If you are in medical field, At the end of say every 2 years you should always ask yourself, "what did i learn in the past 2 years". The 2 years is arbitrary but it always feels good to have a number. I believe if we dont do that we will get stuck in the past and be assembly robots.
The need for "learning" is embedded in medicine thats why we call it "practice". You never stop. But I hardly see people in medicine "practicing". After college, many people believe they have finished studying. And then there are "workshop" and CMEs which some people attend for the food, or your friend organized it, the lecturer who is a broker for the resource person encouraged you to, part of the college function or at last to study. The study crowd is becoming smaller and smaller.
The problems with CME and workshops have been highlighted by the great Sackett as early as late 80s. I also know from personal experience no one learns in a workshop. As J.K said there are 3 types of people.
1. they come sit and listen and go home
2. they come sit, listen and feel as though they have learnt and change for 2 days to a week
3. the smallest minority, they come learn, contemplate and change
I, as usual also have a opinion this- if you go to learn something and you don't have any idea about it (i am talking about medicine here) or you were made dumb by your education from your school to college, you have no chance of learning. When the last time I gave a lecture I said, stretching does not change the length of the muscle". Now if you dont know anything about how a muscle length is maintained or what causes changes in the length, the neurology of muscle length and what does brain injury does to your muscles- you have no way of asking me any question. You have no way of debating to me about how i am wrong. If you dont know whats the evidence you have no right to practice medicine. So, you see learning cannot happen if you have no substrate knowledge or as they in zen if you cup is already full (with bull shit from school ).
Learning happens when we assume there is more to learn and i am a learner and 2 most of the knowledge is bull shit. We know to learn we need to read, listen and observe. After these reflect on it and test it. It is a laborious process. Sadly many of us have to run all day to make a living. I think it is hard to blame them. Already the college have made us into a dumb idiot and the money to live us makes us even dumber.
But that is not to excuse, we need to find a way to observe and reflect. In 2 years time you could have observed a lot and if you have reflected properly, you could no the crap we are doing and the some gold which are peeking out of the crap. We need to learn observe that and then search, read, learn and understand if what we see is gold or its fools gold. I think differentiating fools gold and gold breaks your heart and that makes us hurt. The hurt of I am wrong as we all know leads to becoming defensive.
You the defense our ego uses- well, i know what I saw (the most common i suppose) , Hmm what does this person know, research that is for a bunch of wussies, well he did it differently (the bobath and sensory integration defense) research will come later (modern defense among fascia, muscle imbalance in strength and length gurus and newer machine guys). The person who wants to practice lets his defenses down and try to move beyond and see the truth. Remember the truth has no power so it is not going to show to you clearly or is beautiful. So it is hard work to get the truth. But it is imperative as a person who looks after another person you try to come closer to the truth and use that. Not what you think is the truth.
So where do i start- well observe what you practice. are you doing it because it makes money, someone prescribed, some one told you this is the best or this is the latest. Are you patients happy or they are really improving. Patients happiness can be brought by 3 treatment for 500 rs or rubbing them for 20 minutes- but are they better off without those. Have we asked that? have we asked if they did not come to us- could anything changed? -read, learn and contemplate.
Dont go to study the newest or the shiniest or the hottest topic. Start from your patients problem. What should i study to solve the problem. As i said if you dont have any problem- well you are stuck- you cant learn anything, they world has nothing to offer.
You may think i am sitting in a arm chair and telling others to do the improbable. Well thats true. But think like this next time you or someone is the ICU what medicine do you want- the best which is near to the truth or the most expensive, the newest or the fanciest? If you say nearest to the truth- dont your patient also need the same?
For that to happen- ask yourself what have i learnt in the last 2 years. Do i need to change the practice in accordance with what i have learnt. What are the thing we still dont know? May be just maybe the health care may become better if we do it.
P.S- I do love to flaunt how much i read, I don't see that as anything wrong in it- I think flaunting the wealthy is what I find slightly repulsive
Love
Hariohm
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