Athens Advocate Fall 2011

The Athens AdvocAteFALL 2011

www.medicalpartnership.usg.edu

A QuArterly PublicAtion of the GhSu/uGA MedicAl PArtnerShiP

Medical StudentS Begin local

HoSpital ViSitS

georgia health sciences university and the university of georgia have partnered to create a four-year medical education program in athens to help alleviate a statewide shortage of physicians that threatens the health of georgians.

letter froM tHe dean

well into the second academic year, the Interim Medical Partnership Building is bustling with 80 students, 25 full-time faculty, and 10 staff. Add 17 part-time faculty members, over 40 ‘volunteer patients’, and many volunteer clinical faculty, and the once quiet renovated former Cotton and Wool Mill is transformed into the hub of medical student learning.

In this issue of the Athens Advocate, we begin a series to highlight the unique curriculum developed for the Partnership students. The first article by the Campus Associate Dean for Curriculum, Dr. W. Scott Richardson, explains the rationale for constructing the weekly learning around a weekly theme and clinical cases.

Our second year students are one step closer to achieving a broad foundation in clinical skills through their visits with patients at Athens Regional Medical Center and St. Mary’s Healthcare System in Athens. Approximately four days each week, teams of two medical students and a faculty physician visit hospitalized patients, take medical histories and conduct physical examinations. During these visits, the students have the opportunity to practice what they learned during their first year of medical school - how to communicate effectively with patients and discover the clinical symptoms and physical findings that aid in developing a diagnosis. Dr. Donald Scott, director of this activity, reflects on this important step in the education of the students.

With the growth of the medical campus, both the faculty and the students have begun to broaden their activities in areas of research and community service. In this and subsequent issues, we will highlight these activities. A successful ‘Partnership’ goes beyond the collaboration of two impressive universities. A successful campus must ‘partner’ with the institutions and people of Athens and ‘give back’ to the ‘community’ in-kind. Thanks to all who continue to support the faculty and students of the Medical Partnership.

Barbara L. Schuster, M.D.Campus Dean

GHSU/UGA Medical Partnership

The GHSU/UGA Medical Partnership Campus is currently located at

279 Williams Street, Athens, Georgia

For more information, please visitwww.medicalpartnership.usg.edu

or call 706-369-59002

Editor: Alison Bracewell-McCullick, MPA, :: Director of Outreach & Communications

Design and Layout: Jennifer Stowe, MS

Photography: Andrew Tucker and Dot Paul (UGA Photographic Services)

CRED

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Inside This Issue...

Page 2:Letter from the Dean

Page 3:Curriculum Spotlight

Page 4 & 5:

COVER STORYMedical Students Begin Hospital Visits

Page 6:Faculty Spotlight

Pages 7: Research: Faculty/Student Partnership

Page 8:Student Event Showcase

Page 9:Photos from Student Events

Page 10:Holiday Wishes

CME Credit Information

2012 SGO Golf Tournament

Winter Issue Highlights

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learning Science tHrougH tHe uSe of Medical caSeS

One of the defining characteristics of the curriculum here at the Medical Part-nership campus is how we learn medi-cal science through the study of clinical cases. Three days per week, both first and second year students work in small groups to study authentic clinical cases that are written and selected to fit the week’s curricular themes. The cases are divided into segments that are revealed sequentially, so they unfold over the week. This gives students the opportu-nity to discuss each segment and learn new knowledge before moving to the next segment. It also gives students the chance to find gaps in their understand-ing during the sessions and then fill these gaps between sessions.

In the first year, learners study one case per week, and questions prompt the students to pursue a broad range of rel-evant knowledge, from genes to society. In the second year, learners study two or three cases per week, moving at a faster pace and demonstrating more in-dependence in their clinical reasoning.

In both years, the main emphasis is on how to connect knowledge from sev-eral scientific disciplines and on how to link this knowledge to the clinical deci-sions involved in the cases. At a deep

level, these cases show students how to use sci-entific knowledge while thinking and learning like doctors.

We have organized our curriculum this way be-cause of all that we have learned from our collec-tive teaching experience and from the scholarship in medical education and the learning scienc-es, summarized in the following six notions. First, cases provide au-thentic context in which the knowledge to be learned is used. This helps in two ways – at the beginning, it helps students find motivation to learn and understand their need to know the material; toward the end, it provides students with realistic opportunities to apply their new knowl-edge, thus reinforcing their learning.

Second, students become engaged in an active process where they work to-gether to solve problems and make de-cisions by pooling their existing knowl-edge. This active, collaborative inquiry leads to more complete understanding.

Third, cases provide an effective way to organize each week around an impor-tant theme, select the learning activi-ties and resources to fit this theme, and align the assessments to check students’ learning achievement. Fourth, cases provide an effective means for us to in-tegrate the learning, both ‘horizontally’, i.e. how several sciences fit together in context, and ‘vertically’, i.e. how the sciences fit into clinical decisions and actions.

Fifth, learning science with cases aims to increase our students’ ability to trans-fer knowledge learned in the classroom to the care of their patients in clinical settings like doctors’ offices and hospi-tals. Sixth, learning sciences with cas-es serves to remind students why they are here – to learn how to care for the whole person in each patient.

W. Scott Richardson, MD is the Campus Associate Dean for Curriculum at

the GHSU/UGA Medical Partnership.

By W. Scott Richardson, MD

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In early August, the administration and staff at Athens Regional Medical Center and St. Mary’s Healthcare System gave the students an enthusiastic welcome and a great introduction and orientation to their hospitals, complete with a welcoming banquet and group pictures. The students were about to take their first clinical steps in forming their identities as physicians, spending time with patients at both hospitals. I looked at them, wearing their unblemished white coats a bit self-consciously, beginning to play the part of doctor haltingly, and wondered, “How will they learn to respond to human suffering, decline and death? Will they learn to comfort with words, and looks, and touch, as well as with pills and potions? Will they take comfort and inspiration from patients’ and families’ courage, strength and dedication? How will they cope, and how can we help them thrive?”

I will never forget my own first experience, as a second year medical student, going out to interview and examine a hospitalized patient. What I remember is not the particulars of his disease, the diagnosis or his treatments. What I remember most is the emotional impact that it had on me: a mix of sadness, admiration, and awe at his courage, and the fact that I realized it could have been me in that bed. He was 29, and I was 29. He was in law school; I was in medical school. He was from a small mid-western town, and

so was I. He was experiencing his second relapse of lymphoma, and facing an endless stream of tests, some very painful, and facing a bone-marrow transplant and possible death.

I was worried about asking the right questions, examining him properly, and getting a good grade for my first write-up. After he gave me two hours of his time, most of which we spent just talking, all my concerns somehow seemed pretty trivial. He knew the odds were overwhelming that he would have much less than a normal life-span and that he might in fact not survive the bone-marrow transplant. If he did, it would be tough going. At times he seemed cheerful and strong, and at others he stared off into a place in the room that I could not see. Most of all, maybe because of our similarities, I felt a little of what it must have been like to be in his shoes. I realized that this could have been me, except for a twist of fate or the hand of providence or a different arrangement of genes.

I believe it was the first time I felt a great sense of sympathy and empathy as a clinician in the presence of a patient. I remember feeling very sad and angry, both at the same time, stewing in a cold sweat at the unfairness of what was happening to him. With the benefit of hindsight, however, I realize now that I also was afraid. I was afraid of death, of his death, and, seeing through him that my own could come at any

Medical StudentS Begin local HoSpital ViSitS By Donald W. Scott, MD

◀ Far Left: Dr. Stephen Goggans monitors second-year student Zach Balest as he takes a patient’s history.

Middle: Dr. Shelley Nuss teaches student Joseph Burch about proper physical exam procedure.

Right: Second-year medical student Rachel Taylor listens to her patient’s heart as a part of learning how to perform a physical exam.

time without warning. While I was prepared to ask all the right questions and to perform a complete physical exam using my brain, I didn’t realize the organ that would get the real workout would be my heart.

The most revered and oft quoted clinician and medical educator in American medical history is Sir William Osler. In his address to the graduating class of the University of Pennsylvania School of Medicine, delivered in 1889, he said, “The practice of medicine is an art, not a trade; a calling, not a business; a calling in which your heart will be exercised equally with your head.” Our students have doubtless been exercising their heads with tremendous fervor over the last year. Yet, it is now, on the hospital floors and in the clinics, with “real, sick people,” they begin opening and exercising their hearts as fledgling clinicians, learning to meld their humanity into their budding professional identities.

Donald W. Scott, MD, is the Director of Essentials of Clinical Medicine II

at the GHSU/UGA Medical Partnership.

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faculty SpotligHt: dr. MariatereSa terSigni-tarrant

By Kathleen M. Raven Reprinted with permission from UGA Columns

MariaTeresa Tersigni-Tarrant’s job is not for the faint of heart.

As a forensic anthropol-ogist, she helps solve cases with a decom-posing body or skeletal remains and examines the manner—not the cause—of death.

And the Michigan native, who teaches gross anatomy and embryology at the Georgia Health Sciences University/University of Georgia Medical Partner-ship, can hardly imagine doing anything else. Tersigni-Tarrant approaches nonliv-ing human bodies with serene respect and detective-like enthusiasm. Her at-titude is probably quite comforting to first-year medical students tasked with logging 45 hours in her cadaver lab.

“I tell the students it’s very normal to feel really uncomfortable at first,” she said. Forensic anthropology developed out of a need for science in legal situ-ations involving death; it combines the sub-disciplines of physical anthropology and human osteology.

The popular television show Bones put the relatively obscure specialty on the map—and in the minds of undergraduate students who packed Tersigni-Tarrant’s

fall 2010 “Introduction to Forensic Anthropology” course. She teaches the class every other year to fulfill her joint appointment as an adjunct professor in the Franklin College of Arts and Sciences. Her take-home message for aspiring forensic anthropologists: Be prepared to work in aca-demia. Full-time forensic anthropologist jobs are rare, though television stars lead fans to think otherwise.

Tersigni-Tarrant herself practices her craft in brief intervals away from the university campus. Since 2009, she has consulted with the Georgia Bureau of Investigation on 41 cases. Only a hand-ful of cases require Tersigni-Tarrant to go to the scene of a crime. More often, she drives to the GBI headquarters in Decatur to help with a decomposed or skeletonized body. A full examination can last between one and three days, depending on the body’s condition.

“If I have an entire skeleton, I can make a good estimation of age, sex, stature (height) and ancestry,” Tersigni-Tarrant said. “There is a lot of science involved.”

The information helps her create a bio-logical profile used to understand who a person was. She also may perform a trauma analysis to shed light on the

circumstances of the death. The medical professor laughed as she remembered de-vouring any Nancy Drew or Hardy Boys whodunit as a kid. Real life cases, by con-trast, can be emotion-ally draining.

Tersigni-Tarrant ap-proaches skeletonized remains as a scientist in any field might—by following a specific, tested process. Her ultimate goal is “to do

everything I can to get a person identi-fied and back with (his or her) family. I don’t like knowing that somebody’s still looking and I could do something about it.”

Soldiers’ families benefited from her skills during a post-doctorate fellowship she completed in 2005 at the Joint POW-MIA Accounting Command on Hickam Air Force Base in Hawaii. Tersigni-Tar-rant created a new protocol there to help researchers differentiate animal and hu-man bone fragments found in Southeast Asia on old aircraft crash sites. The new guidelines meant that the pieces were examined at the command center’s lab-oratory first before deciding whether to ship them to Washington, D.C., for DNA analysis. This procedure saved time and money for the researchers. After her post-doc, Tersigni-Tarrant settled back into her other passion: teaching. Before coming to the Medi-cal Partnership, she taught anatomy at the Philadelphia College of Osteopathic Medicine in Suwanee. The faculty posi-tion at the Medical Partnership gave her an opportunity to teach anthropology courses again and to be part of a medi-cal school curriculum that emphasizes small-group learning.

“I love teaching what I’m passionate about,” she said. “I love watching stu-dents come up with the ‘a-ha’ moment, and say ‘Man, I get it!’ ”

▲ Dr. Tersigni-Tarrant, known to students as “Dr. MT,” is shown clarifying key landmark anatomical features to students in the anatomy lab.

Student perSpectiVe on SuMMer reSearcH

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This summer I had the pleasure of working with Dr. Mike Russell on a very unique and exciting research project. The project was entitled “Novel time-domain analysis of tri-axial seismocardiography (3D-SCG) from the cardiac stress procedure.” I first learned of the project from Dr. Cheryl Dickson, Campus Associate Dean of Student and Multi-cultural Affairs, during one of our small group sessions. After talking with Dr. Rus-sell and reading the research proposal, I knew this would be a very interesting project in a field that I have strongly considered pursuing. I be-gan research two weeks after school ended and completed the project one week before the new school year began. I couldn’t have asked for a re-

search site more convenient. My of-fice was located on the first floor of the Medical Partnership building in Athens, a location very familiar to me! My part of the project involved reading previ-

ous articles to familiarize myself with the verbiage and techniques involved in seismocardiography, processing and analyzing patient data, and compiling and summarizing our findings. This was

my first research project and was truly a wonderful ex-perience. I thoroughly en-joyed the discovery process as well as the flexible sched-ule. Research proved to be a wonderful outlet for put-ting knowledge learned dur-ing the year to applicable use. I feel blessed to have been a part of this project and am excited about the future it may hold.

Dr. Mike Russell is in the second year of his NIH-funded project titled “Three-dimensional cardiac acceler-ometry for cardiac monitoring.” The two-year study is designed to assess the diagnostic utility of a method for measuring cardiac mechanical activ-ity in approximately 500 patients un-dergoing the cardiac stress test at the Medical Center of Central Georgia (MCCG) in Macon. Collaborators on the project include Dr. Erskine James and Dr. Ahmed Shah, both Cardiolo-gists from Mercer University School of Medicine (MUSM), Glynnis Haley, a Nurse Practitioner at MCCG conduct-ing the stress tests, Dr. Randall Peters, a Physicist from Mercer University analyzing data in the frequency do-

main, and Jing Kang of MUSM, who has been providing technical assis-tance. This past summer second-year Medical Partnership students Lance McLeroy and Travis Palmer joined the team and conducted two separate projects. Lance worked under the aus-pices of the NIH award on a project titled “Novel time-domain analysis of tri-axial seismocardiography (3D-SCG) from the cardiac stress procedure”. During his time on the project, Lance identified a novel method for SCG waveform analysis that eliminates the need for simultaneous ECG recording. Travis volunteered for an unfunded pi-lot project titled “Seismocardiography as a method for cardiac monitoring in horses.” Working with Dr. Erin McCo-nachie and Dr. Michelle Barton of the

UGA School of Vet-erinary Medicine, Travis showed that horses produced characteristic chest wall accelerations that could be corre-lated with cardiac events using hu-man 3D-SCG waveforms for compari-son. Lance and Travis each wrote and submitted abstracts that were peer-reviewed and accepted to the Georgia Bio Summit Meeting, held September 27 in Atlanta.

Mike Russell, Ph.D, is an Associate Professor of Physiology at

the GHSU/UGA Medical Partnership.

faculty niH-funded reSearcH

▲ Lance McLeroy stands in front of the research project poster, which was presented at the Georgia Bio Summit Meeting this past September.

Lance McLeroy is currently a second-year medical student

at the GHSU/UGA Medical Partnership.

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Second year of participation in Dawgtoberfest

The UGA College of Pharmacy celebrated American Phar-macists Month with its ninth annual “Dawgtoberfest: Rx for Good Health” on October 19. While the rainy weather

moved the event inside, UGA stu-dents, faculty, and staff who attended the event received health screenings, free food, and infor-mation about a vari-ety of health topics.

For a second year, Medical Partnership students participated in the event. They provided information to visitors about Hu-man Papillomavirus awareness and prevention.

Coordinated by Student Government Organization communi-ty service chairs Rachel Weaver and Anna Bunker, the fifteen Medical Partnership students enjoyed working with the Phar-macy school graduate students. Rachel Weaver says “Dawg-toberfest has been a chance to foster relationships with fellow graduate students and health care professionals, as well as to share awareness about important health care topics with visi-tors to the festival.”

firSt Medical partnerSHip Student reSearcH SyMpoSiuM

Students are encouraged to participate in a scholarly activity which could include laboratory science or clinical research during the summer between their first and second years of medical school. To showcase the 2011 summer activities of the Medical Partnership students, the Student Research Symposium was held on Tuesday, October 25.

Twenty students created posters or oral presentations and shared the results of their efforts. Projects were supported by the Children’s Summer Scholar Program, the Dean’s Summer Research Scholar Program, community health experiences, global health experiences, and office-based practice and research. A complete listing of student participants can be found on the adjacent page.

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Medical partnerSHip StudentS Help Light the Night

Thirty Medical Partnership students participated in The Leu-kemia & Lymphoma Society’s Light the Night Walk in Athens on Friday, October 21. With an original goal of raising $500 to support the fight against cancer, the Medical Partnership team raised over $2,500, which will help fund cancer re-search and patient services.

“Whether it is through a family member, a friend, or a patient we have met, cancer has touched the lives of many of the stu-dents here at the Medical Partnership,” says team captain Ni-tya Nair. “By raising over $2,500 to support the fight against leukemia and lymphoma and learning about these devastat-ing diseases in class, we hope to make a difference both now and in the future as caretakers for these patients.”

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The first Student Research Symposium, held October 25th, was a success with students, faculty, adminstration and community physicians in attendance. 2. Erik Hansen and Peter Karempelis are shown dicussing their research findings with symposium attendees. 3. Erik Hansen and Dylan Lovin both received McGraw-Hill 2011 Lange Student Awards for Academic Excellence, presented by Dr. Peter Buckley, Dean of the Medical College of Georgia at GHSU, Dr. Barbara Schuster, Campus Dean for the GHSU/UGA Medical Partnership, and Dr. Cheryl Dickson, Associate Dean for Student and Multicultural Affairs at the Medical Partnership. 4. Justin Brooten explains to first-year medical students, Alison Charruf and Natalie Nicholson, his summer research experience.

Student Summer Research Symposium Participants:

Ashley Austin, Zach Balest, Breana Berry, Justin Brooten, Anna Bunker, Chip Carnes, Joseph Drwiega, Sierra Green, Erik Hansen, Peter Karemplis, Brett Kodish, Xiao Li, Spencer Maddox, Amy Martin, Lance McLeroy, Travis Palmer, Julie Pinheiro, Rachel Taylor, Bijal Vashi, Rachel Weaver, and Katie Zhang.

To view a complete listing of project titles and summaries, please go to www.medicalpartnership.usg.edu.

1. Medical students participated in the Light the Night Walk on October 21st.

Shown in the photo, at left, are (front row) Cristina Elstad, Kayla Koch, Nitya Nair, Ashley Austin, Bijal Vashi, Rachel Taylor, Amy Martin, and Hammad Aslam; (back row) Andrew Johnson, Rocco Cannistraro, Tom Olinger, Spencer Maddox, Breana Berry, and Sierra Green.

Other students that participated but are not pictured include:

Chip Carnes, Logesh Dharmar, Cheney Fenn, Alex Guile, Peter Karempelis, Maggie Kent, Ari Levine, Dylan Lovin, Lance McLeroy, Rutvi Patel, Julie Pinheiro, Michael Schecter, and Rachel Weaver.

SAVE THE DATEGHSU/UGA Medical Partnership

Student Government Organization2nd Annual Golf Tournament

Saturday, March 24, 2012@ the University of Georgia

Golf Course

Contact Alison Bracewell McCullick at [email protected] to sign up!

The 2012 proceeds will benefit the Children’s Specialty Services at

St. Mary’s Healthcare System.

Happy Holidays from the

GHSU/UGA Medical Partnership

Wishing you and your family a safe

and relaxing holiday season!

Need CME Credits?Adjunct Faculty at the GHSU/UGA Medical Partnership can take advantage of video-

conferenced Grand Rounds from the Georgia Health Sciences Medical Center in Augusta.

Many departments are available, including:• Medicine • Obstetrics & Gynocology• Otolaryngology/ Head and Neck Surgery • Pediatrics• Pulmonary and Critical Care

Contact Debra Chambers at 800-221-6437 for more information on these CME credit opportunities.