Overview
This session sits within the Year 2 Professional Development vertical module and centres on a panel of ED (Emergency Department) doctors. It sets out the module’s broader aims, introduces the panel’s own aims, presents a critical-incident case and the reflective questions it raises, records the questions put to the panel, and closes with take-home messages on staff wellbeing and self-care.
Professional Development module
The Professional Development module is a vertical thread running through every year of medical school, focused on the person becoming a professional. It introduces concepts and activities that encourage:
- resilience
- reflection
- integrity
- professionalism
- teamwork
- accountability
- excellence
Year 2 Professional Development covers: becoming a professional/introduction to the Code, the ED panel, Dr-Pt relationship 1, Dr-Pt relationship 2, social media, reflective practice, health and wellbeing of medical students, beyond medical school, and parenting and medicine.
Professional Development links with other modules: Early Professional Experience, Integrated cases, and the Ethics vertical module. Integrated case 1 (Trauma) is a motor vehicle crash involving a young man.
Administrative note carried in this lecture: students not yet signed up must read the Code of Professional Conduct for Medical Students at the Universities of Auckland and Otago (Moodle ELM Home page, Course, general section, Resources, Induction) and complete the one-question quiz confirming: “I have read the Code. I undertake to comply with it and seek clarification on any areas of uncertainty. I agree to familiarise myself with any subsequent revisions.”
Aims of the ED panel session
The ED panel uses ED staff as an example of fully formed professional identity formation. Its aims are to:
- gain an awareness of the work of ED, and the challenges it poses
- begin to understand the work, and consider how work experiences impact staff wellbeing
- consider how an individual’s response can impact patient care
- consider ways of maintaining a staff member’s health: physically, psychologically, emotionally and spiritually
- understand the need for reflective activities
- begin to understand the limits of biomedicine, and uncertainty in care
- appreciate the importance of teamwork
- appreciate the importance of skills in breaking bad news, and dealing with suffering and loss
Panel members: Jon Keast, Signe Stanbridge, Owain.
The case and panel questions
The case: it has been a long, busy night in ED. The doctor is about to go home, having started at 4pm on Saturday and it now being 3.30am Sunday, when the ambulance phones the ED triage nurse to say they will arrive in 30 minutes with 4 young adults from a single high-speed vehicle crash, one of whom is already dead at the scene.
This raises the questions:
- Should I go home?
- Am I fit to work?
- What are the junior staff thinking?
- How do we prepare? (clinically and psychologically)
Questions put to the panel:
- What was it like the first time you dealt with someone who had a severe injury, and how has that changed over the years?
- How do you care for yourself on a personal level? (then vs now)
- How do you care for each other after a significant event?
Take-home messages
- Be respectful of other staff
- Be kind to others
- Take care of yourself: have breaks and exercise
- Remember your humanity, equal to the patient
- Don’t be judgemental
- Put the patient at the centre of care
- Set up mechanisms to support yourself: mentors, opportunities to reflect, other staff to talk to about busy/difficult days
Self-test
- Describe the purpose of the Professional Development vertical module and list the qualities it aims to cultivate.
- List the Year 2 Professional Development module topics.
- Which modules does Professional Development link with, and what is Integrated case 1?
- Describe the stated aims of the ED panel session.
- Describe the case presented to the panel, and the four questions it raised for the doctor about to go home.
- What three questions were put to the ED panel members?
- List the take-home messages from the ED panel session.
- Using the take-home messages and the panel’s aims, explain how the session links an individual doctor’s coping and wellbeing to the quality of patient care.
Answers
Reveal answers
- The module is a vertical thread running through every year of medical school, focused on the person becoming a professional. It aims to encourage resilience, reflection, integrity, professionalism, teamwork, accountability and excellence.
- Becoming a professional/introduction to the Code; ED panel; Dr-Pt relationship 1; Dr-Pt relationship 2; social media; reflective practice; health and wellbeing of medical students; beyond medical school; parenting and medicine.
- It links with Early Professional Experience, Integrated cases, and the Ethics vertical module. Integrated case 1 (Trauma) is a motor vehicle crash involving a young man.
- To gain awareness of ED work and its challenges; understand how work experiences affect staff wellbeing; consider how an individual’s response affects patient care; consider ways of maintaining physical, psychological, emotional and spiritual health; understand the need for reflective activities; understand the limits of biomedicine and uncertainty in care; and appreciate the importance of teamwork and of skills in breaking bad news and dealing with suffering and loss.
- A doctor about to finish a long shift is told the ambulance is bringing in 4 young adults from a high-speed single-vehicle crash in 30 minutes, one already dead at the scene. This raises: should I go home? Am I fit to work? What are the junior staff thinking? How do we prepare, clinically and psychologically?
- What was it like the first time you dealt with someone with a severe injury, and how has that changed over the years? How do you care for yourself on a personal level, then versus now? How do you care for each other after a significant event?
- Be respectful of other staff; be kind to others; take care of yourself with breaks and exercise; remember your humanity as equal to the patient; don’t be judgemental; put the patient at the centre of care; set up mechanisms to support yourself such as mentors, reflection opportunities, and other staff to talk to.
- The panel’s aims explicitly link an individual’s response to a difficult event with the quality of patient care, and the take-home messages (self-care, support mechanisms, remembering your own humanity, not being judgemental) are framed as the means of maintaining that response, so that a doctor who is rested, supported and reflective can keep the patient at the centre of care even after a distressing case.