December 13, 2002

Medical school retreat airs concerns, promotes positives

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Dana Deaton, VMS III, discusses one of her clinical experiences during a break-out session at the retreat for the third-year medical students last week. (photos by Dana Johnson)

Medical school retreat airs concerns, promotes positives

Jeff Smith participates in a group discussion with his classmates.

Jeff Smith participates in a group discussion with his classmates.

The mood and dress were relaxed at Vanderbilt University School of Medicine’s first retreat for its third-year class. But the class had some pretty heavy topics to discuss during the five-hour retreat last week at Vanderbilt’s Center for Better Health.

Members of the third-year class gathered with Dr. Bonnie M. Miller, associate dean for Medical Students, and group session facilitators at last week’s retreat, designed to let third-year students talk about what’s going right and what’s not during their busy transition year to the clinical arena.

The students were divided into small groups and spent time in three sessions, led by Vanderbilt faculty members including Drs. John Tarpley, Scott Rodgers, W. Anderson Spickard III, Larry Churchill, Kimberly Lomis and others. The sessions were: “Making Mistakes, Story Swap,” and “Mind the Gap,” a session at which students were encouraged to define the gaps between the expected and the encountered on their ward rotations. In the final “Mind the Gap” session, each group determined a pressing issue and came up with a solution to close the gap. At the close of the conference each group’s problem and proposed solution was presented.

Miller said the retreat came as a result of the recommendation of this year’s fourth-year class.

“The class leaders felt that a retreat at this time of year would give the third-year students time to process some of the their initial clinical experiences,” Miller said. “Often things move so quickly on the wards, there is little time for students to reflect on what they are going through and how they are changing. We also wanted to challenge them to critically analyze their experiences and make suggestions about how their clinical education might be strengthened.”

Miller said the faculty involved in the retreat also learned a great deal about what the students think.

“Sometimes we get stuck in a rut,” said third-year student Tristan Gorrindo. “The administration assumes things are going well and that things are perfect, and students assume they are powerless to change the things that are bothering them on the wards. But the retreat gave us a nice opportunity to throw all of those pretenses away and just talk about what we would change. Many of the things are frustrations students have faced over time, but it was nice to at least vent those things to the administration and have them say, ‘we hear you; we’re doing our best; thank you for sharing your ideas.’”

The retreat was also a time for the classmates to visit. The third year is typically a time when students leave behind the classroom and become busy with their clinical rotations.

“It was great to see some of the old faces and swap war stories,” Gorrindo said. “It was nice to see that I wasn’t the only one who at times felt clueless, especially early on. I think we all have stories of things we did the first few weeks of the year out of ignorance about how a hospital works, that we now look back on and laugh. It was nice to hear other people’s stories, as well as share my own.”

Gorrindo said getting away from the medical center also helped. “The openness of this forum would never have taken place in a simple one-on-one discussion or in a focus group. It really required an escape from the hospital and school environment to a place where we could all dialogue.”

One of the recommendations that came out of the smaller group sessions is that both students and the residents and attendings who teach students get quick feedback on how the students are learning and the residents and attendings are teaching.

“One of the hardest things about the third year is defining your role on the team and we often feel like we are doing little to directly contribute to our patients’ care,” said third-year student Darcie Reasoner. “The retreat let us talk about those things and realize that we are not alone. We all appreciate the administration hearing our concerns, particularly regarding teaching on the wards and obtaining feedback from our residents and attendings, and we hope that our input will help improve the ward experience for our class next semester, and for the rising third-years.”