The Humanities in Medicine Seminar will give you a chance to reflect with your classmates on incidents that spark a visceral reaction in you during the clerkship. The following information is from the creator of this experience, Dr. Amy Weil.
Medicine Clerkship – Humanities in Medicine Seminar
Welcome to your Medicine Inpatient Clerkship! During these 6 weeks you will work hard and learn a lot. You will take care of very sick people and work in teams, teaching each other. This is where the proverbial ‘rubber meets the road’. The abstractions of your lecture halls, seminar rooms and texts/downloads will now yield to the visceral particularity of your suffering patients, their families and the examples of your colleagues and mentors. You and your team will diagnose, treat, educate, discharge. Sometimes you will cure or heal someone.
There will be times when you are overwhelmed by the enormity of what you still do not know or understand about biomedicine. Though you will do your best, sometimes you will be flummoxed by patients’ problems, unsure of what to do or say next, awed by your colleagues’ approach, shocked by decisions with which you disagree, frustrated by the social/cultural/financial barriers that make it difficult for you/your team to help your patients, improve their quality of life, keep them out of the hospital.
Assignment –Critical Incident Reports
As we discussed in Medicine and Society, many factors enter into situations you face in the real life practice of medicine. Please notice when you have a visceral reaction to a situation (when you feel that something is unfortunate/wrong/unfair/well done) and then jot down the scenario and your reactions. So called Critical Incident Reports (CIRs) offer a unique opportunity to enhance your learning and make you a better doctor.
Please take no more than 1 page to describe briefly the scenario that moved you and begin to analyze it. Please remember HIPAA and try to “deidentify” in order to protect patients and others involved and to free you to discuss the situations frankly.
Examples: patient discharged prematurely due to illegal status (what could you do to help this patient?); experience of racism/sexism etc by patient or staff (what could you have done?); ethical dilemma in care (what did you think was the “right” decision and why?); your own reactions to situations influenced by your life story; an awesome job done by a colleague (why was it great?).
Send your 1 page to firstname.lastname@example.org by the end of Friday of the second week of the clerkship. Dr Weil, along with available Advisors and other faculty, will facilitate discussion beginning with your reports. If you would NOT be willing to have your case shared among your peers, please indicate this on your report. Selected CIRs will be distributed in advance for review. From 12-1pm on the third Friday of the clerkship (after the UNC Exam), you will meet for lunch (which we will provide) to learn from each other’s experiences and brainstorm ways optimize outcomes in situations like these.
Questions to consider when reading the CIRs:
1. Have you experienced something similar?
2. Do you agree/resonate with the framing of the dilemma?
3. How would you improve/act differently in the situation?
An optional reading for inspiration: The Good Doctor, by Susan Onthank
Another reference from the New York Time on end of life decision making: What Broke My Father’s Heart