Generation Tech 1 – Antiquity 0: A Weird Day on the Wards

January 29, 2013
Chief Resident 1

Residency Blog

Photo credit: brownpau / / CC BY

What is the best part of the day for any medical student, intern or resident? Well besides the lunch-break (if you get one) it is morning work rounds. We call them work rounds because you are actually making clinical decisions in conjunction with your attending. Historically rounds are portrayed as being scary, anxiety producing and an all around departure into hell. Honestly they can be, but they are also one of the most exciting components of our schedule because we get to do what we love: see and treat patients! There is also something exhilarating about being in the crossfire of getting “pimped” on rounds that we all love deep down.

Recently while on rounds I noticed something peculiar happen. The question on rounds was which of the following is the hallmark serologic finding in patients with primary biliary cirrhosis? The answer was anti-mitochondrial antibody, but the medical student said anti-histone antibody. Ordinarily when one of us gets something wrong, we jot down what it was, and look it up later.

However, the medical student decided to do something BOLD! He pulled out an iPad mini and decided to look up the information on PBC right there…on the spot. He was even able to show us images of liver biopsies and what the antibody looks like. I was actually quite impressed because when you reinforce knowledge immediately, research has shown it increases long term solidification of the fact. What happened next, none of us expected.

The attending, who albeit isn’t the most tech savvy, turned immediately and chastised the medical student for not paying attention to rounds and accused him of “facebooking” and “nine-squaring” (I think he meant foursquare). The medical student to his credit apologized and simply said I was looking up the answer. The attending then escalated his voice on the wards and said with a stern cruel face “not on my watch”. At this point I think the medical student felt like Harry Potter getting yelled at in Hogwarts. After rounds I spoke to the attending but I felt it did little good, and then told the medical student who by that point was unfazed by the entire ordeal, not to worry as it was only a guest attending for that day.

However it did set my mind running. Does our generation’s ability to have information at our fingertips make us seem less engaged in rounds? Do other students ever get yelled at for this? Are we expected always as training physicians to carry around multiple books, papers, and useless items when it could simply fit in a slightly overpriced tablet? The merits of an iPad device are obvious: it fits into a labcoat, it is small enough to hold in one hand, and it allows you access to Medscape, UpToDate or even an ebook of Master the Boards USMLE Step 2 CK. The downside, however, is that you get misunderstoodfor being on social media, and it’s not exactly infectious disease friendly. It’s one step away from becoming a petri dish if you don’t clean it properly with antiseptic. But the benefits still outweigh the risks, and I think a paradigm shift in rounding with students is already here and spreading everywhere. “MS-Plugged In” is going to catch up…are you ready for the change?

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All of the opinions expressed here are the author’s and his alone, and do not represent necessarily those of Kaplan or its employees.

Chief Resident 1

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