WILTIMS #371: Lessons for my future self

One of the skills that we are supposed to be honing during our clinical years is the ability to understand and thrive in a complex health care institution or, put more succinctly, to brave the bureaucracy. Med students, being somewhat intelligent, are generally capable of figuring out how things work in whatever setting we are thrown into. That includes straightforward things like how to use the electronic chart or the procedure for requesting blood from the blood bank, and more subtle things like who to address by first name, what work is supposed to be done by who, or where it's best to stand in a crowd based on a need-to-know hierarchy.

One of the more specific areas of this general category of learning is not explicitly part of our curriculum. Often subliminally, we are learning how to and how not to teach. Being at the very bottom of the totem poll, we have no one below us to teach yet. But in nearly every interaction with the fourth-years, residents, and attendings above us, we are finding out what styles of instruction are most and least effective.

It's actually remarkable that in a field where after a couple years you are taught, not by dedicated instructors, but by the students themselves that are ahead of you in the educational tract, we are never extensively taught to teach. Because of this, some people are great at it, others learn to be better, and still some remain stubbornly oblivious to their daily missteps. So, in what seems like a surprisingly mature response, some of my classmates and I have come to look at each poor interaction with our superiors as an opportunity to note for our future selves how we can try to consciously avoid the same pitfalls when we are in our superiors' shoes.

Here are some of the takeaways I can think of at the moment:

• Communicate better
• Be explicit- Until proven otherwise, assume that your mentee has no idea who or what you are referring to when you use pronouns or acronyms. "Go down to Dr. Mumble's office and ask her what the EP3!TX value is," is just asking to get a blank stare back from the person.
• Keep everyone in the loop - If the only interesting thing a medical student will get to do today is a surgery and that surgery has been moved up, make sure to let them know.
• Be efficient/respectful with other people's time
• Try not to make someone wait an hour for something that requires 30 seconds of your time.
• If you assign something like a presentation for a student to work on, actually bother to listen to them present it, even if briefly.
• Be nice
• If someone doesn't know the answer to your question, don't judge or berate them. Maybe ask them to look it up for tomorrow.
• Fill out forms
• Remember how important and stressful all the stupid forms that med schools make you fill out are to the students. Just because they're dumb, it doesn't mean they're not a major area of anxiety for your mentee.
• Show/explain everything
• Anything is more interesting than standing in the corner, wishing for something to do. Bring your student everywhere with you and monologue as much as possible to show them why you're doing whatever you're doing. It's much easier to learn when you're A) in the room and B) not guessing in silence about what's happening.
• Be enthusiastic
• At least occasionally, try to show why you chose to go into your field and kindle some excitement in your mentee. Being jaded is poisonous to an enjoyable learning atmosphere.

TIL: Cervidil is a prostaglandin medication (specifically dinoprostone) than can be inserted into the cervix to hurry dilation. Unlike another prostaglandin, misoprostol, which has a formulation that produces the same effect but is immediately absorbed into the tissue, Cervidil is continuously released from a string-like drug vehicle. This means that if a serious side effect occurs, the string can be removed, whereas the misoprostol version is already absorbed.