Few weeks ago I got a distinct privilege of sitting at a viva station in the exam for first year medical students at our medical school. These are brand new students. Fresh out of 10+2, they have started their arduous journey to become doctors. Enthusiasm is palpable. Their trepidation is apparent: it must have been just few weeks or months that they have been introduced to esoteric terminologies and concepts of medicine. Furthermore, our school places a big emphasis on social responsibility and critical thinking. They must be torn out of their minds in this bewildering world where concepts are being played around them, teasing them, taunting them and daring them.
I had two questions to ask : one was about communication with patients and another about a concept in patient care. One answer by three of the twenty six students that I talked to intrigued me. They said, "You should interrupt patients after 17 seconds if they keep talking." It did not make a sense to me. But three students are saying the same thing. It has been a while since I last saw one of these History and Physical Examination cook books. Have they come up with new stuff?
So I decided to pull one out of library shelf and take a look. What they meant was, on an average, physicians interrupt patients after so many seconds. Poor students, who probably have slept only a few hours trying to cover all the bases for next day's exam, got it upside down!
These students are just starting, the mistake is almost cute. But you hope they don't have to go through this confusion in some of the basic stuff of being a doctor.
These are the kind of things they should be learning by seeing it done. There is no good substitute than the example of deed. Let's talk an example:
Being a diligent student at the medical school, text book concepts about good patient care was not totally unknown to me. Concepts of empathy, respect did make a sense. But my real education on those issues was seeing the doctors do it. On my first day of residency rotation, a senior neurologist helped an elderly patient take off her socks to do ankle and plantar reflexes. After being done, he put back the socks, helped her with the shoes and walker before she could sit down to talk about her problems. I was taken aback. Does a senior doctor do such things:Take out a person's socks and put them back as if he is a helper in an elderly home? But as the residency days passed, it became obvious that it was a basic courtesy: helping an elderly person. Subsequent days have offered many more occasions to see such deeds that makes me feel privileged.
Our health care system should be able to provide such an opportunity for our students too. A clinical care area where a patient will be treated with dignity and respect will demand the same from a novice student who has all the good intentions of being a superior doctor. Patient care where patient's interests hold supreme will indeed prime the malleable minds of our young doctors to hold up to that standard. Clinical care is where all the real action of education starts, in my opinion. There are no stronger lessons than seeing things being done. Concepts are abstract, they belong to the realm of imagination. We deal with breathing lives, deeds do matter.
Unfortunately, it is a sad realization, our institutions do not currently have much emphasis on improving patient care. Our educationists are quite fired up when it comes to talking big syndromes in class rooms but when it comes to taking care of small details in patient care (which carry a huge implication for patient outcomes), they are listless, absent and sometimes abhorrent. You will see sleek classrooms in many of these institutions, but they will have crammed up all their patients in a space where breathing is difficult. This needs to change. It is not good.
I had two questions to ask : one was about communication with patients and another about a concept in patient care. One answer by three of the twenty six students that I talked to intrigued me. They said, "You should interrupt patients after 17 seconds if they keep talking." It did not make a sense to me. But three students are saying the same thing. It has been a while since I last saw one of these History and Physical Examination cook books. Have they come up with new stuff?
So I decided to pull one out of library shelf and take a look. What they meant was, on an average, physicians interrupt patients after so many seconds. Poor students, who probably have slept only a few hours trying to cover all the bases for next day's exam, got it upside down!
These students are just starting, the mistake is almost cute. But you hope they don't have to go through this confusion in some of the basic stuff of being a doctor.
These are the kind of things they should be learning by seeing it done. There is no good substitute than the example of deed. Let's talk an example:
Being a diligent student at the medical school, text book concepts about good patient care was not totally unknown to me. Concepts of empathy, respect did make a sense. But my real education on those issues was seeing the doctors do it. On my first day of residency rotation, a senior neurologist helped an elderly patient take off her socks to do ankle and plantar reflexes. After being done, he put back the socks, helped her with the shoes and walker before she could sit down to talk about her problems. I was taken aback. Does a senior doctor do such things:Take out a person's socks and put them back as if he is a helper in an elderly home? But as the residency days passed, it became obvious that it was a basic courtesy: helping an elderly person. Subsequent days have offered many more occasions to see such deeds that makes me feel privileged.
Our health care system should be able to provide such an opportunity for our students too. A clinical care area where a patient will be treated with dignity and respect will demand the same from a novice student who has all the good intentions of being a superior doctor. Patient care where patient's interests hold supreme will indeed prime the malleable minds of our young doctors to hold up to that standard. Clinical care is where all the real action of education starts, in my opinion. There are no stronger lessons than seeing things being done. Concepts are abstract, they belong to the realm of imagination. We deal with breathing lives, deeds do matter.
Unfortunately, it is a sad realization, our institutions do not currently have much emphasis on improving patient care. Our educationists are quite fired up when it comes to talking big syndromes in class rooms but when it comes to taking care of small details in patient care (which carry a huge implication for patient outcomes), they are listless, absent and sometimes abhorrent. You will see sleek classrooms in many of these institutions, but they will have crammed up all their patients in a space where breathing is difficult. This needs to change. It is not good.
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