Socially Stunted Student Remiss Regarding Rotation Requisites

[woebegonewretch]

Hello fellow sufferers.
Having now finished pre-clinical coursework, I am feeling apprehensive about entering a domain which requires greater social grace and know-how. In particular, I struggle with communicating confidently and recognizing cues that are not directly spoken. Though I have had some exposure to clinical settings, I am uncertain of what to expect in the way of the role of the medical student i.e. hospital etiquette, how to communicate effectively to overseers.
Has anyone here found themselves in a similar position prior to beginning clinical rotations, and if so, what were the greatest catalysts for your acclimation to them? If anyone has any recommendations for reading material relevant to this topic, or words of wisdom, those would be greatly appreciated.

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[Mad Jack]

I was super cringe once, but I got better. You learn with time. Social skills are basically like a muscle, you just have to keep working on them and they build up through experience. Just keep at it and fake it until you make it. Communication in the hospital is pretty much the same as communication everywhere else, but remember that you're the bottom person in the hierarchy as a medical student so be respectful to everyone. And when I say everyone, I mean everyone, from environmental staff to nurses to attendings. I recommend that continues throughout your career, as everyone deserves respect always, but the biggest mistakes I see medical students commit involve overstepping themselves and offending staff which results in complaints that find their way into reviews. That and being overly defensive about things. Basically, just, be kind and curious and take criticism and you'll be fine.

Another thing to remember is that almost everyone is kind of weird socially, so they're usually so wrapped up in their own interactions that they don't even notice the things you're doing. Don't sweat the small stuff socially.

 

[Rachapkis]

As Mad Jack says, be kind and respectful to EVERYONE. Remember that you are there to learn: you are not expected to know much. Preparation breeds confidence. Watch others and try to mimic the behaviors that you want to acquire. Understand that you will get a little better each day and that it will get easier.

 

[Niwrad]

Remember that you have to act differently when with patients than when just with the residents. With just the residents you can have the freedom to speak freely but with patients only speak up when asked to unless it’s both a clear and emergent patient safety concern. The goal is to ensure good rapport and also that the patient doesn’t get other ideas about their treatment as you’re just hoping in the middle of the team. Vice versa if there’s something you notice such as a loose housefly in the OR bring it up clearly and concisely so that appropriate measures can be taken.

Also with attendings you want to speak efficiently and also introduce yourself and your role. Include if you’re a third or fourth year and how much previous in person clinical experience you’ve had (may not be necessary now with COVID restrictions lifted)

If you feel comfortable with it what speciality you are interested in at that time you could share that with everyone. If not sure, that’s also ok, you can say you’re still considering or you’re looking forward to seeing what X speciality is like.

 

[Styrene]

Is the alliteration present in this thread title intentional, and if so, what is the purpose?

 

[Terrainport]

this is an important skill. it's not just learning medicine. it's also about knowing how to interact with peers.

 

[Redpancreas]

Hello fellow sufferers.
Having now finished pre-clinical coursework, I am feeling apprehensive about entering a domain which requires greater social grace and know-how. In particular, I struggle with communicating confidently and recognizing cues that are not directly spoken. Though I have had some exposure to clinical settings, I am uncertain of what to expect in the way of the role of the medical student i.e. hospital etiquette, how to communicate effectively to overseers.
Has anyone here found themselves in a similar position prior to beginning clinical rotations, and if so, what were the greatest catalysts for your acclimation to them? If anyone has any recommendations for reading material relevant to this topic, or words of wisdom, those would be greatly appreciated.

I really like Mad Jack's response. I think it’s wholesome and emphasizes that medicine isn’t only a field for social butterflies. Social skills are a muscle and if yours are underdeveloped…then it’s time to develop them. It’s important to remember we all have different strengths and there’s no one ideal communication method. OP, I advise you to find someone you look up to and try to model some of their mannerisms. Eventually you will develop confidence.

I'll expand on Mad Jack’s common mistakes medical students make with tangible examples. No one wants to admit they make these but they're made daily on wards.

1.) I can't agree more that medical students (particularly type As) sometimes can get pretty defensive about feedback. One day I gave gentle feedback to a medical student and the student wrote a passive aggressive comment back to me on WhatsApp. I realized I was the one who mistook something, but a politer reply would have sufficed. It really set the relationship off to a rocky start.

2.) When you're enthusiastic about a subject, you may know more than the residents, etc. Just keep in mind, pimping usually goes up the tree and everyone's a learner. Never answer a question meant for the residents. Just don't. Practice answering it in your head. The student who answers questions correctly only when called upon looks way better than the one who tries to answer everyone else's questions. Additionally, as a student you're taught to be aggressive and take ownership of your patients and I 100% agree with that. Take 100% ownership, but once the resident/attending says XYZ is what is going to be done, just go with it. Arguing for your cause (unless you feel the team is missing a critical deal) is poor form and will be seen as such because there are times where interns, residents, etc. have disagree with the overall team consensus but have learnt to go with it.

3.) Nurses can be abrasive. It will get worse your intern year when you're actually responsible for addressing their concerns and balancing their thoughts vs. your thoughts vs. your team's consensus. For now, don't engage with any of them even if they believe something like Nifedipine lowers HR. Don't try to "educate" or argue with them. Just reply diplomatically that you'll relay their message to the residents.

 

[TragicalDrFaust]

Mask and mirror. Pay attention to what your well liked, successful peers do and copy them without being too obvious about it. Especially pay attention to those who look like you (gender, ethnic background, any other identity grouping you know you’ve been associated with) because social expectations on them and you will be similar.

Imo the most important thing for introverts or people who haven’t developed their social skills much is seeming interested and enthusiastic to help and learn, while being polite and deferent.

Examples
Asking how you can help or what you can do next

Politely greeting everyone you need to interact with and introducing yourself

Strive to guess what people will want you to do next

If the room goes quiet or you’re getting short answers, imitate and avoid breaking the silence unless necessary

When you speak, speak loudly enough to be understood the first time

Pay attention to the space you’re occupying and try to stay out of the way of people who are walking fast or carrying things

Just a few examples. I had very poor social skills growing up but learned how to have them when I was a tipped employee. You can definitely do it.

 

[Lost in Translation]

Another thing to remember is that almost everyone is kind of weird socially, so they're usually so wrapped up in their own interactions that they don't even notice the things you're doing. Don't sweat the small stuff socially.

I definitely don’t use airline pilot vocabulary or demeanor when talking to other providers (with the exception of calling consults) and I often use colloquialisms when referring to medical things. For example I’ll be talking to a nurse about a patient’s elevated blood sugar and when I hear the nurse say “It’s 362” I’ll probably say, “Wow! That sucks!”

 

[Mad Jack]

Yeah I'm super casual myself. There's a lot of "oof" and "oh no, that's not good" in the day- to-day than serious

 

[EmperorK]

I really like Mad Jack's response. I think it’s wholesome and emphasizes that medicine isn’t only a field for social butterflies. Social skills are a muscle and if yours are underdeveloped…then it’s time to develop them. It’s important to remember we all have different strengths and there’s no one ideal communication method. OP, I advise you to find someone you look up to and try to model some of their mannerisms. Eventually you will develop confidence.

I'll expand on Mad Jack’s common mistakes medical students make with tangible examples. No one wants to admit they make these but they're made daily on wards.

1.) I can't agree more that medical students (particularly type As) sometimes can get pretty defensive about feedback. One day I gave gentle feedback to a medical student and the student wrote a passive aggressive comment back to me on WhatsApp. I realized I was the one who mistook something, but a politer reply would have sufficed. It really set the relationship off to a rocky start.

2.) When you're enthusiastic about a subject, you may know more than the residents, etc. Just keep in mind, pimping usually goes up the tree and everyone's a learner. Never answer a question meant for the residents. Just don't. Practice answering it in your head. The student who answers questions correctly only when called upon looks way better than the one who tries to answer everyone else's questions. Additionally, as a student you're taught to be aggressive and take ownership of your patients and I 100% agree with that. Take 100% ownership, but once the resident/attending says XYZ is what is going to be done, just go with it. Arguing for your cause (unless you feel the team is missing a critical deal) is poor form and will be seen as such because there are times where interns, residents, etc. have disagree with the overall team consensus but have learnt to go with it.

3.) Nurses can be abrasive. It will get worse your intern year when you're actually responsible for addressing their concerns and balancing their thoughts vs. your thoughts vs. your team's consensus. For now, don't engage with any of them even if they believe something like Nifedipine lowers HR. Don't try to "educate" or argue with them. Just reply diplomatically that you'll relay their message to the residents.

Pancreas always with valuable feedback.

I'll add something to the mix.
When it comes to nurses: Just be thankful and smile around them, tell them you appreciate their help. Get them chocolates (I've done this and seen my friends do it). This will make your life easier, yes some of them are annoying. The thing is it's hard to be irritating to a sweet person, so abuse that. Learn to say "Thank you very much for your help". The issue is that they don't feel valued, so who's right doesn't matter. So value them, and it will safe u a hassle.

When it comes to feedback, don't debate it and just say "I understand, I'll try to do better next time". Saves u a lot of misery, and if you're not annoying the person giving you the feedback isn't going to be harsh. Just don't fight feedback, it never looks good.
Mad Jack made a good point:
Be nice to everyone, and you won't get into trouble. Smile, and be a bit peppy sometimes. It'll go a long way, particularly when you make a mistake

A good way to practice social skills is with your friends. Try it. If you need some pointers, I coach people on soft skills so u can PM me

 

[TelemarketingEnigma]

Get them chocolates (I've done this and seen my friends do it).

if you’ve developed a friendly relationship and want to be kind and get them a snack, then sure everyone loves food. But please don’t go around approaching random nurses with boxes of chocolates as some kind of bribe. Being kind, introducing yourself, and not interrupting them during their sign out will generally get you far enough without (slightly creepy) gifts of food

 

[mistafab]

Im a clear introvert who honored all my rotations.

Good attitude, work ethic, and being in general good to work with (attendings, residents, AND other students) goes a long way. Don’t be late. Dont make excuses. Do take responsibility for anything you can (i.e. if you make a mistake, say you did). These are general skills to become a professional. The team’s success is more important than your success. If a team wins, you win.

Extroverts tend to make certain kinds of mistakes, just as introverts make theirs. No one expects you to be perfect - just be a professional and recognize the pitfalls.

 

[Billiam95]

When it comes to feedback, don't debate it and just say "I understand, I'll try to do better next time".

This and showing up on time would preempt 90% of the problems I see classmates facing in 3rd year.

 

[Angus Avagadro]

This and showing up on time would preempt 90% of the problems I see classmates facing in 3rd year.

How students accept feedback is something I look for and put in LOR's. It was something I considered quite important when selecting residents for matching our program. I consider being teachable a very important quality for incoming residents. I'm not.interested with debating residents who might not know the right answer, but are never in doubt about the answer they provide.

 

[woebegonewretch]

Thank you all for the advice.