Tuesday, July 21, 2009

to pimp or not to pimp

teaching on the wards
i consider myself a pretty good teacher. when it comes to delivering a lecture, i have a lot of energy and i think i am decent at explaining things clearly and creating an interactive classroom environment. i don't really get nervous in front of a group, and i am comfortable writing things out on a white board. this is all because i worked for kaplan for many years teaching MCAT and then training new teachers, and so i've spent a decent amount of time working on these skills.

but somehow on the wards, i have trouble. i think part of the problems is that enlightening med students and new interns is not that structured, formal classroom environment that i was used to back in my days at the the big K. instead, it's more about pulling out teachable moments and giving mini-lessons on the fly. and i have a hard time focusing on that when there are patient-care-related loose ends floating around -- even if those loose ends are not terribly critical or time-sensitive.

i also have a hard time with pimping, which is medical-academia speak for asking your med students questions until he/she breaks down and cries. okay, not really. i actually never really minded being pimped, as long as it was done nicely. but sometimes i feel overly mean doing it, so i don't. but by avoiding this (or giving answers away 2 seconds after asking), i reinforce my specialty's reputation as a bunch of softies and the students may not try as hard, therefore not learning as much. and i feel bad about that, too.

how can i win? i think that i need to prepare a little more. maybe i could come up with some handouts with open ended cases, basic pediatrics scenarios that i can work the students through during down time. it's a little late in this rotation to be revamping my method, but i'll have plenty of other times to work with students in the future. it's actually something that i DO enjoy when it goes well, so it will be worth it to me!

coming soon!
a poll regarding this site's name. i think a 5th birthday makeover may be in order . . .



workout: 5 miles with 6 x 800m intervals -- pace anywhere from 7:16/mi to 7:39/mi

reading: finally finished the peds in review article on hypothyroidism!


  1. When I used to teach medical students and residents (unbelievable, but true), I would find something in a random case and then sort of zoom in on it so that they knew that thing inside and out...and it doesn't have to be pimping. For example, we see people in the ER on digoxin all the time and I'd ask the (gulp) third year resident whether dig-effect on an EKG was something you saw:
    a) when dig level was low
    b) when dig level was therapeutic
    c) in dig toxicity
    (double-gulp), they would day c most often, which is wrong. This would be followed by two things:
    1) reinforcing that in a few short months (years) they would be standing by themselves all alone in an ER in the middle of nowhere and they would have no one to ask and
    2) telling them to go read about digoxin effects, including toxicity, and be read to give me and their colleagues a 3-5 minute talk on it-no slides, just a talk. And they had to tell me one thing I didn't know about it.

    Everyone wins.

  2. One thing I really miss about working in a community hospital is rounding. During nursing school, we were always encouraged to go hang out by the doctors when they were rounding (in their giant eight person crowd)...Many of them gave the nursing students funny looks, but I learned a lot from listening in. Sometimes doctors and medical students would sit in the nurses' station and get mini-lessons, which I'd always eavesdrop on while charting or something. The questioning/talking seemed less like "pimping" and more like a collective talk about what was going on. I know I learned a lot!

  3. MSB teaches Kaplan!

  4. Jenny7:08 PM

    As a third year medical student, I just have to thank you for even WANTING to teach - I understand residents are super busy with patient care, but it's frustrating when someone can never be bothered to explain something at our level even in spare time. Also, handouts are awesome. I agree with martinidad too that pimping is useful when it serves to remind us we will someday have to be on the ball with this stuff on our own, so as long as it's done just up to and not past the point of tears, I say go for it. :)

  5. i have no real advice about pimping as i am still a lowly pre-med student. BUT i think that if you grill the students in a respectful manner (which you totally seem like you would do) it doesn't matter how hard the q's are because they will feel like it's ok to answer and be wrong. because you're theyre to teach them...

  6. atilla11:17 PM

    probably the best part of pimping is that you get to a point where the res or student does not know the answer and then they learn the most important thing...to say and to realize " I don't know the answer" but if that's followed by I will look it up, then you have succeeded in helping that student. stop them cold when they start bs'ing and call them on it.

  7. I recently took ACLS, taught by a very droll ER doc. On the second day of class, he brought in the movie Slumdog Millionaire and turned the class into a quiz show that he called "Scutdog Millionaire". He was pretty pleased with himself.