all right how are you feeling today hi
I'm Shawn Tackett a general internist at
Johns Hopkins Bayview Medical Center and
the research director for osmosis today
I want to talk to you about three tips
for being an excellent lifelong learner
according to the tips I do want to talk
to you about why it's important to be a
lifelong learner in the old days it was
not important to be a lifelong learner
you could read the same book people were
reading Hippocrates for literally
thousands of years today there's just so
much knowledge that it's actually I'm
completely impossible to keep up so one
fact is that PubMed last year published
five million original research articles
if you were to read every one of those
articles you would have to read one
article every six seconds and not sleep
for the duration of the year so it's
completely impossible to keep up with
everything but you still have to try
because on a flip side studies show that
the longer a doctor is out in practice
the worse their performance becomes and
many think that's because they haven't
kept up with their knowledge and are not
providing optimal care to patients that
is the most up-to-date with that three
tips for being a lifelong learner tip
one make learning to have it you have to
work it into your system it has to be as
natural was waking up in the morning
brushing your teeth putting on your
clothes you have to make it easy and so
to make it easy you have to develop a
system that you can sustain over time so
one system that comes to mind was with a
doctor at Johns Hopkins that I knew who
was kind of old school kept a notebook
and so he tried to just keep up the
tempo of writing one thing that he
learned from a patient per day in his
notebook and so if he learned one new
thing every day he did that over time
and over time he became a sort of a
genius physician my system has been more
electronic based and so I one thing I do
is I keep a patient log so patients who
have taught me a lot I keep their
medical records so that I can look them
up in the EMR later just to see what's
what's going on with them over time so I
remember pretty vividly from my
residency a patient who came in with
iron deficiency anemia to the hospital
and we did a very thorough workup that
included an endoscopy of colonoscopy we
did a small bowel follow through to look
at with the capsule endoscopy and and we
couldn't find any source for why he was
losing blood and causing
iron deficiency anemia about six months
later that same patient returned to the
hospital and I and at that point he did
have a visible mass in his colon so
diagnosed with colon cancer and was able
to receive the treatment and I actually
saw him after that to where he was
getting his treatment and - and to see
that evolution and one it helped me
realize the limitations of our testing
because you know we did all the right
tests but we didn't discover the cancer
that he probably had at that point but
then - you know I also just learned got
to see him and sort of his own
experience in dealing with the disease
over time so keeping a patient log is
another good idea one final thing for
for tip one is to you know to keep your
knowledge base regular it helps to have
something that's less effortful so I set
up emails that come to my inbox from
journals and from medicine digests that
sort of you know so it so these things
get pushed to me so that I just read
them and and in that way it helps me
keep up to date I'm gonna be much harder
if I was gonna rely on myself to you
know sit every Sunday afternoon and open
up a textbook or read the latest
journals so by having things sort of
automated they come to me I think that's
another way to make learning a habit so
tip - the term I'm giving this is trust
but verify I trust myself and I trust
the learning that I've had and I trust
you know the experience that I've had
but I'm constantly fact-checking myself
and so I fact-checked myself against the
literature I've looked up the pneumonia
antibiotic guidelines about once a month
for the last six years or so
just because I'm always afraid that
they've changed and that I'm not going
to provide like the right treatment for
my patients I trust my colleagues but I
like to double check them against what I
read in the literature and then you can
only get so far with the literature
because there is still an art to
medicine and we don't know everything
from scientific studies and so so sort
of triangulating between my own
experience my colleagues what I read I'm
able to form a well-rounded opinion and
make good decisions and it also through
learning through patient care I'm I'm
building my knowledge base in becoming a
better lifelong learner so tip 3 is look
for your blind spots so we all have
blind spots there are things that we
don't know that we don't know and and so
you need to find ways to fight see those
blind spots so
your knowledge blind spots the emails
and quizzes are helpful and I'm doing a
lot of questions is helpful for the
other blind spots that may exist because
there's a lot more to being a physician
than just having a knowledge base you
know you need to be an excellent
communicator you need to be present when
you're with patients you need to be
professional in your actions with
colleagues and others it I think it
really helps to have somebody observe
what you're doing in real time and it's
extremely uncomfortable to have somebody
look over your shoulder and just watch
you do your job especially when you know
maybe you think you've gotten good at it
over time but but it's also extremely
helpful because when you sit down you
realize that they see things that
probably other people are seeing but if
not brought to your attention and then
you can you know discuss those with them
and get some advice and just that the
awareness of how other people perceive
you and what other people were seeing
when when when you're doing your job I
think is extremely helpful and because
then you come up with a plan to improve
the three tips one learning has to be
have it do a little bit every day to
trust but verify fact check all the time
three look for your blind spots
especially having an observer helps with
that
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