Chase DiMarco talks with Dr. Charmaine Gregory, nocturnist emergency physician, host of the Fearless Freedom with Dr. G podcast, and co-author of several books including the Chronicles of Women in White Coats. Charmaine shares tips for navigating an emergency medicine rotation and tips for building constructive student/preceptor relationships.
[4:10] Charmaine’s Background in Emergency Medicine Education
[5:58] Tip 1: Assume the Most Dangerous Entity
[8:36] Tip 2: Ask the Right Questions
[10:28] Tip 3: Build Rapport with Patients
[14:14] Common Obstacles
[17:18] Student/Preceptor Relationships
[25:23] Recommended Resources
Charmaine’s first tip is that students should ask the following question:
What is the most dangerous entity that is associated with this particular chief complaint?
Unlike other specialties, which often require a broad understanding of a patient’s case and a slow & careful diagnosis, emergency medicine is a “high-stakes, low-data” business. Students must assess the situation quickly, and take steps to prevent things that could kill or adversely harm the patient in the short-term.
However, the “chief complaint” in Charmaine’s recommended question is not necessarily what patients say when they first come into the ER. This is why she urges students to learn how to ‘ask the right questions.’ Often, this means keeping questions open-ended. This is to avoid biasing the diagnosis towards the first thing that a patient says and to try to get to the true chief complaint.
Finally, as a third tip, students must learn to build rapport with patients, because this is the best way to get accurate information from them. Common tips to build rapport include utilizing the patient’s name, keeping eye contact and prioritizing a warm interaction.
With respect to student/preceptor relationships, students should “just ask” if they are uncertain of their performance or of preceptor expectations. This is a good way to prevent surprising results at mid-rotation evaluations. From the perspective of preceptors, they should give feedback consistently, preferably after every shift. This encourages students to reflect on their performance and conduct “intentional learning.” Another tip that Charmaine gives to preceptors is to use the “teach back” technique. Every time a preceptor explains something to a student, the student should be able to teach it back to the preceptor.
We hope that this podcast has given you some information and confidence to prepare for your emergency medicine rotation! Here are some additional resources that you can use to continue equipping yourself for this rotation:
Sign up for a Free Coaching session with Chase DiMarco, sponsored by Prospective Doctor! You can also join the Med Student Mentor FB Group to ask questions and receive guidance related to clinical rotations and clinical knowledge!