1-1banner
 
medpundit
 

 
Commentary on medical news by a practicing physician.
 

 
Google
  • Epocrates MedSearch Drug Lookup




  • MASTER BLOGS





    "When many cures are offered for a disease, it means the disease is not curable" -Anton Chekhov




    ''Once you tell people there's a cure for something, the more likely they are to pressure doctors to prescribe it.''
    -Robert Ehrlich, drug advertising executive.




    "Opinions are like sphincters, everyone has one." - Chris Rangel



    email: medpundit-at-ameritech.net

    or if that doesn't work try:

    medpundit-at-en.com



    Medpundit RSS


    Quirky Museums and Fun Stuff


    Who is medpundit?


    Tech Central Station Columns



    Book Reviews:
    Read the Review

    Read the Review

    Read the Review

    More Reviews

    Second Hand Book Reviews

    Review


    Medical Blogs

    rangelMD

    DB's Medical Rants

    Family Medicine Notes

    Grunt Doc

    richard[WINTERS]

    code:theWebSocket

    Psychscape

    Code Blog: Tales of a Nurse

    Feet First

    Tales of Hoffman

    The Eyes Have It

    medmusings

    SOAP Notes

    Obels

    Cut-to -Cure

    Black Triangle

    CodeBlueBlog

    Medlogs

    Kevin, M.D

    The Lingual Nerve

    Galen's Log

    EchoJournal

    Shrinkette

    Doctor Mental

    Blogborygmi

    JournalClub

    Finestkind Clinic and Fish Market

    The Examining Room of Dr. Charles

    Chronicles of a Medical Mad House

    .PARALLEL UNIVERSES.

    SoundPractice

    Medgadget
    Health Facts and Fears

    Health Policy Blogs

    The Health Care Blog

    HealthLawProf Blog

    Facts & Fears

    Personal Favorites

    The Glittering Eye

    Day by Day

    BioEdge

    The Business Word Inc.

    Point of Law

    In the Pipeline

    Cronaca

    Tim Blair

    Jane Galt

    The Truth Laid Bear

    Jim Miller

    No Watermelons Allowed

    Winds of Change

    Science Blog

    A Chequer-Board of Night and Days

    Arts & Letters Daily

    Tech Central Station

    Blogcritics

    Overlawyered.com

    Quackwatch

    Junkscience

    The Skeptic's Dictionary



    Recommended Reading

    The Doctor Stories by William Carlos Williams


    Pox Americana: The Great Smallpox Epidemic of 1775-82 by Elizabeth Fenn


    Intoxicated by My Illness by Anatole Broyard


    Raising the Dead by Richard Selzer


    Autobiography of a Face by Lucy Grealy


    The Man Who Mistook His Wife for a Hat by Oliver Sacks


    The Sea and Poison by Shusaku Endo


    A Midwife's Tale by Laurel Thatcher Ulrich




    MEDICAL LINKS

    familydoctor.org

    American Academy of Pediatrics

    General Health Info

    Travel Advice from the CDC

    NIH Medical Library Info

     



    button

    Friday, December 23, 2005

    Attendance Counts: Can irresponsible behavior in medical school predict who will become bad doctors? Some academic specialists think so. And they say attendance is one of the indicators:

    The study looked at a broad range of unprofessional behaviors in medical students. The strongest association with disciplinary action was seen in students who were irresponsible in attendance or patient care. These students were nearly nine times more likely than their colleagues to be disciplined when they became practicing physicians.

    The study is in yesterday's New England Journal of Medicine, and the data aren't as impressive as the press release makes it sound.
    Thirty-nine percent of physicians who were disciplined at some point in their careers by state medical boards had, in retrospect, some form of unprofessional behavior identified in their medical school records, compared to only 19% of the doctors who had never been disciplined. But, when the authors broke the bad behavior down into specifics, the differences weren't all that remarkable - the two groups only differ by about 6-7 percentage points in any one category. The widest disparity was in "capacity for self improvement" and "irresponsibility." The small absolute differences mean that it's still hard to predict who will be a bad doctor - although chances are if someone's a jerk in medical school, they'll be a jerk in the real world, too.

    The authors published more detailed information on rating medical school behavior in this earlier paper, which includes this evaluation of "physicianship skills".

    They are somewhat subjective, and could potentially be used punatively by a professor to punish a student. Although some students are very good at fighting back:

    Student B, a second-year student, received a Physicianship Evaluation Form because s/he missed several preceptorship sessions, was not sensitive to the needs of patients, and did not respond to feedback and make appropriate changes in behavior. A community-based preceptor, who is an experienced faculty member who had precepted many students, initiated these comments. The course director was convinced of the merits of the observations after discussions with the preceptor, who was considered to have excellent judgment and insight. The student felt that it was inappropriate that s/he receive a Physicianship Evaluation Form. This resulted in extensive communications over a three-month period between the student and the preceptor, course director, ombudsperson, and administration. An informal resolution session was held between the student, the ombudsperson, the course director, and the associate dean for student affairs. The student supplied documentation that demonstrated his/her appropriate attendance at the preceptorship. The course director retracted that aspect of the negative evaluation that had to do with attendance, but not the other remaining deficiencies in professional development. The student received extensive feedback during the multiple interactions, but it is uncertain whether the student was able to incorporate the feedback constructively. The preceptor was so annoyed with the frequency and intensity of the interactions that he is no longer willing to precept our students.

    And this:

    Student C, a second-year student, received a Physicianship Evaluation Form under the category of "relating well to faculty in a learning environment" for making an inappropriate comment about the quality of a written examination to fellow classmates while the examination was in session. At the meeting with the associate dean for student affairs, the student explained that the course director had established a casual environment with friendly interchanges between faculty members and students. The student readily acknowledged his/her behavior, but felt that submission of the form was punitive rather than educational. The student also did not know of the existence of this new professionalism-evaluation system, materials for which had been distributed at the orientation at the beginning of the academic year. S/he made constructive, insightful comments about the process. This interaction highlighted that there are many ways to help a student with professional development. In this instance, one-on-one feedback may have sufficed, which would have lessened the pain that the student felt because s/he received a form.

    Maybe medical schools should treat medical students the way an employer does an employee - make attendance count, and have quarterly evaluations of behavior in addition to grades. But do it for everyone, not just for the problem students.

    P.S. Wouldn't "professionalism" be a better word than "physicianship skills"? Or, even "form" - as in "good form" vs. "bad form"?
     

    posted by Sydney on 12/23/2005 08:43:00 AM 0 comments

    0 Comments:

    Post a Comment

    This page is powered by Blogger, the easy way to update your web site.

    Main Page

    Ads

    Home   |   Archives

    Copyright 2006