“Look at every path closely and deliberately, then ask ourselves this crucial question: Does this path have a heart? If it does, then the path is good. If it doesn't, it is of no use.” ~Carlos Castaneda

Monday, January 28, 2008

We are all in this together ....

"We have two ears and one mouth so that we can listen twice as much as we speak.”

I haven't been a resident for a little while now and I think it has been long enough that I have truly forgotten some of the fear and anxiety I had as a resident. In the past, many attendings taught by pure fear. I have been there. I remember doing things not because I knew it was the right thing to do, but because it kept me out of trouble. I watch the residents come and go on my service. I see them do the same things in the OR and in the clinic. They do them because it has been beaten into them on another service. It was their way of staying "out of trouble." I question them on why and they can not give me a "good" answer. I looked back on my own experience. I tried to put myself back into the resident's perspective, but it is difficult.

From my current perspective, an attending interested in education, I am not here to have you be afraid of me or for you to do things without a reason. I am here to help train orthopaedic surgeons. The resident is here to learn how to be an orthopaedic surgeon. This is an unwritten agreement that we have made. We are in this together.

Sometimes, I feel that residents view the attending/resident relationship as an us versus them battle. Is it really us versus them? I think we, residents and faculty, need to realize that we are in this journey together. The communication about education needs to occur both ways. The attending needs to be clear with his/her expectations; and the resident needs to speak up when s/he has questions. It is a relationship that needs feedback from both participating parties.

During this next year, I will plan to improve the out national economy, get our troops out of Iraq, decrease our national debt, and improve our relationship with the rest of the world. Oh, sorry I was watching the state of the union address. During this next year, I pledge to communicate my objectives to my residents, to give more feedback about their performance, and to ask appropriate questions. I will be responsive to resident questions and concerns. I hope this will improve in our symbiotic relationship.

“The single biggest problem in communication is the illusion that it has taken place.”
~George Bernard Shaw


Anonymous said...

A perfect time for this post! I just started my rotation on ortho during internship, and am of course absolutely loving it! All of my residents and attendings are very excited about teaching at every opportunity possible, and I am like a sponge and loving it.

On the downside, I've never been more anxious in my entire life...it is very odd, and sometimes interferes with my ability to be myself. There is a persistent voice in the back of my head that I'm still not good enough, like what if they think how the hell did we end up with this guy? What if they regret their decision, or do they already? Might anyone have some words of wisdom?

I've got nothing but good feedback so far and am getting along great with everyone, probably just need to be willing to accept my own success and "let it shine".

...in other words, how can I "read between the lines" of good feedback to learn what people really think of me?

sorry for the long comment. I think your pledge to make your objective clear is an excellent idea, and urge you to give them feedback that isn't general but specific. The type that gives them some idea of where they stand compared with your expectations of where they should be would be greatly appreciated.

Bonedoc said...

This is usually a dilemma also in our part, being educator of our residents-some learning essentials is coupled with great fear among them. But in the end of their training, it is the acceptance of mistakes, learning from it and moving on that is the greatest "lesson" we can give to them.

Someonect said...

md007: i hope you internship is going well so far. your self-doubt is normal and expected. if you keep doing the "next right thing," you will continue to do well.

if you are actually getting feedback that you are doing fine, take it an run with it. i think it is more of a problem when you have no feedback at all.

Bone MD: i agree with you completely. sometimes the fear of making a mistake paralyzes the resident. mistakes happen, the question is how will you learn from those mistakes.