This post is part 3 of a 4-part series. The first two parts were “pimping in perspective” and “pimping for the pimpee“.
In “pimping in perspective“, we learnt that pimping is a bit like the Force, in that it has a dark side. What follows is a discussion of pimping etiquette, so that the pimper can be a Jedi-like positive pimper and avoid inadvertently (or otherwise) being a practitioner of the black art of pimping.
Which side are you on?
Positive pimping is all about learning, fun, and safety. These objectives can be achieved by following proper positive pimping etiquette. Once again Detsky [pubmed] lays the foundations for these rules:
- Respect educational order
This is crucial, although critics may perceive it negatively as an imperialist tool designed to preserve the power structure of the medicine machine. When asking questions, according to Detsky, the pimper must:
“…always start at the bottom of the educational chain and move serially up a level if no one at the first level has a correct answer (i.e. third-year students before fourth-year students, before interns, before residents). There is an important corollary for the junior residents and medical students: do not break ranks by showing up the senior resident on the team (or the junior resident or student’s next admission may be a very difficult patient).”
- Detsky, AS. The art of pimping. JAMA. 2009;301(13):1379-81 [pubmed]
- Avoid embarassment
Here Detsky emphasizes the importance of the pimper avoiding asking others of equal or ‘higher rank’ (e.g. consultants or professors) questions unless you are certain that they know the answer. However I would add that avoiding embarrassing pimpees of ‘lower rank’ is just as important. DB of DB’s Medical Rants does this by saying at the outset:
- from “On medical pimping“
- Involve practitioners of pimpee protectionism
The game of positive pimping needs participants. Thus the pimper must make defensive pimpees – especially the “eclipsers“, “camouflageurs“, “meditators“, and “muffin-eaters” – lower their guards and take part in the fun of learning. Detsky suggests a few strategies to achieve this:
“Use humor to acknowledge that this form of teaching can be intimidating and state that your expectations are low (i.e. the question is difficult and you do not expect any of the pimpees to answer correctly).”
- Detsky, AS. The art of pimping. JAMA. 2009;301(13):1379-81 [pubmed]
- public apology
If the pimper embarrasses or offends the pimpee (unintentionally of course!) then the pimper must apologize immediately and publicly (or at least tell a funny story about an even stupider act the pimper did earlier that morning…).
- Give praise
Pimpees will actually want to be pimped if they’re given appropriate public or private praise and feel like they’re learning. No brainer, eh.
- Avoid stupid questions
Another ‘no brainer’ perhaps, but a rule that is rarely adhered to. The pimper should ask the pimpee questions that will enable them to usefully grow their knowledge and understanding of medicine. Most of the classic categories of ‘pumpfrage‘ do not have this key characteristic (e.g. ‘arcane points of history’, ‘the exceeding broad question’, ‘teleology and metaphysics’, ‘eponyms’, and ‘technical points of basic research’…)
And finally, the prospective pimper would do well to remember the ’10 Ps’ of positive pimping excellence:
perfect preparation & practice prevents piss poor positive pimping performance (probably)
“The function of the teacher is to teach and to propagate the best that is known and taught in the world. To teach the current knowledge of the subject he professes – sifting, analyzing, assorting, laying down principles. To propagate, i.e. to multiply, facts on which to base principles – experimenting, searching, testing. The best that is known and taught in the world – nothing less can satisfy a teacher worthy of the name.
- William Osler (from ‘Teacher and Student’ in Aequanimitas)
This post is part 3 of a 4-part series. The final part will illustrate the lessons of the first 3 parts using my personal experience of pimping.
References
- Brancati, FL. The art of pimping. JAMA. 1989;262(1)89 [fulltext]
- Detsky, AS. The art of pimping. JAMA. 2009;301(13):1379-81 [pubmed]
- DrOttematic ‘Pimping (in Medicine): the delicate art of making someone feel small‘
- Life in the Fast Lane Pimping Posts
PDF 
About Chris Nickson
