The Perspective of Attendings and Medical Students on

The Perspective of Attendings and Medical Students on the Use of “Pimping” Anthony Duncan, BS 1; Bridger Rodoni, BS 1; Nicole Pescatore, MPH 1; Steve Kasten, MD 2 1 MD Purpose: • Since the initial article “The Art of Pimping” was published, the use of this Socratic teaching has been further discussed in the setting of medical education. Simultaneously, the AMC continues to administer the Graduate Questionnaire. This survey has shown an upward trend of medical student harassment, which has been classically associated with “pimping”. However, few studies have looked at the factors that influence students viewpoints on the subjects and ways to improve the overall quality of the teaching method. This study aims to examine at the viewpoints of both medical students and facility across the medical schools in Michigan. “Socratic teaching is a term that is often applied to teaching by questioning the student on the subject at hand is commonly referred to as “pimping”. Socratic teaching is sometimes described as being singled out by an instructor for direct questioning. Since being singled out may be viewed negatively, causing some medical schools discourage Socratic teaching for the latter reason. ” Category Students Facility • University of Michigan 71 7 • Central Michigan University 27 6 5% • Michigan State University 121 23 0% • Western Stryker 0 18 Gender 26% Methods Survey A Qualtrics survey was created based off of one created by Williams et al. This survey was modified for use in the medical education setting. Of the 5 medical schools within the State of Michigan 3 elected to participate. The survey was sent to students at these medical schools that had finished their core clerkships at the time of the distribution. Each cohort of students received the survey 3 separate times over a two month period. Faculty at the institutions underwent the same selection process with 3 locations electing to participate 15% 10% Male 84 (38%) 27 (50%) • Female 133 (60%) 27 (50%) • Other 2 (1%) 0 • Prefer not to answer 2 (1%) 0 26 +/- 3 years 50 +/- 12 years Average Age “Preparation of educational objectives by students before a discussion of material with preceptor” • “Scheduled topics relevant to the practice and discussing in small groups with evidence based material to discuss” • “Having group discussions on an assigned topic for the day. This way students can participate in the discussion as much or as little as they want to. ” • “Allow time (studies show at least 7 seconds) for students to respond. Then move to interns, then residents, etc. This allows everyone to think clearly, and takes away the pressure on one person and embarrassment in front of peers. ” Very Postive Slightly Postive Neither Postive nor Negative Slightly Negative • “Questions directed at the group instead of one member specifically” • “I appreciate when preceptors let me know in advance what topics they will be questioning me about so that I can prepare the night before. I learned the most that way because I got to study independently and then essentially 'discuss with the expert' later. ” • “Ask students to study a particular subject, ask them to tell you what they learned the next day. ” Very Negative Why Do Faculty use Socratic Teaching? Suppresses further questions from the students. Race • Asian 31 (14%) • Black or African American 13 (6%) • White or Caucasian • Hispanic 8 (4%) • Other 19 (9%) 147 (66%) Demonstrates faculty's knowledge to the students. * Shows that the faculty are in charge. Summary Socratic teaching is a term that is often applied to teaching by questioning the student on the subject at hand commonly referred to as “pimping”. This study, while being an initial exploration into the perceptions of students and faculty on this modality of teaching, has yielded interesting results. We found that a majority of students perceived their experience to either be positive and a minority of students finding the experience to be negative. This suggests that the upward trend of medical student harassment based on the AMC survey is not entirely attributable to use of “pimping” in the clinical setting. In fact, the use of “pimping” may be a method to further engage medical students during their clinical education. * * Opens to broader discussion. 50% 45% Reinforces teaching points. 40% This study also demonstrated a statistically significant difference between the student and faculty perceptions on the purpose of “pimping”. This could suggest a possible underlying factor that leads to negative medical student perceptions of faculty and their teaching abilities. * 35% 30% Engages students to retain their attention. 25% Future studies should further investigate the effectiveness of “pimping” on clinical education and their potential influence on objective clinical knowledge assessments including USMLE Step exams, NBME Shelf Exams and other institution-specific clerkship examinations. 20% 15% Tests students ability to recall previous teaching/information. 10% * 5% • A significance difference was shown between students and faculty as to the reason that this modality is used for teaching with faculty most commonly answering it is used to “retain student attention” and students most common answer “testing the students ability to recall material”. • 5% Figure. Students rate experience of Socratic Teaching N= 221, students were only able to select one answer. X axis represents the answer choice. Y axis represents the percent of respondents. • “One alternative is to tell the student in advance (even if short notice) that they will be expected to present/discuss a topic in front of a group. Also, if asking questions during rounds, it is better to ask students as a group rather than single one student out” Percent of Students 35% 15% • 39% 40% 20% Institution Hypothesis: There is a significant difference between student and faculty perceptions on the use of “pimping” and it’s role in the clinical education setting. • Of these students, 54% found the use of Socratic teaching either very positive or slightly positive while 20% of students found it to a negative or very negative experience. 45% 25% clinical education. • To assess possible factors that contribute to negative feelings of this method by students. • Starting to investigates ways of improving the receptiveness of medical students to this modality of teaching Results: • 221 students responded to the survey from three different universities seen in Table 1. Suggested Alternatives from Students How would you Rate your experience of Socratic Teaching? 30% Objectives: • To identify how medical students feel about the use of pimping during Statistical analysis At the end of the data collection period all surveys were closed. All incomplete and duplicate surveys were removed from the study. Identifiers of students and faculty were removed prior to the start of data analysis. Candidate, University of Michigan Medical School; 2 University of Michigan Plastic Surgery Department References 0% 0% Did Socratic teahing help you RECALL Did Socratic teaching help you understand the materal better later? the materal better? Yes No I don’t know Figure 1. Perspective of students on the use of Socratic teaching on understanding and recall of information. N=221 Faculty 10% 20% 30% 40% 50% 60% 70% 80% 90% Students Figure 3. Response rates for why faculty use Socratic Teaching. 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