We kick off 2025 on Raise the Line by sharing some good news for providers struggling to keep up with the growing number of applications for genomic testing: a new book from Elsevier Science Direct has been designed to arm you with the knowledge you need. Genomics in the Clinic: A Practical Guide to Genetic Testing, Evaluation, and Counseling dives into the use of this important tool in diagnosis and screening, indicating how individuals may respond to drug therapies, and more. “We really need to educate all healthcare providers about the practice of genetics because they're going to be involved directly or indirectly in genetic testing and conveying information about what the results mean to patients and their families,” explains co-author Dr. Ethylin Wang Jabs, enterprise chair of the Department of Clinical Genomics for Mayo Clinic. Jabs and her co-author, Dr. Antonie Kline, director of Clinical Genetics at the Harvey Institute for Human Genetics at Greater Baltimore Medical Center, chose a format that makes heavy use of case studies to help readers get a better grasp on this complicated field and they also include chapters on direct-to-consumer testing and the ethical and social implications in genomic medicine. “Any kind of potentially predictive testing can have ethical issues related to it, including insurance coverage, testing for family members, protections for minors, and more,” says Dr. Kline. Join host Caleb Furnas for an illuminating episode on an area of discussion in medicine that’s growing in importance as the use of genetic testing rapidly increases.

Mentioned in this episode: Genomics in the Clinic: A Practical Guide

Brothers Inspire and Share Life Lessons Through Endurance Sports: Kyle and Brent Pease of the Kyle Pease Foundation

Today, we have an especially inspiring episode in our Year of the Zebra series on rare conditions featuring Kyle Pease and his brother Brent, who recently helped each other complete the 140.6 mile Ironman World Championship in Hawaii, a challenge they also took on together in 2018. What makes their story extraordinary is that Kyle, who was born with cerebral palsy and spastic quadriplegia, participated in these races with Brent's assistance, making them the first push-assist brother duo to finish the grueling competition. With over 125 endurance races under his belt, Kyle has become a leading disability advocate, demonstrating resilience and breaking barriers through sports. “Competing really reminds me of my life. I go through many ups and downs throughout my day just as I do in this sport. You get through a lot of different challenges throughout the competition by just focusing on the idea that anything is truly possible,” he tells host Lindsey Smith. To amplify their message of inclusivity and determination, the brothers co-founded the Kyle Pease Foundation which sponsors races and other awareness building events and they deliver speeches to a variety of organizations to share the lessons they’ve learned. “We want to encourage people to figure out what their finish line looks like. What are the things you work for and how do you get there,” says Brent. Tune in for an uplifting conversation to learn about the Foundation’s workforce inclusion program, their book, Beyond the Finish, and the “secret weapon” that makes their racing and other endeavors possible.

Mentioned in this episode:

Kyle Pease Foundation

Beyond the Finish

The use of simulation in nursing education has been growing in recent years not only because of its proven effectiveness as a training method, but because of limits on clinical training placements, and a dearth of nursing faculty. Today on Raise the Line, we’re happy to welcome one of the pioneers in this area, Dr. Pamela Jeffries, the Dean of the Vanderbilt University School of Nursing which is consistently ranked among the top graduate nursing schools in the US. “Now that we've moved to competency-based education and outcomes, I feel simulation is one of the mechanisms that's going to help faculty to see our students demonstrate those competencies needed across domains,” Jeffries tells host Maria Pfrommer, director of Nursing Education at Osmosis from Elsevier. Dr. Jeffries is also known for her work improving the online learning landscape in nursing education. “Online learning is so important in nursing because if you look at our students, they're typically working part-time or even full-time and need that flexibility.” Maria and Dr. Jeffries also get into the details of Vanderbilt’s graduate nursing programs and discuss the game changing potential of AI in nursing education and practice in this informative episode.

Mentioned in this episode:

Vanderbilt University School of Nursing

“Being a provider yourself doesn't protect you or your loved ones from illnesses and it really brings the humanity back into medicine to recognize that we're all struggling and that the  patient in front of you is processing what they hear in their own way,” says Dr. Marta Perez, and OB-GYN and mother of a child with a rare condition. As Perez shares with host Lindsey Smith, her young daughter’s struggles with Smith-Magenis Syndrome – which causes an array of developmental delays and other challenges -- has made her, and her physician husband, better doctors by sharpening their understanding of the difficulty patients have navigating the healthcare system and dealing with dismissive providers. “That's been something really formative for us in how we approach patients in our own practices. We understand the stresses in medicine.” In this candid interview, Perez talks about how she and her husband juggle two demanding jobs and a child with special needs, the impediments to finding treatments for rare diseases and the emotional impact of realizing your child will not have the kind of life you hoped they would have. Don’t miss an episode rich with lessons for providers and parents as our Year of the Zebra series continues. 

Mentioned in this episode:

@Dr.MartaPerez

Smith Magenis Syndrome

This episode of Raise the Line is special for a couple of reasons. Our guest, Toh Hong Keng recently graduated from medical school at the age of seventy, making him one of the oldest medical students in the world; and Shiv Gaglani is taking a break from his 3rd year of medical school -- which he is completing at the age of 35 -- to make a rare appearance hosting the show so he can compare notes with Toh about being a non-traditional med student and to learn from his inspiring example. Toh is a retired tech sales executive who earned his medical degree this summer from Southwestern University PHINMA in the Philippines after a long career in the Asia-Pacific region. As he tells Shiv, Toh brushed aside the opinions of acquaintances that pursuing a medical degree in his late sixties was a little crazy. “I’m a firm believer that at this age, we should be able to do what we like to do, not what people think we should be doing.” Tune in to find out what sparked his interest in getting the degree, what his biggest challenges were, how his classmates interacted with him, what he considers highlights of the experience, and what he plans to do next.  You’ll also learn about the concept of “sayang” which Toh relied on when he was facing doubts along this very difficult, but rewarding journey. 

Mentioned in this episode:

CNN Article About Toh

Southwestern University PHINMA School of Medicine

Leaning into the ancient wisdom that ‘practice makes perfect’ nursing educators are increasingly embracing approaches such as simulation and competency based education that provide students with low-risk opportunities to practice skills. You might even say that the  ‘see one, do one, teach one’ framework has evolved into ‘see one, do one, debrief, get assessed and do it again.’ But while research shows these hands-on methods lead to increased patient safety and better clinical outcomes, they can be challenging to implement as we’ll learn on this episode from April Rowe Neal, PhD, RN, the graduate nursing simulation educator at Winona State University College of Nursing & Health Sciences. “It can be hard for a lot of faculty because it's not necessarily how we've all been trained, right? You have to take more of that ‘guide on the side’ role rather than having all of your lecture notes perfectly typed to deliver to your students,” she explains to new Raise the Line host Kelsey LaFayette, DNP,  Senior Content Manager at Osmosis from Elsevier. On the plus side, Rowe Neal thinks these methods build a partnership between the learner and the teacher. Find out why that happens, learn how her program uses scaffolding to set students up for success and get Rowe Neal’s take on the role of mindfulness for medical learners and providers in this insightful conversation.

Mentioned in this episode:

Winona State University College of Nursing & Health Sciences

2024 is the year today’s Raise the Line guest, Michelle Hughes, is supposed to die. That’s according to the diagnosis she received three years ago from an oncologist who told her she had a rare, incurable form of cancer that had already caused innumerable tumors throughout her body.   As a mother of three – with her youngest child being just a few weeks old at the time of her diagnosis – this was obviously devastating news.  But fortunately, the optimism and encouragement of a second oncologist allowed for a new path forward. “It changed my entire world when that one doctor had hope,” she tells host Lindsey Smith.

Fueled by the advice of her new doctor “to just live your life” Michelle embraced a healthy lifestyle that includes distance running, including a recently completed triathlon. She has also embraced the role of empowering others to face their challenges through “My Journey to Just Live” an organization she created that keeps her busy doing a blog, social media posts, speaking engagements fundraisers and other activities. Join us for a special edition of our Year of the Zebra series focused on rare diseases to learn about Michelle’s challenging journey to motherhood, being a parent to three young children, and living with terminal cancer. “I remind my children and myself that cancer doesn't define me. I'm so much more than that.”

For information on the November 16th online premiere of a documentary about Michelle’s story, visit My Journey to Just Live

What good are dazzling advancements in science – such as the rapid development of an effective COVID vaccine – if public distrust of science and medicine leads people to reject them?  That’s the sort of question animating the work of today’s Raise the Line guest Dr. Kathy Reeves, president and CEO of the Arnold P. Gold Foundation. A key part of the answer, Reeves believes, is to increase the level of humanism in healthcare, defined as providing kind, safe, trustworthy care. “Humanism in healthcare is the vehicle to allow science to make an impact, and it is what is needed to change a broken healthcare system,” she tells host Caleb Furnas. Her conviction is based on numerous studies showing that patients who feel heard, understood, and treated with empathy by their healthcare providers report higher satisfaction levels and improved quality of life. The approach boosts provider satisfaction and lowers costs as well. “There's more science in the value of humanism than in many of the things I learned almost thirty years ago when I was a pediatric resident.” Tune in to this insightful episode to discover what providers can do in less than a minute to create a connection with patients, what Reeves and the foundation are doing to support providers who want to incorporate humanism into their practice, and how the White Coat ceremony got started. 

Mentioned in this episode: 

Arnold P. Gold Foundation

We've learned quite a bit on Raise the Line about the growing trend of providing medical care in the home, particularly as it relates to services enabled by advances in remote monitoring technologies. In this episode, we’re adding to that base of knowledge by focusing on what's happening with in-home physical therapy services. Our guide will be Palak Shah, PT, the co-founder and head of clinical services at Luna, a leading provider of in-home physical therapy that has completed one million patient visits in twenty-eight states since its founding in 2019. “Our patients appreciate this option so much because there are so many hurdles to access -- time constraints, ability to come to a clinic, the cost of travel, the dependency on family and caregivers -- and Luna eliminates all of that,” Shah tells host Michael Carrese.  The company has also focused on convenience for its 3,000 licensed providers through developing an app that integrates documentation, care coordination, billing, scheduling and other administrative tasks. But can you actually provide high-quality care for a full range of patient needs in what might often be small spaces? Based on data from its patient population in Southern California, Shah says Luna found that 87% of people can be seen in the home because large pieces of equipment are not needed to provide the required treatments. Tune in to learn how the services are paid for, how the system works for the hospitals and practice groups the company partners with, and what Luna’s providers say about working in the home environment.

Mentioned in this episode: Luna

Over a long and very active career as a researcher, clinician and educator, Dr. Nicholas Talley has witnessed the traditional mind/body dichotomy fade in relevance as science has determined just how integrated they really are. “The body talks to the mind, the mind talks to the body, and we're exploring how this happens and what we can do to interfere, if you like, to make a difference and perhaps restore health by doing so,” he says. Dr. Talley, a distinguished laureate professor at the University of Newcastle in Australia, is an international authority in the field of neurogastroenterology with more than 1,000 peer reviewed publications. Much of his work centers on disorders of gut-brain interaction, including functional dyspepsia, irritable bowel syndrome, and GI complications in diabetes. “What keeps me going is this idea that gut-brain connections are going to be very important, not just in gastrointestinal diseases, but in fact in many diseases that affect people across the spectrum of internal medicine.” Join Raise the Line host Caleb Furnas for a fascinating look at this burgeoning field as well as insights on probiotics, possible pharmaceutical interventions on the horizon and how artificial intelligence is impacting medical education. 

Mentioned in this episode:

University of Newcastle