Nearing the completion of core clerkships,我可以回顾过去的一年，从我开始上医学院以来，这里面充满了一些最具挑战性和深刻的经历。当我仔细考虑的时候，I noticed a common denominator among those memories that stood out most.During these moments,I had sensed more deeply than ever before that my learning needed to be betway必威about more than the provision of biomedical care.They were the experiences that had reminded me that people are parents,sons and daughters before they are patients in the hospital.他们教我的”例行公事对于每天早上遇到焦虑和希望的病人来说，实验室从来都不是常规的。
During these moments of discovery,我从不孤单——我总是和主治医师在一起。无论是在诊断新的心脏杂音时，还是在交流影像学结果时，都会改变患者的病程，我得到了授权，并指导我完成每一步。Following these encounters,我还获得了自我评估和获得建设性反馈的机会。In the process,the attending would reiterate the necessity of palpating pulses while auscultating heart sounds or 必威体育手机安卓app下载comment on how to best objectively verbalize malignant test results.I was given the protected autonomy to practice medicine,receive feedback and then try again.
回头看，我意识到我基本上是在教职人员的关键时刻接受指导的。I was coached to think betway必威about patient care as being about more than correct diagnoses and management.我接受了指导，和病人一起努力寻找超越他们新诊断的快乐和悲伤。为此，I am deeply indebted to the cohort of attendings who encouraged me through each step along the way.
As an avid fan of sports,我对指导的关键作用并不陌生。Competitive athletes are coached at every level and the generational players are often mentioned in parallel with the greatest coaches.Michael Jordan had established himself as one of the best basketball players early in his career,but it was not until Phil Jackson's arrival as coach that he won numerous championships.在他20年的职业生涯中，科比·布莱恩特赢得了几次冠军，但只有菲尔·杰克逊是他的教练。Tom Brady similarly has had Bill Belichick on the sideline for the entirety of his football career.Michael Phelps began his training in the pool with Bob Bowman from age eleven to his retirement.In sports,the best athletes are coached throughout their careers.
阿图尔加万德the renowned surgeon,作家和公共卫生研究员，spoke on the influence that coaching has had in his career:
I'd entered practice in 2003,and for the first several years,就是这么稳定，我的学习曲线在上升。我看着我的并发症率从一年下降到下一年。大约五年后，betway必威they leveled out. I realized I wasn't getting any better anymore. So I said …"好啊，我试试教练。”我请一位前教授到我的手术室来观察我。
The case — I remember that first case. It went beautifully. I didn't think there would be anything much he'd have to say when we were done. Instead,他整页都写满了笔记。"Did you notice that the light had swung out of the wound during the case?You spent betway必威about half an hour just operating off the light from reflected surfaces.你的肘部每隔一段时间就会上升一次。这意味着你没有完全控制住；如果你感觉你的肘部在空中移动，你应该换一种仪器，or just move your feet.""
After two months of coaching,我觉得自己又恢复了。一年后，I saw my complications drop down even further. It was painful. I also felt there were periods where I would get worse before I got better. But it made me realize that the coaches were onto something profoundly important.
教练本质上提供了另一个认知维度。Great coaches become external eyes and ears that provide an accurate assessment for one to improve and excel at their craft.正如Gawande的经验所揭示的那样，efforts to seek coaching are not only important in sports,也在医学上。Similar to the role that coaching has in athletics,我相信在整个医学院指导是至关重要的，住院医师及以上高级医师。
There are numerous aspects of medicine that can be coached: procedural or surgical techniques,subtleties of physical exams and breaking difficult news,to name a few.但我深信，在医学方面的指导可以涵盖患者日常护理之外的其他途径；作为行政领导，辅导也有助于提高，writers for peer-reviewed journals and public speakers at conferences.
In sports,运动员寻求教练逐步提高，并最终发挥其全部潜能。在医学上，受训者应寻求指导，以便在各种角色中持续发展自己的技能。Although trainees may not always like being observed or critiqued,ultimately,in the journey to uphold the highest values of the Oath we profess,我相信指导在医学上是非常重要的。
Aside from the obvious anatomical and physiological implications that dictate sports,我相信医学和体育之间有许多相似的原则。The aim of医学运动是两方面的：一方面显示出理解他人的旅程有能力帮助塑造自己，为什么我相信医学本身就是一项运动，unique way.