“We need multidimensional perspectives”: UNB “Connect the Thoughts” competition motivates students to solve healthcare issues
Published in The NB Media Co-op
(*artwork: ‘Connections’ by Incé Husain)
Established in 2020, Connect the Thoughts (CTT) is a student-led competition at UNB that invites students to think critically about current issues in New Brunswick’s healthcare system.
The competition revolves around a fictional healthcare “case” that features an individual facing barriers to care in New Brunswick’s healthcare system. Student teams then collaborate for eight days to learn about the case and devise solutions for the issues it showcases. At the end of the competition, these solutions are presented to judges with experience in healthcare domains. Student winners receive a monetary prize, and all student solutions are posted on the CTT website.
This year, CTT’s healthcare case is about geriatrics and long-term care. Hala Nasir, a fifth-year biology student and co-chair for CTT, says this topic was driven by student experiences in the CTT organizing team.
“We have some members in our executive team who work in nursing homes and who work in the hospital, things like that, and it influences the kinds of topics that we end up choosing,” says Nasir. “(Coming up with topics) is a collaborative process and it’s things that we have kind of experienced and noticed within our community.”
CTT’s process for officializing their healthcare case is rigorous. Andy Jin, a fourth-year biology chemistry student and co-chair for CTT, says that it is crucial that the healthcare case is realistic and specific. After CTT members discuss ideas for topics, they send research-backed pitches to reviewers - experts in healthcare domains - who provide CTT with feedback on the cases. This process continues until a healthcare case is deemed realistic, relevant, and interdisciplinary. The final product is a “human story” about an individual and their experience with the healthcare system, accompanied by background information on the topic.
“We sort of fabricate a fake patient and we follow them through their journey within the healthcare system,” says Jin. “The criticism process is quite - not harsh - but elaborate. Last year, the case developers were talking about how much feedback they got from the reviewers, and how there were a lot of oversights in the first draft. Realism is one thing; another thing is whether (the case) reflects the issue we are trying to solve. So, let's say we’re trying to solve the issue with long term care, and then we venture into another direction that wasn’t intended. That also gets fixed through this process.”
Sarah Balcom, an assistant professor of nursing at UNB with research interests in interprofessional care and interdisciplinary research, helped with the review process. She says the cases always stem from current events, and identifies access to care as an overarching theme. Past cases involved a newcomer to Canada who was unable to access culturally sensitive care; a university-aged person who was unable to access mental health support; and a man who was unable to access support for a substance misuse disorder.
“The cases are issues that we have within the province, so the solutions would be of interest to a lot of decision makers in the province,” says Balcom. “(We gauge whether a case) is going to be something that's truly interdisciplinary such that anyone in the competition can approach it, if it is something that's particular to New Brunswick, if it is in the media a lot lately.”
To take part in the competition, students must fill out an application form. The form includes open-ended questions designed to probe students’ creativity, attention to detail, and approach to solving difficult problems.
One question on the application form read: “Describe a colour to someone who has been blind their whole life”.
“That question, specifically, is to test the applicant’s ability to think outside the box, and to understand their framework to try to solve these seemingly impossible challenges,” says Jin, who devised the question. “Because some of these healthcare challenges that we face today, they seem like they’re unsolvable. We’re interested in the way that they structure their narrative around that.”
CTT also strives to unite students from different disciplines in the competition. This might nurture diverse dialogues that transcend the frameworks of a single discipline. In future, CTT hopes to open the competition to UNB-SJ and STU students.
“I think having people from different disciplines really breaks the potential of an echo-chamber that might occur with, say, just STEM students or just arts students,” says Jin. “This is also why we encourage people who don't know each other to be on the same teams. (We want) that ideologies challenge each other.”
The eight days of the competition span team-building exercises, training sessions that familiarize students with the healthcare case, brainstorming ideas about solutions, and presenting solutions to judges. Throughout the competition, student teams are aided by mentors - UNB alumni or graduate students - who help students develop ideas and collaborate.
Balcolm speaks highly of the training sessions. Last year, when the competition topic was the opioid crisis, training sessions involved a hands-on component that taught students to administer naloxone, a drug that temporarily reverses opioid overdose. The opening ceremony also included presentations from community members who had expertise in the competition topic.
“One of the exciting things about CTT is that the competitors may or may not have any experience with whatever the topic is, and so the presentations are an opportunity to provide some background information so everybody is entering the competition with some knowledge of the topic.”
After each team presents their solutions, judges discuss the solutions with students to further probe their thinking. Though CTT provides the judges with a criteria for assessing the presentations, it is largely open-ended and allows judges to contemplate student solutions from their unique backgrounds. Last year, the judges were Horizon Health director Emily Bodechon, Sophia Recovery Center director Sam Flewelling, nursing professor Tracy Rickards, and Jules Maitland, director of non-profit partner All In.
Each team also makes posters that are hung in the Wu Conference Center on campus, allowing competitors and judges to converse more informally. In future, CTT hopes to open the poster presentations to all members of the community. This might enrich local understanding of healthcare in New Brunswick and spark discussion with healthcare services.
“We are planning to work with health authorities such as Horizon and Vitalité, and we did reach out to them last year,” says Jin. “We would really want to have these solutions looked at by them, and if they are good, then hopefully enacted.”
Balcom and Nasir discuss their personal thoughts on healthcare in New Brunswick.
Nasir is optimistic that the interdisciplinary, dialogue-rich platform that CTT provides will advance the future of healthcare, equipping students with multidimensional perspectives about healthcare solutions.
“These healthcare issues that we’re dealing with are so complex and it’s always very multidimensional. We need multidimensional perspectives in order to tackle the issues that we’re currently facing,” says Nasir. “So, I feel like being able to have a competition like this where we’re able to provide students with this platform to really showcase their problem-solving skills and really hone those skills in terms of critical thinking and creativity - it’s just going to progress the future of our healthcare system in New Brunswick.”
Balcom believes that there is a desire to engage in more interdisciplinary dialogue, but that some decisions about healthcare need to be made urgently and may not allow deliberation.
“I think people always want to have more inter-professional dialogue. And I think one of the challenges we have right now is that the problems we are currently facing are big, and they take time to solve,” says Balcom. “I think dialogue is happening, but there's always a balance between having enough dialogue and - sometimes decisions just need to be made now. I think the challenges that we have in New Brunswick is balancing the need to make decisions and changes quickly, with making sure that everybody who should be consulted and should be involved in those solutions is able to be as involved as they'd like to be.”
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Last year’s CTT competitors share that CTT instilled them with excitement, empathy, and new insights about the New Brunswick healthcare system. The healthcare case, on the topic of opioid misuse and harm reduction, featured a man who was prescribed opioids for back pain and then began to spiral into opioid addiction. The case also included a fixed budget that student solutions had to accommodate.
Yara Bayoumi, a recent psychology and classical studies graduate, describes her mental flow during the competition as “overwhelming but in a good way”. It was a dive into articles about opioid use, harm reduction, substance use, non-stigmatizing language, and gathering all the information into a narrative that addressed the case.
“The competition was one week of us discovering as much as we could and breaking down the case we were given,” says Bayoumi. “What could be done to fix every single problem along the way? To fix every single problem you had to do research on all the topics.”
Bayoumi’s team came up with solutions that included reducing the price of naloxone kits to render it more accessible, or encouraging people who struggle with addiction to use opioids in groups to reduce the risk of overdose. Bayoumi shares that the research experience helped her empathize with those with substance use disorders.
“Whenever I thought of substance use, I always thought that people who struggle with it are using it recreationally. But I realized that most people who start do take it because they need help, they need medication, it starts as a support system. And from there it just gets worse,” says Bayoumi. “I think that humanized people who struggle with substance use disorder for me. It made me see them more as people who are struggling with a problem than people who are causing the problem.”
Bayoumi believes that medical systems may rely too much on prescribing medication and could shift towards natural treatments. She shares that her mother suffers from migraines, and a doctor had immediately prescribed her a painkiller that can cause addiction. Wary of becoming addicted, her mother instead chose to manage her migraines with physical therapy, lower dose pain medication, and lifestyle changes.
“I just couldn’t stop thinking of my mother,” Bayoumi says of working on the case. “My mom could be like him - just an everyday person struggling with pain, and if you get given the wrong medication or dose, that’s a terrible thing. There’s no coming back from that. It goes back to the issue of doctors over-relying on medication rather than focusing on more natural treatments.”
Leslie Nghiem, a second year business student, says she was “clueless” about opioid misuse in New Brunswick before CTT.
She says she intuitively tended towards “idealistic” solutions, like setting up new support programs for those with opioid misuse, which wouldn’t be feasible within the allocated budget for the case. Her thinking grew by talking with her team, who suggested that her idea could be transposed to an online setting with virtual support sessions that would suit the budget. Nghiem says her strengths lay in designing the poster and articulating the solutions during their presentation.
“I think we worked well in the end. (My teammate) tried to press down my visions into this budget, so I think it's a really good combination of a team. I tend to draw a more emotional path, like having a support aid program or a house for them to stay in. (My teammate) was more realistic.”
Nghiem was most engaged by the topic of stigma in opioid misuse. Guided by their mentor, her team divided their solutions into “short term” goals that aimed to reduce stigmatization, and “long term” goals that sought to build treatment centers.
“I think the word “stigma” is such a strong word in the case study. That’s one thing we broke down and gave solutions on how to decrease stigmatization,” says Hoang. “Of course, it's impossible to talk about everything - our case is just one in many thousands. Different people have different experiences with stigmatization and substance use.”
Arnab Taranga, a 3rd year sociology and criminology student, competed in CTT with a history and biology student. His team addressed social stigma surrounding opioid misuse by proposing town hall community events led by doctors, nurses, and politicians to increase awareness of opioid misuse and available support. These events may shift public support towards broader systemic changes that address opioid misuse and stigma. To ensure financial sustainability, Taranga’s team sought to improve current healthcare systems instead of devising entirely new solutions.
“We were thinking of a solution that would be sustainable and also realistic,” says Taranga. “We can think of making more education in schools, hiring more doctors or nurses to treat folks and create specialized units - those are great solutions, but are they realistic in our current socioeconomic structure? That’s the question we asked, and the answer was no. There’s barely enough funding as it is in healthcare. So then we thought we should focus on the existing structure and how to work on that.”
Participating in CTT also encouraged Taranga to join naloxone advocacy movements. These Canada-wide movements strive to distribute free naloxone kits in the province.
“(Naloxone advocacy) is something I’ve been working on with folks on-campus and off-campus,” says Taranga. “I have to thank CTT for that because, before that, I didn’t even know that something like naloxone existed, but here I am, advocating for it now.” ♦
A shortened version of this article appeared in The NB Media Co-op on February 11th, 2024: