Practice makes perfect?

Gotta know, do doctors and or nurses really have to practice routines on each other? you know of the more private nature. cause if so what a day at school that could be.

I read some stories about that. Some smedical students says that they practice each other various medicla ordeals like injections, enemas, rectal, temps, etc.

Practicing on friends and colleagues is the only appropriate way to learn how to perform some of these difficult or painful procedures (which are very different when done on a live patient who visibly and physically reacts to pain or discomfort) instead of a plastic model). And I think most doctors would find their bedside manner improved if they had to spend some time in the hospital just like their patients.

I heard of a medical school which assigned all of their first or second year students a diagnosis -- appendicitis, or a broken limb, or heart trouble, whatever, and then had them admitted to the hospital overnight, so they could experience the exact kind of treatment they might receive as a patient with that same complaint. They were given the required tests (X-rays or lab work -- including lumbar puncture or spinal tap), prepped for surgery (including pre-op enemas, shaving, pre-op shots, etc) and the follow up treatments (follow up blood work, casting, intravenous feedings -- whatever was called for).

The young medical students were interviewed after the experience, and told reviewers that it completely changed their perceptions of what it is like to be a patient. And it changed the way they would practice medicine for the better.

They complained about the noise of the hospital corridors at night, which made it hard to sleep, of being wakened by nurses and technicians for tests and procedures at all hours when they did fall asleep, of too frequent and unnecessary procedures, such as blood tests (which had to be repeated because a first test turned up "inconclusive" or because the "admitting doctor" forgot to order it, or the technician forgot to draw sufficient amounts the first time. They learned what it felt like to be shaved in an intimate part of the body (and over the next few weeks what it felt like for the shaved spots to grow back in). They met with unsympathetic caregivers who treated them indifferently (or worse) and who were impatient with their embarrassment and discomfort during procedures. Universally the doctors-in-training reported that it made them more sympathetic to the people they were caring for, more aware of their own fears and doubts about the unknown, and more cautious about ordering too many tests or procedures unless they were truly necessary.

This strikes me as a great way to insure that our medical personnel learn more than textbook wisdom in their medical school years, and learn to spend just a little more time with patients -- explaining what is being done, why, and how the patient can work with the medical team to achieve the best possible outcome. I wish more doctors took the time to switch places with the patients from time to time!

As a doc, I can tell you that the only thing we practiced on each other was drawing blood. We did have professors' wives posing as patients when I was on the gyn rotation, but we just interviewed (on tape) but no exams. That was to help us develop rapport (we called it "Rap-whore") with ladies with sensitive problems. I have since gotten a whole lot better and more empathetic than when I was a naive med student.

I too have heard that they do practice bloods on each other, but I think everything else is certainly not in common practice.

What groups of students do though to aid their own studies I doubt we will never know

I think this is a great way for drs to know what other people feel like when theyre udergoing treatment

I had a friend who was studying to be an RN. She asked a few of us if she could practice taking our vitals. I don't recall hearing that the class paired up for things like this.

Actually a lot of it depends on the school nd the emphasses placed on textbook vs hands on knowledge. Vitals, history taking, EKG ...the simple non-invasive stuff we learned on each other. Our first IV, injection, enema, NG, intubation etc were all done on patients after reviewing the procedure in text. Post-Grad we did do more procedures on each other ....but even then it was limited to less invasive procedures ...a complete physical (which was actually required on one of our professors before passing that test). You do learn some empathy when you're doing a gyn exam kn a classsmate with a professor watching over your shoulder. Still ....true first colonoscope I ever slid into warm flesh was a patient, who thankfully had enough versid on board not to care that my hands were shaking worse than theirs were. But there was that unwritten rule ....never let them know it's your first time.

To our advantage though (and then I'll shut up mosh) we ALWAYS had someone right next to us to talk us through it .....and god forbid could stop you or jump in before you did permanent damage or killed someone

Dr T

Quick question for those who are not health care workers .....

If you could attend a seminar where you would not only be taught the basic "how" but maybe a simplified (due to time constraints) "why" .....along with a lab segment where you could practice your new skills as well as have them practiced on you ....would you be interested ....and if you would be, how might this seminar look to you ....expectations ....etc

Dr T

Quick question for those who are not health care workers .....

If you could attend a seminar where you would not only be taught the basic "how" but maybe a simplified (due to time constraints) "why" .....along with a lab segment where you could practice your new skills as well as have them practiced on you ....would you be interested ....and if you would be, how might this seminar look to you ....expectations ....etc

Dr T

Presuming this is a professional,non-rhetorical/roleplay question:

How it would appear? It would require an adequately comfortable setting for patient and practitioner alike. As to expectations, to allow myself and others to experience and learn. Thereby providing an opportunity for broadening knowledge along with refining perceptions /practices for practitioners and non-practitioners alike. Fair and adequate monetary compensation for all attendees who take time out of their daily lives, being that practitioners are already being paid. If a question of rhetoric/roleplay,my answer would be different.

Excellent idea for clinic boarders, Dr T! Many of the new members--and undoubtedly many veteran ones-- would gain a great deal of insight. I don't agree with the earlier poster who suggests attendees be paid. I would expect to pay well as an atendee. Your's is a splendid idea.

It depends on the school's curriculum and policies. But for me, I remember we had theory class, where the basics of health care topics were taught then laboratory where procedures were taught and we did demos.

so basically, the clinical instructors would use dummies to show us how the procedures were done. Then after the lecture/demo we'd be given time to practice since we have skills tests, we show the clinical instructors how the procedures were done and were graded.

so, basically, we have partners. For practice, we either practice on each other or on dummies. Like for noninvasive stuff like Vitals we practice on each other. For more time consuming or more complicated stuff we practice on dummies.

But for the skills tests itself, we did it on ourselves, I remember when we did injections. so, in one sitting, I got and gave IM, SC, ID injections.

And then for the clinical rotations, we were allowed to do procedures on patient with their consent and the presence of our clinical instructors for guidance

Actually, your doctor did screw up, Soumise, because it was his respobsibility to see that the student (or resident) was cutting in the right place before the incision was made. I have been in many operating rooms and have always seen the lead surgeon ask the assitant making the incision where he / she would make it BEFORE the scalpel is handed to him / her.

For the purpose of clarification:

My comment earlier regarding getting paid to be practiced on comes primarily from what I have seen posted here and on the sibling site http://enemas4fun.zity.biz/ termed as a "standard patient". In addition, I have gone to various sites hosted by teaching hospitals that have programs for 'standard patients' that serve the purpose of having a live individual for medical professionals & students in training to practice procedures on/with, these otherwise healthy individuals get paid for allowing their body to be used.

Sincerely,

G.N.

Some medical students do. A close friend of mine is studying at medical school, along with his girlfriend. At the end of each day they "review" the lessons that they learned and practice on each other. My friend once told me that his professor said that many doctors and nurses practice on each other during breaks or off-hours.

The only thing we practiced on each other was drawing blood. All of the other procedures were taught by interns, residents and staff physicians. None of the complicated or life threatening procedures such as intubation, centrat lines and NG tubes were taught to us until we were interns or residents. Naive medical students were terrified of doing such things. Until we were capable of understanding the risks, possible consequences and fallout of any procedures we were kept in the wings. I did learn how to do lumbar punctures as a student but only in third year.

Residency mantra - See one, Do one, Teach one.

Would think that giving an enema to a patient would require a little practice and knowledge, it could be very uncomfortable if not done right.