Improving Clinical Eval Results and "Fairness"
I've been doing some thinking and reading of the forum, and have decided there must be a better attitude for approaching clinicals than I and many of many fellow students have. I've observed the students who are doing well and those who are not and tried a few approaches to see how they work.
Many complain of the unfairness of grading, but I've come to think that in reality its completely fair since it accurately simulates real life clinical evaluations by patients.
Residency programs already have lots of objective data about students (STEP) so clinical evals provide the second half of medicine.
The evals are subjective and based on personality, appearance, talkativeness, flattery, charisma, and a willingness to eat **** with a smile.
For those students who complain about wanting objective evaluations based on knowledge of medicine and science only I have bad news: your in the wrong profession.
You should have done a Phd instead.
We all knew that medicine was going to involve patient interaction and communication skills so thats really whats being tested here.
Is your evaluator judging you based on looks? Yes. So will your patients.
I noticed my interactions improved dramatically when I shaved, wore a nice shirt, and held a good posture.
Are you being judged based on flattery and talkativeness? Yes. The data shows your patients will do the same and that patients have a hard time telling the difference between good and bad doctors but they rate based on subjective things like how friendly a doctor is.
This is probably the toughest one to change, but asking questions that you know the answer to(or aren't interested in) to provide your evaluator with the ability to show how smart he/she is will certainly give you points. Feigning interest in their field and being a humble, obedient student will get you points.
There is some research in psychology showing that expectations shape outcomes. If you approach each day with "God, I hate clinicals...they never give me good evals and they always: ignore my good moments, overly emphasize my mistakes, think that I'm lazy/incompetent, judge and criticize me unfairly", then not surprisingly, your behaviors will match your expectations:
1- You won't bother putting effort into emphasizing your good moments. Yes you knew the answer, but if you spoke loudly, clearly, and with a smile you would be remembered.
2- You'll wince when you make mistakes. If you had a more positive approach, you would let your mistake go more easily. People will now think "Huh, he wasn't that bothered by getting that wrong...he must know a lot to be that confident."
3- You'll have a sour face when your dealing with everyone. This is probably the biggest persistent problem. If you're constantly expecting bad marks you will be angry at your evaluator and they'll be able to tell. They'll pick on it as
"This prick thinks he deserves a great eval and an easy time. He thinks he's better than me. I'll show him"
Of course there is a lot of unfairness. I remember reciting word for word recomendations from the Amer. Colleg. of Cardiology or Amer. Ass. of Family Med. and the guy came back with "No, you're wrong. Don't you remember I mentioned this last week as something never to do!" I looked it up online and saw there was some controversy regarding best practice, but his absolutism was wrong! Of course you could say there are risks-benefits but he was totally wrong to say it should never be done.
I immediately thought: The guy is dick on purpose, perhaps he even envys students that appear to know a lot. He's dumb, I should get a great eval and he shouldn't be in his position if he made a mistake like that.
But that's not how the world works! In fact that example is the BEST test of a student. Patients will be WRONG often and will insist on their errors. The doctor who has the best patient relationships is NOT the one who is lecturing or angrily correcting their patients. You can be the smartest, most well read doctor in the world, but who can you help if no one will visit your practice?
Sometimes, to get the interaction moving forward, you need to smile and agree with things that you don't agree with. There is a wide variety of patients and co-workers.... and a lot of those interactions can get emotional or even ugly. Clinical rotations are just the start to being immeresed in the wonderful and enchanting "Real world" that all of use will have to join once we leave school.
In summary, dress well, ask fake questions to feign interest, nod your head in agreement, and show you're just ecstatic to be there! Evals aren't the most important thing in the world, but they are a great way to practice people skills that are often just as important as knowledge in a successful career in medicine.
I've been doing some thinking and reading of the forum, and have decided there must be a better attitude for approaching clinicals than I and many of many fellow students have. I've observed the students who are doing well and those who are not and tried a few approaches to see how they work.
Many complain of the unfairness of grading, but I've come to think that in reality its completely fair since it accurately simulates real life clinical evaluations by patients.
Residency programs already have lots of objective data about students (STEP) so clinical evals provide the second half of medicine.
The evals are subjective and based on personality, appearance, talkativeness, flattery, charisma, and a willingness to eat **** with a smile.
For those students who complain about wanting objective evaluations based on knowledge of medicine and science only I have bad news: your in the wrong profession.
You should have done a Phd instead.
We all knew that medicine was going to involve patient interaction and communication skills so thats really whats being tested here.
Is your evaluator judging you based on looks? Yes. So will your patients.
I noticed my interactions improved dramatically when I shaved, wore a nice shirt, and held a good posture.
Are you being judged based on flattery and talkativeness? Yes. The data shows your patients will do the same and that patients have a hard time telling the difference between good and bad doctors but they rate based on subjective things like how friendly a doctor is.
This is probably the toughest one to change, but asking questions that you know the answer to(or aren't interested in) to provide your evaluator with the ability to show how smart he/she is will certainly give you points. Feigning interest in their field and being a humble, obedient student will get you points.
There is some research in psychology showing that expectations shape outcomes. If you approach each day with "God, I hate clinicals...they never give me good evals and they always: ignore my good moments, overly emphasize my mistakes, think that I'm lazy/incompetent, judge and criticize me unfairly", then not surprisingly, your behaviors will match your expectations:
1- You won't bother putting effort into emphasizing your good moments. Yes you knew the answer, but if you spoke loudly, clearly, and with a smile you would be remembered.
2- You'll wince when you make mistakes. If you had a more positive approach, you would let your mistake go more easily. People will now think "Huh, he wasn't that bothered by getting that wrong...he must know a lot to be that confident."
3- You'll have a sour face when your dealing with everyone. This is probably the biggest persistent problem. If you're constantly expecting bad marks you will be angry at your evaluator and they'll be able to tell. They'll pick on it as
"This prick thinks he deserves a great eval and an easy time. He thinks he's better than me. I'll show him"
Of course there is a lot of unfairness. I remember reciting word for word recomendations from the Amer. Colleg. of Cardiology or Amer. Ass. of Family Med. and the guy came back with "No, you're wrong. Don't you remember I mentioned this last week as something never to do!" I looked it up online and saw there was some controversy regarding best practice, but his absolutism was wrong! Of course you could say there are risks-benefits but he was totally wrong to say it should never be done.
I immediately thought: The guy is dick on purpose, perhaps he even envys students that appear to know a lot. He's dumb, I should get a great eval and he shouldn't be in his position if he made a mistake like that.
But that's not how the world works! In fact that example is the BEST test of a student. Patients will be WRONG often and will insist on their errors. The doctor who has the best patient relationships is NOT the one who is lecturing or angrily correcting their patients. You can be the smartest, most well read doctor in the world, but who can you help if no one will visit your practice?
Sometimes, to get the interaction moving forward, you need to smile and agree with things that you don't agree with. There is a wide variety of patients and co-workers.... and a lot of those interactions can get emotional or even ugly. Clinical rotations are just the start to being immeresed in the wonderful and enchanting "Real world" that all of use will have to join once we leave school.
In summary, dress well, ask fake questions to feign interest, nod your head in agreement, and show you're just ecstatic to be there! Evals aren't the most important thing in the world, but they are a great way to practice people skills that are often just as important as knowledge in a successful career in medicine.
