See one, do one, teach one

February 27

by Alison

Today we were in the dermatology clinic.  With the new clerkship curriculum, I have had limited clinical exposure to dermatology.  I have tried to learn dermatology from textbooks and online modules, but it is sometimes hard to appreciate the subtleties, and certainly the texture, of skin lesions from books.  I am therefore very happy to have the opportunity to gain more clinical dermatology experience. 

At one point, the staff dermatologist saw a lesion he wanted biopsied and asked the resident and me to do a punch biopsy.  The resident asked me if I would like to do the biopsy.  Ordinarily, I’m happy to have the chance to practice procedures.  However, I had only seen one punch biopsy performed and that was more than a year ago.  Therefore, I didn’t feel comfortable doing the biopsy today and asked the resident if I could just observe.

This got me thinking about the often-used phrase “see one, do one, teach one”.  When I have recently observed a procedure, I am usually comfortable trying the procedure the next time.  However, when a significant amount of time has passed, I may have forgotten some of the steps and may require a refresher before attempting the procedure myself.  I feel like “see one, do one, teach one” is time-dependent.  I think it's a strategy that could work well in ambulatory teaching since there’s some control over which patients are seen at a given time.  For example, an instructor, having recently demonstrated a particular procedure, could arrange for another patient requiring that procedure to return when the trainee is scheduled to be in the clinic.  Perhaps instructors in ambulatory clinics could look for such opportunities to implement the “see one, do one, teach one” learning strategy.  I certainly hope that I get a chance to do a punch biopsy in the near future to reinforce what I have just observed.