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    <loc>https://www.mayrasalazarvolkmann.nl/blog/Blog Post Title One-3zaa9-zlxng-xbkmm-kd5b4</loc>
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      <image:title>Blog - An Odyssey to AMEE: A Conference, A Community, A Culture. - Chapter 1</image:title>
      <image:caption>The adventure set sail on the night train travelling from Utrecht to Vienna. Gisela van der Velden, Rahul Pandit and I found our way into our cozy pods, battling confusion around where to put our luggage and enjoying some cake. Our fourth crewmate, Gönül Dilaver, would meet us in Vienna, choosing a sturdy pegasus as a flying choice of ship to preserve her strength for the journey ahead. The largest challenge was not the narrow corridors of the train or instant-coffee in the morning; it was scrolling through the AMEE app filled with (what felt like) hundreds of options of workshops, talks, performances and something called a PechaKucha. “What will await me? I don’t want to miss anything! I have FOMO.”→ All thoughts running through my head as I scrolled in the evening through the programme. Little did I know, it would all sort itself due to my lovely team, as we decided to ‘take on’ this programme together, each of us attending a different sessions centered around our heroic mission to explore diversity, equity and inclusion (DEI).</image:caption>
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      <image:title>Blog - An Odyssey to AMEE: A Conference, A Community, A Culture. - Chapter 2</image:title>
      <image:caption>After settling into our humble abode (hotel), we ventured to the conference centre over the Donau river. The conference hall was a massive venue, swarming with a sea of people. We encountered our first challenge- getting past the guards to enter. Thankfully, this was an easy challenge to overcome as we just needed to show our badges we had picked up right before. We show them off enthusiastically in the picture on the right—&gt; Our first speech on the ‘value’ of examination for learning blew us all away. Brian David Hodges from the University of Toronto took us on a metaphorical taxi drive (taking us momentarily away from the sail ship metaphor I’m using in this blog). He explored the different examinations that taxi drivers had to take all over the world- from memorising the whole city map for London drivers, to knowing union rights and regulations for Paris drivers, to having an awareness of environmentally-friendly driving for Stockholm drivers. Interestingly enough, none of these exams test how well the drivers can actually drive. I invite you, just as Brian did, to talk to your local taxi drivers about what they needed to do to join the profession. The speech in general was an excellent slide into reflecting on the purpose that examinations actually have, and the influence of emerging technologies reshaping professions. He asked thoughtful questions on how we can actually prepare students to develop the competencies they ACTUALLY need, and how to engage them in learning to learn, not learning to perform well on exams. Much food for thought- which was further stimulated by a lovely series of traditional Austrian dances- from the waltz to the polka. We danced away with a step in our foot towards the next stops on our AMEE-adventure.</image:caption>
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      <image:title>Blog - An Odyssey to AMEE: A Conference, A Community, A Culture. - Chapter 3</image:title>
      <image:caption>Our strong team split up into the different sessions on day 2 and 3 offered by the conference, in a true team work spirit venturing on in our odyssey. Find here my reflections on some of the sessions and speakers that stood out: Adaption &amp; Acculturation This short communication session had five speakers presenting their research in 10 minutes. This format worked really well, as you got to ‘taste test’ what was going on in research internationally. As my own topic of the hidden curriculum entails exploring cultural norms and adaptation, it was really insightful to see how the topic of cultural adaption was explored from different angles: Nikki Waltrich &amp; First Generation Students: Nikki from Illinois University presented her research on the experiences of first generation and first in medicine students in navigating the medical curriculum. I found it interesting that she distinguished between first in medicine (first to study medicine) and first in family (first to study), but presented the results as a summary of the shared experiences of the two groups. One of the main findings in her study were that both groups have high amounts of relational empathy and cross-cultural communication, which is often tokenised (taken advantage of) by their peers and teachers, as they are tasked with translation responsibilities. On a sadder side, Nikki found they often encounter institutional assumptions, financial pressures and feelings of not being valued. She ended on a hopeful note by presenting 4 domains (culture, barrier removal, opportunity creation and stewardship) which an institution may implement to address these concerns. Bruce Lister &amp; The social cost of alexithymia: I had a brief conversation with Bruce from University of Queensland before his speech, and he proudly introduced himself as ‘trying to be the oldest PhD candidate in Australia’. Having worked in paediatrics for many years, his current research explores professional alexithymia (in other words; the emotional detachment or unawareness) of physicians. He found that in most cases, this emotional detachment is learned and profession-specific (as opposed to an innate/pre-existing trait of doctors). In other words: doctors learn to suppression emotions. He highlighted the need to make emotional expectations in training explicit; offering physicians a space by which to process and express, and still manage the emotional labour of the work. Emmanuel Tan &amp; Social Spaces that shape belonging: Emmanuel from Nanyang Technological University took us into another space; the space of his research on how common rooms for medical students shape belonging and identity. He found that ‘house rooms’ in Singapore play a pivotal role in safeguarding wellbeing, learning and social safety for medical students, and that this process is informally created. The main takeaway is that it is pivotal to provide learners for a space to privately grow community, separated from university faculty and staff. Sophia Kilcullen &amp; International Trainees in Ireland Sophia from the Royal College of Physicians in Ireland introduced us to the challenges that international/foreign-born trainees face when joining Irish medical schools; from practical challenges like visa, accommodation and childcare, to relational/cultural challenges in being separated from family in a new cultural world, to training related challenges of mismatched expectations, and limited feedback opportunities. What stood out to me was the feelings as if the college did not priortise their wellbeing and social networking, similar to my own experiences in my masters programme at Utrecht University. Internationalisation in our polarising world still need to be placed as a priority for our globally interconnected society. Sylvia Shitsama &amp; Mentorship in Kenya Sylvia from Kenya/Maastricht University outlined faculty perspectives on the value of mentorship. She found that faculty often have tensions in their teacher- mentor dual roles, struggling to disentangle the boundaries, hierarchy dynamics and mentee passivity they encounter. She specifically also highlighted the influence of generational gaps, whereby faculty feel they cannot provide help for challenges of young people today (Like AI &amp; Social Media). She ended by centering that ‘it takes two to tango’. In other worlds, that it is vital for faculty to address the hierarchy and create a safe space, while also encouraging mentees to take ownership and engagement seriously. I’m curious about her next study, which will explore mentees perspectives on this matter. Gareth Edwards &amp; The Global Doctor Gareth from the Royal College of Physicians in Ireland touched on similar topics as Sophia, but branched it out to a global perspective; that of the international mobility and clerkship rotations of medical trainees. His work raised a very critical question: medicine is international, so why do we not better prepare students to move between these spaces? Decolonizing Health Professions Education Wow. Just wow. This session felt like the rally cry to action at an Amazon warrior training camp- a perfect stop for me and Gisela to get our odyssey-journey training fuel. It was run by Lionel Green-Thompson (University of Cape Town), Kulsoom Ghias (Aga Khan University), Tatjana Topalovic (DEIJBJ Consultant), Nariell Morrison (University of Warwick/UCL) and Ugo Caramori (University of Campinas) and Danica Sims (University of Oxford). This international and culturally-mixed powerhouse of speakers took us through a decolonial gaze on pedagogy, curricula and research. Lionel explored the notion of ‘being a guest’ at a patient’s bedside table, and the colonial legacy of doctor-patient hierarchy- calling for a social accountability of medical schools. The importance of integrating Indigenous knowledge and language to support health systems was discussed, looking at it not just as a cosmetic addition to a curriculum but a critical integrating to not just dismantle colonial systems, but construct intentional new visions. He highlighted the importance of humility in decolonizing efforts- whereby cultural co-existence and not relativism is centered, where western knowledge is not the unquestioned core of medicine. Ugo delved deeper into the tacit education about cultural agreements in medicine, which implicitly communicate what knowledge gets valued, who gets valued, and if assessment teaches belonging or conformity. Quoting one of my heroes Paolo Freire, Ugo said “Reflection without action is verbalism, Action without reflection is activism”. Ugo called for us to move towards a pedagogy of discomfort, towards an education that asks ‘what new freedom is possible'? and how we can liberate us from the oppressive structures lurking in our institutional shadows. Nariell ‘brought it home’ by exploring decolonisation in research. She started with the question ‘can you truly decolonize a system build on colonialism?’ Decolonisation ended, but coloniality did not. Nariell reflected on her own frustrations that despite doing all the ‘inclusivity’ actions in her own research- from reflexivity statements to participant-action research- she felt that the academic systems of scientific articles as reputational currencies meant that she still benefits more from the research than the people she did the research about and for. She fervently highlighted that representation is not enough, questioned whether reflexivity statements in research actually bring about change, and underscored that decolonisation is not a checklist. Rather, it is an ongoing decolonial practice. I would however argue that Nariell herself, and the other scholars at this session, are already steps towards decoloniality by being stewards of change and an inspiration to others. It was unsurprising that there was an endless line of people with questions and comments. My main takeaway was this: it is comforting to know we are not alone, but it is discomforting to see how much there is still to do. But I guess that is the case for any odyssey. From theory to practice: a collaborative workshop on social justice leadership competencies in health professions education We won a prize! This stop in our odyssey was one of a battle; a battle of pitches! Jamiu Busari and Snoor Bayazidi led this session in a creative way: they tasked us to sit in small groups and brainstorm a concrete action plan to integrate social accountabillity in healths profession's education. I was grouped with mighty co-warriors Gönül and Nathanja van Moppes (Amsterdam Medical Centre). We were the ‘bridge’ team and our plan centered on this: We believe that people are inherently good, but may be 'blown off the path of good’ by institutional structures and barriers. It is up to leadership to transform these systems, but they themselves need support too. Our proposal is a transformational leadership course, with modules contesting ego, boosting critical self reflection and pedagogical caring- with the ultimate goal to arrive at a holicratic (google holicracy), bottom up system where every member of education is democratically represented. Leaders are guides, not dictators. They are community builders, not owners. While my own competitive spirit was pleased that we won this eurovision-style pitch competition, the other pitches were equally inspiring. With suggestions more targeted at grassroots activism, to an orchestra of ‘unheard voices’ being heard, it was all in all a lovely collective learning experience. Jamiu and Snoor brought an absolutely warm and energising spirit to the room (and I would suggest they look into careers as gameshow or talent show hosts if they ever want an alternative to their already accomplished academic careers). Fostering Inclusive Environments for Professional Identity Formation Gisela, Gönül and I all found our way to this session of short, yet impactful, communications. Here, the summary: Ellen Pearlman &amp; Immigrant Status USA “They assume you don’t know things” was the title of Ellens slide. She took us through stories of students with a migration background. I was introduced to the concept of ‘1.5’ immigrant (someone who moved at a young age and grew up in the new country). Similar to Nikki’s talk in the Adaption and Acculturation session, Ellen has found that students with a migration background are often interpreters, having to perform additional tasks of translating for patients to their team. Translation in this case becomes both a source of connection, advocacy and relief, but also a liability, minority tax and source of moral distress. Given the technological advancements of today, it is genuinely unacceptable that translation tasks fall onto students already facing structural barriers. Another reasons why DEI work needs more funding and attention. She introduced the concept of ‘conditional belonging’ whereby students need to balance being different just enough that it is an advantage, but not too much that it does not conform to the dominant ideals of medicine. Relating it to my research on the hidden curriculum, this is a pattern throughout medicine whereby diversity is not given much meaningful space, where one way of being is implicitly communicated as the best and only way to succeed. Audrea Burns &amp; Burnout and Moral Injury USA Andrea presented her research on underrepresented (UIM) groups in medicine, who face disproportionate burnout and belonging. She explored the institutions ‘signals’ conveyed during times of social disruption, like anti-DEI legislation and global politics. She found that legal constraints and personal values/roles create moral injuries for UIM physicians, who have to balance their personal values and state laws (i.e. abortion services). She highlighted the structural betrayal of institutions who fail to protect UIM groups and general moral principles, to the point that physicians make career choices based on states, speciality or countries that have more human-oriented policies and structures, for their own personal safety and professional voice. Audrea explicitly said this was not the hidden curriculum- which I would contest as well as the inflexibillity and lack of support of an institution ESPECIALLY in a crisis sends implicit messages of what the actual values of an institution are. In either case, I was saddened to hear more about the political horror show for DEI colleagues in the US at the moment. Juliet Mathew &amp; The ‘Professional’ Doctor Malaysia Juliet’s research focused on appearance norms: what does a professional ‘look like’? She studied how medical students decide to dress and present themselves as part of their professional identity formation. She found that dress codes, informal comments, patient responses, teacher/peer responses all contribute to a homogenous medical ‘style’. She finished her talk highlighting the importance of authenticity and leaving space for expression, as opposed to a uniform ideal of what is ‘accepted’ or not as a professional. Neera Jain &amp; The House of Horrors USA Neera’s talk was an unforgettable experience, and probably one of the most touching talks of the whole conference for me. She approached her presentation in a very creative way- instead of a traditional presentation of themes- she represented these as different rooms in a ‘medical house of horrors’ with each room representing a different horrific encounter a marginalised medical student (i.e. racial or abled minority) finds in their education. I’ll do my best to summarise her harrowing tale: medical students start at a ‘no trespassing’ sign indicating they are not welcome if not conforming, or that they will remain hidden once they do enter the house of medicine. Thereafter, they find themselves trapped in a hall of mirrors, riddled with isolation, hyper-visibility and many obstacles. Room 2 is a dark room with hidden monsters, and fake advocates/allies that do not truly support them in this scary mansion. However in room 3 they find their fellow ‘misfit’ squad, where they can build a community of care and allies against this horror show. Nevertheless, throughout this journey they have to give up their own health, push it to the limit and go all in in order to survive. Neera’s choice to present her research was not only effective and memorable, it was inspiring to look at alternative formats for science communication that actually work. Hannah Connolly &amp; Don’t Rock the Boat USA I was very excited when Hannah started her talk with a reference to Pierre Bourdieu’s system of social capital- as this directly related to my research in seeing medicine as a cultural system of hierarchy and norms. She drew on a concept of social reproduction, whereby medicine is a game (another similarity!!) where one needs to learn the rules (doxa), the feel for the game (habitus), how to even play (practice) and the structures (field). She found that medical students learn the following social norms: a) don’t rock the boat- get in and get out and stay silent or encounter professional suicide, b) awareness does not equal agency; structures of power prevent any action from being enacted, c) playing the game is a survival game in the end, you need to learn an implicit feel for the hidden rules. Play to learn, learn to care: a co-created board game approach to teaching health equity and game empathy This stop in my odyssey was a fun one- I got to play a game. As my own research is focused on playful interventions, I was intrigued by what international colleagues are up to. Pauline Luk and Mei Li Kong from the Li Ka Shing Medical University in Hong Kong presented their student-created game “health seekers”. This educational game is geared at raising awareness of health inequalities and raising empathy in its players. It was created based on interviews with various vulnerable community members in Hong Kong- facing disability, age, abuse, homelessness and climate change. We were introduced to the different characters we would play in this board game, and had little score cards where we could lose (or gain) money, health, wealth, happiness and empathy. The board game was a monopoly style game, similar to the digital poverty-stimulation game spent. As we pulled different cards, we had to decide how our players would react and gained points in empathy if we guessed correctly, and endure any consequences of where our character would land on the board (i.e. loss of friends, heat wave, injury). What made the game especially engaging was the use of props that stimulated some of the physical challenges the characters endure- whether it is blindness or muscle spasms. I got a headache from wearing blacked out glasses with a small hole for light simulating a glaucoma. It was an intriguing game, even if it did raise discomfort and questions. Playing the game for 30 minutes is just an inkling of the terrible reality these people face, so it could have arrived as either a form of poverty porn or a critical self-reflection of privilige. How do you teach empathy without stories? But how do you get these stories without extracting them from people? Did the real people the characters were based on get any help from the game makers or were they just used to make this game? I do think there was a lot to learn from the discomfort I felt playing the game, and am curious to learn more about how this game stimulates long-term perspective change in its players. Final keynote: Where the mind is without fear? by Vishna Devi V Nadarajah As an ending to the AMEE-Island, newly elected AMEE president Vishna gave a very engaging speech on the actual purpose of education and the importance of a global community and integrating planetary health. Her presentation centered around the work of Rabindranath Tagore- reminding us that he himself was educated by travelling the world and speaking to ‘real people’. A strong reminder to all of us in the ivory tower of academia. She highlighted the importance of preparing healthcare workers to work in an interconnected, everchanging global society- towars a transnational education. As an international migrant myself, having had the privilige to study and work in over five countries, it was a beautiful ending to such a global conference.</image:caption>
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