Sharpening the softest skills
The organizations with which Hopkins has partnered in creating the boot camp have laid out 11 critical skills that will be needed during the first week of residency:
- Being the first responder for critically ill or unstable patients.
- Emergency procedures (ventilation).
- Common electrolyte abnormalities.
- Management of common and urgent perioperative conditions.
- Interpreting radiographs.
- Operative anatomy.
- Responding to pages from nurses.
- Difficult patients.
- Informed consent.
Most of these content areas are technical and, while they are covered during boot-camp sessions, they are not the principal emphasis.
“[Technical skills] are the things that surgeons have concentrated on for a very long time,” Dr. Jones said. “Luckily, that means a lot of our students have taken the time to focus on those things themselves—and what they haven’t necessarily spent a great deal of time working on, or thinking about, are these nontechnical skills.”
Nontechnical skills including time management, effective teamwork, and resiliency and wellness, are the greater focus of the boot camp.
Too many students, Dr. Jones said, are only passingly familiar with the roles played by advanced-practice providers before starting their residency.
“They might have heard of nurse practitioners or physician assistants, but have no idea how they fit into the group,” he said. “We try to concentrate on ... some of those things they don’t tend to come across in medical school, but [which] are much more practical and non-operative based.”
The boot camp is offered on a voluntary basis and participants do not receive class credit. About 75 percent of those eligible have taken part.
Dr. Jones believes programs like the one at Hopkins can be instrumental in shaping the transition from medical school to residency. For too long, he said, residency program directors have made too many assumptions about their incoming interns—to the detriment of their early training.
“It is assumed that residents already have good study habits, that residents have good time-management skills, that residents have a good capability for teamwork. I don’t think we need to expect less of our residents,” Dr. Jones said. Rather, it is up to medical educators to help “ensure that they have the opportunity to make up for whatever deficiencies they may have.”