THRIV Hits Milestone with Inaugural Class of Scholars

In January 2018, the University of Virginia will be applying for a Clinical and Translational Science Award (CTSA), which will allow us to join a national network of 60+ medical research institutions working together to improve the translational research process to get more treatments to more patients more quickly. The network collaborates locally and regionally to catalyze innovation in training, research tools, and processes. (We wrote about it last February, which you can read here.)

Before we apply for the CTSA, we need to demonstrate that we already have a thriving clinical/translational research program across Grounds that facilitates activity across the Commonwealth. As such, we are developing the Translational Health Research Institute of Virginia (THRIV), a pan-University effort. One of THRIV’s major milestones is to create a mentored career-development award, a program that will train small groups of junior faculty seeking a clinical and translational research career. The inaugural class — which includes faculty from the Schools of Medicine, Nursing, and Engineering and Applied Sciences — was announced in May and met for the first time just a few weeks ago. The awardees, projects, and mentors include:

  • Jessica Keim-Malpass, PhD, RN, Assistant Professor, Department of Acute and Specialty Care, School of Nursing
    Research Proposal: A pragmatic clinical trial evaluating impact of continuous predictive monitoring on nurse-driven outcomes in a dynamic intensive care setting (Primary mentor: J. Randall Moorman, MD)

 

  • Kyle J. Lampe, PhD, Assistant Professor, Department of Chemical Engineering, School of Engineering and Applied Sciences
    Research Proposal: Bioengineered Hydrogels to Facilitate 3D Neural Stem Cell Survival and Growth in a Stroke Environment (Primary mentor: Bradford B. Worrall, MD, MSc)

 

  • Kathleen McManus, MD, MS, Assistant Professor, Department of Medicine, Division of Infectious Disease, School of Medicine
    Research Proposal:  Affordable Care Act’s effects on persons living with HIV (PLWH) in Virginia (Primary mentor: Rebecca Dillingham, MD, MPH)

 

  • Brynne Sullivan, MD, Assistant Professor, Department of Pediatrics, School of Medicine
    Research Proposal: Pulse Oximetry Cardiorespiratory Scores to Predict Adverse Events and Outcomes in Premature Infants (Primary mentor: J. Randall Moorman, MD)

 

  • Dustin Walters, MD, Assistant Professor, Department of Surgery, School of Medicine
    Research Proposal: The Role of CD8+ T Cell Mediated Tolerance in Non-Small Cell Lung Cancer (Primary mentor: Sasha Krupnick, MD)

Every week, the scholars will come to the THRIV offices to participate in a curriculum which includes experiential learning, research methods instruction, mentored translational experiences, training in data sciences, as well as personal/professional development and off-Grounds site visits. The program started July 1 and the awardees will receive funding from the School of Medicine Dean’s Office for two years.

Thank you to the mentors for participating in the growth and development of colleagues and to the department chairs for providing protected time for the scholars to pursue these research projects and goals.

Please join me in congratulating the inaugural THRIV scholars class!

Margaret A. Shupnik, PhD
Gerald D. Aurbach Professor of Endocrinology
Professor of Medicine
Senior Associate Dean for Research

(l-r) Dustin Walters, MD; Jessica Keim-Malpass, PhD, RN; Karen Johnston, MD; Kathleen McManus, MD, MS; Brynne Sullivan, MD; Kyle J. Lampe, PhD; and Sandra Burks, RN.

Update: Diversity Action Plans

As we approach the University’s 200th anniversary, it is good to remind ourselves of our history, so we can sometimes use it as a point of reference from which to move away. African-American undergraduate students were not allowed into our College of Arts and Sciences until the 1950s, and women were barred until the 1970s. Exclusion was common for three-quarters of this institution’s history. We are working continuously and actively to address this history so we may offer everyone — faculty, staff, and students — equal opportunity to succeed.

Last fall, during the Department Annual Reviews (DAR), each department was asked to think about how to improve diversity and inclusion for their areas. While the School of Medicine has had a diversity plan for several years, we wanted specific actions from the departments. In early 2017, we received thoughtful plans from every department. Upon reviewing these plans, Greg Townsend, MD, Associate Dean for Diversity and Medical Education, and I discovered common ideas and themes. These themes allowed Greg and me to develop guidelines for improving the plans and developing short-term and long-term goals.

These plans and goals provide a reference to one- and three-year strategic actions that departments will undertake. This way, we will all know the expectations for the coming year and by the end of 2020. This transparency provides an opportunity to collaborate, to share creative solutions, and to let our School’s greatest resource — our faculty and staff — be the source of the best ideas.

While we were working on diversity and inclusion action plans at the department level, the Provost’s office asked for a diversity plan from each of UVA’s schools. The School of Medicine’s plan is still under review, though we expect to receive feedback by the end of the summer. I will share it as soon as it is available.

Why be diverse?
Diversity is critical to becoming the kind of institution we think we should be — excellent, innovative, creative. Googling “why diversity matters” will give you abundant reasons why we should do this. Study upon study has been performed, and the data have been scrutinized and examined. In academic medicine, the data confirm that greater diversity is better for science, education, and patients.

Let us assume that you do not have time in your schedule to read the 3.8 billion Google returns for the search “why diversity matters” and you want a local example. Why does it matter for us? Here is an interesting chart showing the association between the school’s percentage of underrepresented in medicine students and the USMLE Step 1 and Step 2 scores.

(Click to enlarge.)

You can see the increased scores as we started making a conscious effort to increase student diversity. While it does not show causation, the correlation is powerful. What the scores do demonstrate is that our focus on diversity has not diminished the academic excellence of our student body.

Stayed tuned for more updates. We will be updating the Diversity website with best practices and will be sharing plans and guidelines in the coming months. Thank you to all of our faculty and staff who have put time and effort into these plans. Your efforts are noticed and appreciated.

Susan M. Pollart, MD, MS
Ruth E. Murdaugh Professor of Family Medicine
Senior Associate Dean for Faculty Affairs and Faculty Development

How We Increased Inclusion Among Residents

Every March we’re excited about Match Day, to see where our students will complete their training. (You can see photos of this year’s event here.) The other side of that process is in seeing who matched with UVAHS and in welcoming new residents in July. We recently have seen a positive difference with regard to the number of underrepresented minorities (URM) in the incoming residents.

The AAMC defines URM as “those racial and ethnic populations that are underrepresented in the medical profession relative to their numbers in the general population.” In recent years, residents who are URM have made up 7 percent of residencies nationwide. UVA usually follows that trend, matching 7 or 8 percent. Last year, however, UVA matched 10 percent URM to our program; and this year 15 percent! Looking at data from the Department of Medicine, our biggest department, the numbers went from 3 percent historically to 15 percent this year. These are outstanding increases.

This change did not happen by accident.

Great Change … But How Did We Do It??
Undergraduate medical education (UME) tackled this problem more than a decade ago and made astounding advances. Because of efforts made in the School of Medicine, we are now proud to say we have one of the most diverse student populations in the country. We wanted to do the same for our residency trainees, but we also wanted to broaden the AAMC definition of URM to be more inclusive.

As a first step, we conducted meetings to hear how minorities fared at UVA and in Charlottesville. These meetings were with the School, the Diversity Consortium, and the Medical Center, and with leaders in the institution like Dean David Wilkes, Dr. Gregory Townsend, and Dr. Michael Williams. While we had good information about our medical students, we lacked a grasp on how our minority trainees felt. After listening and receiving input from many groups, the Graduate Medical Education Committee task force (co-chaired by Dr. Kristen Atkins and Dr. Gerald Donowitz), working closely with Dr. Susan Kirk, Associate Dean for Graduate Medical Education, realized that there was a real need for us to do better.

Every program director was interested in making a change, however there were no mechanisms in place to make a broad, cohesive, and intentional impact. The GMEC task force assisted in creating these mechanisms by bridging the many groups who were already working on this subject.

The program directors started talking openly with applicants about diversity and what it means (and how it feels) to be an underrepresented minority. We created Diversity Days wherein we announced that several of our interview days would be extended for applicants interested in talking about diversity. While these days were sponsored by the Department of Medicine, they were open to all applicants and departments. Our message to the applicants was that UVA wants every trainee at UVA to thrive. The feedback we received from the applicants was eye-opening. Many had never had interviewers discuss diversity with them before. They appreciated it and recognized we wanted a change and that they could be a part of that change. For some, it was the first time they realized how important it was to belong to a place that was interested in their success.

Additionally, the task force educated program directors at monthly GMEC meetings about what was learned from speaking with GME trainees and applicants. We learned (and taught!) how to talk about diversity to an applicant, how to broach the subject, and how to openly discuss where UVA was with regard to diversity, but also where we wanted it to be. We kept the topic on everyone’s radar.

We also decided we couldn’t wait for the applicants to come to us. Like reaching out to high-school students before applying to college, we are now contacting third- and fourth-year medical students and giving them information about UVA Health System. We are going to regional and national meetings such as the Student National Medical Association (SNMA), the largest student-run organization focused on supporting underrepresented minority medical students.

Great Success and Momentum
All of this work is so that we may best serve our patients. A diverse group of trainees who reflect the community we serve leads to better patient care. And we are working on creating the best, most diverse resident teams. The past year has just been a pilot. We are moving forward with plans to propose new programs, create brochures for all programs for outreach, include more representation at SNMA meetings, and work with faculty across Grounds who conduct research on microaggressions. (There is much training and awareness we need to work on in this area.) We are also going to continue to tap into the underrepresented minority trainees who are already here and continue to solicit their help in recruitment and culture change. We will continue to take the pulse of our current trainees and institute activities and sessions that foster a culture of inclusion among all trainees, regardless of race, ethnicity, religion, gender, or sexual orientation.

Other ideas coming down the road: We are proposing formal training for all faculty in handling microaggressions and providing better access to our UVA Ombuds, Brad Holland, with scheduled on-site office hours. New signage has been implemented at the entrance to the Claude Moore Medical Education Building and the hospital lobby to let trainees (and everyone!) know that UVA is a welcoming place.

What we are doing for graduate medical education is a small component of what the whole community is doing — here at the hospital, in Charlottesville, and in Albemarle County. But we want the community to know that this is an important issue. We have learned much this year, and many of the needed connections are now in place. It was a good year. But it is just the first step in a longer process.

The success of initiatives such as this relies upon the willingness of all to participate. We would like to thank Dean Wilkes, Dr. Susan Kirk, the program directors, the task force, and the GMEC for their efforts in making this happen.

R.J. Canterbury, MD, MS, DLFAPA
Wilford W. Spradlin Professor
Senior Associate Dean for Education

Susan M. Pollart, MD, MS
Ruth E. Murdaugh Professor of Family Medicine
Senior Associate Dean for Faculty Affairs and Faculty Development

Assessing Students Today to Be Ready for Tomorrow

How can we ensure our medical students are prepared properly for the United States Medical Licensing Examination (USMLE) and our graduate students are ready to earn their PhDs and become leaders in biomedical research?

The answer: novel ways of assessment.

UME: Predicting the Future
The School of Medicine has had an integrated curriculum for years. This means that our students no longer study subjects in isolation. Learning is organ system-based, and this is how our students progress through the curriculum. Within each system, we assess performance in multiple ways. The weekend formative and summative assessments are main contributors to a student’s grade.

For the past two years, we have been reviewing class performance and determining how it correlates with board scores. James Martindale, PhD, Assistant Professor and Director of Test Development, oversees all SOM testing and is focusing on how overall system grades and weekend formative and summative assessment results relate to Step 1 performance (the application of important concepts of the sciences basic to the practice of medicine). He has found strong correlations in the data and is building a model that can determine how much of the variation in assessment performance can be predictive. While we are not teaching to the test, we do need to know if we are preparing our students for their future careers in medicine — including licensure. Later, we will review Step 2 (clinical knowledge and clinical skills) and Step 3 (taken after medical school graduation) data, to see if similar models can be built.

The impetus for this work is the need to identify the few students who are predicted to perform poorly on Step 1 while they still have time to remediate and enhance their study skills. This will be one additional tool to support our students.

BIMS: Say it out loud!
Amy Bouton, PhD
, Associate Dean for Graduate and Medical Scientist Programs, and her colleagues who teach the first-year core course for PhD candidates in the Biomedical Sciences (BIMS) Graduate Program want our graduate students to speak up. In fact, it’s an expectation.

Every first-year student in the BIMS Graduate Program takes an oral examination as the culminating assessment tool for the core course. This exam marks the beginning of their transition from a focus on grades and formal classes to a focus on self-initiated study, research, and professional development.

The examiners ask questions that cover basic information to ascertain that students understand the outline approaches and the purposes and goals of assigned papers. Students must interpret the results to demonstrate that they can make connections between the paper and topics in the course that apply to research, and show that they can make higher order reasoning and intellectual jumps.

We have found this method to be an excellent way to assess our graduate students. It allows us to determine whether they have acquired the basic skills emphasized in the core course and evaluates their ability to problem solve. It gives students an experience similar to what they will face later in their training when they must pass their advancement to PhD candidacy exam. A student who performs poorly on the oral exam is encouraged to work with the mentor to develop a plan for addressing the identified deficiencies.

A tremendous amount of preparation goes into administering these exams, which take place over a period of between 1-2 days and involve nearly 30 faculty members. These assessments provide an important means for early intervention for those students who have not yet developed the skills and knowledge needed to become a strong researcher and scientist.

We realize that English is not the primary language for some of our students. Our data indicate that this has not been a barrier to success, yet we continuously are monitoring for any outlying performance indicators. Since we have been administering this oral exam for only two years, it is too early to determine outcomes with respect to the impact on students’ advancement to candidacy exams.

Thank You, Faculty!
When I see the dedication of our faculty in ensuring we are continuously improving ways in assessing our students — driven by mission and goals — I am in awe. Thank you to Jim, Amy, and all the faculty whose tireless effort goes into student assessment.

R.J. Canterbury, MD, MS, DLFAPA
Wilford W. Spradlin Professor
Senior Associate Dean for Education

Med Students Offer Unity, Community

In response to recent events in the community, our students in the UVA chapter of the Student National Medical Association (SNMA) organized “A Response of Unity to a Demonstration of Intolerance” in the Claude Moore Health Sciences Library — spearheaded by Marta Getachew, a 1st-year medical student.

Student volunteers held whiteboards that said, “Charlottesville is a place for _____, not hate.” Faculty, staff, and students were encouraged to fill in blank space with what the Charlottesville and UVA community means to them.

In a letter to the School of Medicine, Jewel Llamas, 4th-year medical student and the new president of UVA’s chapter of SNMA, wrote, “In such a time of discord and divergence among so many groups in our nation, we hope to bring peace of mind to the people who may need it by showing that the ideologies of the people involved in the Lee Park demonstration are believed by a minority of people within our community, not the majority.”

Thank you to our students for creating such memorable moments and an atmosphere of unity, respect, and understanding. I could not be prouder of them. It was a well-received event supported by leadership, staff, and faculty from across the Health System. Hundreds of photos were taken over three days. Below is a sampling of the wonderful messages shared and wonderful people who participated.

R.J. Canterbury, MD
Senior Associate Dean for Education

(Click photos to enlarge.)

151 New Doctors Graduate

This time of year is always bittersweet. I am proud of our graduates and know they are stepping into a bright future but, after being with us for four years, I will miss them. On May 20, we graduated the 151 members of the Class of 2017. This class will be doing residencies in 31 states — Virginia being one of those states, as UVA has matched with 21 members of SMD17. That so many have decided to stay speaks highly of the quality of their educational experience, and the character of those who delivered it.

Thank you to our faculty who, for the past four years, have helped these students learn, grow, and succeed in their studies. It is only with your hard work, dedication, and commitment to the education of these future physicians that these 151 students were able to walk the Lawn.

While I can type “thank you” a million times, I believe the smiles and excitement on our students’ faces in the video and photos below are a much better way of showing appreciation.

R.J. Canterbury, MD
Senior Associate Dean for Education

Photo: JFDP Deliver Scholarly Projects

Back in February, we wrote about the Junior Faculty Development Program. This is a program that provides networking, social opportunities, and peer mentoring among colleagues who are at a similar stage in their career; promotes the development and advancement of junior faculty through seminars and mentored scholarly projects; and facilitates mentoring relationships between senior and junior faculty.

On April 19, the first cohort of 12 junior faculty members presented their scholarly projects.

From left to right:

  • Kelly G. Gwathmey, MD, Assistant Professor of Neurology
  • Kelly B. Mahaney, MD, Assistant Professor of Neurological Surgery
  • Laahn H. Foster, MD, Assistant Professor of Medicine
  • Michael K. Keng, MD, Assistant Professor of Medicine
  • Jeanetta W. Frye, MD, Assistant Professor of Medicine
  • Jonathan S. Black, MD, Assistant Professor of Plastic Surgery
  • Sana F. Khan, MBBS, Assistant Professor of Medicine
  • Amanda M. Kleiman, MD, Assistant Professor of Anesthesiology
  • Gilbert R. Kinsey, DPHARM, PhD, Assistant Professor of Medicine
  • Simon J. Lehtinen, MD, Assistant Professor of Medicine
  • Sula Mazimba, MD, Assistant Professor of Medicine
  • Anuj Singla, MBBS, Instructor of Orthopaedic Surgery

Congratulations to all!

Slides: Spring General Faculty Meeting

If you missed the April 20 General Faculty Meeting — or if you attended and just want to review! — you can find a PDF of the presentation slides here.

How did you celebrate St. MATCHrick’s Day?

UVa_SOM_Match_Day_17_e4636On St. Patrick’s Day, March 17, 149 members of the UVA School of Medicine’s Class of 2017 tore open envelopes and learned where they would be heading for additional training as residents.

I could not be more proud of them. Every year seems to be more and more competitive and yet our students always rise to the challenge. The below list shows how the residency spots filled out, by specialty:

  • Anesthesiology | 6
  • Dermatology | 2
  • Emergency Medicine | 11
  • Family Medicine | 9
  • General Surgery | 11
  • Internal Medicine | 36
  • Interventional Radiology | 2
  • Neurological Surgery | 3
  • Neurology | 3
  • Obstetrics and Gynecology (incl prelim) | 7
  • Ophthalmology | 4
  • Orthopaedics | 4
  • Otolaryngology | 4
  • Pathology | 3
  • Pediatrics | 18
  • Physical Med/Rehab | 2
  • Plastic Surgery | 1
  • Psychiatry | 4
  • Radiology/Diagnostic | 10
  • Radiology Oncology | 2
  • Urology | 2

This list represents many great matches to top-rated institutions such as Duke, Mass. General, Yale, Stanford, Northwestern, Brigham & Women’s, Vanderbilt, UCSF, Cornell, Beth Israel Deaconess, University of Washington, and Johns Hopkins. While our students do all of the heavy lifting during their medical education career, I would like to thank our faculty and staff for training and supporting them for four years. Results from Match Days like this should make you feel great — it certainly does for me.

While I will miss the students who are leaving, I find comfort in knowing that 21 of our graduates chose to stay in Charlottesville, doing all or part of their residency program here at the University of Virginia. I look forward to seeing them around the School and the Medical Center.

Please join me in thanking our colleagues at the Medical Alumni Association for hosting such a terrific Match Day event and in congratulating these 149 students!

R.J. Canterbury, MD
Senior Associate Dean for Education

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Med + Architecture Team Up on Human-Centered Design Program

Like many great programs at the School of Medicine, it started with the students.

A few years ago, three medical students expressed interest in “design thinking.” Design thinking is a creative problem-solving tool, a systematic way of looking at challenges, a mindset that teaches how to ask the right questions, to tackle the real problem. This is often used to produce the products and experiences we use every day. Think Apple’s iPad. Why not apply this type of innovation to medicine? Design thinking uncovers latent desires or unmet needs, ultimately answering the question, “What is best for the user?”

humancentereddesign9_03212017Or, in our case, it could be translated to “What is best for our patients?” As its name implies, design thinking began in design-oriented professions but it has grown significantly and is now successfully applied to business, engineering, and social issues. There are only a handful of schools applying it to medicine — and we’re one of them.

Year 1: “Let’s try this …?”
David Chen, MBA
, Coulter Program Director, Department of Biomedical Engineering; Erik Hewlett, MD, Professor of Medicine, Infectious Diseases and International Health; and Matthew Trowbridge, MD, MPH, Associate Professor of Emergency Medicine and Public Health Sciences, ran with the idea and — with support of colleagues like Megan Bray, MD, Associate Dean for Curriculum — have grown it into something wonderful.

(l-r) Matthew Trowbridge, MD, MPH; David Chen, MBA; and Erik Hewlett, MD

(l-r) Matthew Trowbridge, MD, MPH; David Chen, MBA; and Erik Hewlett, MD

Last year, David and Matt co-instructed a program called Human-Centered Design that had 10 first-year medical students field trip to the Be Safe Situation room, where they learned the True North issues of the Health System. While Be Safe was using Lean problem-solving to tackle the Big 6 issues, the students broke into two groups and decided if they could positively affect the “patient falls” and “readmissions” categories. Using design thinking, the students uncovered aspects of patient stories that were a surprise to even the most knowledgeable in the Health System. More importantly, their interviews and enquiries resulted in actions at the patient-care level. (A special thank you to Paul Helgerson, MD, who was vital to their access and Be Safe education.)

My takeaway from this first year is almost Seussian: A healer’s a healer no matter how small their med-school training is. They cared to make a difference and they did. (Additionally: They did it on their own time!)

Year 2: “Let’s partner with Architecture.”
For the 2016-2017 year, the 15 first-year medical students participating in Human-Centered Design are tackling the Emergency Department expansion project — and they’re doing so by partnering with School of Architecture students across Grounds in Elgin Cleckley’s class. (Cleckley, a recent hire, is an Assistant Professor of Architecture and Design Thinking.) Together, the students in both schools are discovering how an emergency room should be designed with a patient-centered focus. They’re challenging themselves to discover the factors that would improve the patient experience. Their goal is to promote a more informed conversation within the Health System by bringing the patients’ voices, ideas, and desire more clearly into view. They’re reframing the question for the rest of us. Can they propose a radical re-imagining of what an emergency room should be? How radical will we let it change? Design thinking teaches that true innovation can sometimes come from examining the extreme ends of the bell-curve. And they’re doing just that.

humancentereddesign5_03212017The program is experimental and dynamic and, itself, a product of design thinking. For the ED Expansion Project, the students gathered thoughts on essential elements for an emergency room, from the patient perspective, and provided it as output to the A-School students. At a recent Friday-afternoon session, the architecture students replied with visual prototypes and video presentations describing improvements. Broad concepts like “chaos” and “comfort” and “uncertainty” and “normal” were considered. No idea was too ridiculous. Nothing was dismissed. As med students watched these videos, they wrote initial impressions in a group-shared Google Doc, after which Matt recorded on-the-spot videos with his phone. All of this became more input data for the architecture students’ design projects.

humancentereddesign8_03212017It is a whirlwind of creativity and out-of-the box thinking. In an institution steeped in tradition and within a Health System governed by necessary protocol and critical procedure, witnessing pure creation and co-inspiration is something to behold.

The Future Is Full of Challenge
Erik, David, and Matt all freely admit this is an experiment. But one worth trying, as design thinking is an emerging area in education. Their goal is to use this small program as a prototyping space for development of relevant additions and new approaches to the core medical school curriculum at UVA (and nationally). For example, Matt recently delivered to the second-year class a workshop on empathy-based interview techniques from design thinking. The idea was to help them develop a diverse set of interview skills — rather than a purely clinical interview — as they transition into their clinical clerkships and onto their full medical careers. Adding this tool to our already vast educational toolbox is yet another differentiator for UVA. We’re only one of a handful of schools in the country who is offering a program like this.

humancentereddesign2_03212017There are grand challenges (not to mention changes!) in healthcare, issues which medical and science knowledge alone cannot solve. The most pressing issues of the day are complex and physicians have a definite role to play in solving them, but it is not a purely clinical role. Alongside their regular medical education, design thinking is helping our medical students learn the language of other fields and cultures, such as technology, business, and design. With this added tool, our med students can cross-cut different spaces to find the common ground. In the future, this will enable them to translate public health and medical knowledge into those fields, which will in turn deliver a broad impact.

The future of healthcare is full of change, too, and design thinking allows us to provide future physicians — alongside their traditional clinical skills — with a structured approach to managing that change. It will aid their ability to work in interdisciplinary teams and tackle systems-level problems. In the end, it will also make them better physicians and researchers.

humancentereddesign4_03212017David, Erik, and Matt tell me that design thinking is fun, as it allows students (and the faculty who are teaching them) to open up their minds, refresh themselves, and think creatively about the field to which they’ve devoted their lives.

I am proud of what David, Erik, and Matt have accomplished just as I am proud of the students and their efforts. UVA is already emerging as a national leader in the conversation of applying design thinking to medicine — Matt recently spoke at Stanford about our program. (Click here to see a clip from that talk.) I look forward to seeing the role UVA can play in using design thinking to improve the human condition.

R.J. Canterbury, MD
Senior Associate Dean for Education

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