Hello, everybody. Hello and welcome to FITFIRE 2021, Reimagining Our Future. I'm Charles Kenyon, and I'll be hosting today's session along with Donald Kasitnam. The past year has been a constant challenge, but I've been blown away by the support of Team Physiatry as we navigate the pandemic together. In particular, I would like to take this moment to recognize the resilience of our in-training members as we have not only adapted, but thrived. Today FITFIRE will feature six of our incredible in-training members as they share their interests parallel to medicine as we reimagine our future and get to know our future leaders that truly make physiatry a unique and promising field. In terms of disclosures today, Dr. Suterer does earn compensation from ads that run to the beginning of his YouTube videos. Otherwise, the speakers have no relevant financial disclosures. Our objectives today are as follows. We will reflect on the 2021 Annual Assembly theme of reimagining our future, identify unique perspectives, facilitate ongoing dialogue, and highlight rising thought leaders in rehabilitation and medicine. So what is FIT? FIT stands for Physiatrist in Training, and we function to amplify the resident and fellow voice within AAPMNR. We serve on various committees and advocate for both in-training members and crucial issues affecting our membership as a whole. Today will be the third iteration of FITFIRE in which we highlight in-training physiatrists sharing their passions parallel to medicine. We aim to reflect on the Annual Assembly theme, which of course this year is reimagining our future. Today, we will have a total of six presenters. Each will give a five-minute presentation, but the twist is that each of these presentations is 20 slides in length and will transition every 15 seconds, creating a fun but challenging public speaking task. At the end of the presentations this year, we will have an audience vote to determine the 2021 FITFIRE Champion, and this year's winner will again receive the much-coveted High Five Award. In 2018, we launched FITFIRE with reflections on success through innovation, and we featured speakers on topics from space medicine to adaptive sports, and were ecstatic to award the inaugural High Five to Dr. Matt Terwitz for his thought-provoking presentation on implicit bias. In 2019, we brought FITFIRE to the big stage in San Antonio, where we had a dynamic set of presentations from resident wellness to emerging technologies in telehealth, with the 2019 High Five ultimately going to Dr. Alexa Royston for her insightful research into maternal leave policies throughout medicine. We took a break in 2020, but we are back with a brand new team. As a father of two toddlers, I've grown fond of the model of teamwork in the PAW Patrol, each member having a unique set of talents to save the day. So without further hesitation, let me introduce you to our physiatry patrol. Dr. Anders is a PGY2 at LSU's PM&R program. After his undergraduate experience, he spent five years engaged with Teach for America in South LA. He will share today how these experiences shaped his perspectives in medicine. Dr. Jason Chang is currently a PGY3 at New York Presbyterian. He's passionate about helping improve the function of people with chronic conditions. Today, he'll be sharing his insights into how technology can provide valuable resources, improving accessibility and optimizing quality of life. Dr. Chavez is currently a PGY4 at UT Southwestern, and she believes that all patients should have access to equitable care. She has a passion for research and health disparities and will be sharing her research with us today. Dr. Anita Lowe-Taylor is a recent graduate of the Stanford PM&R program, and in addition to her clinical interests in electromyography and musculoskeletal medicine, she has developed an interest in the health effects of climate change. Dr. Evelyn Chin is currently a third-year resident at the University of Washington. She's interested in functional outcomes of patients in a variety of rehab settings. However, Dr. Chin is also a talented artist, a quality that she shares with her patients in her humanistic approach to medicine. Dr. Suterer is currently a PM&R sports medicine fellow at the Mayo Clinic in Rochester, Minnesota. He is passionate about teaching and education, and he has expanded his reach outside of clinic with his YouTube channel and has now reached over 500,000 subscribers. As you, the audience, learn from our speakers today, we ask that you judge each on a rigorous set of criteria, taking into consideration their gusto, pizzazz, moxie, charisma, and panache. With your help, we will crown the 2021 FitFire Champion. Lastly, we hope that today's conversations will help spark your interests and passions. We encourage you all to reach out, try something new, and to continue to learn from each other as we thrive in 2021 and beyond. Thank you again for tuning in today. It is our pleasure to introduce our 2021 Physiatry Patrol FitFire speakers. We will begin our session today with Dr. Alpha Anders. Thank you. Hi, everybody. My name is Alpha Anders, PGY2 of LSU's PM&R program, and let's kick it off with lessons from the digital classroom, re-imagining the physiatrist clinic. After graduating from college, I joined Teach for America and taught seventh grade integrated science at Scarborough Middle School in South Los Angeles. It was a lot of hard work, but totally worth it. I got to nerd out with young scientists every day. Coaching football, that was just the cherry on top. Thanks to a very generous grant from the Bill and Melinda Gates Foundation, I had 10 desktops, and get this, 20 laptop computers in my classroom. And at the beginning of each day, students checked out an iPad. This allowed me to re-imagine my classroom. I ditched the traditional model and flipped my classroom. Instead of standing at the front of the class lecture, my students would watch my video recorded PowerPoint lectures. This freed me to run around the classroom like a wild man to engage directly with my students and individualize their learning. Confession time, I've loved video games since day one. The most trivial, meaningless video game award would keep me logged on way past bedtime. I wanted to tap into this dopamine circuit in my classroom. Units were levels, lessons were missions, projects and labs were bosses, and defeating a boss, that earned you a badge. My class was the Skirball Space Odyssey set in the year 3016. Excessive greenhouse emissions, global warming, melting ice caps, rising sea levels, deforestation, poaching, acid rain, nuclear warfare, all led to the destruction of Earth. My students were on a mission to make an eco-friendly colonization plan of an alien planet. So this is a screenshot of one of my students' digital portfolios. At the end of each mission, students uploaded their completed project or lab to their digital portfolios, and I was able to grade their work from my computer. And this was way before the pandemic turned everybody's school online. My class started with a Do Now Google survey that informed me the part of the level of mission each student was on. Mission started with a pre-recorded video PowerPoint lesson. Each video had embedded multiple choice questions that generated real-time data on student understanding. I was able to review that info in the moment. Students that demonstrated understanding of the material, they could go on to work independently or with a small group. Students that had more difficulty worked directly with me in small groups. Once students finished the capstone project, they earned a badge and could move on to the next mission. So let's compare this to the traditional model on, let's say evolution and adaptation. The teacher would lecture about some animals and their adaptations. Students would read the textbook, maybe complete a worksheet on the topic. They're then going to take a quiz that tested rote memory frequently about definitions. In my classroom, students discovered an alien animal that evolved unique adaptations. They explained how each adaptation helped their animal survive in its biome. Successful completion of the project Successful completion of the project, well, that earned them the alien badge. The rest of this talk will focus on elements of the digital classroom that are perfect for the digital clinic. I'm going to focus on readily available technology that could theoretically be incorporated today. One day, all physiatrists will have access to robotics and AI, but that's not today. Like in the classroom, many of these digital elements supplement traditional practice. Technology can't replace hands-on learning in the classroom. Technology also can't replace a hands-on physical exam. I propose leveraging technology to flip the clinic and free up time to work with the patient. And yes, these things can be challenging for an aging patient population. But one of the many things this pandemic has taught us is that people of advanced age can access technology with support. My 85-year-old grandma's last desktop ran Windows 98, and here she is kicking it on Zoom. Patients could complete digital intake forms and draw symptom distributions on a cartoon that auto-populates into the note. The physiatrist could efficiently review the responses with the patient at the start of the encounter, update the note, and save precious time. The video exam can capture elements that are just as important as the bedside exam. Watching a patient complete ADLs and transfers at home or watching an athlete perform dynamic movements in the gym or on the field provide clinical information beyond a five out of five strength scale. Widely available wearable technology can yield objective data. In addition to steps, smartwatches can provide information on exercise frequency, duration, and intensity. In patients at risk for falling, pressure monitors can provide orthostatic data, and biosensors can provide information about full frequency and posture. With all the time saved by technology, the physician can truly flip the clinic and focus on patient education and elements of the treatment plan seldom completed during an encounter. Better than a printout, better than a video is time spent with the patient teaching the different movements in a home exercise program or the plan. There are already an overwhelming number of health-related apps. We can identify solid diet, nutrition, fitness, meditation, mindfulness, and Tai Chi apps or YouTube channels to recommend to patients. Some of those apps can even provide more objective data to fill in that note. Like an advanced student, too often a patient with an improved ailment returned to clinic a year later to report their symptoms return after stopping physical therapy. Utilizing technology and tele-rehab to differentiate follow-up can maximize clinician time and prevent relapse in low-needs patients. Like a flipped classroom, the flipped clinic can leverage readily available technology to gain more comprehensive picture of our patients, streamline our clinical encounters, and free up time to focus on elements of patient care that can go overlooked. Well, thanks for tuning in. I hope you enjoyed my presentation. All right, great job, Dr. Andrews for all of us. So that was very interesting. Next, and we'll have time for questions later. Next, we have Dr. Jason Chang, who's a resident at New York Presbyterian, and he'll be speaking about the similarities between magic and medicine and how he's been able to utilize that. Thank you for the introduction. I'm Jason Chang, a resident physician at NYP Cornell Columbia. And today we're going to talk about the similarities of magic and medicine. So performing magic at UCLA's Ronald Reagan Hospital as a medical student there, I could never forget the smile on the face of the boy with leukemia after I magically pulled out a coin from behind his ear. I was able to provide misdirection and a temporary respite from his illness through magic. Although I've witnessed firsthand the relief my magic performance has brought to the patients, the effects were actually very transient. I wanted to do more, and so I embarked on my journey in medicine. I quickly realized that although we have many medications and procedures that we can utilize to treat diseases, there are still so many chronic conditions that we do not have solutions to. And so I was automatically drawn to the philosophy of PM&R. PM&R brings powerful relief to best help patients cope with their chronic conditions, optimize their function, and live their lives to the fullest. Just like with magic, a person's perception, perspective, and experiences are their reality. Magic has a lot of similarities with rehabilitation medicine. Pain scales are all subjective. If a patient says an intervention helps, then it helps, even if it's just placebo. If a patient believes they achieved their goal, then the goal has been reached. A patient's perception, reports, and goals are their reality. These goals and symptoms are what's important to the patient. Patient-reported outcomes are so essential because it tracks what matters to optimize the patient's quality of life and satisfaction. And you can only improve what you measure. And so during medical school, we actually built an app to allow collection of patient-reported outcomes. Patients can see their improvement over time, find support from others going through similar conditions. Our mission is to empower patients, and utilizing these patient-reported outcomes accelerate treatment innovation. This is an example of symptom improvement after carpal tunnel relief surgery that has been crowdsourced on our platform. Grip strength starts to improve by day five, and pain and neurological symptoms start decreasing, as you see in this chart. In order to continue tracking what matters, we actually built a whole dashboard where physicians and investigators can send out customized patient-reported outcome questions and also validated surveys directly through the application. Here is a case report of a patient who underwent fall-long video exercise, videos to decrease pain and spasticity, and improve his range of motion. Push notifications further improved adherence to the therapy. Initially, we did hip adduction exercises that helped with groin hygiene. Elbow stretching exercises were also incorporated, and after just five days of compliance, the right elbow extension improved by 60 degrees and left by 80 degrees, as you see in these pictures. Ever since the patient started the exercise regimen, pain and spasm improved, allowing for discontinuation of standing Motrin, Tylenol, and Valium PRN. This case report demonstrates that there is improved pain control, minimizing the usage of pain and spasticity medications through the application of consistent standardized stretching exercises via the digital app. We're expanding the program to more cerebral palsy patients to meet them at their homes. At Cornell, we're launching a study to optimize the number of sessions of patients receiving extracorporeal shockwave therapy for different tendinosis of the rotator cuff, Achilles, and patellar tendons through tracking patient report outcomes via the app. These tools in rehabilitation empowers patients and brings them in as an active participant of their treatment team. They live most of their lives outside of the clinic, and so this provides a way to bridge the gap between clinic visits, ultimately improving outcomes in a very scalable way. By utilizing these tools to seamlessly collect patient report outcomes, it allows for rapid crowdsourcing of invaluable information and creates a two-way communication to accelerate treatment innovation. As healthcare becomes more of a collaborative environment, patient report outcomes will continue to play a larger role and will likely also become a requirement for insurance reimbursement in the future as well. Digital technology will fulfill this need in order to bring the patients and their patient report outcomes to center stage. In magic, the best illusions are when the audience is at the center of the show, and every action is to maximize their enjoyment. Similarly, the best medicine all begins and ends with the patient. Thank you very much. Great job, Jason. Thank you for the presentation. Yeah, these are all really great ideas. Next up, we have Dr. Audrey Chavez, who's currently a resident at UT Southwestern, and she'll be talking about her experience being part of a large research team looking at post-stroke care over at UT Southwestern. Hi, everyone. My name's Audrey Chavez, and like Donald said, I'm from UT Southwestern. Oh, sorry. Let me restart this. And today, I'll be presenting Strokes on a New Canvas, Painting the Picture for a NeuroRehab Collaborative Approach led by residents. So first, let's get into the what and why. So research works to help create and expand the body of knowledge for a specific specialty. Without expanding this, we risk complacency and inadequate care for patients. And in addition, scholarly activity is a requirement for residency, and we all know that this requirement is getting even more involved in the near future. And lastly, research in residency is hard. So we're here today to help you get some ideas on how to make a successful resident-led research team. Now, like a lot of things, this started with an idea. This particular idea was a project that combined my interests of stroke rehabilitation, health disparities, and clinical research. Once I identified these interests, then came the next step, finding a mentor to help me execute these interests. Now looking for me and my co-resident who had similar interests, we knew just the person, Dr. Ofejika. We asked and got the enthusiastic yes, and with it came an introduction to research and the start of a new passion for us. So with the support of our attending, we were able to bring our ideas and create a resident-led team for our projects. This team includes our attending, nursing, therapy, PhD researchers, statisticians, a sponsor, who in this case was our chair, and even other specialties. As we navigated this team, we realized we had created something special. So we decided to make a roadmap for others who hope to do the same. We came up with a few key elements in building a successful resident-centered research program. So let's take a tour through this gallery, starting with resident initiative. Residents identify a scholarly interest and career goals, and then a mentor who shares these interests. In order to help facilitate finding these mentors, we recommend making research attendings visible by promoting them in intentional, educational, clinical, and mentoring experiences. Consistent mentorship is also a very important aspect to this. This is done through regular meetings, as well as a comprehensive mentorship model in which residents can also act as mentors to younger trainees. Launching opportunities allow for residents to develop and execute research ideas through departmental and institutional events. One of our events is a Shark Tank thing, where you get to present your idea and compete for funding from sharks. Interdisciplinary collaboration results in holistic hypotheses and lasting relationships, which can help continue the production of valuable research. So now that we've got our key elements down, let's go ahead and go through the roadmap that led us to our results. So as we talked about earlier, the research team foundation consists of the residents, the primary mentor, a sponsor, secondary mentors, and collaborators. Residents then take ownership of their own research projects, while also assisting in projects led by peers. In this way, you're able to be a leader and also a collaborator, which simulates research in your career future. Next, the primary mentor vets research questions and provides guidance and structure throughout the entire research process. The sponsor cultivates opportunities for promotion of resident research. Secondary mentors and collaborators help strengthen the team with their diversity of knowledge, their own individual skill sets, and their experience. And then all of these together lead to our outcomes, which include lasting collaborative relationships, pay it forward mentorship, and dissemination of research through publications and presentations. So by creating this special team, we've been able to create various excellent projects that are currently in different stages of production, from data analysis to manuscript revisions. There are currently six projects to date, which include health disparity projects, and there's more being added even as we speak. Another big aspect of our team is the pay it forward mentorship. Me and my co-resident who started this are PGY4s, and we have younger residents we mentor. They're also leaders in their own projects and mentoring younger residents as well. So in conclusion, find your passion, get a mentor, build your team, and bring physiatry into the future by continuing and augmenting our knowledge to share with others. Thank you. Great job, Audrey. Next up, we have Dr. Anita Lowe-Taylor, who's a recent graduate from Stanford. She's probably one of the greenest people I know, so she will tell us how to, you know, help the environment while practicing safe medicine. I take that as a compliment. All right. So again, my name is Anita Lowe-Taylor, and the title of my talk is Smoke Signals, the Future of Physiatry in a World on Fire. So I'm going to tell you a story. It is a loosely true story that took place this past summer. This story is about a patient who I'll call John. John lives in California, and he has a high spinal cord injury. This past summer, John found himself yet again enveloped in particulate pollution from wildfire smoke, and he learned that droughts and rising temperatures have desiccated the Western U.S., contributing to six of the top seven largest wildfires in California history. And that map on the right is an actual smoke map from this past summer. This matters because wildfire smoke increases the risk of COPD, respiratory infections, heart attacks, strokes, and even COVID-19. And thanks to wildfire smoke exposure, John's list of health conditions starts to grow. With California on fire, John's decided he's had enough. He decides to pack his bags and escape the smoke in the Pacific Northwest. But when he arrives, he finds himself yet in the middle of a historic heat dome, causing record shattering heat. And he learns that seven of the hottest years on record have all occurred since 2014. This matters because heat increases the risk of heat stroke, especially for people with disabilities as well as the elderly, and mass exacerbation, fatigue, and social isolation. Due to heat exposure, John's list of health conditions starts to grow. With California burning and the Pacific Northwest melting, John decides to pack his bags and escape it all by moving to the Northeast. But when he arrives, he finds himself trapped in a flooded basement as Hurricane Ida pummels New York and kills 82 people. He learns that natural disasters like hurricanes are increasing in both frequency and intensity. Now this matters because people with disabilities face daunting obstacles to evacuation, including power outages when they're dependent on power-driven equipment, debris, care disruption, and even psychological trauma. Due to the hurricane, John's list of health problems continues to grow. But what does John's now lengthy list of health problems and the U.S.'s now lengthy list of environmental problems have in common? The answer, of course, is climate change. But where does physiatry fit in a world that's literally and figuratively on fire? I would argue that to protect our patients, we belong on the front lines. Through patient care, education, and research, we can help our specialty combat the worst effects of climate change. From a patient care standpoint, we are uniquely positioned as a multidisciplinary team-based specialty to help our patients develop evacuation plans and heat and stroke mitigation strategies. The AMA has adopted a sweeping policy that supports teaching climate change across the medical education continuum. But today, no PM&R professional society has done the same. What if we all learned the science of climate change and the risk it poses to human health from the moment we entered medical school and continuing well past residency? On the research front, there's been a tendency to group vulnerable groups together when we understand that people with disabilities have unique individual needs and they are definitely not a homogenous group. Imagine if we understood the complex intersection between people with disabilities and other vulnerable groups, such as minorities, and if we could use this information to develop evidence-based natural disaster preparation and understand the long-term health consequences specific to our patient population. Imagine if we used technology to develop solar-powered assistive devices that function despite power interruptions or biodegradable medical equipment that dramatically reduces our specialty's waste and helps us achieve carbon-neutral practices. Imagine including people with disabilities at the table where the policies that affect them are being created and using their insights to develop policies that, for example, prioritize power turn-on for people dependent on electricity for life or function, or reduce transportation burdens through robust telehealth programs and make healthcare carbon neutrality achievable. We as a society can choose to see the smoke signals, to imagine a new world with physiatry on the front lines of climate change, and together we can start to put out the climate fire. That's it, thank you. Great job, Anita, and for clarification, that was a compliment. I know. So next up, we have Dr. Evelyn Chin, who's currently a resident at University of Washington, and she is going to speak about her love for art and then how she's been able to integrate that into medicine. Thanks, Donald. Hi, everyone. My name is Evelyn, and I'm going to tell you how I used what I learned in my high school art class to become a PM&R artist, also known as a physiatrist that creates art, and give some examples as how I can use it in medicine and patient care. My journey as a PM&R artist spurred from this high school art project where the task was to recreate a famous painting using only magazines, a glue stick, and scissors. The right shows the original Champs-Élysées painting, and the left is my partner and I's recreation of it. My next collage piece was created in medical school when I needed something to keep my mind off of all the studying, and I grabbed the only supplies I had, magazines, a glue stick, and scissors, and started creating. Often, people are surprised that these pieces are made from magazines. After that first project, I was inspired to continue focusing on medical art, so I wouldn't feel bad about not studying, and I always found the human body in medicine to be beautiful. So in 2016, I made two different interpretations of the art, again using collage. I began doing research in medical school on lymphedema and all-terrain vehicle crashes, which also inspired me to make art on those topics. I eventually gave these pieces to my PIs. The left is the lymphatic system, and the right is an all-terrain vehicle. My mentors love the art, and this led me to use art to help continuing foster relationships with those I work with. The left is some spine art I gave to my PM&R department in med school, and the right was given to my spine attending because he loved bunny. During my intern year at the University of Iowa, I made this Hawkeye art for my internal medicine prelim program to thank them for all they taught me. And to brighten up their walls. Here I gifted the internal medicine program director this piece during our intern year graduation. This was the first piece of art I created that I gave to my patients. I found that gifting patients artwork has added a positive outlook on their sometimes traumatic hospital visits and reminds them of how resilient they are and everything they have gone through and accomplished. I was initially giving rehab patients the stethoscope art, but I felt it could be even more special to give them art related to their injuries or pathology. I created these pieces of the spinal cord since I remember thinking how beautiful they looked and resembled butterflies in med school. I now give my spinal cord injury patients a print of the SCI at their level of injury to help them appreciate the beauty of their body and to look for brighter things in the future. Here you can see my interpretations of the lumbar, thoracic, and sacral spinal cord levels. Outside of patients and mentors, I wanted to find a way I could use my love for art and crafts to help my co-residents, the people I work with the most. So I picked up a new hobby during COVID. This was because a co-resident of mine wanted to learn how to make wall hangings as a way to relax after a long hours on the wards. So we learned how to do this together. The creation started off relatively simple. I used basic techniques I learned off of YouTube and was able to make some fun landscapes as seen here. This eventually evolved to trying to replicate famous artists as seen here, such as Hokusai, Wave, Matisse, and Van Gogh. These are a few of my favorite projects to date. I actually made the Wave on the left three times and started integrating my own techniques and patterns to make these. And what a time it was to learn how to make these. With COVID forcing people to stay in their homes longer, I got several requests from friends to make wall hangings to complement their home decor, and it makes me happy that people are using my art to enjoy their time quarantining at home. I went from making pieces with and for my co-residents working with patients. One patient I was taking care of was making a latch hook smiley face in their hospital room, and I weaved it into a formal wall hanging for the patient. It was a really fun collaboration. During rehab residency, I've slipped art into my own learning and home decor as well, while reviewing the brachial plexus, I created this simple wall art in my apartment so I can look at it every day without being completely traumatized. One thing I didn't expect was all the collaborations I can make and the overall love people have for art. At the VA, I met a housekeeper and we learned that we both had a passion for art. On the left, I gifted him a wall hanging and a small print of a stethoscope he'd seen, and on the right is a painting he made for me. This mutual appreciation for art led to a formal collaboration. Here's a stained glass heart you saw earlier in a poem he wrote about a stained heart. These two pieces perfectly complement each other, and we put them together and showcased it at a formal art show. Now, since seeing the response people have had with art, I've tried to spread my appreciation for it to my co-residents. The left shows a wall hanging I made to decorate our inpatient workroom. I also started the trend of having our residents create a ceiling tile at the end of their inpatient rotation. Now, since seeing the response people have had with art, I want to say that all physiatrists can be artists, whether it's going to art galleries, paint nights, or having coloring contests. I hope this inspires you all to consider incorporating art into your rehab journey. Thank you. Thank you, Evelyn. Those are really amazing what you were showing. You know, as someone whose best creativity is just building Legos, I would say I'm very impressed. Next up, we have Brian Suter. He's a sports medicine fellow at Mayo Rochester. He was unfortunately unable to make it today due to a conflicting schedule, but we have a recording for him, so we have that played. Hope you enjoy. Uh, Donald, we can't hear anything. Try to Charlie. Are you able to maybe turn on your microphone? Um, when you go to screen share, you need to make sure that you click share sound with it. Yeah, I'm going to show you a little bit of the final piece that we have. Good morning everybody. My name is Brian Suter and I'm a current sports medicine fellow at the Mayo Clinic and I'm excited to be talking with you all this morning about my experience with education and YouTube. So imagine yourself one evening sitting there watching your favorite NBA team play when all of a sudden your favorite player steps awkwardly, looks like somebody maybe hits them on the outside of their ankle and it twists funny and you get concerned when you see them go down in pretty significant pain. Now, of course, the commentators on the broadcast are looking at what happened, talking about it, saying things like, man, it kind of looked like he got rolled up on funny or boy, it looked like he was grabbing high up on his leg and you're curious about what exactly happened, what's going on in his ankle that could have led to this injury. So of course, like any interested sports fan, you go to YouTube and you look for clips of what happened and up pops this video of some doctor talking about the anatomy, the mechanisms of these injuries. You watch through the end and by the end of the video, you're leaving comments like this that you actually learned something. So this is my experience as a YouTuber. I've got around three years experience making 360 or so videos and I'm able to take educational content related to sports medicine to make it more fun and exciting and they've been very fortunate to grow a pretty sizable audience. The whole concept came from this idea of, well, textbooks are kind of boring, it's hard to relate to, it's hard to get people excited and learning, but if we can relate that content to their favorite athletes, their favorite sports, then suddenly we get this much more exciting and robust experience to get them engaged. So what you're able to do is take this list of what looks like very boring, very mundane topics for any sort of young learner and convert it into now these exciting, relevant, applicable videos because they're familiar with the athletes, they're familiar with the sports as well. What I'm able to do is take some really cool online 3D real-time anatomy software, combine that with the stories these athletes and learners are seeing in their sports fields and at the end you get this really awesome product that's both relevant and exciting and gets students engaged in learning. Social media is extremely powerful. Your colleagues are on it, your patients are probably using it and all future colleagues and young learners right now are using it and it's great because the classroom that it provides has no walls and you can truly reach everybody out there through social media. This is just a demographic here of the fact that I can reach 100,000 people in Norway or Poland is mind-blowing and well as the age distribution that I can see from who I can reach through social media with YouTube. So is YouTube specifically for you? Well, there's a lot of pros. It's a visual learning platform. It allows you to be more long-firm. It's personable with people seeing and hearing you but requires a steep learning curve and some technical expertise compared to some of the other social media outlets. Things like Twitter, quickest, easiest. A lot of your colleagues are probably already there. Instagram is great for quick kind of more visual posts like infographics and kind of short form videos and don't laugh but TikTok is actually more viewed currently than YouTube and is where all the kids are at these days. When you're thinking of material, find your unique topic that you're passionate about and what is gonna separate your page or your channel from everybody else. Remember that your growth and your learning are a lot more important than any numbers or followers. So pick a topic that you really are excited about and just get started. You gotta realize that when you first get started with this, it's going to be extremely awkward when you open up that camera, see what you actually look like and sound like for the first time, but you can practice. Use things like Snapchat, Instagram to get those reps. To make it a success, there's no perfect formula. You've gotta have, whether it's a regular posting schedule, posting when you have time, you just have to be patient and remember why you started all this. My growth was certainly not explosive and was more steady just from continued work. In terms of equipment, honestly, the best cameras in the world are usually in your pocket with your cell phone. Remember that audio is king and gradually grow up your equipment as you progress. As you can see from my first video that's super cringy to look back at to one of my more recent ones where it's more refined. Don't forget when you're on social media that your patients and your colleagues are gonna be watching and reading what you say. So make all of your content assuming that your grandma's gonna be watching and that way you'll definitely be safe. And remember, the drafts folder of Twitter is a great place to store things that you might not wanna put out in the public. Some pro tips, don't overthink your content. Remember that simple is better. I'm always amazed at how basic of material people are fascinated in learning about, even though I think it might be too simplistic. If you think it's interesting, the chances are other people are gonna find it interesting too. And be prepared finally here because I guarantee you if you engage in this, you're gonna make connections with future learners, colleagues, patients, and you're gonna simply reach more people than you ever could educate and impact simply by staying in your own clinic. Thank you very much everybody and enjoy the rest of the morning. Thank you. Awesome guys. So that is the end of our presentations. So you finally got to meet our physiatry patrol. I'd like to just first say like congrats to all six of them, not only for their presentations, but also all the work and talent that took to lead up to these presentations. At this point, we're gonna have a Zoom poll where you can vote for your favorite of the six presentations. So it's open now. So take your time to vote for those. And then the winner will get the high five. And we'd also like to open the floor for questions for any of our speakers. If you could type your questions into the chat and then I will go ahead and ask the different faculty members about any questions that come up. Currently there are none, but I also had a couple of questions for them as well while we're waiting for questions to come in. Let's see. The first, and if I could get the six speakers to go ahead and turn on your cameras as well. Great. So I guess my first question is actually to our first speaker, Alpha. I'm kind of wondering, you know, all of these great ideas you had, have you been utilizing the digital education in at LSU currently within the program? How have you been doing that if so? I have logged on and dabbled a little bit. I've been a little bit kind of adjusting to the learning curve of being a resident, but with the SAE coming up in January, I'm super excited to dive in. Awesome. Great. Well, thanks for that. I think it would be really interesting and good luck on the SAE. As a PGY2, don't set the bar too high for yourself. That's my only advice. Next, I actually had a question for Audrey. Audrey, I'm wondering, so, you know, I'm pretty familiar with the system. Dr. Efejica is, you know, kind of a unicorn a lot of times in the clinical world. So do you have any advice on how to find like a mentor to try to build these resident-led programs? If like, if the program didn't necessarily have like a Dr. Efejica who's very focused on research? So I think even, I think everyone, every program has at least somebody who's pretty research oriented, but they're just not necessarily people that you see every day. So I think one of the most important things that we found was really highlighting those people by having them be assigned mentors or give lectures or do some sort of rounds on rotations, even if they're not the regular attendings that are rotating through. That way the residents can see them earlier on and get more exposure to them and connect. Great, thank you. And then this, Jason, don't think I skipped you, but so one question for you is, and in terms of these platforms you're using, are you more so supplying the platforms or are you actually doing the research yourself? Yeah, so we built the whole platform from scratch with people that I met at the UCLA cafeteria. Yeah, and so we provide the technical expertise and collaborate with all of these researchers to push the cutting edge of innovation. And are you supplying this like as a free service or? Yeah, it's free. And especially at these academic centers. In the future, as we build more analytics, we really feel like the information can really push the frontiers of like what devices, what treatments actually work, especially in pain and rehabilitation medicine. A lot of the devices right now, we're just shooting in the dark, trying everything under the sun to see what actually works for the patient. And with more information, we feel like we could be way more targeted. That's really awesome. It looks like Dr. Anaswamy actually had a question for you. He wanted something for clarification. What does crowdsourcing mean in the context of individual patient pro data? Right, right, so great question. So initially when we first built the platform, we were just allowing patients to have their own like diary online where they can see their gradual improvement over time, especially in rehabilitation, a lot of the improvement is so slow. And so patients kind of get discouraged, but when they can see their progress, it really encourages them. And so that public platform is completely free and public for everyone to join different communities and support one another. And then we have a clinical trial component where we work with researchers and biotech companies, and that is private in terms of the information that gets crowdsourced. Great. And then I guess next up we have, well, I have a question for Anita. As a Texan, before I moved to California for the year, I didn't even know what the compost thing was for, the compost bin. So how would you recommend, in somewhere like Texas that doesn't seem as environmentally, I guess, sensitive, how would you go about reaching out to administration, your colleagues, and trying to decrease waste like you have done in California? Yeah, that's a great question. And I'm actually up in Montana now, so in a sort of similar climate environment as you are down in Texas there. And I have so far been surprised that there's still a lot of interest, but if you're talking about approaching an institution, what we found, because I did a waste reduction project at Stanford while I was there, is that it saves money. And so every institution, even if they're not really that invested in the climate crisis, they do wanna save money. And so we found that implementing recycling and reducing waste help with the bottom line. So that's probably the easiest way in on an institution level. Now, that being said, there are local environmental groups everywhere, and I'm sure Texas has a ton of them. So if you're interested more in things like policy or advocacy, I would say start local, reach out to your local chapters because they are generally more than happy to have healthcare providers involved. Yeah. It looks like Dr. Anaswamy has another question for you. What about insidious effects of climate change as opposed to disaster related changes in PM&R's role? Yeah, I mean, in five minutes, I could not go over all the effects on health that climate change has, but you're right. There are the more insidious effects as well. Food scarcity, drought leading to inadequate access to water. There's even evidence of emerging and changing infectious diseases that will affect our patient population, one because they're more vulnerable, but also we might see more cases of West Nile that lead to neurologic sequelae and then more patients that need rehab and that type of thing. So PM&R honestly is just dipping their toes into this arena and there's a lot of room for growth and research. We have barely any research in our field on this. Awesome. Thanks, Anita. Last thing is for Evelyn. I'm actually kind of curious, like how long does your artwork kind of take? And I know you kind of had like a bunch of different pieces, like how do you draw inspiration in terms of deciding what you want to do? Those are some great questions. Just wanted some thoughts on that. So if I have an idea in mind already, it can take me, it'll take me like a whole day to really get it all together. But once I have an idea, it's pretty quick. Getting the idea is the harder part. So I knew for a long time, for example, I wanted to do spinal cord injury art, but didn't know how I wanted to do it. Most likely through the collage medium since that's what I had done previously. So I actually started a piece maybe like December of last year, but then didn't really like how it looked. And then I had an interaction with a patient, inpatient unit. And then at that time I sort of re-inspired to get a closer look at that piece again. Sort of evolves over time based on my energy level and my environment around me, but very variable. Awesome. And I saw some texts about like, starting Etsy, which I definitely think you should do. We'll see how it goes. And then it looks like Dr. Answong is wondering, what's the life cycle of the art that you're no longer actively displaying or using? Are you talking about how long does it last? Like the quality of the art itself? Oh, I just have a pile of it somewhere in my, oh my gosh. Honestly, the prints of the art are better quality because of the medium I use, which is magazines and glue sticks. That doesn't seem to have a good lifespan. So I try to make prints of every piece just so it has better longevity. But then the originals, yeah, they're sitting in my parents' home. I did give one to a patient, but. I think Dr. Answong is going to be your first customer. I think that's what he's going to do. I don't think you want the original, to be honest. Yeah. Great. So if there are no other questions from the chat, you know, once again, I was very impressed by all these presentations. You know, we have, you know, some young leaders in our field. So I think PM&R is gonna, is in really good hands with a lot of different talents. And at this time, I'll hand it over to Charlie to talk about the awards. Yeah, just thank you so much, Yeah, just again, to echo everybody's fantastic presentations by everyone. Every year, like as we start out recruiting and getting to know a lot of some things that people are doing, it's really exciting. And I know we're all yearning for the day when we're meeting again in person and exchanging ideas and collaborating right there in front of each other. But it really is energizing for me to hear about all the passion projects that everyone is carrying forward. So like Donald said, the future is bright and we'll keep an eye on everything that's going on. And without further ado then, I'll have Chris pull up the poll results and we'll deliver the high five for 2021. Do we have the result of the poll? building to the suspense. Were you not able to see it? It was Evelyn Quinn for Chin. Everybody, high five up to Evelyn. Thank you to everybody and thank you for the audience for joining today. And we hope to have another great group and continue this on into the future next year. Thank you, Evelyn. Do you want to say any final words before we depart? Didn't expect to win because it was very exciting to see everyone else's presentation. So thank you all for the support. And yeah, I'm very, very appreciative of my patients and my co-residents for helping me make it possible and keep doing this fit on fire. It's very fun to see. Thanks, guys. Thank you, everybody. And thank you as always to all the support staff, APM&R and the Bizabo folks for making this a successful virtual conference. And we'll see you all around through the weekend.

FITFIRE 2021 conference

in-training physiatrists

technology in the classroom

technology in the clinic

interdisciplinary collaboration

research

art in medicine

climate change on health

patient-reported outcomes