Jennifer Spicer, MD, MPH Profile picture
Sep 15, 2020 16 tweets 7 min read Read on X

Have you ever a junior member of your team ask you a question, and you had NO IDEA what the answer was?

Like, literally no clue.
Racking your brain.

Nope, just me?

This week’s #MedEdTwagTeam #ClinicalTeaching topic: Humility.

#MedTwitter #MedEd Image

On my first day as a senior resident, I was terrified that my interns would ask me a question that I didn’t know.
…And they did.

So I said, “I don’t know, let’s look it up.”

And, (not surprisingly) they appreciated that.
Me, admitting my limitations & offering to help.
3/ Honestly, this fear of not knowing things still plagues me.
I have a weird combination of confidence + imposter syndrome.

Some days I feel confident.
Other days I wonder why everyone else is so much smarter than me.

Why can't I remember the names of those famous trials?!

During residency I watched brilliant attendings solve mystery cases with ease.

I felt that I would never get there.

But then I realized that the “all knowing” physician was a myth.

We are all constantly learning & growing.
5/ And reading this passage from @DxRxEdu @Gurpreet2015 in @JHospMedicine tells me that I’m not alone.

“I don’t know.”
What a powerful phrase.

(Here’s the link to the full article:…) Image
6/ And, over the last few months, @ricapitt & I have had Resident as Teacher sessions with our new(ish) @emoryimchiefs PGY2 residents.

When we ask them what their biggest fear is about being a senior resident, it’s a familiar concern:
That they won’t know enough.
7/ But, funny enough, when I hear them say this, I know they are going to be just fine.

Because they are humble.
They recognize their limits.
And they are sharing their fears.
8/ Which all comes back to today’s concept of remaining humble.

Humility has helped me in 3 important ways on my clinical teams:

1⃣Flattening the hierarchy.
2⃣Establishing a growth mindset.
3⃣Creating trust. Image
9/ First, flattening the hierarchy.

On the first day of wards, I make it clear that everyone on the team has unique knowledge & value.

There is a LOT that I don’t know.
I’m very up-front about that.
I tell the team to correct me (and they do).
10/ I emphasize teamwork.
And I encourage everyone to speak up if they have an idea, even if it’s not “their” patient.

I make it clear that a “correction” from someone else doesn’t reflect poorly on the person who was corrected.

We are all a team, and everyone gets the credit.
11/ If you haven’t read Atul Gawande’s book “The Checklist Manifesto,” I highly recommend it.…

And this article from @MedEd_Journal is also a great read:…
12/ Second, establishing a growth mindset.

If you aren’t familiar with the term growth mindset, here’s a link to a 2 page summary from @MedEd_Journal:…

Growth mindset = success is due to effort
Fixed mindset = success driven by innate ability

Part of a growth mindset is recognizing that we all can improve.

So, in the spirit of a growth mindset, I remind my team that we are all (myself included) there to learn.

I HOPE they have gaps in their knowledge; otherwise, what am I doing there?!
14/ Third, humility engenders trust.

When trainees come to me and admit that they don’t know something (i.e. humility), it helps me trust that they know the boundaries of their knowledge.

I know that I can trust what they say and do.
And vice versa.
15/ So, in summary, consider how you can role model your humility by:

Admitting “I don’t know”

This will help your team by:
1⃣Flattening the hierarchy
2⃣Encouraging a growth mindset
3⃣Creating trust
16/ And keep an eye out for @GStetsonMD’s thread next Tuesday on ”Never Judge”

And check out the @MedEdTwagTeam if you want to see all of our threads in one place!

Thanks for joining, and we will see you next week! Image

• • •

Missing some Tweet in this thread? You can try to force a refresh

Keep Current with Jennifer Spicer, MD, MPH

Jennifer Spicer, MD, MPH Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!


Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @JenniferSpicer4

Mar 17, 2023
Kicking off BST Mode ⁦@emoryimchiefs⁩ Grady campus on #MatchDay2023

Do you want a 4-step process for questions to ask when you get a page next year when you’re alone on nightfloat or ICU call?

Check out this framework! Image
And now, do you wanna remember who the heck to order DEXA scans for in clinic?

Thankfully Miko De Bruyn comes to the rescue. Image
Read 16 tweets
Mar 7, 2023
1/ You're seeing a new consult with your team, and you want to teach the primary team too.

But WHEN is the best time to teach them?

On the phone?
At the bedside?
In their team room?

And in the morning?
Or maybe the afternoon?

This week: Image
2/ Last week @VarunPhadke2 described all of the individuals whom we can teach during the day.

But when should we teach them?

Often we default to teaching on the phone when receiving the consult or giving recommendations, but there are other options too.
3/ This week we will discuss the pros & cons of those options.

With one caveat.

Often the best time to teach is the one most convenient to your team & the primary team, which depends on your local institution's workflow.

But let's explore some general principles to consider.
Read 15 tweets
Feb 21, 2023
1/ You're finishing your last consult of the day.

It's late.
And it's been a long day.

You intended to find the primary team to teach them, but you have a million other things on your "to do" list.

Here are 8 reasons why you should still find time to teach the primary team. Image
2/ Reason #1: They want to learn

The primary team called with a question.
They are invested in the answer.

It's all about finding out what they want to know and targeting your teaching accordingly.
3/ Reason #2: It empowers them

Often the primary team has an idea of what to do but wants reinforcement that their plan is correct.

Teach them general rules that they can re-use. Image
Read 12 tweets
Jan 31, 2023
1/ Your team just saw a patient with syphilis, and you're ready to teach, but:

Resident #1: on week 2 of their rotation
👉 Has already seen 2 patients w/ syphilis

Resident #2: started today
👉 Hasn't seen a single patient with syphilis

What should you do now? Image
2/ Unfortunately, learners on our team may miss teaching that occurs during the rotation for multiple reasons. Image
3/ As @VarunPhadke2 previously pointed out, all learners on the team are usually not present all day, every day for the entire time we are on clinical services.

Read 16 tweets
Jan 24, 2023
1/ A member of your consult team presents a patient w/ suspected neurosyphilis.

Your team:
⭐️ 3rd year medical student
⭐️ IM intern
⭐️ 2nd year IM resident
⭐️ 1st year ID fellow

How can you possibly provide valuable teaching to all of them?

This week: Multi-level teaching Image
2/ Teaching multi-level learners is hard.

Their range in baseline knowledge means a single teaching point is often not effective for everyone.

So how can you support everyone's learning without taking too long and/or boring others?
3/ A prior thread discussed the importance of clarifying learners' needs & interests at the beginning of the rotation.

This is one 🗝️ for effective multi-level teaching.

Know what materials is RELEVANT and INTERESTING for each learner level.

Read 14 tweets
Jan 10, 2023
1/ *Re-consult 📞*

You: What did the last consult note say?

Them: I don't know how to interpret it...

*reading the ✍️ yourself*
- send tick serologies
- start broad-spectrum antibiotics
- we will follow up OSH data

You: 🤦 I feel you... We'll see the patient again. Image
2/ You wonder...

💭 What tick serologies were we referring to?
💭 What antibiotics were we wanting to start?
💭 And which OSH has prior records?

And you're not the only one wondering...

How can we ✍️ more effective notes?
3/ Clinical notes are used for many purposes, as previously highlighted by @YihanYangMD

Read 15 tweets

Did Thread Reader help you today?

Support us! We are indie developers!

This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!


0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy


3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us!