Angels, Constructive Dialogue Institute, Essential Partners, and Greater Good Science Center are working to advance open inquiry and discussion, as are psychology leaders whose methods encourage empathy and learning from one another before engaging in a charged, polarized discussion topic. These and others are using methods that can benefit medical education in supporting diversity of ideas and deliberative discussions to equip students with skills to overcome divisiveness in their training and clinical practice.Promoting civil discourse is critical to society's well-being, and respectful engagement and open inquiry are essential to medical education and patient care. Despite the challenges posed by current societal divides, there are ways to talk with each other respectfully and constructively. The authors assert that this requires ongoing effort and practice, which are crucial for the health care enterprise to flourish.

Create a COVID-19 commission.

We need a definitive public reference for the history of events.

Emerging topics in dementia care and services.

BACKGROUND: The National Institute on Aging (NIA), in conjunction with the Department of Health and Human Services as part of the National Alzheimer's Project Act (NAPA), convened a 2020 Dementia Care, Caregiving, and Services Research Summit Virtual Meeting Series. This review article summarizes three areas of emerging science that are likely to grow in importance given advances in measurement, technologies, and diagnostic tests that were presented at the Summit. RESULTS: Dr. Cassel discussed novel ethical considerations that have resulted from scientific advances that have enabled early diagnosis of pre-clinical dementia. Dr. Monin then summarized issues regarding emotional experiences in persons with dementia and their caregivers and care partners, including the protective impact of positive emotion and heterogeneity of differences in emotion by dementia type and individual characteristics that affect emotional processes with disease progression. Finally, Dr. Jared Benge provided an overview of the role of technologies in buffering the impact of cognitive change on real-world functioning and their utility in safety and monitoring of function and treatment adherence, facilitating communication and transportation, and increasing access to specialists in underserved or remote areas. CONCLUSIONS: National policy initiatives, supported by strong advocacy and increased federal investments, have accelerated the pace of scientific inquiry and innovation related to dementia care and services but have raised some new concerns regarding ethics, disparities, and attending to individual needs, capabilities, and preferences.

Making Doctors Effective Managers and Leaders: A Matter of Health and Well-Being.

The COVID-19 crisis has forced physicians to make daily decisions that require knowledge and skills they did not acquire as part of their biomedical training. Physicians are being called upon to be both managers-able to set processes and structures-and leaders-capable of creating vision and inspiring action. Although these skills may have been previously considered as just nice to have, they are now as central to being a physician as physiology and biochemistry. While traditionally only selected physicians have received management training, either through executive or joint degree programs, the authors argue that the pandemic has highlighted the importance of all physicians learning management and leadership skills. Training should emphasize skills related to interpersonal management, systems management, and communication and planning; be seamlessly integrated into the medical curriculum alongside existing content; and be delivered by existing faculty with leadership experience. While leadership programs, such as the Pediatric Leadership for the Underserved program at the University of California, San Francisco, and the Clinical Process Improvement Leadership Program at Mass General Brigham, may include project work, instruction by clinical leaders, and content delivered over time, examples of leadership training that seamlessly blend biomedical and management training are lacking. The authors present the Leader and Leadership Education and Development curriculum used at the Uniformed Services University of the Health Sciences, which is woven through 4 years of medical school, as an example of leadership training that approximates many of the principles espoused here. The COVID-19 pandemic has stretched the logistical capabilities of health care systems and the entire United States, revealing that management and leadership skills-often viewed as soft skills-are a matter of life and death. Training all physicians in these skills will improve patient care, the well-being of the health care workforce, and health across the United States.

Social license for the use of big data in the COVID-19 era.

Strategies to enable the reopening of businesses and schools in countries emerging from social-distancing measures revolve around knowledge of who has COVID-19 or is displaying recognized symptoms, the people with whom they have had physical contact, and which groups are most likely to experience adverse outcomes. Efforts to clarify these issues are drawing on the collection and use of large datasets about peoples' movements and their health. In this Comment, we outline the importance of earning social license for public approval of big data initiatives, and specify principles of data law and data governance practices that can promote social license. We provide illustrative examples from the United States, Canada, and the United Kingdom.

Addressing Student Burnout: What Medical Schools Can Learn From Business Schools.

Although they enter school with enthusiasm for a career in medicine, medical students in the United States subsequently report high levels of burnout and disillusionment. As medical school leaders consider how to address this problem, they can look to business schools as one source of inspiration. In this Invited Commentary, the authors argue-based on their collective experience in both medical and business education-that medical schools can draw three lessons from business schools that can help reinvigorate students. First, medical schools should offer more opportunities and dedicated time for creative work. Engaging with diverse challenges promotes intellectual curiosity and can help students maintain perspective. Second, schools should provide more explicit training in resiliency and the management of stressful situations. Many business programs include formal training in how to cope with conflict and how to make high-stakes decisions, whereas medical students are typically expected to learn those skills on the job. Finally, medical schools should provide better guidance on practical career considerations like income, lifestyle, and financial skills. Whether in medicine or business, students benefit from open discussions about their personal and professional goals. Medical schools must ensure that students have an outlet for those conversations.