On October 17, I was transferred to a rehabilitation hospital located deep in the mountains.
This is a hospital specializing in rehabilitation, so many people, from children to adults, go there for rehabilitation, either as outpatients or as inpatients.
As I wheel my wheelchair down the corridor, I pass children who are doing gait rehabilitation. When I see these children working hard, I honestly feel that I should work hard too. I feel once again that the presence of others has a great impact on my motivation.
When I am in a university hospital or a large hospital, I often encounter students who are on practical training.
As with educational training for everyone, there is much to be learned from being in the field.
I feel that medical professionals place great importance on learning in the field. There is a system in place for students to learn not only through practical training as students, but also from their seniors in the field. At university hospitals, doctors see patients as a team. Within that team, there are specialists, residents, and medical students, and a system is in place for learning from senior doctors in the field. I believe that being able to learn while seeing the same patients is a great learning experience.
For example, in my case, I have had my spinal fluid tested several times because of inflammation in my spinal cord. The spinal fluid is collected by inserting a thin wire-like object, called a lumbar puncture needle, from around the waist. The new resident was in charge of this procedure every time. He was a little nervous as he was given detailed instructions by his seniors. He was under local anesthesia, so there was no pain, but I could feel his nervousness. Behind him, medical students were watching. Furthermore, I was fine, but if the spinal fluid collection does not go well, a senior doctor on site takes my place. If it still did not work, a more senior doctor would come in and take the sample. When the collection took less than an hour, I would talk with the doctors, but if I gave voice instructions when the collection did not go well, the patients would be worried, so I tried to give instructions with gestures as much as possible. In the past, he used to kick the legs of new doctors who could not collect samples well so that the patients could not see them.
This on-the-job learning by watching and learning from seniors has long been practiced not only by doctors and medical professionals, but also by craftsmen.
Focusing on the so-called master-apprentice learning, the American researcher Brown and his colleagues have developed the concept of cognitive apprenticeship. Cognitive apprenticeship is a process of learning from one’s mentor and is applied to education by proposing six stages: modeling, coaching, scaffolding, articulation, reflection, and exploration. Modeling is the phase of learning by seeing. In the spinal fluid collection I mentioned earlier, this is the stage where the medical student was watching from behind. The next stage is the coaching stage, where the patient learns the basics from a skilled person. It was at this stage that residents were taking spinal fluid samples under the direction of senior doctors. Furthermore, this is the scaffolding and scaffolding stage. This is the stage where the senior doctors watched over the resident as he performed the procedure alone and kicked his feet when he seemed to make a mistake. This is the stage where support is gradually reduced so that the resident can do the procedure alone. Further articulation, verbalization to clarify the learning, reflection, and reflection, and finally exploration, where they are able to explore on their own, are followed by exploration.
I may have made it difficult to understand with my own lumbar puncture story. It is a process of watching and learning, trying it while being taught, learning to do it alone with support, and becoming able to do it completely on your own.
Seeing this process of proficiency in the medical profession, teachers also have many opportunities to learn from their seniors after entering the field, but I wished I had more time and opportunity to learn in the field in an apprentice-like manner. This is, of course, a concept that can be applied not only to professional learning, but also to children’s learning. I encourage everyone to try to incorporate cognitive apprenticeship as a method of education as well.
Lumbar puncture is a procedure that no patient likes because it is a very embarrassing outfit and takes a long time, but it was an opportunity to slowly talk with a young doctor, which I myself enjoyed.
Hideki Mori