Yesterday, we had a CPS for Grand Rounds. I had a colleague from Birmingham come to Huntsville and present me 3 unknown cases. For 1 hour I opened my thought processes – warts and all – making a few mistakes and having some successes.
In Birmingham we have done this monthly for several years. Our students and residents love the conference and tell us it is the best learning experience. Yesterday after the conference I heard incredibly positive feedback and several requests to do more of that style of Grand Rounds.
As a leaner, but also as a colleague I find these exercises extremely useful. The audience plays along, sometimes getting ahead of the discussant. But I believe the unmasking of the thought process has the greatest benefit for all.
Often medicine requires a cerebral approach. We too often teach facts without making explicit how to incorporate those facts into decision making. Medical decision making is dynamic not static, yet traditional teaching focuses on the static information.
NEJM regularly publishes CPS cases. The Journal of General Internal Medicine has just added a similar exercise. I believe that these exercises allow us to teach wisdom in addition to knowledge. As physicians we continuously strive to improve our wisdom for wisdom requires us to use knowledge.
”“Wisdom is not a product of schooling but of the lifelong attempt to acquire it” – Albert Einstein
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I agree that judgment is more important than factual knowledge. It’s a lot easier to teach the latter than the former. Our standardized testing mentality is an impediment to acquiring true wisdom and judgment. So, are all of the new P4P initiatives, which are counting and rewarding the wrong measures.