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Was so lovely to meet you all yesterday. Hope you all had an awesome day!!

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Speaking with as many patients as you can.

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Join the Nepean Clinical School Sustainability team

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Join the Nepean Clinical School Sustainability team

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If you like to join our active team please email hiam.simonsen@sydney.edu.au

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https://onthewards.org/teach-me-teaching-medical-students-part-1-teaching-styles/

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What to make of teaching on clinical rotations, and how to get taught
Teaching styles in medical student clinical rotations

As a relatively recent medical graduate, the odd limbo of medical student clinical rotations are still fresh in my mind. Many great teachers - consultants, registrars, interns and patients - stand out in my memories. Nonetheless, I also remember swathes of time spent waiting around, watching the umpteenth laparoscopic cholecystectomy, or feeling a little mentally bludgeoned after an interrogation on the radiological differences between acute and chronic pancreatitis. How do you make sense of the piecemeal teaching you are getting, and how do you squeeze out a little more teaching from your team?

Some of the common teaching techniques employed in medicine may seem like you as the student are either being targeted or neglected. Why do doctors teach in this way?

Here are some of the usual suspects:

1. Question time - first stop: the student

You'll notice that, as questions are asked on a ward round, you'll often be the first target of questions. These questions may be well beyond what you know, or are expected to know - they may be even more at a registrar level. Unfair to ask you? There are a few reasons that you usually get first bite of the cherry.

a) Opportunity to shine: believe it or not, at times you'll be sharper on some of the theory than the junior medical staff - if for no other reason than that you may have visited the subject more recently. Use it as an opportunity to show you're engaged. Even if you don't know the answer, showing some structured approach to an answer goes a long way.

b) Team dynamics: as the student you're often not actually expected to know a great deal (though you do) and whatever you get right is a bonus. If you get a hard question wrong and the registrar knows the answer - no worries. If the registrar gets shown up by a student, some registrars may feel like they are being undermined (particularly if they themselves are not very confident). Having the question go to the student, then the intern, then the registrar means that no one is shown up.

c) When you get taught, everyone gets taught: while the teaching/quizzing may be directed at the student, you are not necessarily the sole target audience. One way for the senior to tell their juniors how they would like a problem approached is to talk through it with the most junior member of the team - often the student - and explaining their own approach from first principles. If the senior were to talk through the basics with their junior, the latter may feel like they are being told how to suck eggs. With the student as a proxy, the whole team can explore a problem from first principles without any ruffled feathers.

2. The grilling...

One common technique used in medical teaching is to 'grill' a student on a particular topic. You'll be asked a question, then pushed on it until you don't know the answer, and then get pushed a little more until you feel pretty sheepish. Why are they picking on you?

First, the teacher needs to find where the limits of your knowledge are to be able to teach you something new. The teacher wants to find something they can contribute, rather than wasting your time with things you already know. But why make it so stressful?

The best justification for this technique is that people learn and remember better when they are under a degree of stress. You'll see all doctors have stories of similar 'grillings', and it doesn't take long to realize that being grilled can aide recall, even decades down the track.

Teaching styles can have powerful impacts

While being an effective technique, achieving adequate stress without overstepping the mark is a tough balance. Moreover, the forum for said grilling needs to be carefully chosen - the goal is mild stress, not public humiliation. Occasionally the would-be teacher overdoes the stress component or chooses an inappropriate forum - this can leave the grillee feeling dejected and incompetent, feeling more like they are being bullied than taught. If you're ever on the receiving end of a lesson that leaves you feeling like this, try to take the experience for what it usually is: a bungled lesson rather than a reflection on your competence.

Grilling is a powerful technique, but as the mighty Spiderman said, "With great power comes great responsibility". Grillings need to be delivered carefully to be effective - it is not a method to be emulated without serious consideration of how the grillee is taking the grilling. If a griller has a pattern that you believe to be one of degradation and humiliation, this isn't teaching - and it is not ok. Talk to your supervisor or clinical school.

3. "Read up on it"

While this may feel like a cop-out on the teacher's part, this can be an effective method, particularly if teacher and student follow up on it. There are some good reasons to have a student read up on a topic rather than simply start talking:

a) Sometimes this is an opportunity to be pushed to explore an area that hasn't come up clinically, then discuss it with a senior in a way that will help consolidate knowledge.

b) At times the teacher is thinking, "I once knew this, I know it is important, but it is now way too rusty for me to be able to give you a decent structured lesson on it...if you read up on it then tell me about it then we'll both know". If you as the student are forced to teach someone else about it, then you'll really have to get your head around it. Talking about it with a senior can help you sort it out in your head as well as give it some clinical context.

c) Some subjects don't lend themselves to a chat, you simply have to sit down and learn them - for example, anatomy that is completely unfamiliar to the student. If the pterygopalatine fossa came up, and the student had no idea what or where this was, any conversation on this front is going close to or exactly nowhere. Better off reading about it and looking at pictures, then discussing it with your teacher the following day.

Understanding teaching styles

Understanding why people teach in the way that they do can not only stop you beating yourself up when you don't know the answer to a question, it can help you get the most out of the teaching you are getting. Teaching, like medicine, is both an art and a science. Throughout your career you will encounter some exceptional teachers who will make complex problems simple and intuitive - these are the teachers who inspire you.

Next in Teaching medical students - Part 2: Making the most of your clinical rotation.

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Teaching Styles | Teaching Medical Students Part 1 | onthewards

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What to make of teaching on clinical rotations, and how to get taught As a relatively recent medical graduate, the odd limbo of medical student clinical rotations are still fresh in my mind. Many great teachers - consultants, registrars, interns and patients - stand out in my memories.

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Westmead is definitely the Gryffindor of the clinical schools, well done !!

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Westmead is definitely the Gryffindor of the clinical schools, well done !!

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Don't be late to stuff. It wastes everyone's time and reflects poorly on SMP and everyone in the cohort. Westmead can be a bit of a maze so allow time to find where you're going.

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You’re coming from an environment where you’re competing against other students to get into med. However, you shouldn’t carry this mentality in med. You’re expected to work together in teams when you’re doctors, so make sure you befriend as many people as you see. They will eventually be your colleagues. Making friends will also help you academically as you can share notes and information. Lastly, it’s good for mental health because med can be very isolating. Reach out to one another because chances are, the person you’re reaching out to probably feels the same way you do.
-Mustafa

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"Everything will be so good so soon, just hang
in there and don't worry about it too much."
- Adam J. Kurtz

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Pani Patu - Education Support Manager

Faye Hurwitz - Senior Education Support Officer

Lena Afeaki - Administration Officer

Anna Perrins - Year 1 Education Support Officer

Margaret Fernandes - Year 2 Education Support Officer

Waing Lai - Year 3 & Year 4 Education Support Officer

Kia Liao-Mackun - Clinical skills educator and simulation coordinator

Anne-Marie Xuereb -  Clinical skills educator and simulation coordinator

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Reward yourself with a weekly MEDFREE day

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Reward yourself with a weekly MEDFREE day

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YOU deserve it!

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Relax. Ask for help. You aren't expected to know (that) much. Also you deserve to be here as much as everyone else :-)

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Relax. Ask for help. You aren't expected to know (that) much. Also you deserve to be here as much as everyone else :-)

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If you find yourself hanging around WECC go visit the common room which is a level below the library (turn left after going down the stairs in front of the library).

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This isn’t novel advice, but don’t be afraid to ask questions!

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This isn’t novel advice, but don’t be afraid to ask questions!

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In general, people respond well to earnest curiosity, and if you don’t want to ask something because it’s something you feel like you should already know, that is if anything all the more reason to patch your knowledge now.

Do mind the context, though, because there are definitely times that are better for questions than others. In a tute, ask freely; in a clinical situation, if everyone seems very focused and you’re in doubt about whether it’s okay to interrupt, make a note and ask your tutor later.

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Try and exchange contact info early with your tutors! It can really help if there’s ever miscommunications or conflicts between timetables.

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You made it! Breathe a little. Don't sprint, this is a marathon. Burnout is your number one enemy so please please try to fight it off from day 1! Try to socialise, exercise, hydrate, see councellors/psychs if you need to.

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Struggle earnestly, and you shall triumph
- Buddha

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You won't need your laptop at the pt bedside

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You won't need your laptop at the pt bedside

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Don't carry your laptop/tablet around on the wards when you're doing bedside teaching. If you must take notes, get a small paper notepad, but it's usually better to just engage with the activity without technology plus it's less intimidating for patients. If you need uni things signed off, most drs are happy to do it on a phone.

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Always carry a pen with you - it's not for you, it's for the drs and nurses who will be frantically looking for one and you will be the knight in shining armour handing them one

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Anatomy: Netter's Atlas of Human Anatomy // Duane E Haine's Neuroanatomy // Moore's Essential Clinical Anatomy
Physiology & Biology: Silverthorn's Human Physiology // Janeway's Immunobiology // Robbins and Cotran's Pathologic Basis of Disease // Hampton's ECGs Made Easy.
Clinical Skills: Talley and O'Connor is your bible along with Geeky Medics (Youtube). Medzcool (Youtube) for heart and lung sounds.
Online Tools/Resources:
Amboss - Great for getting a summary/overview
PassMedicine - Question bank: Their clinical vignettes in the Final Year paid question bank is higher yield for after learning the basic sciences.
eTG - eTherapeutic Guidelines via USYD library: Provides Australian management guidelines. Is not as comprehensive as UptoDate (American) or BMJ Best Practice (British)
Anki - Great for rote learning a fact but struggles for concepts and connecting ideas.
Forest - App: To help with timing studying
TripView - App: So you don't get caught out by surprise delays or outages on the rail network if you haven't already downloaded this.
HeyYou - App: Cafe/Coffee ordering service. Look up Westmead and then order your coffee from somewhere like Kongfucius on the train ready for pickup on the walk from the station to Westmead.

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Parking is expensive at Westmead unless you have a valid concession card. Parking police are strict.

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There is a gorgeous Vietnamese bakery that does $6 Banh Mi as well as really cheap desserts and pastries if you are looking for inexpensive lunch options! They are under Westmead Tavern right next to Mina's Bakery!

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You are representing Sydney Medical School and the medical profession every day, so ensure your dress, general appearance and behaviour is appropriate. Refer to specific guidelines on your Canvas page.

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Head of Nepean Clinical School

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Head of Westmead Clinical School

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Please read the handbooks prior to your skills classes with Kia and Ann-Maria

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Get your coffee outside at Leaf cafe or bring your own in. See your proc skills educators for more info.

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The Education Support Team is here to help you! No problem is too big or to small.
Westmead Students - email Anna
(westmeadcs.education-support@sydney.edu.au)
Nepean Students - email Michelle
(michelle.williams1@sydney.edu.au)

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The University of Sydney's Health and Wellbeing Website has some excellent resources to support you while you are studying

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Contacts in China

With the assistance of Lifeline colleagues in Shanghai, China, we have verified the following services in-country:

Guangzhou Crisis Research and Intervention Center

Mandarin and Cantonese speaking
24 hour service
(020) 8189 9120, please add +86 if calling from outside China

Chinese Mental Health Line in Shanghai only

Mandarin speaking
24 hour service
(021) 6303 6588, please add +86 if calling from outside China

HopeLine

Mandarin speaking
24 hour service
400 161 9995

Chinese Crisis Line, Beijing Suicide Research and Prevention Center

Mandarin speaking
24 hour service
(010) 8295 1332 if calling from a mobile or 800 810 1117 if calling from a landline

Lifeline Shanghai

English speaking only
24 hour service
(021) 6279 8990, please add +86 if calling from outside China

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When we are mentally and physically healthy we can fully enjoy and appreciate our day-to-day life, environment and relationships, as well as deal with life's challenges.

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If you are going to be absent let your education support team know & submit a special consideration

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Check Canvas regularly for any updates

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Good luck bro