Prespectives on Goal Setting and Clinical Expectations on Shift Medical Student Perspective Taylor Daniel
SAEM PULSE | JANUARY-FEBRUARY 2022
Fourth-year medical student, University of Pennsylvania
26 26
The Importance of Clarifying Expectations
A unique aspect of rotating in the emergency department is that students rarely work with the same attending or resident more than once. While this presents an opportunity to learn from a diverse array of providers, it also necessitates adapting to different expectations each shift. Just as different supervisors may have different notions of the medical student role in the emergency department (ED), each student will have been shaped by the expectations of each prior evaluator; thus, the practice of clarifying expectations at the start of shift can
enrich the learning experience in the following ways: • Avoiding poor evaluations due to misunderstanding of expectations • Opportunities for enriched learning by understanding each instructor’s teaching styles • Upfront expression of enthusiasm for learning and intent to contribute meaningfully to team To clarify expectations at the start of each shift, ask the supervising resident or attending how they prefer you to see and present patients. What is the goal number of patients per shift? Do they expect you to function independently or would they prefer you work directly with a senior resident? Who should you present to? Should you complete notes, orders, consults, or discharge instructions?
The Utility of Identifying Specific Goals
While clarifying expectations allows the supervisor to give the student a sense of their teaching style, identifying
specific goals allows the student to direct the educator’s focus. There are three distinct aspects to incorporating goals on shift: Create SMART Goals Goals should be created using the SMART criteria and be specific, measurable, attainable, relevant, and timely. Discussing goals at the beginning of each shift gives evaluators time to consider actionable approaches for improvement. Prioritize Learning Setting specific goals allows the attending and/or resident to prioritize student learning in an efficient manner. Let’s face it – the ED can be a hectic place. However, EM physicians are generally incredibly skilled at keeping miles-long mental to-do lists; therefore, when the student adds something specific to this to-do list, it helps evaluators ensure that it gets addressed. Doing so at the beginning of shift also allows educators to pay attention to the highest-yield educational opportunities throughout shift.
