Here’s something I wrote shortly after 9/11/01. I will never forget the lives lost, the bravery, the sadness, the fear, and the way we all came together for that one all-too-brief moment in time. My heart still aches.

The Frozen Zone

Soft autumn breezes rattle

The first crackling leaves

Dancing in crazy spirals

Across the graying asphalt

Silted with ash

Slick with tears

A surreal montage

Helmets and hoses

Buckets and backhoes

Streaked faces etched in horror

Working, hoping, working,

working

Debris flaming red as leaves

flutters the air

Amid unthinkable chaos,

A stillness grows

Enfolding souls lost

Souls at a loss

The world stops

Frozen in one aching moment

Then another, and another

But soft autumn breezes rattle

The first crackling leaves

And redden warm child cheeks

Hands reaching hands

Holding tight

Holding tighter

and the thaw begins

In memory of those who lost their lives September 11

In hope for those of us they leave behind

–Sue Pelletier, September 2001

From Anne Taylor-Vaisey:

Every September, the Journal of the American Medical Association publishes a theme issue devoted to medical education. This year’s issue is now online.

 

Access it directly here [subscription required] or read the blog entry I wrote while watching over an almost completely empty library.

Note from Sue: I found this article particularly interesting: Accuracy of Physician Self-assessment Compared With Observed Measures of Competence

A Systematic Review

David A. Davis, MD; Paul E. Mazmanian, PhD; Michael Fordis, MD; R. Van Harrison, PhD; Kevin E. Thorpe, MMath; Laure Perrier, MEd, MLIS

JAMA. 2006;296:1094-1102.

Context Core physician activities of lifelong learning, continuing medical education credit, relicensure, specialty recertification, and clinical competence are linked to the abilities of physicians to assess their own learning needs and choose educational activities that meet these needs.

Objective To determine how accurately physicians self-assess compared with external observations of their competence.

Data Sources The electronic databases MEDLINE (1966-July 2006), EMBASE (1980-July 2006), CINAHL (1982-July 2006), PsycINFO (1967-July 2006), the Research and Development Resource Base in CME (1978-July 2006), and proprietary search engines were searched using terms related to self-directed learning, self-assessment, and self-reflection.

Study Selection Studies were included if they compared physicians’ self-rated assessments with external observations, used quantifiable and replicable measures, included a study population of at least 50% practicing physicians, residents, or similar health professionals, and were conducted in the United Kingdom, Canada, United States, Australia, or New Zealand. Studies were excluded if they were comparisons of self-reports, studies of medical students, assessed physician beliefs about patient status, described the development of self-assessment measures, or were self-assessment programs of specialty societies. Studies conducted in the context of an educational or quality improvement intervention were included only if comparative data were obtained before the intervention.

Data Extraction Study population, content area and self-assessment domain of the study, methods used to measure the self-assessment of study participants and those used to measure their competence or performance, existence and use of statistical tests, study outcomes, and explanatory comparative data were extracted.

Data Synthesis The search yielded 725 articles, of which 17 met all inclusion criteria. The studies included a wide range of domains, comparisons, measures, and methodological rigor. Of the 20 comparisons between self- and external assessment, 13 demonstrated little, no, or an inverse relationship and 7 demonstrated positive associations. A number of studies found the worst accuracy in self-assessment among physicians who were the least skilled and those who were the most confident. These results are consistent with those found in other professions.

Conclusions While suboptimal in quality, the preponderance of evidence suggests that physicians have a limited ability to accurately self-assess. The processes currently used to undertake professional development and evaluate competence may need to focus more on external assessment.

Link

And a related editorial: Self-assessment in Lifelong Learning and Improving Performance in Practice: Physician Know Thyself, by F. Daniel Duffy; Eric S. Holmboe

This is remarkable: Check out the Accredition Council for CME’s new accreditation criteria for continuing medical education providers. I haven’t had a chance to look them over in detail, but it seems like the general trend is an alignment with everything else going on, from Maintenance of Certification to point-of-care CME.

Hoo boy, guess this means I’ll be doing some last-second writeups on this for Medical Meetings, which goes off to the printer this week. If anyone has a comment they’d like to share, please e-mail me. Wow.

Here is my entrant into Dr. Charles’ tomato contest. Does he not look like a fruit equal to the task of raising public awareness of global warming and then defusing the global threat of terrorism? He’s nothing if not green (though he does blush pink in parts, awaiting for the world to understand that while tomatoes like heat, they will not survive global warming in a Massachusetts garden. A few more days on the vine also would have been good). And in his coloring, he also is a symbol of the golden mean, or the “middle between two extremes, one of excess and the other of deficiency,” which many see as a root cause of terrorism in the world today. And, of course, the spiral he displays is both a further symbol of the interconnectedness of all things, and thus the futility of trying to solve problems by blowing each other up. His lovely spiral also follows (OK, very loosely) the Fibonacci numbers explained so deliciously in the runaway bestseller, The Da VInci Code. While usually the Nautilus shell is used as an example of this perfection expressed in nature, why should not the humble tomato as well?

In Hopi symbology, “the spiral represents a broadening of consciousness, which is the destination arrived after a long journey,” which is something we all need to combat global warming and terrorism. And given that terrorism has so often and so tragically struck at planes, is it a coincidence that the spiral also is painted on jet engines as a safety precaution? In the Wiccan religion, the spiral also is the symbol of the godess, who I’m sure is none too happy about either of the challenges our little tomato has taken on.

Is inspiring us all to consume less energy, conserve the planet, and learn to live in peace too much to ask of a tomato? I think not.

Plus, his friends and neighbors are rooting for him:

P.S. To regular Capsules readers, please humor me on this off-topic post. It is Labor Day weekend, after all, and a girl just has to have fun!