This is Jeopardy!
It is Tuesday. This is the third week of my month on academic service. This is always a point of focus for me because it is traditionally when I become the laziest, or rather just operate in a holding pattern, instead of pushing to improve as much as I should. That is because I have put in the whole first half of the month, and yet have so much more to go. The fourth week is usually easy to keep pushing because there are topics I want to be sure are discussed. Well, today, we will be doing two Walkn’Talks (See previous entries that mention Feedback for further details) and those usually excite me. Tomorrow, I am also doing my monthly Morning Report where I teach students and residents how to write up all the interesting cases that we see in the hospital. Then have the Hospital Medicine Mystery Case of the Week in the afternoon. Then Thursday is the Faculty Development workshop on Trust. All of these activities excite me and are parts of my job that I love. Let’s go!
When I am on academic service seeing patients, I like to ask the students and residents questions about their thinking and what led them to the medical decisions they are making. I ask them about medical information they used to make these decisions. The questions that are challenging are almost always answered in the form of a question. Meaning I will say, “What can you order if you are worried the patient has pleural tuberculosis?” They will say, “What about AFB cultures on the pleural fluid?” Then I will say something along the lines of “Who is asking the questions here?” or “Is this Jeopardy?” or “Do I look like Alex Trebek?” (RIP) or I will start making noises that vaguely resemble the Jeopardy theme song. It is fun for me. I think it annoys many learners initially, but they all come around eventually. I also pretend like I am Mr. Miyagi every time I use the hand sanitizer walking into a patient’s room that nobody but me is aware is a great reference.
If there are plenty of opportunities to amuse myself during the day, then why force this Jeopardy bit into rounds you may ask. Well, it is because I think the habit of answering questions in the form of other questions is a bad habit that is beaten into us by the educational system the encourages a finite mindset. It pushes us to feel worse about ourselves if we miss a question rather than seeing the discussion as a learning opportunity. We would rather cover up that we might not know something (poorly cover up, I might add) than admit there is an opportunity for us to learn. No one is consciously thinking this as best I can tell, but it does serve that idea every time we display fear of being wrong. Some of the time it is just a signal of the responder’s level of certainty. More often than not it represents a hedge against possibly being wrong. I had an attending in medical school who suggested that we be “strong and wrong”. I stop short of encouraging people to be wrong, but it does emphasize that this is a problem in healthcare education. Most of the learners are over tested and many see each opportunity to answer a question as an opportunity to prove or lose their worth as a human. Randomly and confidently shouting nonsensical answers is no way to learn either, but that tends to be less of a problem with people who have made it through 20+ years of formal education. My hope is that the simple attempt at game show related humor opens the door to consider this idea for the people in the discussion. If I responded to learners who respond to questions with a question with, “Your fear that giving the wrong answer invalidates you as a human is limiting your opportunities for deeper learning” I don’t think it would lead to the same productive conversation that usually follows when I answer with “I am not Alex Trebek and this is not Final Jeopardy”. The hope is that by making small changes, the people who have to deal with my simple attempt at humor, will trust themselves. The hope is that they will not question their value to the patients and our team. It is not the only thing that is going to fix it if that is the issue, but it could be a change that leads to other bigger changes in the journey of self-realization
Improv has served as an opportunity for me to investigate many topics in a small way that have led to big changes in how I interact with the world. The main skills that I was unaware I had fallen behind in are listening skills, how I communicate with body language, and my ability to empathize. Before starting improv lessons, I was unaware that these areas needed improvement. Practicing improv gave me the understanding and feeling that these skills needed to improve or I would not make any sense on stage. The humor has allowed these topics that I would have avoided to be examined. I am also able to practice the skills in a way that doesn’t make me feel like I was inadequate before improv and am capable of being better than I am.
Ok, one more Walkn’Talk for the day! Tomorrow is 3 weeks of daily writing. Best believe I am gonna mention that! Thanks for making it to the end