July 19, 2021

John Snow comes to Duke Primary Care 

Bruce Peyser, MD, FACP

Provider, Duke Primary Care Pickett Road
Professor of Medicine, Duke University School of Medicine
Director of Education and Teaching, Duke Primary and Urgent Care
On Monday, August 19, medical school students came to clinic with something in addition to their reflex hammers, stethoscopes, and granola bars. They came with individualized QR codes we can use to record our observations of their work.
Now you might be wondering what this has to do with John Snow, the protagonist from Game of Thrones. Well, look at the image below and you will see what I mean.
Here’s more background that might be helpful. First, the learners who work in our primary and urgent care clinics repeatedly write about how much they value their experience and learn a ton about our respective areas of expertise. Also, we work closely with our learners, and we get to observe a lot! You might think to give these folks feedback along the way; but if you are like me, I oftentimes get distracted at the end of my work sessions (and occasionally I am hungry and tired and stressed), so I might not give my learner feedback.
The new system was devised as a simple, fast, and easy way to record a few observations about your learner. The mechanics are easy. (If a baby boomer like me with terrible IT skills can do this, so can you!)
Basically, if you have a phone, you can take a picture of the QR code. Then you are magically taken to a website that allows you to record what you have seen and observed. You can type in your observations. Or you can dictate them.
Your observations are saved, and the student can and should read them soon after the session so they will know what to work on in the future. At the end of a rotation, a designated person within the group can view all the observations and summarize them in one group evaluation.
There are different things you can comment on and observe depending on your field. There are various expectations and areas of focus that each specialty has agreed were super important. If anyone wants to learn more about this, I am happy to share more information and articles separately.
But what if you don’t have a smartphone? If that is the case, write down your observations and give that to your group lead. Perhaps that might just be the impetus you need to head to the Verizon Wireless store to get the amazing new Apple iPhone Xs Max with 512GB of memory. (Recall that this purchase — just the cost of the phone — can be reimbursed from your DPC continuing medical education fund.)
Like everything new, this may not work perfectly right away. But experiment with this a little… Try taking a picture of John Snow’s QR code and see what happens. Unfortunately, right now this method is set up only for medical students, but I expect by next summer our amazing NP and PA students will have QR codes, too.
Finally, take a look at this three-minute video, in which two of our clinician-educator colleagues demonstrate the new application.