Efficiency vs. Learning in the TB Clinic

In TB clinic this morning I saw several patients referred for abnormal tuberculin skin tests. During these visits I asked about all of the various risk factors that would make it more or less likely for them to truly have TB, given the positive results. The clinic is highly organized and has clearly worked on improving efficiency in patient flow. What made my morning easier was a prepared template of key questions. These questions helped me organize my history taking, physical exam, and considerations of investigations. I found it to be an excellent tool to help me be functional in the clinic and contribute without much experience. It is also a way to standardize patient encounters in a clinic where staff and learners rotate through. I ended up taking the template home as a study tool. Reflecting on the clinic I thought about the balance between efficiency and learning during medical training. Set templates clearly can help streamline clinical encounters, however I see how they might take the onus off of the student to learn for themselves. As I move forward in this clinic and beyond, I will strive to not use set encounter templates as crutches, rather to leverage them as tools in my own learning process. I have already seen how reviewing the template as a guide in my own studying, rather than a substitute for my own studying provides a much richer learning experience. 

- MH