Friday, January 18, 2013

Fascinating Professionalism Class: We Learned Stuff

This post conforms to the blog rules.So, the other day I had my first EXCELLENT professionalism class. We were told to wear professional dress and come to the Simulation Center. (And that was all we were told.)

I'd heard about this professionalism class from an older student last year. She told me that they put you in ethically sticky situations and see how you perform. I shouldn't say any more specifically, since not all of my classmates have had this session and we're supposed to keep the standardized patient cases secret. That would be like giving away the beginning of a speed chess problem before the tournament. 1) Against the rules, 2) Especially in professionalism class, and 3) Lame anyway.

So although I can't tell you about the chess game, I can tell you about the human-human interaction between the players. This interaction is especially interesting in a standardized patient setting, because one player is an actor, and the other is being tested. To begin the test, we are walked from a waiting room to a hallway of exam rooms, which look (on the inside) just like a room in any real doctor's office. We are placed in front of preassigned numbered rooms. On each door is an introduction of the situation, e.g. "Mrs. Spazz is the patient of a physician who recently left your practice; she is a new patient of yours today. You have a very busy clinic day today and only have ten minutes to see her. Her previous medical records indicate [some ethical issue that sends cold sweat shooting out of every pore, or just makes you moan and say 'gaww, you're kidding, I have no clue what to do with this.']."

To my right and to my left down the hall of doors stand other medical students like me, reading about other sticky or apparently-not-sticky situations. Then, a voice announces over the intercom: "Students, you may enter the rooms to begin your encounter." A chorus of polite doctor-tapping on the doors is succeeded by the clacking of ten door latches and the faint cheery "Hello, I'm..." before the other students disappear from me and I am entirely wrapped up with the patient-actor in front of me. They are extremely ordinary people, who are chosen to match their pretend situation ("script").

During each of yesterday's sessions (and I saw four "patients") was videoed by two cameras and was at times watched in real time by the lawyer who teaches the class. Each standardized patient fills out a form after I finish with them, and I can watch the video footage later.

I love these sessions, because I get to act like a doctor. I love acting, and I love (or think I love?) being a doctor, so it's an awesome combination. And the standardized patients are so good! One guy seemed so stressed out that I passed him the tissue box after bumblingly following the instructions on the door (then the illusion sort of ended as he pretended to have to blow his nose). Another person seemed so truly fragile that I hesitated to complete my ethical duty. (I did, just...not very gracefully.)

There's a definite sense that the Sim Center is a game, though. I knew certainly in at least two of the four settings that I had a goal and if I obtained it, I would "win." I knew that I needed to leave the room with Thing X done, and if I did that, the encounter was a success.

I've had this feeling occasionally in preceptorship. Like "Achievement unlocked: Rapport with Patient," or "Achievement unlocked: Held Uterine Manipulator." But although natural to being in a student's role and growing up, learning, and living on a constantly-changing permissions (one day you can't scrub in, the next day you can), it's finally an immature attitude. An adult would work with patients and not count successes in terms of thrilling achievements or personally exciting lists. (Given: an adult can have milestones and recognize when something important happens in an encounter or a career.) I hope that my success in medicine and life does not depend on a little shelf of invisible trophies.

Rather, I hope it depends on being made like Christ and becoming love for others. Even in my workplace, I hope "success" is "love." Otherwise, what an unsatisfying life, never complete! Even now (after a lifetime of school) I'm already realizing that living in expectation of the next prize is a completely stupid way to live. I want to be full all the time, not at some unspecified future time that might never come.

All that heady thinking aside, though, it was wonderful to anticipate a life of working with people all day--going from room to room and touching lives. I can't wait to be a doctor!

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