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Change Your Mind, Think Differently

Stefania Paolillo, MD, PhD
University of Naples Federico II
Naples, Italy

A brief report on my ISHLT International Traveling Scholarship Award at Brigham and Women's Hospital and Harvard Medical School

Change your mind, start thinking differently. This the main message instilled in me during my ISHLT International Traveling Scholarship at Brigham and Women's Hospital (BWH) and Harvard Medical School in Boston, USA. After I completed my Postgraduate Course in Heart Failure and acquired my Certificate in Advanced Studies from the University of Zurich in 2015, I applied for the ISHLT award to further enhance my skills in the management of advanced heart failure (HF) and develop a more comprehensive worldwide view. Two short weeks of a visiting fellowship at the Center for Advanced Heart Disease at BWH with Dr. Mandeep R. Mehra and his outstanding colleagues has been nothing short of an indelible and unique clinical experience.

In observing a seamlessly integrated multidisciplinary team composed of various professional disciplines, I was struck by the essence of collaborative spirit in the perfection of the delivery of healthcare, with a patient centered approach. Strikingly, I observed "tough medicine" practiced with ease in diverse clinical areas of advanced HF, focusing on the management of heart transplantation or the complex handling of patients with durable ventricular assist devices (VADs) or participating in the diagnosis of unexplained dyspnea by performing an invasive cardiopulmonary exercise test.

This incremental experience has helped me learn the importance of a complete clinical overview from the acute setting to the transition to homecare by observing and analyzing an integrated system that helps in reducing errors due to overwork by delegating different responsibilities across professional disciplines and that creates a network between the hospital, the patient and local healthcare system. I have been impressed by the profession of a nurse practitioner, not found in my country of Italy, which contributes to simplify a physicians' daily work, giving them the time to be involved in other activities and yet provides an unparalleled level of clinical patient centered care. Moreover, I had the opportunity to participate in educational conferences, using clinical cases, on specific HF topics and even was lucky enough to have the unique opportunity of a personal tutorial lecture by Dr. Marc Pfeffer on the evolution, uncertainty, and advances in HF therapy over the years.

This international traveling scholarship also provided me the chance to develop collaborations with Dr. Mehra in scholarly research activities, by starting from an idea in a personal point of view, then reflecting on it, analyzing the topic, examining the literature and finally converting the thoughts to an entirely new way of thinking and approaching the initial hypothesis. At Harvard Medical School, teaching knowledge is approached differently, by giving individuals the time and adequate resources to tailor their scholarly activity, leading you to start thinking differently, finally evolving your thoughts to develop a novel point of view.

In my opinion, this experience is best directed to those clinicians and researchers with expertise and mature skills on a specific topic that are seeking to extend their mental outlook, to create a connection with a leading research center and to develop a different approach to interweaving research and practice.

I am grateful to ISHLT for providing me with the opportunity to acquire this experience in Boston and hope that this can be shared with colleagues with similar experiences, promoting this ISHLT initiative in order to continuously improve our knowledge. Change your mind, think differently. ■

Disclosure Statement: The author has no conflicts of interest to disclose.

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