Thoughts on Incoming Intern Orientation

This particular week is the week that the new intern physicians arrived, and become oriented to clinical care. Ours start on June 24 with managing real patients. They are brimming with excitement, but also have a lot to do during the week.

It is interesting to hear from the "old guard" about how it used to be. "My

orientation was 'here is the ER, and here are the bathrooms: now go and see some patients.'" While I certainly would not think that such an orientation is acceptable nowadays, I have to reflect on what exactly we now make the new interns go through.  HIPAA training, ACLS, PALS, NRP, FIT testing, composites, meal cards, explanation of the numerous (not an exaggeration here) computer systems and log-in codes that are necessary are literally just a small part of orientation--and that doesn't even include Handoff training (my personal area of interest).  I mean no disrespect to our hospital administrative personnel by these comments, but am constantly reflecting on what we could do better for our incoming learners.

So what do they actually remember? While as educators we certainly do feel that it is important to have them learn why HIPAA training is critical, or that they have to foster professionalism within the context of social media, I do think that what currently exists truly is an overwhelming mass of "do this, don't do that, you must sign this, you must complete that." So how much do they really retain, when we KNOW that many learners lose interest after a very short time (adult learning theory tells us this)?

Does making interns sign a "I heard this info"-form really help? Does "don't forget to do this" really mean translation of knowledge? Will taking multiple modules online actually help when they won't be back to that particular hospital for 5 months? I'm not so sure.

If anyone has better ways of completing this training in an environment that

promotes retention of information, believe me, I am all ears. I suppose that a similar situation exists in starting other new jobs, and new hires are frustrated. What is so telling is that so many come back later saying "if only I had known that information during orientation, then I wouldn't have done X".

So how long are your orientations, and what do you do to make it educational and fun? Do you feel that the interns complete orientation ready for direct patient care within your system?  Personally, I am looking forward to the "10 things you ought to know about internship"-talk that one of the CURRENT residents is giving later in the week. I would be willing to bet that that is the most useful "orientation" information that the incoming interns will actually get for the entire week, despite months of planning and trying to fit so many “required” things into the week.

I am curious as to any ideas that others have. Believe me, everyone is learning here, and this is after knowing for 10 years exactly what previous trainees have told us about orientation.  I’m sure other educators out there have similar thoughts.  Please let me know your ideas.

Learning from Technology in Education

Yesterday, I had the privilege of attending a conference hosted by my children’s school corporation on the use of tablet computers/iPads in education.  As a medical educator, this absolutely piqued my interest.  In addition, as a parent, I have a big voice in how my children are educated, and want to know how I can help.  As it is now, my children are pretty tablet computer-savvy, and are always asking “Can I borrow your red iPad?” 

This conference was nothing short of incredible!  I learned so much, from how to get organized, to how to use video conferencing, to what apps are helpful for children in 3^rd grade.  The keynote speaker was truly inspirational, with a wonderful message that “technology is always changing, but teachers will never be replaced.”  This was so great to hear, as an educator myself.  I also loved seeing teachers from all over Indiana come together to learn for themselves and ultimately for their students.

It is my opinion that the medical education world can learn from what the Center Grove Community School Corporation put on yesterday.  The focus was how to embrace technology in order to connect, create and collaborate.  I saw my kids’ teachers there as well, which was invigorating to see that other educators take an interest in their own personal professional development.

As a take home, I am now jazzed up to learn more about how to use tablet in education, for my own personal learning network (I love the phrase “personal learning network”, which is similar to medicine’s “individualized learning plan”).

To the organizers of the iPossibilities Conference at Center Grove, thank you so much, from one education arena to another.  I have taken away so many great ideas from your conference, both for helping my own children learn, and also for my day-to-day work as a medical educator.  I hope to be able to put on a similar conference within medical education, to demonstrate what is possible.  Our learners deserve nothing less!

[To learn more about the iPossibilities conference hosted by the Center Grove Community School Corporation, which was funded through a grant from the Department of Education, and to see handouts, please click here.]

Medical Administrators – Should They Still Care For Patients?

I have been relatively absent from social media for the past week or so.  I have been doing inpatient duties on a general medicine service, and really enjoy working with medical students, interns, residents, pharmacists, and inpatient floor nurses.  It has been a wonderful opportunity to experience the day-to-day activities involved in hospital medicine, and of course, to see and care for patients.

The time on the inpatient service is demanding, both physically and emotionally.  Managing ill patients, long hours caring for complex patients and updating their families leave little time for my other duties in overseeing a CME office and a residency program.  I am trying my best to juggle all of these duties, but for now, the patient care priorities do come first.

As I was arriving one day this week, I saw the chair of another department coming in, and mentioned that I was on service doing inpatient work.  He remarked: “So good to hear that you are continuing this great work, and that you are still actively involved in patient care.  Keep it up!”  That made my day.

So I have been pondering this: should physicians who have major administrative duties and oversee programs, and thus have major time devoted to such activities, still care for patients?  Should they still remain clinically active in order to have “street credibility” with their mostly clinical colleagues? 

I think the answer to this is “yes”.  As busy as it is, I still believe that it keeps me fresh.  It allows me the opportunity to reflect on why I went into medicine in the first place.  It allows me to still remember what it is like to talk with a worried family member about a loved one, to see the gradual changes when a patient improves from hospital admission to discharge.  It allows me to also see the trainees doing what we want them to do: learn to care for patients.

The more I become involved in overseeing administrative programs, the less time I can devote to direct patient care.  But I still really enjoy doing the day-to-day patient care, and working with trainees as they learn the art and science of medicine.  I still haven’t forgotten the old adage by Francis Peabody: “The secret in the care of the patient is in caring for the patient.”

A Medical Educator Joins Social Media: One Year Later

I just realized that yesterday was my one-year “anniversary” for joining Twitter.  Wow, what a ride it has been.  I have learned so much in this short year.  Here are a few take-home points:

1.      If physicians and other health care professionals are not becoming involved in social media, they are missing out on a “place” where many of the patients already are.

2.      Despite #1, there are late adopters who feel that social media is a “waste of time” for physicians.  That is ok.  Forcing them to “do social networking” will not be fruitful.

3.      Social media is a fantastic way to meet other like-minded individuals who have similar interests.  I never would have met a great group of people (some in real life) had I not joined social media.

4.      Patients crave information about their health.  If they want it via social networking routes, we should offer it to them.

5.      There is a lot of mis-information floating around on the internet.  It is a duty of physicians to combat this and provide correct information.  I fail to understand why physicians don’t embrace this more: it is advocacy in the truest sense!

6.      If you decide to join social media, start slow, but start.  It will take a while, like riding a bike is not learned in 15 minutes.

7.      Do not let social media take over your life.  The important things (family, friends, etc.) are still the important things, so don’t lose the priorities.

8.      Push the envelope.  It is time for curricula in social media within medical education to be formally written, and also to be disseminated.  Policies or guidelines are one thing, but curricula are another.

9.      There are many “tools” to make it easier to integrate social media into “what you do”.  Pick one or two, and use them.  It will make the process less overwhelming.

10.   Have fun!  There is some great learning, and in addition there are some fun people out there, and I am a better person for having met them virtually.