The prevailing model of medical education encourages students and residents to project two traits patients expect to see in their physicians — certainty and confidence — but it may actually be detrimental to learning and growth, Dhruv Khullar, MD, a resident physician at Boston-based Massachusetts General Hospital and Harvard Medical School, wrote in a blog for The New York Times.
In particular Dr. Khullar discusses "pimping," or a rapid fire questioning process, typically done in front of an audience of colleagues, nurses and patients, in which residents and students are expected to recall facts. It is a process that can be constructive and help students remember important information, or it can devolve into esoteric interrogation, he wrote. Dr. Khullar, as a second-year resident has both pimped and been pimped, he said, and on the whole, finds the process problematic. "It encourages us to learn to show, not grow — to project confidence and dismiss uncertainty," he writes.
It encourages what Dr. Khullar calls a fixed intelligence mindset — one in which students view intelligence as a stable trait and want to avoid situations in which they look unintelligent. However, this doesn't encourage learning and growth, he wrote. "The most important medical learning comes not from memorization and recitation, but by thrusting yourself into situations just beyond your comfort zone," Dr. Khullar wrote.
Instead, students must be encouraged by educators to adopt a growth mindset, one that teaches students how to deal with and communicate uncertainty — and learn from it.
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