“Toxic Quizzing” in Medicine
- Charlotte W
- 10 hours ago
- 2 min read
By Sarah Ghantiwala
“Pimping” or "toxic quizzing”, in the context of medical education, is when an attending, physician, or resident asks a student to answer a clinical question on the spot while doing rounds. However, if the student answers incorrectly, rather than giving them constructive feedback, the attending, physician, or resident will incur a sense of shame, embarrassment, or intimidation on the student. This method of education is extremely toxic and relies heavily on Yerkes-Dodson law which illustrates that a task's performance will increase with stress. However, rather than this being valuable towards learning, it actually proves to induce psychological distress which can impede upon learning.
I believe the idea of “pimping” relies on a method to expose what a student does not know rather than teaching them what they should know. This often stems from the experience an attending might have had in their own training, resulting in this cycle of “toxic quizzing”. Ultimately, this cycle results in unwanted stress for students, and rather than putting their mental strength toward learning, it shifts towards controlling their anxiety and embarrassment. It can also create a culture where silence is much safer than participation, and asking questions, a vital step in learning, can feel risky and unsafe. Additionally, there is often a hidden curriculum behind pimping. Rather than learning the content in the questions, students also absorb messages about power, authority, and competence. This similarly results in a fear-based approach to medicine, making students more focused on something not being wrong than understanding why it is right.
However, I don’t think the questioning of attendants should disappear entirely from medical education. Rather than blindly asking questions, attendants should ask thoughtful questions such as: “What makes you think that?” or “How would you approach this differently?”. This creates a space for uncertainty and wrong answers, recognizing that learning is a process rather than an interrogation. This reframe of asking questions in medical education requires a cultural shift. Rather than solely basing questions off of evaluation, medical professionals should facilitate an environment of learning, and move towards a mindset of helpfulness. For example, they should set expectations and normalize not knowing. They should use questions to build confidence rather than break it. This responsibility truly relies on the medical professional and how they want their students to act in the future.
In conclusion, while pimping is known to be a spontaneous test for medical knowledge, it also results in shame, anxiety, and embarrassment, ultimately harming the students. So if a teaching method is known to be harming students psychologically, it should be questioned. However, this problem can be applied to outside of solely medical education, making us think about whether the questions we ask are helping anyone learn.
Sources:
Comments