Sunday, February 12, 2012

teaching

In two weeks I start teaching medical students clinical skills. I went to a meeting last week about the curriculum etc. I realized that this school does not have a clinical skills manual like we did when I was in med school and the expectations of the modules is not set out for the students. I find this very odd. The modules are based on clinical problems rather than body systems - i.e. heart failure, dehydration, kidney stone. I find this odd as many clinical problems have examination overlap. Relating the examination to a clinical problem is great, but one has to have the basics down. Pairing the renal and bladder examination (part of the abdominal exam) with the peripheral vascular exam and the "fluid status examination" of the JVP - which should be part of the cardiac exam, seems very odd to me. Hopefully I'll have my head wrapped around how to do this logically in the next week or so.

6 comments:

XE said...

If you're teaching Mac students, I might be able to help -- I had AMAZING clin skills teachers and could let you know some of the stuff they did.

Liana said...

That seems very strange. U of C was one of the first schools to adopt clinical based teaching (meaning you learn about the symptom and then the possible causes rather than the other way around) and even so, our clinical skills were still split up by system (cardiac, resp, msk, etc.)

Good luck. I think it is great that you're teaching!

medstudentitis said...

Liana - they call this the "renal" exam... but honestly, a "renal" exam is really just parts of other exams.

XE - yes, it's Mac students. I'm gonna have to figure out how to be inspirational in the next week and a half.

XE said...

So for MF3 people already know the abdominal exam ans already know the cardiac exam (incl JVP). It's really just showing people how to put it all together. We learned assessment of volume overload/dehydration, with a focus on pediatric dehydration, and the history taking for renal colic and renal failure. We did "approaches to" hyponatremia, hypokalemia, and hyperkalemia and reviewed all our acid/base abnormalities. MF3 is a REALLY weird block to teach clinical skills; all the other MFs are much more straightforward and traditional. It's too bad they didn't start you with an easy to teach MF like MF1 (history taking, vitals, cardiac exam, resp exam, approaches to SOB and chest pain, and murmurs).

XE said...

Oh! And MF3 is repro also -- ob/gyn clin skills are taught separately, but it's only a one day thing. Your group might really love getting a chance to review things again (ie leopold's, SFH, approach to gestational HTN, etc).

Dr. J said...

Teaching is just like everything else in medicine, it's all about practice. Whatever happens do an autopsy, figure out what you did that worked, what didn't, refine your technique and do it again. Repeat over and over again, plan on being an eternal student of everything you do.

I sincerely think that this is the best and most humble way to practice everything in medicine. You don't have to be an amazing teacher on day one or even day one hundred, but if you incrementally improve at something each time you do it you will eventually be an expert.