April 02, 2013
Fatigue vs. Handoffs
Shorter shifts in residency mean more frequent handoffs between people who are least skilled to do handoffs and the result is more medical errors.
And of course there's the sobering fact that post-residency docs will have seen very little continuity of care.
Basically we declared doctors should put more heart into their craft, then turned hospitals into assembly lines.
March 07, 2013
Residents and Med Students have different needs
Don't overwhelm the med students by teaching them alongside residents. There is a qualitative difference in what and how they need to learn.
January 17, 2013
Med Ed Buildings
When I was at Iowa, there was a new Med Ed building just finished and it was a big deal: learning communities! practice rooms for SP and physical exam skills!
At Michigan we don't have a special Med Ed building, though we do have a "Learning Resource Center" and a "Clinical Simulation Center" housed in different parts of the hospital/bioscience complex.
How big of a deal is it for a medical school, embedded in a big university hospital to have a dedicated building for medical education? Is it worth $75 million?
January 08, 2013
Also, we need more teachers
What happens to medical education as undergraduate medical student enrollment rises? Canada is already finding teaching time rising precipitously. How do we keep the growth and ensure high quality education?
The options, as I see them, are:
- More teachers or teacher hours
- More efficient curricula
What am I missing? Teaching takes time and content. Which gives us better leverage over education efficiency? It's an empirical question.
December 03, 2012
Are doctors more musical?
It seems like docs tend to start bands and play concerts more than other types of people. Am I wrong? It's just something I've noticed over the years in Med Ed and maybe it's just the confirmation bias but this sort of thing never surprises me.
November 16, 2012
October 22, 2012
Hospitals are sad
This is an insight worth pursuing. If we want doctors to be more patient-centered, we'll need caring, sensitive people to go to medical school. If hospitals are sad, some of these people will be deterred.
September 21, 2012
Distrust and Assessment
I think assessment is the most important aspect of any standards-based education system. But we don't talk nearly enough about the distrust that assessment causes. We know self assessment is wildly inaccurate. So we know there are lots of people who think they're great but bomb a test. Of course they distrust the testers.
How can we build a more relaxed summative testing environment?
August 10, 2012
Bullying stinks and schools and residencies need to eliminate it. But there is always going to be a frustration in a system where trainees are involved in life-and-death patient care. Plus, people are people and people are impatient and cross. Especially the people who are selected for their competitiveness and self-assuredness.
As I get older I'm more and more surprised how hard it is to remember what it was like to be less experienced. Graduate students seem unqualified to me, largely because I've forgotten how incompetent I was when I was a graduate student. This grumpy "harumph: kids today" attitude must be an intolerable frustration for attendings on a stressful hospital ward.