Personal Best: top athletes and singers have coaches. Should you? by Atul Gawande

Read the full article here.

The search for constant improvement was introduced to me by Tom Donnelly, my track coach at Haverford College. Excellence to him is something that we can all attain, in any number of pursuits.

Really interesting how all but one of the teaching departments here is really good. I've noticed that these departments always have faculty in attendance that are not teaching, but instead evaluating how well the presenter is getting across information. They also keep tabs on how many people come, how many people are asleep, and can write test questions based on the information provided in lecture.

The department that is not good at teaching does not send anyone but the presenter to the lecture. Thus I feel that they have a lack of coaching within their department.

Unfortunate to see how much of our curriculum being test driven, without any more meaningful outcomes extrapolated from beyond the test. (referring to the USMLE step 1s here)

Fun fact.

Our brains are oil cooled and air cooled. Cavernous sinus us filled with venous blood on it's way back from near the surface of the skull. This blood cools arterial blood (the internal carotid artery runs through the cavernous sinus) without mixing and makes the blood 

Tests and More Tests

I'm writing this post during a lunch hour in which I should be preparing for a written final for interviewing and physical examination skills. Unfortunately, I lack all motivation to cram these things into my head because I am unconvinced that a written test about skills that are fundamentally not written will make me a more skilled doctor.

Frustrating that changes are made without measuring outcomes.

I read another blog post last night that speaks to the same issue.

http://well.blogs.nytimes.com/2011/11/03/being-a-med-student-take-two/?ref=health

Yes it would seem bad that some people would take an open book test and not actually learn something, but are there any data to suggest this is what was happening? Instead, these tests were changed from open book to closed book based on some perception, without getting a baseline on performance and then seeing if making the tests more formal actually improves patient care.

Public perception perhaps drives many things in the end. If the American Board of Pediatrics wanted to go back to open book re-certification exams, the media might have a field day reporting how you could just "cheat" on your exam to be a pediatrician. 

Whatever the media says, I would bet that if outcomes were actually measured, it would turn out that people who were better at accessing accurate up to date information from literature and colleagues probably provide better patient care.

Seem to remember reading something else about standardized testing in MA reducing teacher freedom and leading to poorer outcomes, not on the tests, but in some things that matter more than the tests, like getting into college. Anyway, just thinking...