Helen Macdonald: Light reading over the festive season for the e-portfolio

Helen MacdonaldI was considering what I might learn (if anything) over the Christmas period on a chilly cycle home last night. It has been an intermittent and nagging thought for some weeks.

Most of my non-doctor friends would find the idea of Christmas learning ridiculous. But the end of my genitourinary medicine placement looms. There are resolutions to think about, and also a slightly bald looking e-portfolio. Surely during a long weekend of overindulgence, freezing weather, family overload, and bad telly, I might suddenly have the urge to learn something. But what?

Should I attempt a quick skim through the rest of my handbook of sexual health? With efficiency in mind, I could go straight for guidelines or reading the department protocols? (I read the protocols before, but they were overwhelmingly dull and assumed a diagnostic ability I did not have at the time.)

An alternative would be to cut my losses and psychologically prepare myself for my next job, rheumatology. I’ve always been envious of those who have managed to do pre-reading. I think the closest I have come is having ordered a relevant sounding textbook off the internet.

So today when I read a pair of articles in the Christmas BMJ about information overload, I don’t know if I was comforted, depressed, or just pleased that I might have found evidence that my learning ambitions are so futile I should just watch another James Bond film.

Both articles are in the Christmas BMJ and describe the impossibility of keeping up to date. Maybe I could just read these two articles and make a little e-portfolio entry as follows.

(For those unfamiliar with e-portfolios, UK junior doctors are supposed to make a couple of entries a week. One category of entry is about reading. The boxes below have to be filled in each time.)

Date  17/12/2010

What were you reading?

Why were you reading this?

  • Happened across the articles while searching for material for the junior doctor portal

What did you learn?

  • Fraser et al assume a junior can read five papers an hour for eight hours per day. They do a literature review and calculations to see how much reading juniors would need to do each year to keep up to date with echocardiography.
  • They found that “reading all papers referring to echocardiography would take 11 years and 124 days, by which time at least 82, 142 more papers would have been added, accounting for another eight years and 78 days.”
  • “The gap between what we can learn and what is known is increasing all the time. We now know less and less about more and more,” they go on to explain.
  • Smith’s editorial reinforces the enormity of learning. And it seems worse for GP trainees, as he writes that Fraser’s results “show that even within a narrow specialty it is impossible to keep up with published medical reports.”
  • He likens doctors’ learning strategies to birds. It seems a “pigeon” hangs around with other doctors picking up tit bits of learning. Owls seem good at systematic learning and searching Medline. Jackdaws are capable of both behaviors.
  • His conclusion is that we need machines to process all the information for us.

What will you do differently in future?

  • Perhaps feel less inadequate about my general knowledge.
  • Try and develop my learning from a headless pigeon strategy to one of the other mentioned bird learning styles.
  • Perhaps invest in machine, or brain chips that might help GP trainees.

What further learning needs did you identify?

  • Impossible to list

How and when will you address these?

  • Evidently by reading and searching for many years to come.