The Grand Rounds Conference: “An Event Sociological”

Remember this quote from the movie Close Encounters of the Third Kind?:

Laughlin [translating for Lacombe]: I believe that for every one of these anxious, anguished people who have come here this evening, there must be hundreds of others also touched by the implanted vision who never made it this far. It’s simply because they never watched the television. Or perhaps they watched it, but never made the psychic connection.

Walsh: It’s a coincidence. It’s not scientific.

Lacombe: Listen to me, Major Walsh. It is an event sociological.

Several years ago, someone told me frankly, “You’ll never be a scientist.” I’m not sure what was meant by the remark, but it’s hard not to imagine it was an instance of either/or thinking. I was reminded of that particular close encounter by a couple of recent blog posts about science and scientists:

This led to my online search for definitions of a scientist, which led me to this and that, both pieces making the case that most scientists are not dispassionate and even require a fire in the belly to keep searching for what our patients need. Like a lot of academic departments, we’re made up of what are loosely termed “research track” and “clinical track” faculty. That could make you think we’re divided into scientists and non-scientists, but the world is never that simple.

So how do clinical and research track faculty get along? Pretty well, actually. One of the traditions in academia is the weekly Grand Rounds educational conference. Our Grand Rounds was recently revamped. We used to have a separate Research Rounds and Grand Rounds, which lends the impression that we divided them based on whether we were in the research or clinical tracks.

In general, we did.

Now the rules have changed and the presentations have been restructured into one. This Grand Rounds includes presentations by representatives from both tracks. Sometimes they don’t work because they’re not in the same fields, but the opportunity is there to bring together clinicians who mainly conduct research and those who mainly do clinical patient care.

The Grand Rounds presentation has been around since the late 19th century and I had a look at a recently published paper entitled “Can We Make Grand Rounds ‘Grand’ Again?”

I suspect those involved with restructuring our Grand Rounds might have read this paper because it appears to be modeled on the authors’ description, although the idea of combining faculty with diverse career tracks seems original to our department. The objectives are generally similar to that outlined in the Sandal et al paper, although I’m still puzzling over how income can be generated from it–and I wonder if that should even be a goal.

  • Provide updates in diagnosis and treatment
  • Provide updates in medical research
  • Promote collegiality among faculty
  • Provide continuing medical education credit
  • Educate residents and faculty
  • Provide income and generate referrals
  • Make departmental announcements
  • Mentor residents
  • Highlight expertise in the faculty
  • Showcase the department to residency applicants

The patient interview is still an integral part of the Grand Rounds, even in our Psychiatry Department. Occasionally a live interview is not possible or even desirable; videotaped interviews can be substituted. According to the literature, the majority of patients are glad to make a contribution by participating in the presentation. The clinical track faculty member generally presents the case (although the resident may also fill that role). The clinical track faculty also presents relevant background on the clinical aspects pertinent to the case. Many patients elect to stay for the “scientific” presentation by the research faculty member.

So is this a scientific conference? If you mean that it’s a meeting to disseminate clinically relevant, patient-centered care knowledge supported by important updates in the research literature that could lead to changes in the way we care for patients–then that’s exactly what it is.

Because our patients want us to stick by them and because it’s vitally important for researchers and clinician-teachers to stick together, the Grand Rounds and any other lifelong learning activity we engage in might also be called “…an event sociological.”

Reference:

Sandal, S., et al. (2013). “Can we make grand rounds “grand” again?” J Grad Med Educ 5(4): 560-563.

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Comments

  1. Good point. I never really stopped to consider that the definition of “scientist” isn’t clear. As a physician, I think of myself as using science for my work, and I think practicing medicine is scientifically based, but doing so doesn’t make me a scientist. A Biochemist friend says, “Science is common sense as practiced by a nudnik.” For me, actual science doesn’t need to involve test tubes and petri dishes. But it does need to involve formal, well-considered experimentation.

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  2. Here’s a quote another colleague brought to my attention recently,

    “The ideal scientist thinks like a poet and works like a bookkeeper. It’s…the poetic aspects of science that seldom get talked about. But I’ve always felt that scientists fantasize and dream and bring up metaphor and fantastic images as much as any poet, as anyone in the creative sciences–art, the creative arts. And the difference is that at some point, the scientist has to relate the dreams to the real world, and that’s when you enter the bookkeeper’s period…It’s the bookkeeper period which leads sometimes to months or years of hard work.”–E.O. Wilson

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  3. Jim,

    In my experience anyone telling you what you will never be is invariably wrong. I had the good fortune to discuss that issue with some people right after it happened and they always made me look good.

    On the meeting of the minds about who is or who is not a scientist – I think it comes down to how you approach things. I saw a video of Eric Kandel and Aaron Beck and Kandel was explaining why they were scientists and the average physician was not. As you know I am a long time student of Kandel’s work. I might say that he is so far in a league of his own that he may be justified in saying that we are certainly not scientists even close to his order.

    I think that when it comes to colleagues, teaching and patient care you have to approach things scientifically and you have to teach what is known about science and the scientific method. That doesn’t put me on the level with a Nobel Laureate but I consider myself to be a scientist using scientific reasoning every time I consider the treatment of patients with both basic and complex problems.

    I commented on it in the last fews paragraphs of this post:

    http://real-psychiatry.blogspot.com/2013/05/brooks-on-psychiatrists-as-heroes-of.html

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