Remember when you were a new learner? Approach situations with that open, creative, and nonjudgmental mind that you may have had when you started training.
Lifelong Learning in Clinical Excellence | March 30, 2023 | 2 min read
I’ve wanted to be a nurse for as long as I can remember. I’m now a junior at Emory University studying nursing and was so excited to begin my clinical learning. Colleen, the mother of my partner and an experienced geriatrician who is passionate about medical education, was so excited for me too. When my first day arrived and I texted her to share with her my excitement over finally working with patients.
Clara’s enthusiasm and wonderment prompted me to reflect on my first days as a medical student over 30 years ago when I encountered my very first patient. What joy this exchange with Clara brought me and helped me reflect on those values that led me to this three-decade-long medical career in the first place.
A few weeks later I texted Colleen to tell her about something that happened on my second clinical day. There’d been a patient getting a bowel prep in the hospital and had fecal incontinence in her bed. The poor person was embarrassed and felt tremendous shame over what had happened. I responded by holding her hands and explaining to her that the bowel prep was part of the reason why this happened, that it was very common, and that it was an honor to be needed and to use my skills to help another individual no matter what the situation. She cried in gratitude while squeezing my hands tightly. I realized that I didn’t want to be part of the healthcare system that inflicted shame onto their patients and vowed to always be on the lookout for this.
Once again, this exchange forced me to reflect on my years of experience in similar situations. I envisioned how I might’ve reacted had I been in the room with this particular patient. Having experienced such situations many times, I’m sorry to admit I think I would have quickly acknowledged her discomfort, told her not to worry, and moved on. Talking with Clara, I recognized not only the value of expertise, but of also cultivating a “beginners mind” to challenge my own hubris.
In medical education we readily recognize the value of expertise and expect that more senior teachers will impart knowledge and wisdom to novice trainees. We believe, however, that we are best served by actively seeking out and acknowledging how less experienced learners can also help more experienced teachers to learn and continue to grow.
3 tips for cultivating a “beginner’s mind” in medicine:
1. Try to suspend what you think we know about any given situation, check your biases and potentially false narratives, and try to observe each situation with a fresh and nonjudgmental mind. Ask yourself, “Could the opposite of what I think is true be possible?” or “Could I have approached this in a more creative way?”
2. If you’re fortunate enough to be among beginners, explicitly invite them to share their experiences with you. Consider the value of their perspectives for growth and lifelong learning.
3. Rediscover the joy of not knowing. Celebrate uncertainty for its ability to foster curiosity and deepen engagement. Beginning learners often fear not knowing; we do them and us a great service by highlighting its value in the path toward expertise.
This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.