Dear Colleagues,
As more and more people return to on-site work, joining all of the folks who have been coming to UCSF and working throughout the pandemic, there has been great anticipation of a welcome resumption of in-person work, learning, and community-building activities. But frustratingly, this is proving to be a significant challenge. In parallel, Zoom fatigue is causing folks to be more selective about what they tune into, be it a meeting, course, or training – the numbers are down.
For those working from home for most of the past two years, you may have thought that the March 1, 2022, return to on-site was going to be like turning on a water faucet… and it was – but more of a dripping one. Reminder: we’re finding our way with hybrid work as well as with academic programs that now offer hybrid learning environments. The somewhat comforting news is that we aren’t alone in this struggle, and we need to understand that it’s going to take time and patience for us to figure out just what this post-pandemic world will look and feel like.
As you know, UCSF students are one of the brightest lights in my work life, and this month we’re going to learn about how we care for them…and how they are caring for our planet.
This month’s topics:
- A Warm Hand-Off: Returning learners to in-person instruction
- Students Showing Up for Climate Change: 2022 Planetary Health Report Card
I also ask that you please consider making a donation to UCSF’s Scholars at Risk Program in support of Ukrainian scholars, physicians, and learners.
Is there something on your mind that might make for a good Expresso story? Let me know at [email protected].
With best wishes,
Dan
A Warm Hand-Off: Returning learners to in-person instruction
Have you had this common nightmare? You’re in a classroom and realize you haven’t attended class for the entire semester, and now you’re sitting for the final exam. Feelings of panic and anxiety rise and cause you to wake up. What a relief, it was all a dream!
Alas, the pandemic is not something we’re going to wake up from and breathe a sigh of relief. It really happened. And those feelings of panic and anxiety? Well, they are also very real.
“There was no monolithic return to campus,” says Jeanne Stanford, executive director of Student Health and Counseling Services (SHCS). “It really depended on what program our students were in, and it’s a complicated story. Some people welcomed the return. For others, it was scarier.” By example, for some, the first time back on campus was to take a high-pressure exam, and there were those, particularly people with asthma, who nearly passed out from wearing an N-95 mask for eight hours while taking the test.
Stress levels run the gamut, and for many folks mental health played a big factor in how they viewed their return to on-site learning. Given the diversity of our population, Jeanne and her SHCS team witnessed a wide range of reactions from learners.
Some felt joy at seeing classmates after a sudden and prolonged absence from each other or – for the new cohorts – the first time ever. But others felt stirrings of anxiety, insecurity, and fear. Each experience was and continues to be unique, but since the pandemic, concerns have heightened – whether it’s loneliness, a fear of catching COVID, or trauma due to racial attacks, protests, or seeing loved ones become ill and die.
The SHCS team worked to support students through these experiences. “We offered additional groups for BIPOC well-being,” Jeanne says, referring to Black, Indigenous and people of color. “We did healing circles, we partnered with the Office of Student Life, and we helped students who got COVID or were exposed to COVID and missed classes and rotations. SHCS nurses checked on students to provide connection, food vouchers, and support during isolation.” Given all of that, the service continued to see an uptick in mental health appointments. Thankfully, over time the stigma around seeking help for mental health has been lifting. “In regard to mental health,” Jeanne says, “telehealth was the silver lining. It allowed people to reach us wherever they were.”
And in some cases, progress is made incrementally. Consider this situation: spring 2020 – sudden shutdown. A student who is an extrovert became isolated and, with no family nearby, depressed. Weight gain ensued, and the individual sought help from SHCS and started therapy. SHCS increased the number of sessions due to the level of anxiety over returning to in-person instruction, talking about the individual’s social anxiety and fear of being judged. When the academic program gave the option to attend class in person or via Zoom, the learner chose Zoom. After about a month, the individual was able to go to a school-sponsored celebration and community event. They reconnected with someone they knew, and it was reassuring. There was no judgment. They found a common interest in research and discussed the possibility of a partnership. Thanks to this positive outcome, the learner felt encouraged and willing to try attending class in person.
Pre-pandemic, SHCS was able to do what Jeanne calls a “warm hand-off” – when a student comes in with, say, a sprained ankle or some other physical ailment, and the care professional senses a need for mental health counseling and just walks the student down the hall. This is especially important if someone comes in after experiencing trauma from violence. The pandemic made providing this level of care extremely challenging, but clinicians and counselors are trying to make a potentially awkward and abrupt transition as smooth and thoughtful as possible. Jeanne hopes to return to on-site, warm hand-offs as the threat of the virus is mitigated and people seek more in-person help. While counseling appointments remain virtual for now, SHCS will offer private office space to learners for their mental health appointments, if that’s their preference.
Hybrid work and education are here to stay, and for many, online appointments provide a greater sense of safety, security, convenience, and privacy. All of the reasons our learners went to SHCS before COVID-19 still happen and are now compounded by the impact of the pandemic. Whether over video or in person, the most important thing we need to do is make sure they seek the help and care that’s available to them, thanks to the professionals who make up the SHCS team.
Students Showing Up for Climate Change: 2022 Planetary Health Report Card
Everyone here knows that climate change is having a detrimental impact on our lives, e.g., drought, wildfires, food insecurity, extreme weather, climate migration, among many others, so how well are we training the next generation of health care providers and researchers to confront this multi-faceted threat to human health?
That’s where the Planetary Health Report Card (PHRC) comes into the picture. Founded in 2019 by four UCSF School of Medicine students (Karly Hampshire, Nuzhat Islam, Bennett Kissel, and Colin Baylen), the PHRC seeks to inspire and support planetary health engagement among health professionals. To summarize the basis for this tremendous undertaking would do a disservice, so I hope you’ll read about it in The Lancet Planetary Health and view the PHRC website.
School of Medicine students Gunnar Mattson, Valerie Kahkejian, and Alison Chang, along with faculty member Katherine Gundling, led the UCSF PHRC this year, and the report card has us as third overall in the U.S. (and UC Berkeley-UCSF Joint Medical Program is second).
For 2022, UCSF received an overall grade of B+ (up from B in 2020 and holding steady with our B+ in 2021). Below are our individual grades for the four PHRC topic areas, along with comments from the contributing reviewers.
Curriculum, B-
- While climate health content is integrated throughout the preclinical core curriculum, these topics are sparse and limited in their depth as it is associated with only two testable learning objectives. However, there are ongoing student and faculty efforts to implement the Climate Health and Sustainability Education (CHASE) curriculum.
- We recommend more substantial discussion of and engagement with planetary health (PH) topics, such as those covered by the Inquiry Immersion Mini-Course on climate change. Additionally, clinical training could be improved by providing students with strategies on how to counsel patients affected by climate change.
Interdisciplinary Research, A+
- The EaRTH Center, Program on Reproductive Health and the Environment, the Office of Sustainability, and the University of California Center for Climate, Health, and Equity, housed at UCSF, all provide interprofessional opportunities for environmental health engagement in addition to research and funding opportunities.
- Similar to the EaRTH Center’s Stakeholder Advisory Board, we encourage the broader SOM to consider institution-wide strategies for incorporating the feedback of community members disproportionately affected by climate change.
Support for Student-Led Initiatives, A-
- The administration is supportive of student-led PH initiatives, offering time, funding, and enthusiasm for student work. The Environmental Scholars Program and Carbon Neutrality Initiative fellowship are funded opportunities for students to engage in planetary health at UCSF.
- We recommend the institution have a student liaison who represents sustainability interests and serves on a medical school or institutional decision-making council to advocate for curriculum reform and/or sustainability best practices.
Campus Sustainability, B
- UCSF has robust waste reduction, water conservation, toxics reduction, sustainable food, energy efficiency, green procurement, green labs, and education/engagement efforts.
- The university has committed to achieve carbon neutrality by 2025. Despite current efforts, only 62% of total energy consumption is clean and sustainability criteria only require 25% of indicated products and services to be from sustainable sources. Efforts must be substantially expanded to meet carbon neutrality by 2025.
The full UCSF report contains an impressive level of feedback with further detailed scoring and analysis, and I encourage you to take the time to read it.
While the PHRC may have its origins at UCSF, the evaluation is completely impartial. By the numbers, the 2022 report card was made possible by 74 participating teams in seven countries (U.S., United Kingdom, Canada, Ireland, Germany, Japan, and Malaysia), comprising over 450 medical student leads and 94 faculty mentors. The rapid growth of this initiative since its founding in 2019 is a testament to the growing movement of health care professionals recognizing the health threat of ecological destruction and seeking to advocate for change within their spheres of influence. And it’s working – their feedback survey this year was rich with examples of how the PHRC is already catalyzing institutional change. In addition, 39 of the 50 schools participating for a consecutive year have improved their score.
For an overview of the entire outcome, check out the 2022 Planetary Health Report Card summary report, which summarizes the incredible efforts of student climate leaders around the world. But if video is more your vibe, then tune into the Earth Day video, which tells the story best, featuring testimonials from the participating teams about what PHRC involvement has meant for them.
And the PHRC is gaining traction to transition into an interprofessional tour de force with the addition of nursing and pharmacy pilots. For more information, visit the new nursing and pharmacy pages on the PHRC website.
Once again, our remarkable students are catalysts for global change – read more!
Dan’s Tip of the Month
The new PBS series Changing Planet is a stunning, unprecedented, ambitious global reporting project to monitor climate change in six of Earth’s bellwether biomes. Conservation scientist Dr. M. Sanjayan is our guide, traveling from California to Kenya to Cambodia. Featuring the latest in science technology, Changing Planet also explores how communities are taking pragmatic actions to turn the tide of climate change. And you’ll learn about surprising animal behaviors as species adapt to their changing habitats. Season 1 has just aired, and PBS and Sanjayan plan to return each Earth Day for the next seven years. Yes, the series boldly faces the serious consequences of climate change, but it will also give you reasons for hope.