On rounds- IS it bad to report what the resident's wrote on note?

[Transformers]

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Not trying to take any shortcuts...well actually I partially am but I am unsure of the perception and response

This is a pretty naive question rounds, after admitting a new patient the day before WITH the resident and having to present the following day, is it bad to report pretty much the resident's admission note +/- what you have in mind. I understand it's important to be novel and form your own thinking which is the fun of 3rd year but at the same time, you have the temptation to come off competent and covering all your basis in the differential dx/management so I wasn't sure how to approach this. I only ask this because as it might be the case for most students, sometimes your only interaction with an attending is just the oral presentation so I was curious what the strategy would be for that +/- at the same time not sounding like some sort of copycat to your fellow resident.

 

[Raryn]

You should talk about your plan with your resident before you write your note, and you should present off your own note. Generally speaking, your note should contain the same plan as your resident, though there will probably be stylistic differences in the order of the problems/how you lump or split them/what you emphasize in your ddx. At that point, during your presentation, just make sure all the important information comes across one way or another. (Your job, if done well, is to make it so the resident doesn't have to say a word).

If there's management decisions that the resident made since you wrote your note/discussed it with them, it's perfectly ok to include those in your oral presentation. But you should try to at least understand why, and there shouldnt be radical differences between your plan and the rest of the team.

 

[NickNaylor]

I would suggest doing your own A/P first to see what you come up with and then do what Raryn said above. Just reading the resident's note is doing it wrong - you don't get any practice working through a differential and developing a plan (even if correct). I don't think most people will fault you for coming up with an incorrect plan as long as you have a thought process behind what you came up with.

Sent from my SGH-M919

 

[boogaloo]

Always try to check with the resident or NP before you present your patient, and make changes to your A/P if necessary. It's not bad to be wrong, but it's better to be wrong in front of the resident than the attending. A good resident/NP can make you look really smart.

 

[evilbooyaa]

Agree with above. Present to the resident, ask for any feedback. When the resident tells your A/P is garbage and tells you what should be done, include that into your presentation to the Attending.

I don't think it's a terrible idea to use the resident's note in a pinch, but I would try to use my own brain and A/P formation skills before I relied on the residents.