Tips for IM Attendings – Chapter 10 – Repetition

As a resident, I prepared a number of “chalk talks”. They were (at least in my mind) brilliant. I wowed the students and interns. But I never checked to see if they learned the topic. As attending physicians our goal should involve learners’ learning the material, which differs from “brilliant teaching”. How do we induce learning? Repetition helps learners absorb the material. As an educator it may seem boring or a waste of time to focus on repetition. But we teach not to look smart, but rather to transfer understanding. A brief anecdote may help. Several years ago the house staff presented a patient at morning report. The patient was a young woman with liver failure. She had Wilson’s disease. One clue on laboratory testing was a low alkaline phosphatase level. I did not know the diagnosis, nor the clue. 2 weeks later another house staff group presented the same patient, and I missed it again. Once again they taught me that a low alkaline phosphatase was a major clue to the Wilson’s diagnosis. I got it right the 3rd time they presented the same patient at a 3rd morning report. Learning new information is difficult. We do not remember everything that we hear the first time we hear it. Over the past 12 years our internal morning report in Huntsville has included students, interns and residents. Some of the students have continued at residents. Many have told me that each time I cover a topic (for example hyponatremia) they learn more about the topic. These are ver...
Source: DB's Medical Rants - Category: Internal Medicine Authors: Tags: Medical Rants Source Type: blogs