You are teaching a clerkship seminar and a student kept checking her iPhone for Facebook updates. You reminded her that she probably should not be distracted and she replied, "Well, I don't need to know ACLS. I am applying to Dermatology anyways."
You happen to be meeting the Dermatology Program Director later that day...
Please feel free to type in your comments below to explain your answer.
Please feel free to type in your comments below to explain your answer.
Wow Stella, this Ethics poll is a tough one! I don't think there's a single perfect answer to this professionalism issue. Will this continue in her training to also justify "I plan to be a stratum-corneum specialist, so I don't need to pay attention to this talk on the dermis"? All medical learning is relevant. Ideally one should tell the student this in private before she leaves the ACLS course.
ReplyDeleteFor the poll, I would say either "Yes" or "Mention in Eval". There's even a third option which is "Mention in Eval within the confidential section to PROGRAM DIRECTOR ONLY". This 3rd option is probably the way I'd go.
If I were the Derm PD and already had professionalism issues with the student, I'd want as much written evidence of unprofessional behavior as possible when giving her feedback as to why she scored lower on the professionalism competency. It's better than just verbal disclosure to the Derm PD. It's hard to give a student feedback when it starts with "Well, I heard that... "
I'd leave it off the official eval section to give the student the benefit of the doubt (maybe it was a bad day and this was an isolated event). The confidential eval accomplishes the same purpose and allows the Derm PD to use his/her best judgment in how to use the information.
Hope my convoluted thinking makes sense.
Derogatory input like this should ALWAYS be communicated through formal channels. To do otherwise is unprofessional for the instructor and also leaves the instructor at risk for accusations of slander -- ask any HR professional and they will tell you the same. This is what the written evaluations are for, and that format is superior since it's where you can be more objective, leave a permanent record of your experience with the student, and you can be confident it will go to any person who has legitimate access to this student's record, not just to a single selected individual. (say, in case the student changes her mind and decides to go into something else).
ReplyDeleteIt's also just unprofessional to gossip about students, and if you give a verbal, informal "heads up" about a student to another instructor in an effort to influence him or her, that's all you are doing.
As a former surgery PD, I would have preferred to have seen this in writing. I would have put it in her eval for the clerkship but doubt it would ever have made it into a dean's letter. Negative information is rarely found in dean's letters. I have blogged about this. (http://is.gd/iySX22)
ReplyDelete@Shadowfax: The Clerkship Director indeed has to think from a HR perspective. Well said.
ReplyDelete@Skeptical Scalpel: I agree with you- the Dean's goal is to "sell" their student to the residency program. That means that sometimes less-than-flattering evals are omitted (or at least very buried) in the summative text. Glad to know that we're on the same page.
I would also reprimand her for using the term "anyways."
ReplyDeleteThis happens fairly regularly with rotators at the poison center. It's sometimes difficult to tell if someone is neurotically checking email, looking up information on a medical reference app, or surfing the web.
ReplyDelete@Rick: Ha! I didn't catch that.
ReplyDelete@SFTox: I think you can't really fault someone for being on their computer/mobile device. I agree that it's hard to tell what they're doing. For instance, when I sit in the back of the room during residency conference, I can tell that about 3/4 of the residents are actually reading something related to the talk...
But when they blatantly tell you that what you are teaching isn't important to them, that becomes an issue.
Agreed, I think this situation points less toward use of a mobile device and more toward a lack of professionalism. As I have mentioned to some of the prelim, transitional, and categorical residents focused on a Fellowship it doesn't matter what you will be in a few years, what matters is now. Right now you will be a resident or student at a hospital on the in patient services: you will be in or running resuscitations. You owe it to your patients to learn ACLS and do your best. This lack of professionalism and lack of insight in to patient care can be disturbing at times.
ReplyDeleteI think a mention in the evaluation and in person is important since it was mentioned the negative things may not make it to the Dean's Letter.
If a student tells me that what I am teaching is not important to them, I would politely exit the seminar/class. If it not important to him/her, why attend in the first place? I would also make sure that it will appear in the evaluation but I don't think I should directly inform the Dermatology Program Director.
ReplyDelete@Elise: Good question. Students are adult learners. The problem is that medical schools still treat them less so -- many classes require mandatory attendance. I think that the consensus (at least in the comments) is that this should appear in the written evaluations. Haven't heard any arguments from the naysayers...
ReplyDeleteThanks for commenting!