Take a Pause for Thought

How often do you do it? Take a pause for thought?

Photo on 2010-10-29 at 12.20: a pause for thoughtCreative Commons License Chris Best via Compfight

Clinical medicine has evolved into a fast paced endeavour. Where our forefathers would have time to write poetry, or take the horse and buggy out for an all afternoon housecall, we now have eight minutes per patient. If we take more than that, we hope to drop other appointments by a similar amount of time, or we just work into lunch, and through breaks.


Residents pause for thought. They have to. They have to ascertain their level of knowledge is adequate, challenge themselves, then leap. We help them leap, possibly the biggest role of a clinical professor. We need to ensure that cognitive apprenticeship is primed, greased, and humming, then let them go, and hold our collective breath. Harder than it sounds: assessing a student’s capacity, then letting that student stumble, and find their way. Without this, learning happens, but it’s much slower. We need to let them make mistakes, and most importantly, go back and fix them.


That’s a leap, a leap of faith. A leap that’s easier to take when you know your resident takes that pause for thought.


Do you do it? Some of us charge through the day, then go back to finish notes. Here’s an opportunity. There’s your built in pause for thought. Can you think of anything else, or a better way? A lab test you’ve forgotten? An implication you forgot?


The question really is, do you go back and fix it? How often do you pick up the phone and call, and say, “You know what, Evelyn? Really, I think it would be better if we do it this way, and here’s why.” Taking that pause for thought, analyzing the situation, coming up with a better way to do things and not taking action is even worse than not doing it!


Thoughts are meaningless. Only behaviour is measurable, only behaviour has impact with other people, other systems, with the world. Thinking of a better, more quality way to do something, and then continuing on the same old merry way is simply non professional, and not in your patient’s (or student’s, or family member’s, etc) best interest.


I occasionally do drawings. I work away for a few hours, and think I have things pretty good. I never move directly to framing. Never. If I’m in a great rush, and that’s never a good situation for producing anything of quality, then I at least turn it upside down, and stand back about ten feet, and see if there are glaring errors. I prefer to do this after 2-3 days break.




Because you find more. Glaring errors. There always are some.


Take a pause for thought. Catch your oversights, your assumptions, your errors.


Quality. Another word for professional.

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