Residents ideas about involving hospital nurses and staff in medical education

During a recent workshop, residents brainstormed the following list of suggestions about how hospital nurses and other staff could be involved in medical education:
Have a coordinator who has all the info/contacts that students need
Give students an orientation manual that includes maps
Ask staff to wear nametags when students are new
Inform staff about the student’s schedule
Don’t overwhelm students the first day with information
Ask staff ahead of time if they are willing to provide:
a tour of staff rooms, washrooms, lockers, eating facilities
an orientation to the hospitals administrative system
information about and location of equipment used
basic skills orientation such as wts, BP, IV’s
informed consent of patients who will be working with the student
a friendly, helpful, congenial, sharing environment (Golden Rule)

Involving patients in medical education

A group of residents identified the following list of ideas for how patients might be recruited into helping with medical education:
Collect a pool of interesting, willing and practiced patients who would be willing to spend some extra time with students (ask people who might be bored, lonely, house bound)
Build rapport prior to request for assistance
Educate patients about working with students
Provide an explanation of expectations to patients
Emphasis how important the patient’s contribution to medical education is and how they impact the quality of future physicians
Post or hand out flyers to recruit patients
Ensure privacy and confidentiality
Be clear about the experience level of the learner
Respect cultural, religious and social values and beliefs of the patients
Ask permission (nurse, front desk might take this role)

What residents want in the hospital environment

In a recent workshop, residents identified the following list of what they would like to see in hospital environments:
Safe parking
Lockers
Easy access 24 hours a day
Easy access to scrubs when on a short rotation away from home location
Lounge area
Adequate space in classrooms
Computer access
Comfortable call rooms with extra blankets, pillows available
An orientation
24-Hr access to food
Onsite childcare that opens early and closes late
Staff bathrooms that are easily accessible
Gym
Non-hostile environment
Security and Safewalk personnel who respond quickly

Correcting Medical Errors

Allowing medical students to correct mistakes in a respectful and understanding manner is a key element of the Deliberate Practice model.
The following quote from Promoting Patient Safety and Preventing Medical Error in Emergency Departments is particularly pertinent when contemplating this process. http://www.aemj.org/cgi/content/full/7/11/1204
Drawing from the results of a questionnaire completed by 114 internal medicine houseofficers, Wu et al. suggested that encouraging discussion of mistakes with attending physicians along with encouraging acceptance of responsibility with a view toward constructive change would better equip residents to learn from mistakes made during training. They believed that medical educators have a role in dispensing specific advice about preventing a second occurrence of the mistake, providing emotional support, and helping residents interpret the feelings of distress that are part of learning from error. These approaches would differ greatly from what Mizrahi observed during a sociological study of graduate medical education: “Little in their 3 year graduate program allowed them to work through the attendant vulnerability and ambiguity accompanying the managing of mistakes.”
Mizrahi T. Managing medical mistakes: ideology, insularity and accountability among internists-in-training. Soc Sci Med.1984; 19:135 -46.[Medline]
Wu AW, Folkman S, McPhee SJ, Lo B. Do house officers learn from their mistakes? JAMA. 1991;265 : 2089-94.
Wu AW, Folkman S, McPhee SJ, Lo B. How house officers cope with their mistakes. West J Med. 1993;159 : 565-9.[Medline]

World Aids Day

I’m a week late on posting this but I think it needs to be said.
15 million children worldwide have been orphaned by Aids. Let’s take a minute to think about what that means. More than 50% of these children are in countries with fragile infrastructures, so children end up looking after their brothers and sisters. School becomes increasingly difficult to afford both in terms of money and in terms of time. Literacy goes down, future employability goes down. Girls become more vulnerable to prostitution and child marriages. Boys become more easily drafted into child armies, terrorism or the drug trade. A whole generation of healthcare workers are lost to illiteracy.
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