Medical Education: The Confident but Incompetent

Image Credit: Flickr

Author: Michelle Mitchell MS-IV
Geisinger Commonwealth School of Medicine
Scranton, PA
Social Media Committee

This post was peer reviewed.
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In 1995, a 44-year-old man named McArthur

Weeler devised the perfect plan to rob a bank. Wheeler knew (or supposedly knew) a lot about the chemical properties of lemon juice. As is taught in grade school science class, lemon juice can be used to create invisible ink. With this logic, Wheeler thought that by smearing lemon juice on his face, he would become invisible to the security cameras at the bank. He confidently walked into two banks in Pittsburgh, robbed them, and was promptly caught hours later when the security video aired on the news. When Wheeler was apprehended, he could not believe it. “But I wore the juice,” he puzzlingly mumbled.[1]

This story was the inspiration behind psychological experiments carried out by David Dunning and Justin Kruger of the Department of Psychology at Cornell University.[1] In essence, their question pondered, are the stupid too stupid to realize they are stupid? More eloquently, the article states:

“People tend to hold overly favorable views of their abilities in many social and intellectual domains. The authors suggest that this overestimation occurs, in part, because people who are unskilled in these domains suffer a dual burden: Not only do these people reach erroneous conclusions and make unfortunate choices, but their incompetence robs them of the metacognitive ability to realize it.”

AAEM/RSA Congressional Elective: Be the Exception and Make the Rules

Author: Ashely Alker, MD, MS in Public Health
University of California, San Diego Emergency Medicine PGY2

Originally Published: Common Sense January/February 2017

Returning to Washington, D.C. at the end of my intern year, I am fortunate to be in a city filled with the familiar faces of old classmates. Sitting around the rooftop dinner table with old friends who were medical school classmates just a year ago, I realize how much has changed. What hasn't changed is how quickly time flies when we are together.

At our table of residents are an orthopedic surgeon, an OB/GYN, a pediatrician, a urologist, an anesthesiologist, and myself — an emergency physician. After attending medical school at George Washington University we pursued different specialties, but with the same goal: to serve patients.

Discussing the challenges of our intern year, we seem to have similar concerns about residency. We talk about the threat of repealing work hour restrictions, medical school debt burden, the amount of paperwork vs. resident educational time, and the lack of maternity rights for medical residents. We talk about how these policies affect us and affect patient care.

Board Review: Traumatic Globe Rupture

Image Credit: Flickr

Author: Sophia Johnson, DO
Shane Sergent, DO
Conemaugh Memorial Medical Center
Originally Published: Modern Resident October/November 2014

A 32-year-old male presents to the ED after being struck in the right eye with a ball during a friendly tennis match. He complains of discomfort in the right eye, decreased visual acuity and nausea secondary to pain. Physical exam reveals periorbital ecchymosis, an irregularly shaped pupil and a shallow anterior chamber.

Patients may present with globe rupture after blunt or penetrating injury.[1] They may complain of pain in the eye or decreased visual acuity.[1] Maintain a high index of suspicion in patients who have any injury that may have penetrated the cornea.[1] This includes projectile objects launched while mowing the lawn, weed whacking or working with metal.[1] Blunt trauma to the eyeball or trauma with objects that impact the ocular rim and create a seal around the orbit can cause a rapid peak in intraocular pressure that ultimately leads to globe rupture.[1]

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