In the latest Med Student Over Easy podcast, host Andy is joined by Kaitlin Bowers, Tim Montrief, and Vlad Mordach to discuss observing procedures.


As a student, observing procedures can seem monotonous and not as exciting as getting to try things on your own. However, if you take advantage of each observation opportunity and follow our roadmap you will feel more confident stepping into the role of the proceduralist when your time comes.


The procedure begins before you enter the room

As a learner, it is important to always know why you are doing a procedure. What are the indications, contra-indications, risks, benefits, and complications? Doing the procedure starts with understanding it and being able to talk to the patient and family about it. You should also be able to verbalize each step of the procedure including what materials you need to gather and any other preparation that needs to be done. Be familiar with talking through the steps both prior to and during the procedure as this reinforces your learning.


Ask good questions

Cliche but necessary. Asking good questions demonstrates that you are critically thinking of the intricacies of the procedure, and no question is a bad question. Embrace the role of a learner and recall that everyone was once in your position. Ask them now while you’re watching as opposed to when things go wrong and you are holding the reigns.


Know when to not ask questions

Not everyone you observe will have mastery of the procedure you are watching. Interns may only have a few repetitions under their belt. Read the room and recognize when they may be struggling – that’s probably not the most ideal time to have them distracted to answer the question you have, which very well might be the question they have themselves. Always offer to help in whatever way might be needed. Also, If the patient is awake during the procedure it might be best to hold some of your questions till afterward when you aren’t in the room.



If time allows, ask the proceduralist if they have anything to add to what they described or did. What advice do they have for you when you do it the first time? Ask if there are different approaches they might take in a similar situation. Express interest, instill confidence, elicit trust, and express that you would like to try it yourself next time.


Perfect practice makes perfect

To become the best at something, to really master it, you have to study it, and practice at it – meticulously. The way you practice something is the way you will perform it when it counts most. If it is a procedure, set it up the same way, the right way, every time. That way when you run into trouble, you can focus on the troubleshooting, and not on the technique leading up to it, because you know you did it right because you do it the same way every time.


With every procedure you observe, look at it from a different perspective and focus on a different aspect of it. By paying attention to the smallest details and putting them all together in your head you learn by watching, and it will translate into your performance when you get the opportunity to take the reigns.


Take Home Points:

  • Before you watch or do a procedure, you should know it inside and out. The indications, the materials, the steps, the complications. Have the supplies ready and set up for the proceduralist and follow the steps as you watch.
  • Focus on a different aspect every time you watch, and focus your questions on that particular part of the debrief. It’s tough to go over every detail intimately in the middle of a shift, but piece by piece, with each go around, you can build your own approach.
  • Perfect practice makes perfect. Set things up the same way every time, in the order, you’ll need them to cognitively unload those things in your mind because they will become reflexive. Get a trainer, get a kit, rerun it over and over again and obsess with it.


Listen to the Audio


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Observing Procedures- Med Student Over Easy

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