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U N I V E R S I T Y O F P I T T S B U R G H |
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Volume X, Number 2 |
November
2004 |
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U N I V E R S I T Y O F P I T T S B U R G H |
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Volume X, Number 2 |
November
2004 |
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Elmer J.Holzinger, MedicineI emphasize the need to be able to listen carefully and interpret appropriately and also to know which questions to ask in order to obtain the most information.
My teaching of medical students involves students at all four years of the medical school curriculum. However, the major portion is in the third and fourth years, and the teaching at this level is predominantly centered on patient care. It is at this time when the students have the opportunity to apply their basic science knowledge to the care of patients in the clinical setting. The students must be able to accurately assess the clinical picture of each patient and this begins with a detailed history and physical examination. Students must develop the appropriate techniques of obtaining a good history and must be able to interpret the symptoms. I emphasize the need to be able to listen carefully and interpret appropriately and also to know which questions to ask in order to obtain the most information and to not inappropriately interrupt. This is followed by a detailed physical examination during which the student’s proficiency is assessed. On the basis of this initial information the student then must decide on a differential diagnosis and appropriate laboratory investigation in order to make an accurate diagnosis and proceed with appropriate therapy. The students are uniformly excited about applying their basic science knowledge to patient care in a thoughtful and precise manner. In addition to the scientific aspect of patient care, it is certainly important that the student understand the psycho-social aspect of each patient in the clinical setting. It is exciting for me to watch the students carefully approach these many aspects of patient care and then develop a reasonable differential diagnosis and list the reasons for their choices. It is in this manner that the students gain experience and thought processes in connecting their basic science knowledge to the clinical aspect of patient care. During this time I gently challenge them so that even the relatively simple clinical problems become a teaching experience. The entire student-patient encounter is, therefore, a very dynamic experience that varies with each patient and it is intriguing to see how the students quickly adjust to the variability in patient presentation, both from the psycho-social aspect and the presentation of various disease processes. The effectiveness of this method is evident in the excitement that the students demonstrate while delivering patient care. The students many times return the following day after having reviewed current literature regarding the patients that they had seen the day before, and now each experience from a patient encounter represents a tremendous amount of gain in medical knowledge. The opportunity to be involved in the education of medical students in clinical medicine has given me a great deal of satisfaction, and this is particularly so when I observe the competence that the students have gained at the end of their medical school training. It is during these clinical years of teaching that students are able to experience the enormous responsibilities and great satisfaction in being a physician. It is also at this time that the importance of remaining curious is emphasized along with the need for constant, almost daily, continuing education in order to remain a good physician. | |||||||||||||||||
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