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Training With a Greater, Global Impact

Each day in Baltimore, my Johns Hopkins physician colleagues and I train students, residents and fellows in the clinical field where we hold our expertise. As our trainees go out into the world to practice medicine, it broadens the reach of our impact on health care.

However, most individuals who train at Johns Hopkins will stay in the United States to practice, which limits our ability to more widely disseminate our unique approaches and techniques for solving clinical problems.

As several of these blog posts have noted, health care is a global concern. So, wouldn’t it be great if there were a way for physicians to have a greater—and more global—impact on improving health?

That’s where Johns Hopkins Medicine International comes in. As a Johns Hopkins physician, I find that one of the great things about partnering with JHI is the ability to make an impact in health care beyond my own clinical practice.

Technically, this concept is called “knowledge transfer” or “program building.” Practically, though, these relationships are a robust way to share with our affiliates the “how we do it” of clinical practice.

Johns Hopkins has an incredible institutional history that affects all of us who practice here in Baltimore, and we’re able to see a little farther by standing on the shoulders of the giants who went before us. This history impacts our training and practice, but it’s not easily replicated. Therefore, we have to be organized and structured as we share our expertise with our colleagues around the world.

I think most physicians at Johns Hopkins have participated in various educational endeavors, whether through presenting courses nationally or regionally, serving as visiting professors or hosting observers. Certainly, there is value to these types of programs, which can give others a glimpse into our clinical management strategies.

However, by their very nature, these programs are time-limited, and they aren’t structured to maintain long-term connections. Therefore, we can’t guarantee the durability of any practice-changing lessons participants learn in these brief interactions.

Engagement Encouraged
The great value of JHI is that it provides the expertise necessary for knowledge transfer to succeed. Over my years at Johns Hopkins, I’ve been fortunate to work with several of our international affiliates as they grow their urology programs. Throughout all of these clinical knowledge-transfer or program-development projects, I have learned that success lies in providing a thoughtful structure that encourages engagement.

In some ways, physicians have the most straightforward set of tasks in these relationships. Essentially, we are just asked to do what we already do on a daily basis—teaching what we know how to do.

However, for a knowledge-transfer program to succeed, we have to teach in a more structured fashion. Structure is critical, given the geographic and logistical distances that are at play. In my experience, we need to center projects on a set of deliverables that describes what is to be accomplished, such as creating a surgery program.

The needs analysis, which JHI staff often perform, provides a more nuanced understanding of what specific knowledge the Johns Hopkins content expert, or experts, should provide. With this background information, I find that creating content is a straightforward activity.

I generally focus my projects with JHI knowledge-transfer programs around a particular surgical technique or technology. Based on the needs analysis, we generate a curriculum that includes theoretical components, as well as hands-on learning.

Another component that’s critical to the success of these interactions is the long-term commitment that JHI facilitates. In this way, once a participating Hopkins physician returns to Baltimore, there’s already an established practice of distance mentoring. For example, if we encounter a particularly challenging case at the affiliate, we can continue a meaningful discussion of treatment options and recommendations with our colleagues across the geographic separation.

I believe this type of continuing relationship is critical to the long-term success of these knowledge-transfer programs. And this is the same thing we do with our trainees in Baltimore—we make sure we’re available to discuss the complex cases we so often encounter in practice.


Brian Matlaga

Dr. Brian Matlaga is the Stephens Professor of Urology at the Johns Hopkins University School of Medicine and serves as the director of ambulatory care for the James Buchanan Brady Urological Institute as well as the regional director of community urology for Johns Hopkins. Dr. Matlaga has worked with Johns Hopkins Medicine International in a number of capacities, most recently with Johns Hopkins Aramco Healthcare.

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