Jennifer Spicer, MD, MPH
Jennifer Spicer, MD, MPH

@JenniferSpicer4

16 Tweets 9 reads Jul 27, 2021
1/
Have you ever a junior member of your team ask you a question, and you had NO IDEA what the answer was?
Like, literally no clue.
Racking your brain.
Nothing.
Nope, just me?
This week’s #MedEdTwagTeam #ClinicalTeaching topic: Humility.
#MedTwitter #MedEd
2/
On my first day as a senior resident, I was terrified that my interns would ask me a question that I didn’t know.
…And they did.
So I said, ā€œI don’t know, let’s look it up.ā€
And, (not surprisingly) they appreciated that.
Me, admitting my limitations & offering to help.
3/ Honestly, this fear of not knowing things still plagues me.
I have a weird combination of confidence + imposter syndrome.
Some days I feel confident.
Other days I wonder why everyone else is so much smarter than me.
Why can't I remember the names of those famous trials?!
4/
During residency I watched brilliant attendings solve mystery cases with ease.
I felt that I would never get there.
But then I realized that the ā€œall knowingā€ physician was a myth.
We are all constantly learning & growing.
5/ And reading this passage from @DxrxEdu @Gurpreet2015 in @JHospMedicine tells me that I’m not alone.
ā€œI don’t know.ā€
What a powerful phrase.
(Here’s the link to the full article: journalofhospitalmedicine.com)
6/ And, over the last few months, @ricapitt & I have had Resident as Teacher sessions with our new(ish) @emoryimchiefs PGY2 residents.
When we ask them what their biggest fear is about being a senior resident, it’s a familiar concern:
That they won’t know enough.
7/ But, funny enough, when I hear them say this, I know they are going to be just fine.
Because they are humble.
They recognize their limits.
And they are sharing their fears.
8/ Which all comes back to today’s concept of remaining humble.
Humility has helped me in 3 important ways on my clinical teams:
1⃣Flattening the hierarchy.
2⃣Establishing a growth mindset.
3⃣Creating trust.
9/ First, flattening the hierarchy.
On the first day of wards, I make it clear that everyone on the team has unique knowledge & value.
There is a LOT that I don’t know.
I’m very up-front about that.
I tell the team to correct me (and they do).
10/ I emphasize teamwork.
And I encourage everyone to speak up if they have an idea, even if it’s not ā€œtheirā€ patient.
I make it clear that a ā€œcorrectionā€ from someone else doesn’t reflect poorly on the person who was corrected.
We are all a team, and everyone gets the credit.
11/ If you haven’t read Atul Gawande’s book ā€œThe Checklist Manifesto,ā€ I highly recommend it.
atulgawande.com
And this article from @MedEd_Journal is also a great read: onlinelibrary.wiley.com
12/ Second, establishing a growth mindset.
If you aren’t familiar with the term growth mindset, here’s a link to a 2 page summary from @MedEd_Journal:
onlinelibrary.wiley.com
Growth mindset = success is due to effort
Fixed mindset = success driven by innate ability
13/
Part of a growth mindset is recognizing that we all can improve.
So, in the spirit of a growth mindset, I remind my team that we are all (myself included) there to learn.
I HOPE they have gaps in their knowledge; otherwise, what am I doing there?!
14/ Third, humility engenders trust.
When trainees come to me and admit that they don’t know something (i.e. humility), it helps me trust that they know the boundaries of their knowledge.
I know that I can trust what they say and do.
And vice versa.
15/ So, in summary, consider how you can role model your humility by:
Admitting ā€œI don’t knowā€
This will help your team by:
1⃣Flattening the hierarchy
2⃣Encouraging a growth mindset
3⃣Creating trust
16/ And keep an eye out for @GStetsonMD’s thread next Tuesday on ā€Never Judgeā€
And check out the @MedEdTwagTeam if you want to see all of our threads in one place!
Thanks for joining, and we will see you next week!

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