My usual Friday morning O&G outpatient clinic activities would comprise of consultation of seven or eight patients, with a group of three or four medical students observing me handling the session. This is a part of an ambulatory clinical teaching for students undergoing the O&G rotation. McGee et al (1997) emphasized the importance of teaching medical students in the outpatient clinic setting to offer unique educational opportunities.
What started off as an ordinary morning clinic turned out to be a very exciting teaching session for my students. Four out of the eight patients I saw that day brought surprise gifts for me! It was not unusual for patients to bring some tokens to my clinic, but to receive four presents during the same clinic session was indeed overwhelmingly exciting! At the end of the clinic, I was looking at these gifts on my table - a pretty pink pouch-bag from Beijing, a hand-woven shawl from Indonesia, a home-baked carrot cake and a small box of `serunding daging’ or spicy meat floss, a local delicacy from Kelantan. It must have been one of those best days at work!
I could not forget the facial expressions on my students’ faces that day. They were obviously surprised and shocked to discover how `fruitful’ and productive a routine and mundane clinic session have turned out. I decided to share the carrot cake with the students and took the opportunity to carry out a brief reflection exercise on doctor-patient relationship while we were eating in the pantry. One student’s observation was particularly meaningful and made an imprint in my lifelong memory when he said: `Doctor, I observe that many patients walked into your clinic as strangers, but they walked out minutes later as your friends! That would surely motivate a pleasant encounter for both the attending doctor as well as the sick patient. How did you do that? I would like to have such a positive relationship with my patients when I become a doctor one day ’. I listed out some tips for an effective and positive relationship between doctor and patient, emphasizing that the gifts and token of appreciation should not jeopardize one’s professional judgement and clinical decisions. It was an important learning opportunity to drive the message across. Schon (1987) described this communication as reflection in action (reasons we are doing it), on action (impact on patient, students and oneself) as well as for action (guide for future interaction).
I was particularly moved by the question because it contained a deep-seated desire of a young learner who wished to role-model his teacher’s conduct. He might have been motivated by the pleasant tokens of appreciation I received from my patients. I am sure the experience was powerful enough to convince him that he should also try to emulate the positive doctor-patient interaction. It dawned on me how important it is for clinical teachers to be very aware of their professional conducts since the medical students are consistently watching and observing. They could see the good and exemplary behaviours, as well as the bad and ugly. Cruess et al (2008) cautioned the clinical teachers, to be aware of the conscious and unconscious components of learning from role modelling, with a major aim to produce a positive net effect of the process for the medical students.