Recent 'tongue in cheek' research which has been reported in a Washington Post blog recently has caused a lot of questions to be raised concerning inattention blindness, which could cause concern unless you understand the underlying psychology.
Here's a CT scan:
During psychology lectures at Med School, you may have encountered the basketball bouncing students in front of a bank of elevators where you were asked to count the number of passes the basketball made from the player wearing the white T shirt, while a gorilla ran between the students. (Even if you did watch it before, you can re-watch the video on the Washington Post blog).
The recent study asked radiologists to identify and count how many nodules are present in the lungs on a regular CT thorax. If you look at the image you may see a gorilla waving his arms about. As a radiologist, I see the anatomy in the background, the chambers of the heart and mediastinum, but nothing there out of the ordinary.
As radiologists, we are looking for pathology, but also report pathological findings that are unexpected. The clinical history of a patient is very important for us in interpretation of imaging examinations, as we need to answer the question you are asking, but have to be careful we do not miss anything else of serious import. As we do not see any other pathology, we would not expect to find a gorilla in the chest, so our brains can pass over distracting findings.
The other psychological issue is the satisfaction of search, where we can see the expected pathology, but may miss the other cancer if we do not carefully and systematically look through the images.
So the main thing to learn from this is that your training should always keep you alert, not just to expected happening, but to not discount the unexpected, then many lives will be saved as a result of your attention to detail.
Who are we?
This society has been formed by a core group of clinical year medical students at the University of Birmingham. We are hoping that lots more healthcare students at UoB will join us soon. This society is open to any student who has a keen interest in healthcare management – Nurse, physio, BMedSc, Medical student, Business student, dentist and pharmacist are all welcome.
Why do we exist?
Healthcare has become more complex. To ensure that patient’s receive the most effective treatments then healthcare services need to be organised effectively. This might be your role one day and you won’t receive any formal training in management theory or on team working and leadership skills from the University – knowledge that is essential to providing the best care for our patients.
Studies have shown that clinicians who have received management training and who take an active role in managing the departments they belong to have achieved significantly decreased complication and mortality rates.
What do we plan to do?
1) Raise awareness amongst healthcare students about the opportunities to be involved in healthcare management in their future careers.
2) The society hopes to act as an intermediary between healthcare students keen to make contacts with likeminded individuals in other course and years. We intend to have regular social events that allow everyone to practice their essential networking skills while at discussions over coffee, nights out, games of golf or away day visits to conferences and organisational visits.
3) The society will be holding lectures given by eminent professionals from all areas of healthcare management – The NHS, DoH, Armed forces, private organisations, think tanks, consultancy firms and leading researchers.
4) The society aims to help students foster essential leadership and team working skills that will be required in their future professional roles. These skills will be developed informally and during seminars and workshops. These skills will then be put to the test in high stress situations like Paintballing, laser tag and outdoor activities.
5) The final main aim of this society is to help students make contacts with clinicians and researchers who are working on improving healthcare systems and who need healthcare students to help with research. We hope to develop a network of contacts who are willing to provide research and audit opportunities to keen students.
Are you interested in joining the Birmingham Students Medical Leadership Society?
Then please email the committee at: firstname.lastname@example.org
Or join us on Facebook: https://www.facebook.com/groups/676838225676202/
Or come find us at the MedSoc Freshers fair in September.
The Student medical leadership society (SMiLeS) useful resources!!!
Why is it important?
student BMJ 2012;345:e5319
Foundation year opportunities
Future career opportunities
Free Learning/ Relevant organisations
Did you know that you may not just work for the NHS, but also help to run it? The new Medical Leadership Society aims to foster leadership skills in healthcare students through talks from NHS leaders, the DoH and even the Armed Forces.
We provide a way for you to learn about being a leader and influencing policies in the NHS, and our talks and events will serve as an excellent platform for you to start making influential contacts within areas that interest you. You’ll also practice those leadership skills in an array of activities, including paintballing and laser tag!
The biopsychosocial model of disease existed in my notes... an excuse to get out the colouring crayons and draw a diagram, but ultimately another collection of facts that needed to be digested then regurgitated in the summer exams, something to be fitted in around learning about the important stuff - the science.
But the biopsychosocial model has come alive for me recently, now I realise what an impact the later two components, psychological and social, can have on patients. As a former medical student and now full time patient, the model really means something to me now.
In the 1977 paper in Science, George Engel introduced the biopsychosocial model:
"The dominant model of disease today is biomedical, and it leaves no room within it's framework for the social, psychological and behavioural dimensions of illness. A biopsychosocial model is proposed that provides a blueprint for research, a framework for teaching and a design for action in the real world of health care."
Following some conversations on Twitter recently and from my own experience at medical school and now as a patient, I wanted to explore my thoughts on this model.
Twitter, in the wonderful way it does, recently introduced me to the Disabled Medic blog, which among many other great posts, has also explored the biopsychosocial model, and I would recommend a read.
The biopsychosocial model shows the influence that emotions and social circumstances have on physical health, which is important. But while conversations about the model focus on the way it can be used by healthcare professionals (very important!), it needs emphasising that the model can provide a framework for patients to look at/after themselves. The model highlights the psychological and social causes of disease, but more optimistically, it can show that there are a range of treatments for disease, from the medical to the social and psychological. A diagnosis of a long-term health conditions is often simultaneous with loss of control. There are limitations to the success of medications, treatments and surgeries. And in receiving these, we are relatively passive as patients, no matter how engaged we are. The biopsychosocial model looks at our biological, psychological and social needs, and how these factors influence our overall health. Establishing that these factors affect our health is only the first step. As patients, when psychological and social factors are brought in to the equation, it becomes clear that we ourselves have some power to help ourselves. By framing our health in this more holistic way, as patients we are not as powerless as suggested by the medical model. Through self-management we can make positive changes to our own psychological and social situations, which can in turn benefit our physical biological health.
To return to the traditional ground of the model - healthcare professionals....
One strength of the model is that it places psychology side beside its (generally considered) more superior counter-part, biology. I hope that by seeing the biopsychosocial model in action, physicians can appreciate the detrimental psychological impact of a diagnosis, and the assumption of "it is all in the mind" can fall by the way side. By integrating all three elements, the model shows that neither is independent of the others, so it can't be all in the mind, because other factors, biological or social, will be involved to some degree.
For me personally, the biopsychosocial model makes me look at what a 'life' is. One of the attractions of medicine is saving lives. Without getting too deeply into philosophy or ethics, I just want to explore for a second what saving a life really means for me, as a patient. I still believe that A&E staff heroically save lives. But I have come to realise that a life is more than a swiggly line on a heart rate monitor. My counsellor has been just as heroic in saving my life, through addressing my emotions. My life is now something I can live, rather than endure. With saving lives being a key (and honourable) motivation among medical staff, it is important that we can allow them to save lives as often as possible, and in many different ways. It may not always be through emergency treatment in resuscitation, but if we embrace the biopsychosical model, they can save lives in many more ways.
When there is a limit to the effectiveness of the biological approaches to an ill person, and they can't be returned to the land of the healthy, medical science becomes unstuck. Within the biopsychosocial model, the issue of doctors not being able to do anything is slightly less. As I mentioned in my post about making the transition from medical student to patient, I went to medical school because I wanted to make people better. But I was only being taught one way to make people better - drugs and surgery. If we really embraces the biopsychosocial model, doctors could make a difference, even if their standard tools of drugs aren't available because they could turn to psychological and social support. This isn't to say that all clinicians have to be counsellors or social workers - far from it. But an awareness and appreciation of their contribution to the management of a patient is important, as well as an understanding of the basic principles and skills such as motivational interviewing.
In 2013, I don't think I can talk about social in this context without mentioning social media. It was not was Engel originally meant in 1977, but social media has become a vital social tool for patients to manage their health. Ignoring anxieties and postural problems associated with sitting at a screen seeing everyone else's photo-shopped lives, it is undeniable that social media is a big and good resource that can empower patients to take responsibility and manage their own health. To see the best examples in action, take a look at Michael Seres and his blog, Being a Patient Isn't Easy to see a whole new meaning to the social in biopsychosocial!
I am still very grateful for the biological expertise of my medical team. Don't get me wrong - it's a good place to start and I wouldn't be here writing this post today if it wasn't for the biological support. But with chronic illness, when you are past the dramatic relapses, the biological isn't enough....
The biology has allowed me to live, but its the psychological and social support I have received that has allowed me to live.
Anya de Iongh
A Pecha Kucha talk (400 second video). I hope that by sharing my personal story in this way, it will help raise awareness of unfit drivers and the responsibilities involved when assessing fitness to drive.