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| This Process Called Learning |
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by Bob Blumm, MA, PA-C, DFAAPA - May 31, 2011
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It starts from infancy: we learn how to attract attention, we cry when we desire to be picked up and cuddled by a parent of caregiver, we cry when we are hungry, wet, soil our diapers, need attention. We smile when we are looking for affirmation, learn to vocalize in order to both communicate as well as please our grownup parents or caregivers. We attend nursery school and learn fundamentals, which continue from Kindergarten through the last year at High School. We go to a college or university and get a degree or postgraduate degree and prepare for the next 35 years of our life where income and possession of “things” usually demonstrate a process called learning.
I once read an article in Medicine Today and came upon a familiar passage, “The study of medicine is a science, the practice of medicine is an art.” I reflected on those words then and do so again tonight as I am working in the last decade of my art form and appreciate the description even more. I have learned so much from my “practice” of medicine and now I am honing in on the fine points that make it a true art form. It took many years, much study, a desire to learn and an understanding of what a lifelong commitment to learning is really all about. I share my experiences, my successes and my failures with the realization that there were patients on the receiving end of both. I am grateful to them for tolerating my practicing and for communicating with me to help improve my approach, my skill, my understanding of human nature and my shortcomings.
The practice of medicine, becoming a PA or NP is a commitment to a lifetime of reading journals and studies and practicing on “real time” patients. It is a continuum of our early education and it culminates when we retire and encourage the next generation and challenge them to continue to improve. There is only one barrier to our learning process---a smug, arrogant attitude that refuses to believe that we can, in fact, continue to learn. True wisdom and satisfaction in the process of learning can be appreciated with years of experience. This experience is a plumb bob of where we have started and where we wish to end. How we embrace the learning process will determine how wise we become.
What attitudes are necessary to become a learner?
The first trait of a learner is the ability to be taught. Learning presupposes that there are areas where we have limited experience or exposure and that there are others that surround us that can be our mentors. The learner has the ability to discover the mentors and to submit to their directives until they have mastered a skill and become innovative. One of my greatest opportunities to learn took place in a 95,000 patient visit per year emergency room where there were other PAs and NPs who had skills in dermatology, ophthalmology, medicine, cardiology, orthopedics, plastic surgery, general surgery and trauma. In reality the list can continue to grow but the focus of my thinking is to conclude that there are others around us that have skills and approaches that we can do well to emulate.
The second trait of a learner is initiative, a desire to learn, a self-driven attitude that causes us to excel. If we are on a night shift and have no mentor we can ask ourselves “how can I learn when there is no one available to teach me?” I read every journal and every article in those journals. I read outside of my specialty and my profession. I read journals like Nursing Made Incredibly Easy and Nursing 2011 besides all of the PA and NP journals. I am a conference speaker therefore when I am at a conference I sit in on many other speakers and remain up to date. I am an author and know firsthand, the pain of co-authoring a textbook. I read textbooks by multiple authors on various subjects. I listen and participate in webinars and roundtable discussions and I seek the education that is given in my specialty and then in family practice since we all need to understand the systems and diseases in our task of supplying care to a specialty area. When I am confused or need more info I can use my computer or I can place a question on one of my favorite websites where PAs and NP gather for the purpose of helping each other. I have learned quite a bit from Blaine, Charlene, our deceased Neurological NP, Mr. Hudson and from many others such as Eric in emergency medicine and Kim in her compassionate approach to patients. Mimi Secor has livened up gynecology and Peg Fitzgerald has opened up the partially closed door of pharmacology. Elayne DeSimmone has a deductive and organized approach to understanding and learning. Oh, there are so many people responsible for my learning.
The third trait is application. We require more than philosophy and physiology and explanation of techniques, we need hands on workshops. The smarter associations have included them in their conference offerings and I dare say that without them a conference will become a dud and attendance will drop steadily. This is one of the components that are sometimes missing at a general conference such as AAPA, where the number of participants far outweigh the number of instructors and there becomes an absolute limit to how much can be taught within a timeframe that is too short.
In surgery, I learn by reading about the anatomy and potential complications and then assisting on that type of surgery. Placing central lines, Swan Ganz catheters, inserting chest tubes---all require knowledge of anatomy, physiology and proper sterile technique after observation of successful procedures by a mentor. The learning process requires the determination of self-education, the ability to learn from others with more experience and the task of putting it together by your personal actions. Taking an ACLS course is a futile experience unless you are involved in the resuscitation of a patient.
We will remain a force to contend with, professions that are on the cutting edge, only if we are involved in the process of continued learning.
Robert M. Blumm has received national recognition as a distinguished fellow of the American Academy of Physician Assistants (AAPA). He is the past president of the Association of Plastic Surgery Physician Assistants, and was past-president of the American Association of Surgical Physician Assistants, past president of the American College of Clinicians and NYSSPA, as well as Chairman of the Surgical Congress of the AAPA. In addition, Bob received the John Kirklin MD Award for Professional Excellence from the American Association of Surgical Physician Assistants. Along with his associate, Dr. Acker, Bob was the first recipient of the AAPA PAragon Physician-PA Partnership Award. He has been a contributing author of three textbooks, written 150 plus articles and is a sought out conference speaker throughout the United States.
The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
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