Sunday, August 28, 2011

Education Beyond the Classroom

Learning the tricks of the medical trade comes from lots of exposure to lectures, books and hands-on experience. Initially we are expected to be attentive to professors who create a basic foundation and then pick up the rest on our own time through personal study and discussion with colleagues. When it comes to the clinical setting, the direct form of teaching dissipates and we carry more of the responsibility to be self taught. Yet there remains plenty of room for a student-teacher relationship. [Classroom at the Washington University School of Medicine 1943]

Learning Through Respect

In speaking with one of the residents at the program I am visiting, he reminded me that not all physicians remember what it is like to be a student. They have forgotten the basics and want to be identified as one who no longer has to be "at that level" of training. In doing so they often seem to have a chip on their shoulder, teach very little to students and ignore even the existence of students trying to be friendly. So doctor, my morning greeting was not an attempt to waste a breath of air, it was intended to be pleasant and acknowledge your existence in hopes that perhaps you would acknowledge mine. Little things like that are what really set a tone in my opinion. It standardizes a sense of mutual respect and understanding allowing for potential growth beyond that point. Maybe it is perceived as a "brown-nosing" tactic wherein I am gunning for a response. Whatever the case, I thought it was a simple common gesture in human interaction. What do I know, I am just a medical student.

Medical students just learn to grow thick skin. Patients give you grief because you are the first person willing to listen to their complaints and desires. After hearing out the patient, the student finally presents to the residents who are the first to think you have set them back because "you must have been delivering a baby in there." If you are not thinking what they are thinking, they will let you know without hesitation that you are wrong. But this mode of action comes from their superiors too. The attendings are looking at them in a similar light but may not always say so out loud. So it only makes sense that the residents become calloused and project their troubles onto the medical student who will smile, be pleasant and always take a verbal lashing for the ever coveted passing grade. All the while the student is thinking, "why do I pay good money to be demoralized in front of patients and coworkers?" We know our end goal and will walk through the gauntlet to get there, even if that means we will be red in the face a few times.

Once in a while, however, there are those who will remember the emotional strain medical students experience. In their wisdom, the residents will slow down and teach or maybe even learn something because we are all in this together. What one person may have recently studied, the other has not heard in a while. This resident remembers the efforts students are making to impress and succeed even if they fall short once in a while. The effects of the classroom extend beyond those four walls into the community and clinics. It has the potential to reside within each relationship we have for better or for worse. I refuse to let my education be compromised by those who have forgotten how a patient teacher can influence an eager student.

Question of the Week
A 24 year old medical student admires and begins to pattern her life after her surgical mentor. Which one of the following defense mechanisms does she exhibit?

A. Introjection
B. Projection
C. Rationalization
D. Identification
E. Conscious Control

Answer & Explanation


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