Dean Taylor

Dean Taylor, Associate Dean for Student Learning, explains the origins, impact, and legacy of the GEMS program at its 40th Year Anniversary Celebration. GEMS  is a “post-baccalaureate experience for students from disadvantaged backgrounds who are most likely to make a significant contribution to meeting the needs of the nation’s minority and underserved populations.” 

Dean Taylor started with GEMS in 1990. Before he joined, program coordinators had organized GEMS students to complete classes with the medical students while taking “tutorial” classes together with professors who sought to give them tools to succeed. Initially, while the program certainly had structure, Dr. Hoyte (the founder of GEMS) instilled a certain flexibility into the program, allowing things to be more loosely structured so that the students could gain more autonomy in their learning.

Once Dean Taylor joined, his understanding from Dr. Hoyte was that the program would begin to especially revolve around the faculty’s ability to provide “supplemental instruction.” This entailed the faculty initially providing review sessions and one-to-one mentoring with each GEMS student. 

“We found that, regardless of the student’s prior ability to learn successfully in the classroom, if you found a way to engage the student so that they could take ownership of the learning themselves, their experiences would be enhanced as they would begin to teach one another rather than just themselves. This was the impact of supplemental instruction. The “facilitating proctor” who was the faculty member that would preside over classroom discussions, was not an expert. Instead, his or her role was to present direct instruction in a logical manner to help each student get actively involved and to allow them to discuss information amongst themselves.

In the late 80’s and early 90’s, Dr. Hoyte thought it would be a good idea to bring supplemental instruction to GEMS. 

“Before I had joined the GEMS initiative, Dr. Hoyte and I met up. He sat me down and said that he had this idea about utilizing “facilitated learning” in the GEMS program, which he had started in 1976. After a brief discussion, we stand up and start walking down the hall. “Come with me,” he tells me as he beckons me into a room. The moment I step in, Dr. Hoyte introduces me at the front of the room in the presence of all the GEMS students and says, calmly and without warning,  “Hello everyone. This is my associate, Mr. Taylor. Mr. Taylor, take charge.”

And just like that, Dean Taylor was to become an integral part of GEMS for the next two and a half decades. Dean Taylor was a natural for the position. After his first impromptu Facilitated Session, Dr. Hoyte was impressed.  

Dr. Hoyte had created GEMS after being inspired by a similar program that had existed at the University of Kansas. Just as the University of Kansas’s program had proven that supplemental instruction caused grades to go up for their students, GEMS too came to share in that success. Due to the ever-changing requirements for medical schools, the GEMS program would adapt over time, growing from large demonstrations to smaller group discussions where students would learn to self-direct themselves. Today, the program encourages students to embrace the mentality of having the whole group thrive rather than just survive. This is done by reframing the small group “Peer Facilitated Learning”; now students work in “Peer Facilitated Cooperative Learning Groups” where faculty members provide problems without giving the solutions until the students are able to come together and cooperate with one another on the whiteboard in front of class. 

“This new approach has helped GEMS explode in success. Now the faculty members are encouraged to just ask questions and allow the students to come up with the answers themselves. By struggling together through it, they retain it more.”

 The program has come so far in this short amount of time. GEMS has used the teaching experience of many facilitators in the past, with the current one being Dr. Kriengo. Seeing its progress, and looking back on it, Dr. Hoyte once told Dean Taylor some words that he will never forget: “Gems may have started 1977, but, in fact, you should know that GEMS really started within 2 years of you arriving, Mr. Taylor. I blame its success on your pioneering work in facilitation for the students.” Indeed, while the facilitator does not need to have a solid background in every topic, they need to be able to direct students appropriately. Luckily, Dean Taylor had both the science background and the directional know-how. “Gems is you, Mr. Taylor,” said Dr. Hoyte. 

“One of the most powerful challenges that we’ve faced as a program is to help others understand the real role that numbers (in terms of GPA and tests) play in a student’s potential. Numbers only tell some of the story, but not all of it. Although many educators only look at the scores, we’ve demonstrated that with intervention there is immense potential for every student.”

This year, GEMS is celebrating its 40th year anniversary. Dean Taylor hopes that the program continues to flourish, providing a few choice words for the students. As a lesson for the classroom, and for life: “You’re not always going to be given the answer, you’ll have to work for it.”

By: Charles Miller, Innovations Associate for The Office of Diversity & Inclusion

GEMS 40th Gala: The year 2017 marks 40 years since the inception of the Georgetown Experimental Medical Studies (GEMS) Program. This milestone represents an opportunity to reflect on the legacy and success of the program to date, and the continual engagement of alumni, administrators, staff, and GEMS supporters for the delivery of quality education and mentorship of future GEMS physician graduates! The celebration occurred on Thursday, July 20, 2017.

Throughout my interview with Professor Goode, I was constantly led to ponder: Why do we value medicine? The question is intentionally transparent. Medicine is obvious in its essentiality; its value is innate to our own experiences with sickness and infirmity. Sometimes, however, we forget to value the individuals who are to receive that medicine. 

Professor Tawara Goode, Assistant Professor and Director of the Georgetown University National Center for Cultural Competence, calls for a reinvestment in value with what she, and other partners, identify as cultural and linguistic competence. As a proud D.C. native, Professor Goode’s work has centered on educating and encouraging medical professionals to recognize the value of cultural competence both in the District of Columbia and nationally. 
​Many medical centers and organizations continue to struggle with providing care that addresses cultural differences. Such organizations need to become more responsive to the socio-cultural and economic contexts of diverse populations and communities.
 
In the 1980’s, when Goode first joined the Georgetown University Center for Child Development, the focus of her work was a program that assisted in the early identification of young children at risk for, and already suffering from, developmental delays and disabilities. Focus was placed especially on children residing in low-income areas within the District.  Goode’s preschool developmental screening clinic was built on a foundation that emphasized focusing on areas of the city that were underserved and providing services to address the unique socio-cultural contexts of families and communities. Her impact has only grown from there. 

“When I first came to the Georgetown University Center for Child and Human Development (GUCCHD), my role was largely community-based. The knowledge I gained expanded from more of a clinical role to a much larger project--one that started in D.C., and then expanded to the national and international arena. These early experiences marked the beginning of my personal and organizational journey toward cultural and linguistic competence."
 
Goode’s work eventually led to the establishment of the National Center for Cultural Competence (NCCC) in 1995 with an initial focus on children with special health care needs and disabilities.  In the past two decades, the work of the NCCC has grown exponentially and now reaches an array of audiences in health, behavioral health, social services, and higher education.  Goode is the long-term Director of the NCCC, and has stated that the current mission of the organization is to “increase the capacity of health care and mental health care programs to design, implement, and evaluate culturally and linguistically competent service delivery systems to address growing diversity, persistent disparities, and to promote health and mental health equity.” 
 
But what exactly is “cultural competence,” and why is it important? 

A cultural competence framework and definition was created in 1989, by Cross et al., GUCCHD consultants, to enhance the capacity of child and adolescent mental health service systems to address the needs of culturally, ethnically, and racially diverse populations.  This framework, which the NCCC uses today, established a foundation for health and human services by making a new contribution ─  extending the scope of cultural competence far beyond the provider level. It proffered a comprehensive view that encompassed an organization’s or system’s capacity to integrate the values of cultural competence into its policy, structures, attitudes, behaviors, and practices. The core concepts espoused in this framework remain highly relevant today and are perceived as universally applicable across multiple systems. Many of the definitions that have emerged in the past 20 years have their roots in this work, but have been adapted for specific disciplines, professional societies, and organizations in both the public and private sector. 
 
“We define cultural competence at two levels: organizational, and individual,” Goode explains. “In terms of the framework, we look at cultural competence as requiring that organizations (those who seek to provide care to our local patients) have a defined set of values and principles. Organizations must value the broad sphere of diversity (not just race or ethnicity), and they must be able to conduct self-assessment to determine the extent to which they are responsive to diverse populations. This means that they must be able to both manage and value the dynamics of difference within the communities they serve and analyze what this means as demographics shift.”
 
In health care, so often we see organizations expecting a sole individual or small committee alone to be committed to understanding cultural needs of communities.  However, this is not the goal of true cultural competency.
 
“ Organizations must be able to acquire and systematically embed cultural knowledge in their operations.  In many instances, individuals might be appointed to a position to address diversity,  but often times the organization will view that one person as the having the primary responsibility and liaison for the community. Conversely, a culturally competent organization will ensure that all individuals are invested and embrace this approach to care and services ...not just one or two designated people. All individuals must be able to adapt and be responsive to the diverse cultures within the communities that they serve.  Cultural competence is  a process of systemic change. Both the organization as a whole and each of its individual personnel components can and should address culture as an integral aspect of its mission.
 
What, then, is “linguistic competence”?
 
“This concept is highly important in medicine. Linguistic competence is a more recent concept than cultural competence. We define it as the capacity of the organization and its personnel to communicate effectively and to be able to convey information in a way that is easily understood by diverse groups, including people who have limited English proficiency, low literacy, illiteracy,  individuals with disabilities, or individuals who are deaf or hard of hearing. Health care professionals must be able to address the health literacy needs of their patients and communities in which they live. Linguistic competence looks at the general concept of communication. It is not limited to just individuals who speak languages other than English.  We, as professionals in the medical field, must be able to address all people who walk through the door. Linguistic competence has to be reinforced by organizational policies, structures, practices, and dedicated resources.”

As Goode recognizes, however, “Cultural competence and linguistic competence are not a panacea; they are a set of practices to help in achieving health equity, but they are certainly not the only tools we require to promote healing and well-being within our  communities.” 

Toward this end, her work with the Georgetown Howard Universities Center for Clinical and Translational Science focuses on culturally and linguistically competent approaches to engage communities in research leading to better outcomes for the District’s diverse populations. Indeed, we must always be considering some important thoughts:

What are our values? How can we emotionally care for the  “whole” person without understanding the socio-cultural context in which they live?  How can we physically care for the  “whole” person without understanding their culture, and their inherent ability to impact their own health, and the well-being of their community?   Such questions are integral to all states of health care. 

As of July 1st, 2017,  Goode is the new director of the GU Center for Excellence and Developmental Disabilities, the federally designated program in the District of Columbia.  The mission of the GUCEDD  is  “to advance self-determination among the diversity of people with developmental and other disabilities and their families, throughout the life course, and advocate for their full participation in all aspects of community life.“ Working to assist individuals with disabilities is where she started and remains one of her great passions. 
 
Tawara Goode is also currently an Assistant Professor & Director for the National Center for Cultural Competence; Center for Child and Human Development, Department of Pediatrics, Georgetown University Medical Center.  
See her website for more

 

Spotlight: Olivia Chan - Finding Focus

Olivia Chan

Olivia Chan is a former Innovation Associate at the Office of Diversity and Inclusion. She worked with ODI during the summer of 2016. She has since graduated from Princeton University. Here is her spotlight interview.

First Generation American to First Generation Student
    Olivia began telling her story, welcoming us into her world warmly by inviting us to get some insight on how she was brought up. Born to two Chinese immigrants, she grew up in a low-income family. “Because of my financial situation and neither of my parents having pursued college degrees,” Olivia said, “ I didn’t really know anything about higher education as a kid.” Olivia felt that the situation she was born into put her at a significant disadvantage due to lack of adequate guidance and resources. Despite these obstacles, she dreamed of attending an Ivy League institution. With hard work and perseverance, this dream was achieved as Olivia set off for Princeton University in the fall of 2013 to study sociology.

A Fish Out of Water
“ Upon arriving at Princeton, I felt a bit out of place.” Olivia stated, “ It wasn’t so much a racial thing, as Princeton has a fairly significant Asian American population, but it was socioeconomic.” Having an experience that so drastically contrasted that of many Princeton students who were brought up in more than comfortable economic standing, Olivia found it difficult finding people with whom she could relate, which took a noticeable toll on her educational experience. Through her personal experience, she saw explicitly that low-income students are at a serious disadvantage in the educational system. She thinks that education, and equal accessibility to it, is the only way to overcome this pitfall

Finding Her Path
    “I had never heard of an office of diversity before” Olivia recounted, “ I honestly didn’t know what I wanted to do with my life. I saw the posting for the Innovation Associate program and knew that diversity was an idea that I could get behind.” During the summer before her senior year of college, Olivia ended up at the Office of Diversity and Inclusion almost by chance. Little did she know how large an effect it would have on her life in the years to come. 
    While working at ODI, Olivia mainly focused on diversity standards Georgetown Medical School’s LCME accreditation. Before this project, she had very little knowledge of this process, but soon regarded it with a “weird fascination,” and that fascination stuck. Returning to school in the fall, Olivia chose the process of accreditation as the subject of her senior thesis, extensive independent work required for all Princeton seniors to graduate. Due to the knowledge she gained while working at the office and with help from her committed mentor, Dean Cheng, Olivia secured a job at Columbia University College of Physicians and Surgeons. Here she is currently doing data analysis, preparing the medical school for their upcoming accreditation. In the process of accreditation, she found a curious passion, learned essential skills, and gained a competitive edge that has shifted her career path in ways she never imagined. In the near future, Olivia plans to resume her studies, seeking a Ph.D. or Master’s Degree in the arena of education.
    
By: Temiloluwa Aladesuru, Innovations Associate for The Office of Diversity & Inclusion
 

Interview with Second Year Medical Student, Bryce Jones

An interview with Bryce Jones, a rising second-year medical student at Georgetown. Bryce has been working with fellows of the Academy for Research, Clinical, and Health Equity Scholarship program over this summer. These six ARCHES fellows are undergraduate juniors and seniors from different colleges across the country, who are each being provided resources for furthering their pre-medical experiences.

What are you doing here at Georgetown’s School of Medicine?
I am in the MD-Ph.D. program going into my M2 year. With the Ph.D. component, I am currently researching breast cancer in my first rotation, specifically researching palbociclib and its role in treating breast cancer. I plan on entering the department of pharmacology. 

What has been your role with ARCHES so far?
I am working as a Summer Research Mentor. I was given the position because of my background in research and with my current role as an MD-PhD. It’s something that I could really bring to the table.

What are some of the things that you think you’ve been able to do best with ARCHES?
I drew on my summer undergraduate research experience and was able to use that as a model for ARCHES. Many of the requirements for my program are also requirements for the ARCHES program. One of the things that I really appreciate about ARCHES is the incorporation of research and shadowing opportunities. I think that that is something that Dean Cheng and the other organizers did a really good job with.

How do you see this program helping you in your role as a mentor in the future?
I am planning on having a role in academia in the future. Being a good mentor is something that takes time and experience and I believe that any chance to mentor others helps everyone grow together. I can really learn from the ARCHES students in that way.

What are your future plans?
I see myself running a lab as well as seeing patients in the clinic in the same field of my research. I really want to be able to bring new discoveries into practice when they are proven safe and effective. I really envision going beyond the physical interaction with patients besides taking care of patients but also helping future doctors through advancements in the scientific portion of medicine through my PhD.

So far, Bryce has helped ARCHES students in their own research projects by supplying them with tools and a plan of action for data collection, paper writing, and poster-making. His efforts will continue to help the program flourish in its inaugural year. 

By: Charles Miller, Innovations Associate for The Office of Diversity & Inclusion
 

Care for Caregivers: The Needs of a Healthcare Provider

Ngoc T. H. Bui, a rising fourth year from El Monte, California in pursuit of a practice in Pediatrics, along with Carol Barnes, a rising fourth year from Silver Spring, Maryland in pursuit of a practice in Psychiatry, both share their joint inspiration for a "Care for Caregivers" initiative. Given the mental and physical strain that healthcare providers undergo, Care for Caregivers seeks to provide much-needed council and support.  The initiative is in its developmental phase. If you would like to help see it through, please contact Ngoc and Carol with the information provided below.
 
What inspired you to help facilitate conversation for the Care for the Caregivers initiative?
 
As a M3 on the wards, I learned what it feels like to lose a patient to a terminal condition. I was filled with guilt and anger. I fought to process and cope with these overwhelming feelings, and it was through these dark times that I realized what our medical education was missing. We were never given the tools needed to cope with the stresses and emotional challenges of being a physician. As a brand-new third-year medical student, I was not prepared to lose my first patients. I struggled with the balance of caring for my patients and putting up a safety wall to protect myself. I didn’t know how to get close enough to the wonderful fire that is medicine for warmth, without burning myself. Fortunately, I was aware of my emotions and realized I needed to talk to someone. But finding the time to seek professional help was another struggle; the available CAPS services did not coincide with the demands of my rotations. I thought then that I could not be the only student on campus who has or is currently struggling to get help. The high prevalence of depressive symptoms and suicidal ideation across all medical campuses is well known, and it is unlikely to be different here at GUSOM. GUSOM has an obligation to its students to address these issues and offer help when needed, but we currently lack the resources to do so. That’s why we fought to start the Care for the Caregivers initiative. We believe that it is of utter importance that young medical students learn the necessary tools to cope with the emotional impact of being a physician and to heal in the healthy, productive manner. After all, if we’re able to do this now, we can potentially prevent physician burnout down the road and make for better physicians.
 
What do you see the program doing for the community? In what ways do you think it will help Georgetown to become a healthier place?
 
It is our hope that with Care for the Caregivers, we will gain insight into what students need and how to we better serve their mental health needs. We hope to provide students a safe space among peers to talk about the stresses of school, discuss the emotional impact of clinical rotations, and address a wide range of mental health needs on campus. Most importantly, because these sessions will be with the facilitation of a psychologist, we hope that students will learn the essential tools needed to cope with the challenges of our medical training. This program will also serve as a bridge to connect high-risk students to 1:1 CAPS resources or emergency mental health care.
 
What are specific goals for the program, and how do you think others can help/get involved?
 
Please see above. We encourage anyone who would like to help out or get involved in Care for the Caregivers to send us an email and join our support-group sessions starting in September!
Ngoc Bui: nb598@georgetown.edu
Carol Barnes: cb1237@georgetown.edu

Whitman-Walker Health: Four-Week Multidisciplinary Clinical Experience with LGBT Patients
 

This elective at Whitman-Walker Health,  a federally qualified health center recognized for providing culturally competent care to the LGBT community in Washington, DC,  will provide fourth-year medical students with a four-week multidisciplinary clinical experience in the health care of LGBT patients. Students will work with a multidisciplinary team of general internists, family practitioners, infectious disease specialists, and mental health and addiction counseling professionals who will provide exposure to a diverse array of topics  including but not limited to culturally competent patient interviews and physical exams, HIV medicine, gender affirming hormonal therapy, PrEP, STI screening and prevention, and mental health and addiction services. Supervised clinical training will be supplemented with self-directed learning in current literature related to core concepts in LGBT health. Tailoring the elective to individual interests in LGBT and sexual health will be highly encouraged and supported.  The current capacity is 1 student per block with oversight mentorship provided by 2 physicians.  

Application Requirements and information
All applicants must be rising 4^th year medical students. If interested, please email Dr. Michael Plankey: mwp23@georgetown.edu