The simulation training program here is quite
remarkable, and I felt extremely lucky to have received excellent teaching from
several staff members, each with their own approach to identifying murmurs and
bedside exams. Some of these sessions were very personalized to the learning
objectives of me and my colleague, which made the sessions even more adaptive
and interactive. Internal medicine was something both of us were interested in
pursuing, and being able to receive simulation training for bedside procedures,
such as detection for ascites and paracentensis, which were tailored to the
required skills of internal medicine residents was a great way to help us
develop a basic level of confidence to attempt these procedures on real
patients in the future. Simulation training is something that will be very
prominent during our next years of residency; I'm glad to have initiated this
training process in such a safe learning environment.
Dr. HPK's clinic was also a fascinating
experience - you could never predict what he's about to quiz you on... medical
knowledge, geography, bizarre pieces of trivia... He created an interesting
environment where learning about patients' conditions was integrated with the
art of examineship, conversation and relationship-building. He also introduced
us to the “grey zone of medicine”, an area I’ve never heard of where physicians
and patients must learn to recognize and appreciate the fact that sometimes,
things in medicine can neither be proven nor disproven, and depend largely on
the patient’s preferences and available options. Being able to accept this fact
is difficult, especially in an advancing technological age where it can be easy
to believe we have found the definitive truth to most things. Many of Dr. HPK’s
patients sit within the grey zone; being able to help these patients navigate
their frustrations on their conditions is something that he seems to have
become extremely proficient in. His holistic view on health is an important
quality I will take away from this experience. His clinics also introduced me
to many rare conditions I've never seen before including Gitelman syndrome,
dermatomyositis, malignant exophthalmos, post-herpetic neuralgia, reflex
sympathetic dystrophy and scleroderma. The opportunity to learn about these
complex conditions from real patients is uncommon and certainly helped me
appreciate the art of diagnosis in medicine.
My
primary research area was formal mentorship programs in the medical curriculum
and this led me into debates on whether it is effective or not. Interestingly
after reading through several studies, my initial perception of mentorship being
a great addition to any medical school was quickly altered by understanding the
practical challenges in implementing such a program. As I go forward in my
training, I’m certain my interest in mentorship will continue to grow and I
hope I may use some of the knowledge I gained in my readings during encounters
with medical learners in the future. My colleague and I also did some minor
research into teaching strategies that can be employed in the ambulatory
setting. We came across the concept of SNAPPS and One-Minute Preceptor, both
evidence-based teaching models that have been shown to be effective in
improving student clinical performance. We were able to teach these strategies
to our fellow selective colleagues at the end of the selective. I felt it was a
great opportunity for us to connect with our peers and discuss medical teaching
in general, as well as learn how to formally develop a teaching session by
going through the steps of creating learning objectives, choosing content, choosing
a method of delivery, and finally, receiving feedback.
Overall,
this selective was an extremely positive experience. I felt that there was a
good balance of ambulatory clinics, teaching sessions, and dedicated time for
research, reading and blog reflections. I was particularly fond of how open the
requirements were for independent research. Apart from being provided a helpful
list of resources to search from, the research topics were completely decided
upon by us with minimal guidance on narrowing the research question along the
way. My colleague and I chose this rotation because of our interest in medical
education and curriculum development. I would definitely recommend this
selective to any student who has similar interests and wishes to gain new
insights on the art of medicine.
-JJ
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