Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Here’s why clinicians should give shadowing a try

Peter Pronovost, MD, PhD
Education
October 2, 2015
Share
Tweet
Share

How many of our conflicts could be handled better or averted if we had the opportunity to spend some time in the shoes of the person on “the other side”? When we experience a situation through another’s eyes, and when we understand their work and world, true empathy, understanding and trust can emerge.

This is certainly true in our hospitals, where the frenzy of patient care activities involves multiple roles — physicians, nurses, pharmacists, therapists, social workers and so many others. You can work with other disciplines every day yet know very little of their daily work demands, the challenges they face, and how some of your own actions impact them and the patient.

A straightforward and powerful approach to bridging these divides is the exercise of shadowing other health care professionals. Spending just a few hours with a colleague from a different discipline or clinical area can help you understand the larger hospital systems in which we work, and shed light on the communication and teamwork issues that are so often at the root of unsafe care.

At Johns Hopkins, shadowing has become a staple of the training of our medical students. In a clerkship called The Hospital, third-year students spend time with nurses, respiratory therapists and others, seeking a broad perspective of the environment in which they will later deliver care. The value of these experiences was eloquently captured by student Michael Foote in a recent Academic Medicine article, “The Many Faces of the Hospital.”

Foote, now in his fourth year, explained how some of the inner workings of the hospital were mysteries to him before he shadowed different professionals. Reflecting on his experience with nursing staff members as they tried to juggle multiple orders and tasks, he writes: “Tasks poured in helter-skelter throughout the day; many had mistakes or were unintentional repeats. The result was a dizzying maelstrom of multitasking by the nursing staff. The experience convinced me of the importance of coordinating physician goals with, not against, nursing staff plans.”

Foote’s previous medical school education did not prepare him for the feeling of being close to patients in their weakest moments, such as when a dying man needed his bedsheets changed. However, “living as a nurse gave me a sense of the deep intimacy of experiencing another’s vulnerability,” he writes.

Later, when Foote shadowed a respiratory therapist, Foote needed to approach the attending physician with advice that went against his plan. “Although he cheerfully acquiesced to my request, I, for the first time, experienced how powerless different-colored scrubs could make one feel.”

Shadowing among working clinicians can also be enlightening.

For example, several years ago, staff members on a medical-surgical floor were frustrated with the quality of patient transfers into their unit. They worried about the safety of patients who arrived with outdated reports or without care orders, or who were transferred during shift changes. To understand the reasons for these events, they began shadowing nurses in the three units that commonly transferred patients to them.

What they found helped the teams to avoid mutual finger-pointing, develop empathy and trust, and delve into the systemic issues that were at the root of care coordination flaws. For instance, on the perianesthesia care unit, the shadowing nurse discovered there was often a long backup of patients waiting to be transported off the unit. As a result, patients would arrive hours late on the med-surg unit, and their reports would no longer be timely.

Getting students to shadow is relatively easy because we can make it part of a course. However, it can be a struggle to make this happen among clinical staff members, because time spent shadowing someone else is time you aren’t spending on your normal duties. It’s thus “unproductive time.”

But clinicians should give shadowing a try. Use it to prevent handoff errors and improve care coordination, by understanding how your work affects those “upstream” and “downstream” from you, and vice versa. When you make the commitment, it can be worth it.

Peter Pronovost is an anesthesiologist and director, Armstrong Institute for Patient Safety and Quality.  He blogs at Voices for Safer Care, where this article originally appeared.

ADVERTISEMENT

Image credit: Shutterstock.com

Prev

The story of the brave doctor who jammed a catheter in his heart

October 2, 2015 Kevin 1
…
Next

A pediatrician gives vaccine advice to presidential candidates

October 2, 2015 Kevin 11
…

Tagged as: Medical school

Post navigation

< Previous Post
The story of the brave doctor who jammed a catheter in his heart
Next Post >
A pediatrician gives vaccine advice to presidential candidates

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by Peter Pronovost, MD, PhD

  • Explore the behavioral factors behind antibiotic misuse

    Peter Pronovost, MD, PhD
  • Revamp health regulations to reduce cost and improve patient safety

    Peter Pronovost, MD, PhD
  • How peer-to-peer review helps hospitals

    Peter Pronovost, MD, PhD

Related Posts

  • A call to clinicians: Contrary to what you’ve been taught, use social media

    Joshua Mansour, MD
  • The medical profession needs more shadowing opportunities

    Edwin Leap, MD
  • Is physician shadowing immoral?

    David Penner
  • Why clinicians can’t keep ignoring care coordination

    Curtis Gattis
  • When Western medicine fails patients and clinicians

    Kimberly Rogers, MD
  • Clinicians shouldn’t be punished for taking care of needy populations

    Peter Ubel, MD

More in Education

  • Graduating from medical school without family: a story of strength and survival

    Anonymous
  • 2 hours to decide my future: How the SOAP residency match traps future doctors

    Nicolette V. S. Sewall, MD, MPH
  • What led me from nurse practitioner to medical school

    Sarah White, APRN
  • Bridging the rural surgical care gap with rotating health care teams

    Ankit Jain
  • Why tracking cognitive load could save doctors and patients

    Hiba Fatima Hamid
  • The hidden cost of becoming a doctor: a South Asian perspective

    Momeina Aslam
  • Most Popular

  • Past Week

    • Why flashy AI tools won’t fix health care without real infrastructure

      David Carmouche, MD | Tech
    • Key strategies for smooth EHR transitions in health care

      Sandra Johnson | Tech
    • 2 hours to decide my future: How the SOAP residency match traps future doctors

      Nicolette V. S. Sewall, MD, MPH | Education
    • Reassessing the impact of CDC’s opioid guidelines on chronic pain care [PODCAST]

      The Podcast by KevinMD | Podcast
    • When the diagnosis is personal: What my mother’s Alzheimer’s taught me about healing

      Pearl Jones, MD | Conditions
    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • My journey from misdiagnosis to living fully with APBD

      Jeff Cooper | Conditions
    • “Think twice, heal once”: Why medical decision-making needs a second opinion from your slower brain (and AI)

      Harvey Castro, MD, MBA | Tech
  • Recent Posts

    • How to survive a broken health care system without losing yourself [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why some doctors age gracefully—and others grow bitter

      Patrick Hudson, MD | Physician
    • Why removing fluoride from water is a public health disaster

      Steven J. Katz, DDS | Conditions
    • What the research really says about infrared saunas

      Khushali Jhaveri, MD | Conditions
    • How the cycle of rage is affecting physicians—and how to break free

      Alexandra M.P. Brito, MD and Jennifer L. Hartwell, MD | Conditions
    • Why ADHD in adults is often missed—and why it matters [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 6 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why flashy AI tools won’t fix health care without real infrastructure

      David Carmouche, MD | Tech
    • Key strategies for smooth EHR transitions in health care

      Sandra Johnson | Tech
    • 2 hours to decide my future: How the SOAP residency match traps future doctors

      Nicolette V. S. Sewall, MD, MPH | Education
    • Reassessing the impact of CDC’s opioid guidelines on chronic pain care [PODCAST]

      The Podcast by KevinMD | Podcast
    • When the diagnosis is personal: What my mother’s Alzheimer’s taught me about healing

      Pearl Jones, MD | Conditions
    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • My journey from misdiagnosis to living fully with APBD

      Jeff Cooper | Conditions
    • “Think twice, heal once”: Why medical decision-making needs a second opinion from your slower brain (and AI)

      Harvey Castro, MD, MBA | Tech
  • Recent Posts

    • How to survive a broken health care system without losing yourself [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why some doctors age gracefully—and others grow bitter

      Patrick Hudson, MD | Physician
    • Why removing fluoride from water is a public health disaster

      Steven J. Katz, DDS | Conditions
    • What the research really says about infrared saunas

      Khushali Jhaveri, MD | Conditions
    • How the cycle of rage is affecting physicians—and how to break free

      Alexandra M.P. Brito, MD and Jennifer L. Hartwell, MD | Conditions
    • Why ADHD in adults is often missed—and why it matters [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Here’s why clinicians should give shadowing a try
6 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...