How scribing has helped me in my 1st year

Hello Medhatters!

I’m pretty comfortable giving advice on scribing since I used to teach scribes. And I’m comfortable talking about my experiences in medical school. Although I will let you decide on how helpful they are.

What I would like to discuss today is how scribing has (or hasn’t) helped me in medical school (so far). I’m writing this on the last few days of my winter break before I dive head first into my second semester of my first year. So that definitely means it will be posted way later… It also means I have many more semesters to go to see how scribing has helped me. But we will stick to what has helped me so far.

In general, we hope that our pre-med experiences help us out in some way, shape, or form by the time we get to medical school. Or nursing school. Or PA school. We are hoping to not have to start from square one or get thrown into a situation head first without any context to draw from. Because let’s be real: as humans, we react to situations, especially new situations, by drawing off of previous experiences. So we hope as medical students that we have some context to help us out. Mostly because we have no idea what we are doing most of the time anyways. So a little bit of help is amazing!

I’m also hoping for this post to be much shorter than some of my other, very lengthy posts. I really like to talk, and surprisingly when I think I have nothing to write about, I still end up with a long post. So if you aren’t in the mood to read a lengthy post today, you are in luck!

How it as helped: Anything related to interacting like a future doctor 

In general, I would say my scribe experience has helped me the most in my PCM course (or Principals of Clinical Medicine/How to be a doctor course). Mostly because doing charting and seeing interactions between patients and physicians or physician-extenders was something that would occur multiple times a day, all day, for many years for me.

I’m comfortable here. I’ve seen how a physician asks questions, helps guide their patients along during their conversation, and they types of exams to choose for their complaints. I’ve even thankfully had some interaction with medical decision-making and ordering certain things for certain issues.  It’s very different being on the other side though, so that part does make me a bit nervous. But overall, I’m definitely a lot more chill than some of my other classmates when it comes to this part of our education.

Here are some more specific points for you:
  • Knowing how to write notes. They don’t really give you a great grasp on how to do this in medical school. But they do teach you all of the necessary components of the chart and how to get information for those parts.
  • You are more comfortable with being in a room with a patient
  • You know and are comfortable with so.many.terms!
  • You are comfortable with the outline of how to do an exam. You may not know how to do something specifically, but you are learning why you do it in medical school and how to actually do it. But from being as scribe, you’ve seen your physicians run through this like the back of their hand. You could probably give a run down of how to do one or a good order to perform one in before they actually teach you. (Doesn’t mean you are good at it though).
  • You will utilize that same “on the fly” learning ability to quickly pick up things/research them. Remember when you had to do so much searching and figuring out on your own to get the information you needed? Same thing applies here. Use it. You can thank me later.
  • This “on the fly” learning transfers to other courses; not just in your ‘how to be a doctor’ course.
  • Trouble-shooting.  This one is interesting for me. I would do this all the time as a scribe and then try to figure out the best way to fix my problem before asking for help from the doctor. But turns out it works great here too when you are learning so many things.
What I’m expecting it to help with in the future:
  • Mostly in my rotations. I expect to feel pretty at home in a variety of clinics. My last scribe job had me starting up clinics and I would work in several different clinics throughout the week. I’m hoping that having to be thrown in and learn my way around different clinics will help me feel more comfortable.
  • Putting my ability to ask other staff for resources in my rotations. This one was hella helpful as a scribe. I fully intend to utilize every resource possible during my rotations.
  • Charting on new EMRs. Well using an EMR in general.

And I will see how much more I can come up with in the years to come!

What it hasn’t helped with:
  • I’m still a little nervous. Check out my “What Still Makes Me Nervous” post from last week to see more in-depth and specifics on this!
  • It doesn’t mean I will pass on everything I do. Especially skills wise. I failed a few things my first semester. One of them being a competency for taking vital signs. To be fair, I wasn’t allowed to touch patients as a scribe… so handling patients is definitely a new skill I’m learning!
  • Multitasking isn’t as helpful. What I mean by this is multitasking is needed and very helpful with scribing. But honestly, in medical school you are learning difficult concepts at lightening speed. So it’s actually easier to pull all your focus on that one concept than trying to spread yourself thin.

And that’s all I’ve been able to come up with! If you are thinking about scribing and want to know the benefits and pitfalls to your future in medicine, hopefully this helps. Also, check out my scribing section on my blog if you are interested in scribing. Lots of information on there.

As always, let me know what you liked, didn’t like, and what you would like to see next in the comments!

What Still Makes Me Nervous in Medical School

Let’s talk about mental health today…

Mental health and the ability to overcome your fears and anxieties in medical school is a major component to deal with. Well, I mean really its a component in almost every aspect of life if you think about it. Depending on your personality, how you deal with/face things, and what hoops you decide to jump through can all affect your mental health and anxiety in life. But in medical school it gets amped-up. Like, x10.

Why you might ask? For those of you who have not had the ability to experience some sort of graduate schooling or advanced medical schooling such as nursing, PA, or medical school, it’s a whirlwind of information hurled at you that you need to at least somewhat master. Call it mental Olympic gymnastics. And just because you may not be getting gold, it’s still hella hard.

You need to be able to understand all of these complex ideas and master several skills that you will eventually apply onto real humans (gasp!). And, with the want to do well (or the need in some cases) in your courses and to master the material, along with trying to master these skills and learn to deal with humans in complex and unpleasant situations, it can be a lot for one human to handle at one time.

I’m not saying it cannot be done. Obviously it can be. Think of the hundreds of nurses, PA’s, and medical students that graduate each year in the US. (Or is it thousands? IDK. Fact check me please). But throughout the schooling years (and even in the training years such as residency) anxiety is real. Needing to be on-top of your game is a big deal. You are after all dealing with human lives.

But until you’ve learned to deal with it or simply master the type of medicine you are working under, it can be a hell of a lot. Even if you aren’t prone to anxiety; it will find you at some point in medical school.

And if you are someone prone to it, this will most definitely be added to your hurdle pile (like myself).

I’ve gotta say, medical school has both improved and worsened my anxiety all at the same time. I would be lying if I claimed that I wasn’t nervous for how medical school would affect my mental health at the start of the year. But I am pleasantly surprised that medical school so far hasn’t wrung me out to dry completely. I mean so far, anyways. We will see by my second year…

What I Still get nervous about:
courtesy of giphy.com
  • Anything that requires a performance. 

Right now this includes things such as right before an SP encounter or right before a PCM competency. SP encounters (or practice doctors’ office encounters with an actor) are used at my school to help us master interpersonal and communication skills with our “patients”. I’m usually really calm right up until an hour or a few minutes before I have to walk in and actually perform.

Could be because I’m having to talk to another human and sound confident while still being able to start working on my new doctor knowledge. Could be because I have to verbalize everything I do to get the points on a competency. Could be a lot of things.

  • Lab practicals.

I never know how bad it’s going to be. We’ve had 2 units that have had labs so far and will have at least another 2 units if not 3 next semester. Sometimes they are fairly straightforward tags but I psych myself into thinking that I put an answer to quickly and think I failed. Sometimes they are actually really really tough tags.  It’s a draw and you never know what they are going to tag and how bad it’s going to be. Also, you have to remember exactly how they have the structure spelled and named on their list (that you need to memorize). So even if you know the common name (but it’s not what they want you to call it) you get it wrong. A lot of pressure for me on these.

  • Procedures on live humans.

Now, I’m sure this will improve with time. And exposure. But for right now, anytime we have a lab that’s not learning how to do a physical exam I get a little nervous. I did get nervous for the first time using a mannikin part for learning a procedure, but turns out everyone in my group was struggling so it wasn’t too bad!

But overall, learning to do things on actual humans is a little scary. You could cause pain. You could cause harm. You could completely screw up. Or everything could go well.

Really it’s a draw right now as a first year with limited skills.

  • Giving tours

Now, I know you are thinking: Joyce, what on Earth does this have anything to do with what we are talking about? And you’d be correct in thinking that this doesn’t directly apply to medical school. But, I am a student ambassador. And as part of what I get to do, is give tours and mingle with potential hopeful future students during interview days, etc. Even though the tour groups can be small, I really hate public speaking. Not to mention the perfectionist in me (which has been hard to dampen at times) is terrified of messing up what I’m supposed to say!

Hit-or-Miss on my nerves:
courtesy of giphy.com
  • OS competencies

Okay. Here is another lingo term that I will probably always debunk every single post. OS stands for my osteopathic skills course. Now these competencies are similar to the PCM ones, except we have 3 a semester and they are worth way more. Eek!

In these we are to complete 2-3 tasks in front of our grader. Then our partner does their 2-3 tasks (which are different from mine). The thing is, the first one we had I was incredibly nervous. Like had a full on panic attack just because I didn’t know what to expect. It was my first one! By the second one I didn’t really sweat it all. To the point that E was asking me if I was going to study or take it seriously…

Well unfortunately for me I lost a few easy points on that one but NBD. Life moves on. The third one I was a little nervous for solely for the fact that I had several other important tests to study for at the same time. I was nervous that I wouldn’t be able to give the required attention to studying for this competency. But thankfully everything turned out well in the end.

I’m hopeful for next semester that my worries or anxiety for this will get much much better.

What I Am no longer nervous about:
  • Prepping for anything PCM related

I kind of already mentioned this above, but in general when prepping for this course I’m not usually nervous. Most of the time everything hits me right before I’m about to walk in to do to the competency or interaction. But I’m cool as a cucumber before the anxiety of having to perform hits!

  • Lecture tests

I’m honestly shocked about this one. Last year in my COB/master’s program at KCU, I was pretty terrified before every test. Couldn’t really sleep the night before, had a hard time focusing during the exam, freaked myself out of answers, the whole 9-yards. I even had to bring in some “liquid xanax” to help calm me down right before the test (it’s a mix of essential oils people..don’t worry, it’s safe and doesn’t need a prescription). I would rub a bit of the mixture on my wrist or my chest, and when I started freaking out mid-test, I could always stop, take in a big whiff of the oils, and give it a few seconds to calm me down. I always get a comment from E that I smell like a grandma when I wear it but whatevs.

I’m proud to say that I really haven’t needed to use this before bed or on test day. In fact, I’m usually so ready for the test to be over that I can funnel my anger/frustration towards just taking the damn thing instead of wasting my energy on being nervous. I really haven’t had to employ any other techniques this year for test anxiety either. Yay!

  • Labs themselves

By this I mean before doing a physical exam lab on a classmate, going in for my osteopathic lab to work on a classmate, or going into anatomy lab. I was a little nervous at first for both the physical exam portion and the osteopathic portion, but those wore off pretty quickly. Mostly because no one was judging me for not knowing how to do anything…

As for anatomy lab, that rocks! I love getting in there (when I’m in a good mood anyways). Plus, I had a cadaver lab in undergrad and worked in an ER. Dead bodies don’t make me squeamish or nervous.

  • Writing notes/feedback/criticism

This one specifically applies to PCM and my SP encounters. As a dancer, I hated constructive criticism. As a cheerleader in high school I didn’t like it either. As a newbie scribe I hated it. Once I grew up and realized the world wasn’t out to get me and that I wasn’t perfect all the time, this was easier to accept getting criticism back.

As for notes, I can thank scribing for that. Note-writing for the encounters is my bread and butter. Bring it on!

I’m sure this list will change in the year or so to come. But for now, this is what I’ve been able to compile! Just know, that if you are feeling some anxiety or nerves, this is totally normal! Especially if it is your first time doing it. As time goes on and you get exposed to a situation or testing scenario, hopefully your nerves will improve. I know mine did in some occasions.

As always, let me know what you liked, didn’t like, or what you would like to see next in the comments below!