Search for tag: "practice"

Dr. Gellner: Playtime is fun time and there's a reason why it's important for development. I'll discuss the magic of play on today's Scope. I'm Doctor Cindy Gellner.

Announcer: Keep your kids healthy and happy. You're now entering "The Healthy Kids Zone with Doctor Cindy Gellner" on The Scope.

Dr. Gellner: We all remember a time when we had few obligations, we could play dress up like a princess or a superhero and spend our days creating our own magical universe. Then, life gets in the way. Those preschool years are called the magical years for a reason. That's when a child's brain is developed enough to imagine amazing stories, but not yet complex enough to understand reason and ask, "Can that really happen?" See, in their world of imagination, anything can happen.

Babies use their senses to explore their world. As they develop, they learn to understand how things work. "If I push this button, the cow comes out of the barn. Wow, I did that!" Now, as preschoolers, they take this knowledge and combine it with a growing imagination to come up with some fantastical ideas about why and how things happen.

Pretend play, like being a superhero, allows kids to learn problem-solving and the all-important skill of learning how to share. Self-control is a tough skill to learn and pretend play helps kids practice it as well as play out the frustration it creates. So how can you, as a parent, help encourage imaginative play? Rule number one, be a big kid and play. Go along with anything they come up with and keep away from those electronics. Let them play the old-fashioned way with dolls and blocks and trucks and anything that requires them to be creative. I personally am a Little People fan. Give them the chance to free time play all by themselves as well and with friends.

Reading to your child is a great way to get kids thinking, "Hmm, what comes next in the story?" It also promotes language skills so don't surprised if your preschooler becomes a little chatterbox; that's a good thing. The day will come when the magic ends. The princess tiaras sit on the shelf, the superhero action figures stay in the box. It's a bittersweet moment. Your little one is growing up and your child's brain is developing, as it should.

This time in childhood, sometimes called "the age of reason," is also when kids begin to form a conscience, differentiating between right and wrong and not just acting on impulse but because something is the right thing to do. So be sure to enjoy the magic while it lasts and have fun playing.

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Interviewer: Learning Spanish as a second language and applying it to your medical practice, next on The Scope Radio.

Announcer: Navigating your way through med school can be tough. Wouldn't it be great if you had a mentor to help you out? Well, whether you're first year or fourth year, we got you covered. The Med Student Mentor is on The Scope.

Interviewer: Many of us have had language education at some point in our life, however there's a big difference between passing a required language class, and being proficient in that language. Today we're here with Dr. David Gontrum, a family practitioner who works at the Oquirrh View Community Health Clinic. Dr. Gontrum has been working in this clinic for over 15 years and uses Spanish every day to communicate with his patients. How did you learn Spanish?

Dr. Gontrum: I learned Spanish the only way people can learn a language and that is by an immersive program. After the end of my first year of medical school and not knowing how to count to 10 in Spanish, my wife and I took our honeymoon and spent the whole summer down in Central America. We showed up off the plane, literally not knowing how to ask directions, or count, or ask the price of anything and threw ourselves into five weeks of an immersion language program.

In Central America, many other Spanish speaking countries, in Mexico, in South America, there's an opportunity to study Spanish with just one or two other students five, six, seven hours a day and live with a family. Through my multiple failed attempts to learn other languages, I've come to the conclusion this is the only way you can gain any remote proficiency in speaking a language. There are very affordable and frankly quite fun opportunities to do immersion Spanish and I think anyone can do it with a reasonable ability in language.

Interviewer: If I go to spring break in Cancun, is that going to help my Spanish?

Dr. Gontrum: Unfortunately I'd probably say no, as I don't think you'd have the opportunity to . . . If you were in Cancun, remember that that's essentially a resort area, which is not a great area to learn Spanish. However, if you were to go into Wahaka or the Guatemalan Highlands and take a one week, six, seven hour a day language class and stay with the family, you could make great progress in a week.

Interviewer: I'm pretty much an adult at this point in my life, or at least I'm told. Is it too late for me to learn to speak Spanish?

Dr. Gontrum: Definitely not, I'd encourage you to look around at some of my partners who didn't speak a word of Spanish as our clinic evolved to more and more of a Hispanic and Spanish speaking population that we serve. They did it as well and they learned on the job essentially. There is an incredible opportunity to learn Spanish quickly, here in this hemisphere, with a short plane ride to Mexico, Guatemala, or El Salvador. Any of the Central American countries.

Interviewer: So you mentioned earlier that a lot of your Spanish you learn on the fly, well, with patients. Is that kind of a nerve-wracking thing to be in with a patient who's sick and you don't understand a word, or can you sort that out pretty well?

Dr. Gontrum: Nerve-wracking, exhausting, exactly, but also tremendously rewarding. Fortunately, at our clinics, most of our ancillary staff are bilingual. So we have at our fingertips, or certainly outside the door, we have ready translators, ready interpreters. Gradually with help with interpreters we can get better and better.

Interviewer: Has there been a specific example, of maybe a humorous anecdote or a lost in translation moment where you and a patient were on completely separate pages?

Dr. Gontrum: Daily, and they continue. Which is a great source of fun for all of us, as we again, remind ourselves how difficult it is to communicate. Let alone in another language, even sometimes in our own. My favorite recently, we have a hospital here in the city, which was founded by the LDS Church, which is called LDS Hospital. I had a patient just the other day, who told me that she had went to the 10 hospital. I scratched my head, I couldn't figure out what she was talking about until I remembered "El diez" the 10 is LDS Hospital. So wonderful little experiences like that throughout the day make the day joyful.

Interviewer: Is there a certain threshold where you felt comfortable in the clinic, that your Spanish had progressed far enough? Or is it something where you always feel uncomfortable, you always feel like you're improving and you always feel like it's always a work in progress?

Dr. Gontrum: Yeah, I'm going to go with the latter. I always feel like I could do a better job, and that's what makes going to work everyday interesting. There's always an opportunity to learn, not just medicine but language as well. Like with anything in life, the more energy you put into it, the more rewards you get. That said of course, to achieve true fluency at my age, I'm now approaching 50, but I love working on it. I just spent two weeks this summer in Mexico doing an intensive language program, even though I certainly get by on a day-to-day basis in the clinic, I want to get better. That trip also helped me really see where my patients come from.

Interviewer: What advice do you have for someone who is considering doing the same?

Dr. Gontrum: Go abroad. It's a great idea to try and build a base with grammar and studying grammar. But the only way you're going to learn to speak is by throwing yourself into . . . and being willing to take a risk in speaking as much as you can during the day. The languages I studied as written language, like German and French, have completely evaporated from the recesses of my mind. In Spanish, since I learned it as a spoken language rather than a written language, I can get by. I can speak on a daily basis. Not with anything remotely like correct grammar, but my patients nod and appear to understand me and we get by through the visit.

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Interviewer: Hospitals and clinics are under pressure to become more patient-centered, which in today's fragmented health industry means taking a more team-based approach to care. But you can't expect providers to work as teams if they haven't trained as teams. I'm talking with Rebecca Wilson, Director of Interprofessional Education of the University of Utah. Let's talk about the University's efforts to make medicine a team sport. What is Interprofessional Education, and why is it important?

Rebecca Wilson: Interprofessional Education is students from two or more professions that are learning together to improve the quality of patient care and their collaborative skills. It's important because, as a professional, if the first time you ever meet the other people on your time is when you are just kind of striking out for the first time, that's a very difficult time to have to put all that together. By having students learn together during their programs, they get a better feel for the entire healthcare team and how we all work together in the interest of the patient.

Interviewer: Give me an example of how this works sort of on the ground level.

Rebecca Wilson: The students come together around a patient who is just about ready to go home. We all know that transitions in care are some of the most difficult times for patients when they go from hospital to home or other care settings. So we have the team put together to do what they think is going to be a routine discharge, and as can happen in healthcare, a family member shows up, and the information changes. So how does that team make a change in their plan? How do they communicate it to each other and make sure that they are getting back on the same page about what they think is best for the patient, and then how do they turn around and communicate that with the patient and the family member?

Interviewer: You were recruited from the Mayo Clinic College of Medicine in Arizona where you taught interprofessional courses in a simulation setting. What drew you to Utah or to the University of Utah?

Rebecca Wilson: I think what drew me to the University of Utah was the opportunity to talk with pre-professional students. I had some wonderful experiences with people in the profession that wanted to have that influence. I came to the University of Utah because I've been to Utah before and had great respect for the healthcare education that is happening in this environment, and I was excited with the idea of being able to be part of that.

Interviewer: And you started in medicine as a nurse, right? And you have a Ph.D. in Education Technology. What about those experiences sort of informs your vision for Interprofessional Education?

Rebecca Wilson: I think coming from a nursing background and having been a nurse for many years and seeing where we came from, where teams weren't really considered to be something that was in my education, we were all trained very separately, and seeing, though, in my practice, when practice went well, when teams worked well, and when teams didn't work well, I became an educator probably about 17 years ago. I have been working with different professionals and putting together those team-based experiences and seeing, again, some of the quality improvements and other initiatives that we took and how much improving the team improved the overall patient care.

Interviewer: It sounds like we've come quite a way with Interprofessional Education. Where are we headed?

Rebecca Wilson: I believe that we're headed, number one, towards making sure that students see this in not just the classroom where we have control, but also in the clinical areas, where wonderful practice may be taking place. But maybe they don't even recognize it when they see it. So helping the students to understand what Interprofessional practice looks like in the day-to-day around patients and around population health. So that's one of the places we're heading. I think the other is getting a little bit broader about what we consider team and who's part of the healthcare team and how do pieces that we wouldn't necessarily always think of right away fit in. Social care. Social work is a pretty easy one to think about, but healthcare administration, law, business, all of those areas. How do we help students to learn about each other so they're not encountering each other for the first time when they're trying to solve a practice problem?

Interviewer: If the sky was the limit, what would you like to see accomplished here at the University of Utah in the realm of Interprofessional Education?

Rebecca Wilson: I think my ultimate dream is that Interprofessional Education becomes the way things are done. So it becomes a part of the fabric of how patients are cared for, that everyone has the opportunity to work to the top of their preparation, and that we understand how to work with each other and work with patients and making sure that the patients are always brought into the team. I think if we can get education, experiences, and learning to get people to that point, we will have been very successful.

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Interviewer: Pressure, whether you're an elite athlete or speaking in public, it can be a killer. Tips to deal with it next on The Scope.

Announcer: Medical news and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Interviewer: No matter who you are you deal with pressure, and if you deal with pressure a little bit better, your life might be better. We're going to find out some tips from Nicole Detling. She's a sports psychologist and has worked with Olympic athletes, most recently the U.S. ski team's freestyle aerialists in Sochi. She's also a visiting faculty member in the Exercise and Sports Science Psychology program at the University of Utah. Let's talk about pressure for a second.

Nicole Detling: Sure.

Interviewer: What is pressure? Let's get that definition out because I don't think a lot of people think about what exactly that means.

Nicole Detling: Sure. I think we all feel pressure to a degree almost every day of our lives. Probably what would be a better term for most of us out there is stress. I can't think of a single person I've ever met who hasn't experienced stress on a daily basis. But I would say if we think of stress or pressure, it's more of when you feel that your resources do not match the demands that you are under so whether you have this big project that's due at work and you don't feel you have enough time to complete it, something like that would be stress or pressure where you're under a situation that you have to perform and you just don't feel like you're able to do it the way you want it to be done.

Interviewer: So for Olympic athletes for example, the jump or the trick, whatever they're going to try is something that they're not completely confident with.

Nicole Detling: Maybe not, or they just feel that, "Gosh, I've only done this a couple of times. I'm confident that I can compete it when I don't have all these cameras on me and all these expectations, but gosh, I'm in this situation and all these other things are happening." The pressure can be increased.

Interviewer: So it's a lot like if I'm relaxed and just talking to somebody I'm passionate about, the words flow so easily and my thoughts come out so coherently, but when it's in front of a room of 500 people, all of a sudden I'm a different person. That's pressure.

Nicole Detling: That's pressure, and typically the situation's the same, right? You could give that speech, and you can nail it when no one's watching. It's the exact same speech when there's 500 people there so the difference between those two situations is how your mind perceives that situation. That's where pressure comes from. It's typically something that we create in our minds in response to a situation.

Interviewer: Alright, so now let's talk about this in real terms. So whether I'm an Olympic athlete or giving that presentation, are my strategies going to be the same?

Nicole Detling: You're strategies will be very similar. Yes, absolutely. The things that I teach Olympic athletes are the exact same things that anybody out there can use when they're dealing with stress and pressure.

Interviewer: Cool, OK, well give me so tips how I can nail that presentation that I know I can do anyway.

Nicole Detling: Sure, well I will say the Number 1 source of confidence is preparation so if you're giving that speech, it's probably best that you practice that speech many, many times prior to going into that situation. Practice it by yourself. Practice it in front of friends and family, friendly audiences so to speak, and maybe increase the number of people you're practicing it to each time you practice it so you get a little bit more comfortable. If you step on that stage and you feel like you have put the time in and you are ready, you're more likely to not feel as much pressure in that situation and be able to really nail that performance.

Interviewer: How important is it that I do it in front of other people? Because I feel funny doing that, right?

Nicole Detling: Sure, you do, but you're going to feel funny in front of 500 people if you don't practice.

Interviewer: OK, so you've really... That's an important step is what you're telling me.

Nicole Detling: Sure, it's an important step, absolutely, and it may not be for everyone, not everyone needs to do that, but that would be a good idea for someone who does feel a lot of pressure if they are speaking in front of 500 people.

Interviewer: Do your due diligence that way. What else could I do? What other things could I employ?

Nicole Detling: There's a lot of different exercises that I'll teach an athlete in terms of the thought processes that they have going on in their head. So something athletes hear me say all the time is, "I don't care who you are or what sport you do, how good you are if you look for reasons to fail, you will find them." So in that situation you can look for, "Oh my gosh, what are these people going to think about me. Are they going to know more than I do? What if I sound like an idiot?" Yeah, sure you can find those reasons, but on the other hand, if you look for reasons to succeed, you will find those reasons as well. So in that situation, the speech situation, you can also think, "I have put my time in. I know my material. They asked me to give this speech because I have something to offer. They believe I have something to offer." And so thinking about it in terms of just reframing the thoughts in your mind from looking for reasons to fail to looking for reasons to success, that's one strategy.

Interviewer: OK.

Nicole Detling: Another strategy would be using deep breathing techniques, anything that will help deal with the butterflies in your stomach and just kind of calming your body down. Something I say a lot to is, "You have to control yourself first before you have a chance to control your performance." And for many people, that pressure is going to cause anxiety. So the anxiety feelings may be you have to pee 20 times before you perform, sweaty palms, butterflies in your stomach, things like that, and when you feel uncomfortable, you might feel out of control. Imagine how good you would feel if your body felt comfortable and you felt in control of your performance. What would that do for your confidence?

Interviewer: Yeah.

Nicole Detling: So if you do deep breathing techniques or some kind of a meditation prior to going out in that situation, you get your body under control, it's easier to get your mind under control.

Interviewer: So when I was watching the Olympics, I noticed a lot of the athletes listen to music beforehand. Is that their way of taking their mind out of the moment, relaxing themselves?

Nicole Detling: Yeah, and that's actually another strategy is to use distraction, use a deliberate type of distraction, and music can be a great deliberate distraction. So if you have a particular kind of music that you listen to that just helps you feel calm and relaxed and comfortable then absolutely, listening to that music prior to going onstage and performing could be really beneficial for you to get your body under control and then it's easier, as I said before, to get your mind under control.

Interviewer: That seems counter-intuitive that I would want to distract myself from what I was about to do. I would think I'd want to really think about it and make sure I've got my steps down but not so helpful.

Nicole Detling: Well, you know, it depends on the person. Everybody's different so for some people, absolutely not, that would not be helpful at all. For other people, it would be incredibly helpful so part of this whole process is knowing what works for you, and one way to find that is you can find any performance in your life, and sport is one performance, but we perform all day long, every day in everything that we're doing. We perform at our jobs. We perform driving to and from our jobs, some of us better than others. We perform as parents. We perform as spouses. We perform in every aspect of life so think back to a time when you feel that you were performing exceptionally well regardless of what that performance was.

Interviewer: Like that great parenting moment where you really felt you explained something to your children, and they got it, and...

Nicole Detling: Exactly, it clicked. It worked. You got the result you were looking for, and then rewind the tape just a little bit further and say, "Where was my mindset before that? What was I doing? Was I really thinking about what I was going to say and what I wanted to happen? Or was I in the car listening to the radio, and I got home and it clicked?" Right? So what are some of those scenarios where you've had performance in the past, and if you look at many of those scenarios, you'll be able to find trends, and what you did prior to a good performance, that will help you determine some ideas going forward for what may help you in those situations deal with that pressure and stress.

Interviewer: Alright, I'm sure we could talk about this for hours.

Nicole Detling: Easily.

Interviewer: We've got to wrap it up though. Is there a final thought that you have for our audience when it comes to this topic?

Nicole Detling: Probably, knowing yourself. Finding what you need and then finding the tools that are necessary in order for you to really get what you need out of each experience so that you can perform your best every single time you perform.

Announcer: We're your daily dose of science, conversation, medicine. This is The Scope, University of Utah Health Sciences radio.