Authors often compare publishing a book to birthing a baby – a metaphor that is even more apt when the book in question is THE medical textbook on high-risk pregnancy, delivery, and fetal health.

At 1,494 pages, the 9^th edition of Creasy & Resnick’s Maternal-Fetal Medicine: Principles and Practice weighs in at 9.79 pounds – a good two pounds heftier than the average newborn baby. Clad in a glossy purple cover, it is a book that demands attention on any shelf.

“I should have warned you guys to bring a wheelbarrow for your books,” joked Dr. Judette Louis, professor and chair of Obstetrics and Gynecology (OB/GYN) at the USF Health Morsani College of Medicine and one of seven co-editors of the newest edition.

The department celebrated the publication of the new edition with a book-signing breakfast Wednesday for its trainees: 24 OB/GYN residents and four fellows in Maternal-Fetal Medicine (MFM). Both Dr. Louis and Dr. Charles J. Lockwood, dean of the Morsani College of Medicine and executive vice president of USF Health, were on hand to sign each copy. The publisher describes the book as “the definitive reference in the field for more than 35 years.”

“I am incredibly honored that Drs. Creasy and Resnik honored me as the new chief editor,” said Dr. Lockwood. He noted that the book would be 400 or so pages longer if it included all the references, which are only listed online.

“It’s definitely a great weight-bearing exercise,” joked Dr. Lockwood about the textbook’s heft.

Jokes aside, the residents said the book signing was a nice recognition that the physicians they are learning from are among the nation’s top experts.

“Knowing that we have some of the best mentors in the field as we go on to our careers – I think it’s inspiring,” said resident Dr. Rachelle Price, who will start her MFM fellowship next year.

“It’s amazing,” said Dr. Danielle Hardman. “I went to medical school here, so Dr. Lockwood’s been here during all my time here. It’s an honor” to have her textbook signed by him.

Resident Dr. Brittany Manobianco said one of her friends, who is going into MFM, was especially excited to get her copy.

“This is her Taylor Swift tour,” she proclaimed.

Perhaps fortunately, Ticketmaster did not work on the books – but the editors definitely did. Each editor was assigned a different section of the book, which includes chapters by a variety of authors who are experts on a variety of maternal and fetal high-risk conditions, such as premature labor and pregnancy-related hypertension. Editors conducted multiple levels of review and fact checks to ensure that each chapter reflects the latest science, evidence and best practices.

And then they proofed it all over again.

“I read every word in this book,” Dr. Lockwood said. “Every. Single. Word.”

Just how familiar is Dr. Lockwood with Creasy & Resnick?

Back when he was an MFM fellow himself, Dr. Lockwood studied the textbook’s first edition.

Photos by Allison Long, USF Health Communications.

For the first time, the exercise brings together students from all USF Health colleges.

Living in the moment is a way of life that countless people strive to achieve, but for those living in poverty, the concept takes on a much more somber meaning. If someone is struggling to make ends meet, their daily life is so stressful that they’re probably not thinking about or planning for the long term.

Every day, health care professionals come face-to-face with patients in poverty and in order to teach students empathy and an understanding of these barriers, USF Health Morsani College of Medicine Office of Student Diversity and Enrichment hosts poverty simulations. This training is in its sixth year, but this year is the first with an interprofessional mix of athletic training, medical, nursing, public health, pharmacy, physician assistant, and physical therapy students, as well as residents, and fellows. At the end of 10 sessions provided in the 2018-19 academic year, about 840 people will have participated.

The local American Legion Post donated its community hall to accommodate the large groups of students and volunteers.

Based on a simulation activity from Central Missouri Community Action, participants have the opportunity to experience life in the shoes of a fixed, limited-income family.

Shirley B. Smith, MA, Director of the Office of Student Diversity and Enrichment for MCOM, begins the activity by instructing the group to take it seriously because, “these are real people who have lived this experience.”

The students were assigned to fill various family roles, with identities ranging from seniors living alone to single-parents and blended families. Each family struggles with barriers such as unemployment, disabilities, and transportation. Over the course of a simulated four weeks, the families’ priorities are shelter, electricity, food, and keeping the family together.

The assigned identities range from single seniors living alone to single parents and blended families. Some are recently unemployed or struggling with disabilities.

A variety of resources are offered to the families by volunteers stationed around the community center room.  The volunteers simulate the roles of bankers, grocery store clerks, hospital staff, social service workers, and a pawn broker. Over the course of the activity, participants may run out of time or money, or even just forget to pay rent or buy groceries. One family was visited by law enforcement after she forgot to pick up her child from day care. Another family pawned their furniture for extra money. At least three families were evicted.

“This experience gives insight to health care workers, because sometimes we don’t know what is going on in a patient’s life and how it’s affecting their treatment or compliance,” said Brolivia Harvey, an adjunct faculty member in the College of Nursing.

Volunteers staff the resource tables that represent businesses such as banks, groceries, social service agencies, pawn brokers, and quick cash operators.

Participants without private transportation have to budget for public transportation passes needed to get to each resource station.

Just like in real life, when the rent is not paid, families are evicted.

At the end of the interprofessional education simulation, the participants sit down for a debrief. More than half of the students raised their hands when asked if they felt stressed or anxious during the experience. One student shared that she felt a “sense of insecurity” the entire experience and how you don’t realize the mental health strain it’s having on you or your children.

“I think the poverty simulation made everyone more aware of the struggles that people go through. We saw how much had to be accomplished in one day and that someone living in poverty may have to choose to pay rent instead of buy their medication,” said Rumour Piepenbrink, a first-year public health student.

“It was an eye-opening and humbling experience. I felt an array of emotions from frustration to gratitude for what I have,” said Ashley Reed, a fourth-year nursing student.

First-year public health student Rumour Piepenbrink visits the payday advance quick cash station.

Fourth-year nursing student Ashley Reed speaks with the volunteers at the simulated hospital.

During debrief, the group discussed how they can apply the lessons they learned from the poverty simulation to their health care careers:

• Don’t judge your patients.
• You have to consider the situation your patient is coming from to best help them.
• Be aware of local resources to refer a patient in need.
• Besides providing a resource to help a patient right now, empower them for the future.
• Teach patients the importance of long-term health.
• Physician burnout can happen when you do not deal with not being able to help everyone.

“Don’t ever get to the point where you’re numb to the poverty or problems of the people in the community,” said Priscilla Perez, a case manager for Positive Spin, a community-based social service agency that assists children and families to live healthy, and long-time poverty simulation community partner. “Helping a patient is more than just taking care of the reason for their visit,” she added.

Students are not the only ones participating in the poverty simulation. A session in April will include USF Health leadership and faculty.

“At USF Health, we are committed to preparing health professionals who recognize the importance of interprofessional team-based care, not only in the clinical setting but also in working together to address the social determinants of health in the communities we serve. Engaging our faculty in this intensive training will help us be better teachers and encourage us to recognize and emphasize the important role that every member of the team plays, including our patients and our community partners,” said Donna Petersen, ScD, senior associate vice president of USF Health and dean of the College of Public Health.

USF Health students, residents, and fellows debrief after the poverty simulation.

-Multimedia story by Torie Doll.

The speaker for this year’s John Curran Lecture was Vinod Bhutani, MD, professor of pediatrics at Stanford University School of Medicine. Dr. Bhutani’s research relates to quality- and equity-driven maternal and child healthcare.  At the Nov. 13 lecture, titled “Each Baby is Precious,” he discussed how high maternal and child morbidity and mortality rates can be addressed by implementing evidenced-based interventions that use innovative and culturally-adapted strategies to bridge barriers.

Dr. Bhutani has wide experience in neonatal practices in developing countries, particularly India.  He challenged the fellows and others in the audience to consider a global view of neonatal care embracing low-cost technology and research. The topic was especially fitting, given Dr. Curran’s long-standing role as an exceptional advocate for child health.

L to R: Dr. John Curran, for whom the neonatal lectureship is named; distinguished lecturer Dr. Vinod Bhutani of Stanford University School of Medicine; and Dr. Patricia Emmanuel, chair of the USF Health Department of Pediatrics.

The John Curran lectureship — one of the medical school’s first —  was established in 1992 by Dr. Robert Nelson, who served as chief of the Division of Neonatal-Perinatal Medicine from 1992 to 2002 prior to his role as chair of the Department of Pediatrics.  The lectureship honors Dr. Curran as the founding Neonatology Division chief and founder of the Neonatal-Perinatal Fellowship Program.

Each year, individuals with national and international reputations in neonatal care are invited to give the honorary lecture and to participate in the Curran Lectureship events, which include a dinner, a reception following the lecture, and time spent rounding in TGH’s neonatal intensive care unit with the fellows.  The speaker also visits with fellows during a luncheon to discuss their research and clinical interests.

Neonatology fellows with Dr. Bhutani and Dr. Michael Fant, current director of the Neonatal-Perinatal Medicine Fellowship Program at the USF Health Morsani College of Medicine.