Teaching Logs
Introduction - Reflection on the Process of Teaching Logs
Throughout the year, I am excited to use this log as a tool of actively reflecting on my teaching activities. This journal is meant as a place for expression post-teaching activity, but also as a means of reflecting on keeping these logs themselves. Having self-reflective logs will better enable me to understand where my gaps in teaching exist, where my passions for teaching arise, and moreover what strategies I can use to be both a better teacher and a better learner. Here I can track my skills and progress as INTAPT unfolds.
Although, at times, I have found keeping a log to be cumbersome, and wish instead for it to be a google form to fill out and automatically have template documentation, I have enjoyed the process of re-discovering meaning in my work; through the COVID pandemic, these logs have given me a better sense of self, and that there is truly more work to do in medicine and in life, than COVID itself.
The following entries comprise 24 hours of the teaching and committee work that I have done, but serve as a sampling of the communities I serve.
Teaching Log Reflection #1
(08/11/2021)
As equity, diversity, and inclusion (EDI) portfolios expand across the University of Toronto, the need for greater representation in healthcare leadership and in patient care has been at the forefront of institutional change. I received an invitation to speak on LGBTQ+ issues in medical/dental education as an inaugural speaker for third year dentistry students enrolled in DEN308Y1 – Dental Public Health III. This came as a surprise, as imposter syndrome leapt into action immediately. My name had been passed down from a friend of a friend, landing me at this opportunity. I decided to set-up this lecture in a less conventional method; instead of my typical academic lectures filled with slide-after-slide of evidence-based literature, this talk for me was about vulnerability and the patient-perspective. Using Kolb’s experiential learning as a model, I provided a narrative-based lecture of my own concrete personal experience as a queer woman. The reflections of experience were told from a lens of intersectionality, the multiple oppressed groups that I had belonged to, linking this to how LGBTQ+ patients, although heterogenous groups, face homogenous experiences of poor health, and poorer healthcare. At the end of the session, we broke into small groups to discuss real-world cases of discrimination faced as patients and by colleagues. My hope is through this active experimentation and case-based discussion, students were left with greater knowledge, skills, and attitudes surrounding LGBTQ+ medical and dental education. This talk was filled with tender moments that were backed by evidence, but the subject of the matter, was me. Without keeping a teaching log of this event and eliciting verbal and written feedback post-session, I would not have known how much it meant to other LGBTQ+ students in the class to finally be seen and heard. We cannot rely only on evidence and instinct to teach person centered care, we must show learners the person, and that is why they should care. I am determined to pave inroads up this academic mountain to improve LGBTQ+ education, so that those who come after me will be able to enjoy the view.
Teaching Log Reflection #2
(17/11/2021)
Sometimes medicine can feel like a bit of a Harry Potter sorting hat, particularly when it comes to decisions between becoming a clinician teacher, clinician educator, clinician investigator or clinician scientist. As someone who is most interested in the clinician educator role, many of my extra-curriculars fit into this scope – a mixture of leadership, education, and administrative work. I have recently become a member of the Internal Medicine/General Internal Medicine Taskforce, where my role involves preparing briefs on behalf of Resident Doctors of Canada (RDoC). Although this may not seem like conventional teaching, much of what we do has an interprofessional nature, with stakeholders across Canada. It is imperative to form relationships to adequately bring resident voices to decision making tables. I found preparing for our group project to be extremely similar to preparing for a meeting. From the modelling in our class, meetings should run a bit like performances; each person has a role and something to add. They’re the right person, at the right time, with the right knowledge. Often, I am taking minutes and timekeeping to ensure the meeting is running smoothly. What has surprised me most is the practice of reflection during the meeting to analyze and assess, what is everyone’s role, and if we are all on the same page. This has allowed me to take a step-back and pay more attention to what is not being said, and by who. I have found myself inviting more people to the conversation table, as I recognize it can be challenging to speak out when there are more boisterous personalities (including my own) in the room. I hope to continue emulating the role-modelling from our class-meetings with as much poise and organization in my future administrative and educational roles.
Teaching Log Reflection #3
(25/11/2021)
The Canadian Society of Endocrinology and Metabolism (CSEM) conference is a large annual gathering of Endocrinologists and associated health care workers across the country, keen to catch up on the latest literature, case reports, and guidelines. The conference week also serves as an opportunity for Endocrine Fellows to demonstrate interesting diagnostic dilemmas and case-based scenarios. My case-report entitled, “A Grave Situation: TRAb Negative Graves and Cerebral Venous Sinus Thrombosis” showcased a situation of diagnostic uncertainty regarding Thyroid Receptor Antibody negative Grave’s Disease. There is considerable preparation time, with literature review, involved in case presentations. The presentation itself was a small-group format, with learners consisting of medical students, fellows, and a staff reviewer. The dialogue itself was conversational, but it was clear that the dialogue was more-so between myself and the reviewer, and the learners were in a more passive role. I think these conferences serve as opportunities for engagement with learners at all levels and because the server did not have a chat function tool, I think an element of engagement was lost. In the future, if the server was upgraded to have adequate chat and annotation features, this case presentation would be less didactic, talking ‘at’ you, and more of a discussion for all to enjoy.
Teaching Log Reflection #4 (27-28/11/2021)
The Resident Doctors of Canada (RDoC) annual Winter Board of Directors meeting always sets the stage for the organizations work for the year. As a former Finance, Audit, and Risk Committee Chair, one of the organizational risks flagged in our annual review is one of good governance structure and following best practices for non-profit organizations. Although we had and have had a governance structure and bylaw review performed in the past, we have a new Executive Director (ED), who is bringing our internal structure up to speed. Building on the clarifying, ideating, developing, and implementing (Osborne-Parnes) model, we have now reached the ideation phase to generate as many ideas as possible of good governance frameworks based on best-practices of current Non-profit organizations. This four step process of problem solving has been pivotal in creating a framework for asking questions, developing plans, and finding meaningful solutions to internal organization structure in medicine. Our ED had a business consultant take our Board of Directors through a work-shop on governance models and organizational membership, and how this ties into the mission and work of the organization itself. Although, it can often be difficult to have buy-in from across Canada on how each province is contributing toward governance restructuring, we were able to work through preliminary steps of problem solving. It is important to recognize when expertise is unknown, and to turn to the expertise of others (strategists). In the case of RDoC, we as residents are content experts, working to unite the voices of residents’ coast to coast and that starts with good governance and good internal policy.
Teaching Log Reflection #5 (7/12/2021)
This three panel discussion brought a diverse audience of healthcare professionals and social media influencers together to highlight the clinical stories and importance of providing safe access to transgender health. The panel (consisting of myself, Dr. Weisdorf and Dr. Fung) were there to discuss our experiences of paving way for transgender healthcare in a medical community that is only just starting to come around and understand the biases and barriers that exist for trans-individuals. I had developed the content concept and edited the script for medical accuracy to help develop www.theclinicfilm.ca ; a video production that is all too sadly based on real-life events. In many subtle and overt ways, we showcased how trans-individuals not only battle for access to appropriate healthcare, but deal with performative aspects of medicine (ie: safe space stickers in clinics without actually having clinic staff trained in creating that safe space). Although, some of the importance of this session was subject to tech delays with our co-partners at GETReal, the screening caught media attention and was featured in CBC news. As always, preparation is a must in the digital world and no matter how many rehearsals or time spent ensuring no delays, it is essential to have back-ups. The filming did run successfully post-tech delays. Ultimately, The Clinic was made after learning that about 45 per cent of transgender and non-binary people have unmet healthcare needs compared to four per cent of the general population; a stat from TransPULSE Canada that we are hoping to change.
Teaching Log Reflection #6 (9/12/2021)
This session was based on journeying through medicine as a daughter of refugee settlers, intersected by being POC and queer in medicine; this was a discussion facilitated by Dr. Mamta Gautam on navigating challenges as women in medicine. We had two prior meetings in preparation for this interview discussion to discuss flow-elements of how the session will be run, and to set objectives ahead of time. This discussion came after the release of the McKinsey Report on women in the workplace, highlighting for example: “Women continue to face a broken rung at the first step up to manager: for every 100 men promoted to manager, only 86 women are promoted.” As an interviewee, although I had prepped discussion points, the session was more of a conversation and had an unpredictable flow; moreover, it required an element of vulnerability and sharing in a room that I am not familiar with, however ground rules were set ahead of time. We discussed complex topics of intersectionality and white fragility and often these are challenging conversations to have – it was nice to be interviewed by a mentor who had the ability to navigate through participant questions and responses. The full interview, “Conversations with a Master” is available in the Teaching Archives section of the ePortfolio.
Conclusion - ePortfolio Reflection (28/02/2022)
I was skeptical of this process when it first began, as it seemed like I was doing “busy-work” over and over again on top of an already busy clinical year compounded by the PTSD of working through a global pandemic – keeping multiple reflections has been a lot. What I have found most beneficial is recognizing how far I have come in the learning process, from theories to frameworks of how to teach, how we learn as adults, and how to develop curriculum. I have found the art of keeping a teaching dossier/archive to be so valuable – as I had no idea this is valued when it comes to obtaining a job. The practice of achieving teaching (and feedback!) is something that I will continue to carry forward, not just for my career, but as a reminder of hard-work, perseverance, and the ability to nurture change in others. I want the teaching dossier/archive to serve as an evolution of accomplishments and teaching overtime. I am excited to see how this will change and how my ability to teach will grow as my career advances. Although, I may not enjoy the frequency of reflections, I have enjoyed the process of developing into a good clinician and an even better teacher.
