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What is your most embarrassing / frustrating experience with PIMPing ?
Being PIMPed Ain't Easy
Neil Chanchlani Defends a Dying Teaching Method
I remember my first time. It was early in the morning, and I had barely slept the night before. A few of us were standing around, and I was at the front of the pack. Secretly, I wanted to be chosen, pushed to the limit so I could learn a thing or two. It's a competitive environment though, so I knew I had to be alert and look interested when someone eventually came.
You, he pointed at me, "What are the most common complications of thyroidectomy?" This was easy, but I didn't know it. Silence ensued, and eyes rolled. "What is a thyroidectomy?" This was easy, and I did know it, so responded cheerfully with a textbook one liner. Question after question poured out. I didn't know the exact surgical incision length, nor which arteries and veins needed to be divided. A Hartley Dunhill operation? Forgot to cram that one in. And, to hammer it home, the sensitivity of fine needle aspiration cytology for thyroid nodules had escaped me. I had been PIMPed, short for "Put in my place."
PIMPing is a US term, but familiar territory in the UK. It involves the Socratic method of learning through questions and answers rather than lecture style teaching. Students might be required to reel off pointless facts of a certain disease or biological process, or seniors can push students by questioning them about something beyond normal expectations. It is more commonly the former. Students might walk away in shame, despair, and embarrassment. In clinical education, we face it all the time: ward rounds, observing in theatre, assisting in clinic, or even when minding our own business writing in a patient's notes. It's not unheard of for a senior to ask: "So can you tell me what's wrong with Mrs. Smith's tube?" to be met with, from a junior, blankly "Mrs Smith has a tube?" The beginning of a PIMP that's headed only one way.
Brancati first broadly described the term in 1989.[1] In a light hearted manner, he said that it was a teaching method that was largely politically motivated: "Proper pimping inculcates the intern [trainee] with a profound and abiding respect for his attending physical [trainer] while ridding the intern of needless self esteem." Although PIMPing might be seen to exist simply to give seniors a method to humiliate the junior members of their team, others have felt that it is a valid educational tool: a provocative method that might help students retain the knowledge that is being imparted.[2] Brancati felt pimping was dying, so he provided some advice to trainers. Among them, ask students arcane points of patient history and excessively broad questions. Readers agreed, and hoped PIMPing wouldn't die.[3]
More than 20 years later, and PIMPing is still alive. Trainees and students come home complaining of consultants and registrars embarrassing them in front of their patients and colleagues on a daily basis. For some it's justified, others less so. When not being used for teaching, PIMPing can point out serious errors in judgment: "In front of everyone, he asked me if I was trying to kill the asthmatic patient when I mistakenly gave her a ß blocker." I doubt that doctor would make the same mistake again. PIMPing didn't hinder, it may have helped.
It's a fine line between education and bullying. If the student or trainee should have known the answer, does that make it more acceptable? Perhaps. What if a teacher just wants to push a student's limits, and get them to think more critically? In the learning environment, we should be soaking up as much as we can, whether it's on the syllabus or not. Although, thankfully, getting quizzed about the technical points of laboratory research or metaphysics, as Bercanti suggests, rarely occurs.[1]
The topic was revisited at the International Conference on Physician Health in Montreal, Canada. A presentation concluded that PIMPing causes trainees stress.[4] The authors said that, with the high number of medical students that experience burnout—about 50%—and trainee doctors that experience burnout—about 80%—PIMPing doesn't help to keep these numbers low. Study authors blamed bad teachers with ill defined roles, rather than not-so-smart students and trainees, and took a "it's not their fault they're stressed out" line.[4]
But no one said being PIMPed is easy. Of course it's difficult to stare a senior in the face and exclaim those hated three words: "I don't know." But after his or her explanation, you will never forget. Although it might be perceived as stressful and even a cause of burnout, PIMPing can be helpful, educational, and is likely facilitate students' remembering something. Research shows that most students enjoy this teaching method, more formally known as "active learning."[5,6]
It's one of the many things they don't tell you about before starting medical school. A thick skin might be a more useful attribute than a Duke of Edinburgh Gold award or Grade 8 piano.
SOURCE:
http://www.medscape.com/viewarticle/781525?src=mp&uac=155699BZ&spon=25
Being PIMPed Ain't Easy
Neil Chanchlani Defends a Dying Teaching Method
I remember my first time. It was early in the morning, and I had barely slept the night before. A few of us were standing around, and I was at the front of the pack. Secretly, I wanted to be chosen, pushed to the limit so I could learn a thing or two. It's a competitive environment though, so I knew I had to be alert and look interested when someone eventually came.
You, he pointed at me, "What are the most common complications of thyroidectomy?" This was easy, but I didn't know it. Silence ensued, and eyes rolled. "What is a thyroidectomy?" This was easy, and I did know it, so responded cheerfully with a textbook one liner. Question after question poured out. I didn't know the exact surgical incision length, nor which arteries and veins needed to be divided. A Hartley Dunhill operation? Forgot to cram that one in. And, to hammer it home, the sensitivity of fine needle aspiration cytology for thyroid nodules had escaped me. I had been PIMPed, short for "Put in my place."
PIMPing is a US term, but familiar territory in the UK. It involves the Socratic method of learning through questions and answers rather than lecture style teaching. Students might be required to reel off pointless facts of a certain disease or biological process, or seniors can push students by questioning them about something beyond normal expectations. It is more commonly the former. Students might walk away in shame, despair, and embarrassment. In clinical education, we face it all the time: ward rounds, observing in theatre, assisting in clinic, or even when minding our own business writing in a patient's notes. It's not unheard of for a senior to ask: "So can you tell me what's wrong with Mrs. Smith's tube?" to be met with, from a junior, blankly "Mrs Smith has a tube?" The beginning of a PIMP that's headed only one way.
Brancati first broadly described the term in 1989.[1] In a light hearted manner, he said that it was a teaching method that was largely politically motivated: "Proper pimping inculcates the intern [trainee] with a profound and abiding respect for his attending physical [trainer] while ridding the intern of needless self esteem." Although PIMPing might be seen to exist simply to give seniors a method to humiliate the junior members of their team, others have felt that it is a valid educational tool: a provocative method that might help students retain the knowledge that is being imparted.[2] Brancati felt pimping was dying, so he provided some advice to trainers. Among them, ask students arcane points of patient history and excessively broad questions. Readers agreed, and hoped PIMPing wouldn't die.[3]
More than 20 years later, and PIMPing is still alive. Trainees and students come home complaining of consultants and registrars embarrassing them in front of their patients and colleagues on a daily basis. For some it's justified, others less so. When not being used for teaching, PIMPing can point out serious errors in judgment: "In front of everyone, he asked me if I was trying to kill the asthmatic patient when I mistakenly gave her a ß blocker." I doubt that doctor would make the same mistake again. PIMPing didn't hinder, it may have helped.
It's a fine line between education and bullying. If the student or trainee should have known the answer, does that make it more acceptable? Perhaps. What if a teacher just wants to push a student's limits, and get them to think more critically? In the learning environment, we should be soaking up as much as we can, whether it's on the syllabus or not. Although, thankfully, getting quizzed about the technical points of laboratory research or metaphysics, as Bercanti suggests, rarely occurs.[1]
The topic was revisited at the International Conference on Physician Health in Montreal, Canada. A presentation concluded that PIMPing causes trainees stress.[4] The authors said that, with the high number of medical students that experience burnout—about 50%—and trainee doctors that experience burnout—about 80%—PIMPing doesn't help to keep these numbers low. Study authors blamed bad teachers with ill defined roles, rather than not-so-smart students and trainees, and took a "it's not their fault they're stressed out" line.[4]
But no one said being PIMPed is easy. Of course it's difficult to stare a senior in the face and exclaim those hated three words: "I don't know." But after his or her explanation, you will never forget. Although it might be perceived as stressful and even a cause of burnout, PIMPing can be helpful, educational, and is likely facilitate students' remembering something. Research shows that most students enjoy this teaching method, more formally known as "active learning."[5,6]
It's one of the many things they don't tell you about before starting medical school. A thick skin might be a more useful attribute than a Duke of Edinburgh Gold award or Grade 8 piano.
SOURCE:
http://www.medscape.com/viewarticle/781525?src=mp&uac=155699BZ&spon=25
Love it.
