The Tenants of Clinical Pimping

The following tenants are used:

  1. To guide Pimped question curators in the development of effective questions;
  2. To raise awareness among medical students and faculty regarding effective practices; and
  3. As a means to promote, incentivize, and recognize Advanced Clinical Educators (Pimped ACEs).

The Tenants of Effective Pimping

The Resident/Fellow/Attending:

  1. Has as their primary goal the improvement of student understanding and, as a secondary goal, the modeling of expert physician diagnostic practice.
  2. Asks questions that address clinically important information and scenarios.
  3. Models evidence-based medicine as opposed to relying on personal experience, drawing upon research and professional clinical guidelines and guiding students to appropriate resources for more information on the topic (published guidelines, Up-to-Date, Harrison’s, etc.).
  4. Helps students bridge the gap between textbooks and clinical diagnosis – between collections of facts and their integration within complex systems.
  5. Ascertains student baseline knowledge, and then leads the learner to solve the problem him- or herself by applying baseline knowledge to a clinical scenario.
  6. Carefully calibrates student stress/anxiety in order to maintain a level that promotes effort and learning.
  7. Encourages continuous learning by welcoming questions, observations or findings from recent research or guidelines as well as the admission by students of the need for additional learning or review to solve a problem or care for a patient.
  8. Models lifelong learning by welcoming new research findings brought forward by colleagues and talking through how they will impact diagnosis or treatment decisions.
  9. Avoids humiliation of the learner; praises strong performance and uses wrong answers as an opportunity to teach or to encourage independent review of the topic.
  10. Asks the students, from time to time, for feedback on the effectiveness of their pimping practice.

The Characteristics of Ineffective Pimping

The Resident/Fellow/Attending:

  1. Has as their primary purpose the reinforcement of hierarchy through the embarrassment or humiliation of the learner in a group environment.
  2. Focuses on “stumping the student” with trivia, historical facts, clinically irrelevant or minimally relevant information, or questions so far beyond the current knowledge level of the student that they cannot promote connections or deeper understandings.
  3. Asks questions designed to expose ignorance — rather than to stimulate new understandings.
  4. Asks a series of unrelated questions or solely those focused on basic facts and body systems, rather than sets of questions that reflect effective diagnostic practice.
  5. Models the mindset of an expert who has already learned all one needs to know.