(Before I Let Them Touch A Patient…)
On the ICU we get many interns and it is our responsibility to make sure they learn as much as possible. Before I let them see patients on their own or do any procedures I want to get to know them and get an impression on where they are in their career.
That’s why I ask a series of at least three questions:
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Which rotations did you complete so far?
Their answer gives me an impression what level of experience I can expect regarding history taking, physical examination and so on.
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What were your impressions there?
That is an open question and from their answer I will get an idea what they think is the most important thing in a rotation:
theoretical knowledge?
practical experience?
patient contact?
freetime?For example: One student once told me: “During my last rotation they didn’t let me do any blood transfusions on my own!!” (which obviously was a surprise to her). From that point on I knew that she tends to overestimate her own importance and her performance. I explained to her, that she isn’t going to do that here, either.
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What would you like to learn here?
This gives the student the opportunity to verbalize his expectations. Sometimes I can tell them at that moment: “OK, that won’t happen during my shift.”
Other times I can question their intentions because many times they will be very focused on learning the wrong things. Is it important for a second year student to implant central venous catheters? (No!) Or should he focus on taking good histories first? (YES!)
So: Get to know your interns!
Once you know what they know, and what they can, you’ll be a better mentor and teacher to them, and you may save yourself a lot of trouble.