Transformational Times
Words of Hope, Character & Resilience from our Virtual Community
Friday, May 29, 2020
In this Issue:

  1. Director's Corner by Adina Kalet, MD: Performance-Based Assessments to Ensure Physicians Have the "Right Stuff"
  2. Perspective from Katie Recka, MD: Make it to the Mat
  3. Perspective from Adrienne Klement, MD: The Power of a Letter
  4. Take 3 from Patty Starr, APNP - Palliative Care & COVID-19 Survivor
  5. Reflections: As businesses reopen, what do you think you'll see?
  6. Links | Resources | Ways You Can Help
Director's Corner
Performance-based assessment, done well, is the best way we have to ensure physicians have the "right stuff"

by Adina Kalet, MD, MPH

Despite the suspension of the USMLE Step 2 CS exam, Dr. Kalet argues that this high-value assessment should be brought back as soon as possible…

The earth just shifted again! And this one worries me more than most of the agile adjustments required in the days of COVID-19 because it may portend a loss of the hard-won support for valid, high stakes, performance-based clinical skills assessments.

This week the National Board of Medical Examiners (NBME) and the Federation of State Medical Boards (FSMB) made the decision to suspend the United States Medical Licensing Examination (USMLE) Step 2 Clinical Skills (CS) exam for the next year or so. The organizations are concerned about the health and safety of the standardized patients, testing center staff, and medical students at the five free-standing testing centers where students demonstrate that their clinical skills meet the thresholds to be licensed to practice medicine in the US.
What are your thoughts?
Make it to the Mat

by Katie Recka , MD

Dr. Recka shares her story as she learns that her father has coded in an Emergency Room two hours away…

It was March 31, 2020. I was happily isolated in my VA office, attending a WebEx meeting. My phone vibrated. It was Mom. Probably a misdial. She only calls in emergencies. Couldn’t she just text?
I was already grabbing my coat and keys before the voicemail was done. Something was wrong. It was Dad. Stomach pain, coded in the emergency room, now in the ICU. Or was it surgery?
The Power of a Letter on Memorial Day Weekend, 2020

by Adrienne Klement , MD

Dr. Klement describes a project that connects hospitalized, seriously ill veterans with their families in a way that is both familiar and powerful…

Hours to days. This is the prognosis required to allow a patient up to two visitors in the VA hospital.
It was a Memorial Day to remember. The Wood National Cemetery looked bare without flags marking each tombstone. Instead, a wreath ceremony took place. Celebrations were virtual and the day subdued.
For our veterans and their families, Memorial Day is for celebration and mourning to honor fallen brothers and sisters, family members, and loved ones in service. It is a day to reflect on the price and sacrifice of military duty.
From the Front Line
Three Questions for
Patty Starr, APNP

Patty has been part of the Inpatient Palliative Care and Hospice unit at Zablocki VAMC since 2015. Prior to coming to the VA, she was a member of the Palliative Care Program at ProHealth Care.

  1. 1. What has surprised you most in navigating the COVID crisis?

  1. 2. Can you share your experience being sick with COVID-19 in the early days of the crisis when outcomes were so uncertain?  

  1. 3. Has this experience impacted your approach to caring for patients and families now?  
"I want to see more people enjoying the beautiful weather.

As more businesses open, I hope people will continue their daily forays outside and increased (but distant) interactions with their neighbors.

These are connections I hope people build in to their new normal!"

-Meaghan Hayes, Staff, MCW-Milwaukee

"I think there will be lots of confusion about what's safe to do and what's not. As restrictions are lifted and rules are different from municipality to municipality, confusion is everywhere.

I worry when I see people get into arguments about masks and social distancing on playgrounds and in parks. As our weather warms and more people want to spend time outside, I worry about that a lot.

-Anonymous, Student, MCW-Milwaukee

Respond to next week's reflection prompt:
What is one thing that made you laugh this week?
"I enjoy contact with people and look for ways to know them and personalize their care while carefully calibrating conversations to maintain the professional boundary between doctor and patient. To me, this is part of the art of medicine, meeting new people and finding ways to immediately establish rapport with them..."

-James R. Warpinski, MD

"In the Stairwell"
The Pharos , Spring 2020

Treating cancer in a COVID-19 world…

The mother’s breast cancer surgeon:
“They can’t see my smile. I can’t shake their hands, and I certainly can’t give them a hug,”

The son’s pediatric oncologist:
“This is adding complexities to cancer care in a way we never imagined.”

"Forced to retract completely into ourselves,"
a mother and son confront cancer in the age of COVID-19
by Gabrielle Glaser
STAT , May 27, 2020
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Bruce Campbell, MD, Editor-in-Chief
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