Throughout this shadowing experience, the most obvious AAMC core competency has been teamwork. To think about teamwork is to think about individuals working together towards a common goal. In the healthcare context, physicians, nurses, health administrators, custodial staff, and many more all work collaboratively for the patient’s well-being. If one deviates from this plan, the service will be impacted. This week I was in Hepato-Pancreato-Biliary (HPB) surgery so I was able to observe this AAMC core competency from the operating room (OR) perspective. In the OR, the surgeons, anesthesiologists, residents, nurses, and surgical techs have fascinating teamwork skills. On Monday, I shadowed two intern residents operating two back-to-back cholecystectomies. Since this surgery is minimally invasive, I wondered how four individuals, the two interns, the surgeon, and the surgical tech, can surround one patient during laparoscopic surgery. This is only possible through a clear understanding of one’s role, constant communication, and the continual reminder of the shared goal.
Operating a surgery through three small incisions is possible only when each participant is aware of their role. During the cholecystectomies, Dr. JoÃo Gongalves’ main responsibility was to be in charge of the camera. The other intern, also named Dr. JoÃo, was in charge of the needle driver and the scissors. The surgeon was standing on the other side of the interns and explained everything step by step while the surgical tech knew exactly when and what to pass over to the interns. Not only was there a flow of movement during the surgery but there was also a flow of conversation. Although I could not understand what the surgeon was saying, it was obvious that she was walking the interns through the surgery by her body language and hand movements. This was certainly necessary for the shared common goal of removing the gallbladder as well as for the education of the interns. Not only does this require teamwork but it also requires excellent oral communications skills. I was able to see this later on in the week when another surgeon, Dr. Raquel was explaining the procedure to me during the surgery.
Going off of oral communication, the participants in the clinical settings are also experts at making sure everyone is kept updated on the patients’ situations. During this and last week's shadowing, I have noticed that it is a common routine to have daily morning meetings with all the physicians in a department. In addition, the physicians broke off to their units and had their separate meetings with their teams that consisted of interns who overlooked the patients in that ward. The physician listened to each of the 20-25 patients’ states and discussed it with the intern. This required the interns to productively convey information to the physician and for the physician to listen effectively to the interns. Lastly, I always admire when the physicians, interns, and students I speak to apologize for their English. This not only signifies their humility but also their acknowledgment that something may get lost in translation. This is important because when one is aware of potential mistakes, one can discover them quicker.
An AAMC core competency that I need to improve on is written communication. I believe there is so much value in the way things can be explained with written words, however, such a thing must be done concisely. I haven’t had the chance to see any physicians do their charting so I haven't gained any skills for that competency yet. I think that this is a skill I need to improve because I usually end up calling someone rather than texting them to explain a situation. However, physicians rely heavily on charting from themselves to others. Especially in a public health system, like this one, one needs to master their writing skills to effectively provide the most useful information to their future selves and their coworkers.
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