The role of residents in teaching and creating a positive clinical learning environment

The hallways were dark, and the door had a passcode that I didn’t know. What I knew was that I was nervous about entering the team room on my first day of internal medicine, my first rotation of the third year of medical school. Fortunately, it didn’t take long to realize that my main teachers, those I would spend the most time with, would be the residents, who were fun people very close to my own age. There were so many of them. They would come and go, with different backgrounds, talents, and dreams.  There was the resident who would start every day saying: “Today will be a great day,” and the resident who told me, “don’t do medicine.” There was the PhD, the AOA, the IMG, the intern who understands four languages, and the one who ate nine cupcakes on a call day morning.

For me, the team room became a safe space filled with light, stories, laughter, and food. There, my residents helped me read CT scans, interpret CBCs, come up with the differential for bradycardia, and organize my oral presentations. My residents gifted me confidence, advice on the third year and specialty selection, and Dr. Pestana’s Surgery Notes. They took away from their time on the wards to go over my notes, and from their time with their loved ones at home to prepare me short and helpful whiteboard lectures.

In describing the interplay between residents and medical students, Dr. Abby Spencer mentions in episode #152 of The Curbsiders podcast, “everyone’s job is to make the rest of the team look good … The savvy ones know that resident worked really hard to make the intern look that good and that intern worked really hard to make the student look that good.” Similarly, my residents told me to be ready when the attending asks for the CURB-65 score and the patient’s potassium to ensure that I could shine on rounds and be acknowledged for the hard work they saw me do.

Reflecting back on my experience, I can easily understand studies that describe how residents’ medical knowledge may not be as significant in the students’ perspective as the residents’ ability to create a safe, nonthreatening, and supportive learning environment. On the contrary, a multicenter survey found that 76 percent of medical students reported that they were mistreated by a resident during their clinical years, and recurrent mistreatment by a resident positively correlated with burnout (32 percent, P < .01). In addition to the residents’ important role in wellness, they play an essential role in education. Highlighting the importance of residents’ role in teaching, one study found a positive correlation between student’s perceived quality of instruction given by residents and the student’s performance on shelf exams (p = 0.038). Another study found that students evaluated lectures given by residents similarly to those given by faculty members.

For all these reasons, I will always be grateful for my residents and will work passionately about creating a positive learning environment for my students in less than a year when I graduate and become a resident myself.

The author would like to thank Jillian S. Catalanotti and Katherine Chretien for their mentorship and support.

Reem Al Shabeeb is a medical student and can be reached on Twitter @reemalshabeeb.

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