Social IQ and what NOT to do as students

[percipient]

After reading a few posts on away rotations in this forum, I've realized that what people really should be working on, in addition to learning Oto, is their social IQ. Everyone's smart. I get that. But learning how to "not get in the way" while showing interest, knowing how to be "normal" yet interesting, etc., are very difficult things to delineate and learn, especially when many people may not critique or confront you about these issues. Yet it's paramount to whether a team likes you.

Could we discuss some things that as students, we should and should not be doing on aways? It may be easier to just say "what NOT to do" than perhaps "what to do." Share your stories!

Some subjects to consider:
- what are appropriate questions to ask attendings vs. residents in a clinic vs. OR setting? Moreover, what are inappropriate questions too.
- how can students be helpful yet not get in the way? what are common pitfalls of overeager students that actually end up being more annoying than helpful?

for example, my Oto advisor today said, "it's best to be seen, not heard in the OR. you really should never be asking questions concerning anatomy or physiology during a case."
- would love NeutropeniaBoy's input on this!

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[OtoHNS]

My advice to anyone looking to improve their social skills is to read the self help classic "How to Win Friends and Influence People" by Dale Carnegie.

Unfortunately, it's hard to tell med students how to behave in every situation. It always depends. My best advice would be to practice reading other people: i.e. what kind of mood are they in? Are they talkative or quiet? Do they seem interested in teaching or not?

If your attending/resident seems irritated by what you are doing or is giving 1 word answers, just stay in the background and look for opportunities to help (like hold a flashlight for them or grab wound care supplies, etc). If they are happily chatting away with you, it's probably fine to ask questions and get to know them better.

Also, read the situation. Are you in a massively overbooked clinic that is running an hour behind? If so, it might not be the best time for questions. Wait for downtime. Are you in a head and neck case and they are struggling to control bleeding or stressed about something else? Wait until it's closing time for questions.

As far as your advisor, it's hard to say. I would avoid asking questions in his/her OR. But asking educated questions that show that you have knowledge of the case and the patient are a good thing. Asking "what is that thing" about some anatomical structure is not so good.

 

[DrBodacious]

Agree with the book recommendation, and that it is all about being observant and responding to the situation.

Realize that you can learn a ton watching and observing. I am often amazed at some of the things I remember from observing surgeries as a medical student. One guy used an irrigating bipolar and a McCabe for parotids. No one in residency used those instruments. That is now in my tool box as an attending. There is a lot you can pick up on technique. You don't have to ask what is going on every 10 seconds, people who do that are always annoying.

But, for the wrong attending, if you just watch the whole time and don't make a peep, they may think that you are disinterested.

As far as the comment about asking questions concerning anatomy or physiology - never pimp an attending or resident... Big no, no. Even if they play it off well. Make a mental note and look it up, or better yet, prepare ahead of time so you already know all of the anatomy and physiology. One time a 4th year asked one of our more intense attendings for tips on how to learn head and neck anatomy, and our attending responded, "are you kidding me? I knew head and neck anatomy cold by the second month of gross anatomy!" It is almost never a good idea to point out what you don't know.

That brings up how to respond when you attending asks during or after the case, "do you have any questions about the case?" The smart questions would be about something unique to the attending's experience. The point is to try to get the attending talking about things that were interesting about the case, again, not to highlight things you don't know. "Was that a typical cholesteatoma case?" "How long does it take for the gel foam to dissolve so the patient can hear again?" etc

 

[neutropeniaboy]

I agree with DrBodacious.

Never pimp your senior residents or attendings, and it is also unwise to expose what you don't know about things. We hear a lot of the same questions over and over again, and this just suggests to me that students aren't reading, aren't paying attention or are just trying to make chit chat. Don't make chit chat unless it's about something social that happens to be in the discussion.

As DrB suggested, ask questions that are about the specifics of surgery. Don't say things like, "So, I see you're putting in the prosthesis now." (Yes, that's obvious.) But you could ask: "Dr. Neutropeniaboy, why do you like X prosthesis as opposed to the Y prosthesis?" If you're bold, you could ask something like "I saw Dr. So-and-So use gelfoam here, but you used hyaluronic acid. Why do you prefer to use HA?"

Most attendings want students engaged. I feel comfortable saying we don't like to hear questions that students already know the answer to, and we definitely don't like questions that clearly demonstrate that you haven't read.