What's Wrong with this Medical Student Today? Dysfluency on Inpatient Rounds

This paper shows how a medical trainee's verbal delivery can provide clues to detrimental conditions that may exist in his or her medical learning environment and argues that medical trainees would be better served by faculty who listen to their students with the same attentive skills that are considered essential to good patient care.

Abstract

Medical Writings1 April 1998What's Wrong with this Medical Student Today? Dysfluency on Inpatient RoundsCatherine V. Caldicott, MDCatherine V. Caldicott, MDState University of New York; Syracuse, NY 13202Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-7-199804010-00037 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail As they strive to improve student and resident training in patient care, many medical educators refer to the extensive literature on physician–patient communication [1-3]. However, physicians speak differently in front of patients than they do among themselves, and studies of communication among physicians appear less frequently in the medical literature. Conversations between medical teachers and their students can illuminate attitude and value conflicts that affect a trainee's skills and knowledge acquisition, as well as professional development [4, 5]. In this paper, I show how a medical trainee's verbal delivery can provide clues to detrimental conditions that may exist in his ...References1. Lipkin M Jr, Putnam SM, Lazare A, eds. The Medical Interview: Clinical Care, Education, and Research. New York: Springer-Verlag; 1995. Google Scholar2. Todd AD, Fisher S, eds. The Social Organization of Doctor-Patient Communication. 2d ed. Norwood, NJ: Ablex; 1993. Google Scholar3. Cassell EJ. Talking with Patients. v 1-2. Cambridge, MA: MIT Pr; 1985. Google Scholar4. Anspach RR. Notes on the sociology of medical discourse: the language of case presentation. J Health Soc Behav. 1988; 29:357-75. Google Scholar5. Donnelly WJ. Medical language as symptom: doctor talk in teaching hospitals. Perspect Biol Med. 1986; 30:81-94. Google Scholar6. Sacks H, Schegloff E, Jefferson G. A simplest systematics for the analysis of turn-taking in conversation. Language. 1974; 50:696-735. Google Scholar7. Drew P, Heritage J. Analyzing talk at work: an introduction. In: Drew P, Heritage J, eds. Talk at Work: Interaction in Institutional Settings. New York: Cambridge Univ Pr; 1992:3-65. Google Scholar8. Mishler EG. The Discourse of Medicine: Dialectics of Medical Interviews. Norwood, NJ: Ablex; 1984. Google Scholar9. West C. Routine Complications: Troubles with Talk between Doctors and Patients. Bloomington, IN: Indiana Univ Pr; 1984. Google Scholar10. Burnum JF. Medical diagnosis through semiotics. Giving meaning to the sign. Ann Intern Med. 1993; 119:939-43. Google Scholar11. Bateson G. Steps to an Ecology of Mind. San Francisco: Chandler; 1972. Google Scholar12. DuBois JW, Schuetze-Coburn S, Paolino D, Cumming S. Santa Barbara Papers in Linguistics. v 4. Discourse Transcription, Department of Linguistics, University of California, Santa Barbara; 1992. Google Scholar13. Hill JH. The voices of Don Gabriel: responsibility and self in a modern Mexicano narrative. In: Mannheim B, Tedlock D, eds. The Dialogic Emergence of Culture. Urbana, IL: Univ of Illinois Pr; 1995; 97-147. Google Scholar14. Duffy TP. The many pitfalls in the diagnosis of myeloma. N Engl J Med. 1992; 326:394-6. Google Scholar Author, Article, and Disclosure InformationAuthors: Catherine V. Caldicott, MDAffiliations: State University of New York; Syracuse, NY 13202Acknowledgments: The author thanks Laura M. Ahearn, PhD; Rodney A. Hayward, MD; Joel D. Howell, MD, PhD; Laurence F. McMahon Jr., MD, MPH; and A. Lesley Milroy, PhD, for their critical reviews of earlier drafts of this manuscript, and Clare Weipert for her expert assistance in the preparation of this paper.Grant Support: This paper was written while the author was a Rober Wood Johnson Clinical Scholar at the University of Michigan, Ann Arbor, Michigan.Corresponding Author: Catherine V. Caldicott, MD, Department of Medicine, State University of New York Health Science Center, 90 Presidential Plaza, Syracuse, NY 13202. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byMeasuring the Intensity of Resident Supervision in the Department of Veterans Affairs: The Resident Supervision IndexQuestioning Competence: A Discourse Analysis of Attending Physicians’ Use of Questions to Assess Trainee CompetenceLearning oral presentation skillsImplications of the Hospitalist Model for Medical Studentsʼ EducationContext, Conflict, and Resolution 1 April 1998Volume 128, Issue 7Page: 607-610KeywordsBehaviorFearHospital medicineInpatientsMedical educationMedical servicesOtitis mediaPatientsSarcoidosisWeight loss ePublished: 15 August 2000 Issue Published: 1 April 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...