<?xml version="1.0" encoding="UTF-8"?><rss version="2.0" xmlns:content="http://purl.org/rss/1.0/modules/content/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:atom="http://www.w3.org/2005/Atom" xmlns:sy="http://purl.org/rss/1.0/modules/syndication/" > <channel><title>Comments on: Why can&#8217;t young doctors intubate patients correctly? Blame television</title> <atom:link href="http://www.kevinmd.com/blog/2009/03/why-cant-young-doctors-intubate.html/feed" rel="self" type="application/rss+xml" /><link>http://www.kevinmd.com/blog/2009/03/why-cant-young-doctors-intubate.html</link> <description></description> <lastBuildDate>Tue, 14 Feb 2012 23:00:00 +0000</lastBuildDate> <sy:updatePeriod>hourly</sy:updatePeriod> <sy:updateFrequency>1</sy:updateFrequency> <xhtml:meta xmlns:xhtml="http://www.w3.org/1999/xhtml" name="robots" content="noindex" /> <item><title>By: Mike</title><link>http://www.kevinmd.com/blog/2009/03/why-cant-young-doctors-intubate.html#comment-90620</link> <dc:creator>Mike</dc:creator> <pubDate>Tue, 31 Mar 2009 01:10:00 +0000</pubDate> <guid isPermaLink="false">http://clients.emmense.com/kevinmd/2009/03/why-cant-young-doctors-intubate-patients-correctly-blame-television.html#comment-90620</guid> <description>What about the fact that in residency they don&#039;t LET you intubate anyone. I tried during my anesthesia rotation, to no avail. &lt;br/&gt;&lt;br/&gt;Anyway, what&#039;s the big deal with TV? They show that when ER was big, applications for ER spots went up. It&#039;s the nature of the beast.</description> <content:encoded><![CDATA[<p>What about the fact that in residency they don&#8217;t LET you intubate anyone. I tried during my anesthesia rotation, to no avail.</p><p>Anyway, what&#8217;s the big deal with TV? They show that when ER was big, applications for ER spots went up. It&#8217;s the nature of the beast.</p> ]]></content:encoded> </item> <item><title>By: Anonymous</title><link>http://www.kevinmd.com/blog/2009/03/why-cant-young-doctors-intubate.html#comment-90609</link> <dc:creator>Anonymous</dc:creator> <pubDate>Mon, 30 Mar 2009 20:19:00 +0000</pubDate> <guid isPermaLink="false">http://clients.emmense.com/kevinmd/2009/03/why-cant-young-doctors-intubate-patients-correctly-blame-television.html#comment-90609</guid> <description>JFS -&lt;br/&gt;  I&#039;m glad this is noted at a higher level in the educational system because I found that I was very nervous coming out of residency with my competency during procedures. I was very aggressive at doing them (I didn&#039;t hand them off even if I was over my 80 hours - but that is a secret, right?) and I didn&#039;t have complications. But, if you don&#039;t do that many, then you won&#039;t have many complications. And that is what separates the doctor from a kid playing a video game - how to recognize and manage the complications. I agree, it is an overall cultural attitude, not that of any single individual (although I could single a few of my attendings out who were clearly scared to have the residents do any procedures.)&lt;br/&gt;&lt;br/&gt;Also, did you know that it is no longer a requirement for internal medicine residents to perform a certain number of procedures to graduate? You won&#039;t get credentialed to do them, but you are still board eligible. This surprised me...but I guess you would just be limiting your own practice abilities.&lt;br/&gt;&lt;br/&gt;One more thing - I love the Glidescope.&lt;br/&gt;&lt;br/&gt;Anon #1</description> <content:encoded><![CDATA[<p>JFS -<br /> I&#8217;m glad this is noted at a higher level in the educational system because I found that I was very nervous coming out of residency with my competency during procedures. I was very aggressive at doing them (I didn&#8217;t hand them off even if I was over my 80 hours &#8211; but that is a secret, right?) and I didn&#8217;t have complications. But, if you don&#8217;t do that many, then you won&#8217;t have many complications. And that is what separates the doctor from a kid playing a video game &#8211; how to recognize and manage the complications. I agree, it is an overall cultural attitude, not that of any single individual (although I could single a few of my attendings out who were clearly scared to have the residents do any procedures.)</p><p>Also, did you know that it is no longer a requirement for internal medicine residents to perform a certain number of procedures to graduate? You won&#8217;t get credentialed to do them, but you are still board eligible. This surprised me&#8230;but I guess you would just be limiting your own practice abilities.</p><p>One more thing &#8211; I love the Glidescope.</p><p>Anon #1</p> ]]></content:encoded> </item> <item><title>By: Carey</title><link>http://www.kevinmd.com/blog/2009/03/why-cant-young-doctors-intubate.html#comment-90600</link> <dc:creator>Carey</dc:creator> <pubDate>Mon, 30 Mar 2009 02:01:00 +0000</pubDate> <guid isPermaLink="false">http://clients.emmense.com/kevinmd/2009/03/why-cant-young-doctors-intubate-patients-correctly-blame-television.html#comment-90600</guid> <description>Interesting discussion and perspectives. Do residents really have that much time to watch tv? Aside from blaming television, how are things being done in terms of medical education/medical training to instill a sense of confidence, composure and skill when having to intubate? What sorts of barriers get in the way from allowing young doctors to learn differently and master such an important part of their practice? Seems like a discussion we should be having with multiple voices present...Thanks for the post!</description> <content:encoded><![CDATA[<p>Interesting discussion and perspectives. Do residents really have that much time to watch tv? Aside from blaming television, how are things being done in terms of medical education/medical training to instill a sense of confidence, composure and skill when having to intubate? What sorts of barriers get in the way from allowing young doctors to learn differently and master such an important part of their practice? Seems like a discussion we should be having with multiple voices present&#8230;Thanks for the post!</p> ]]></content:encoded> </item> <item><title>By: Joseph Sucher, MD FACS</title><link>http://www.kevinmd.com/blog/2009/03/why-cant-young-doctors-intubate.html#comment-90559</link> <dc:creator>Joseph Sucher, MD FACS</dc:creator> <pubDate>Sat, 28 Mar 2009 12:47:00 +0000</pubDate> <guid isPermaLink="false">http://clients.emmense.com/kevinmd/2009/03/why-cant-young-doctors-intubate-patients-correctly-blame-television.html#comment-90559</guid> <description>First... Is this a joke?  Really?  You think that intelligent people actually are taking their teaching from TV?  &lt;br/&gt;&lt;br/&gt;Second... Anonymi (whatever the plural is for Anonymous).&lt;br/&gt;&lt;br/&gt;You&#039;re correct.  It is getting harder for the less experience to gain experience.  This is a function of societal demands, and less an individual trainer issue.  As our society has increased its demand for safer care this has been translated into our training programs as not allowing students to essentially learn (practice) on real live patients.  Everyone  knows the phrase &quot;See one, do one, teach one&quot;.  However, few of you will every actually see this in practice.&lt;br/&gt;&lt;br/&gt;Ethically, this seems to make sound sense. Practically, it is clear that we are not fully achieving the goals of graduating independant practitioners ready to go take care of patients straight out of residency. This is a well known concern at the highest levels of education, and there is a considerable amount of effort directed at making changes in the educational system that meets with societies demands, but achieves the goal of training people to become the best physicians in the world. &lt;br/&gt;JFS</description> <content:encoded><![CDATA[<p>First&#8230; Is this a joke?  Really?  You think that intelligent people actually are taking their teaching from TV?</p><p>Second&#8230; Anonymi (whatever the plural is for Anonymous).</p><p>You&#8217;re correct.  It is getting harder for the less experience to gain experience.  This is a function of societal demands, and less an individual trainer issue.  As our society has increased its demand for safer care this has been translated into our training programs as not allowing students to essentially learn (practice) on real live patients.  Everyone  knows the phrase &#8220;See one, do one, teach one&#8221;.  However, few of you will every actually see this in practice.</p><p>Ethically, this seems to make sound sense. Practically, it is clear that we are not fully achieving the goals of graduating independant practitioners ready to go take care of patients straight out of residency. This is a well known concern at the highest levels of education, and there is a considerable amount of effort directed at making changes in the educational system that meets with societies demands, but achieves the goal of training people to become the best physicians in the world. <br />JFS</p> ]]></content:encoded> </item> <item><title>By: Anonymous</title><link>http://www.kevinmd.com/blog/2009/03/why-cant-young-doctors-intubate.html#comment-90556</link> <dc:creator>Anonymous</dc:creator> <pubDate>Sat, 28 Mar 2009 02:55:00 +0000</pubDate> <guid isPermaLink="false">http://clients.emmense.com/kevinmd/2009/03/why-cant-young-doctors-intubate-patients-correctly-blame-television.html#comment-90556</guid> <description>Plus as a med student you have to constantly fight with PAs and NPs to do anything. After fighting with them, you still have to luck into an attending who will teach you. It took me 2 weeks to deliver ONE baby and 4 days to TRY an intubation from start to finish. ABGs, PA would do them before we even knew about them.&lt;br/&gt;&lt;br/&gt;So when the old fogey docs complain about new ones being incompetent, it&#039;s because YOU wouldn&#039;t let us do anything.</description> <content:encoded><![CDATA[<p>Plus as a med student you have to constantly fight with PAs and NPs to do anything. After fighting with them, you still have to luck into an attending who will teach you. It took me 2 weeks to deliver ONE baby and 4 days to TRY an intubation from start to finish. ABGs, PA would do them before we even knew about them.</p><p>So when the old fogey docs complain about new ones being incompetent, it&#8217;s because YOU wouldn&#8217;t let us do anything.</p> ]]></content:encoded> </item> <item><title>By: Anonymous</title><link>http://www.kevinmd.com/blog/2009/03/why-cant-young-doctors-intubate.html#comment-90554</link> <dc:creator>Anonymous</dc:creator> <pubDate>Sat, 28 Mar 2009 00:39:00 +0000</pubDate> <guid isPermaLink="false">http://clients.emmense.com/kevinmd/2009/03/why-cant-young-doctors-intubate-patients-correctly-blame-television.html#comment-90554</guid> <description>Maybe we could have some manequins with huge necks. I practiced on a manequin, yet everyone I need to intubate for real is 20x heavier. I am a small woman and sometimes just don&#039;t have the upper body strength. That being said, my success rate on first try is over 95%. I feel like I should fail more. Also, I don&#039;t watch ER so I didn&#039;t learn poor technique from them. &lt;br/&gt;&lt;br/&gt;I did notice that in my residency, procedures get passed on to the most experienced, so young people have a hard time learning them. I was a medicine resident and the anesthesiologists NEVER let us intubate if they were there. So, how are we supposed to learn and keep our skills up? Now that I am a hospitalist, I make a point to do the procedures myself despite the fact that it isn&#039;t cost-effective just so I don&#039;t &quot;forget&quot; some day. It is tempting to call IR though...</description> <content:encoded><![CDATA[<p>Maybe we could have some manequins with huge necks. I practiced on a manequin, yet everyone I need to intubate for real is 20x heavier. I am a small woman and sometimes just don&#8217;t have the upper body strength. That being said, my success rate on first try is over 95%. I feel like I should fail more. Also, I don&#8217;t watch ER so I didn&#8217;t learn poor technique from them.</p><p>I did notice that in my residency, procedures get passed on to the most experienced, so young people have a hard time learning them. I was a medicine resident and the anesthesiologists NEVER let us intubate if they were there. So, how are we supposed to learn and keep our skills up? Now that I am a hospitalist, I make a point to do the procedures myself despite the fact that it isn&#8217;t cost-effective just so I don&#8217;t &#8220;forget&#8221; some day. It is tempting to call IR though&#8230;</p> ]]></content:encoded> </item> <item><title>By: Anonymous</title><link>http://www.kevinmd.com/blog/2009/03/why-cant-young-doctors-intubate.html#comment-90548</link> <dc:creator>Anonymous</dc:creator> <pubDate>Fri, 27 Mar 2009 20:25:00 +0000</pubDate> <guid isPermaLink="false">http://clients.emmense.com/kevinmd/2009/03/why-cant-young-doctors-intubate-patients-correctly-blame-television.html#comment-90548</guid> <description>Buckeye, I&#039;ve been watching (again) this season - the very last. &lt;br/&gt;&lt;br/&gt;And Nurse Hathaway was on last week, she&#039;s a transplant coordinator in Seattle, married (presumably) to Dr. Ross.&lt;br/&gt;&lt;br/&gt;Next week is the very last show.  It&#039;s been a pretty good run, all things considered.&lt;br/&gt;&lt;br/&gt;And if students are going to learn from TV, it&#039;s a darned bit better they learn from ER than Gray&#039;s Anatomy.</description> <content:encoded><![CDATA[<p>Buckeye, I&#8217;ve been watching (again) this season &#8211; the very last.</p><p>And Nurse Hathaway was on last week, she&#8217;s a transplant coordinator in Seattle, married (presumably) to Dr. Ross.</p><p>Next week is the very last show.  It&#8217;s been a pretty good run, all things considered.</p><p>And if students are going to learn from TV, it&#8217;s a darned bit better they learn from ER than Gray&#8217;s Anatomy.</p> ]]></content:encoded> </item> <item><title>By: Peter</title><link>http://www.kevinmd.com/blog/2009/03/why-cant-young-doctors-intubate.html#comment-90544</link> <dc:creator>Peter</dc:creator> <pubDate>Fri, 27 Mar 2009 18:19:00 +0000</pubDate> <guid isPermaLink="false">http://clients.emmense.com/kevinmd/2009/03/why-cant-young-doctors-intubate-patients-correctly-blame-television.html#comment-90544</guid> <description>The way the media portray medicine does significantly affect the attitudes of some entering the medical profession.  Though procedural technique can be slightly influenced by media, it can be fixed relatively quickly.  The problem is in the portrayal of professional ideals and ethical conflicts, which can be significantly influencing and serve as a role-model and test-case for young physicians.  These effects are probably much more difficult to undo.  &lt;br/&gt;&lt;br/&gt;I did a series on of the ways that TV shows and movies incorporate components of medical practice on my blog &lt;a HREF=&quot;http://medicalpastiche.blogspot.com/search/label/medicine%20in%20media&quot; REL=&quot;nofollow&quot;&gt;here&lt;/a&gt;.</description> <content:encoded><![CDATA[<p>The way the media portray medicine does significantly affect the attitudes of some entering the medical profession.  Though procedural technique can be slightly influenced by media, it can be fixed relatively quickly.  The problem is in the portrayal of professional ideals and ethical conflicts, which can be significantly influencing and serve as a role-model and test-case for young physicians.  These effects are probably much more difficult to undo.</p><p>I did a series on of the ways that TV shows and movies incorporate components of medical practice on my blog <a HREF="http://medicalpastiche.blogspot.com/search/label/medicine%20in%20media" REL="nofollow">here</a>.</p> ]]></content:encoded> </item> <item><title>By: shadowfax</title><link>http://www.kevinmd.com/blog/2009/03/why-cant-young-doctors-intubate.html#comment-90543</link> <dc:creator>shadowfax</dc:creator> <pubDate>Fri, 27 Mar 2009 16:38:00 +0000</pubDate> <guid isPermaLink="false">http://clients.emmense.com/kevinmd/2009/03/why-cant-young-doctors-intubate-patients-correctly-blame-television.html#comment-90543</guid> <description>Funny, but I call bullshit.   The view from the side of the bed and the head of the bed are so different that you couldn&#039;t possibly think to mimic technique.  Plus, when you do it for real, there&#039;s an attending there teaching you, and if he/she doesn&#039;t teach you about the sniffing position, then they have failed as a teacher.&lt;br/&gt;&lt;br/&gt;No, more likely someone saw an idea for a funny article that would get play in the press -- and it worked.  But it&#039;s still BS.</description> <content:encoded><![CDATA[<p>Funny, but I call bullshit.   The view from the side of the bed and the head of the bed are so different that you couldn&#8217;t possibly think to mimic technique.  Plus, when you do it for real, there&#8217;s an attending there teaching you, and if he/she doesn&#8217;t teach you about the sniffing position, then they have failed as a teacher.</p><p>No, more likely someone saw an idea for a funny article that would get play in the press &#8212; and it worked.  But it&#8217;s still BS.</p> ]]></content:encoded> </item> <item><title>By: Buckeye Surgeon</title><link>http://www.kevinmd.com/blog/2009/03/why-cant-young-doctors-intubate.html#comment-90542</link> <dc:creator>Buckeye Surgeon</dc:creator> <pubDate>Fri, 27 Mar 2009 16:30:00 +0000</pubDate> <guid isPermaLink="false">http://clients.emmense.com/kevinmd/2009/03/why-cant-young-doctors-intubate-patients-correctly-blame-television.html#comment-90542</guid> <description>As per BowmanMD.  Don&#039;t blame TV.  If medical students nowadays are honestly attributing poor techniques to tips they learned on fictional television shows then we&#039;re in a heap of trouble.  Does anyone actually watch ER anymore?  Is Nurse Hathaway still on that show?</description> <content:encoded><![CDATA[<p>As per BowmanMD.  Don&#8217;t blame TV.  If medical students nowadays are honestly attributing poor techniques to tips they learned on fictional television shows then we&#8217;re in a heap of trouble.  Does anyone actually watch ER anymore?  Is Nurse Hathaway still on that show?</p> ]]></content:encoded> </item> </channel> </rss>
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