Medical education and engaging children in wearing masks [PODCAST]

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“Children are being encouraged to take on the superhero persona and help protect others.  They do this in true average-person-as-the-superhero style by wearing a facemask alone, without any superhero powers or words.  Just as wearing a facemask in public has been the norm for years in many Asian countries, it may become the norm worldwide.  For this to happen, we need buy-in by the younger generations who are less likely to wear a mask in public but are equally likely to unknowingly spread infection.  In this group, the ability to make a fashion statement may motivate them to give up their laissez-faire view of their personal risk of harm in favor of the ethically favorable and trendy decision to protect others.”

Lauren Fine is an allergy-immunology physician and a medical educator.

She shares her story and discusses her KevinMD article that she co-authored, “The superhero within during the time of COVID-19.” She would like to thank her co-author and colleague, Dr. Vijay Rajput.

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show, we have Lauren Fine. She’s an allergist-immunologist and a medical educator, and she co-wrote the KevinMD article “The superhero within during the time of COVID-19.” Lauren, welcome to the show.

Lauren Fine: Thank you so much, Dr. Pho. I appreciate you having me here.

Kevin Pho: So we’ll get into your article in a little bit, but first off, if you could share your story and your journey to where you are today, that’d be great.

Lauren Fine: To be honest, I was one of those people who always knew they wanted to be a physician, but I didn’t always know what I wanted to do. So I took a little bit of a journey figuring that out in undergraduate and medical school. I had a wonderful set of mentors in allergy-immunology who were actually teachers for me, so that actually inspired me a little bit to be a teacher and to be a writer.

I ended up opening up a clinic with a colleague of mine, an allergy-immunology clinic, which was very interesting and exciting to do. I got into some medical education, where I was with one of my previous teachers of clinical skills, and that inspired me to move forward into medical education. So a position opened up at my current institution, and I jumped on that, and I’ve been exploring and learning every day since then.

Kevin Pho: And how has the pandemic affected not only your practice, but also your role as a medical educator?

Lauren Fine: So it’s greatly affected our practice. It’s been very hard to take care of patients in a way that we feel is safe, that we can see them and have them in a waiting area and not have them get sick just from coming in for a basic, not life-threatening or urgent issue. So that’s been hard for us in practice.

In medical education, it’s been truly altering in every way possible. It’s been very, very hard for us to teach the students the clinical skills that we want them to be able to have, because right now everything is kind of like telemedicine, right? We’re over video doing everything, so we lose that personal connection that you have in the clinical skill of being a physician. You don’t get to touch somebody. You don’t get to really see exactly what’s going on. There’s a barrier. So it’s really changed how we approach teaching. It’s made us be creative, and I think it’s made us better educators in certain ways.

Kevin Pho: So if you’re a medical student in the midst of your medical training, do you have any advice or tips to share with these students?

Lauren Fine: You know, I think that the most important thing is to be as engaged as possible and to try and figure out what it is that you can do to learn the most in the sessions that you’re in. I think when you’re in a meeting over Zoom, or whatever modality you’re using, it’s very easy to kind of tune out and not really think about what’s being discussed, and “What can I learn from this? How can I take this a little bit further?” So as a student, preparing as much as possible, being as engaged as possible, and figuring out, “How can I take this to the next step myself, in my own studies?” would be the best thing.

Kevin Pho: And you mentioned that the change in medical education has made you a better medical educator. Now, what kind of tips can you share with your fellow colleagues who may be in the same position as you are in terms of medical education?

Lauren Fine: So I think it goes back to engagement. When you’re remote, it’s a lot harder to engage people in a conversation and in a topic. So I’ve had to think about what are the ways that I can really make this feel relevant. I’ve used a lot of videos that I found on things like YouTube and other medical education websites to kind of weave into what I’m teaching, and a description of something that’s based on a video, even if it’s another TEDx talk where somebody talks about something really relevant.

Trying to get other experts into the teaching, because sometimes we have to recognize that other people are better at teaching something than we are, and we can’t do everything. So I think having other people, either in person or through a video, demonstrate something for us, and then commenting and asking students to engage in a discussion on what they’ve observed, how that affects them, what they think about it, whatever the topic is.

Kevin Pho: Wonderful. Thank you so much for sharing those tips. So let’s shift gears and talk about the KevinMD article that you co-wrote, “The superhero within during the time of COVID-19.” Now, for those who haven’t read your article, can you walk my audience through it and share the story of why you decided to write it?

Lauren Fine: Yeah, so I think that one of the most difficult things in seeing patients, and even seeing other people out in the community, is when our face is covered. I think we lose a little bit of the connection. In the United States, the mouth is actually a very important part of interpreting emotion, and in other countries, it may be the eyes and other parts of the face. And it’s actually also known that kids use the face in different ways to recognize emotion and even recognize people.

So as I was walking around in the community, doing the things I need to do to keep my life in order as much as possible, I recognized that I was missing a certain part of that connection. I was also seeing stories and reading about patients who are at the end of their life. I’m not taking care of those patients currently, but I was thinking about how it must feel as a patient to have a nurse or a physician next to you, knowing that you’re that critically ill, and you can’t read their lips, and you can’t really see the emotion on their face, because we were not trained, at least not in this country, culturally, to interpret emotion with the eyes as much as with the mouth.

And so I was just thinking about how terrible it must have been, and still is, for many of those patients to have to deal with that. And then thinking about how my kids are reacting to it. They make comments about what’s going on and who’s wearing a mask and why we have to wear it, and just wondering what’s going through their mind.

Kevin Pho: Now, there are a lot of physicians who are in the same position as you are, being physician parents. What are some of the ways that you could better engage patients wearing a mask, as well as your kids? What are some of the tips that you use to engage children when it comes to the new phenomenon of mask wearing?

Lauren Fine: So one of the things I did in my own house is I put a movie on, and I had my kids wear a mask while they were watching a movie, because they don’t love the idea of wearing a mask. I mean, it’s very restrictive, it’s uncomfortable, it gets very warm, and we live in South Florida, so wearing a mask outside is really not fun at all. So I put on the mask while they were watching TV, just to say, “Wear it while you’re watching this.” And because they were distracted, they kind of got desensitized to it a little bit, so that helped. I also explained to them why we’re doing it.

Kevin Pho: Now, one of the things that you pointed out in that article was the importance of buy-in from the children when it comes to mask wearing. Can you elaborate more on why that’s so important?

Lauren Fine: Yeah, I think the buy-in is really important for our younger generation, in the teens and the 20s and even some into the 30s. You really have to, I think, take on that social responsibility to make sure that we help prevent each other from getting sick. And so part of the buy-in, I think, in that generation is to feel that there’s a purpose to it, and sometimes that it’s cool.

So there are a lot of trendy things going on with masks. People are making masks that have particular designs on them, and they’re really having fun with even representing things. So for example, there’s somebody that’s making, I think it’s a 94-year-old woman who’s making polka-dot masks. She was one of the Rosie the Riveters, the originals, and so she is making polka-dot masks to represent the women who have helped in health care in the past, who have helped in war times.

So I think that having a meaning behind your mask, right, it’s almost like a brand, and what you’re representing can help with buy-in, to say, “I’m representing this. This is who I am.” This is kind of like piercing your ears, and wearing jeans and a white T-shirt is so classic. Maybe at some point, particular masks and styles would be representative of who you are and what you want to say.

Kevin Pho: We’re talking to Lauren Fine. She’s an allergist-immunologist and a medical educator. She co-wrote the KevinMD article “The superhero within during the time of COVID-19.” Lauren, is there anything that you know now that you wish you knew back before the pandemic started?

Lauren Fine: I really wish I knew how much this was going to impact all of us. I think if we had known how to be more prepared or react better to this, it would have been really, really nice. It’s hard. We don’t always know, right? That’s the hard part. We don’t know what we don’t know, and we don’t know how to react to something. We don’t know what’s coming. But I really wish that we all had known how to react to this in a way that we could be better about it, right? That we knew what to do, we knew what the consequences were of some of our actions as a community.

Kevin Pho: Sure. And my final question: Do you have any take-home messages that you want to share with the KevinMD audience?

Lauren Fine: I think that engaging each other, engaging our community, engaging our families and our children in a conversation about this as something that’s impacted all of us, and understanding how it’s impacting every one of us differently, is really important.

Kevin Pho: Wonderful. Lauren, thank you so much for your advice and tips, and thank you for being on the show.

Lauren Fine: Thank you, Dr. Pho.

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