Improving medical students

Archive for the ‘Wellness & Health’ Category

Caffeine Maintenance – Can Missing Your Morning Cup of Coffee Reduce Productivity?

Posted by medliorator on June 2, 2010

An update on Professor Peter Rogers caffeine research…

“Although frequent consumers feel alerted by caffeine, especially by their morning tea, coffee, or other caffeine-containing drink, evidence suggests that this is actually merely the reversal of the fatiguing effects of acute caffeine withdrawal,” wrote the scientists, led by Peter Rogers of Bristol’s department of experimental psychology.

The team asked 379 adults — half of them non/low caffeine consumers and the other half medium/high caffeine consumers — to give up caffeine for 16 hours, and then gave them either caffeine or …placebo.

The medium/high caffeine consumers who got the placebo reported a decrease in alertness and increased headache, neither of which were reported by those who received caffeine.

But measurements showed that their post-caffeine levels of alertness were actually no higher than the non/low consumers who received a placebo, suggesting caffeine only brings coffee drinkers back up to “normal.”

Caffeine addicts get no real perk from morning cup [Reuters]

Corollary: Achieve Morning Alertness without Caffeine
Corollary: Neuroprotective Effects of Caffeine
Corollary: Coffee Drinking and Heart Disease
Corollary: A critical review of caffeine withdrawal: empirical validation of symptoms and signs, incidence, severity, and associated features.

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RePost: Managing Exam Stress & Optimizing Performance

Posted by medliorator on December 27, 2009

Philip Zack:

Many people have an automatic train of “self talk” in their heads, which has the effect of giving up control to external factors with unhelpful statements such as, “The exam is making me stressed” or “I’m bound to fail again.”

Take control of these self talk messages by challenging them—for example, “The exam is making me stressed” becomes “I let myself get stressed in the exam;” or “I’m bound to fail again” becomes “I might fail, but if I prepare well I might pass.”

You can also control your emotional state by practising simple meditation or visualisation exercises, both before the exam and during short breaks in the exam itself. Box 3 shows a simple example, using a technique called anchoring. You can use a range of techniques, which can either be self learnt or taught by a professional, such as a yoga teacher or hypnotherapist.

the Yerkes-Dodson curve:


Exam technique 2: performing [BMJ Careers]

Posted in Productivity, Wellness & Health | 1 Comment »

Finding Quiet Time

Posted by medliorator on December 7, 2009

2. Take Two Minutes to Plan Your Morning – take just two minutes to plan your morning. Grab a post-it note. Jot down three things that you want to get done before lunch.

5. Have a Complete Rest When You Get Home – How often do you get home from work feeling frazzled, exhausted and irritable? Do you end up wasting time watching television shows that don’t really interest you, or surfing the internet just to unwind?

For the last year and a half of my previous job, this was my routine when I would arrive home from work. I would literally go in, lay down on the bed for about twenty minutes with my eyes closed, and think about nothing. I’d breathe in deeply, breathe out deeply and slowly, and just let my mind and body drift away. After twenty minutes, I would feel tremendously refreshed.

Six Ways to Find Quiet During a Busy Day [Dumb Little Man]

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Case Studies – Tackling Common Sleep Problems

Posted by medliorator on November 10, 2009


The worrier

  • challenge:  “My sleep problems are definitely stress-related,” she says …She lies in bed thinking about work, making mental to-do lists, and even listening to random songs that play in her head.
  • advice: “She seems to have a predisposition for insomnia, and for people like her, whenever there are additional pressures, like a new job, the insomnia bubbles to the surface,” says Gary Richardson, M.D., a senior research scientist and a staff physician at the Sleep Disorders Center at the Henry Ford Hospital, in Detroit, Michigan …she needs to find ways to handle her stress better so that it doesn’t wake her up at night.
    • Distract her brain by trying a relaxation technique, like focusing on her breathing.
    • Working on keeping her sleep environment quieter, such as using an air conditioner or a fan, as well as blackout shades to block street light.

The night owl

  • challenge: She grows more alert late at night, then stays up until about 3 a.m., watching TV, reading, clearing out e-mail, and organizing things for her family.
  • advice: To start slowing down and readying herself for an earlier bedtime, psychologist Rubin Naiman suggests blocking blue light. “The blue end of the light spectrum — emitted by ordinary lightbulbs, televisions, and computer screens — suppresses melatonin,” says Naiman. Nicole might consider …reducing the amount of light in general. “Being exposed to too much light at night is the environmental equivalent of caffeine,” says Naiman. So at least two hours before bed, dim the lights. In addition, Nicole needs to find time earlier in the day for catching up on e-mail and organizing.

The slow riser

  • challenge: Elizabeth …struggles with an innate tendency is to stay up till midnight, then hit snooze so many times in the morning. “The clock has been known to give up,” she says. Even when she feels exhausted all day, she becomes more alert at night. When she does get into bed, it takes her up to an hour to fall asleep. Elizabeth has tried going to bed earlier so she’ll have less trouble getting up in the morning, but then she just lies awake. She doesn’t drink caffeine, and she reads when she gets into bed, does yoga three times a week, and uses an aromatherapy-oil diffuser in her bedroom.
  • advice: While avoiding caffeine in the afternoon and the evening is a wise move, physician and sleep researcher Gary Richardson says that having some first thing in the morning can be helpful for people like Elizabeth, who have trouble waking up.
    • Modulating her exposure to light could reset her internal clock gradually, according to Richardson. “Too much light at night will push her clock even later,” he says, so the key is to keep the lights dim the closer she gets to bedtime. Elizabeth should also maximize her light exposure first thing in the morning. If she can go outside in bright sunlight for some exercise, that would provide a double whammy of wakefulness.
    • Taking a melatonin supplement (0.3 milligram before bed) might help Elizabeth if light manipulation isn’t enough, Richardson suggests. It may help pull her internal clock to an earlier hour so she can get the sleep she needs

How to solve 9 sleep problems [CNN Health]

Correlate: Making Time for Sleep
Correlate: Sleeping Smarter
Correlate: Understand the Mechanics of Sleep

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A Guide to Medical Student Dating

Posted by medliorator on April 6, 2009

4. Support them when they come home after each test, upset because they failed—and gently remind them after they get their well above passing grade how unnecessary the “I’m going to fail out of medical school and never become an MD” dramatics are.

10. Their study habits will make you feel like a complete slacker. For them, hitting the books 8-to-10 hours a day is not uncommon, nor difficult. You’ll wonder how you ever managed to pass school on your meager one hour of studying per night.

How to Date a Med Student [FOXNews]

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Managing the Stress of a Medical Career – Talking to Eachother

Posted by medliorator on January 28, 2009

George Hossfeld, MD, assistant professor of emergency medicine at the University of Illinois-Chicago, on is medical malpractice experience:

It felt very personal when they asked for an award far more than my policy limits, and I, as the sole defendant, had to imagine the possibility of losing my house, retirement savings, and kids’ college fund. Through a stroke of luck, the jury returned a decision for the defense. No one will convince me that on another day, a different group of 12 people could not have found me guilty, and awarded my future to the plaintiff.

There is no way the term winner can be applied to me. With luck, survivor is all I hope to realize.

Physicians do not advertise the fact that they are being or have been sued because they know that it is a slur on one’s reputation. The secrecy with which we treat the issue serves to underscore that point.

Silence contradicts all we know about stress management. Stress causes anxiety, isolation, and helplessness, and has led some to suicide. Enlightenment through exposure would go a long way in removing the stigma associated with its very name.

The public has been told that malpractice occurs to those few bad doctors, and that the rest of us have no experience with it. It’s hard for them to have much sympathy when that’s the case. What an epiphany it will be to find that their doctor, in fact, all of their doctors have experience with being sued! Now that’s a horse of a different color! Exposure will lighten the shame, disgrace, and dishonor that we have falsely granted it. Exposure may create a groundswell of disgusted colleagues who are going to demand change.

Speak the Unspeakable: ‘I Was Sued for Malpractice’ [Emergency Medicine News:Volume 31(1)January 2009p 3, 16]

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Making Time for Sleep

Posted by medliorator on December 8, 2008

1. Put work early in the day. If you’re working until 2 a.m. on a regular basis, it’s probably because you don’t manage your time well. Move work into earlier hours in the morning. This will put less pressure on you to stay up all night to finish.
2. Set a bed time. Sounds childish, but it works. If you currently go to bed whenever you feel like it, there’s a good chance you’ll keep pushing your day later and later into the night. Humans didn’t evolve with electric lighting, so you can’t just trust your body for when the best time to sleep is.
3. Get rid of the caffeine. Caffeine is a band-aid.

How to Get More Time to Sleep [Scott H Young]

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How to Take Strategic Breaks

Posted by medliorator on November 25, 2008

On a short time span, there are really only two kinds of breaks you can take:

  • Short breaks to rest during the day
  • Breaks that finish a day and begin the next morning

Here’s my rule for taking short breaks:
Whenever I hit a roadblock in my energy and can’t accomplish anything, I set myself a timer for 15-30 minutes.  My goal is to keep working throughout this time.  Once the timer is done, I see if I’ve made any progress.  If I haven’t, I know it’s time to take a break.  This rule helps because it prevents you from quitting whenever you hit a small obstacle.

Don’t Waste Day-Ending Breaks
If you’re going to quit for the day, rest fully.  Set a big to-do list for the next day and plan to start early again.  You’ve postponed work to rest strategically.  That will only be successful if you actually regain your energy.

How to Know When to Take a Break [Scott H Young]

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Why You Lose Focus & How to Recover

Posted by medliorator on November 21, 2008

Lack of Sleep – Even one night of tossing and turning can “give you symptoms that resemble ADHD… says Kathleen Nadeau, Ph.D., director of the Chesapeake ADHD Center of Maryland, in Annapolis.

  • Get a good night’s sleep: You should try to get the amount of sleep required for you to wake up without an alarm.
  • Have a snack: If you’re running on fumes… drink a glass of water and eat a snack with a balance of carbohydrates, fat, and protein, like an apple and a piece of cheese, recommends Hallowell. “This hydrates you and keeps your blood sugar levels even, both of which aid focus,” he says.

Stress and Anger – When you’re tense, you get a rush of brain chemicals, like norepinephrine and cortisol, that cause you to hyperfocus “like a deer in the headlights,” says psychologist Lucy Jo Palladino …this only means that you have a harder time focusing on work… When you’re irritated by something, your stress hormones rise and your concentration levels decrease.

  • Start moving: A quick burst of aerobic exercise relieves stress and improves concentration by flooding the brain with oxygen and activating brain chemicals such as dopamine. Recent studies have shown that people who engage in aerobic exercise [at least two days a week] have better concentration levels than do nonexercisers.
  • Think happy thoughts: Thinking of things that promote warmth, connection, and happiness reduces the hormones associated with stress, fear, and anger that can impede concentration,” says author Edward Hallowell

Fuzzy brain? Improve your attention span [CNN Health]

Correlate: How to Sharpen your Focus

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Empathy’s Strengths & Weaknesses in Medical Education

Posted by medliorator on November 4, 2008

In a third study, Dr. Dyrbye found that when tested for empathy, medical students at baseline generally scored higher than their nonmedical peers. But, as medical students experienced more burnout, there was a corresponding drop in the level of empathy toward patients.

“What do they really need to know before graduating from medical school, and how could they most efficiently learn?” Dr. Drybye asked, reflecting on one of the central challenges of medical education. “All the information we want to share with them is not necessarily what they really need to learn.”

Medical Student Burnout and the Challenge to Patient Care [NYT]

Objective – To determine whether lower levels of empathy among a sample of medical students in the United States are associated with personal and professional distress and to explore whether a high degree of personal well-being is associated with higher levels of empathy.

Results – Medical student empathy scores were higher than normative samples of similarly aged individuals and were similar to other medical student samples. Domains of burnout inversely correlated with empathy (depersonalization with empathy independent of gender, all P < .02, and emotional exhaustion with emotive empathy for men, P = .009). Symptoms of depression inversely correlated with empathy for women (all P ≤ .01). In contrast, students’ sense of personal accomplishment demonstrated a positive correlation with empathy independent of gender (all P < .001). Similarly, achieving a high quality of life in specific domains correlated with higher empathy scores (P < .05). On multivariate analysis evaluating measures of distress and well-being simultaneously, both burnout (negative correlation) and well-being (positive correlation) independently correlated with student empathy scores.

How Do Distress and Well-being Relate to Medical Student Empathy? A Multicenter Study [J Gen Intern Med]

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