My guest is Dr. Elizabeth Franklin, Associate Professor in the School of Health Related Professions at the University of Mississippi Medical Center. Elizabeth teaches research, communications, and health policy for the doctorate in health administration degree program. Elizabeth shares her considerable knowledge about online learning and interprofessional learning in the state of Mississippi and draws on a deep well of teaching in high school, community college and university settings. She shares strategies to support engagement in online learning and gets into the nitty gritty of software integrations that make online interactions fun.
School of Health Related Professions
Alliance for continuing education in the health professions
Alliance Learning Lab
Accreditation Council for Continuing Medical Education (ACCME)
Journal of Applied Social Psychology
Host: Alexandra Howson PhD
Sound Engineer: Suzen Marie
Shownotes: Linzy Carothers
qualitative research, people, students, faculty, continuing professional development, online, patients, learning, learners, clinicians, thought, providers, education, important, areas, talk, qualitative, teaching, question, interaction
Alexandra Howson 11:13
Okay, so 321 Hello, and welcome to Write Medicine. I'm your host, Alex Howson. And I'm here today with a wonderful Elizabeth Franklin, who is an Associate Professor in the School of Health Related Professions at the University of Mississippi Medical Center. Welcome, Elizabeth.
Elizabeth Franklin 11:35
Thank you. So great to see you again.
Alexandra Howson 11:38
It's great to see you, as well. And we first really met when we work together in the Alliance for continuing education in the health professions research committee, several years ago, we’ve done quite a bit of work together on various topics. So it's great to be here today talking about the work that you do in continuing medical education, continuing professional development. And we're going to talk a little bit about some of the work you've been doing lately, particularly in the online space. But let's start with if you could share with listeners, who you are and what you do.
Elizabeth Franklin 12:20
Well, I am Elizabeth Franklin, I am associate faculty in school, it is the School of Health related professions where we're housed, but it's a doctor of health administration degree that is my faculty appointment. And so I teach research, communications, and part of the health policy course in this program. It's a wonderful program, preparing healthcare leaders, and we really need those now. So we're very proud of our graduates and what they do when they leave us. I also 25% of my job actually, is to help with students, staff, faculty, clinicians, not their CPD continuing professional development. Now we do have the CE office that I was the director of four years before I came here for full time faculty work. And I'll talk about that in a minute. I work very closely with the director now she actually is a DHA graduate, a graduate of our program. She's very close friend, and we enjoy working together. So we have a lot of collaborative projects.
Alexandra Howson 13:39
That's wonderful. Can you talk a little bit about what the focus is of the continuing professional development that that that you provide education on?
Elizabeth Franklin 13:50
Sure, yes, we know for student out I'll talk about for students and then what I do with the CEA office for accredited CME. For students, we are trying to really get them used to the fact that lifelong learning is essential. And so, we develop, some used to be in person and some more hands on skills type things. Now, we have worked with vendors and videographers and things to actually make online offerings for continuing professional development for students, and staff and faculty who want to learn about things maybe that were not covered in the formal curriculum. The double AMC does a survey every year of medical students when they graduate and ask kind of what areas they wish they had learned about that they really need more information about. It varies each year, but health policy is one, business practice is another how to manage a business. And then this is interesting, but Nutrition is the other one, we know that that has a lot to do with, with disease management and wellness. And those who graduate often don't really understand the importance of that. And they admit that, you know, they talk about that in the survey. So those are the kinds of things we try to kind of use as a needs assessment, we actually have one on the importance of breastfeeding. So it's an interprofessional course, that nurses can take, and, you know, pharmacist and dentists, and that's a very important part of that. So to learn more about the importance of that and convey that to their patients, we have one called the patchwork insurance patchwork, and it does teach them about policy, why some people fall through the cracks, why they come to the Jackson free clinic, because they have no insurance. Many of our students don't really understand that. And so to be more empathetic with their patients, that kind of education is necessary. We have one on recognizing child abuse that they may see. So if they're an emergency room rotation, and they say that they can recognize that and how to report, we have another one that is in development, but very important. And it's I never thought about this until someone mentioned it but was it's how to do an oral cavity exam. And all students need to do that. So these are just areas that are sometimes left out of the classroom, but are very important as well. My work with the CE offices is great fun, because some of the things that I mentioned are also provided for clinicians. So the breastfeeding one for example, it offers accredited CE, so I worked with her to make sure on our learning management system, the instructions, the COI information, all that is clear for our learners. On the front end, that we also, this is exciting have developed a course called navigating the online teaching environment note. And this also offers accredited CE. And this is for clinicians and faculty who had to very quickly transition from in person hands on to an online remote environment and had no experience with that. So we fashioned that we design that after the Quality Matters rubric, which covers eight areas of utmost importance to be successful in an online course development for faculty. And that has been very popular. A lot of people have had claim CE for that. So it's really fun to work with all the students and accredited CE through the CE office as well.
Alexandra Howson 18:01
There's a lot of rich material there, I'm struck by what you were saying about the CE course focusing on online learning. I interviewed several oncologists in late fall early winter of 2020 and that was one of the things that they universally taught, you know, uniformly talked about was that when they had to move online or into kind of virtual consultations, you know, early in 2020, especially in community settings, you know, they didn't have any training, they were you know, a lot of people were basically told, here's doximity here's Web MD have at it. So it's encouraging to hear that that kind of education is going to be is going to be offered and the other courses that you were talking about, well, they really hit the social determinants of health, don't they?
Elizabeth Franklin 19:02
And Mississippi is a state that right needs to address.
Alexandra Howson 19:07
Right. So how did you find your way into, you know, academia, first of all, and continuing professional development, in particular?
Elizabeth Franklin 19:17
I love this question. And I listened to your podcast and I love the variety of answers. I was just listening to Scott Coburn's in I think was Episode Four. And he said it very clearly nobody chooses to get into this nonsense. Not that they don't like it. It's just there's no degree for it. There's no real preparation on the front end for it.
Alexandra Howson 19:40
And it's pretty subterranean. Right?
Elizabeth Franklin 19:42
Right. Some people think that this job, this CE job, CPD is basically event planning. But no, I have an MD and a PhD in higher education leadership. So I taught at the high school and community college level for a long time, 28 years or so. And our Director of assessment here or academic, she does all the accreditation things for the whole, all the schools here was in my Ph. D. program. In one November, I was teaching, and I got a call from her. And she said, Would you consider a career change? And I was kind of getting burned out on, you know, high school and community college teaching. And I said, What, as a matter of fact, yeah, what are you thinking about? And so there was an opening here, actually, it was a, it was an education liaison between it, and faculty. At that time, they had a very hard time communicating their needs, one did not speak the same language, they got frustrated with each other. So it was it was called the position was a solution strategist. And mainly, it was akin to a program manager that helped faculty in need of technological tools, assistance, help software, those type things. And that was quite fun. And I loved it. But at the end of that year, my same friend said the continuing medical education director, job, the director was retiring. And that position was open, would I please apply, and I did and was hired there. That position here is a faculty position. So you have to teach a course or two in a program here, and BBC director. And so I began teaching in this program in the DHA program at that time to keep my faculty position. I loved it, you know, I love teaching, I love education, I love to watch learning happen. And so that went there in 2017, four years later, a full time faculty position came up in in this program, and I couldn't turn it down. But I love CE so much that I asked our dean are actually the dean of the school and our Vice Chancellor of Academic Affairs kind of collaborated and he pays 25% of my check. And I do CPD so that what I was talking about earlier is through the academic affairs office with him. So that's, that's what I do.
Alexandra Howson 22:38
That's a very interesting story, and very, very heartening to hear that there's kind of local support for making sure you know, you've talked about friends that you work with, and people that you work with as friends. So, it's very heartening to hear that there that there's that network of people who are looking out for each other, and growing local talent. That's what I'm hearing when you when you share that story.
Elizabeth Franklin 23:07
You're doing qualitative research already.
Alexandra Howson 23:12
We're gonna talk about that. And in fact, one of the things I miss most about being in an academic setting is teaching and working with students. But you talked about the new courses being offered on remotes on moving online, and recently you presented work at the Alliance for continuing education in the health professions, one of their learning labs, on that whole kind of process of moving courses online, and how to optimize online teaching and learning. Can you talk a little bit about what online what online learning has meant for you in the last, you know, 15 months or so in particualr.
Elizabeth Franklin 24:02
Of course, our program is fully online. So, since I've been teaching in this program, I've learned how to successfully teach online and stay engaged. And you know, the goal is that an accrediting bodies and everything will say and require that you prove that you have pretty constant interaction with the students and interaction. They have interaction with content and with the faculty and with each other. And so there's peer to peer contact, just like in a classroom. And the thought was, we never want an online course to be like the old-fashioned correspondence course when you got a packet in the mail. And you read this content, filled out something you wrote a paper and you sent it back. And there was very little interaction you know what the faculty look like or really who they weren't. So, to avoid that learning management systems now, and even homegrown ones have ways that you can very easily facilitate interaction in those three areas that I mentioned. And when I was in the faculty meeting in March of 2020, sitting with PT, physical therapy faculty, OT faculty, HIM faculty is also here. All the medical laboratory sciences are housed here, and they are very hands on as you can imagine, yeah, they were sitting all around me when our Dean said, you will now be teaching remotely. So, talk with whoever, you just got to figure out how to do it and, and I saw the look on their faces, they were panicked. They want to be good faculty members; they want to prepare their students for working with patients. But they've never delivered content or interacted with students really using anything other than face to face. And so of course, we offer to help them any way we could. And we did. But I'm also on a committee here called the E campus committee that really does focus on monitoring and providing the needs for online programs. And so, a subcommittee of that committee, convened and developed this note course for faculty as quickly as we could. And so that is a resource for them. And they may, for example, not need help in one area, like interaction with students, but they do need help with how to make it accessible to all students. And so that's one module that they can just go to and get what they need. So it's a one stop shop, a toolbox for anything that they may need to know when they when they develop and deliver content online. And, and my thought was, when I saw those panic faces, we do this all the time. And we are evaluated all the time and go through program reviews. And one of the courses that I teach was certified through Quality Matters, that's a peer reviewer from outside and to inside. And so we have to make sure that it's very good in all areas. And so my thought was we do this for academic programs. I know that CPD is going that way it you know, that's the first thing that popped in my mind, what is Vicki going to do in the CE department? What am I going to do with students who have a year long series of in person IP activities planned and we can't do that anymore. So I thought, then the concepts that we use for teaching online will, we can use and teach those who are delivering CPD, so that it's not just a barrage of recorded lecture videos that are just thrown out there that there is some component of interactivity of follow up, of stop and reflect. And all those things that we use in academia can be used in continuing professional development as well.
Alexandra Howson 28:22
So it sounds to me and so you were in a really pivotal position in order to kind of make that connection between the work that you were doing and online learning and our real, immediate material need amongst colleagues in the wider school. If you hadn't been in that position, what do you think would have happened?
Elizabeth Franklin 28:45
Well, you know, I'm not the only one that teaches in online programs. But I do think it took some of us to come along aside the hands on in person faculty to say, we're here to help. Here are some resources. You know, I can't imagine what that felt like. Because when you first start, it's hard to get your head around how to really teach when you're not with somebody if that's all you've ever done. It's a hard concept to even think about until you see it in action. If you've never taken a course online, then developing one and teaching that way is extremely hard. And so, you know, we had the support of our Dean and we kind of stopped what we were doing and offered to help them and then the e-campus committee and I will say instructional designers, for those people who have the resources to hire an instructional designer. I would say they're so so so valuable in this process. They know how things should look where it should go, the sequence that should be presented, those type things a lot of us just don't know. So sometimes we would get things content in a course. But the instructional designers would say, we have to make this easy and visually attractive for the students. And this is how you do it don't indent five times, you know, make sure your headings are this font. And again, I go back to the accessibility part, they helped me with that, because that was a thing that I really had not given much thought to, is if everything is going to be remote what about the elderly physician who may have trouble seeing online? Well, they said you don't use colored fonts, and you don't put a photo in there, but without the alternate text, so that you know that's in there. And just little things that could tweak a course that can make learning so much easier for people who have accessibility issues. So, things like that, that weren't not at the fore. When remote teaching became so universal, we had to start thinking about every body.
Alexandra Howson 31:21
No, that makes total sense. One of the things that comes to mind when you were speaking there is you know, a lot of people in the continuing professional development world at the moment, I guess, in lots of different settings, actually, you know, they're talking about Zoom fatigue, because what a lot of people did was move live content online, and really kind of, you know, use Zoom mostly for that. But you've been teaching and designing and delivering online education for a while. So you must have evaluation material that tells you about, what, what are the fatigue points in online learning? Because knowing some of that would be helpful for those in the continuing professional development community who are still struggling with that question of how to create online content that isn't going to wear people out and is actually going to be effective in terms of learning?
Elizabeth Franklin 32:21
That is a great question. Because I think good educators and good clinicians try to get into the skin of their learners and their patients. So I really tried to do that. And the other day, I was thinking about a faculty clinician, a teaching clinician. So he comes to work in the morning, or she and they have to teach remotely, they either recorded their lecture, and they put an alarm and management system, or they wake up and they do a lecture or whatever, to medical students, you know, remotely over a resume or whatever. And then they go to their patients. And they're working with patients as they can. But then they've got to turn to the screen and do the electronic health records and notes, those type things. And then they're lacking CME credits, and they need to finish that. So they log on to our, you know, city central site here and let's say that the offering they need is just a recorded lecture video, how much can we expect them to actually absorb and learn from that after a full day of watching the screen, except for a few minutes when they're doing patient work? So that's why the interactivity, the reflection, the stop, the doing more synchronous things, instead of recorded are really quite necessary if this type of learning continues. And so there are lots of ways to do that, depending on what technology you have. But if it's synchronous and live, you know, use that comment box, use those breakout rooms, use the whiteboard that you have right there in front of you. And if it is a lecture on their adjust vetted software that does great interactive videos, and they can be recorded videos. So you can set a time stamp kind of thing and have a conversation. So while the person is talking, other learners can hop in and say, hey, that's an interesting point. What do you guys think about that, and then someone else can hop in and sort of have a give and take during the lecture even though it is recorded. And of course, quizzing can be done just to kind of keep people away can engage in a pretest that helps them know what they're looking for and what's important. All those good practices for education we can use in the CE space for medical folks as well. And I think it takes time it takes learning, it takes a little bit of a there is a learning curve, but it's necessary really if we want really robust learning activities and a lot of learning to happen.
So, are there any other tips and tricks that you would recommend to optimize online learning for busy clinicians that, you know, listeners in the continuing professional development world might do well, to us?
Elizabeth Franklin 37:21
Well, I would just, you know, the main objective should be some sort of interaction with, as I said, all three of those components with the content. So if you have an interactive quiz, that's interaction with the with the content, so you can kind of gauge what's gone on there. With the actual faculty member, the presenter, if there's a way to do a synchronous session later, after, so that you can have q&a, you can have just some feedback from the learners. Not necessarily at that time, but just at a time that's convenient for the speaker. I was talking to one of my CE colleagues in Pennsylvania in the Magni group, and she said that they really have looked at this whole COVID time with the glass half full, because they have gotten speakers that they would not have been able to afford because of travel, and honoraria and things like that, which are. So it's much cheaper. Now it's affordable to ask them to just sit down on their lunch hour in a zoom meeting, and address learners in so that I thought that was really interesting. And she said one time, they had a faculty member because of the time zone had to record his lecture, his information, his PowerPoint, but then he was at a later date, he set aside time for those learners who come back and Q&A with him to chat with him to do comment box stuff with him. And that was just the best of all possible worlds, because they had time to actually think about the content, process it and then get back with the presenter later on. And so, I just thought, you know, that's a great, very positive way of looking at that, but, but being innovative and creative is what we need to continue to do because the fatigue of just staring at a screen is not going to get any better. I hope it does, but it doesn't look like it will be very soon. So just keeping that in mind and understanding the needs of the learner are very important.
Alexandra Howson 39:40
Absolutely. And I think we're beginning to see in the literature, some studies that are parsing out what some of the challenges with you know, staring at a screen all day are and I do think I love that example of, you know, the faculty kind of jumping back in to do a live response to learners after the presentation, as I think that that one of the things I hear a lot from physicians that I interview for various projects is having that access to experts, both within and outside of your practice setting is kind of becoming more and more important, because, you know, I guess there just isn't the time for people to have those kind of curbside consults that perhaps were more a feature of clinical practice, even 10 years ago. And so maybe that's something that we're going to see growing in the in the online space, you've talked a couple of times about stepping into the shoes of learners of clinicians and I think that takes us to qualitative research. And I know that you're a proponent of qualitative research in education and education is actually one of the areas and health to where qualitative research methodologies have really kind of expanded as a way to, you know, collect credible and reliable insights over the last five to ten years. And we've worked on some projects together for the alliance in a qualitative approach, what draws you to qualitative?
Elizabeth Franklin 41:20
I am so glad you asked this question I get this is where I get really kind of excited, because I got my PhD, in kinda tells my age, but in 1998, and at that time, all the research courses that courses were, you know, when we talked about analysis, we did all the, the ANOVA sisters, you know, man Cova, ANOVA, and cover all those things, and we didn't really get to anything qualitative, unless maybe there was a question on a survey or a questionnaire that says, What else would you like to tell us? Or if there was an other check, you know, a text box that said that, but, but there was really no very formal, transparent way of analyzing words to me that I was exposed to. And I know that qualitative research kind of can be dated all the way back to the 70s. But I think in the past few decades, it's really, as you said, become more popular and more understood. But qualitative research to me, can bring life to quantitative can bring life and meaning to numbers. And I really do believe that a very robust analysis of qualitative data tells clinicians tells researchers tells policymakers much more than a list of summarized numbers, or a table of numbers, I know that's important. And so we often tell our students that mixed methods research is what is kind of where they need to go to, so that the quantitative can kind of feel the gaps of qualitative and vice versa. But pure qualitative research to me is, I don't mean to sound overdramatic, but it's, it's almost like poetry, it really tells us so much about what we're asking. And in fact, we can get information about things that we did not ask and never thought we would understand, it really tells a story about an experience, a perception of someone and that's really what we need to know, in a lot of cases. So, I just read an article about a qualitative study about the experiences of women that came into the emergency department thinking or that they were having a miscarriage. And they would often say that the emergency department experience was the worst of it all, even the treatment afterwards, those type things. And so, the researchers wanted to find out why. And that's what qualitative research can do. We know they're not happy with it on H CAP scores and things like that, but we need to know why in order to fix it. So, they spoke to several women who had had that experience and they developed, you know, four or five themes around miscommunication and misunderstanding of what was going on and conveying that well to the mom. And then in qualitative research often, well usually, a quote, kind of goes with a theme or something to kind of support that. One of the quotes was that the lady came in bleeding and didn't even know she was pregnant. And then she heard a doctor on the phone telling someone else that this woman had been pregnant. So that was the first time she had heard, so the experiences that they conveyed were not good. But they gave the researchers good, very clear information about how to fix that. And so we wouldn't have gotten that if there was a on a scale of one to five, how satisfied were you with your experience in the emergency room? And so, it's very rich, it's very deep and detailed. And what I like about it, it's very nuanced. So, if you are doing a, say, an interview to collect qualitative data, and someone rolls their eyes before the answer, or, or they chuckle, or they refuse to answer the question, that tells you a lot of information that you that you may not have gotten on some quantitative tool, data collection tool. So I absolutely love it. I feel like we we learn a lot in the health professions with qualitative, especially from the perception of the patient. And I know that is becoming more and more important, the ACCME, you know, in the commendation criteria, gives you for lack of a better word extra brownie points for including the patient in the planning and delivery of CME. And we really, when we do that, we're doing qualitative research, when we have a panel of patients that are describing what happened to them and how they dealt with it. We're learning a lot. And so I just really, I can't say enough about the value of qualitative research, especially in the health professions. And with, you know, continuing education, we can talk about this later. But there's in my opinion, a great need for qualitative information when we develop things like needs assessments. And during a CE event, you can do breakout into focus groups and get very detailed information about what about the content that's being delivered? And what are their experiences with that with that information? And then after very strong qualitative research opportunity, they are for sit to learn this information, what were your experiences, as you put this into practice? How have you seen patient reactions change. And so that is just very rich. And I know that it's time consuming. And not a lot of CE staff may have people with them that understand how to analyze qualitative data, so that it's very transparent and trustworthy using air coders and member checking and things like that. But that's just an education of staff that I think we could we could make available.
Alexandra Howson 48:23
Yeah, I do hear from, from people that you know, who, who share that view of the value of qualitative, but kind of get stuck at the implementation and the analysis in particular. And I really appreciate that story about using focus groups during a CE event, almost as doing kind of double duty. So, the focus groups become an opportunity for the learners to reflect on what they're learning, but also an opportunity for the providers, the education providers to collect data about some of the challenges and some of the experiences that learners have in thinking about how they might implement what they've learned. And in fact, I'm kind of working on a project at the moment, interviewing oncologists and a couple of them have said, and this happens commonly in lots of different projects, a couple of them have said at the end of the interview, that part of the value in participating in that kind of exercise is gives them that opportunity to reflect on their practice. You know, we're talking about reflection earlier is such an important aspect of learning. So, there are different ways to think about the value of qualities of research beyond simply gathering data.
Elizabeth Franklin 49:52
You know, the downside, it does take more time. You have to sit and talk to people and listen and journal about what you're doing and those type things, which is, it's more timely. But, you know, I think with more training more, more and more people who understand the value of it, and I think that could and maybe should be a more common practice than we have new.
Alexandra Howson 50:20
And other particular places where you see qualitative insights as being particularly helpful in the continuing education space?
Elizabeth Franklin 50:31
I do. And as I mentioned earlier, it's the experiences of both the provider but I think, as important or maybe more important is of the of the patient. Because when we talk about practice change, we know that the endgame there is for better patient outcomes. And just quite frankly, you know, H CAP scores are tied to reimbursement and things like that. So, we do want the patients to be satisfied in a lot of areas, how we communicate to them, how we teach them the information that they need to know, to go home, and manage their illness. And so, you know, that would be very useful. So, a recent project we did with a group of OBGYN providers here is we knew that there was a problem with a perceived stigma of treatment of obese obesity of these patients that came to our department. And so we did a focus group with patients who came because of some other it was like a support group or whatever. So it was like a convenient sample of patients and talk to them about how they were treated. And they had quotes from providers, they had scenarios that they will never forget. And they share that with us. And then we paired that with some quantitative data, some testing some questionnaires to the providers, and sort of put all of that together, and came up with an educational solution for the providers that, you know, educated them on, on patient experience as it relates to how they treat an obese patient. And then, you know, some of the providers said things like, we just know that they're not going to be compliant so sometimes we skip some of the education. And so if they're very open with you, when you're asking them those questions, you know, you can really get a lot of good insight into what can be done. So that in itself is a needs assessment, really, for the mayor. And then, you know, the follow up is so, so important. And I think qualitative data collected from DAM [AH1] actually would be more much more robust than that three to six month survey that says, Did you change your practice? Yes or no.
Alexandra Howson 53:12
Right. Right. And when you're working with qualitative data, when you're doing this, this kind of work? Are you doing that all in house? Or do you partner with other organizations? Or because I think a lot of people in the continuing professional development world would if they're, even if they're interested in this would be thinking, Well, where do I start? Right?
Elizabeth Franklin 53:35
What it would start in house for sure. And you know, even some people think that qualitative research project does not have to be approved and reviewed by our B[AH2] , but it does, it is research. And so when you interact with humans, you're, you're some people say that is human research. And so we're collecting information from them. And so start in house. So if there's, you know, like I said, I think this is a great way to do a needs assessment. When you have that first planning meeting, treat it like a focus group, before you dive into, Oh, I know a speaker that can speak on this, well, that might not be a need. And so knowing really kind of in a rich format, you know, what the needs are straight from the mouths of the providers, I think is really quite good. And you know, that the editor of the JSAP journal for continuing education and health professions, is a qualitative researcher. So those out there who do qualitative research, don't be afraid to send your work in to that journal, because that is very accepted that type of research is and I think more and more journals are, I mean, there's a whole Journal of qualitative research in the health professions and so don't be afraid of it. There are ways that you can collect and analyze your data. And it be done with much transparency, trustworthiness, I hesitate to use the word validity, because that's used so much with quantitative data. But there are measures that prove your research was done well, and, you know, can be replicated and, and all of those things that we look for in strong research, even in the qualitative space.
That's wonderful. Thank you for sharing all those insights. We've talked about online learning, we've talked about accessibility, and tips and tools to optimize online learning. We've talked about qualitative research and its value in the continuing education space, is there anything that we haven't covered that you'd like to address before we wrap up?
Elizabeth Franklin 56:03
Well, you know, I don't need to say this, but the last year and a half have been quite difficult for every human being. And I noticed this with our students, we just had a conversation this morning, about in the past, our, our interactions with students were what was very academic, it was, you know, critical feedback on their writing, or, you know, a project they were doing, but it seems in the past year or so, our interactions with our students, and our learners in other situations, even in CE even students has been more it, it has, it has necessitated more counseling type interactions, and softening of how we criticize each other and our students. That's all necessary. But it's a, it's a very interesting time for us all. And our emotions sometimes are such that we don't even realize things are going on that really are. And so just that one thing that you throw at somebody that's an extra criticism, or an extra job, or an extra duty that they need to do might be that tipping point that, you know, just puts him in a state. That's not what we want. So, I guess, from my point of view, just being considerate and kind and understanding and maybe backing off of the pressure a little bit. It's just a good thing for us to use now. And, forever, really. And if it took this to kind of make me more cognizant of that, then this was a good thing. You know what I mean? Not medically, or anything like that. But if we learn lessons from this in terms of how we teach how we interact, how we deal with patients, then I think I think we need to try to do that, and not forget what we've learned as we go forward. And so, making somebody look at a screen for hours and hours at a time and expect them to actually perform or do well, on any kind of assessment that just may not happen these days. So, being creative, being innovative, being funny, being understanding, you know, just being a human and expecting everybody else to be that way too, I think is a lesson that we all should learn.
Alexandra Howson 58:45
Humanizing learning. I love that. Dr. Elizabeth Franklin, thank you so much for sharing time with us today.
Elizabeth Franklin 58:51
Thank you, Alex.