Thread by @Brian_M_Wong

Excited to launch #CWCSTARS leadership summit with @ChooseWiselyCA chair Wendy Levinson and patient and public advisor Amy Ma welcoming the next 34 students representing all 17 medical schools in Canada 🇨🇦

Amy Ma tells our students “You are the stewards of patients and families’ trust” #CWCSTARS @ChooseWiselyCA

Any tells story of her son being prescribed unnecessary opiates after wisdom tooth removal. Can read about it here in op ed written with @DrSSutherland1 #CWCSTARS cbc.ca/news/opinion/w…

Now @bornk introducing #CWCSTARS students to the @ChooseWiselyCA lists. Can read them all here choosingwiselycanada.org/recommendation…

Just a reminder that @ChooseWiselyCA turned 5 this year — such amazing impact in partnership with 70 professional societies with 350 lists, #CWCSTARS initiatives in all 17 medical schools, 60 patient and public materials, and 12 active regions across 🇨🇦

None of this would have been possible had it not been for funding received by @ABIMFoundation & @WolfsonD, past funding of #CWCSTARS by medical school deans and now @CMA_Docs

Now @HemeHillis giving our #CWCSTARS students a primer on resource stewardship. Sharing data variation re: BZD prescribing in elderly patients in Canada @ChooseWiselyCA

The #CWCSTARS students only in their first year yet they have very deep knowledge and first-hand experience of healthcare resource overuse. Sharing their stories right now. It’s never to early to introduce education on @ChooseWiselyCA in #Meded

There are some great web-based modules out there for @ChooseWiselyCA education #CWCSTARS:

The @IHIOpenSchool has a learning module TA 103 app.ihi.org/lms/coursedeta…

@DellMedSchool & @ChrisMoriates / @ValueVictoria created Value-based Learning Modules
vbhc.dellmed.utexas.edu

Love how @HemeHillis makes somewhat dry topics like AAR and RRR relevant by reminding students to communicate in ABSOLUTE risks with patients when engaging in shared decision making. #CWCSTARS

Here’s a great repository of online patient decision aids
decisionaid.ohri.ca

There’s a @CochraneLibrary review on the use of patient decision aids. Some evidence that they work cochrane.org/CD001431/COMMU…
#CWCSTARS

The great Olivia Ostrow (from @SickKidsNews @uoftmedicine @CQuIPS but still not on Twitter) bringing attention to antibiotic overuse — because we are going to charge #CWCSTARS students with tackling this issue this year!

Olivia Ostrow shares sobering data re: the emergence of Carbapenem-resistant enterobacteriaceae over the past decade #CWCSTARS

The four ways to address antibiotic resistance:

1) Surveillance
2) Infection prevention & control
3) Research & innovation
4) Stewardship

We want our @ChooseWiselyCA #CWCSTARS students to take a lead role in advancing this cause in #MedEd

canada.ca/en/health-cana…

For #MedEd there are cases that you can use to explore the complications of unnecessary antibiotic use in healthcare -- @JAMAInternalMed has a series of Teachable Moments (jamanetwork.com/collections/44…) and some relate to Abx overuse -- like this one:
jamanetwork.com/journals/jamai…

Olivia Ostrow provides useful framework to #CWCSTARS for how to use antibiotics more apporpriately

Opportunities exist at initiation, choice and duration of antimicrobials

4 Moments of ABx Decision Making #CWCSTARS
jamanetwork.com/journals/jama/…

1) Does pt have an infxn that requires Abx?
2) Have I ordered appropriate C&S before starting ABx?
3) 1 or more days have passed -- can I stop? Can I narrow? Change from IV to PO?
4) What Abx duration needed?

Proud to have partnered with @CFMSFEMC @FMEQ and @CMA_Docs Ambassador Program to create #CWCSTARS — Ajay Shah, Roxanne St-Pierre and Brandy Love (@HemeHillis sitting in) share with students what organizations can do to help

Closing out the day with @DellMedSchool Assistant Dean for Health Care Value and @CostsofCare Executive Director helping #CWCSTARS students to learn how to Lead From Where They Stand

Leadership = Vision + Task + Responsibility

Achieved through the use of Power & Influence

Key leadership message from @ChrisMoriates at #CWCSTARS leadership summit @ChooseWiselyCA

.@ChrisMoriates says: #CWCSTARS students need to wield 2 types of power:

Positional power = authority, reward, discipline
Personal power = expertise, information, goodwill

More importantly though -- @ChooseWiselyCA #CWCSTARS need to think about how they can exert influence through their use of power, says @ChrisMoriates

Whe proposing a change, need to frame for common ground — illuminate the advantages (“What’s in it for me?”)

Have to spend time figuring out what issues are important to your key stakeholders

Important leadership lesson on how to influence from @ChrisMoriates at #CWCSTARS

.@ChrisMoriates summarizes common leadership pitfalls:
1) Doing the hard sell upfront
2) Not being willing to compromise
3) Thinking that only great arguments will work
4) Thinking it is a 'one shot' effort
#CWCSTARS @ChooseWiselyCA