Welcome, everyone. We're very excited that you're joining us today, as we're talking about empathy and exploring paths to empathy in the educational space as educators. And our focus, we have a theme, as you may have picked up on, on the pre-workshop exercise of luggage, and we'll tie that all in because we're going to be unpacking truth and goodness in an objective way. So just to introduce myself, I'm Danielle Fortuna. I'm a pathologist here at the University of Pennsylvania, and I work with Martine. Hi, everyone. My name is Martine Boggs, and I am a pathologist assistant technical manager here at the Hospital of the University of Pennsylvania. And I want to thank you for joining our workshop today. And that being said, for our learning objectives, we're going to describe our individual strengths and discuss the application in personalized empathy and teaching. We're also going to assess the purpose and process of feedback through the lens of empathy, identify how we can model empathy as teachers, and of course, co-create a definition of empathy and generate collective empathy highlights as a team. All right, so let's go to our pre-workshop exercise here. And we were talking about luggage, and we kind of asked you to think about your luggage. So our scenario was imagining that, you know, instead of this workshop being virtual, that you were invited to Philadelphia, maybe you were traveling by plane, train, car, or bus, it's totally up to you, but you were going to stay for a bit. So you're packing some luggage. So your assignment was, what does your luggage look like? And we gave you some options here. You had some options about what your luggage looked like, some add-ins here. So I'll show you what some of your luggage looked like. I put it together based on your descriptions. We can see we have some things in common here, choosing A with the backpack and the rolling suitcase. Here we have it. We have a lot of electronics, laptops, chargers, iPads, snacks. Here we have a duffel bag. And, you know, people were explaining why they chose, you know, what they chose based on where they were traveling, where they were coming from. So Martine, why don't you talk about your luggage? So for my luggage, I chose A. And for me, it's just a backpack and a small luggage. And my favorite color is black. I've got my cell phone charger along with some snacks, which, you know, I might be able to store in my backpack. So for my luggage here, I also chose A, but mine is a little bit different. I have a pink suitcase. And usually I have multiple electronics, including usually two phones, tablet, laptop, lots of different chargers. And this is at least four electronics here. And then I have my different beverages that I like, coffee, some books. And if there's a smoothie place, I'll definitely get one of those. So what we wanted to do is just take a moment to reflect. We're going to tie the luggage piece of it back in when we're talking about empathy. But think about why you joined this workshop. If you want to put your impressions in the chat of, you know, why you joined, what you're looking to get out of this, that would be great. Think about, was it challenging for you to prepare for the workshop? And then when you were doing your exercises, like, how long did it take you to do them? And would that change if we would have, let's say, added a time limit and said, okay, you have to pick out your luggage, but now you only have 20 seconds to do it. So what else do you think can affect how you approach or complete at least this exercise? Some of the things you want to think about is your mood. How did that impact you? The way that you're packing your suitcase to prepare for this exercise. Was it difficult for you to select your luggage? Was there anything that happened prior to you preparing that could potentially affect the mood in the moment? We have personal things going on. We have work things going on. And, you know, when you come into the workspace or you're traveling, are you able to separate the two? Are we able to have that switch where you can turn it on and off? You know, is there a right or wrong way to approach this? Okay, so luggage is what we're carrying and how we carry it. So let's think about this in terms of what our luggage is made up of. We have the content, we also have the organization, and we have the volume. So what does that mean in terms of us and what we carry? So for your contents, you know, you're preparing for this conference. What's important for you? What's important to you in that aspect with regards to what you're packing? When it comes to your experiences, what is it that you're carrying? You're coming to work. What is it that you're putting in your luggage to bring to your experience for the day? We have all of that content that we're carrying with us, but then we also have to think about how we're organizing all that content. How do we sort all of our experiences? How do we sort our feelings? How do we ascribe significance? So what's important? What's important to carry with us? What's important to carry with us on a daily basis? And where do we keep those different aspects of our lives? We have so many roles. We wear many hats. Where do we keep them? What role do they play in our daily life? And how much of it are we carrying, right? Are we able to accumulate, continue to accumulate more content, or are we able to lose some of them along the way in order to get through the day? So basically, the point here is that we're all on a journey. We're all traveling every day. We're encountering other travelers every day. We're carrying all of this every day. And the question is, do we approach other people that way? So we have this about ourselves, but are we approaching situations and people knowing that they have their luggage that has content, a certain organization, and volume? So let's talk about unpacking, Martine. Do you love unpacking from a trip? I know I don't. What if it were people who could help others unpack is the question. In the education space, as educators, this is the purpose of this session here. We can help others unpack. We're keeping this workshop focused on unpacking truth and goodness, but there's various paths to empathy and ways to bring empathy into the education space and into your teaching. So let's go back to luggage, but let's talk about luggage in terms of education. What is our educational luggage? So when we are talking about luggage and we're thinking about all of our experiences in our lives, this is really what we carry. So you could take a look at these different symbols and maybe looking at them means something to you. Maybe it means something different to all of us, but this is basically what we're carrying here and how we sort it and organize it throughout our day. So in terms of education, what's important to you as an educator? What challenges you? What is it that engages you when you come in in the morning? Is it having that quiet moment to have a cup of coffee? Is it that having that moment where you're going to meditate for a little bit before you tackle on all the challenges ahead? We have to start thinking about those things to understand how our personal mood is going to affect the experiences that we're going to encounter with others in the educational space and that includes your students, your residents, etc. How do we organize our classroom and our learning anxieties and our fears and our apprehension? And when we talk about significance and how we ascribe that, are we motivated or discouraged? And where do we keep different aspects of our lives? Are we focused or are we distracted? And then you want to look at how much you're carrying, right? How much of the day's events, whether it was a loved one that passed, whether it was heavy traffic for the day that, you know, made us a little bit more anxious. How overwhelming is that for us and how can we manage that? Are we making those connections? Are we seeing the correlation between our moods and what led us to that particular mood prior to us interacting with our the residents and your students? So this is all that we summarized in terms of luggage and the things that we're carrying. So what we want to do is we want to move forward and we want to focus on four main tenets of how we can unpack the truth and goodness and how we can use empathy in the education space. So the first thing that we're going to explore is listening with your eyes and ears and this is creating the positive space to start unpacking. The next thing we're going to do is we're going to explore checking your own luggage and we'll talk about what that means. The next point is the concept that we are a traveling village. So sharing that common mission of empathy in education and creating new learning experiences from different answers. Okay, so the first thing that we're going to focus on is listening with your eyes and ears. So this is really creating that positive space to start unpacking and learning and exploring new things. So no two learners learn in the same way. You know you may have experienced that as a teacher or you know as a student. So who is the learner and how can we learn about the learner and what if this is in a group setting and you have multiple learners? So it's this initial interaction that helps to create that positive space that enables your learners to feel empowered to share and engage. So we're really setting the stage. So how do we do that? And the way that we do that is that we start with the question of where is the learner and I'll show you what we how we can do that. We're going to talk about something called zooming out. So how do we zoom out? Where do you start? Well when you're in an educational or teaching situation start with questions and I'll walk you through examples of how to do this. But what we want to do by asking questions, asking the learner questions about their thoughts and their rationales is we're uncovering a foundation and we're assessing a foundation so that we can keep taking steps back in the discussion to get to a good and comfortable starting point and this is the foundation for your learner. So for instance a great question is why? So whenever you encounter a situation or you're asking a question a learner gives an answer. Why? Tell me your rationale. Talk me through it. It is a really great way to assess that understanding and understand someone's practice and you know Martine and I we like we said we work together and sometimes we are surprised when issues or problems arise and we're asking the question of why and we realize that that's the first time that that question is being asked. So let's talk about zooming out. So zooming out what is it going to do for you? It's going to help you identify where the learner is comfortable. That's the foundation. Then where we can start building from there. It also allows you to understand more about how the learner learns and then it really helps you to start building the mutual trust and the rapport. The time that you're spending with the learner here it may take more time to get there but it's it's invaluable. So let's look at an example here. So you're planning to give a tutorial on how to make guacamole. So we the difference between objectives and and goals or whether or not they're actionable and specific when we're talking about objectives but when we're talking about goals these are really things where we focus on knowing and understanding. So our first goal in our tutorial is to have our learners know that the major ingredients of guacamole are avocados, onions, tomatoes, cilantro, peppers, lime juice, garlic, and salt. Okay so from here then you're going to start talking about peppers and you're going to talk about heat levels and how to prepare the garlic. But my question for you is what are we missing? Is there anything that will help ensure that we're all on the same page moving forward? So what do you think a learner may need to know before we start talking about types of peppers and heat level and how to prepare garlic? What are your thoughts? Put it in the chat. How can we establish that foundation and figure out where people are? Okay yeah so have they ever eaten guacamole before? Do they know what it's what it tastes like? Do they eat spicy foods? Right so getting to know the learner. Do you have a recipe that you like? Now if you're telling if you're telling the learner that these are your major ingredients what else should we make sure about? Yeah kitchen skills, chopping, any allergies. Perfect yeah so we're really kind of getting to that foundation. Okay before we we get started before we start chopping into these let's talk about where you are. Let's talk about what you like. Let's talk about what works and so here are some of the things that I was thinking about. How do you tell if an avocado is ripe? So we're telling people to go and get these supplies but how do they pick them? Do they know how? Where do you find the ingredients? Where would you find cilantro? Right that's going to be in like kind of that like cold produce section. What kind of lime juice are we using? Are we using the one from a bottle or fresh squeezed? So kind of asking those questions like okay before we move on let's let's talk about a few things. Let's make sure we know where where to find all these ingredients. So then using a clinical example here we're talking about esophageal pathology and let's say we're going to talk about an entity called barret esophagus which is a change that occurs in the esophagus secondary to reflux. So before we want to start discussing that and showing the various pathology images what do what should we do as a stepping stone? Let's think about the learners. We're going to talk about different tissue changes here. So what should we make sure of before we start moving on? We should probably make sure that people are comfortable with the anatomy. Okay, let's do a quick review of the anatomy. This is the site we're talking about. We're talking about the esophagus as it joins the stomach here. This is our area of interest. Well, what's normal here? Because we're going to talk about tissue changes. So before we get to pathology, let's do a quick refresher of normal. So these are different things that we could do to zoom out, to take those steps back. And you can ask them as questions like, hey, tell me about the normal histology here. Okay, so let's move on to our next tenant. Now we need to check our own luggage, right? Okay, will you be checking your luggage or will you be carrying on? Now, I want to tell you about an example based on an experience with some high school students. I worked at a place and we actually had an annual summer program where we had high school rising juniors and seniors that showed interest in pursuing a medical career. And they were given an opportunity to basically come to the hospital and rotate in various departments, such as the ED, labor and delivery, and of course the laboratory, both clinical and anatomic pathology. Now, part of the program, of course, rotated with AP. And that being said, they got an opportunity to walk in the day of a pathologist assistant, since that is my career and that's my field. And we picked out a couple specimens that we felt the students could directly relate to, such as tonsils. Most of the students have had, at some point, a tonsillectomy procedure done. So it's usually a great opportunity for them to kind of understand and see what a tonsil looks like. And we've also shared with them gallbladder specimens for them to be able to see gallbladder stones, the different sizes, the different colors. That usually is something that really strikes them. And of course, a placenta. Obviously, the placenta for all of us, we've come from a placenta, so that's an easy specimen to kind of share with the students. And during that process and during that experience in showing those specimens, the group typically will show a high level of interest, especially with the tour and reviewing some of the specimens, being able to touch them. However, there was one particular student that seemed disinterested in the middle of the session. And slowly stepping back, having some not so pleasant facial expressions, almost seemingly disgusted. And so at that point, and I'd like to give you an opportunity to type in the chat, some questions are starting to surface in my mind. What would be something that you would be thinking of and that you would question given this scenario? Feel free to type it in the chat. Okay, is this their first time seeing medical specimens? Yes, that's a great one. Are they comfortable with blood, history of fainting? Very good. Yes, those are some great answers. Now, what was I thinking? Why is the student on this tour? You know, they're getting an opportunity to go through the lab. Was it something that was mandatory? Did they voluntarily do it? Was it something that their parents made them do? And are their feelings stirring up in us? You know, as educators, are we starting to take this a little bit personal that they did something against us, right? Now, we completed the tour and, you know, I decided it was time to just, let's have a one-on-one with the students, especially the one student that I saw that was a little bit displeased with the whole session. And it was during that interaction, they were actually very enthusiastic about the experience. You know, they were asking a lot of follow-up questions, asking more about pathology. How do I get into pathology? What are some of the routes that I can take? But, you know, one of the things that struck him was, wow, the smell in the room was really strange. And in speaking with him, it turned out, well, he'd skip breakfast that day. And for us being in the lab, you know, it's easy. We have formalin and all other types of chemicals and we kind of grow immune to the scent. But for someone just coming into the laboratory, but knowing that they are interested in the field of pathology, that smell could take us aback. And it does stir up some feelings and facial expressions, but that's where this was coming from. And had I taken this personal, I would have missed an opportunity to really highlight, you know, the beauty of career in pathology and share additional information with the student to help them continue to pursue a career. So again, these are circumstances, that was one experience, but, you know, other experiences that have occurred, we have people with different cultural and educational backgrounds. You know, they come from different experiences as we all do, and they process things differently. And so it's really important in the educational space that we do take the time to acknowledge each learner, take the time to have that one-on-one to understand their strengths and areas that might need improvement. You know, it helps us make a deeper connection with our student, and that can make all the difference, okay? Ask more questions, check yourselves before you check them. All right, so let's move on to our next tenant here. We're a traveling village, sharing the common mission of empathy in education. So I will turn this over to Martine again. Now, when you're raising kids, we always say it takes a village, and it's the same thing here in education. It takes a traveling village. And for us, every year as an academic institution, every year we prepare for residency orientation in a grocery room. And that is a very exciting time for us. We prepare from May till about June so that we can get ready for our new anatomic pathology residents. You know, they receive a brief orientation in the lab. We work with different molds. We make molds of different types of specimens for them. And, you know, we teach them how to use the different tools in the lab from forceps to scalpel. It's AP intro week. It's a great time. It's an exciting time. But we also know that it's also a time where, you know, for the residents, the anxiety levels, it goes through the roof because again, we have a variety of residents, some that have had prior experience in pathology, some that this is really the first time they're in the grocery room and others have had opportunity to actually shadow and actually experience spending ample hours of time in a surgical pathology grocery room and seeing the entire process. But we're making progress and things are coming along. However, we have some residents that they're getting more and more comfortable. They've had an opportunity to play around with some mold specimens and everybody is making sure that they are preparing themselves. They're, we, of course, you all know in the gross lab, PPE is of utmost importance. We have to make sure we gown up, we glove up and we also wear our goggles. And one of those things we provide here in the lab is cut resistant gloves. And it's a time where enthusiasm is really starting to replace the initial anxiety because they're really getting into the nitty gritty of the specimens and how to process. But again, in this scenario, we're seeing that there's a resident that's struggling. They're being more and more hesitant, unsure of the work, starting to show signs of concerns. Am I wearing this appropriately? They're seeing some imprints on their hands. It's concerning and, you know, it starts to build some question in us as educators on how to then approach that particular resident. But again, it takes a village. And so during that process, we have to start looking at this as a team and start engaging the other mentors, the other educators involved within this whole introduction period. And so we have to communicate with each other and we have to sit down and try to have a better understanding of our student. Is this something that we're doing? Are the other educators, are they noticing some of the same concerns that I'm noticing? So communication. Now, this is looking more and more like fear. We're having a resident almost concerned with cutting themselves consistently, having a scrape and feeling concerned that they need to go to occupational health. They need a Band-Aid. They felt the edge of the ruler might've cut them. You know, it's becoming concerning. And having conversations with the other mentors, it seems that this particular resident might've had some sort of previous traumatic experience because there's a constant fear of cutting themselves. Now it's time to, as an educator, we need to come up with a teaching plan that's going to be specific to that resident and that's gonna be shared by all the members of the mentoring team, but also acknowledging and not dismissing that resident's personal fear because one thing you don't want, you don't want for your student to start pulling back and feeling they can't trust, they can't share. We wanna provide what we're trying to provide, a positive environment. We're trying to empathize with that person's personal experience and not take it, again, we're trying not to take it personal. We're not taking this as our own baggage. Now, having said that, creating that additional communication with the other mentors where we're really starting to make sure that we're creating a plan specific to that resident, we allowed an opportunity to make the resident feel safe and comfortable. And eventually that presumed traumatic experience that we all suspected, the resident actually felt empowered and felt comfortable enough to share their previous experience. And that experience was actually a severe hand injury while cutting a produce, which led to not only surgery, but months and months of therapy. But for that resident, pathology is their heart. They want to be able to step out of that fear. They want to be able to continue to pursue their goal in that career path. And in spite of those trials, they kept pressing on and on. Undoubtedly, unfortunately that our career, it requires us to use sharp knives and other cutting tools, but nonetheless they press forward. So sometimes we're in situations and as educators, we might be feeling like, why isn't this working? Why am I not effective? It can be a little frustrating if you feel like you've done everything, but it's just not going right. And I think the important point of, what Martine was highlighting with this scenario is that we have to be patient with others, be patient with yourself, but also remember that we have people to work with and we're a village and it takes a village. And sometimes it takes a teaching plan and it takes looping in mentors to share the common goal so that we can help people move forward. So practice and pass it on. Patience is a virtue. So wherever you are, create a shared mission of empathy. Whatever workspace you're in or whatever area of the lab that you're in, it's a collaborative effort with other mentors to ensure consistency in creating the positive learning environment. Discuss this, emphasize it, model it frequently in your groups and patience grows with practice. One thing that's also important is sharing this mission with your learner. It's one thing to share it with your colleagues as educators, as teachers, but be honest, honest and transparent because that is a tremendous tool to help engage and continue to help that learner to achieve their goals. We are a team. You have to co-create your plan for the learner and provide day-to-day words of encouragement and support. Okay, so we're moving into our last tenant and this part of empathy is going to focus on creating new learning experiences from different answers. So as educators, we ask questions a lot. What do we do when the answer's different from what we expected? So we're saying different, but sometimes it's incorrect or wrong, but let's just talk about different answers. So what I wanted to do is I just wanted to walk you through a scenario. So one of the things that I'm able to do as a pathologist is teach pathology. So that includes the foundations of pathology and through the organ systems, which is amazing. And I love it. So let me walk you through this. So one of the things we talk about in the foundations of pathology is the normal physiology of vessel and fluid balance. And this is really important because in order for us to learn about the pathology of fluid balance, which is edema, we have to understand, well, what are the normal physiologic processes happening here? So here we see an animation that I made here of a blood vessel and within the blood vessel, you have your red blood cells, you have inflammatory cells like neutrophils, you have your plasma proteins. These are all going to be important parts of this physiology that we have here. And then our blood vessel is lined by endothelial cells. And we know that certain traumas and injuries and processes affecting the endothelial cells can also create complications here. So we need to talk about what are the different forces at play here? How does fluid balance become maintained on a daily basis every second? So what we have here is we have this force that's pushing the blood against the wall of the blood vessel. And this is called our hydrostatic pressure. So it's the pressure pushing against. So we talk about this icon here and that's how we can remember it. But acting in opposite that to create that balance is a force that is drawing the fluid and keeping the fluid in. And this is our oncotic pressure. So that's the pulling power of this. And it's maintained by those plasma proteins that are floating around. So that's our oncotic pressure. So we have that balance there, but it's not totally perfect because some fluid leaks out from time to time, but that's okay because we have our lymphatic vessels. So they're drawing up all that excess fluid to return it back to circulation. And so that is the summary of the physiology here. And then when we talk about the pathology of edema, what we do is we focus on, okay, well, what are the factors that perturb each of these areas that we talked about? So hydrostatic pressure, we see an increase in that in hypertension and heart failure and obstruction of a vein. But oncotic pressure, because it's driven by these plasma proteins, we're thinking about, okay, well, what affects proteins? Maybe it's liver disease, maybe it's malnutrition, maybe it's renal disease with a loss. How about our lymphatics? What can disrupt our lymphatics? Tumors, surgical excision of lymph nodes, and then we have endothelial cell and vascular injury. So these are some of the things that we go over. So then in our review sessions, we have more open-ended discussions. And the question came up, what is an example of how changes in oncotic pressure lead to edema? So the answer that was given, an aneurysm. And I love it because it's different. It's totally different. It's not on this slide at all. It's a completely different answer. But then the question is, how do we handle this? How do you handle this as an educator? Can you create a new learning experience from different answers? And we absolutely can. So, you know, I put wrong in quotes, but I prefer different answers because they all give us opportunities to do something really interesting. And we'll see that with our multiple choice questions in just a couple minutes. So let's talk about this. So I said, okay, aneurysm, that's interesting. Tell me more about what your thought process is. Walk us through it. And this was in a group and, you know, the student actually admitted, I'm not really sure anymore. And you know what, that's totally fine. I'm like, all right, let's work on it together. Let's explore. So what we have right here, this is a gross image of a sectioned heart. And we see the left ventricle and the right ventricle. And this is an aneurysm, it's an outpouching. And basically why this happened was this was probably a myocardial infarction, heart attack in this area, and the wall was weakened and it got blown out. And it's this aneurysm here. And this is all non-functioning tissue. So we walked through it. We're like, okay, let's choose an aneurysm. This is, like I said, non-functioning tissue, but that has a progressive impact on the entire left ventricle and on its function. And so what would that lead to? Okay, that would lead to left-sided heart failure. Okay, so then what happens in left-sided heart failure? Well, we have backup of that congestion into the lung vasculature. And it was like, okay, what would we see then? Well, we'd see pulmonary edema. Wow, so we got to edema, right, from the example of aneurysm. Now the question is, okay, what physiology does that fall under? Are we still talking about oncotic pressure here? No, not so much. We're actually talking about hydrostatic pressure because of the congestion. But you could see how we created this new learning experience from a different answer, and that's okay. So let's kind of do a brief review before we take a look at your, some of the multiple choice questions that you submitted and talk about how we would approach these in different scenarios. So we talked about listening with your eyes and ears. So that was creating the positive space to unpack. And we really focused on zooming out. And this could involve like talking about goals, talking about objectives, but really going to that foundation, keep working backwards until we find that foundation where the student is comfortable. And we talked about checking your own luggage, and that was more about us not taking things too personal and asking more questions to get the answer that is needed. And again, we are a traveling village. And so sharing that common mission with your other educators because it takes a village. Be transparent and honest in the education space and have that engage your mentors and also validating the goodness of participation and the honesty and collaboration of your learners. And then the last thing we were talking about is creating new learning experiences from different answers where we turn different conclusions into learning experiences. And we highlight the truth and the accurate points from the answers that are given. So I wanna take a couple minutes to go over some of your multiple choice questions that you submitted, and let's practice unpacking different answers and turning them into teaching points and learning exercises. So some of these might be familiar to you if you were the author of these. So a patient receives a kidney biopsy due to proteinuria. And so when we're looking at the biopsy, the histology shows no inflammation or increased cellularity but a thickening of the glomerular basement membrane and effacement of podocytes and the formation of spikes here. Okay, all right. So I like this question because I thought that one of the things that could be illustrated here is if let's say the learner chose minimal change disease. And this might be a good example where you say, okay, walk me through your rationale here. And so a learner may say, well, I chose minimal change because one of the things that I noticed was that there's no inflammation or increased cellularity. So that sounds like minimal change. And so you validate those truths. That's totally true. You're absolutely correct. That's what we see in minimal change disease. But then walk them through what they think about the thickening of the glomerular basement membrane and can we see that on H&E? And we can. And what special stains would we use? Silver stains. And kind of walking them through that until they can kind of get to the correct answer of membranous nephropathy. So I find that to be super helpful technique just as starting out with why and say, tell me about your rationale. What were some of the things that you were thinking about? So then moving right along into our next question. In our experimental model of R-C, R-C binds to arabinose. Together this dimer will bind to what part of the GFP operon? Okay, so this is a great question. It is very sustained and it's a brief question stem here. So I thought that this would be a good way to kind of talk about what if you ask this question and you get no answers? Where do you go? Do you just give the answer? How can you kind of unpack that? And so zoom out. So one of the things you can start with is say, okay, so you hear crickets in the room. That's totally fine. That happens, right? But then start breaking things down and say, okay, let's talk about operon. What does that mean? And then so, okay, that's a cluster of genes and they operate under the same promoter, right? Okay, and then from there, then we can start saying, okay, so this is a group of genes that we're talking about. What do we think this dimer does? Where would that function? Where would that turn these genes on? And so, and whoever submitted this, you're the expert. I'm just kind of working through it, but I wanted to use this as an example of how to work in those situations where you hear crickets. And sometimes that's what I do. I just take a dive into the question and break it down and unpack it. So the answer here is promoter. And so as you walk through and break things down, then you can find out where the foundation is. What are people's level of understanding of these different terms? And where are they with their understanding of this specific process here? Okay, all right. This one here is something that we can definitely relate to. It's a question about a mastectomy specimen with multiple clips. Patient has a clinical history of a prior biopsy of a lesion in the upper outer quadrant, which shows carcinoma, invasive carcinoma. So then the question is, what are the most appropriate next steps? So I don't want to put Martine on the spot, but what is the correct answer here? You want to correlate your clips and specimen findings with imaging and prior biopsy collection. So it's always good to, what I do in the growth room is always refer my grocer to let's first look at the patient's history. Let's go, let's look up the chart, radiographic images, because that's important, okay? It's always good to revert back, to finding history to help them at the growth bench. That's always going to be key. You've seen this before where sometimes when learners are just starting out with grossing, the carcinoma seems like it's the most important. So the question is always like, well, why am I not just focusing on the invasive carcinoma? So how would you help someone if they said, well, you focus on the invasive carcinoma? What I always tell my learners is there's always opportunity to do a more extensive search for the patient because the initial lesion that was shown is not necessarily the only lesion. And so we have to look at the entire specimen and not just focus on one area. There's always incidental findings. And so doing a thorough gross examination is always key. Yeah, and I think that one of the things about this question is you could use this as an opportunity to fill in the gaps and turn the question around and ask your learner, okay, let's take a look at this. There's three clips. What are you curious about? And so getting the learner to say, oh, okay, well, there must be other biopsy sites there. Okay, well, is it important what the other biopsy showed? Well, what is a biopsy? Is it the whole lesion? Do we always know if it's representative? So kind of taking a step back and allowing them, the learners to point out where they're curious and then the learner can follow their own path. So like, yeah, you know what? I wonder what those three clips are. And I think it might be important to know what the clips are because Martine and I have encountered this before. It seems that the carcinoma is the main diagnosis. Why would we wanna know anything else? But as Martine was explaining, there's a way to walk through it. But also for you as an educator, kind of saying, what are you curious about? What about the history makes you curious? And so I think that that's a good opportunity there. And then this last question we're going to review, what is the primary role of a forensic pathologist? And I'll go back to a scenario where maybe you don't have any answers and you're kind of just standing there and you're waiting. And sometimes after 12 seconds goes by, people feel a little uncomfortable and they might say something, but sometimes not. So another way that we can sort of approach this is turn the answer choices into questions and just work backwards. So sometimes that's kind of the scenario I'm in. And I'm like, all right, let's just take, if we don't know the exact answer, let's go through some of these answer choices and ask the question, well, who performs surgical procedures? Or who diagnoses diseases in living patients? What kind of positions do that? And kind of working through and just going backwards and saying, okay, I'm not getting an answer here, that's fine. But let's work through these answers because actually all of the answers is giving you very important information. And it's gonna give you some learning points too. All right, so if your multiple choice question did not make it here, that's okay. Just take what we've learned and think about them again and think about how you'd approach them with different answers. So now what we're gonna do, we're going to collaborate on a word cloud together. And I'm going to open up Poll Everywhere and I'll show you what to type in. What does empathy look like in the education space? So you can type in one word answers and kind of keep answering the question and we'll create like a word cloud together to kind of highlight what we've learned here. So just take a minute, open that up and type in your thoughts. Communication, inclusivity. Yeah, right, we're building trust. It takes patience. We absolutely have to communicate. We have to listen with our eyes and ears. Takes humility. Yeah, assuming. Yeah, not assuming. Awesome. I love how this looks. This is amazing. Asking, yeah, ask, just ask. Perfect. Collaboration. Yeah, the great word cloud. And thank, yeah. Thank you so much for participating in that. I don't see anything in the Q and A, but in the last minute, we are going to go to our last slide. And again, thank you for joining our workshop. It was a pleasure and hope you all were able to achieve the learning objectives. Thank you all for joining.

empathy

education

University of Pennsylvania

teaching

learning

collaboration

student engagement

personalized teaching