Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

Recognize, Synthesize, Execute


Reflecting about the inspiring clinicians that I’ve shadowed, I noticed that they have a gift for synthesizing information in a way that’s clear and appropriate for the patient.

“And there we can see the right external jugular vein is about three centimeters above the clavicle,” my attending said on rounds. I could see it and so could the other two medical students on the rotation. It was the first time we felt we could actually understand and assess the JVP. And it was all via Zoom.


Learning the physical exam is one of the foundational, but often daunting, parts of medical education. Some movements come more naturally, while others (like assessing JVP), seem to be impossible no matter the amount of practice. Our attending recognized our difficulty with this physical exam maneuver. So, he synthesized a simplified approach and gave us an effective demonstration in challenging teaching conditions.


I later noticed that this attending always synthesized information for his listeners, from patient interactions to teaching sessions. In one encounter, the patient had a neurological concern that wasn’t urgent or related to the admission. Instead of dismissing the concern or calling for a consult, my attending executed a plan involving three additional neurological exam maneuvers to the physical exam and explained to the patient what was occurring clinically. He eased the patient’s worries while adding no more than two minutes to the encounter. In both instances (and many others), this attending exceeded my expectations of what a clinician and an educator should do. He was an inspiring role model.


On reflection, I realized that many physicians I consider role models do the following:


1. Recognize what needs to be addressed.


2. Synthesize.

Inspiring clinicians bring together their clinical knowledge and experience in a manner appropriate for the patient and/or learner. They share this information comprehensively, but succinctly.


3. Execute with ease and expertise.


I aim to incorporate these three steps into my clinical interactions to hopefully serve as a role model to future learners as I progress through my career.





This piece expresses the views solely of the author. It does not represent the views of any organization, including Johns Hopkins Medicine.