As I am relatively new to the attending physician role, I am still getting used to the idea that my students and residents are watching me. All the time. Whether I am consciously teaching them something or not. I put a great deal of thought and preparation into the didactic talks that I give them, the teaching points to bring up on rounds, and the formal feedback that I deliver. But I am starting to realize that there are many dimensions to the team’s education that are more subtle.
When I am leading a team of residents and medical students, I am supervising their patient care. They are absorbing knowledge about clinical judgment, the management of the diseases that we encounter, and integrating their scientific foundation with practical applications. However, they are also learning the art of dealing with uncertainty and with the infinite variety of humanity. I feel a responsibility for their clinical development and also their moral awareness.
While I am on the inpatient wards, or in the residents’ clinic, everything that I do or say communicates something about being a doctor. My tone of voice can convey respect or exasperation. When I speak about disagreeing with a colleague, I can be collegial or unprofessional. I am modeling attitudes for my learners, which may be subconscious to them (and to me) but nonetheless influential as they are growing into their doctor identities.
Sometimes it is hard to avoid mixed messages. When I stay late at the hospital with my call team, I show them dedication to the job. But do I also undermine the ideal of work-life balance? When I admit to not knowing something, does it shake their confidence in me? Or can we use the opportunity to look it up and promote life-long learning?
Even my lifestyle choices are under scrutiny. My team knows what I get from the cafeteria or what I bring in for meals and snacks. It actually motivates me toward healthier eating. If I spend all day counseling others about their diet, I had better practice what I preach.
It is exhausting to be constantly alert, not only to the high demands of patient care but the role of teacher as well. I need to keep in mind that my team of doctors-in-training is learning a science and an art at the same time. They are figuring out how to apply clinical knowledge, analyze data, keep up with advances, interact with people, improve systems, behave professionally, balance their work and personal lives, and countless other complex tasks.
They are learning through observation. I must keep all of this in mind, as they are observing me.